Claimant Wins CPP Disability Pension Appeal Due to Severe Knee Injury

OUTCOME: Allowed

Citation: BL  v  [RESPONDENT] and [NAME] , 2026  SST  257 Social Security Tribunal of Canada General Division – Income Security Section Decision Appellant: [redacted] Representative on record: [COUNSEL] at the hearing: [COUNSEL] Respondent: [redacted] [RESPONDENT] and [NAME] reconsideration decision dated February 3, 2025 (issued by Service Canada) Tribunal member: [NAME] of hearing: Teleconference Hearing date: June 8, 2026 Hearing participants: Appellant Appellant’s representative Decision date: June 11, 2026 File number: GP-25-711 On this page Decision Overview What the Appellant must prove Reasons for my decision Conclusion Decision [ 1 ] The appeal is allowed. [ 2 ] The Appellant, B. L., is eligible for a [NAME] ( [NAME] ) disability pension. Payments start as of July 2022. This decision explains why I am allowing the appeal. Overview [ 3 ] The Appellant is 52 years old. He last worked as a heavy equipment operator. He stopped working when he injured his left knee while playing soccer. He hasn’t worked since the injury. [ 4 ] On June 26, 2014, the Appellant applied for a [NAME] disability pension. Footnote 1 The [RESPONDENT] and [NAME] (Minister) refused his application. On June 15, 2023, the Appellant reapplied. Footnote 2 The Minister refused that application, too. This time, the Appellant appealed the Minister’s decision to the Social Security Tribunal’s General Division. [ 5 ] The Minister says the Appellant’s knee injury doesn’t keep him from doing some type of work. Footnote 3 The Appellant disagrees. He doesn’t think he can do any work at all. Footnote 4 [ 6 ] I agree with the Appellant. What the Appellant must prove [ 7 ] The [NAME] says a person is disabled if they have a severe and prolonged mental or physical disability. [ 8 ] The Appellant must prove he became disabled by December 31, 2014. In other words, he must prove he has a disability that was severe and prolonged no later than December 31, 2014, and continuously since then. This date is based on his contributions to the [NAME] . Footnote 5 [ 9 ] The [NAME] defines “severe” and “prolonged.” [ 10 ] A disability is severe if it makes a person incapable regularly of pursuing any substantially gainful occupation. Footnote 6 [ 11 ] This means I must look at all of the Appellant’s medical conditions together to see what effect they have on his ability to work. I must also look at his background (including his age, education, language abilities, and experience). This is so I can get a realistic or “real world” picture of whether his disability is severe. If he is capable regularly of doing some kind of work that he could earn a living from, then he isn’t entitled to a disability pension. [ 12 ] A disability is prolonged if it is likely to be long continued and of indefinite duration, or is likely to result in death. Footnote 7 [ 13 ] This means the Appellant’s disability can’t have an expected recovery date. The disability must be expected to keep him out of the workforce for a long time. [ 14 ] The Appellant must prove he has a severe and prolonged disability. He must prove this on a balance of probabilities. This means he must show it is more likely than not that he is disabled. Reasons for my decision [ 15 ] I find that the Appellant had a severe and prolonged disability as of June 2011 and continuously since then. I reached this decision by considering the following issues: Was the Appellant’s disability severe? Was the Appellant’s disability prolonged? Was the Appellant’s disability severe? [ 16 ] The Appellant’s disability was severe as of June 2011. I reached this finding by considering several factors. I explain these factors below. The Appellant injured his left knee in June 2011 [ 17 ] When I decide whether someone is disabled, I must focus on their functional limitations, not their diagnosis. Footnote 8 Functional limitations are things that you can’t do or have trouble doing because of a medical condition. [ 18 ] Before I consider the Appellant’s functional limitations, it is important to establish the date of his knee injury, since his injury and the four surgeries that followed it are the cause of his limitations. I find that he injured his knee on June 8, 2011. [ 19 ] At the hearing, the Appellant insisted that he injured his knee on June 8, 2012. But the documentary evidence shows that the injury actually happened in 2011. On his first application, he said he stopped working in June 2011. Footnote 9 He saw Dr. [NAME], an orthopedic surgeon, on June 20, 2011, regarding a knee injury that happened two weeks earlier. Footnote 10 On March 26, 2012, the Appellant’s family doctor at the time, Dr. [APPELLANT], wrote that the injury happened on June 8, 2011. Footnote 11 [ 20 ] I find that the Appellant had functional limitations as of June 2011, when he injured his left knee. What the Appellant says about his functional limitations [ 21 ] The Appellant says his knee injury has resulted in functional limitations that affect his ability to work. His first application from August 2014 gives me a good idea of his limitations in the first few years after the injury—that is, from June 8, 2011, to December 31, 2014, when his [NAME] coverage ended. Footnote 12 [ 22 ] In his application, the Appellant said he had constant knee pain. His knee would give out without warning, so he had to be careful when taking stairs. It was hard for him to put weight on his left leg. He could only stand for 15 minutes at a time. Lifting and walking, especially on uneven ground, were challenging. He could only sit for a few minutes at a time. After that, the pain increased. The pain impacted his sleep and sometimes his focus. [ 23 ] The Appellant has had four surgeries to try to fix his knee. The first three surgeries took place before December 31, 2014. Only the report from the fourth surgery is in the appeal file. But I can figure out approximately when the other surgeries took place by looking at other pieces of medical evidence: The first surgery was between December 22, 2011, and March 12, 2012. Footnote 13 The second surgery was between October 22, 2012, and April 24, 2013. Footnote 14 The third surgery was between April 24, 2013, and January 7, 2014. Footnote 15 The fourth surgery was on April 10, 2019. Footnote 16 [ 24 ] The Appellant doesn’t think that these surgeries helped much. What the medical evidence says about the Appellant’s functional limitations [ 25 ] The Appellant must provide some medical evidence to support that his functional limitations affected his ability to work by December 31, 2014. Footnote 17 [ 26 ] The medical evidence supports what the Appellant says about his functional limitations between June 8, 2011, and December 31, 2014. [ 27 ] The medical evidence shows that the Appellant was already having trouble bending his knee and taking stairs in the first couple weeks after the injury. Footnote 18 Dr. [APPELLANT] operated on the Appellant’s knee. But the Appellant was still unable to fully bear weight on his left leg. His knee was swollen and severely painful. His leg felt weak and unstable. He had a limp. As a result, he had difficulty lifting, carrying, pushing, pulling, standing, walking, kneeling, and taking stairs. Footnote 19 [ 28 ] There is no direct medical evidence from this period about the Appellant’s sleep. But I accept that severe pain could have impacted his sleep. [ 29 ] The medical evidence from this time period says little about the Appellant’s ability to focus or sit. However, there is no medical evidence that contradicts the Appellant’s claims on this point. [ 30 ] On October 22, 2012, Dr. [APPELLANT] completed an insurance form indicating that the Appellant didn’t have restrictions with focusing or sitting. Footnote 20 I think it is important that the form asked about the Appellant’s restrictions. In my opinion, there is a difference between a limitation and a restriction . I consider a limitation to be something that you can’t do or have trouble doing, whereas a restriction is something that you should not do for medical reasons. Dr. [NAME] didn’t place restrictions on tasks that required focusing or sitting. But that doesn’t mean the Appellant could do those tasks without difficulty. [ 31 ] I accept that the Appellant had limitations with focusing and sitting. [ 32 ] In summary, the medical evidence supports that the Appellant’s functional limitations kept him from working as a heavy equipment operator as of June 2011. He testified that he had to climb stairs to get in and out of the equipment that he drove. And he had to sit for long periods to drive the equipment. [ 33 ] Next, I will look at whether the Appellant followed medical advice. The Appellant followed medical advice [ 34 ] To receive a disability pension, an appellant must follow medical advice. Footnote 21 [ 35 ] The Appellant followed medical advice. The Minister doesn’t dispute this. He has had four surgeries on his knee. He did physiotherapy. He wore a knee brace for a while. [ 36 ] I now have to decide whether the Appellant could regularly do other types of work. To be severe, his functional limitations must have kept him from earning a living at any type of work, not just his usual job. Footnote 22 The Appellant could not work in the real world [ 37 ] When I am deciding whether the Appellant can work, I can’t just look at his medical conditions and how they affect what he can do. I must also consider factors such as his age, education, language abilities, and experience. These factors help me decide whether he can work in the real world—in other words, whether it is realistic to say he can work. Footnote 23 [ 38 ] I find that the Appellant could not work from June 2011 to December 2014. [ 39 ] The Appellant’s personal characteristics are positive. He was only 37 years old in June 2011. He had completed high school and one year of a college course in heavy duty mechanics. He had experience as a forestry professional, dump-truck driver, and heavy equipment operator. Footnote 24 He is fluent in English. [ 40 ] Unfortunately, the Appellant’s functional limitations outweigh these positive factors. He could not do a physical job because his knee was unstable and painful. He had trouble lifting, carrying, pushing, pulling, and kneeling. He could not stand or walk for very long. He was also unable to do a sedentary job. The longer he sat, the more his knee hurt. [ 41 ] A March 2012 insurance form completed by Dr. [NAME] supports my conclusion. Dr. [APPELLANT] believed that the Appellant was incapable of part-time or modified work, in any occupation. Footnote 25 Dr. [APPELLANT] predicted in October 2012 that the Appellant would be suited to modified duties by January 2013, after his second surgery, Footnote 26 but the medical evidence shows that his functional limitations didn’t improve with the second surgery. In his last report, dated April 24, 2013, Dr. [APPELLANT] said he was no longer sure when the Appellant might be able to return to work. Footnote 27 [ 42 ] I find that the Appellant’s disability was severe as of June 2011. Was the Appellant’s disability prolonged? [ 43 ] I find that the Appellant’s disability was prolonged as of June 2011. His disability is long continued and likely to be of indefinite duration. Footnote 28 The Appellant’s disability is long continued [ 44 ] The Appellant’s disability is long continued. He hasn’t been able to work for years. I have already addressed his work capacity in the first few years after his injury. Now, I will explain why I conclude that he had no work capacity from 2015 to the hearing date. I will do this by addressing the medical evidence that weighs against work capacity. Then I will address the medical evidence that supports work capacity, and explain why I don’t give it much weight. Medical evidence that weighs against work capacity [ 45 ] First, insurance forms and clinic notes from Dr. [APPELLANT] and Dr. [APPELLANT] (the Appellant’s current family doctor) weigh against work capacity. Footnote 29 They reflect minimal change in his functional limitations over the years. This aligns with his testimony and with what he wrote in his second application, from June 2023. Footnote 30 [ 46 ] In February 2015, Dr. [APPELLANT] mentioned that the Appellant would need to retrain since he could no longer be a heavy equipment operator. Footnote 31 I don’t take this as evidence of work capacity. Dr. [APPELLANT] didn’t say what jobs he thought the Appellant might be able to do. The Appellant testified that Dr. [APPELLANT] never told him he could work. I believe the point of Dr. [APPELLANT] comment was to emphasize that the Appellant could not do his usual job anymore. It wasn’t to suggest that he could do something else. [ 47 ] In June 2021, Dr. [APPELLANT] thought that the Appellant could maybe do a sedentary job. Footnote 32 However, by March 2022, Dr. [NAME] changed his opinion and ruled out work completely. Footnote 33 [ 48 ] Second, a May 2015 functional abilities evaluation (FAE) weighs against work capacity. Footnote 34 The evaluation took place over two days. The evaluators considered the Appellant’s subjective reports to be consistent with objective testing. The report documents numerous limitations. The Appellant walked with a limp and could only sit for 10 minutes before he had to change positions. Several comments in this report show that even sedentary work would not be practical for the Appellant, both in terms of his limitations and his relevant skills: He “did not demonstrate fluent typing competency and a computer based position would not be recommended for him at this time due to limited sitting and static standing tolerances.” “Static standing and sitting are not recommended …” “He would not be recommended to complete office type duties that require him to sit for longer than 10 minutes …” “… he would not be recommended to complete seated office work for longer than 7 minutes at a time …” [ 49 ] Third, a May 2021 musculoskeletal progress report (done after the fourth surgery) weighs against work capacity. Footnote 35 It reflects a sitting tolerance of 15 to 30 minutes, depending on whether the Appellant could sit with his left leg extended. While this report suggests some improvement from the fourth surgery, it is clear that he could still only sit for so long. Considering his limited computer and administrative skills, a sedentary job would not be realistic. Medical evidence that supports work capacity [ 50 ] Some of the medical evidence seems to support work capacity. However, I don’t give it much weight. Here is why. [ 51 ] First, a [NAME] concludes that the Appellant could do a full-time sedentary job if he could alternate sitting and standing. Footnote 36 He would also need typing training. Although this report differs from the May 2015 FAE in terms of their conclusions, both reports are similar in their portrayal of the Appellant’s abilities. The [NAME] says he would have to take a 30- to 60-second break every 10 minutes to change positions. In my opinion, this isn’t realistic. [NAME] would be unlikely to hire him with this limitation. [ 52 ] Second, an October 2019 functional capacity evaluation (done a few months after the fourth surgery) concludes that the Appellant’s abilities fell into the “medium strength” category. Footnote 37 It says he could do the following tasks on an occasional to frequent basis: lift, carry, push, pull, sit, stand, squat, crouch, and walk. Yet the report says he could only sit for 15 minutes at a time, and he only sat for 1 hour and 10 minutes in total during the entire day of testing. When he stood, he leaned heavily on his right leg. When he walked, he limped. He was only observed to walk for 50 feet. So, I doubt the accuracy of this report’s conclusions. [ 53 ] Third, a 2019 transferable skills analysis concluded that the Appellant was suited to a job as a supervisor in the [NAME]. Footnote 38 The Appellant testified that, as a supervisor, he would still have to go to job sites. This would involve some physical tasks, like walking on uneven ground. He doesn’t view such a job as practical. Neither do I. The Appellant testified that he asked his employer if they could give him accommodated duties, and they refused. The fact that the Appellant’s usual employer refused to offer him accommodated duties means it is unlikely that another employer would hire him on similar terms. [ 54 ] On balance, the evidence shows that the Appellant hasn’t had work capacity since his injury in June 2011. The Appellant’s disability is of indefinite duration [ 55 ] The Appellant’s disability is likely to be of indefinite duration. He has had four surgeries with minimal improvement in his knee pain, knee stability or overall function. There are no immediate prospects for further treatment. Dr. [NAME], an orthopedic surgeon, recommended hyaluronic acid injections, but the Appellant can’t afford them. Footnote 39 Dr. [APPELLANT] says the Appellant needs a total knee replacement. Without one, his prognosis is poor. But Dr. [NAME] also says he is too young to get a knee replacement. Footnote 40 Even if he were to get one, there is no evidence regarding the probable outcome of that procedure. This makes his disability indefinite. When payments start [ 56 ] The Appellant’s disability became severe and prolonged in June 2011. [ 57 ] But the [NAME] says a person can’t be deemed to have become disabled more than 15 months before the Minister receives their disability pension application. Footnote 41 After that, there is a four-month waiting period before payments start. Footnote 42 [ 58 ] The Minister received the Appellant’s second application in June 2023. That means he is deemed to have become disabled in March 2022. [ 59 ] Payments of his pension start as of July 2022. Conclusion [ 60 ] I find that the Appellant is eligible for a [NAME] disability pension because his disability was severe and prolonged. [ 61 ] This means the appeal is allowed. Footnotes Footnote 1 See GD2-412 to 419. Return to footnote 1 referrer Footnote 2 See GD2-25 to 37. Return to footnote 2 referrer Footnote 3 The Minister’s written submissions are at GD5. Return to footnote 3 referrer Footnote 4 The Appellant’s representative made written submissions (GD3) and oral submissions. Return to footnote 4 referrer Footnote 5 The Minister uses a person’s years of [NAME] contributions to calculate their coverage period, or “minimum qualifying period” ( MQP ). The end of the coverage period is called the MQP date. See section 44(2) of the [NAME] . The Appellant’s [NAME] contributions are at GD2-49 and 50. Return to footnote 5 referrer Footnote 6 Section 42(2)(a) of the [NAME] gives this definition of severe disability . Section 68.1 of the [NAME] says a job is “substantially gainful” if it pays a salary or wages equal to or greater than the maximum annual amount a person could get from a disability pension. Return to footnote 6 referrer Footnote 7 Section 42(2)(a) of the [NAME] gives this definition of prolonged disability. Return to footnote 7 referrer Footnote 8 [NAME]  v  Canada (Attorney General) , 2013  FCA  81. Return to footnote 8 referrer Footnote 9 See GD2-412 to 419. Return to footnote 9 referrer Footnote 10 See GD2-387. Return to footnote 10 referrer Footnote 11 See GD2-327 to 330. Return to footnote 11 referrer Footnote 12 The application is at GD2-412 to 419. Return to footnote 12 referrer Footnote 13 See GD2-334 and 360. Return to footnote 13 referrer Footnote 14 See GD2-318 to 324. Return to footnote 14 referrer Footnote 15 See GD2-318 to 320, 429, and 430. Return to footnote 15 referrer Footnote 16 See GD2-192 and 193. Return to footnote 16 referrer Footnote 17 [NAME]  v  Canada (Attorney General) , 2008  FCA  377; and Canada (Attorney General)  v  [NAME] , 2020  FC  206. Return to footnote 17 referrer Footnote 18 See GD2-387. Return to footnote 18 referrer Footnote 19 See GD2-318 to 324, 327 to 330, and 425 to 430. Return to footnote 19 referrer Footnote 20 See GD2-321 to 324. Return to footnote 20 referrer Footnote 21 [NAME]  v  Canada (Attorney General) , 2018  FCA  48. Return to footnote 21 referrer Footnote 22 [NAME]  v  Canada (Attorney General) , 2008  FCA  33. Return to footnote 22 referrer Footnote 23 [NAME]  v  Canada (Attorney General) , 2001  FCA  248. Return to footnote 23 referrer Footnote 24 See the hearing recording. Return to footnote 24 referrer Footnote 25 See GD2-327 to 330. Return to footnote 25 referrer Footnote 26 See GD2-321 to 324. Return to footnote 26 referrer Footnote 27 See GD2-318 to 320. Return to footnote 27 referrer Footnote 28 In the decision Canada (Attorney General)  v  [NAME] , 2020  FC  1093, the Federal Court said a person must show a severe and prolonged disability by the end of their MQP and continuously after that. See also [NAME]  v  Canada (Attorney General) , 2011  FCA  318. Return to footnote 28 referrer Footnote 29 See Dr. [NAME] insurance form dated February 2, 2015, at GD2-313 to 317. See Dr. [NAME] insurance forms and clinic notes at GD2-89, 90, 92, 93, 100, 101, 109 to 111, 118 to 124, 187 to 191, 224 to 229, and 248 to 250. Return to footnote 29 referrer Footnote 30 The Appellant’s second application is at GD2-25 to 37. Return to footnote 30 referrer Footnote 31 See GD2-313 to 317. Return to footnote 31 referrer Footnote 32 See GD2-118 to 124. Return to footnote 32 referrer Footnote 33 See GD2-92. Return to footnote 33 referrer Footnote 34 See GD2-287 to 306. Return to footnote 34 referrer Footnote 35 See GD2-132 to 136. Return to footnote 35 referrer Footnote 36 See GD2-230 to 242. Return to footnote 36 referrer Footnote 37 See GD2-163 to 184. Return to footnote 37 referrer Footnote 38 See GD2-137 to 162 and 201 to 223. Return to footnote 38 referrer Footnote 39 See GD2-111 and the hearing recording. Return to footnote 39 referrer Footnote 40 See GD2-89, 90, and 118 to 124. Return to footnote 40 referrer Footnote 41 Section 42(2)(b) of the [NAME] sets out this rule. Return to footnote 41 referrer Footnote 42 Section 69 of the [NAME] sets out this rule. This means payments can’t start more than 11 months before the application date. Return to footnote 42 referrer