CPP Disability Pension Appeal Dismissed Due to Insufficient Medical Evidence

Citation: MA  v  [NAME] , 2026  SST  329 Social Security Tribunal of Canada General Division – Income Security Section Decision Appellant: [redacted] Representative: A. R. Respondent: [redacted] Decision under appeal: [NAME] reconsideration decision dated January 22, 2025 (issued by Service Canada) Tribunal member: [NAME] of hearing: Teleconference Hearing date: April 28, 2026 Hearing participants: Appellant Witness Appellant’s representative Observer Decision date: May 4, 2026 File number: GP-25-638 On this page Decision Overview What the Appellant must prove Reasons for my decision Conclusion Decision [ 1 ] The appeal is dismissed. [ 2 ] The Appellant, M. A., isn’t eligible for a [NAME] ( [NAME] ) disability pension. This decision explains why I am dismissing the appeal. Overview [ 3 ] The Appellant is 39 years old. He has diabetes. He last worked as a fisherman until September 2019 and hasn’t tried a return to work since this time. [ 4 ] The Appellant applied for a [NAME] disability pension on September 8, 2023. The [NAME] (Minister) refused his application. The Appellant appealed the Minister’s decision to the Social Security Tribunal’s General Division. [ 5 ] The Appellant says that he is disabled from working any job since September 2019. He says that he had a loss of consciousness at work then. He didn’t feel safe returning to work. He rates all of his physical and some of his cognitive abilities as poor since that time. Footnote 1 [ 6 ] The Minister says that the evidence doesn’t support a finding of disability under the [NAME] . The Minister says that he likely had residual work capacity. The Minister says that there is an absence of medical evidence between October 2020 and December 2021. Footnote 2 What the Appellant must prove [ 7 ] For the Appellant to succeed, he must prove he has a disability that was severe and prolonged by December 31, 2020. This date is based on his [NAME] contributions. Footnote 3 He must also prove that he continues to be disabled. Footnote 4 [ 8 ] The [NAME] defines “severe” and “prolonged.” [ 9 ] A disability is severe if it makes an appellant incapable regularly of pursuing any substantially gainful occupation. Footnote 5 A disability is prolonged if it is likely to be long continued and of indefinite duration, or is likely to result in death. Footnote 6 [ 10 ] The Appellant has to prove he has a severe and prolonged disability a balance of probabilities. He has to show it is more likely than not that he is disabled. Reasons for my decision [ 11 ] I find that the Appellant hasn’t proven he had a severe and prolonged disability by December 31, 2020. I reached this decision by considering whether his disability was severe. Because I found that it wasn’t, I didn’t consider whether it was prolonged. Was the Appellant’s disability severe? [ 12 ] The Appellant’s disability wasn’t severe. I reached this finding by considering several factors. I explain these factors below. The Appellant’s functional limitations affected his ability to work [ 13 ] The Appellant has type 1 diabetes. [ 14 ] However, I can’t focus on the Appellant’s diagnosis. Footnote 7 Instead, I must focus on whether he has functional limitations that got in the way of him earning a living. Footnote 8 When I do this, I have to look at all of the Appellant’s medical conditions (not just the main one) and think about how they affected his ability to work. Footnote 9 [ 15 ] I find that the Appellant has functional limitations that affected his ability to work. What the Appellant says about his functional limitations [ 16 ] The Appellant says that his medical condition resulted in functional limitations that affect his ability to work. He says that by December 2020: He had a poor ability to walk one block on flat ground, go up one flight of stairs. He had a poor ability to sit for 20 minutes. He had a poor ability to drive a vehicle. He had difficulty keeping a schedule. His insulin fluctuated unpredictably. He felt nauseated, weak, and dizzy. He would vomit most days. This was ongoing, and he was constantly sick. Physical activity such as lifting, repetitive movement, and pulling caused dizziness, vomiting, loss of coordination, and slurred speech. He had maybe two good days per week where he could do light housekeeping duties. He couldn’t cook for himself. Some days he had no energy to move at all. Some days he couldn’t communicate clearly with others. Footnote 10 [ 17 ] The Appellant says that he saw doctors about his diabetes, but they weren’t taking him seriously. At the hearing he told me that he would beg to get testing done. He also says that he didn’t get along well with his family doctor, [NAME], who wouldn’t help him. [ 18 ] The Appellant’s partner testified. She reported that since 2019 the Appellant had memory loss and confusion. She did the household chores. She recalled that it would take him one day to unload the dishwasher due to fatigue. He would throw up if he tried to mow the lawn. She remembers him throwing up daily. When he had low blood sugars, she would help to dress him. What the medical evidence says about the Appellant’s functional limitations [ 19 ] The Appellant must provide some medical evidence to support that his functional limitations affected his ability to work no later than December 31, 2020. Footnote 11 [ 20 ] The medical evidence supports that the Appellant had type 1 diabetes since childhood. I accept that he occasionally had functional consequences of glycemic instability and a symptom of early peripheral neuropathy. Footnote 12 [ 21 ] There are problems with the medical evidence. First, the appeal file doesn’t have a record of a September 2019 loss of consciousness incident. The Appellant described this event as a turning point which led him to stop all work. I don’t have any medical assessment, investigations, or other evidence that helps to tie this to a date of disability onset. [ 22 ] The medical evidence from July 2020 noted that the Appellant had very rare low blood sugar levels. In October 2020, he had some low glucose symptoms intermittently, but didn’t check his blood glucose at those times. He had glucagon, but didn’t need to use it. He didn’t report any hypoglycemic episodes for at least 20 years. He had no known complications from diabetes. [NAME] (endocrinologist) thought he might have possible early diabetic peripheral neuropathy. He described feeling a numbness in his feet and legs that was intermittent. It got worse at night. Footnote 13 At the hearing, the Appellant reported frequent vomiting [ 23 ] The Appellant and witness highlighted the impact of frequent vomiting on his ability to function by 2020. But there wasn’t any medical evidence to show that he had this symptom by the relevant time. [ 24 ] The Appellant’s representative asked me to rely on the testimony of the witnesses to establish that the Appellant experienced near daily vomiting in lieu of the medical evidence. I wasn’t persuaded to do so. [ 25 ] The Appellant failed to provide objective medical evidence of this symptom by 2020. That means I won’t consider any limitations arising from this symptom. [ 26 ] The medical evidence doesn’t support that the Appellant had near daily vomiting by 2020. There weren’t entries in the medical records about this until 2023. This first entry noted diarrhea and vomiting. This was in the context of a recent hospital discharge after his stroke. Footnote 14 [ 27 ] I prefer the medical evidence over the Appellant’s and witness’ recollection of when his vomiting started and the impact that it had on his ability to work and function around the home. I don’t have reason to discount the medical evidence from [NAME] (endocrinologist), or [NAME] (later family doctor) or [NAME] (family doctor). I think that if he told one or more doctors that he had near daily vomiting that they would have at least charted it. If it was connected to his diabetes and was ongoing for years, then I think [NAME] would have listed this in the [NAME] medical report, but he didn’t. [ 28 ] The Appellant didn’t seek assessment or treatment for his diabetes from doctors during this time. This doesn’t suggest that he had or developed a severe disability by the end of 2020. The medical evidence after 2020 [ 29 ] The appeal file contains medical evidence after 2020. I considered what this evidence says about his health by 2020 and in the next section, his treatment adherence. [ 30 ] The Minister points out that there is an important timeline gap in the medical evidence. The medical evidence supports that the Appellant didn’t see a doctor from October 2020 until December 2021. His next appointment was in March 2022. This doesn’t support that he had a severe disability by the relevant time. Footnote 15 I agree with the Minister. I will address this topic further in the medical advice section. [ 31 ] The [NAME] medical report was completed in 2023 by [NAME]. He had been treating the Appellant for one year or less. By this point he had diabetic neuropathy, which impaired his balance and fine motor hand skills. Footnote 16 [ 32 ] The medical report doesn’t address the Appellant’s health at the relevant time. I accept that he did develop peripheral neuropathy as [NAME] thought. But by the relevant time, he didn’t have these limitations. [ 33 ] The Appellant developed another condition after 2020. He had a stroke in 2023. I cannot consider this condition or its associated limitations in this [NAME] disability analysis. The stroke amplified his pre-existing hand fine motor co-ordination issues. Footnote 17 But he didn’t report fine motor skill issues by 2020. [ 34 ] The medical evidence supports that the Appellant’s blood sugar fluctuations caused symptoms that occasionally affected his abilities. Early peripheral neuropathy impacted sensation in his feet. This could interfere with some types of work. Footnote 18 Appellants must pursue treatment and follow medical advice [ 35 ] To receive a disability pension, an appellant must follow medical advice. Footnote 19 [ 36 ] The Appellant had a history of not seeking medical care for diabetes and treating diabetes without medical advice. He didn’t have a reasonable explanation for not doing so. Not following medical advice might have had an impact on his disability. Footnote 20 Next, I explain how I came to this conclusion. The Appellant largely managed his own diabetes care [ 37 ] The Appellant didn’t have much medical supervision in treating his diabetes by the end of 2020. At the hearing, he said that he purchased insulin on his own because he somewhat knew how to manage his diabetes. He last had specialist care when he was 18 years old. Footnote 21 [ 38 ] From the medical records, the Appellant attended his family doctor’s clinic in October 2020. The next time he attended was in December 2021. He made an insulin refill request. His labs were overdue. Footnote 22 [ 39 ] The Appellant next attended a medical appointment in March 2022. He saw [NAME]. His last endocrinology appointment was in 2020, and he was lost to follow up. His labs were long overdue. Footnote 23 The Appellant claimed costs were a factor in his diabetes management [ 40 ] The Appellant testified that he didn’t have medical insurance and couldn’t afford diabetic care until 2022, when he first was on his partner’s extended health insurance. Footnote 24 I wasn’t persuaded by this argument. [ 41 ] First, the record doesn’t support the Appellant’s reasoning. At the October 2020 appointment, he told [NAME] that he could afford his insulin for now out of pocket. Costs could be an issue in the future. Footnote 25 [ 42 ] Second, there was no mention of cost being an issue in the medical records about insulin or medications for other conditions (Champix and Lipitor). Footnote 26 [ 43 ] Finally, the Appellant was eligible to receive personalized diabetes care and education through the [NAME] publicly funded health care system. He was able to receive medically necessary services without out-of-pocket charges. It doesn’t make sense for him to determine his insulin amounts without medical guidance for many years. The Appellant missed a diabetes specialist appointment in 2020 [ 44 ] [NAME] referred him to a diabetic clinic in August 2020. Footnote 27 He had a scheduled appointment with the Dartmouth General Diabetes Centre on August 14, 2020. He missed the appointment and was discharged from the Centre. Footnote 28 [ 45 ] In October 2020, [NAME] re-referred him to the [COMPANY] for them to help titrate his insulin to achieve his glycemic targets. Footnote 29 [ 46 ] In March 2022, the Appellant was referred to a nurse practitioner for diabetic care management. Footnote 30 [ 47 ] On its own, failure to attend one appointment isn’t highly persuasive of a lack of treatment adherence. But in this case, it does two things. It speaks to the Appellant’s approach and pattern of medical care. It also doesn’t support his argument that [NAME] wouldn’t help treat his diabetes and refused to request lab work or do investigations. The Appellant doesn’t have a reasonable explanation [ 48 ] The Appellant’s explanation for managing his medical condition on his own is unreasonable. I considered the medical records, context, his unique circumstances, and his explanations. [ 49 ] First, [NAME] expressed his concern about the Appellant’s approach to his diabetic care. In July 2020, [NAME] wrote that the Appellant was purchasing his own insulin without a prescription or medical advice. He rarely attended clinic or went for any testing or appropriate routine diabetic screening. [NAME] encouraged him to get routine labs done. Footnote 31 [ 50 ] [NAME] wrote to [NAME] in August 2020. He noted that the Appellant hasn’t been seen by a physician in three years. Footnote 32 [ 51 ] This suggests that [NAME] didn’t think it was reasonable or appropriate for the Appellant to manage his diabetes on his own. I gave weight to this. [NAME] was best positioned to determine the potential benefits and risks of treatment and the consequences of non-compliance or poor compliance. [ 52 ] The Appellant’s participation in his medical care didn’t change after 2020 or under the care of another family doctor. In March 2022, it was noted that he didn’t see his endocrinologist again after the October 2020 appointment. He was supposed to see [NAME] in early 2021, but he didn’t. Footnote 33 [ 53 ] Attending the October 2020 endocrinology appointment resulted in optimizing the Appellant’s treatment. [NAME] changed the Appellant’s insulin to one called [NAME]. Footnote 34 This suggests that he did need medical care for his condition because a modification was made. [ 54 ] The Appellant’s decision to mostly manage his diabetes alone is unreasonable. Diabetes type 1 is a lifelong medical condition. Untreated or incorrectly treated, it could cause various complications. He could likely appreciate this, as he saw a diabetes clinic in the past and had discussions with [NAME] about his condition. No doctor noted barriers for him to get medical care or noted obstacles to complying with treatment recommendations. [ 55 ] Next, I must also consider what effect, if any, that not following medical advice might have had on the appellant’s disability. Footnote 35 Following medical advice might have made a difference [ 56 ] I must now consider whether following this medical advice might have affected the Appellant’s disability. I find that following the medical advice might have made a difference to the Appellant’s disability. [ 57 ] [NAME] encouraged the Appellant to participate in the management of his diabetes. He wasn’t highly engaged with managing his diabetes. He was at risk of adverse outcomes in the future. Footnote 36 [ 58 ] I gave weight to [NAME]’s words and prognosis. He was a family doctor tasked with overseeing the Appellant’s medical care. [ 59 ] Following medical care for diabetes is directly related to the Appellant’s [NAME] disability claim, as it is based exclusively on limitations from this condition. He failed to mitigate his disability. This means that his disability wasn’t severe. [ 60 ] When I am deciding whether a disability was severe, I usually have to consider an appellant’s personal characteristics. This allows me to realistically assess an appellant’s ability to work. Footnote 37 [ 61 ] I don’t have to do that here because the Appellant didn’t follow medical advice and didn’t give a reasonable explanation for not following the advice. This means he hasn’t proven that his disability was severe by December 31, 2020. Footnote 38 Conclusion [ 62 ] I find that the Appellant isn’t eligible for a [NAME] disability pension because his disability wasn’t severe. Because I have found that his disability wasn’t severe, I didn’t have to consider whether it was prolonged. [ 63 ] This means the appeal is dismissed. Footnotes Footnote 1 See GD2-53 to 54. Return to footnote 1 referrer Footnote 2 See GD7. Return to footnote 2 referrer Footnote 3 Service Canada uses an appellant’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 on GD2-86. Return to footnote 3 referrer Footnote 4 In Canada (Attorney General)  v  [NAME] , 2020  FC  1093, the Federal Court said that the appellant has to show a severe and prolonged disability by the end of their minimum qualifying period and continuously after that. See also [NAME]  v  Canada (Attorney General) , 2011  FCA  318. Return to footnote 4 referrer Footnote 5 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 receive as a disability pension. Return to footnote 5 referrer Footnote 6 Section 42(2)(a) of the [NAME] gives this definition of prolonged disability. Return to footnote 6 referrer Footnote 7 [NAME]  v  Canada (Attorney General) , 2013  FCA  81. Return to footnote 7 referrer Footnote 8 [NAME]  v  Canada (Social Development) , 2008  FCA  33. Return to footnote 8 referrer Footnote 9 [NAME]  v  Canada (Attorney General) , 2011  FCA  47. Return to footnote 9 referrer Footnote 10 See GD2-60 to 65. Return to footnote 10 referrer Footnote 11 [NAME]  v  Canada (Attorney General) , 2008  FCA  377; and Canada (Attorney General)  v  [NAME] , 2020  FC  206. Return to footnote 11 referrer Footnote 12 See GD2-166 and 168. Return to footnote 12 referrer Footnote 13 See GD3-44 to 46 and GD3-145. Return to footnote 13 referrer Footnote 14 See GD3-185 and 189. Return to footnote 14 referrer Footnote 15 See GD7-5 to 6. Also see GD2-118 to 119 and GD3-44. Return to footnote 15 referrer Footnote 16 See GD2-161 to 169. Return to footnote 16 referrer Footnote 17 See GD2-165 and 166. Return to footnote 17 referrer Footnote 18 See GD2-168. Return to footnote 18 referrer Footnote 19 [NAME]  v  Canada (Attorney General) , 2018  FCA  48. Return to footnote 19 referrer Footnote 20 [NAME]  v  Canada (Minister of Human Resources Development ), 2002  FCA  211. Return to footnote 20 referrer Footnote 21 See GD3-144 to 146. Return to footnote 21 referrer Footnote 22 See GD3-44. Return to footnote 22 referrer Footnote 23 See GD3-43. I understand “being lost to follow up” as meaning that the Appellant was no longer participating in this specific medical care or couldn’t be contacted when additional appointments were recommended. Return to footnote 23 referrer Footnote 24 See GD3-43. Return to footnote 24 referrer Footnote 25 See GD3-145. Return to footnote 25 referrer Footnote 26 See GD3-44. Return to footnote 26 referrer Footnote 27 See GD3-45 to 46. Return to footnote 27 referrer Footnote 28 See GD3-144 to 146. Return to footnote 28 referrer Footnote 29 See GD3-144 to 146. Return to footnote 29 referrer Footnote 30 See GD3-43. Return to footnote 30 referrer Footnote 31 See GD3-45 to 46. Return to footnote 31 referrer Footnote 32 See GD3-134. Return to footnote 32 referrer Footnote 33 See GD3-43 and 146. Return to footnote 33 referrer Footnote 34 See GD3-144 to 146. Return to footnote 34 referrer Footnote 35 [NAME]  v  Canada (Minister of Human Resources Development ), 2002  FCA  211. Return to footnote 35 referrer Footnote 36 See GD3-46. Return to footnote 36 referrer Footnote 37 [NAME]  v  Canada (Attorney General) , 2001  FCA  248. Return to footnote 37 referrer Footnote 38 [NAME]  v  Canada (Attorney General) , 2018  FCA  48. Return to footnote 38 referrer