CPP Disability Pension Granted Due to Severe and Prolonged Disability

Citation: [NAME]  v  [NAME] , 2026  SST  41 Social Security Tribunal of Canada General Division – Income Security Section Decision Appellant: [redacted] Respondent: [redacted] Decision under appeal: [NAME] reconsideration decision dated May 29, 2025 (issued by Service Canada) Tribunal member: [NAME] of hearing: Teleconference Hearing date: December 29, 2025 Hearing participants: Appellant Decision date: January 5, 2026 File number: GP-25-1307 On this page Decision Overview What the Appellant must prove Reasons for my decision When payments start Conclusion Decision [ 1 ] The appeal is allowed. [ 2 ] The Appellant, T. L., is eligible for a [NAME] ( [NAME] ) disability pension. Payments start as of February 2025. This decision explains why I am allowing the appeal. Overview [ 3 ] The Appellant is 52 years old. She worked as an insurance agent from 2004 until 2024. She stopped working because of chronic pain and insomnia. The Appellant also has trauma issues, tennis elbow, vertigo, alopecia, and depression. [ 4 ] The Appellant applied for a [NAME] disability pension on September 11, 2024. The [NAME] (Minister) refused her application. The Appellant appealed the Minister’s decision to the Social Security Tribunal’s General Division. [ 5 ] The Appellant says all of her issues together are getting worse and making it hard to work. [ 6 ] The Minister says there is no evidence to support a severe disability which would prevent her from doing any suitable work. What the Appellant must prove [ 7 ] For the Appellant to succeed, she must prove she has a disability that was severe and prolonged by the hearing date. In other words, no later than December 29, 2025. Footnote 1 [ 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 2 [ 10 ] This means I have to look at all of the Appellant’s medical conditions together to see what effect they have on her ability to work. I also have to look at her background (including her age, level of education, and past work and life experience). This is so I can get a realistic or “real world” picture of whether her disability is severe. If the Appellant is capable regularly of doing some kind of work that she could earn a living from, then she isn’t entitled to a disability pension. [ 11 ] A disability is prolonged if it is likely to be long continued and of indefinite duration or is likely to result in death. Footnote 3 [ 12 ] This means the Appellant’s disability can’t have an expected recovery date. The disability must be expected to keep the Appellant out of the workforce for a long time. [ 13 ] The Appellant has to prove she has a severe and prolonged disability. She has to prove this on a balance of probabilities. This means she has to show it is more likely than not that she is disabled. Reasons for my decision [ 14 ] I find that the Appellant had a severe and prolonged disability as of October 2024. She continues to be disabled. 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? [ 15 ] The Appellant’s disability is severe. I reached this finding by considering several factors. I explain these factors below. The Appellant’s functional limitations affected her ability to work [ 16 ] The Appellant has: Chronic pain Insomnia Depression and anxiety Tennis elbow Alopecia (hair falling out) [ 17 ] However, I can’t focus on the Appellant’s diagnoses. Footnote 4 Instead, I must focus on whether she has functional limitations that got in the way of her earning a living. Footnote 5 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 her ability to work. Footnote 6 [ 18 ] I find that the Appellant has functional limitations that affected her ability to work. What the Appellant says about her functional limitations [ 19 ] The Appellant says that her medical conditions have resulted in functional limitations that affect her ability to work. The following is her testimony on her functional limitations and her conditions while working. Her functional limitations preventing her from working: Mental health. Worsening pain and mobility. She used to be able to stand and sit all day but now she can’t even stand to do the dishes. Pain in her elbow is so sharp her hands go limp. Daily vertigo preventing her from driving. Hair loss with lesions on her scalp caused by stress. Inability to leave the house because of depression and finances. Her conditions over the years [ 20 ] She had a bad car accident around 1999 which caused the pain in her neck and back. Over time it has worsened. Stress makes it worse. She now has pain in her arms and tennis elbow. She was never given strong pain medication but took a lot of Advil. She was always able to work with the pain until 2024 when it worsened. Recently, she received an epidural in her back which was painful and ineffective. [ 21 ] In 2017 her husband took her children. She has been fighting in the courts to get them back for eight years. This caused great stress, which then caused a number of physical conditions such as the alopecia and oozing lesions on her head. [ 22 ] She had psychotherapy in 2017, 2019, and 2020. She was to have specialized family counselling in 2021 but then her husband took the children again and it never happened. She was on the wait list for private counselling but didn’t have the money. It took from 2021 until December 2024 to get 10 sessions of free trauma counselling from the [COMPANY]. The 10 sessions ended in May 2025, and she hasn’t been able to afford counselling since. She will be eligible for another 10 sessions this new year. [ 23 ] In 2020 she switched companies to a job with a more relaxed pace. She continued working as an insurance agent. The new company approached her instead of her looking for a new job. Covid happened right after she was hired, but the company continued to work as they were considered essential. She was able to do the work and learned a lot more than she did at the other company. [ 24 ] She had a lot of family stress still. Her family doctor, [NAME], put her on Duloxetine for her stress and pain in 2021. She is still on 120 mg of duloxetine which makes her feel numb, so she doesn’t get upset. [ 25 ] In January 2022 the stress from the family situation with her husband and children was making her a “wreck”. [NAME] is her family doctor since 2007. He told her to take off work. He wanted her to get used to some medications and get some rest. She was working a lot at this job in order to distract herself from her family stress. She stated her body was breaking down from the stress and she was having a breakdown at work. She stated she has been trying not to think about the situation with her children because her stress gets worse. [ 26 ] She stayed off work until August 2023. [NAME] told her to try and return because he was worried about her mental health. Nothing got better with the family situation. She returned to work for four hours a day for a few months, until she got back to working 30 hours a week. [ 27 ] The stress made her physical health worsen. In 2023 to 2024 she had pain in her neck and back and the new pain in her arms and elbow. Her hair was falling out. She became more depressed and stayed in bed all day. She started to take later shifts because she wasn’t getting up for work in time. The medications made her drowsy. [ 28 ] She was let go from work in October 2024. She called Employment Insurance ( [NAME] ) who put her on [NAME] sick benefits. Since August 2025 she has been receiving social assistance. [ 29 ] The Appellant stated she would love to go back to work even part-time if she could. She has never not worked in her life. She sees no light at the end of the tunnel with her family situation, and therefore, her stress. What the medical evidence says about the Appellant’s functional limitations [ 30 ] The Appellant must provide some medical evidence to support that her functional limitations affected her ability to work no later than December 29, 2025. Footnote 7 [ 31 ] The medical evidence supports what the Appellant says. [ 32 ] [NAME] put in two medical reports. In the first one on July 14, 2024, he noted a diagnosis of myofascial pain syndrome and insomnia since December 1991, and depression and anxiety since December 2020. Her functional limitations were an inability to lift heavy items, fatigue, poor concentration and motivation and sleep impairment. He noted the limitations will remain the same. Footnote 8 [ 33 ] Then on July 30, 2025, [NAME] submitted a new medical report with the same diagnoses. However, in this one he clarified the depression was likely to stay the same, but the myofascial pain would likely deteriorate. He also noted the medical issues affected her activities of daily living and ability to be gainfully employed. He did not expect her to return to any type of work. Footnote 9 [ 34 ] The medical evidence supports that the Appellant’s physical and mental conditions prevent her from working any type of work. [ 35 ] I now have to decide whether the Appellant can regularly do other types of work. To be severe, the Appellant’s functional limitations must prevent her from earning a living at any type of work, not just her usual job. Footnote 10 The Appellant can’t work in the real world [ 36 ] When I am deciding whether the Appellant can work, I can’t just look at her medical conditions and how they affect what she can do. I must also consider factors such as her: age level of education language abilities past work and life experience [ 37 ] These factors help me decide whether the Appellant can work in the real world—in other words, whether it is realistic to say that she can work. Footnote 11 [ 38 ] I find that the Appellant can’t work in the real world. She hasn’t been able to work since October 2024. [ 39 ] The Appellant is age 52, which would be somewhat of a hindrance, but would not prevent her from finding work. She has her high school diploma. She also has taken numerous courses in accounting and insurance. She worked in both accounts receivable for a number of years in the 1990’s and then worked for 20 years to become an insurance agent. She would have some transferable skills. [ 40 ] There are no “real world” barriers to the Appellant finding suitable employment. However, I must take into account her disabilities, as well as her “real world” situations. The Appellant has been fighting for the custody of her children for seven years. This is the root cause of her stress and depression, along with some of her physical conditions such as the alopecia and scalp lesions. There is no indication this situation will resolve any time soon. As such, realistically her mental and physical health will continue to suffer, as suggested by [NAME]. This has affected her ability to work and will likely continue to affect her ability to work. [ 41 ] She also has long-standing myofascial pain syndrome. This has affected her ability to work October 2024. As [NAME] has determined the condition is likely to deteriorate, then her physical condition will also continue to affect her ability to work. [ 42 ] I find that the Appellant’s disability was severe as of October 2024. Was the Appellant’s disability prolonged? [ 43 ] The Appellant’s disability was prolonged. [ 44 ] The Appellant’s conditions began many years ago and have continued since then. Footnote 12 [ 45 ] [NAME] noted the depression and anxiety have been present since 2020. However, the Appellant indicated she had received psychotherapy since 2017. The Appellant went on stress leave for almost two years from January 2022 to August 2023. She continues to go to as much counselling as she is able to afford. She continues to require medications. [NAME] note that the depression is likely to stay the same. Footnote 13 [ 46 ] The Appellant has had myofascial pain syndrome and insomnia since 1991. She has worked for years with her conditions. By 2025, [NAME] stated that the prognosis for the pain was likely to deteriorate. Footnote 14 [ 47 ] The Appellant’s conditions will more than likely continue indefinitely. [ 48 ] I find that the Appellant’s disability was prolonged as of October 2024 when she stopped working. When payments start [ 49 ] The Appellant’s disability became severe and prolonged in October 2024. [ 50 ] There is a four-month waiting period before payments start. Footnote 15 This means that payments start as of February 2025. Conclusion [ 51 ] I find that the Appellant is eligible for a [NAME] disability pension because her disability was severe and prolonged. [ 52 ] This means the appeal is allowed. Footnotes Footnote 1 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 pages 135-136. In this case, the Appellant’s coverage period ends after the hearing date, so I have to decide whether she was disabled by the hearing date. Return to footnote 1 referrer Footnote 2 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 2 referrer Footnote 3 Section 42(2)(a) of the [NAME] gives this definition of prolonged disability. Return to footnote 3 referrer Footnote 4 [NAME]  v  Canada (Attorney General) , 2013  FCA  81. Return to footnote 4 referrer Footnote 5 [NAME]  v  Canada (Social Development) , 2008  FCA  33. Return to footnote 5 referrer Footnote 6 [NAME]  v  Canada (Attorney General) , 2011  FCA  47. Return to footnote 6 referrer Footnote 7 [NAME]  v  Canada (Attorney General) , 2008  FCA  377; and Canada (Attorney General)  v  [NAME] , 2020  FC  206. Return to footnote 7 referrer Footnote 8 See GD2-159. Return to footnote 8 referrer Footnote 9 See GD2 page 7-13. Return to footnote 9 referrer Footnote 10 [NAME]  v  Canada (Social Development) , 2008  FCA  33. Return to footnote 10 referrer Footnote 11 [NAME]  v  Canada (Attorney General) , 2001  FCA  248. Return to footnote 11 referrer Footnote 12 In the decision Canada (Attorney General)  v  [NAME] , 2020  FC  1093, the Federal Court said that an appellant has to show a severe and prolonged disability no later than the end of their minimum qualifying period and continuously after that. See also [NAME]  v  Canada (Attorney General) , 2011  FCA  318. Return to footnote 12 referrer Footnote 13 See GD2 pages 7-13. Return to footnote 13 referrer Footnote 14 See GD2 pages 7-13. Return to footnote 14 referrer Footnote 15 Section 69 of the [NAME] sets out this rule. Return to footnote 15 referrer