Social Security Tribunal Rejects Claimant's Delay in Sickness Benefits Claim

OUTCOME: Dismissed

[TRANSLATION] Citation: CB  v  Canada Employment Insurance Commission , 2026  SST  37 Social Security Tribunal of Canada General Division – Employment Insurance Section Decision Appellant: [redacted] Respondent: [redacted] Decision under appeal: Canada Employment Insurance Commission reconsideration decision (725597) dated April 7, 2025 (issued by Service Canada) Tribunal member: [NAME_1] of hearing: Videoconference Hearing date: December 10, 2025 Hearing participant: Appellant Decision date: January 21, 2026 File number: GE-25-3057 On this page Decision Overview Matters I have to consider first Issue Analysis Conclusion Decision [ 1 ] The appeal is dismissed. The General Division disagrees with the Appellant. [ 2 ] The Appellant hasn’t shown that she had good cause for the delay in making her initial claim for benefits. Footnote 1 In other words, she hasn’t given an explanation that the law accepts. This means that her claim can’t be treated as though it was made earlier. Overview [ 3 ] The Appellant made a claim for [NAME_15] ) regular benefits on July 26, 2022. She was paid during the period from July 31, 2022, to November 19, 2022. Footnote 2 [ 4 ] On May 13, 2024, the Appellant asked the Commission to extend her benefit period so that she could receive additional benefits—specifically sickness benefits—as of November 20, 2022. The Commission denied this request. [ 5 ] I have to decide whether the Appellant has proven that she had good cause for not claiming sickness benefits earlier. [ 6 ] The Commission says that the Appellant didn’t have good cause because she made her claim 540 days late. She should have known that she could make a claim for sickness benefits after receiving regular benefits. In fact, this wasn’t her first time claiming [NAME_2]  benefits. She also didn’t show that her mental health condition caused her to be late. [ 7 ] The Appellant disagrees. She says that she was sick until May 2024, so she wasn’t able to make the claim earlier. She didn’t know that she could claim sickness benefits after her regular benefit period. Also, her medical condition prevented her from doing so. Matters I have to consider first The Appellant asked that the start of the hearing be delayed [ 8 ] The Appellant contacted the Tribunal the day before the hearing to say that she had an urgent medical appointment, and that she could not attend the hearing at the scheduled time. I agreed to delay the start of the hearing. The hearing took place on the scheduled day, but later in the day. The Appeal Division sent the file back to the General Division [ 9 ] This isn’t the first General Division decision dealing with the Appellant’s claim. [ 10 ] The Appeal Division sent the file back to the General Division for reconsideration. It directed the General Division to give the Appellant the opportunity to submit the medical report she mentioned and to apply the correct legal test in its analysis. I accept the documents sent in after the hearing [ 11 ] At the hearing, I told the Appellant that the Appeal Division had mentioned a medical report that she hadn’t had the opportunity to present to the General Division. I noticed that I hadn’t received a copy of this document. I asked her to submit it. I gave her one week to send the document to the Tribunal and any other document she would like me to consider. [ 12 ] Having received no documents from the Appellant, the Tribunal followed up on January 14, 2026. It appeared that the documents had been sent but never received. The Appellant agreed to send them again. [ 13 ] I accept the documents. They are relevant to supporting the Appellant’s comments about her medical condition during the relevant period. Issue [ 14 ] Can the Appellant’s application for benefits be treated as though it was made on November 20, 2022? [ 15 ] To decide this, I first have to look at whether the Appellant had good cause for the delay in claiming [NAME_2]  benefits. Analysis [ 16 ] To get your application for benefits antedated, you have to prove that you had good cause for the delay during the entire period of the delay. In other words, you have an explanation that the law accepts. Footnote 3 [ 17 ] To show good cause, the Appellant has to prove that she acted as a reasonable and prudent person would have acted in similar circumstances. Footnote 4 In other words, she has to show that she acted reasonably and carefully just as anyone would have if they were in a similar situation. [ 18 ] The Appellant has to show that she acted this way for the entire period of the delay. Footnote 5 That period is from the day she wants her application antedated to until the day she actually applied. So, for the Appellant, the period of the delay is from November 20, 2022, to May 13, 2024. [ 19 ] The Appellant also has to show that she took reasonably prompt steps to understand her entitlement to benefits and obligations under the law. Footnote 6 This means that she has to show that she tried to learn about her rights and responsibilities as soon as possible and as best she could. If she didn’t take these steps, then she has to show that there were exceptional circumstances that explain why she didn’t do so. Footnote 7 [ 20 ] The Appellant has to prove this on a balance of probabilities. This means that she has to show that it is more likely than not that she had good cause for the delay. [ 21 ] The Appellant says that she had good cause for the delay because, in November 2022, she didn’t know that she could extend her regular benefit period by claiming sickness benefits. It was only in 2024, after she had regained some strength, that she researched and realized that she could make a claim for this type of benefit. [ 22 ] The Commission says that the Appellant hasn’t shown good cause for the delay because she had already, in the past, made claims for regular benefits and later for sickness benefits. Her medical condition didn’t prevent her from making claims for benefits in the summer of 2022. Even though she had no income in 2023, she made no effort to get information from the Commission. [ 23 ] I find that the Appellant hasn’t proven that she had good cause for the delay in applying for benefits. [ 24 ] I acknowledge the mental illnesses and personal difficulties she experienced during the period from November 20, 2022, to May 13, 2024. But I am of the view that the Appellant was still able to try to understand her rights and obligations under the law—especially after she went back to work in March 2024. [ 25 ] The Appellant left her teaching job on February 7, 2022, because she was having difficulties in her workplace. She filed a complaint for psychological harassment. [ 26 ] The Appellant received services from an employee assistance program starting on May 12, 2022. After nine sessions with a [NAME_3], the sessions ended because she no longer had any ties to her employer. Footnote 8 [ 27 ] I accept that the Appellant experienced many distressing events during the period in question. She testified emotionally about the legal difficulties she had faced and how they had affected her mental health. I find credible her explanations about the difficulties she faced and how they affected her ability to function on a daily basis. [ 28 ] There are a few medical documents on file showing that the Appellant made efforts to get help. They also describe the difficulties she had because of her mental health condition. I noted the following documents: Footnote 9 a) There is a doctor’s note from the [NAME_12] [1851 medical clinic] dated February 9, 2022. This note said that the Appellant would be off work from February 9, 2022, to March 5, 2022, because of an adjustment disorder. Footnote 10 b) There is a letter dated September 2, 2022, from an employee assistance program counsellor. The letter said that the Appellant had been off work since February 7, 2022, and that she had been receiving counselling since May 12, 2022. The counselling ended because she no longer had ties to her employer. Footnote 11 c) There is an undated document from the employee assistance program counsellor, summarizing each of the sessions with the Appellant between February 16 and August 22, 2022. Footnote 12 The notes repeatedly said that she was worried about her finances. d) There are incomplete handwritten notes under a heading titled [translation] “Progress Notes” dated June 2, 2023. These appeared to record the Appellant’s comments during a medical consultation while she was preparing a complaint under section 47.2 of the Labour Code. Footnote 13 e) There is an assessment note from a [NAME_3] who the Appellant saw at the local community service centre on September 28, 2023. This note said that the Appellant talked about the difficulties she had faced over the past few years and the many legal efforts she was making. Her mood shifted between sadness and irritability. A follow‑up appointment was scheduled for October 10 at 11 a.m. Footnote 14 f) There is a doctor’s note from the [NAME_4]‑Rosemont [Maisonneuve‑Rosemont medical clinic] dated October 29, 2023. This note said that the Appellant had an adjustment disorder with moderate anxiety, difficulty concentrating, and insomnia. Footnote 15 g) There is a report from the Commission des normes, de l’équité, de la santé et de la sécurité du travail [Quebec’s labour standards commission] ( CNESST ) dated December 20, 2023. Footnote 16 This report said that the Appellant’s condition was stable, even though follow‑ups had been difficult to complete. She had to stop her psychotherapy sessions since the CNESST was no longer paying for them. The report also said that she didn’t have a family doctor. h) There is an undated document that a psychiatrist signed. The document confirmed that the Appellant participated in group psychotherapy sessions based on the ECHO method. These sessions took place at the [NAME_5] [Notre‑Dame hospital] between June 2023 and November 2024. Footnote 17 i) There is a final report for the CNESST dated January 7, 2025. The report said that the Appellant gradually went back to work from March 19, 2024. Footnote 18 j) There is a doctor’s note from the [NAME_12] dated February 24, 2025. This note confirmed that the Appellant was off work from February 8, 2022, to March 19, 2024. It also said that she gradually went back to work from March 19, 2024, and that she was now working on an on‑call basis. Footnote 19 [ 29 ] The Appellant says that she was off work during the period from February 8, 2022, until she started working at a private school on March 19, 2024. [ 30 ] Based on the medical documents and the Appellant’s testimony, I find that she had been looking for medical and social support for her mental illnesses since she stopped working in February 2022. [ 31 ] I also accept that, during that period, the Appellant also had to deal with many legal and administrative procedures—including the one against her former employer. [ 32 ] She says that she was feeling foggy and had difficulty concentrating throughout the entire period, until early 2024. [ 33 ] But I also have to consider the fact that, even though she was facing challenges, the Appellant was able to work for a day in July 2022 as a toll collector for a production company. She was also able to make a claim for regular benefits. [ 34 ] I note that, in July 2022, a [NAME_3] supported the Appellant, and her employer paid for it. On September 21, 2022, the [NAME_3] wrote that the Appellant was experiencing anxiety, panic attacks, difficulty sleeping, and depressive episodes. She also cried a lot. [ 35 ] It was in this context that the Appellant made a claim for benefits in July 2022. [ 36 ] I don’t see any document that talks about the Appellant’s situation in November 2022, when her benefits from the July 2022 claim were ending. [ 37 ] The [NAME_3]’s notes from September 22, 2022, said that the Appellant was worried about her finances. But I see that she didn’t contact Service Canada to ask about extending her benefits before May 2024. [ 38 ] So, I find that it is likely that in November 2022, the Appellant was in a similar situation to the one she was in when she made a claim for benefits in July 2022. Just like in July 2022, there was nothing preventing her from making a claim for benefits or contacting the Commission for more information. [ 39 ] The medical information that the Appellant provided also doesn’t lead me to believe that her mental health issues prevented her from contacting the Commission about [NAME_2] between November 2022 and when she asked to have her claim antedated in May 2024. [ 40 ] I recognize that the Appellant was having difficulty managing her daily life. But the evidence shows that she was able to get help while having medical, legal, and administrative problems during that period. [ 41 ] The Appellant says that, before regaining her strength toward the end of January 2024 and doing some research in May 2024, she didn’t know that she could extend her benefit period to receive sickness benefits. [ 42 ] I realize that before 2024, when one of her legal procedures was ending, the Appellant was experiencing mental health issues that made it difficult for her to manage her daily life. But I have to point out that she confirmed to me that she had received sickness benefits in the past. So, she was aware of this type of benefit. [ 43 ] I asked the Appellant about her financial resources when she was no longer receiving [NAME_2]  benefits and still wasn’t working. She said that she was using her credit cards, money from her pension fund, and compensation she received after a workplace accident. She also had help from her mother. But she never thought of contacting the Commission to find out whether she was entitled to any other [NAME_2]  benefits. For her, once the benefit payments ended, it was final. [ 44 ] She says it was only in May 2024 that she felt able to research her [NAME_2]  rights. When she found out that she might be able to have her benefits extended, she immediately contacted the Commission to ask questions and apply. [ 45 ] So, I recognize that when the Appellant realized she could get more benefits, she acted quickly to apply. [ 46 ] I acknowledge the difficulties that the Appellant experienced because of her mental health challenges. I understand that she had difficulty concentrating, and that she wasn’t able to go through some of the hardships. [ 47 ] But I have to note that, between November 20, 2022, and May 13, 2024, the Appellant didn’t try to understand her rights and obligations under [NAME_2] . [ 48 ] The Appellant didn’t know in November 2022 that she was entitled to sickness benefits. But I find that her medical condition in November 2022 was similar to how she was in February 2022 and in July 2022. At that time, she was able to contact the Commission to understand her rights and make claims for benefits. [ 49 ] I am of the view that a reasonable person in the Appellant’s situation would have contacted the Commission when their benefits ended to find out whether they could get sickness benefits. The Appellant had done that in the past. [ 50 ] In addition, the Appellant says that she was looking for work and medical consultations during the period from November 2022 to May 2024. While doing this, she was also dealing with the legal and administrative procedures that were burdening her. She had concentration and motivation problems, but she proved that she was resourceful in many ways. This shows that her medical conditions would not have prevented her from contacting the Commission or making a claim for benefits during this period. [ 51 ] The Appellant didn’t have the ability to look at the Commission’s website or contact an agent—by phone or in person—because she had difficulty concentrating. But it seems that her situation had improved in early 2024. She was able to look for a job, and she even went back to work as a substitute on March 19, 2024. [ 52 ] So, I am of the view that, as of March 19, 2024—at the latest—there was nothing preventing the Appellant from contacting the Commission to find out whether she was entitled to other benefits or recourse. But she waited about another month before researching and contacting the Commission to ask for her benefit period to be extended. Her benefit period had ended in November 2022. [ 53 ] Finally, I find that the Appellant didn’t show that there were exceptional circumstances for her delay. If there were exceptional circumstances, they didn’t exist throughout the entire period of the delay. [ 54 ] I recognize that the Appellant went through a very difficult time. But I am of the view that she didn’t intend to make a claim for sickness benefits during the period from November 2022 to May 2024. I understand this was likely because she didn’t know that she might be entitled to sickness benefits. Unfortunately, not knowing the law isn’t good cause for being late in applying for sickness benefits. Footnote 20 [ 55 ] The Appellant’s difficulties certainly contributed to her delay in asking for her benefit period to be extended so she could receive sickness benefits. Unfortunately, I am not satisfied that she took prompt steps to understand her entitlement to sickness benefits and obligations under the law—even though she had previous experiences with the [NAME_2]  program. She didn’t show that her medical situation prevented her from applying or trying to get information about her rights. [ 56 ] I find that the Appellant hasn’t proven that she had good cause for the delay in asking for her benefit period to be extended for the entire period from November 20, 2022, to May 13, 2024. Conclusion [ 57 ] The Appellant hasn’t proven that she had good cause for the delay in making her claim for benefits throughout the entire period of the delay. Her claim can’t be treated as though it was made earlier. [ 58 ] The appeal is dismissed. Footnotes Footnote 1 Section 10(4) of the Employment Insurance Act (Act) uses the term “initial claim” when talking about an application. Return to footnote 1 referrer Footnote 2 The Appellant had also received benefits for the period from May 15, 2022, to July 23, 2022, under a previous benefit period. Return to footnote 2 referrer Footnote 3 [NAME_6]  v  Canada (Attorney General) , 2006  FCA  309; and section 10(5) of the Act. Return to footnote 3 referrer Footnote 4 See Canada (Attorney General)  v  [NAME_7] , 2012  FCA  139. Return to footnote 4 referrer Footnote 5 See Canada (Attorney General)  v  [NAME_7] , 2012  FCA  139. Return to footnote 5 referrer Footnote 6 See Canada (Attorney General)  v  [NAME_8] , 2010  FCA  336; and Canada (Attorney General)  v  [NAME_9] , 2011  FCA  266. Return to footnote 6 referrer Footnote 7 See Canada (Attorney General)  v  [NAME_8] , 2010  FCA  336; and Canada (Attorney General)  v  [NAME_9] , 2011  FCA  266. Return to footnote 7 referrer Footnote 8 See GD3-20. Return to footnote 8 referrer Footnote 9 Two additional documents relating to consultations for a physical injury were among the documents, but I don’t find them relevant to the antedate issue. Return to footnote 9 referrer Footnote 10 See RGD5-8. Return to footnote 10 referrer Footnote 11 See GD3-20. Return to footnote 11 referrer Footnote 12 See RGD5-9 to RGD5-11. Return to footnote 12 referrer Footnote 13 See RGD5-4. Return to footnote 13 referrer Footnote 14 See RGD5-15. Return to footnote 14 referrer Footnote 15 See GD3-19. Return to footnote 15 referrer Footnote 16 See GD3-18. Return to footnote 16 referrer Footnote 17 See RGD5-5. Return to footnote 17 referrer Footnote 18 See RGD5-6. Return to footnote 18 referrer Footnote 19 See GD3-22. Return to footnote 19 referrer Footnote 20 See Canada (Attorney General)  v  [NAME_10] , 2010  FCA  101. Return to footnote 20 referrer