The Straight-Up Truth About Applying for ODSP
If you are poor, sick, disabled and/or psychiatrized and are kept from working because of it and it will last for a year or more, you could apply for Ontario Disability (ODSP).
Important Things to Know:
Disabled – The way ODSP defines disability means that many disabled people aren’t considered disabled. ODSP rules specify that to qualify you must have or be expected to have your disability for at least one year. You have to be able to prove that you have a health problem that substantially limits your ability to work, look after yourself, or carry out normal daily activities at home or in the community. It is important to know that if you have a medical condition that changes ODSP should look at your worst day.
You have to qualify financially (have few assets and not have a significant income) and medically.
However, if you are getting disability benefits through CPP you do not have to show you medically qualify, only that you qualify financially. There are different rules for people over 65, people just discharged from a developmental or psychiatric service facility - if this is you, get legal advice.
Lawyers – You can get a lawyer at any time. We strongly advise you to get a lawyer to help you. They know the system and are much more likely to win the case for you. Some lawyers will start working on the case knowing that you will get a legal aid certificate. Other lawyers will make you get the certificate before they start working on the case. You have to wait until you have to appeal your case to the tribunal before you qualify for Legal Aid. To get Legal Aid in Toronto, take your financial and legal information to 375 University Ave. Suite 204. It is best to go early in the morning because it is the least busy.
If you are really sick or otherwise unable to apply for legal aid, your lawyer may be able to write a letter for you so you do not have to go into the office.
You can also go to a Community Legal Clinic to get help with your case rather than hire a lawyer. In Toronto, call 211 to find out where the closest clinic is.
Time limits – All of the time limits that the government makes you follow can be fought. This is especially the case when you can’t meet a time limit because of your health or disability. They have a duty to reasonably accommodate you and if you tell them that you cannot meet the time limit they should give you more time. If they don't give you more time, you can fight them on it. You may want to get a lawyer to help with this.
Adjournments – If your case is going to be heard at the Tribunal and you or your lawyer want to delay the hearing for a little while, you should know that it could take as much as 3 months to a year to get another hearing date.
Back Pay It can take months or even a year or two to finally get disability. Likely, you will have been on welfare that whole time – making less than enough to get by. When you finally get ODSP, the government has to give you the difference between your welfare and ODSP for each month since you sent in your whole application. This could be anywhere between $400 and $13,000 depending on how long you had to wait to get on ODSP. If they don’t give it to you or they only give you part of this money, talk to your lawyer, or if you don't have a lawyer, contact a Community Legal Clinic, lawyer or if you are in Toronto, you can call OCAP.
Medical Information If you get additional medical information send it in when you get it. The clock starts on your application when it is considered complete so the faster you send stuff in and the more you send in, the sooner it will be deemed complete (this will affect back pay and hearing dates).
OCAP OCAP cannot help you do your internal review or your appeal. These are things that you need legal help with. However, if they refuse to give you forms, deny you benefits or are being unjust in other ways, we can help you if you live in Toronto. If you live in another part of the province, there may be another anti-poverty organization that does casework. For the list of Ontario Common Front organizations, click here. Not all of these groups do casework but some do.
A Step By Step Process:
Step 1: Get on welfare and tell them you want to apply for ODSP
If you are not on welfare you should get on it because your ODSP application may take a year or two and you will need money to live on. If you have assets that would normally mean that you can't get welfare they should make an exception for you if you are applying for ODSP (they are supposed to use the ODSP asset cut-off).
For information about how to apply for welfare, click here.
Step 2: Get your ODSP application forms
Ask your welfare worker for these forms. They have to give them to you. If they don't, get legal help or, in Toronto, contact OCAP.
Step 3: Fill out the forms
Take your forms to your doctor and get them filled out. If you have a condition that changes day-to-day, tell your doctor to fill them out for your worst days. You can give your doctor this pamphlet to help them. You can also submit copies of tests, specialists' reports and any information that would help your case.
There is a personal statement that you can also fill out if you wish.
Send in your forms to the DAU (Disability Adduction Unit). They tell you you have only 90 days to hand these in and that you will have to reapply if you don't get them in or you can fight the deadline.
There is a small chance that you will get ODSP after they receive your application. The denial rate at this stage is very high so prepare to be denied.
The government denies many claims because they know a percentage of them won't appeal and it will be able to save money. Don't get discouraged, keep going.
Step 4: Internal review
Within 10 days of receiving your denial, you have to set the first stage of the appeal in motion with an internal review. You can write this letter by hand if you wish and it needs to clearly say you request an internal review because the DAU was wrong in finding that you are not disabled.
The chances of getting ODSP at this stage are pretty much zero. It is simply a formality designed to discourage people and delay giving poor people the money they need to survive.
Step 5: File an Appeal
After your internal review is denied, you will be sent an appeal form. Fill it out and send it in within 30 days (see the timeline section above if you can't meet this deadline).
Step 6: Update your medicals
If it takes a long time to get a hearing, go see specialists again to update your file. The decision at the hearing is based on the fact if you were disabled the day you applied, however; if you have updated medical reports it is useful.
All of your medical evidence has to go in 30 days in advance and other evidence has to go in 20 days in advance.
Step 7: Appeal hearing
Your hearing will be in front of an adjudicator. There is a very good chance that the people from the Disability Adjudication Unit (DAU) won't show up – that they will just send in something in writing. If that is the case, you just have to argue your side. If they show up both sides will make their arguments. You will have a chance to respond to whatever the DAU says.