Disability Pension Reassessment

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Disability Pension Reassessment

Post by By the Bay on Fri 22 Sep 2017, 17:46

Hi ya'll,

I was just wondering if anyone know how the Disability Pension Reassessment calulations work under the old pension act?

I requested a reassessment of my Sept 2005 Pension. I currently receive 1/5 of 60%. If an increase to my reassessment is favorable, how does the percentages work? For example, would it stay within the 60% range such as 2/5 of 60% to 5/5 of 60%. Maxing my pension out at 60% or could that 60% baseline increase as well during my reassessment? I have not had a reassessment competed in 12 years since my first application so I have no clue how this works.
Any info would be appreciated.
Cheers,
By the Bay
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Re: Disability Pension Reassessment

Post by Guest on Fri 22 Sep 2017, 18:36

By the Bay wrote:Hi ya'll,

I was just wondering if anyone know how the Disability Pension Reassessment calulations work under the old pension act?

I requested a reassessment of my Sept 2005 Pension. I currently receive 1/5 of 60%. If an increase to my reassessment is favorable, how does the percentages work? For example, would it stay within the 60% range such as 2/5 of 60% to 5/5 of 60%. Maxing my pension out at 60% or could that 60% baseline increase as well during my reassessment? I have not had a reassessment competed in 12 years since my first application so I have no clue how this works.
Any info would be appreciated.
Cheers,
By the Bay

Hello By the Bay,

As far as I can remember, and looking at a reference, your calculation would be done in 5% intervals as an award. In other words they would look at the disability pension from the old act, and if approved for an increase from reassessment, the increase would be in the form of a disability award.

Others can jump in here and give their view on your question, but the way I'm reading the reference, it looks like you would get a disability award.

Disability Pension - Assessment/Reassessment http://www.veterans.gc.ca/eng/about-us/policy/document/1459#anchor48271

Disability Pension - Assessment/Reassessment

6. An increase in an assessment is an award provided for under the Pension Act and a request for a reassessment is an application for an award. The effective date of an increase in assessment resulting from a reassessment request is determined pursuant to section 39 of the Pension Act.

http://www.veterans.gc.ca/eng/about-us/policy/document/1459#anchor48271

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Re: Disability Pension Reassessment

Post by bigrex on Fri 22 Sep 2017, 21:33

Yes, the reassessment process will only determine if the overall disability percentage, not the entitlement. The actual 1/5 would have to had to be appealed through VRAB, at the time. Unfortunately the old table of disability, that was used to assess the initial 60%, has been replaced, and the new ToD isn't always as generous. So even if the actual disability may have worsened, the new ToD, might actually determine that it is a lower disability rating, because it doesn't provide for a range in the disability percentage, based on the symptoms. But if it does, they will not reduce your current PA pension, but they won't be increasing it either.

Example old ToD for someone with severely affected unstable knee, would get a pension in the range of 30-40%, where the actual pension amount was left up to the adjudicator. Under the new ToD, an unstable knee with severe loss of ROM, gets 26%, and between 3% to 7% for Quality of Life, for a max of 33%. Or, a lower back injury with intractable pain, in the old ToD, only says over 40%. So it could be 41%, or it could be 100%, with the actual amount being determined by VAC. Where as the new ToD, intractable lower back pain is set at 34%, plus a maximum of 9% for QOL.
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Re: Disability Pension Reassessment

Post by By the Bay on Fri 22 Sep 2017, 22:49

Thank you Trooper and Bigrex!

Good grief!
Why did my case manager push so hard for me to request a reassessment when it really does nothing for me! I wish I knew how it worked before submitting my request!

What a waste of time and energy! The worst thing is that my doctor work so very hard on completing the doctor's portion of my medical! By the end, my doctor's questionnaire look like a novel!
Now VAC has access to certain private information I didn't want them to have in the first place!
I should have listened to my gut..it was screaming, 'NOOOOO, Don't do it! Don't give VAC access to your medical files!'
Darn it! My gut is always right!
Cheers,
By the Bay
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Re: Disability Pension Reassessment

Post by pinger on Fri 22 Sep 2017, 23:07

BTB,
That used to confuse the heck out of me.
Entitlements are 5th's. Reassessments approach the percentages of the 5th's.
For example, 10% more of 1/5 ain't the same as 20% more of 5/5.

Also... " For example, would it stay within the 60% range such as 2/5 of 60% to 5/5 of 60%. "
No, re-assessmemts re-evalutes the % not the 5th's.
But deteriorations or consequentials can impact a review of the %'s favourably.
And fighting for a change of one's entitlement... 1 to 5/5 th's probably does need a big baseball bat for vrab.
It gets worse but I'm blubbering right now. Hope I helped.
btw btb, my doctor is freelancing my novel...
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Re: Disability Pension Reassessment

Post by pinger on Fri 22 Sep 2017, 23:11

It's called DSM-6
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Re: Disability Pension Reassessment

Post by By the Bay on Fri 22 Sep 2017, 23:42

Pinger,

It gets worse?😳
I should have kept my head in the sand!

Cheers,
By the Bay
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Re: Disability Pension Reassessment

Post by Guest on Sat 23 Sep 2017, 08:11

Here is some more info that may be of interest:

Dual Entitlement - Disability Awards/Disability Pensions

Purpose

The purpose of this policy is to provide direction with respect to whether an application should be adjudicated under either the Pension Act or Canadian Forces Members and Veterans Re-establishment and Compensation Act (CFMVRCA).

Adjudication

- In specific circumstances, applications submitted for disability awards after the coming into force of the CFMVRCA must be re-directed to the Pension Act.

- If after the coming into force of the CFMVRCA, a new claim is submitted for the same disability (i.e., the same medical condition or a different medical condition resulting in the same disability) which has been the subject of an application for pension under the Pension Act and the Minister (or the Canadian Pension Commission) has rendered a decision in respect of that application, the Department will invoke the provisions of section 56 of the CFMVRCA and the claim will be re-directed to the Pension Act for adjudication.

- Once under the authority of the Pension Act, the specifics of the new claim will be reviewed and the case will be adjudicated accordingly as follows:

If the evidence presented in the new claim supports a Departmental Review, the application will be dealt with as a Departmental Review and the effective date will be determined in accordance with Departmental Review provisions;

If the evidence presented in the new claim does not support a Departmental Review, the claim will be adjudicated as a "first decision" and the effective date will be established in accordance with subsection 39(1) of the Pension Act; or

If it is determined that the original application has been the subject of a decision of the Veterans Review and Appeal Board (VRAB), the Department will have no jurisdiction on the new application and as such, the claim will be referred to the VRAB for consideration.

Examples - Dual Entitlement Pension Act and CFMVRCA - Canadian Armed Forces (CAF) Service Only

The following examples are meant to demonstrate some circumstances that may present with respect to dual act entitlement claims.

a. A CAF member applied for disability pension for Lumbar Disc Disease under the Pension Act claimed to be related to his service in a Special Duty Area. The member received an unfavourable decision as the service relationship was not established. Subsequent to the coming into force of the CFMVRCA, the member applies for Lumbar Disc Disease claimed to Regular Force service. As this disability has been the subject of a decision under the Pension Act, subsection 56(1) of the CFMVRCA is invoked and the new claim for Lumbar Disc Disease is re-directed to the Pension Act for consideration. The evidence submitted with the new claim does not support a Departmental Review so the new claim will be adjudicated as a "first decision". If favourable, the effective date will be established in accordance with subsection 39(1) of the Pension Act.

b. A CAF member applied for disability pension for Internal Derangement Left Knee under the Pension Act claimed to be related to Regular Force service. The member received an unfavourable decision as the service relationship was not established. Subsequent to the coming into force of the CFMVRCA, the member applies for Osteoarthritis Left Knee claimed to Regular Force service. The effects of Internal Derangement Left Knee and Osteoarthritis Left Knee are inseparable (for assessment purposes), and as such are the same disability for the purposes of section 56. In accordance with subsection 56(1) of the CFMVRCA, the left knee disability has been the subject of a decision under the Pension Act and therefore not eligible for a decision under the CFMVRCA. The new claim for Osteoarthritis Left Knee is re-directed to the Pension Act for consideration. The evidence submitted with the new claim does not support a Departmental Review so the new claim will be adjudicated as a "first decision". If favourable, the effective date will be established in accordance with subsection 39(1) of the Pension Act.

http://www.veterans.gc.ca/eng/about-us/policy/document/887

Consequential Claims

Dual Entitlement - Clients Holding Entitlement Decisions Under Both the Pension Act and the CFMVRCA

- If a condition is ruled as consequential to a primary condition related to WWII, Korean War service, Royal Canadian Mounted Police service, or other service eligible under the Pension Act, the claim will be adjudicated under the Pension Act.

- If a condition is ruled as consequential to a primary condition related to Regular Force or Special Duty Service, the claim will be adjudicated under the CFMVRCA, even if the primary condition was ruled under the Pension Act, unless sections 42 or 56 of the CFMVRCA apply.

http://www.veterans.gc.ca/eng/about-us/policy/document/1533

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Re: Disability Pension Reassessment

Post by Nemo on Sat 23 Sep 2017, 12:41

A few years ago, I wanted a reassessment done. I am under the old pension act. They replied back and said that under the new act, I would actually get less of a monthly pension than I did under the old act. I threw their reply in the garbage. However, I should have pursued it because I am under the old act for my condition and it's worsening. So it does not matter in my case that the CFMVRCA is less generous than the pension act and they should not have referred to that as it was not applicable in my case. But their deceptive little ploy worked and I dropped it. However, I will shortly be pursuing it again.
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Re: Disability Pension Reassessment

Post by bigrex on Mon 25 Sep 2017, 10:33

Nemo, even if the new ToD states a lower assessment, they cannot reduce your current pension. But it's not hard to tell if the assessment is lower under the new ToD. You just need to look at the appropriate charts, and you should have a pretty clear picture of what can be expected. If you want, send me a PM with any details you want to share, and I can try to assist as much as I can.
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Re: Disability Pension Reassessment

Post by Nemo on Mon 25 Sep 2017, 14:39

Thanks bigrex. I was so pissed a couple years ago when I tried to increase my % due to condition worsening, I threw out the letter. But they told me that under the new ToD that I would have qualified for less than under the previous ToD which I qualify under. What I should have done at the time, was send them back another letter telling them to go by the old ToD and not tell me that under the new one, I would qualify for less.
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Re: Disability Pension Reassessment

Post by Newfie on Mon 25 Sep 2017, 15:11

I was granted a favourable reassessment in May 2017. I went from 40% to increase of 49% and QOL to 7 on my monthly pension


Last edited by Newfie on Mon 25 Sep 2017, 15:13; edited 1 time in total (Reason for editing : Missing info)

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Re: Disability Pension Reassessment

Post by bigrex on Tue 26 Sep 2017, 00:13

Nemo,they cannot say that your assessment would be lower under the new ToD before even having the medical questionnaire completed.Unless of course you are currently getting more than the current maximum amount for that disability, plus the highest level of QoL. But if that was the case, it would likely mean that you were already getting the maximum amount under the PA as well.
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Re: Disability Pension Reassessment

Post by Nemo on Tue 26 Sep 2017, 00:53

Bigrex. I had filled out the medical questionnaire. And even tho my condition which was covered under the Pension Act had worsened, they failed to increase my pension. They stated as I mentioned above that had I been under the new charter, they would have assessed me lower. I was only receiving a VAC pension and nothing else. Tho in the last 2 or 3 years after a surprise call from VAC, I now get some VIP.
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Re: Disability Pension Reassessment

Post by bigrex on Tue 26 Sep 2017, 12:46

OK, it sounded as if they sent the letter in response to you request for a reassessment. Personally, I think that when reassessing disabilities that had been initially assessed under the old ToD, I think that both Tables should be compared, old and new, and whichever one is more favorable to the Veteran, based on the current symptoms, should be applied.
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