What is the Ontario Disability Support Program (ODSP)?
ODSP is a program of the Ontario government that helps to financially support persons that, due to a disability, cannot work or earn enough to support themselves. It provides both a basic income as well as health benefits, such as drug coverage, dental and certain other benefits that cover the needs of people with disabilities. Many people with disabilities that are legitimate have difficulty getting this benefit.
In order to get ODSP, you need to go to your local Ontario Works office, or in some cases, directly to ODSP, to be financially assessed. This means you need to find out first if you are “poor enough” to get ODSP benefits. This would include any earnings and assets of your spouse, if you have one, or any of your children (who live with you) if they are over eighteen years of age and not in school full-time. There are changes that have recently been made to the program that allow more assets to be retained by the “benefit unit” (which is usually the total of people living your household). There are also other exemptions, where even if the particular asset is worth more than what is allowed on ODSP, it won’t be counted as an asset when you go in to be assessed financially. These limits and exemptions are relatively complicated, so it is best to ask somebody with legal expertise in this area before you attend a financial assessment meeting.
After your financial assessment meeting, you will be given a Disability Determination Package, which must be filled out by your doctor, psychologist, nurse practitioner, audiologist (for deafness) or occupational therapist (for various physical limitations). Most people go to their family doctor or a specialist that deals with their primary health concern. There is also a Self-Report section for you to fill out to add your perspective as to how your health and disability issues affect your life. I strongly suggest people attempt to fill this section out, but only after the medical provider completed their section.
After this is done, you mail in your completed and signed Disability Determination Package to a department of government called the Disability Adjudication Unit (DAU). This department is headed in Toronto and staffed by people with health assessment knowledge. Many are OTs, nurses or other medical professionals. They review your application forms and decide if you meet the criteria of being a “person with a disability”. If you do meet this criteria, there is no need to contact us, as your local Ontario Works or ODSP office will contact you and start you on the program. You will be entitled to retroactive pay making up the difference between the monies you were receiving prior to your application and what you will be getting on ODSP. These monies go back to when your completed application was received by ODSP. For example if your application was received on May 20, 2016, then your retroactive pay will go back to June 1, 2016.
What if I am turned down for ODSP Benefits?
This happens quite frequently, even for people with serious or substantive disabilities. This is because all the staff at the DAU have available to them to make a decision is the medical submitted by your doctor. You would receive a letter explaining that your denial was because “you are not found to be a person with a disability”. This means you have up to thirty days to apply for what is called an “Internal Review”. This is also sent back to the DAU, which will pick another adjudicator that was not involved in the first decision to look at your application and then see if they support or overturn the original decision. The decision is overturned only a few times because at this stage, there is usually not a lot more medical information to submit. After the Internal Review is completed, you will receive a letter with a decision. If you are still turned down, then you must appeal the decision to what is known as the Social Benefits Tribunal.
The Social Benefits Tribunal is made up of people who are knowledgeable about the law regarding ODSP and disability issues, and are independent adjudicators. They do not work for or get paid by ODSP to work for SBT. If you appeal to this Board, you will get a hearing in about a year’s time, where you and preferably, a legal representative, can appear before it to argue why you should qualify for ODSP Benefits. The benefit of having a legal representative assist you at this stage is because they know about the time frames in which things need to be submitted, as well as what kinds of arguments to make that are more likely to get the Tribunal to decide in your favour. Many times, your legal representative will secure documents from your medical and health care providers, as well as provide a summary or further information about your disability (particularly if you have an unusual health condition).
How can we help you with your ODSP Claim or Appeal?
Invictus Legal LLP has a representative with more than twenty years arguing before these tribunals and has been largely successful in helping people obtain benefits. Give us a call today if you are appealing a decision by ODSP at (905) 688-5598.
We also assist people who are already on ODSP fight other issues they might face over the course of time they are on ODSP, such as overpayments, arbitrary reductions, suspensions or cancellations of benefits, as well as numerous human rights related issues tied to ODSP rules and regulations. We have been involved at the legislative and political level as well in making changes for not only ODSP, but for the whole system as to how people with disabilities are treated by society.