SG v Minister of Employment and Social Development

SG v Minister of Employment and Social Development Collection Canada Pension Plan (CPP) disability Decision date 2022-05-30 Neutral citation 2022 SST 532 Reference number GP-21-2243 Member Pierre Vanderhout Division General Division Decision Appeal allowed Decision Content Citation: SG v Minister of Employment and Social Development, 2022 SST 532 Social Security Tribunal of Canada General Division – Income Security Section Decision Appellant/Claimant: S. G. Respondent: Minister of Employment and Social Development Decision under appeal: Minister of Employment and Social Development reconsideration decision dated July 5, 2021 (issued by Service Canada) Tribunal member: Pierre Vanderhout Type of hearing: Teleconference Hearing date: May 5, 2022 Hearing participants: Claimant Claimant’s witnesses (2) Decision date: May 30, 2022 File number: GP-21-2243 On this page Decision Overview Matters I Considered First What the Claimant Must Prove Reasons for My Decision Conclusion Decision [1] The appeal is allowed. [2] The Claimant, S. G., is eligible for a Canada Pension Plan (“CPP”) disability pension. Payments start as of December 2019. This decision explains why I am allowing the appeal. Overview [3] The Claimant is currently 51 years old. He was 41 years old at the end of 2011. He last worked in June 2009 as a produce clerk at a No Frills store. He stopped working because of back pain and uncontrolled diabetes. In the early stages, his symptoms included persistent and continuous lumbar pain with radiation to the right gluteal area.Footnote 1 [4] By mid-2011, the Claimant’s lower back pain was radiating down his right leg and he also reported back weakness. Walking made his pain worse.Footnote 2 He’d also been diagnosed with an adjustment disorder with mixed anxiety and depressed mood (severe). He felt sad, hopeless, helpless, and anxious. Additional health concerns at this time included severe sleep apnea and liver disease. He had impaired sleep; he was always tired and fatigued. His cognitive symptoms included being forgetful and having trouble with concentrating and making decisions.Footnote 3 [5] The Claimant applied for a CPP disability pension on three previous occasions. He filed his fourth application on November 23, 2020. The Minister of Employment and Social Development (“Minister”) refused his application. The Claimant appealed the Minister’s decision to the Tribunal. [6] The Claimant says he initially had a severe and prolonged disability because of his back pain. Depression then further disabled him. He says he now has multiple disabling conditions, including Stage 4 liver failure. He is awaiting a liver transplant. He has been in hospital on several occasions. His cognitive abilities have declined so much that he could not give meaningful evidence at the hearing. He had a very poor MoCA score of 12/30 in December 2021.Footnote 4 He now needs 24-hour supervision. [7] The Minister says that while the Claimant may be disabled now, he didn’t have a severe and prolonged disability by December 31, 2011. It is irrelevant that his condition later deteriorated. The Minister says several reports suggest capacity for retraining or lighter work. The Minister says the Claimant declined to take part in retraining or light work, and therefore cannot have a severe disability. The Minister also noted few objective medical findings to support a disability finding by the end of 2011. The Minister said the Claimant hasn’t appeared to require ongoing mental health treatment since then either. Matters I considered first [8] While the Claimant was affirmed as a witness at the hearing, he gave essentially no evidence. He is in very poor health. He now suffers from hepatic encephalopathy. This means his severe liver disease has decreased his brain function.Footnote 5 However, I did hear extensive evidence from his wife, M. G.. I also heard evidence about his medical condition from his occupational therapist, Laura Nelson. [9] I accepted the evidence given by the Claimant’s wife on his behalf. [10] Despite the Claimant’s serious current limitations, he confirmed that he heard and agreed with the evidence of his wife and Ms. Nelson. The Claimant married his wife in the early 1990s and she has been with him since then. She would have observed his condition over time. I found her evidence credible, particularly as she admitted her own limitations. She has had multiple sclerosis (“MS”) since 2005, and MS sometimes affected her ability to help the Claimant. What the Claimant must prove [11] For the Claimant to succeed, he must prove he had a disability that was severe and prolonged by December 31, 2011. This date is based on his CPP contributions.Footnote 6 [12] The Canada Pension Plan defines “severe” and “prolonged.” [13] A disability is severe if it makes a claimant incapable regularly of pursuing any substantially gainful occupation.Footnote 7 [14] This means I must look at all of the Claimant’s medical conditions together to see what effect they have on his ability to work. I must also look at his background (including his age, education, and past work and life experience). This is so I can get a realistic or “real world” picture of whether his disability is severe. If he can regularly do some type of work from which he could earn a living, he can’t get a disability pension. [15] A disability is prolonged if it is likely to be long continued and of indefinite duration, or is likely to result in death.Footnote 8 [16] This means the Claimant’s disability can’t have an expected recovery date. The disability must be expected to keep the Claimant out of the workforce for a long time. [17] The Claimant must prove he has a severe and prolonged disability. He must prove this on a balance of probabilities. This means he must show it is more likely than not that he was disabled. Reasons for my decision [18] I find that the Claimant had a severe and prolonged disability by December 31, 2011. I reached this decision by considering the following issues: Was the Claimant’s disability severe? Was the Claimant’s disability prolonged? Was the Claimant’s disability severe? [19] The Claimant’s disability was severe by the end of 2011. I reached this finding by considering several factors. I explain these factors below. The Claimant’s functional limitations affected his ability to work by the end of 2011 [20] By the end of 2011, the Claimant’s main diagnoses were lower back pain, diabetes, liver damage, sleep apnea, and an adjustment disorder. However, I can’t focus on his diagnoses.Footnote 9 Instead, I must focus on whether he had functional limitations that interfered with earning a living.Footnote 10 When I do this, I must look at all of his medical conditions (not just the main one) and think about how they affect his ability to work.Footnote 11 [21] I find that the Claimant has functional limitations. What the Claimant says about his functional limitations [22] The Claimant says his medical conditions have resulted in functional limitations that affect his ability to work. In 2012, he said he was always in pain. Based on the medical evidence, his functional limitations at that time would have been similar to those at the end of 2011. His limitations includedFootnote 12: could sit or stand for only 15 minutes could only walk one or two blocks unable to lift or bend needed to use the washroom often, due to diabetes difficulty with memory and concentration sleep difficulties (couldn’t stay in one sleeping position for long) could drive a car for only 15-30 minutes couldn’t take public transportation needed help putting on socks and shoes [23] These limitations flowed from the Claimant’s back pain, diabetes, and adjustment disorder. He said his medical conditions stopped him from working because he was always in pain and had trouble concentrating.Footnote 13 What the medical evidence says about the Claimant’s functional limitations [24] The Claimant must provide medical evidence showing that his functional limitations affected his ability to work by December 31, 2011.Footnote 14 [25] The medical evidence supports what the Claimant says. [26] In March 2011, Dr. Shaul (Psychology) said the Claimant had an adjustment disorder with mixed anxiety and depressed mood (severe). Dr. Shaul said his pain, physical limitations, and inability to work caused depression and anxiety symptoms. This made him feel sad, anxious, hopeless, helpless, and lacking in self-confidence. He was also forgetful, had trouble concentrating, and did not trust himself to make appropriate decisions. His sleep impairments left him tired and fatigued daily. [27] Besides chronic pain, Dr. Shaul also noted vertebral deterioration, sciatica, damaged discs, hemochromatosis (leading to diabetes and liver damage), and severe sleep apnea.Footnote 15 Dr. Rosenbluth (Psychiatry) agreed with Dr. Shaul’s diagnosis in a July 2011 report for the Claimant’s insurer.Footnote 16 [28] In June 2011, Dr. Marmor (Neurosurgeon) and Barbara Abel (Physiotherapist) said the Claimant suffered from chronic lower back pain. His back felt weak and got worse with walking.Footnote 17 A September 2011 ultrasound confirmed a fatty liver. Dr. El-Ashry made this diagnosis in April 2011. She linked it to his diabetes, at least in part.Footnote 18 [29] In November 2011, Dr. Faclier (Pain Clinic) said disc disease caused the Claimant’s back pain. In January 2012, Dr. Brutus felt his symptoms were suggestive of a herniated lumbar disc.Footnote 19 [30] The medical evidence supports that the Claimant’s pain, diabetes, and liver disease impacted his ability to walk, sit, stand, lift, and get sufficient sleep. His mental health limitations affected his memory and concentration. Together, these limitations prevented him from doing his usual job (produce clerk) by December 31, 2011. [31] Next, I will look at whether the Claimant followed medical advice. Did the Claimant follow medical advice? [32] To receive a disability pension, a claimant must follow medical advice.Footnote 20 If a claimant doesn’t follow medical advice, he must have a reasonable explanation. I must also consider what effect, if any, the medical advice might have had on his disability.Footnote 21 [33] The Claimant hasn’t followed all medical advice. However, through his wife’s evidence at the hearing, he gave a reasonable explanation for not following the advice. [34] The medical evidence in the Tribunal file is irregular. While there are many medical documents, there are also some long gaps without documents. This doesn’t mean the Claimant had zero medical care during those gaps, but he might have had suboptimal or minimal care. I also note that he depends on his wife, but she had MS even before he stopped working. She admitted she was unable to organize herself for extended periods. This explains the long gaps without documents. [35] In August 2012, the Claimant clearly didn’t follow medical advice. That month, Dr. Castiglione (Family Doctor) referred the Claimant to Dr. D’Alessandro (Psychiatrist) for his chronic depressed mood. In the referral, Dr. Castiglione also mentioned the Claimant’s chronic back pain, diabetes, underactive thyroid, and fatty liver.Footnote 22 I see no evidence that Dr. D’Alessandro declined the referral or that no appointment was made. [36] I asked the Claimant’s wife whether he attended any medical appointments between August 2012 and April 2014. She said he only attended the diabetes clinic during this time. While she also had difficulty with dates, she said they moved to X, Ontario (near X) around August 2012. They had previously lived in X. [37] When asked why the Claimant didn’t attend other appointments between August 2012 and April 2014, the Claimant’s wife said the drive to X was too much. However, she also said the Claimant reached the point where he had given up on himself. She said this continued until he ended up in hospital. Normally, “giving up” would not be a reasonable explanation. However, in this case, it is reasonable because the Claimant’s medical conditions explain his “giving up.” [38] To explain this, I prefer to rely on Dr. Shaul’s evidence. Dr. Shaul treated the Claimant for an extended period starting in April 2010. In March 2011, Dr. Shaul gave a diagnosis of adjustment disorder with mixed anxiety and depressed mood (severe). This manifested itself in various ways, such as feeling hopeless and helpless. The Claimant was also ruminating over financial concerns around that time. Those concerns appear to have motivated the move from X to X. His wife was unable to work due to her MS. Dr. Shaul said the Claimant was quite discouraged and overwhelmed by his situation, including his inability to take pain medication (due to his liver condition). He lacked the motivation to deal with issues. In particular, he struggled with feelings of anxiety, sadness, and confusion about what to do. His depression medication had not reduced his emotional apathy. He lacked psychological insight.Footnote 23 [39] Based on Dr. Shaul’s diagnosis and the Claimant’s symptoms, I conclude that his adjustment disorder caused his failure to pursue the referral to Dr. D’Alessandro. [40] The Claimant therefore gave a reasonable explanation why he didn’t follow medical advice. So, it doesn’t matter that he didn’t follow it. [41] I now must decide whether the Claimant can regularly do other types of work. To be severe, the Claimant’s functional limitations must prevent him from earning a living at any type of work, not just his usual job.Footnote 24 The Claimant couldn’t work in the real world [42] When I am deciding whether the Claimant could work by the end of 2011, I can’t just look at his medical conditions and how they affect what he can do. I must also consider factors such as his: age level of education language ability, and past work and life experience [43] These factors help me decide whether the Claimant can work in the real world—in other words, whether it is realistic to say that he can work.Footnote 25 [44] I find that the Claimant can’t work in the real world. [45] The Claimant was 41 years old by the end of 2011. I see conflicting evidence about his level of education. However, most evidence suggests that he completed high school in his native Italy.Footnote 26 He lived there until his late teens.Footnote 27 [46] The Claimant’s first language is Italian. While he spoke enough English to find work in Canada, he does seem to face limitations in English. In November 2009, he spoke to Ms. Roppoli (Vocational Rehabilitation Consultant) partly in Italian. She thought he might respond best to a mental health professional who spoke Italian.Footnote 28 He was very insecure about his English fluency and lacked the confidence in his English writing and reading ability to consider a manager role.Footnote 29 He said he “can get by with the basics.” Footnote 30 In 2009, Ms. Roppoli thought he “appeared to be very intelligent and enjoys learning.”Footnote 31 However, in 2011, Dr. Rosenbluth suggested he had a learning disability.Footnote 32 [47] The Claimant can use a computer for e-mail and internet searches, but didn’t feel comfortable using it for word processing as he lacked confidence in his English skills. [48] The Claimant worked for about 19 years as a produce clerk at various grocery stores. He has also stocked grocery store shelves. The produce clerk job can be physically demanding, as it requires constant walking, standing, and occasional heavy lifting. Before leaving Italy, he filled unskilled roles for construction companies. His work related to roofing, plumbing, and electricity. He never obtained any certificates.Footnote 33 [49] Without considering the Claimant’s medical conditions, I find that he would have been suited for relatively physical roles in a retail setting. This would include grocery stores, but potentially also other larger retailers such as home improvement or hardware stores. He would also be suited for unskilled physical roles in construction-related trades. Given his language concerns, he was unlikely to be a candidate for any significant retraining. However, given his age, he likely had at least some learning potential in “familiar” environments. For example, he would likely have been able to train for a different role in a grocery store. [50] However, when I consider the Claimant’s medical conditions, I see little that he would have been capable of doing in the real world. His limited ability to stand, bend, lift, or walk precluded any physical labour. His limitations with sitting, concentration, and memory precluded any sedentary work (and the training required for such a role). [51] I find that the Claimant’s disability was severe by December 31, 2011. [52] Before moving on to the rest of my analysis, I would like to address two “one-off” reports from 2011. The first is the June 2011 assessment by Dr. Marmor and Ms. Abel. They concluded there were “no absolute activity restrictions” for the Claimant. They also said, “it is certainly safe for him to engage in whatever physical activities he can tolerate both at home and in the workplace.” While this may appear to suggest work capacity, I do not interpret it this way. In my view, this just says that the Claimant could not do further harm to himself if he engaged in physical activity. They acknowledge that it would depend on what the Claimant could tolerate. They also accept that he has chronic back pain, and said “it is hoped that there is still room for improvement.”Footnote 34 [53] The second report was a psychiatric evaluation by Dr. Rosenbluth in July 2011. Dr. Rosenbluth did not give ongoing care to the Claimant. The Claimant’s insurer asked him to prepare the report. Once again, the report seems to suggest some work capacity. Dr. Rosenbluth found that “there are no current psychiatric restrictions or limitations, which would prevent him from seeking work that was not physically demanding.”Footnote 35 [54] I have two concerns with this conclusion. Firstly, it does not consider the Claimant’s real-world work capacity. His only work experience was in physically demanding jobs. Secondly, this opinion is at odds with the March 2011 opinion of the Claimant’s regular mental health care provider (Dr. Shaul’s office) and the August 2012 opinion of his family doctor. In August 2012, Dr. Castiglione said the Claimant still had major depression, and his various conditions left him “completely and permanently unfit for the work force.”Footnote 36 In the circumstances, I prefer the evidence of the Claimant’s regular care providers to a “one-off” report for insurance purposes. [55] I will now determine whether the Claimant has remained severely disabled. Has the Claimant’s disability been continuously severe since the end of 2011? [56] has developed many more medical conditions. [57] By August 2012, the Claimant had an underactive thyroid, hypertension, and right sciatica with advanced fibrosis.Footnote 37 By late 2020, he also had liver cirrhosis, pancytopenia (low blood cell count), enlarged veins in the esophagus, and an enlarged spleen. His diabetes was still not under control. He had profound fatigue and needed frequent naps. He still had chronic abdominal pain.Footnote 38 [58] By early 2022, the Claimant had decreased brain function, high cholesterol, anemia, cholecystitis (inflamed gall bladder), and post-concussion syndrome with short-term memory problems.Footnote 39 He had recently been in hospital with delirium.Footnote 40He also had a severe GI bleed. His functional limitations appear to be much greater too.Footnote 41 [59] However, I see three lengthy gaps in the medical documents. These gaps are between (1) August 20, 2012, and April 8, 2014, (2) November 20, 2014, and July 18, 2017, and (3) August 31, 2017, and November 6, 2020. I will look at each of these periods to decide whether the Claimant was still severely disabled despite the lack of medical documents. [60] My analysis of the Claimant’s failure to follow medical advice essentially covers the first period from August 2012 to April 2014. While he received little treatment during this time, it can be attributed to his adjustment disorder. I find that his disability stayed severe during this period. In August 2012, Dr. Castiglione said the Claimant was completely and permanently unfit for the work force.Footnote 42 In 2014, Dr. Meharchand (Family Doctor) said his prognosis was not good because “this is going on 5 years.”Footnote 43 [61] For the second period between November 2014 and July 2017, I find that the Claimant remained severely disabled throughout. I place significant weight on the August 2017 report from Dr. Tatiana Felipe Ramirez (Family Doctor). Dr. Ramirez said she started treating the Claimant’s condition in January 2016. This affirms that he was still receiving medical treatment. Two of the three main diagnoses (chronic back pain and uncontrolled diabetes) given by Dr. Ramirez went back to 2009.Footnote 44 [62] Dr. Ramirez also said the Claimant’s back pain had been debilitating since 2009. She added that his diabetes was poorly controlled despite using insulin. Dr. Ramirez said he could not lift weight, bend, twist, or sit, stand, or walk for prolonged periods. She also observed a decreased lumbar range of motion, an antalgic gait, weakness, and paresthesia in his legs.Footnote 45 [63] When I asked the Claimant’s spouse about this period, she said he attended the diabetes clinic, the liver specialist, a chiropractor, and a massage therapist. He also had a family doctor. She said “there must be records somewhere,” and didn’t realize there had been such a gap in documents. I accept her evidence on this point. [64] For the third period between August 2017 and November 2020, I again find that the Claimant remained severely disabled throughout. I find it likely that he continued to receive treatment during this period. In November 2020, Dr. Ramirez said she had treated him seven times in the past year.Footnote 46 Dr. Ramirez also identified some worrying new diagnoses and said the Claimant was in a “fragile state of health.” His functional limitations would have continued to preclude any type of work capacity, especially with his profound fatigue and anemia. Dr. Ramirez said he required frequent naps and was unable to perform chores at home.Footnote 47 [65] When I asked the Claimant’s wife about this period, her answer resembled the answer she gave for the previous period. She admitted that she was not good at keeping the Claimant’s records up to date until recently, when her MS symptoms were in remission. MS makes her forgetful. MS also makes it hard to concentrate. She said her condition was really bad up until about three years ago. She also affirmed that records would have existed. Again, I accept her evidence on this point. [66] I will now consider an issue that the above analysis may not fully address. Lack of ongoing mental health treatment [67] The Minister submits that the appeal should not succeed because the Claimant hasn’t had ongoing mental health treatment. I agree that his mental health treatment has been minimal for many years. The 2017 and 2020 CPP reports from Dr. Ramirez say nothing about the Claimant’s mental health.Footnote 48 Even the 2014 CPP report from Dr. Meharchand says his depression was controlled.Footnote 49 However, it is the cumulative effect of the Claimant’s conditions that I must consider. His adjustment disorder was more pronounced in the early days of his disability. While his mental health concerns may have abated over time, his many other conditions still left him severely disabled. [68] I will now determine whether the Claimant’s disability has been prolonged since at least December 31, 2011. Was the Claimant’s disability prolonged? [69] The Claimant’s disability was prolonged by December 31, 2011, and continues to be prolonged now. [70] At least two of the Claimant’s conditions (uncontrolled diabetes and chronic back pain) began by June 2009. By the end of 2011, he also had liver damage, sleep apnea, and an adjustment disorder. Other than the adjustment disorder, these conditions have continued since then. They will also more than likely continue indefinitely.Footnote 50 Since then, he has developed additional medical conditions causing even more limitations. His liver damage progressed to cirrhosis, and the associated liver damage is now causing decreased brain function. He also has a low blood cell count, post-concussion syndrome (with memory difficulty), enlarged spleen and veins, an inflamed gall bladder, high cholesterol, high blood pressure, and anemia. He recently suffered from delirium. [71] Many of the Claimant’s ongoing conditions have persisted for more than 10 years. His liver damage has progressed to the point where he is waiting for a liver transplant. His cognitive ability has worsened so much that he was unable to give meaningful evidence at the hearing. Even with the health care limitations imposed by the pandemic, he was admitted to hospital for 4 days in October 2021, 6 days in November 2021, 3 days in December 2021, and 11 days in January 2022.Footnote 51 [72] While Ms. Nelson has only been treating the Claimant since January 2022, her evidence helped me assess his current condition. She confirmed he had Stage 4 liver cirrhosis and was on the transplant list. She confirmed he has had a cognitive decline, and is no longer able to check his sugar levels. He requires monthly “banding” which takes about 5-7 hours each time (for laparoscopic surgery). He needs a walker, as his balance is poor and he has fallen at home. He suffered a severe internal bleed in 2021. [73] Ms. Nelson sees the Claimant weekly. She helps with cognitive management, safety, mobility, and independence. He sees personal support workers during the rest of the week. Ms. Nelson says he needs 24-hour supervision. This is for safety reasons, to ensure he takes his medication, and to help him respond properly to situations. [74] The recent medical documents also support a prolonged disability. In May 2021, Dr. Ramirez confirmed that the Claimant had a severe and ongoing medical condition that prevented him from working. He continued to have ongoing fatigue, chronic pain, and uncontrolled diabetes and cirrhosis.Footnote 52 In November 2021, Dr. Ramirez added that he had severe and prolonged liver cirrhosis with multiple complications, including brain damage.Footnote 53 In December 2021, a discharge report said he “still has a very tentative status and can decompensate in many different ways and return to hospital.”Footnote 54 When payments start [75] The Claimant had a severe and prolonged disability in April 2010. At that time, Dr. Shaul said the Claimant was incapable of fulfilling the duties of any employment from a psychological perspective. Dr. Shaul also said his depressive symptoms and pain from his injuries left him incapable of performing and concentrating in a work environment.Footnote 55 In May 2010, Dr. Girgla (Psychiatrist) came to the same conclusion when reporting to the Claimant’s insurer.Footnote 56 [76] In both December 2010 and March 2011, Dr. Shaul’s office said the Claimant’s injury and its consequences had a much greater effect on the Claimant than initially thought.Footnote 57 I place significant weight on the reports from Dr. Shaul’s office: they had an ongoing treatment relationship with the Claimant. I also accord some weight to Dr. Meharchand’s evidence. Dr. Meharchand was his family doctor and saw him regularly. In January 2011, Dr. Meharchand said his back pain had not significantly improved.Footnote 58 [77] Although the Claimant stopped working in June 2009, I am not prepared to find an onset date before April 2010. His actions in early 2010, when a vocational rehabilitation program ended, concern me. In February 2010, he said he would refuse a job working in the bakery section or stocking health and beauty products. He did not think such a job had “a future,” although he might then have had the physical capacity for it.Footnote 59 Such a refusal is inconsistent with having a severe disability. [78] Despite that February 2010 refusal, it does not appear to have been a pattern for the Claimant. In fact, in January 2011, Dr. Meharchand confirmed that the Claimant was compliant with medical advice at that time.Footnote 60 His February 2010 refusal even surprised the rehabilitation consultant. It was not consistent with his prior behaviour. The consultant appears to link the refusal to the Claimant’s new advocate at the time.Footnote 61 [79] I accept that the Claimant’s disability has been severe and prolonged since April 2010. However, the Canada Pension Plan says a claimant can’t be considered disabled more than 15 months before the Minister receives their disability pension application.Footnote 62 After that, there is a four-month waiting period before payments start.Footnote 63 [80] The Minister received the Claimant’s latest application in November 2020. That means he is considered to have become disabled in August 2019. [81] His pension payment starts as of December 2019. Conclusion [82] I find that the Claimant is eligible for a CPP disability pension because his disability is severe and prolonged. [83] This means the appeal is allowed. Footnotes Footnote 1 GD2-315 and GD2-316 Footnote 2 GD2-296 Footnote 3 GD2-264 to GD2-266. Footnote 4 “MoCA” stands for Montreal Cognitive Assessment Test. The test assesses cognitive impairment and early Alzheimer’s disease. A score of 26/30 or more is considered normal. Footnote 5 GD8-2 Footnote 6 Service Canada uses a claimant’s years of CPP contributions to calculate his coverage period, or “minimum qualifying period” (MQP). The end of the coverage period is called the MQP date. See s. 44(2) of the Canada Pension Plan. The Claimant’s CPP contributions are on pages GD9-5 to GD9-6. Footnote 7 Section 42(2)(a) of the Canada Pension Plan gives this definition of severe disability. Footnote 8 Section 42(2)(a) of the Canada Pension Plan gives this definition of prolonged disability. Footnote 9 See Ferreira v Canada (Attorney General), 2013 FCA 81. Footnote 10 See Klabouch v Canada (Attorney General), 2008 FCA 33. Footnote 11 See Bungay v Canada (Attorney General), 2011 FCA 47. Footnote 12 GD2-525 Footnote 13 GD2-524 Footnote 14 See Warren v Canada (Attorney General), 2008 FCA 377; and Canada (Attorney General) v Dean, 2020 FC 206. Footnote 15 GD2-264 to GD2-266. Footnote 16 GD2-229 Footnote 17 GD2-296 to GD2-297. Footnote 18 GD2-512 and GD2-516 Footnote 19 GD2-298 and GD2-505 Footnote 20 See Sharma v Canada (Attorney General), 2018 FCA 48. Footnote 21 See Lalonde v Canada (Minister of Human Resources Development), 2002 FCA 211. Footnote 22 GD2-495 Footnote 23 GD2-264 to GD2-266 Footnote 24 See Klabouch v Canada (Attorney General), 2008 FCA 33. Footnote 25 See Villani v Canada (Attorney General), 2001 FCA 248. Footnote 26 See GD2-55, GD2-197, GD2-228, and GD2-282. References to only doing Grade 8 are at GD2-469 and GD2-522. Footnote 27 GD2-44 Footnote 28 GD2-277 and GD2-281 Footnote 29 GD2-281. Note that a word appears to be missing on that page, based on the context of the sentence in question. See also GD2-87 and GD2-525. Footnote 30 GD2-282 Footnote 31 GD2-281 Footnote 32 GD2-228 Footnote 33 GD2-223 and GD2-281 to GD2-283. Footnote 34 GD2-295 to GD2-297 Footnote 35 GD2-231 Footnote 36 GD2-486 to GD2-489. Footnote 37 GD2-486 Footnote 38 GD2-18 and GD2-158 to GD2-161. Footnote 39 GD8-3 Footnote 40 GD8-6 Footnote 41 The Claimant’s physical abilities (see GD2-49) were particularly poor by November 2020. Footnote 42 GD2-489 Footnote 43 GD2-217 Footnote 44 GD2-184 Footnote 45 GD2-184 and GD2-185. Footnote 46 GD2-154 Footnote 47 GD2-158 to GD2-161. Footnote 48 GD2-154 to GD2-162 and GD2-184 to GD2-187. Footnote 49 GD2-214 Footnote 50 In the decision Canada (Attorney General) v Angell, 2020 FC 1093, the Federal Court said that a claimant has to show a severe and prolonged disability by the end of their minimum qualifying period and continuously after that. See also Brennan v Canada (Attorney General), 2011 FCA 318. Footnote 51 GD4-3, GD4-29, GD8-2, and GD8-6. Footnote 52 GD2-18 Footnote 53 GD4-2 Footnote 54 GD8-8 Footnote 55 GD2-261 Footnote 56 GD2-241 Footnote 57 GD2-248 and GD2-267 Footnote 58 GD2-243 Footnote 59 GD2-273 Footnote 60 GD2-243 Footnote 61 GD2-274 Footnote 62 Section 42(2)(b) of the Canada Pension Plan sets this out. Footnote 63 Section 69 of the Canada Pension Plan sets this out. This means payments can’t start more than 11 months before the application date.