In June 1998, the law was changed with regards to Social Assistance. Prior to June 1998, there were two social assistance systems in Ontario. There was the Family Benefits Act and the General Welfare Act. Family Benefits assisted single parents, elderly people and the disabled. General Welfare assisted families and single non-disabled people. In June 1998, all this changed.
Family Benefits was replaced by the Ontario Disability Support Program Act (ODSPA) and General Welfare was replaced by the Ontario Works Act(OWA). Unlike the Family Benefits Act, elderly people and single parents do not qualify under the ODSPA but will be subject to the rules of OWA such as workfare, etc.
Only disabled people qualify under the ODSPA. The definition of disabled has been significantly changed and it will be harder to qualify for this program. There are some exceptions in the legislation which allow for some people to automatically meet the definition of disability. These exceptions are if the person is in receipt of Canada Pension Plan disability, if the person is a resident of a psychiatric facility, if the person is over 65 years of age and does not qualify for Old Age Security, if the person is a resident of a facility designated under the Developmental Services Act or a person resident of a home designated under the Special Care Act. All other people applying for disability under ODSPA must meet the definition.
The definition of a person with a disability is: the person has a substantial physical or mental impairment that is continuous or recurrent and expected to last one year or more; the direct and cumulative effect of the impairment on the person's ability to attend to his or her personal care, function in the community and function in a workplace, results in a substantial restriction in one or more of these activities of daily living, and the impairment and its likely duration and the restrictions in the person's activities of daily living have been verified by a person with the prescribed qualifications.
Firstly, to apply for such benefits, one must qualify financially by meeting the asset and income criteria. If the person qualifies financially, an application is sent. The package contains a Health Status Report (HSR), an Activities of Daily Living Report (ADL), a Self-Report and a Release Form. The HSR and the ADL must be completed and signed by a doctor. The self-report is not mandatory, the person may choose to complete it or not. The person applying explains why he/she believes they should get disability and how the definition applies to them.
The ADL lists the medical condition(s), the treatment required, any hospitalizations, the duration of the illness and whether assistive devices are required. It is important that ALL medical conditions be mentioned, even if they don't feel as problematic as the main condition.
The ADL is a very important form. This form rates the person's ability to perform certain tasks, such as household chores, standing, sitting, grocery shopping, etc. When a person receives this form, it is suggested that the person make a copy before bringing it to the doctor. Once a copy has been made, complete it and show it to the doctor. It has been our experience that these forms do not reflect the situation as described by the person applying for disability. Given the specific answers required, the doctor may not know the extent of the difficulties in performing certain activities. The reason why this is so important is because a doctor must verify the restrictions. If the doctor is not in a position to complete this form to reflect the actual restrictions, then those restrictions are not verified.
A person must show that they have a substantial impairment. In order to prove this, you need a doctor stating that the medical condition is affecting the person substantially. Given that this is a fairly new system, it is difficult to assess the meaning of “substantial” impairment. It is becoming clearer that consultations with specialists help (physiatrist, psychiatrist, rheumatologist, surgeons, etc.).
A denial of disability can be appealed, first by requesting an internal review. This is done by sending a letter asking for a review. If the person is receiving Ontario Works, the worker can assist with this request.
If the Internal Review confirms that a person is not disabled, an appeal to the Social Benefits Tribunal can be filed. This must be done within 30 days of receiving a response to the Internal Review. Contact your nearest Community Legal Clinic for assistance and/or representation.
For residents west of Holland and Fisher Avenue, please call West End Legal Services at:
West End Legal Services
1301 Richmond Road