Canadians with terminal illnesses face new rules in test for speedy benefits

FILE: Auditor general Michael Ferguson’s February 2016 review of the disability pension program found people with terminal or grave conditions were waiting too long for benefits, or being snowed under by complicated paperwork.(Photo: Office of the Auditor General in Canada website)

OTTAWA — The people who walk into Ilene Shiller’s office are usually more stressed about their finances than the diagnosis that they only have a short time left to live.

Shiller helps terminally ill Canadians fill out the forms needed to receive a federal disabilities pension and hear back from officials in short order about whether they qualify for benefits.

In a few weeks, these Canadians will face a new test for fast-tracking their Canada Pension Plan disability requests in a bureaucratic bid to finally unclog a system that has faced years of criticisms.

The $4.3-billion CPP disability program aims to rush through benefits decisions for dying Canadians, but has faced hurdles in meeting the processing timelines.

Now, the government plans to change the rules in a few weeks to grant an expedited review to people whose doctors declare they have just six months left to live.

“The certainty of the six months is a good thing because it’s a been little bit open-ended in terms of what ‘terminally ill’ meant,” said Shiller, a case manager with Wellspring Centres, which helps patients navigate myriad benefit systems.

The decision to set the standard for six months was aimed at untangling — again —problems in how the government decides who deserves a speedy decision, according to documents obtained by The Canadian Press under the access to information law.

Auditor general Michael Ferguson’s February 2016 review of the disability pension program found people with terminal or grave conditions were waiting too long for benefits, or being snowed under by complicated paperwork.

Ferguson’s teams found that only seven per cent of dying people who sought disability payments got a decision on their application within the government’s 48-hour guideline, while just over half of those with chronic conditions had their cases decided within the established 30-day window.

The department’s latest results report said it now aims to make decisions within five business days after receiving a completed application.

Shiller said the faster the turnaround, the better for someone who has been told their condition is fatal. That’s because that person is likely dealing with a reduction of income from being unable to work and an increase in expenses like parking at hospitals, medications, or child care.

“We see someone who is diagnosed and the financial piece of their life sometimes becomes more stressful than the health issues themselves,” she said.

A briefing note earlier this year to senior officials in Employment and Social Development Canada notes that the department’s definition set in 2017 for terminal illness may have clogged up the fast-track system because key words used in the definition were “not always accurate markers of terminal illness.”

There was also a risk that the promise of a fast decision drew “applications from individuals who don’t have a terminal illness,” since some applicants could self-identify as having as short window left to live.

A spokesman for the department said setting a six-month life expectancy standard was a compromise between varying definitions of terminal illness, which can range from three to 24 months left to live, and the varying survival predictions from doctors, who can overestimate life expectancy by a factor of five or more.

Setting the standard at six months also lines up with the time limits on federal compassionate care benefits to anyone who takes a temporary break from the workforce to care for a gravely or terminally ill family member, and the guidelines for a medically assisted death.