I have been found medically ineligible for Ontario Disability benefits and have filed an appeal to the Social Benefits Tribunal. What is the appeal process?
After submitting your appeal to the Social Benefits Tribunal, you will receive a notice of hearing letter. This letter notifies you of the time and date of your hearing as well as whether you will have a telephone hearing or videoconference hearing over Zoom. If you have made a request for an in person hearing and have been granted your request, you should make sure you know the address and how to get to the hearing location at least 30 minutes before the hearing time.
A hearing at the Social Benefits Tribunal is not as formal as a court hearing. However, there are rules about the hearing and about how the Social Benefits Tribunal is supposed to make its decision. Try to contact your nearest community legal clinic for advice and/or assistance with your appeal.
At the hearing, you should have your documents with you such as: your Appeal form, Notice of Hearing letter, your Disability Determination Package (which would have been sent to you shortly after you filed your appeal), any documents you have filed with the Social Benefits Tribunal and any documents you have that the Disability Adjudication Unit filed with the Social Benefits Tribunal.
At the hearing there is usually one Social Benefits Tribunal Member. The Member is in charge of the hearing and makes the decision about your appeal. The Ontario Disability Support Program (ODSP) can send a Case Presenting Officer to the hearing. The Case Presenting Officer may question you and any other witnesses and say why the Social Benefits Tribunal should not change the decision made by the Disability Adjudication Unit.
The Social Benefits Tribunal permits you to have someone beside for support during the hearing. This person could be a family member, friend, or other support person.
The Member begins the hearing by introducing themselves and asking for the names of everyone at the hearing. The Member will explain what will happen at the hearing, confirm your mailing address to send you the decision, and will make sure that they have all the documents that you and the ODSP office filed before the hearing.
If you miss your hearing or are late, the Member might decide your appeal without you being there. You must have a significant reason for arriving late or not at all; otherwise there will be consequences such as losing your appeal and maybe even losing future appeal rights.
At the hearing you and any witnesses will take an oath to swear to tell the truth. Then the Member will ask you questions and any other witness, if any. If ODSP sends a Case Presenting Officer to the hearing, they can also ask you and the witnesses, questions.
At your hearing you have to convince the Social Benefits Tribunal that the decision you are appealing (i.e., the denial of benefits) is wrong. The Member makes a decision based on the evidence from you and ODSP. Evidence includes what you say and documents that have been filed with the Social Benefits Tribunal. Normally the focus of the hearing will be on your medical state at the time your application for ODSP was first refused. After all the evidence has been presented, you may explain to the Member why you think that the decision you’re appealing is wrong.
You will receive a decision in the mail within 60 days. If you win your appeal, the ODSP office will have to abide by the decision made by the Social Benefits Tribunal Member.
*The above is a simply a brief overview of the appeal process at the Social Benefits Tribunal and, if interested, you should seek more information and/or legal advice. You may start by contacting our intake line.