Docket: T-1674-15
Citation:
2017 FC 391
Ottawa, Ontario, April 21, 2017
PRESENT: The
Honourable Mr. Justice Russell
BETWEEN:
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PETER JOSEPH
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Applicant
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and
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ATTORNEY
GENERAL OF CANADA
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Respondent
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JUDGMENT AND REASONS
I.
INTRODUCTION
[1]
This is an application under s 18.1 of the Federal
Courts Act, RSC 1985, c F-7 [Act] for judicial review of a decision of the
Appeal Division of the Social Security Tribunal [AD], dated August 27, 2015
[Decision], which denied the Applicant’s application for leave to appeal a
decision of the General Division of the Social Security Tribunal [GD].
II.
BACKGROUND
[2]
The Applicant applied for a disability pension
under the Canada Pension Plan, SC 1985, c C-8 [CPP] on February
28, 2012. The application was initially denied on June 21, 2012 and, upon
reconsideration, was again denied on October 16, 2012. The matter was then
heard by the GD, which denied the application on July 17, 2015. The GD found
that the Applicant did not meet the criteria for payment of a CPP
disability pension on the basis that he had not demonstrated, on a balance of
probabilities, that he had a severe and prolonged disability on or before
December 31, 2011, which is the Applicant’s minimum qualifying period [MQP].
[3]
The Applicant then sought to appeal the GD’s
denial to the AD on imprecise grounds.
III.
DECISION UNDER REVIEW
[4]
In a Decision dated August 27, 2015, the AD
refused the Applicant’s application for leave to appeal the GD’s decision to
deny the Applicant a CPP disability pension.
[5]
Although the Applicant had not identified
grounds of appeal in his application, the AD concluded that the Applicant had sought
leave to appeal to the AD on the grounds that the GD decision should be
characterized as based upon an erroneous finding of fact which it made in a
perverse or capricious manner, or without regard for the material before it. In
addition to this issue, the AD also considered whether the appeal would have a
reasonable chance of success, which is the test to be applied when considering
leave to appeal.
[6]
The AD found that the Applicant’s submissions
were no more than statements disagreeing with the outcome of the GD’s decision
and expressing the continued belief that the Applicant met the requirements for
a CPP disability pension. The AD found that the Applicant challenged the
weight placed on the medical evidence but did not set out how the GD erred in
law or fact, or whether a breach of natural justice had occurred and in what
manner. Thus, the AD concluded that the Applicant’s submissions invited the AD
to reweigh the evidence, which is not the function of the AD.
[7]
In its review, the AD found that the GD had
considered and addressed both the objective medical evidence as well as the
Applicant’s oral testimony about his medical conditions. Although the Applicant
had submitted that insufficient weight was given to Dr. Samuels’ medical
evidence, the AD found that this evidence had been appropriately addressed in
the GD’s decision. Furthermore, the AD found that the GD had appropriately
analyzed the content of the other medical reports in its decision. Overall, the
Applicant’s disagreements with the conclusions of the GD were found to be insufficient
to ground an appeal.
[8]
The AD concluded that it was not persuaded that
the Applicant’s submissions disclosed a ground of appeal that would have a
reasonable chance of success, and refused the application for leave to appeal.
IV.
ISSUES
[9]
Based on the oral and written submissions, it
appears the Applicant submits that the following are at issue in this
application:
1. Did the Applicant have a severe and prolonged physical disability as
defined in s 42(2)(a) of the CPP to qualify for a disability pension?
2. Did the GD and the AD fail to apply the appropriate legal test to
arrive at their decisions to reject the Applicant’s application for payment of
a disability pension under the CPP as a result of his permanent
disability?
3. Was the GD’s decision based upon an error of fact made in a perverse
or capricious manner or without regard for the materials before it?
4. Are the decisions of the GD and AD reasonable?
5. Is the Certified Record deficient?
[10]
The Respondent submits that the following is at
issue in this application:
- Was the AD’s Decision refusing the
application for leave to appeal reasonable?
V.
STANDARD OF REVIEW
[11]
The Supreme Court of Canada in Dunsmuir v New
Brunswick, 2008 SCC 9 [Dunsmuir] held that a standard of review
analysis need not be conducted in every instance. Instead, where the standard
of review applicable to a particular question before the court is settled in a
satisfactory manner by past jurisprudence, the reviewing court may adopt that
standard of review. Only where this search proves fruitless, or where the
relevant precedents appear to be inconsistent with new developments in the
common law principles of judicial review, must the reviewing court undertake a
consideration of the four factors comprising the standard of review analysis: Agraira
v Canada (Public Safety and Emergency Preparedness), 2013 SCC 36 at para
48.
[12]
The standard of review for any findings of fact
by the Social Security Tribunal and for the interpretation of the Department
of Employment and Social Development Act, SC 2005, c-34 [DESD Act] is
reasonableness: Reinhardt v Canada (Attorney General), 2016 FCA 158 at
para 15.
[13]
When reviewing a decision on the standard of reasonableness,
the analysis will be concerned with “the existence of
justification, transparency and intelligibility within the decision-making
process [and also with] whether the decision falls within a range of possible,
acceptable outcomes which are defensible in respect of the facts and law.”
See Dunsmuir, above, at para 47, and Canada (Citizenship and
Immigration) v Khosa, 2009 SCC 12 at para 59. Put another way, the
Court should intervene only if the Decision was unreasonable in the sense that
it falls outside the “range of possible, acceptable
outcomes which are defensible in respect of the facts and law.”
VI.
STATUTORY PROVISIONS
[14]
The following provisions from the DESD Act
are relevant in this proceeding:
Grounds of appeal
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Moyens d’appel
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58 (1) The only grounds of appeal are
that
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58 (1) Les seuls moyens d’appel sont
les suivants :
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(a) the General Division failed to
observe a principle of natural justice or otherwise acted beyond or refused
to exercise its jurisdiction;
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a) la division générale n’a pas observé
un principe de justice naturelle ou a autrement excédé ou refusé d’exercer sa
compétence;
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(b) the General Division erred in law
in making its decision, whether or not the error appears on the face of the
record; or
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b) elle a rendu une décision entachée
d’une erreur de droit, que l’erreur ressorte ou non à la lecture du dossier;
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(c) the General Division based its
decision on an erroneous finding of fact that it made in a perverse or
capricious manner or without regard for the material before it.
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c) elle a fondé sa décision sur une
conclusion de fait erronée, tirée de façon abusive ou arbitraire ou sans
tenir compte des éléments portés à sa connaissance.
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Criteria
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Critère
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(2) Leave to appeal is refused if the
Appeal Division is satisfied that the appeal has no reasonable chance of
success.
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(2) La division d’appel rejette la
demande de permission d’en appeler si elle est convaincue que l’appel n’a
aucune chance raisonnable de succès.
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Decision
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Décision
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(3) The Appeal Division must either
grant or refuse leave to appeal.
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(3) Elle accorde ou refuse cette
permission.
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[15]
The following provisions from the CPP are
relevant in this proceeding:
When
person deemed disabled
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Personne
déclarée invalide
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42 (2) For
the purposes of this Act,
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42 (2) Pour
l’application de la présente loi :
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(a) a person
shall be considered to be disabled only if he is determined in prescribed
manner to have a severe and prolonged mental or physical disability, and for
the purposes of this paragraph,
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a) une
personne n’est considérée comme invalide que si elle est déclarée, de la
manière prescrite, atteinte d’une invalidité physique ou mentale grave et
prolongée, et pour l’application du présent alinéa :
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(i) a
disability is severe only if by reason thereof the person in respect of whom
the determination is made is incapable regularly of pursuing any
substantially gainful occupation, and
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(i) une
invalidité n’est grave que si elle rend la personne à laquelle se rapporte la
déclaration régulièrement incapable de détenir une occupation véritablement
rémunératrice,
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(ii) a
disability is prolonged only if it is determined in prescribed manner that
the disability is likely to be long continued and of indefinite duration or
is likely to result in death; and
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(ii) une
invalidité n’est prolongée que si elle est déclarée, de la manière prescrite,
devoir vraisemblablement durer pendant une période longue, continue et
indéfinie ou devoir entraîner vraisemblablement le décès;
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(b) a person
is deemed to have become or to have ceased to be disabled at the time that is
determined in the prescribed manner to be the time when the person became or
ceased to be, as the case may be, disabled, but in no case shall a person —
including a contributor referred to in subparagraph 44(1)(b)(ii) — be deemed
to have become disabled earlier than fifteen months before the time of the
making of any application in respect of which the determination is made.
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b) une
personne est réputée être devenue ou avoir cessé d’être invalide à la date
qui est déterminée, de la manière prescrite, être celle où elle est devenue
ou a cessé d’être, selon le cas, invalide, mais en aucun cas une personne —
notamment le cotisant visé au sousalinéa 44(1)b)(ii) — n’est réputée être
devenue invalide à une date antérieure de plus de quinze mois à la date de la
présentation d’une demande à l’égard de laquelle la détermination a été
faite.
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…
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…
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Benefits
payable
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Prestations
payables
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44 (1)
Subject to this Part,
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44 (1) Sous
réserve des autres dispositions de la présente partie :
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…
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…
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(b) a
disability pension shall be paid to a contributor who has not reached
sixty-five years of age, to whom who
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b) une
pension d’invalidité doit être payée à un cotisant qui n’a pas atteint l’âge
de soixante-cinq ans, à qui aucune pension de retraite n’est payable, qui est
invalide et qui :
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(i) has made
contributions for not less than the minimum qualifying period,
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(i) soit a
versé des cotisations pendant au moins la période minimale d’admissibilité,
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(ii) is a
contributor to whom a disability pension would have been payable at the time
the contributor is deemed to have become disabled if an application for a
disability pension had been received before the contributor’s application for
a disability pension was actually received, or
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(ii) soit est
un cotisant à qui une pension d’invalidité aurait été payable au moment où il
est réputé être devenu invalide, si une demande de pension d’invalidité avait
été reçue avant le moment où elle l’a effectivement été,
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(iii) is a
contributor to whom a disability pension would have been payable at the time
the contributor is deemed to have become disabled if a division of unadjusted
pensionable earnings that was made under section 55 or 55.1 had not been
made;
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(iii) soit
est un cotisant à qui une pension d’invalidité aurait été payable au moment où
il est réputé être devenu invalide, si un partage des gains non ajustés
ouvrant droit à pension n’avait pas été effectué en application des articles
55 et 55.1;
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…
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…
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Calculation
of minimum qualifying period in case of disability pension and disabled contributor’s
child’s benefit
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Calcul de
la période minimale d’admissibilité dans le cas d’une pension d’invalidité et
d’une prestation d’enfant de cotisant invalide
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(2) For the
purposes of paragraphs (1)(b) and (e),
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(2) Pour
l’application des alinéas (1)b) et e) :
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(a) a
contributor shall be considered to have made contributions for not less than
the minimum qualifying period only if the contributor has made contributions
during the contributor’s contributory period on earnings that are not less
than the contributor’s basic exemption, calculated without regard to
subsection 20(2),
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a) le
cotisant n’est réputé avoir versé des cotisations pendant au moins la période
minimale d’admissibilité que s’il a versé des cotisations au cours de sa
période cotisable sur des gains qui sont au moins égaux à son exemption de
base, compte non tenu du paragraphe 20(2), selon le cas :
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(i) for at
least four of the last six calendar years included either wholly or partly in
the contributor’s contributory period or, where there are fewer than six
calendar years included either wholly or partly in the contributor’s
contributory period, for at least four years,
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(i) soit,
pendant au moins quatre des six dernières années civiles comprises, en tout
ou en partie, dans sa période cotisable, soit, lorsqu’il y a moins de six
années civiles entièrement ou partiellement comprises dans sa période
cotisable, pendant au moins quatre années,
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(i.1) for at
least 25 calendar years included either wholly or partly in the contributor’s
contributory period, of which at least three are in the last six calendar
years included either wholly or partly in the contributor’s contributory
period, or
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(i.1) pendant
au moins vingt-cinq années civiles comprises, en tout ou en partie, dans sa
période cotisable, dont au moins trois dans les six dernières années civiles
comprises, en tout ou en partie, dans sa période cotisable,
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(ii) for each
year after the month of cessation of the contributor’s previous disability
benefit; and
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(ii) pour
chaque année subséquente au mois de la cessation de la pension d’invalidité;
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(b) the
contributory period of a contributor shall be the period
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b) la période
cotisable d’un cotisant est la période qui :
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(i)
commencing January 1, 1966 or when he reaches eighteen years of age, whichever
is the later, and
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(i) commence
le 1er janvier 1966 ou au moment où il atteint l’âge de dix-huit ans, en
choisissant celle de ces deux dates qui est postérieure à l’autre,
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(ii) ending
with the month in which he is determined to have become disabled for the
purpose of paragraph (1)(b),
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(ii) se
termine avec le mois au cours duquel il est déclaré invalide dans le cadre de
l’alinéa (1)b),
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but excluding
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mais ne
comprend pas :
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(iii) any
month that was excluded from the contributor’s contributory period under this
Act or under a provincial pension plan by reason of disability, and
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(iii) un mois
qui, en raison d’une invalidité, a été exclu de la période cotisable de ce
cotisant conformément à la présente loi ou à un régime provincial de
pensions,
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(iv) in relation
to any benefits payable under this Act for any month after December, 1977,
any month for which the contributor was a family allowance recipient in a
year for which the contributor’s unadjusted pensionable earnings are less
than the basic exemption of the contributor for the year, calculated without
regard to subsection 20(2).
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(iv) en ce
qui concerne une prestation payable en application de la présente loi à
l’égard d’un mois postérieur à décembre 1977, un mois relativement auquel il
était bénéficiaire d’une allocation familiale dans une année à l’égard de
laquelle ses gains non ajustés ouvrant droit à pension étaient inférieurs à
son exemption de base pour l’année, compte non tenu du paragraphe 20(2).
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VII.
ARGUMENT
A.
Applicant
[16]
In his written submissions, the Applicant
submits that both the GD and AD failed to apply the appropriate legal test in
their decisions to deny the Applicant’s application for the CPP
disability pension because the Applicant’s disability qualifies and is verified
by medical evidence.
[17]
With regards to the GD’s July 17 decision on
severity, the Applicant says there are several errors of law. The decision
wrongly concludes that the Applicant should have sought work opportunities
despite being on an unpaid leave of absence. This conclusion disregards the
medical evidence and encourages a breach of employment law. This conclusion
also ignores the fact that, despite his employer’s accommodations, the
Applicant was unable to complete even a four-hour work day due to his medical
condition. The expectation that the Applicant could pursue employment, despite
the medical evidence demonstrating that the Applicant was incapable of pursuing
any employment, is unreasonable. Furthermore, the decision incorrectly applies
case law in the interpretation of s 42(2)(a)(i) of the CPP, as the legal
test is not whether the Applicant is able to pursue any employment, but whether
the Applicant is able to regularly pursue “any
substantially gainful occupation”: Villani v Canada (Attorney
General), 2001 FCA 248 [Villani].
[18]
As for the GD’s July 17 decision regarding the
prolonged “criterion,” the Applicant says that the
decision ignores the medical evidence that demonstrates the Applicant had a 27%
permanent disability in March 2011 during the MQP. This finding is also contrary
to subsequent decisions by the GD which have found that a period of three years
is a prolonged period of “indefinite duration,”
and that there is no requirement for objective medical evidence to be adduced
to support a finding of severe disability.
[19]
The Applicant asks the Court to amend the style
of cause to name the appropriate Respondent in these proceedings.
[20]
The Applicant seeks relief in the form of an
order that sets aside the finding of the GD and finds in favour of the
Applicant or, in the alternative, that the Court refer the matter back to a
different tribunal and direct that the Applicant be granted a CPP
disability pension. The Applicant also requests any other relief that the Court
may deem just as well as the costs of these proceedings on a substantial
indemnity basis, including the proceedings before the GD.
B.
Respondent
[21]
The Respondent submits that the AD’s Decision to
deny leave to appeal was reasonable and this application should be dismissed.
(1)
Leave to Appeal
[22]
According to s 58(2) of the DESD Act,
leave to appeal is refused if the appeal has no reasonable chance of success,
which can only be found if it is based on one of the enumerated grounds in s
58(1): Belo-Alves v Canada (Attorney General), 2014 FC 1100 at paras
70-73. The Federal Court of Appeal has found that a reasonable chance of
success means an arguable case: Fancy v Canada (Attorney General), 2010
FCA 63.
(2)
Disability under the Plan
[23]
According to ss 42(2), 44(1)(b), and 44(2) of
the CPP, a person must satisfy three requirements to be entitled to a
disability pension. They must: meet the contributory requirements; be disabled
within the meaning of the Plan when the contributory requirements were met; and
be so disabled continuously and indefinitely. Subsection 42(2) of the CPP
also provides that a person shall be considered to be disabled only if he or
she is determined to have a severe and prolonged mental or physical disability.
[24]
A disability is considered “severe” only if the person is incapable regularly of
pursuing any substantially gainful occupation, and not whether they are capable
of performing their usual occupation: Canada (Minister of Human Resources
Development) v Scott, 2003 FCA 34 at para 7. An applicant who seeks to satisfy
this definition must demonstrate a serious health problem and, where there is
evidence of work capacity, that efforts at obtaining and maintaining
employment have been unsuccessful by reason of the health condition: Klabouch
v Canada (Social Development), 2008 FCA 33 at paras 14-17 [Klabouch].
This must be demonstrated by medical evidence and evidence of employment
efforts and possibilities: Villani, above, at para 50; Klabouch,
above, at para 16. An applicant must also prove that the disability existed
prior to the expiry of the MQP and continuously thereafter: Granovsky v
Canada (Minister of Employment and Immigration), 2000 SCC 28 at para 28.
(3)
Reasonableness
[25]
The Respondent submits that the Applicant has
argued grounds in this review application that were not raised in his leave to
appeal before the AD. In characterizing the sole issue as being whether the
Applicant has a severe and prolonged disability under the CPP, the
Applicant attempts to re-litigate the matter, which is not the purpose of
judicial review. The Applicant also fails to address how the grounds presented
before the AD raised a reasonable chance of success and how the AD erred in
refusing to grant leave to appeal. Instead, the Applicant raises an alleged
error in the application of a legal test that was not before the AD.
[26]
In its consideration of leave to appeal, the AD
is not obliged to scrutinize all the evidence before it, but only the grounds
raised on leave: Mohamed v Canada (Attorney General), 2016 FC 482 at
para 12. The Applicant was represented by a paralegal with a specialization in CPP
disability claims. Thus, the Applicant should have advanced the relevant
grounds in seeking leave to appeal, and the new ground advanced before the
Court should not render the Decision unreasonable. Furthermore, even if the
Applicant had advanced this ground before the AD, the Respondent submits that
this would not have demonstrated a reasonable chance of success on appeal, or
warrant a grant of leave to appeal.
[27]
The first of these new grounds refers to the GD
and AD’s application of the appropriate legal test to determine disability. The
Respondent argues that the GD clearly set out the appropriate legal test for
disability in its July 17 decision and considered multiple factors, including
the Applicant’s age, language skills, education, work history, and medical
conditions. The second of the new grounds refers to the contention that the GD’s
conclusion that the Applicant should have sought other employment opportunities
indicates a complete disregard for the medical evidence. These grounds do not
have a reasonable chance of success because the evidence that the Applicant
claims was disregarded is actually referred to in the decision. However, the
conclusion based on the evidence is simply not favourable to the Applicant;
that is, the GD did not agree with the medical reports that the Applicant was “totally disabled from any employment.”
[28]
The Applicant also maintains that there was a
failure to apply the standard of reasonableness, but the Respondent submits
that both the GD and AD applied the appropriate standard in assessing the
applications. The GD determined whether the Applicant had a severe and
prolonged disability on or before the MQP on a balance of probabilities, and the
AD determined whether the appeal had a reasonable chance of success.
[29]
In particular, the AD reasonably assessed the
grounds that were put before it on leave to appeal. The Applicant argues that
the medical evidence of Dr. Samuels was not given appropriate weight, but the GD
referred overtly to Dr. Samuels’ medical report and reasonably analyzed that it
did not reveal severe conditions that would prevent the Applicant from seeking employment.
The GD also noted that the May 2015 letter which did reveal Dr. Samuels’
opinion that the Applicant had severe conditions that would prevent employment
was written well past the relevant MQP. As such, the GD was obligated to accord
that letter less weight than the evidence up to the date of the MQP. In light
of these considerations, the AD found that the GD did not disregard the medical
evidence. Since the function of the AD is not to reweigh evidence on leave to
appeal, it did not do so. Instead, the AD reasonably concluded that the GD’s
consideration and weighing of the medical evidence had been reasonable and,
consequently, this ground did not have a reasonable chance of success on
appeal.
[30]
In his leave to appeal application, the
Applicant argued that he had medical conditions that qualified as severe and
prolonged in nature and that are sufficient to render him unemployable in any
capacity. The AD noted that these statements did not identify errors in Decision
but rather expressed disagreement with the outcome of the Decision. Thus, it
was reasonable for the AD to conclude that this ground did not have a
reasonable chance of success on appeal.
[31]
Overall, the decisions by the GD and AD
demonstrate clear justification for why the application was denied. The
Respondent submits that these proceedings are merely an attempt to re-litigate
the Applicant’s appeals.
[32]
Furthermore, the Applicant implies that he may
have been entitled to benefits under other insurance regimes and that this
should favour his position as qualifying for a CPP disability pension.
However, this Court has determined that qualification for a benefit provided
under provincial legislation does not raise an arguable issue concerning a
decision that similar evidence does not qualify for benefit under another
statute such as the Plan: Callihoo v Canada (Attorney General), 2000 FCJ
No 612 at para 12.
(4)
Order Sought
[33]
The Respondent maintains that although it is not
clear whether the Applicant seeks to set aside the decision of the GD or AD, it
is clear the relief sought is inappropriate as the Applicant seeks a directed
verdict on the merits that would substitute the Court’s opinion for the GD’s. The
Respondent submits that the Court should only consider the AD’s denial of the
leave to appeal and that the Decision does not warrant judicial intervention.
[34]
The Respondent also requests that the style of
cause to be amended to reflect the Respondent as the Attorney General of
Canada.
[35]
The Respondent seeks an order dismissing the
application for judicial review without costs.
VIII.
ANALYSIS
A.
Issues Raised
[36]
In writing and in oral argument before the
Court, the Applicant has raised a series of issues for review, and I will deal
with each of them in turn.
B.
Severe and Prolonged Disability
[37]
The Applicant says that the Court should
determine whether he has a severe and prolonged physical disability as defined
in s 42(2)(a) of the CPP to qualify for a CPP disability pension.
[38]
This is not an issue that is appropriately
before the Court. This issue was for the GD to decide, which it did. The Court
is not reviewing the GD’s decision. The Court is reviewing the AD’s Decision of
August 27, 2015 which refused the Applicant leave to appeal the GD’s decision
of July 17, 2015.
[39]
The Applicant is asking the Court to substitute
its decision on this issue for that of the GD. The Court has no jurisdiction to
do this.
C.
The Wrong Test
[40]
The Applicant also raises the following issue:
19. It is respectfully submitted that
the Board (General Division – Jackie Laidlaw on July 17, 2015 and Hazelyn Ross
– Appeal Division – August 27, 2015 (sic) failed to apply the
appropriate legal test to arrive at their decision to reject the applicant’s
application for payment of CPP disability benefit as a result of his permanent
disability verified by appropriate medical documentary evidence as shown in
paragraphs 4-13 [inclusive] above.
[41]
As in most applications of this nature, the
critical issue was the severity of the Applicant’s disability, and what the
medical evidence adduced by the Applicant had to say on this central point.
[42]
The AD’s Decision sets out and applies the
correct test for a leave to appeal:
[5] Leave to appeal a decision of the
General Division of the Tribunal is a preliminary step to an appeal before the
Appeal Division. To grant leave, the Appeal Division must be satisfied that the
appeal would have a reasonable chance of success. In Canada (Minister of
Human Resources Department) v. Hogerworst, 2007 FCA 41 as well as in Fancy
v. Canada (Attorney General), 2010 FCA 63, the Federal Court of Appeal
equated a reasonable chance of success to an arguable case.
[6] There are only three grounds on
which an applicant may bring an appeal. These grounds are set out in section 58
of the DESD Act. They are,
(1) a breach of natural justice;
(2) that the General Division erred in law; and
(3) the General Division based its decision on an error of fact
made in a perverse or capricious manner or without regard for the material
before it.
(footnotes omitted)
[43]
Justice Boswell provided guidance as to how the
AD should go about its task in Griffin v Canada (Attorney General), 2016
FC 874 at para 20:
It is well established that the party
seeking leave to appeal bears the onus of adducing all of the evidence and
arguments required to meet the requirements of subsection 58(1): see, e.g., Tracey,
above, at para 31; also see Auch v. Canada (Attorney General), 2016 FC
199 at para 52, [2016] F.C.J. No 155. Nevertheless, the requirements of
subsection 58(1) should not be applied mechanically or in a perfunctory manner.
On the contrary, the Appeal Division should review the underlying record and
determine whether the decision failed to properly account for any of the
evidence: Karadeolian v. Canada (Attorney General), 2016 FC 615 at
para 10, [2016] F.C.J. No. 585.
(emphasis added)
[44]
Likewise, in Karadeolian v Canada (Attorney
General), 2016 FC 615 at paras 9-10, Justice Barnes wrote:
I do agree that the Tribunal must be wary of
mechanistically applying the language of section 58 of the Act when it performs
its gatekeeping function. It should not be trapped by the precise grounds for
appeal advanced by a self-represented party like Ms. Karadeolian. In cases like
this, the Tribunal should examine the medical evidence and compare it to the
decision under consideration. If important evidence has been arguably
overlooked or possibly misconstrued, leave to appeal should ordinarily be
granted notwithstanding the presence of technical deficiencies in the
application for leave.
[45]
The Applicant elaborates in his written
submissions what he means by the “wrong test”:
20. It is further respectfully submitted
that Ms Laidlaw erred in law when at paragraph [46] of her decision she opined
“....has been unpaid leave of absence since 2009” but wrongly concluded that
the applicant - while on unpaid leave of absence - should have gone to look for
work elsewhere thereby completely disregarding the medical evidence at
paragraph 6 above [the applicant was “totally disabled any employment”]
and also committing a breach of the Employment Act. She also completely ignored
the fact that the applicant had a sedentary job - sitting all day before a
computer and his employer Bell had not only accommodated him by allowing him to
work a four hour day but had acquired a special chair to accommodate him
and his medical condition. However all of this failed and as of September 21,
2009 - because of his constant pain - he was unable to return to work.
21. It is further respectfully
submitted that Ms Laidlaw erred in law when she gave her version of the Villani
v. Canada (AG) [2001] FCA 248 - because all the medical evidence points to the
fact that the applicant was incapable at all times of pursuing any conceivable
occupation:
At paragraph 38 of that decision the
Court found reviewing the decision of the Barlow case:
“38. The analysis of subparagraph
42(2)(a)(i ) strongly suggests a legislative intention to apply the severity
requirement in the “real world” context. Requiring that an applicant be
incapable regularly of pursuing any conceivable occupation is quite different
from requiring that an applicant be incapable at all times of pursuing any
conceivable occupation. Each word in the subparagraph must be given meaning and
when read in that way the subparagraph indicates, in my opinion that Parliament
viewed as severe any disability which renders an applicant incapable of
pursuing with consistent frequency any truly remunerative occupation. In my
view, it follows from this that the hypothetical occupations which a decision
maker must consider cannot be divorced from the particular circumstances of the
applicant such as age, education level, language proficiency and past work and
life experience.
“39. I agree with the conclusions in
Barlow, supra and the reasons therefor in that case was brief and sound. It
demonstrates that, on the plain meaning of the words in subparagraph
42(2)(a)(i), Parliament must have intended that the legal test for severity be
applied with some degree of reference to the "real world" . It is
difficult to understand what purpose the legislation would serve if it provided
that disability benefits should be paid only to those applicants who were
incapable of pursuing any form of occupation no matter how irregular, ungainful
or insubstantial. Such an approach would defeat the objectives of the Plan and
result in an analysis that is supportable on the plain language of the
statute.”
22. It is further respectfully
submitted that the Board has adopted the strict abstract approach in the
interpretation of the “severity requirement” in subparagraph 42(2)(a)(i)
without analyzing all of the legislative language - Villani above: see [42]
“[42] The explanation by the
Deputy Minister of Welfare is unambiguous. The test for severity is not that a
disability be “total”. In order to express the more lenient test for severity
under the Plan therefore the drafters introduced the notion of severity as the
inability regularly to pursue any substantially gainful occupation.”
23. It is further respectfully submitted
that the Board failed to apply the standard of reasonableness when arriving at
its decision to deny the applicant’s application for CPP disability benefit.
See: Villiani v Canada (Attorney
General) supra.
24. It is further respectfully submitted
that during the Minimum Qualifying Period (MQP) the , applicant on March 2011
was found to have a 27% permanent disability as a result of the assessment of a
WSIB independent medical examiner and was granted a NEL award based upon this
assessment but Ms Laidlaw erred in law when she completely disregarded this
independent medical finding.
25. It is further respectfully submitted
that the Tribunal in a subsequent matter concluded that a period of three years
was a prolonged a period of “indefinite duration” and predictability and
reliability in the workforce are of significant considerations - quite contrary
to the finding against the applicant.
See: J.A. v. Minister of Human
Resources and Skills Development Reference GT-11746 February 3, 2014.
[11] The job she held when the medical
problems made it impossible for her to keep working was in sales and marketing
with the Rainbow Country Travel Association from January, 2009 until her
contract ended in March, 2010. She was rehired by CRA (Canada Revenue Agency)
at that time on another short term contract on another short term contract, but
at the orientation session, she had an attack of muscle spasms, was driven home
and could not continue on that contract. It was at this point she realized she
could no longer work at any job.
[29] The Respondent submitted that there is
insufficient Objective medical evidence to support a finding that the Appellant
was disabled within the meaning of the CPP (Canada Pension Plan) by December
31, 2011. The Tribunal notes that there is no requirement in the CPP (Canada
Pension Plan) that objective medical evidence must be adduced to support a
finding of severe disability In determining this issue, the Tribunal must
assess all of the relevant evidence.”
26. It is further respectfully submitted
that in the interest of justice the decision of the Board [Jackie Laidlaw and
Hazelyn Ross be set aside.
See: Kheiri v. Canada (Minister of
Citizenship and Immigration), 2000 Can LII 1533 (FC).
[errors and emphasis in original]
[46]
As the AD’s Decision makes clear, the Applicant
was somewhat imprecise in his grounds of appeal, but the AD did decide what
those grounds of appeal were:
ANALYSIS
[7] In order to grant leave to appeal
the Tribunal must be satisfied that the appeal would have a reasonable chance
of success. This means that the Tribunal must first find that, were the matter
to proceed to a hearing,
(a) at least one of the grounds of the
Application relate to a ground of appeal; and
(b) there is a reasonable chance that the
appeal would succeed on this ground.
For the reasons set out below the Tribunal
is not satisfied that this appeal would have a reasonable chance of success.
The Alleged Errors
[8] As stated earlier, the Tribunal
concludes that Counsel for the Applicant was alleging that the General Division
decision was based on errors of fact. In Counsel’s submission, the Applicant’s
medical and mental conditions prior to the MQP were of such a nature that they
brought him within the CPP definition of “severe” disability. Counsel submitted
that the medical evidence supported such a finding and that in its decision the
General Division failed to give significant weight to that evidence, notably
that of Dr. Samuels.
[9] The following is the main portion
of the submissions of Counsel for the Applicant:
According to the recent decision
dated July 17, 2015 the Tribunal determined that the medical evidence on file
does not establish that the appellant’s overall medical condition was severe
prior to the MQP. The decision avers that while Mr. Joseph has limitations with
his health conditions, he does not have a severe disability that would prevent
him from partaking in gainful employment.
Contrary to the Tribunal’s decision,
it remains this Firm's contention that Mr. Joseph’s physical medical conditions
and psychological impairment are both severe and prolonged in nature prior and
render him unemployable in any capacity. The medical evidence on file supports
the severity of the appellant’s overall medical condition, which consists of a
chronic low back pain and degenerative disc disease, with limited movement in
all directions and spasms down to his legs, bladder incontinence and
depression, which disables him from partaking in activities of daily living. He
also has functional limitations of standing, sitting, walking, lifting,
reaching and bending and difficulty with memory and concentration, due to his
depressed state of mind and poor sleep caused by his severe pain, which is a
significant barrier to him returning to any form of gainful employment since
December 2011 and continuously thereafter.
It is respectfully submitted that the
medical evidence on file from the appellant’s primary treating practitioners,
most notably Dr. Samuels, was not given significant weight when rendering a
decision in this claim. At this time we kindly request a Leave to Appeal as we remain
confident in our belief that the medical evidence on file confirms our position
that Mr. Joseph is totally and permanently disabled and that his overall
physical and psychological conditions are both severe and prolonged in nature.”
(AD-1 application for leave to appeal)
[47]
The AD’s Decision under review is a critique of
the Applicant’s appeal submissions. Essentially, the AD decided that the appeal
was a request to “reweigh the evidence” which is
not the AD’s function. It also points out that Dr. Samuels’ reports and medical
conclusions were “specifically addressed at paragraph
39 of the General Division decision.” However, the AD appears to
overlook the crucial fact that the Applicant’s doctors had indicated he could
not work before Dr. Samuels’ opinion to that effect of 2015.
[48]
I think that while the Applicant’s counsel could
have been more precise and should not have characterized this as simply an
issue of “weight,” the GD did overlook crucial
evidence that goes to the heart of the Applicant’s claim (which was that the
medical evidence supported a severe disability that prevented him from
returning to work) and, in so doing, based its decision on an error of fact
made in a perverse and capricious manner and without regard for the materials
before it.
[49]
In its treatment of Dr. Samuels’ medical report,
the GD says, in reference to the 2011 report, that: “There
is no mention of his ability to return to work or his limitations preventing
work.” The GD also says that, “His opinion in
2015 is that the Appellant is unemployable, however that was not his opinion
prior to the MQP. The Tribunal is bound by the legislation and as such is
required to give more weight to evidence up to the date of the MQP.”
[50]
Dr. Samuels’ Report of 2011 states that the
Applicant has three diagnoses (chronic back pain, depression, and urine
incontinence) and notes, under relevant physical findings and functional
limitations, “limited lumbar [unclear], difficulty with
prolonged sitting/standing/walking.” The report also states that the
prognosis of the main medical condition is “guarded.”
Guarded, in medical terminology, generally means the patient is acutely ill
with questionable outlook and is often used by nurses and physicians to
indicate that a patient is unlikely to recover from an illness. Dr. Samuels’
report also states, in reference to treatment type and response, “no sig[nificant] improvement.” See KT v AS,
2009 BCSC 1653 at para 141; Maldonado v Mooney, 2016 BCSC 558 at para 60;
and Brough v Yipp, 2016 ABQB 559 at para 400.
[51]
It is important to note that Dr. Samuels took
over the Applicant’s care from Dr. Gordon, whose medical report in 2009 opined
that the Applicant’s condition had deteriorated and, read in conjunction with
the questions asked, appears to indicate that the Applicant’s condition has
deteriorated in a way that affects all aspects of his daily living. This has to
include work and, in my view, must reasonably be taken as a response to the question
“What are the limiting factors preventing your patient
from returning to work?”
Since Aug 18/09
last visit, has the medical condition improved or deteriorated? (1) What are
the limiting factors preventing your patient from returning to work? Please elaborate
on the functional capabilities. (2) What is preventing your patient from
following the treatment plan and working at the same time? (3)
(1) - deteriorated
(2) - pain [uncertain if this is the
word, the writing is difficult to read], mobility
(3) - generally affects all aspects of daily living
[52]
In conjunction with the other medical history
that demonstrates the Applicant’s condition had deteriorated since 2009, such
as the MRIs that consistently showed his back to have mild degenerative changes
with no progression noted, and Dr. Gordon’s medical opinion, it does not appear
to be reasonable to infer that Dr. Samuels’ silence on the matter in 2011
indicated an opinion of employability. He appears to be confirming – “no significant improvement” – the conclusion that Dr.
Gordon had come to in 2009 and that the Applicant could not return to work
because of the pain and mobility problems that affected all aspects of daily
living.
D.
Other Evidence
[53]
In his written submission, the Applicant refers
to various pieces of documentation that he believes support his position that
he was severely disabled and was not able to work. This evidence includes
reports from Dr. Gordon, the Applicant’s family doctor prior to
Dr. Samuels, reports of Dr. Germansky, the Workplace Safety and Insurance
Board consultant and the March 21, 2011 decision of the Workplace Safety and
Insurance Board, as well as other medical evidence. The Applicant argues that
all of this medical evidence was before the GD and was overlooked.
[54]
However, as the Certified Record shows, much of this
evidence was not before the GD and so could not be taken into account by the
AD.
[55]
At the hearing before me on December 8, 2016,
Applicant’s counsel suggested that the Certified Record did not contain all of
the evidence that the Applicant had produced before the GD and the AD should
have checked this issue. The Applicant requested an adjournment to give him
time to check this matter out.
[56]
The Applicant had some 14 months to raise any
problems with the Certified Record but only did so on the eve of the hearing
and at the hearing itself. In addition, the Applicant produced nothing (an
affidavit would have helped) that the Court could rely upon to determine
whether the Certified Record is incomplete, or in what ways it is incomplete.
[57]
On the other hand, it would have been obvious to
Applicant’s counsel when preparing the Applicant’s Record and the Applicant’s Memorandum
of Argument if there was anything missing from the Certified Record. The Court
has before it the Certificate of the Tribunal which says:
Pursuant to Rule 318(1) of the Federal
Courts Rules, the Social Security Tribunal is forwarding certified copies
of the following material as requested by the Applicant.
A. Decision of Hazelyn Ross, Member,
Appeal Division
B. Application for Leave to Appeal to the Social Security
Tribunal – AD1
C. Decision of Jackie Laidlaw,
Member, General Division
D. General Division Letter – Appeal
Ready to Proceed
E. Notice of Hearing for the General
Division – GT0
F. Notice of Hearing – Administrative change of hearing date
and type - GTOA
G. Legacy File – GT1
H. Notice of Readiness with
Additional Documents – GT2
I. Claimant Submissions – Medical
Documents – GT3
J. Respondent Submissions – GT4
K. Claimant Submissions – Medical
Documents – GT5
L. Respondent Submissions – Record
of Earnings – GT6
[emphasis in original]
[58]
There is nothing before me to suggest that the
Certified Record is not complete. The Applicant appears to have submitted
medical evidence in this application that was not before either the GD or the
AD.
[59]
A reading of the GD’s decision shows the Member
setting out the evidence before her and dealing with it all in some detail. The
Applicant is suggesting she overlooked extensive evidence that he has now
produced for this application. This is not convincing and there is nothing
before me to suggest that the Court does not have the full Tribunal record. Given
the Applicant’s assertions that the GD overlooked important medical evidence
that supported his position, I requested the Applicant to file, post-hearing, a
list of citations to show where any unreferenced medical reports could be
located in the Certified Record. The Applicant has made further submissions on
this issue but has failed to show that any such unreferenced reports appear in
the Certified Record. Consequently, the Applicant now alleges that the reports
were before the GD but were not included in the Certified Record.
[60]
There is simply no evidence before me to support
the Applicant’s position on this issue. The Applicant has not provided
affidavit evidence on point or explained why his counsel did not, or could not,
challenge the Certified Record when preparing his Memorandum of Fact and Law in
July 2016, at the latest.
[61]
On the other hand, the Respondent’s affiant is
clear that all of the materials in the Respondent’s possession were examined in
assembling the Certified Record that was before the GD and the AD. The
Respondent’s affiant has also sworn an unchallenged affidavit saying that
Exhibits A and B of the Applicant’s affidavit were not part of the Certified
Record.
[62]
The Applicant, without evidence, is simply
asking the Court to accept that he submitted additional medical reports to the
GD that were excluded from the Certified Record.
[63]
Counsel for the Applicant now says in his
post-hearing letter of December 19, 2016 that medical reports of Dr. Gordon and
others were submitted by the Applicant in 2012 but do not appear in the
Certified Record. But, as Respondent’s counsel points out, when the Applicant
sought reconsideration on August 1, 2012, he referred to four reports that he
said demonstrated that his medical condition worsened from September 2009 until
July 2012. However, all of these reports can be found in the Certified Record.
[64]
In particular, the Applicant refers to the medical
reports from October 2006 to June 2008 listed in his Application Record under
Tab 3 [pre-2009 medical reports]. The Applicant claims these reports were
submitted in his application for a CPP disability benefit on February 6,
2012.
[65]
The initial denial of the application, dated
June 21, 2012, noted several documents that were reviewed, which ranged from
November 2010 to February 2012.
[66]
The Initial Adjudication Summary [IAS] refers to
the information provided with the application as:
• (ISP 1151) Application dated Feb 6/12 Signed by
Client
• (ISP 2507) Questionnaire dated Feb 6/12 Signed by
Client
• (ISP 2502) Authorization to Disclose Information (yes)
dated Feb 3/12 Signed by Client
• (ISP 2519) Medical Report dated Feb 25/12 Signed by
Dr O Samuel Last visit Aug 21/11
• Enclosed Documents: As noted below
[emphasis in original]
[67]
The IAS also notes the enclosed documents in the
Medical Reports section, which include medical reports ranging from November
2010 to March 2011.
[68]
The Applicant also claims that on August 1,
2012, he provided additional medical records from September 2009 to July 2012.
These records appear in the Certified Record and are referenced in the Tribunal’s
reconsideration decision dated October 12, 2016:
We reviewed all the information and documents
in your file, including all the reports you sent with your application and with
your letter of August 1, 2012. In addition to the reports listed in our letter
of June 21, 2012, here are the new reports we have on file:
• Your urologist’s report dated
June 2010
• Your orthopaedic surgeon’s
report dated November 2010 and previously on file
• X-rays dated October 2009
[emphasis added]
[69]
The Reconsideration Adjudication Summary [RAS]
also refers to the enclosures in the request for reconsideration: “Enclosures: Specialists’ and test reports dated September
2009 to November 2010”. The Medical Reports section of the RAS refers to
documents dated September 2009 to August 2011.
[70]
Based on the above evidence, it appears that the
pre-2009 medical reports that are alleged to be omitted from the Certified
Record were not submitted by the Applicant either in the original application
or in the request for reconsideration. There is no reference, in the initial
denial or reconsideration, of any medical reports that are pre-2009.
[71]
While the Applicant did submit additional
medical reports on August 1, 2012, these medical reports were considered by the
Tribunal and form part of the Certified Record. It is possible that the
Applicant mistakenly believes he submitted the pre-2009 medical reports in the
reconsideration request, but the reconsideration decision confirms all the
additional information received and the pre-2009 medical reports are not
included.
E.
Conclusions
[72]
Notwithstanding these disputed evidentiary
issues, I think the Applicant has identified a material error with the AD’s
Decision in that the AD failed to notice that there were persuasive grounds for
appeal on the basis of the medical evidence that was before the GD in that Dr. Samuels’
opinion in 2015 that the Applicant could not work, which opinion confirmed
earlier medical evidence that, as of the MQP, the Applicant had a severe and
prolonged disability that prevented him from returning to work.