HUMA Committee Report

Since its inception, CPP(D) has afforded only modest attention to help beneficiaries return to the workplace. In April 1990, approval was given to launch a pilot project in Ontario and British Columbia to identify potential CPP(D) recipients who could benefit from vocational rehabilitation services. The following year, this pilot was combined with a five-year national strategy on the integration of persons with disabilities and was extended to all provinces. In 1996, a proposal was approved to establish a Vocational Rehabilitation Program within CPP(D).¹¹⁸ Since then, vocational rehabilitation has become a permanent feature of CPP(D) and today this voluntary program works with each of those who participate in it to develop a customized return-to-work plan. Clients continue to receive CPP(D) during the rehabilitation period and on completion have a three-month period (with a possible extension of up to one year in certain circumstances) to search for employment. A three-month work trial is also provided and CPP(D) benefits are only terminated after the client has demonstrated the capacity to return to work.  To participate in the Vocational Rehabilitation Program, individuals must be: medically stable, motivated and willing to participate, reside in Canada and considered by a doctor to be a suitable participant. Rehabilitation services are provided under contract with private sector vocational rehabilitation providers across the country.¹¹⁹

Even though CPP(D) benefits remain premised on the fact that an individual will be permanently out of the workforce, the goal of helping CPP(D) recipients return to work has assumed a higher profile in recent years. The number of clients completing their participation in the Vocational Rehabilitation Program more than doubled between 1998-1999 and 2002-2003 (Chart 7.1). Some 322 individuals completed their participation in the program in 2002-2003, of which about one third of the participants regained the capacity to work and no longer received CPP(D). In 2002-2003, HRDC allocated $4.6 million to the Vocational Rehabilitation Program, a modest sum in view of the fact that HRDC estimates that those who successfully completed their participation in this program in that year saved CPP about $5.3 million over five years.  Given the estimated payback associated with the Vocational Rehabilitation Program, the Subcommittee believes that more resources should be allocated to it.

Many of those who participated in our online consultations and public hearings supported vocational rehabilitation and other initiatives designed to encourage individuals to return to work following disablement. Some called for an increase in what was sometimes referred to as an “earnings exemption.” All CPP(D) beneficiaries are required to inform HRDC when they earn more than $3,900 annually. However, this amount is not an earnings exemption; it is simply a mechanism for HRDC to consider a client’s current capacity to work, future work goals and to discuss supports that are available in the community. More importantly, it is nota threshold at which CPP(D) benefits are terminated. In fact, the earnings threshold for considering whether CPP(D) benefits should cease is much higher and is set at an amount equal to 25% of the most recent five-year average of the year’s maximum pensionable earnings. This amount is known as “Substantially Gainful Occupation” (SGO), which in 2003 is equal to $9,615, or $801.25 per month, more than 80% of the maximum monthly CPP(D) benefit.

7.1       What We Discovered

Our issue poll asked respondents if they would agree or disagree with paying higher CPP contributions to: (1) allow people who have tried to return to work to be immediately reinstated if they qualified for the benefit in the past; (2) allow people to engage in more part-time work by increasing the earnings exemption; and (3) encourage more vocational rehabilitation where possible.¹²⁰

A majority of respondents (approximately 85%) either agreed or strongly agreed to pay higher contributions to support these proposals. Overall, a breakdown of respondents by category of identification revealed wide agreement on this particular issue. During our public hearings, government representatives, medical rehabilitation specialists, members of the business community, NGOs and injured workers expressed similar support for measures to encourage CPP(D) beneficiaries to return to work.

So legislation may have to be changed in a way that allows them to return to work and maintain the benefit before they can return to work entirely, which is part-time work. If they could change that rule and then also reward them with more benefit, instead of maintaining the same benefit. ... They are afraid. People are afraid of losing the benefit, which is $1,000 per month. If they go back to work part-time and they don’t have the salary equal to that amount, they won’t want to come back to work. So something has to be done with the legislation to allow that to happen. (Dr. Lily Cheung Past President, Occupational and Environmental Medical Association of Canada)¹²¹

I feel returning to work is important but this has to be determined on an individual basis and without unnecessary pressure on the individual. Most people want to return to work (I realize that some have no intention to) but, the people who are doing everything they possibly can, have to rehabilitate at their own pace. People also have to be at a certain level of their illness or disability in order to have the energy to put into rehabilitation. After all, who really wants to be disabled and unable to contribute financially to their families and feel worthwhile. (Marjorie, NB, E-Consultation Participant)

I have been taking a few courses to improve my marketability — if I feel able to work at least part-time. I have been diagnosed with MS and I live with uncertainty of each day etc. I am a nurse and if I am able to work even casual part-time I will exceed the amount I can earn very quickly. I then run the risk of losing my pension and this is a concern as I cannot commit to the consistency of work as others do. If the pension is withdrawn and I am ill even at a casual part time level I will not have money to eat or pay rent. This is a difficult way to live and if it can be changed it would help many of us. (Elizabeth, ON, E-Consultation Participant)

7.2       CPP(D) and Earnings, and the Automatic Reinstatement of Benefits

To promote the development of work-related skills, CPP(D) beneficiaries are not required to report to HRDC if they engage in volunteer work or attend school. However, as noted above, a CPP(D) beneficiary is required to contact HRDC when his earnings reach $3,900 (2003), at which point a discussion about the individual’s current work situation and future work goals takes place. If the CPP(D) beneficiary can only work once in a while, he may be able to earn more than $3,900 while in receipt of CPP(D) benefits. An assessment is made to determine if, and when, a work trial is appropriate. A three-month paid work trial begins only when the client has demonstrated regular capacity to work and has earnings exceeding the monthly SGO (i.e., $801.25 in 2003). If the client continues to earn at least the SGO monthly amount during this three-month trial period and is working regularly, then an individual is considered to have successfully returned to work and CPP(D) benefits cease. During the three-month work trial, if an individual’s disability precludes a successful return to work, CPP(D) benefits continue. Within a five-year period of successfully returning to work, if a former CPP(D) client is forced to stop working because of the same medical condition, the individual may be able to use the “fast-track” re-application process.¹²²

To be eligible for “fast-track” re-application consideration, a number of conditions must be met that include:

Our online and public testimony generally supported encouraging CPP(D) clients to return to work, provided this was done without exerting undue pressure on them. In this context, many also supported lengthening the return to work trial period and the period for the automatic reinstatement of CPP(D) benefits in the event that an individual’s disability forces a withdrawal from the workplace following a successful return to work. We support both of these positions.

We’d also like to see the program increase the trial period. Currently, the trial period when you go back to work is three months. We don’t feel that is enough time for someone to evaluate their new work environment, to be able to evaluate the skills that are going to be required, whether this is a high-stress job, as well as what kind of physical capacity is going to be required of them. This is especially important for people who have been out of the workforce for a number of years. Currently, many people living with HIV have been on disability for five to ten years, and to return to the workplace is going to take quite a bit of training and rehabilitation. (Ainsley Chapman, Program Consultant, Canadian AIDS Society)¹²³

We had several suggestions around the payments; for example, retroactivity going from the date of disability, and incentives for trial returns for work, so that people, again, attempting to return to work are not in essence penalized and losing their benefits if they try for a number of months and then it doesn’t work. (Dr. Cheryl Forchuk, Chair, Core Policies, Office of the Commissioner of Review Tribunals Canada Pension Plan/Old Age Security)¹²⁴

Many of these people are gainfully employed when they are diagnosed with rheumatoid arthritis, often they need to go on disability because of fatigue, joint pain and inflammation of their joints. … Often they will go on disability for a short time to get medications regulated to treat their disease. When it comes time for them to try to return to work, they need to start back on a modified work schedule, however the expectations no matter how good the intentions start out to be, the patient is expected to perform the full duties in half or less time than previously expected. It is unfortunate that we do not have a system either insurance or CPP that facilitates these people to return to work in an environment that is organized for them to succeed instead of to fail. It seems that the system is such that it is better for them to remain on disability than to be a burden to the workplace. These people are demoralized and made to feel a burden on society. How about a system that will facilitate them to be productive citizens, as many of them want to be. (Terri, ON, E-Consultation Participant)

It is imperative that, given the episodic nature of HIV, individuals can easily make the decision to stop working and have disability benefits reinstated quickly. The mechanisms currently in place require unreasonable waiting periods for evaluation and decision-making. Many people who are on disability do not have a pool of personal financial resources, either through cash, credit or assets, and are not in a position where they can rely on savings to be reimbursed if approved. (Canadian AIDS Society and Canadian Working Group on HIV and Rehabilitation, ON, E-Consultation Participant)

It may be that in some cases recipients will be able to reintegrate into competitive employment, either permanently or for shorter periods of time. CPP should be encouraging this outcome by providing recipients with assistance in returning to work, and implementing a "rapid reinstatement" program that would encourage and support recipients who chose to return to work. A "rapid reinstatement" program would allow CPP disability recipients to attempt to return to work, and if that proves impossible, they would be automatically and immediately reinstated to their CPP disability status, without having to reapply. (Northumberland Community Legal Centre, ON, E-Consultation Participant)

A major disincentive facing CPP(D) recipients who contemplate a return to work pertains to the negative affect of a modest increase in earnings on other disability income and supports. As noted in the previous chapter, this problem arises because of the poor interface between all these various sources. The combined loss of disability income and supports often outweighs the benefits of earnings and, as a result, undermines the incentive to return to work. A number of years ago, HRDC participated in a pilot project to address this very issue. We understand that the results of this exercise were positive and we believe that HRDC should engage in more of these pilot projects to test various approaches involving other disability income and support providers so as to determine what works best in overcoming these return-to-work barriers.

… this was actually several years ago now. HRDC through Canada Pension Plan and some other programs in the region of BC linked up with several BC ministries … with the auto insurer, and the WCB, and a private insurer. We actually ran a pilot for about 18 months. A return to work, removing the barriers for people on income assistance who are on more than one program, they had to be on more than one program … we found about 70 mutual clients. It was really hard to convince them to take the chance of returning to work. We got about 15 people to actually go through a return to work process. Part of it was the fear — well, the fear of losing the benefit. We couldn’t guarantee to everybody that if something happened, they could get back on the benefits that they had left. Secondly, there was the interface issue between the various programs that was very hard to resolve. But, that was the purpose of learning more about how to work together in that environment. Fortunately, the people that did try, and got jobs, I think got very well-paying jobs. We found more jobs than we had people who were willing to try … (Nancy Lawand, Director of CPP Disability Policy, Income Security Programs Branch, Human Resources Development Canada)¹²⁵

Although not directly related to an incentive to return to work, many who participated in our a study expressed a desire for CPP(D) to be more supportive of those who have returned to work by providing partial benefits to those engaged in part-time work. While we support incentives to encourage CPP(D) beneficiaries who want to work as much as they believe they can, most members of the Subcommittee do not believe that CPP(D) can offer a bigger earnings supplement than is now being provided (i.e., earnings up to the SGO amount) without compromising the current universal nature of this program by moving it closer to a means-tested benefit. We nevertheless recognize that earnings supplementation would form an essential component of a reconfigured, fully integrated pan-Canadian disability income and support system. Since it is important to better understand the employment incentives associated with this type of support, we think HRDC should undertake a pilot project to test this out.

7.3       Vocational Rehabilitation

Between 1998-1999 and 2002-2003, HRDC’s aggregate allocation to the Vocational Rehabilitation Program totalled $21 million or an average of $4.2 million annually. In our opinion, this is a very small effort for a program that pays out more than $2.5 billion in disability benefits each year. This effort seems even smaller considering the testimony we received that outlined the significant benefits from vocational rehabilitation, provided the intervention is early and comprehensive.

We believe strongly that there should be strengthening of the vocational rehabilitation initiative. Essentially, the area of people with disabilities returning to work has win-win possibilities. Everyone agrees that it should happen, but it still appears that people with disabilities get a very mixed message. On the one hand, yes, they should work; we’re encouraging them to work. On the other hand, if they pursue rehabilitation and return to work, we are going to reclassify them as not disabled enough for our program. I think that is really not something that can be addressed by tinkering but requires a more in-depth look at disability assessment and how it’s done, with perhaps a broader perspective than just a medical one, as was indicated before. (Harry Beatty, Canada Pension Plan (Disability) Working Group)¹²⁶

According to an evaluation of the National Vocational Rehabilitation Project in 1996, the 160 clients who successfully completed their rehabilitation plans saved the CPP an estimated $4.5 million after three years, $15 million after 10 years and $30 million by the time these former CPP(D) beneficiaries reached the age of 65. However, the evaluation notes that the true cost savings could not be estimated because the longer term impacts of the program were not known.¹²⁷ As far as we can ascertain, this is still the case today and in our opinion, HRDC should try to estimate the longer term impacts of the Vocational Rehabilitation Program.

Medical advances continue to increase the likelihood that some individuals with a severe disability can experience a meaningful return to work. Moreover, we suspect that as our labour force continues to grow more slowly, an increasing number of employers will become aware of the need to provide adequate accommodation measures for persons with disabilities in order to attract the skills they need into their workplaces. We think that these factors will serve to create a more appealing climate for CPP(D) beneficiaries to return to work and, in our opinion, HRDC should begin immediately to enhance the role played by vocational rehabilitation in its overall CPP(D) policy.

I was receiving benefits after a double kidney transplant and things seemed to be going well. I contacted CPP about a year into my recovery to discuss the possibilities of retraining. I am a welder and was unsure if I would be able to handle the heavy work and the fumes etc. that go with the job. I was told that they would gladly retrain me as long as it was within reason and I was stable enough to complete the training. At this point I was still returning to the hospital every month, meds were up and down and I didn’t think I was stable enough. I was told to contact them again in six months and we would see. About six months later I was contacted by CPP and notified that my benefits would terminate at the end of November. I thought well that is sudden but if I’m lucky I can get a job. I called the office in Ottawa to find out what happened to my retraining option and this is what I was told. I had been placed on reassessment and my Doctor considered me a successful transplant and so benefits were cancelled. As to retraining I was told they won’t retrain me if I’m unstable (which I thought made sense) once on reassessment it is illegal to retrain me and once declared successful they no longer have to. (Greg, NWT, E-Consultation Participant)

The Subcommittee was informed of several relatively recent initiatives that have achieved success in helping persons with disabilities return to work. These involved both an early response to an individual’s departure from the workplace as well as the joint participation of many stakeholders in facilitating a successful return to work. For example, the Ontario Roundtable Project on Safe and Timely Return to Work involves 15 stakeholder sectors, including the medical community, working together to create a coherent and seamless system from disability, to function and to work.

… let’s use stakeholder energy to build this comprehensive system. We need federal government support for these projects. This will help create a clear path from disability to ability and support those who do not have the ability. The benefits of a better system of return to function will result in improved function, health, and productivity at all levels, at the levels of individuals, organizations, communities, and the country. The process must support the person. (Dr. Lisa Doupe, Co-Leader, Round Table Project on Safe and Timely Return to Function and Return to Work)¹²⁸

The Sherbrooke model brings together early detection, early participatory ergonomics, reassurance of disabled workers and early rehabilitation initiatives centralized in the workplace.

… the [Sherbrooke model] … was tested through a randomized trial … That research included 31 companies … One group received a more clinical type of intervention and another a workplace-based intervention. Finally, the Sherbrooke model brought clinical intervention into the workplace. You have a statistic here that indicates the time generally required for a person to return to regular work. As you see, the Sherbrooke model resulted in a return to work that was 2.4 times faster, and the main factor for that result is the intervention in the workplace. Is this expensive? Well, we did a follow-up six years later of workers who were included in the model. … The costs were a little higher at the time of intervention, so there was an initial investment. … However, in the following years, the costs associated with disability were avoided … Health care costs are … much higher for the control group, not to mention the income replacement costs, which were considerably higher … If the same study were carried out today on the same people, the gap would be greater, because those receiving a pension until their retirement would continue to cost money. (Dr. Patrick Loisel, Professor, Faculty of Medicine, Longueuil Campus, Université de Sherbrooke)¹²⁹

In addition, the Canadian Imperial Bank of Commerce has developed a program called “Co-ordinated Return to Work” based on an abilities-based model for disability management in the workplace. It involves third-party intervention to identify a disabled worker’s abilities and this approach has helped workers and managers in the vast majority of cases to identify necessary workplace accommodations and job functions that result in the continued employment of persons with disabilities.¹³⁰

In our opinion, all levels of government must continue to support the development of timely and comprehensive responses to assist persons whose disabilities either threaten the loss of employment or are likely to result in a prolonged absence from the workplace. These types of initiatives need recognition, encouragement and rewards.

An early intervention is also critical for individuals to gain access to Employment Insurance Part II benefits (i.e., Employment Benefits and Support Measures — EBSMs).  Participation in these requires individuals to be eligible for regular EI benefits or to have received regular benefits in the past 36 months or maternity/parental benefits in the past 60 months. Members of the Subcommittee maintain that eligibility for EBSMs is too restrictive for unemployed individuals generally, and for persons with disabilities in particular, given the fact their disabilities often result in a tenuous attachment to the workplace, thus making it very difficult to qualify for these benefits. In addition, we think that the income support provided to individuals who participate in EBSMs should be treated as earnings for the purposes of qualifying for CPP(D).¹³¹

Finally, members of the Subcommittee believe that it is time to realize the long promised commitment in the 2002 Speech from the Throne to fast-track a comprehensive agreement to remove barriers to participation in work and learning for persons with disabilities. We know that provincial Ministers of Social Services approved a framework for a comprehensive strategy in December 2002. But this is not an agreement and we strongly encourage both levels of government to move quickly to help facilitate the return to work of all persons with disabilities capable of doing so.

In addition CPP(D) employment retraining programs are limited to those who are "job ready". People with Multiple Sclerosis do not fit that description due to the unpredictability of their disease. (Vida, ON, E-Consultation Participant)

Lastly I would like to address the incentives CPP Disability has for encouraging people with disabilities to return to work. To be brief — fantastic. Because of them I had the courage to return to work. My caseworker was very supportive and I have been successfully working for one and a half years helping other consumers become actively involved in the community again. Working again has had a very positive effect on my mental health as well — almost two years without hospitalization and no major depressive episodes [the longest period of time since before 1991!]. (Roy, NS, E-Consultation Participant)

… programs like CPPD that equate disability with unemployability create a huge barrier for people. If a start could be made to changing the provisions so that people who were undergoing training or education could return to work with less possibility of losing their eligibility.... it’s almost as if we’re saying to people: just remain dependent; don’t do anything. (Harry Beatty, Canada Pension Plan (Disability) Working Group)¹³²

Recommendation 7.1

The Committee recommends that Human Resources Development Canada double its budget of $4.6 million (2002-2003) for the Vocational Rehabilitation Program and begin to measure the long-term impact of this program on the success of clients’ return to work and the total economic benefits associated with these outcomes.

Recommendation 7.2

The Committee recommends that Human Resources Development Canada undertake a pilot project to measure the impact of increasing the amount associated with substantially gainful occupation (SGO) to 125% of annual maximum CPP(D) benefits. In addition to measuring the impact of this measure on program costs, this pilot project should study the benefits and work incentive effects of a gradual reduction in CPP(D) benefits as the earnings of project participants exceed the experimental SGO threshold following the return-to-work trial period.

Recommendation 7.3

The Committee recommends that Human Resources Development Canada extend the three-month work trial period to six months and provide an immediate and automatic reinstatement of benefits for two years following a successful return to work.

Recommendation 7.4

The Committee recommends that the federal government create the necessary conditions to permit Human Resources Development Canada to implement pilot projects that test various approaches for integrating CPP(D) with other disability income and supports, including the medical community, to strengthen incentives for beneficiaries to return to work.

Recommendation 7.5

The Committee recommends that the federal government increase expenditures under Part II of the Employment Insurance Act as well as extend eligibility for these benefits to a much broader population than is currently captured under the definition of “insured participant.” Moreover, Part II benefits should be treated as pensionable earnings for the purpose of determining CPP(D) eligibility.