Eligibility

The Ontario Disability Support Program (ODSP) provides income support only to those who meet a certain set of qualifications.  To be eligible for benefits, you must:

• Be 18 years of age or older
• Reside in Ontario
• Be able to demonstrate your financial need
• Live with a substantial mental or physical disability

A substantial disability is one that is expected to persist for one year or longer.

It also must make it difficult for you to:

• Work or earn an income
• Participate in family or community activities
• Participate in self-care activities, such as dressing, bathing, etc.

The Ontario Disability Support Program (ODSP) uses the Ontario Disability Support Program Act as a guideline when assessing whether an applicant meets these qualifications.

Providing Evidence of your Disability

The most onerous part of qualifying for ODSP is to establish that you have a long-term or permanent disability that is recognized under the Ontario Disability Support Program Act.  While you may believe you should qualify and you doctor may indicate that he believes you should qualify, it is not uncommon for applicants to be denied, especially upon their first time applying for ODSP. 

When applying for ODSP the Disability Adjudication Unit of the Ministry of Community and Social Services will examine your application and supporting evidence to determine if you meet the program's definition of disabled. 

This unit will assess your Disability Determination Package when evaluating your claim.  This package may include the following forms:

• Health Status Report and Activities of Daily Living Index
• Self-Report
• Consent to Release Medical Information

You do not have to complete this portion of the application process if you already meet certain qualifications.  These include:

• You already receive federal disability benefits via the Canada Pension Plan
• You already receive disability benefits via the Quebec Pension Plan
• You are 65 years or older but do not qualify for Old Age Security
• You live in a qualifying institution, such as a mental health facility or a residential facility catering to those with certain developmental disabilities

All applicants must meet the financial eligibility guidelines in order to qualify for the Ontario Disability Support Program.

The Financial Assessment

Upon successfully being accept onto ODSP you will be assigned a case worker.  If you have made it this far, that case worker will setup a meeting with you where they will go over your financial needs.  They will require details about your finances and resources.  You must provide this information during your initial meeting and provide updates to any changes to this information at regular intervals.  Failure to provide honest and accurate information can not only result in you being terminated from ODSP, but can often lead to an overpayment and in some cases even fraudulent criminal charges.

Be prepared to provide information such as:

• How many people are included in your immediate family, including dependent children
• Whether you are married or can account for any other adult dependents
• Your monthly living expenses
• Other sources of income
• All available assets (such as bank accounts, vehicles and property)
• Previous year tax assessment
• Signing an authorization for ODSP to review your information and yearly taxes with CRA

Representation for ODSP Reviews and Appeals

Once you've filed your application with ODSP and waited the 8 to 12 week time period for your application to be reviewed and you have received your decision letter.  Should the letter indicate that you are not qualified for ODSP you can choose a number of options:

• To request a reconsideration or review
• To appeal the decision
• To accept the decision and re-apply for ODSP with updated medicals

More often than not being denied for ODSP on your initial application is a result of insufficient information to establish you have a disability that falls under the act.  You can choose to accept the decision and re-apply for ODSP, however by doing so you forfeit any retroactive monies owed to you from the initial date you initiated your application.  For some, this may only be a period of a couple months and re-applying is not that detrimental to your financial situation.  However, to others you may have applied one or even two years prior to finally receiving a decision determining you ineligible and by forfeiting your option to review or appeal the decision, you also forfeit all of the money owed to you since the initial date of your application.

This is why we encourage people who comes to use to retain our services for their ODSP matter so that a knowledgeable representative will ensure you get what is owed to you. 

Upon taking your matter on we will represent you throughout the review process and, if necessary, the appeal process.  We will review the entirety of your application and your medical records in addition to reaching out to your medical practitioner and requesting additional supporting documentation that may have been missing during your initial consideration.  More often than not, we have been successful on appeals solely due to medical evidence not being properly compiled or available for the adjudication unit to weigh and consider and in some cases just not being accurately argued and or having significant weight put to it.

Do I really need to hire a lawyer?

It can be extremely difficult to undergo this process on your own, not being able to find the answers to your questions and not being prepared for what lies ahead.  Navigating the process can be painfully frustrating and in some cases feel down right unfair.  This is why representation pays for itself in that they help prepare you for each step of the process and ensure your application is being given the proper weight as well as all of your documentation supports your claim.  For representation before the ODSP adjudication unit you can hire both a paralegal or a lawyer, just ensure whoever you choose has the knowledge and experience to take on the roll.

What are the costs involved?

Because ODSP Reviews and Appeals typically involve people with restrictive finances, we will more often than not take on your matter on contingency.  This means that there are no upfront legal costs to you and we only get paid if we are successful.  In the event that we do not feel you may have a strong claim or that you may not qualify for ODSP, we will consider whether or not payment on contingency is available to you or whether we would require an upfront retainer fee to work on your matter.

How long does the Appeals process take?

In most cases the Appeals process takes anywhere from 6 months to a year depending on both counsel availability and how backlogged ODSP is. 

What do I do for income in the meantime?

During this time you will be deemed ineligible and not receive any income support from ODSP.  If you are without employment due to your disability during this time you may apply for Social Benefits through your municipal Social Benefits office.  This can provide you with a basic form of income to help cover your rent and costs of living until your Appeal is heard and a determination is made.  You may be required to pay Social Benefits back any monies given to you during this time if you are successful on your ODSP Appeal and are deemed eligible for ODSP. 

What are my options if I am unsuccessful on my Review or Appeal with ODSP?

If you have requested a review already and the reviewing officer determined you are ineligible and you have already proceeded to appeal and were still determined ineligible you have two options available to you:

• Accept the decision and re-apply for ODSP with updated medicals
• Appeal the decision to the Ontario Social Benefits Tribunal

Appeals to the Ontario Social Benefits Tribunal

When you have exhausted all of the recourses available to you through ODSP you can bring an appeal before the Ontario Social Benefits Tribunal (SBT).  The SBT reviews the decisions of those who are denied eligibility for Social Benefits or ODSP. 

Appeals before the SBT are more complicated than Appeals heard before ODSP as the process to apply is different and less laid out for applicants.  In addition, arguing the matter before the SBT requires knowledge in both the guidelines as well as the law. 

We recommended you have a qualified legal representative handle your matter when it escalates to an appeal before the SBT to ensure your rights are preserved.