February 24, 2014
Via Facsimile:
1-855-814-4117
Social Security
Tribunal
Attention: General
Division (IS)
PO BOX 9812, STN T
CSC
Ottawa ON K1G 6S3
Re: January 15, 2014
Client Identification Number - xxxxxxxx
SIN
#xxxxxxxxx
Dear Social Security
Tribunal:
I acknowledge receipt
of a decision by Service Canada dated January 15, 2014 denying my CPP
Disability benefits. Please accept this letter as my formal appeal to
that decision.
My first application
for disability benefits was in 2008. I was told I would not receive
disability benefits because my case would have to be resolved first.
My Doctor did not fill in the first medical report in my claim for
Disability Benefits in 2008. (My doctor has since filled them as you
know.)
My conversation with
Service Canada further verified at that time, that my application did
not have to be filed at that time “ we will look into your
entire file when we make a decision” , “funds would be
retroactive to 2008” “when I reapplied at a later time”.
Both our lawsuits were
unable to receive justice from the justice system in 2010. To be
clear, the crash was not my fault and we were not justly compensated,
we were burned by the insurance system and the justice system. Our
lawsuits were concluded by a forced settlement due to the FSCO
backlog and fraudulent pay for hire doctors, and much of the same
conduct that Service Canada has been providing and supposing.
Service Canada is
fraudulent in their letter of January 15, 2014. The excuses for
denial of benefits fail to provide any reasonable valid reasons.
Health Canada Says:
“According to your doctor you received a sprain to your
neck and back and receive pain”. Why is Service Canada
downplaying my injuries?
Many disability
certificates and doctors reports as you know from 2007 – 2010 say
different.
“WAD III” ,
“Associated ICD-10-CA code for injuries and sequelae that are the
direct result of the automobile accident Code numbers: F39, F41, G44,
R51, S034, G47, M545, S33, M546, M6261, S49, R41, S19, Z56, Z723,
Z733, Z736, M501, S234, S8340, F067, S9351”.
The Diagnostic imaging
Report in 1999 states: “Early degenerative disc desease at C6-7”
In the March 28, 2012
Psychological Legal Assessment Report by xxxx and xxxx states:
“Moderate Major Depressive Disorder, PTSD in partial
remisssion”, “we are of the opinion that this man suffers
permanent and serious impairment with respect to overall
psychological functioning”.
Page
1 of 22
Health Canada Says: “I
have the ability to do sedimentary work”.
Report dated March 12,
2012 by xxxx Occupational Therapist / Director states the following:
“Mr. xxxx is completely disabled for any
occupation to which he is suited by way of his education, training or
experience”.
Even for the healthy
and uninjured finding work in our area- is very difficult, if not
impossible.
The Niagara area
reports highest unemployment rate in Ontario.
According to Niagara
this weeks newspaper article January 16, 2014
“NIAGARAS
UNEMPLOYMENT RATE HIGHEST IN ONTARIO.”
Add to the resume that
you are a 53 year old 3rd generation truck driver with
nerve damage in my spine and can’t drive much because of the pain,
etc., then add to the resume you have limited education from 12 grade
schools, reaching a level of only grade 9. What is suitable,
available, work for me?
The imaginary laptop
that Service Canada mentions in their denial letter January 15, 2014
was never provided by my insurer.
Service Canada comments
about work are unfounded and as you know I have been thoroughly
investigated by doctors, therapists, lawyers, and insurance
investigators at a great cost.
As you know I was in
the Insurance fiasco for 6 years and cooperated with all
interrogations (eg; rehabilitation, work hardening, multi
disciplinary assessments, situational assessment etc.). I tried to
go back to work after the crash, on my own, and was unsuccessful. The
issue of work has been answered at great physical, mental, and
financial lengths.
In the Service Canada
Denial letter of January 15, 2014 it states the following to
establish denial of benefits:
(1)- “in
2011 you were provided with a utility tractor for you outdoor
maintenance.”
(2)-“This tractor
included a backhoe and a loader.”
(3)-“This work
activity would be indicative of capacity for suitable work”
I WAS NEVER PROVIDED
WITH A TRACTOR WITH A BACKHOE FROM MY INSURER
Service Canada is
fraudulent in writing that I did. According to E. Chase- Medical
Adjudicator, Service Canada letter of January 15, 2014 she writes:
“According to the
occupational therapist in 2011 you were provided with a utility
tractor for you outdoor maintenance. This tractor included a backhoe
and a loader.”
How could a medical
adjudicator have written such an uneducated sentence?
If E. Chase- Medical
Adjudicator had given my application the attention it deserves than
he/she would know of the attached copy of the file management log by
Vista Disability (the assessment mill).
The log will prove the
assessment mill getting instructions from my Insurance adjuster (xxxx
-xxxx Insurance) to deny this device. His instructions to the
Occupational Therapist were Pryor to his examination (interrogation)
at our home.
My adjuster xxxx says
in the log: “he would like the OT to go to the home and
address the OCF -18 regarding a tractor for approx $25000.00. Advised
OCF -18 would be denied next week so Ax
in week of Nov 14th”.
The Occupational
Therapist xxxx then came to our house to write the
denial report as he was instructed and agreed upon (“xxxx
called and confirmed Ax”).
Page
2 of 22
The following will
provide even more evidence to prove that I WAS NEVER PROVIDED WITH
A TRACTOR WITH A BACKHOE FROM MY INSURER:
The assessment mill
excerpt below, and email attached, will show that even after my
insurer received the paid for hire doctor report it still wasn’t
good enough for my insurance adjuster xxxx of xxxx Insurance.
Email #1states the
following:
From:
xxxx
Sent:
November 28-2011 3:08 PM
To:
xxxx
Cc:
'xxxx'
Subject:
xx – OT OCF-18 In-Person – (Kaine) – due ASAP
“Green highlights
are revisions for xxxx. Due to the adjuster – ASAP.
xxxx mentioned xxxx would like to see
this report, so I have copied her.”
Email #2 states the
following:
From:
xxxx
Sent:
December -02-11 9:03 AM
To:
'xxxx'
Subject:
RE: xx – OT OCF-18 In-Person – (Kaine) – due ASAP
Follow Up Flag:
Follow up
Flag Status:
Red
“Hi xxx,
xxxx has reviewed and approved the revisions. The final
is saved to the claimants folder.”
As you know the tractor
that is mentioned above and in the Service Canada denial letter of
January 15, 2014 was explained in the xxxx OT submitted treatment
plan of May 4, 2012.
As the report states
the tractor was to enable me to:
(1)- “to maintain
his 1.5 acre property.”
(2)- “The
recommended tractor is anticipated to minimize the effects of Mr.
xxxx functional losses.”
(3)- “the client
would be able to pace himself”
(4)- “is best
suited to meet his property maintenance needs”
If the purpose of the
tractor was for work (it wasn't according to the treatment plan
above), and if I had received this assistive device from my insurer
(I didn’t as proved above), I would still need funds to buy
equipment to haul the tractor. A truck and trailer etc. would be
necessary. Then even if the money fell from the sky to provide these
funds then I would need to get training, and licences, and insurance,
to operate the tractor/backhoe as a business.
Then I would need to
find work in an area that has “the highest unemployment rate in
Ontario.”
Most of all I would
then need the health and stamina that I do not have because of the
injuries I sustained in the fatal crash of 2007.
Page
3 of 22
How can a Medical
adjudicator have concluded that I can work driving something?
If Service Canada had
completely read my medical file then they know I am limited in
driving because of my injury’s sustained in the crash.
The Psychological Legal
Assessment Report dated March 28, 2012 states the following:
“He is incapable
for psychological reasons of returning to any work that involves
driving, and clearly is incapable of returning to his lifelong
profession as a driver.” “This also poses a barrier to work in
general, as he is avoidant of leaving home due to fearfulness in the
car.”
Why would Service
Canada deny my claim for a benefit I am clearly entitled too?
If I had to make some
guesses why a Service Canada Medical Adjudicator would act
unreasonable I would guess that it’s because they know I am an
outspoken critic of the track record to receive CPP Disability
benefits and write a blog about Service Canada and the Insurance
industry.
Could the reason why
Phyllis Brodie, Medical Adjudicator- Service Canada denied my
Disability benefits was because Service Canada did not like my fax
letters?
Would a Medical
Adjudicator act unreasonable toward me because I filed a complaint to
the Collage of Physicians and Surgeons of Ontario about a doctor pay
for hire interrogation?
Would an insurance
decision maker be biased as to my claim for benefits because I have
written letters to FSCO on what I have learned about Insurance
industry practices?
Maybe why a Medical
Adjudicator would act unreasonable is because as they know I am an
active member of Fair Association of Victims for Accident Insurance
Reform, and publicly disputed an IBC advocates remarks.
I don't know why I have
been denied Disability benefits but there is enough evidence to
establish that Service Canada did not read my health file prior to
making a decision to deny my CPP Disability Benefits, or they did
read my health file and are committing a crime.
In the case of the
latter we are enquiring an investigation into the following
individuals that work for Service Canada:
(1)- E. Chase Reg. N,
Medical Adjudicator, Service Canada.
(2)- L. Cuthbert,
Benefits Officer - Service Canada.
(3)- Phyllis Brodie,
Medical Adjudicator- Service Canada.
The quality of health
care is in crisis. The white coat black art podcast at CBC radio
episode December 27, 2013 states: “We have to make
partners out of patients because I will help keep you from making
catastrophic medical errors if you just let me be on my own care
team. The hazards would be far fewer if we were like pilots. We're
passengers in our own plane.”
“This means I am
let in on the conversation so I may be informed and I may help
correct the human mistakes Doctors are so destined to make”.
My insurer has deleted
files in my file at HCAI. There have been assessment mill errors
writing the records for the doctors, errors by doctors, and even
anonymous access to my medical file at the HCAI online database. Now
Service Canada has altered my health file to provide false
representation.
Page
4 of 22
Phyllis Brodie, Medical
Adjudicator- Service Canada has admitted that “we know you
cannot work” in her denial letter of July 16, 2013.
Again, how can Service
Canada write “we know you cannot work”, and at the
same time deny my disability?
Service Canada and the
Insurance industry have made me feel that I have entered a world of
unicorns leprechauns and magic beans. There should be legislation to
protect the most vulnerable in our society.
Obviously there is
something wrong if a crash victim must be put threw a process that is
designed to fail. It’s very disturbing that Service Canada can deny
a claim without even speaking to a claimant. Saying in denial letters
“we tried to contact you” without even a phone message -
is not trying.
Injured victims deserve
better treatment.
Service Canada does a
lot of imagining in denial letters. But as you know the 18 year old
boy that was speeding, and passing on a solid double line, and blind
hill, that hit me head on, at 102 km per hour,
taking off the front
wheel, and making me roll 8 times, with the airbag going off in the
side of my head at a force twice as powerful of that of today’s
cars, and hit a tree, and was trapped upside/down in the twisted
seat, has left me with severe and prolonged injury’s.
Doctor Report date Feb
10th 2012 states:
“Cervical Spine
(July 17th , 2007) –C6-C7 and C7-T1 disc
spaces can not be commented on secondary to obstructed view.”
“MRI (September
2008) 1 year post MVA and C-Spine x-ray:
Degenerative Disc
Disease worse at C5-C6
-Moderate spinal
canal stenosis c4 c5
-Bilateral
neuroforaminal narrowing C3-C4
\-C6-C7moderate to
severe right rear frontal narrowing and moderate left rear frontal
narrowing”
“suffered significant
LONG-TERM and PERMINANT disability secondary to the motor vehicle
crash on July 17th 2007:
- Chronic Myofascial Pain Syndrome of the Neck.
- Chronic Myofascial Pain Syndrome of the Trapezium.
- Chronic Mofascial Pain Syndrome of his shoulders Bilaterally.
- Biceps Tendonosis in his left shoulder.
- WADS lll of his neck
- Occipital Neuralgia;
- Cervical Degenerative Disc Disease and Canal Stenosis”,
“obvious
degeneration and disease in Mr. xxxx spine”,
“at least 60-
70 % of his pre-accident function”,
“it is
medically sound to conclude that Mr. xxxx suffers form Degenerative
Disc Disease in his Cervical Spine, as well as debilitating
MyoFascial pain syndromes in his cervical spine trapezium and
Bilateral shoulders”.
Page
5 of 22
The reality is that I
suffer in constant pain, and I wonder what it would be like, to not
have to fight for years in a realm of dishonesty, for the rights and
security I paid for all of my adult life.
I do not belong in your
world please conclude this conflict as it is detrimental to my
recovery.
Please accept this
Notice of Appeal to the tribunal as instructed by the Service Canada
letter of January 15, 2014. I kindly ask that CPP Disability Benefits
be granted without further delay, denials, and fraudulent conduct.
Please acknowledge
receipt of this correspondence.
I look forward to
hearing from you in this regard, as soon as possible. Thank you.
Sincerely,
Mr. xxxx
*
I would like to thank my wife for making this letter intelligible and
supporting me emotionally, physically, and financially,
with
her part time job since the crash in 2007.
Attachments
First Mailings:
-File
management log xxxx Disability February 8, 2012
-xxx - xxxxxxx December 12, 2011
-Cpp
Decision -July 16, 2013
-Cpp
Decision -January 15, 2014
-Cpp
Decision -February 5, 2014
-pictures
of crash
First mailings March
2014:
Cc: Dr. xxxxx
Cc: Rhona DesRoches,
Board Chair - Fair Association of Victims for Accident Insurance
Reform
Cc: Phyllis Brodie,
Medical Adjudicator- Service Canada
Cc: E. Chase Reg. N.
Medical Adjudicator – Service Canada
Cc: A. Trudell, Benefit
Officer - Service Canada
Cc: Surviving a
Collision Blog