Tuesday, February 25, 2014

CPP Disability Benefits - realm of dishonesty


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:
  1. Chronic Myofascial Pain Syndrome of the Neck.
  2. Chronic Myofascial Pain Syndrome of the Trapezium.
  3. Chronic Mofascial Pain Syndrome of his shoulders Bilaterally.
  4. Biceps Tendonosis in his left shoulder.
  5. WADS lll of his neck
  6. Occipital Neuralgia;
  7. 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







Page 6 of 22



REMOVED PAGES 7- 22



 











File management log blow proves claim above that adjuster sent OT to home of claimant to deny tractor.



4 comments:

Anonymous said...


Article: "Jobs picture not rosy" Jan 16, 2014 Niagara This Week - St. Catharines

"If Niagara residents needed a stark reminder of just how tough the jobs market is in this region, they only needed to read the latest employment survey released by Statistics Canada last Friday.

The numbers show that the jobless rate climbed to 7.9 per cent in Ontario in December, and inched up to 7.2 per cent nationally. That represents about 46,000 lost jobs in Canada, with Ontario bearing the brunt of that: some 39,000 jobs were lost in this province, with about 26,000 of those jobs being full-time.

But while tiny Prince Edward Island had the highest unemployment rate in December, at 11.3 per cent, Niagara had the dubious distinction of having the highest jobless rate of 35 census metropolitan areas across Canada. "

Good luck!

Bearsworld Blog said...

"Niagara had the dubious distinction of having the highest jobless rate of 35 census metropolitan areas across Canada. "

Thank you for the added information on employment.

Anonymous said...

How can a non medical person ( insurance adjuster) be legally able to tell a medical person ( OT) what to write in a medical report?

Is that not fraud?

Anonymous said...

can you say conflict of interest

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