Social Security Tribunal appeal stacked against claimant

Monday, July 27, 2015
Social Security Tribunal appeal stacked against claimant


Via Facsimile 1-855-814-4117 Social Security Tribunal of Canada
RE: IN THE MATTER OF APPEAL GP-xx-xxx

Dear Social Security Tribunal:

I acknowledge receipt of a letter by xxx -IS Operations Manager, General Division Dated July 16, 2015 informing me that your are now “ready to proceed” with my Appeal.

I do not understand how you can be ready to proceed without fulfilling your obligation to provide me a copy of my previously requested file.

Until I am able to receive a complete copy of my file I am unable to proceed in defending myself and presenting the facts.

As you know my file represents the how, when, and why I have an appeal with you, and is the record of events for any future actions against the Social Security Tribunal in the event of the continuation of these unjust denials. Its all relevant. I wish to discuss with the Member assigned my file all relevant information regarding my file and my Appeal. So again, I kindly ask for an updated copy of my file.

Even if I am unsuccessful in my Appeal I still require everything that I sent to the Tribunal to be part of the record as it confirms and demonstrates the facts of my long journey through this preconceived nightmare designed to deny, humiliate and thoroughly frustrate legitimate victims that have already been threw enough interrogations from their insurance companies hired guns and wordhirelings. All orchestrated by the IBC and bad politicians that pray on the week, sick, and injured, for profit.

Doctors that don't stand up for legitimately injured patients are most to blame in this charade of politics and money makers. My 7 year Appeal process is just another example of an upside down world where the money doesn’t go to where its suppose to. Bad Doctors that don't properly investigate are at the core of the backlog problems at F.S.C.O, our courts, and the Social Security Tribunal of Canada.

As Service Canada has used my blogging (about them) as an excuse not to pay my disability benefits attached you will find my latest blog entry advocating for the thousands of people waiting at your Tribunal because of bad decisions by disgraceful, dishonourable and unprofessional Service Canada employees.



As you know my faxes to you and my blog still asks for the Chairperson of the Social Security Tribunal xxx to answers numerous, unanswered, questions.
I have no acknowledgement that the Chair is getting my correspondences. Is she receiving anything? Should I resend?

Also, will I be permitted to audio/video record my appeal hearing?

Finally, attached you will find my completed “Hearing Information Form”. You will notice that I have not answered the witness question at this time. What are the rules for witnesses?
I submit that anyone that has correspondences, investigations, or relevant knowledge of this appeal makes them a witness to this Appeal. Furthermore, is there a limit to the number of witnesses?

With my injuries, no consumer protection, no consultation or mind reading skills I continue to have difficult understanding why this process is designed so difficult for a legitimately injured person. You should all be ashamed.

Looking forward to hearing from you as soon as possible in this regard.



Thanks to all those who help me write my letters and blog postings since 2007.


Cc: undisclosed

Source: http://survivingacollision.blogspot.ca/2015/07/social-security-tribunal-appeal-stacked.html

CPP Disability take a number now serving appeal 200,000

What are the number of appeals backlogged at the Social Security Tribunal?

The following comment was made by Fair Association of Victims for Accident Insurance Reform on the Toronto Sun site back in November of last year.

In February of this year Minister Jason Kenney pledged to wipe out the Social Security Tribunal backlog of 11,000 by this summer.


The backlog was also discussed later in the house by Mr. Robert Aubin (NDP).
He said: "Mr. Speaker, on Tuesday the chair of the Social Security Tribunal confirmed that there are significant delays in the processing of cases: 14,677 cases are languishing on her desk."


So what are the numbers now?


More importantly, how would you get rid of such a backlog of appeals...fairly?


The Tribunal Chair refuses to acknowledge or respond to my letters as an appeal applicant, or as an advocate for these disabled Canadians that have been waiting for years at the tribunal backlog.


Knowing that these disabled Canadians can't respond our government has reaped the $$$ in withholding these benefits. Appeals in the take-a-number-lineup because of bad decisions by Service Canada and their policy of delay, deny, wait for them to die.

In my case these benefits that my employers and I have paid into mandatorily since 1979.

http://survivingacollision.blogspot.ca/2015/01/delay-deny-wait-for-them-to-die-at-sst.html

http://survivingacollision.blogspot.ca/2015/05/where-do-victims-go-when-insurers-dont.html

And what of my appeal that was launched back in 2008?

Will it be fairly heard after my blogging about the Social Security Tribunal and advocating for the unknown thousands of Appellants?

What do I have to do to be heard and what will It take to at least acknowledge my correspondences by the Social Security Chair Ms. Brazeau.

Sincerely,
Mr. xxxx xxx
Surviving a Collision:   http://survivingacollision.blogspot.ca/
Crash Survivor 2007.



Social Security Tribunal says more than 14,600 Canadians are now waiting for a hearing:
http://survivingacollision.blogspot.ca/2014/11/social-security-tribunal-says-more-than.html

Medical-Rehabilitation & Attendant Care - Summary of Cuts to Accident Benefits

Click here to email your MPP today about these cuts!

• Rehabilitation (“rehab”) benefits cover a range of medically necessary goods and services that aren’t funded in the public system such as physiotherapy, speech therapy, psychology, medications, accessibility renovations, nursing, wheelchairs, artificial limbs, etc.
• Attendant care (“AC”) benefits cover the services of personal support workers to assist with bathing, dressing, toileting, etc.
• All goods and services are always subject to the insurer’s determination of what is “reasonable and necessary”, so insurers can deny any request for rehab or AC services even if funds are available
• There are approximately 65,000 people injured in motor vehicle accidents in Ontario each year: minor injuries account for about 80% of all injuries, serious injuries account for about 19%, and catastrophic injuries account for just 1%; insurers have strong controls over which individuals get classified into which severity category

1996	2010	2014	Budget 2015
Rehab for Minor and Serious Injuries: $100,000 plus the cost of assessments; minor injuries were subject to care pathways AC for Serious Injuries: $72,000 Rehab for Catastrophic Injuries: $1,000,000 plus the cost of assessments Attendant Care for Catastrophic Injuries: $1,000,000	Rehab for Minor Injuries: $2,200 with an option for an additional $1,300; in-home assessments eliminated Rehab for Serious Injuries*: $50,000 including the cost of assessments (approximately a 65% cut in benefits) AC for Serious Injuries: $36,000 (a 50% cut) Rehab for Catastrophic Injuries: $1,000,000 including the cost of assessments (approximately a 20% cut in benefits) Attendant Care for Catastrophic Injuries: $1,000,000	Rehab for Minor Injuries: No further changes to limits but additional documentation required Rehab for Serious Injuries*: No further change to limits AC for Serious Injuries: $36,000 for outside caregivers; family member caregivers must demonstrate direct economic loss Rehab for Catastrophic Injuries: No further change to limits Attendant Care for Catastrophic Injuries: $1,000,000 for outside caregivers; family member caregivers must demonstrate direct economic loss	Rehab for Minor Injuries: Awaiting a report with recommendations Rehab and AC for Serious Injuries**: $65,000 combined (a $21,000 or additional 25% cut) Rehab and AC for Catastrophic Injuries**: $1,000,000 combined (a $1,000,000 or additional 50% cut) Budget also suggests changing the criteria for “catastrophic”

 
* Optional Benefits
In 2010, the government introduced “optional benefits” to allow buyers of auto insurance to buy better coverage.  Our members’ experience with agents and brokers is that this is rarely discussed when policy renewals come up and most brokers are unable to speak to what med-rehab and attendant care benefits cover.  Data from FSCO released a couple years ago confirmed that less than 2% of policy holders bought optional coverage.  This is in stark contrast to optional liability coverage which agents and brokers always encourage policy holders to increase from the mandated $200,000 to $1,000,000 or $2,000,000 (liability coverage pays for the rehabilitation and expenses of someone a policy holder injures in an accident, whereas accident benefits pay for one’s own rehabilitation and expenses when injured).  It is unconscionable that drivers in Ontario are encouraged to ensure they cover someone else’s health care needs to the tune of $2,000,000 in coverage, yet are told that they need less than $50,000 to cover their own health care needs.
 
** Combining Rehab and AC Benefits
The 2015 budget suggests combining rehabilitation and attendant care benefits into one fund, meaning the most seriously of injured people (e.g., those who are paralyzed, people with amputated legs or arms, individuals with severe brain damage, etc.) will be required to choose between getting help to maintain their personal hygiene (bathing, toileting, dressing, etc.) or getting rehabilitation to improve their functional abilities.  This represents one of the most distasteful slashes to the dignity of those with disabilities in the province of Ontario, and because of the small percentage of people who fall into these categories, the savings to insurance companies will be negligible.
 
SUMMARY OF IMPACT ON DISABLED ONTARIANS
Prior to the 2015 Budget announcement, Ontario had already devolved to having the worst rehab insurance coverage in the country on a weighted average basis (80% of injuries access up to $3,500, 19% access up to $50,000 and 1% up to $1,000,000 = weighted average of up to $22,300 in available rehab benefits, if the insurer approves the funding).  With the 2015 Budget announcement, this figure drops to an appalling $15,400.  In 6 years, the Ontario government has reduced rehab funding in the auto sector from a weighted average of $50,000 to $15,000 – and this in the context of publicly funded outpatient and home care rehab services being drastically reduced or eliminated in most jurisdictions across the province.

Numerous other changes have been made to the Accident Benefits package in the past 6 years, all designed to constantly boost insurers’ profitability and all on the backs of injured and vulnerable Ontarians.  The important balance between insurer profitability, premium levels and consumer protection was pushed to the brink in 2010 and will be completely destroyed with the 2015 Budget announcement.  Our government passes seatbelt, helmet and smoking laws to keep people safe.   And one of our most deeply held Canadian values is to provide a safety net for the most vulnerable among us.  The Ontario government needs to show that it cares as much about its citizens as it does about insurer profitability.  Disabled Ontarians and their families are too busy trying to get through basic daily activities with some dignity and hope; they can’t lobby the way the insurance industry can.  You, our MPP, need to be their voice. 

Please stop these proposed changes, review insurer profitability, and let the impact of all the other cuts take place before enacting any new regulations that further disadvantage injured Ontarians.

Source: http://www.ontariorehaballiance.com/page/insurancechanges

Hundreds rally against cuts to auto insurance benefits

By Maryam Shah, Toronto Sun

First posted: Wednesday, June 03, 2015 08:22 PM EDT | Updated: Wednesday, June 03, 2015 08:27 PM EDT  

TORONTO - Changes to auto insurance benefits for motor vehicle accident victims passed in the Ontario legislature Wednesday as part of the provincial budget.

“God help us all,” Tammy Kirkwood said upon hearing the news. “We’re getting a lot less coverage for a lot more money and I’m not sure why.”

Kirkwood was one of hundreds of protesters at Queen’s Park rallying against reductions in auto insurance benefits which they say will have the most effect on victims with catastrophic injuries.

The 47-year-old Orillia woman said protesters were “flabbergasted” that the provincial government “was trying to disable our resources and our funding to recover.”

Part of the changes to auto insurance rules under the new budget mean that combined coverage for medical, rehabilitation and attendant care benefits for the catastrophically injured will be cut in half from its current cap of $2 million to $1 million.

Kirkwood survived a 2008 collision when a dump truck hit her car. She had to be pried free from her vehicle by firefighters, and was deemed catastrophically injured.

She says she was only able to move forward because she had access to the services she needed.

Unable to return to work, Kirkwood now volunteers as an advocate with FAIR Association of Victims for Accident Insurance Reform.

New Democratic Party MPP Jagmeet Singh spoke at the rally in support of their cause.

The cuts affect “the most vulnerable people,” such as people with brain and spinal cord injuries, he said.

“They need benefit coverage ... to live an at least somewhat decent life,” Singh pointed out.

A spokesman for Finance Minister Charles Sousa said the government is “working hard to create a fair and affordable insurance system” for the province’s 9.4 million drivers.

Ontario is “the only province in Canada to offer exclusive catastrophic coverage,” Kelsey Ingram said in an e-mail.

“Catastrophically impaired claimants will also continue to be able to sue an at-fault party to recover damages for health-care expenses and potentially other claims,” she added.

The provincial government is also committed to making sure any savings from these changes do not result in “excess profits” for insurance companies, Ingram said.

“This is about lowering premiums while providing support and protection for all Ontario drivers,” she said.

maryam.shah@sunmedia.ca

Advocacy groups to hold rally protesting “very shady” industry practices

by Jill Gregorie | 29 May 2015

In response to last week’s advancement of Bill 91, Building Ontario Up Act, two advocacy groups are organizing a public protest to be held on June 3rd at Queen’s Park, Toronto called #Rally4AccidentVictims.

FAIR Association of Victims for Accident Insurance Reform and the Accident Benefit Coalition are not just protesting provincial government, however.

The groups feel that insurance companies also unfairly benefit from the legislation, and allege that provincial government’s proposals to reduce coverage for the catastrophically injured is uncalled for, given the industry’s profit margins.

“It is unacceptable to be giving away money to wealthy insurance companies who are already using some very shady business practices to deny a record number of claims,” reads a release from FAIR.

Among these practices, FAIR contends, are insurance companies employing "for-hire physicians who provide insurers with the medical reports used to decide whether or not an injured claimant is entitled to treatment and benefits.”

In addition, the non-profit association alleges that this arrangement allows insurance companies to place severely injured victims in numerous social services programs, forcing taxpayers to cover their expenses instead of insurance payouts.

“Our government is giving insurers a financial gift by allowing insurers to pay injured victims less and simultaneously download the cost of victims to the unsuspecting taxpayers who are the same drivers looking for a break on insurance premiums,” FAIR said.

The groups are also calling for supporters to sign an online petition.