The Ministry of Community and Social Services (MCSS) intends to accelerate the process of medical reviews1 for a large section of people on the Ontario Disability Support Program (ODSP). Starting April 1, 2015, medical reviews will go out to up to 1,900 randomly selected people on ODSP. Currently, only 600 cases per month are reviewed so, this plan will significantly intensify the process. Following a medical review, if the person is no longer considered to have a disability, or if the person fails to submit the Disability Determination Package (DDP) within the prescribed 90-day time frame, the person’s disability income may be cut-off.
Stakeholders and ODSP recipients have expressed grave concerns about the potential impact of receiving a medical review notice, especially for people with mental illnesses and those who are homeless. Given that 46 percent of the overall ODSP caseload had a mental illness diagnosis as their primary or secondary disability, these medical reviews will affect the lives of people with mental illnesses at disproportionately high rates.
For many years, MCSS has not done medical reviews on a regular basis because of a lack of resources. Consequently, many people receiving ODSP benefits have never received a medical review notice and assume that their disability status is no longer in question. In that context, unexpected medical reviews with short timelines will likely cause confusion and stress, as individuals will need to ‘prove’ their disability status all over again. The new review process will be identical to the initial disability assessment process required to obtain ODSP. For people with a mental illness diagnosis, re-living this process may be extremely disturbing. Some individuals may even choose to ignore the notice and stand the risk of losing their benefits.
In summary, the accelerated medical review process will mean a lot of unnecessary stress and hardship, especially for the most marginalized people on ODSP. For example, people who have literacy issues, face language barriers, have significant mental health issues or are homeless will be particularly hard hit by this review process. It will also mean resources will be needlessly spent by government, doctors, the legal clinic system, and the appeals tribunal.
Canadian Mental Health Association, Ontario is concerned about these changes and urges the government to review the medical review system and make steps to ensure it becomes less onerous and more just for vulnerable individuals. In this regard, stakeholder groups and ODSP recipients are continuing to engage with the Ministry to make recommendations.
It is important for community mental health programs to be aware of this situation and to inform their clients that the ODSP program gives only 90 days to complete the DDP forms, including sections to be filled out by a doctor. An extension is possible if a client cannot complete all the necessary forms within 90 days, but a request to the Ministry (well before the deadline) is necessary.
If for some reason the application is rejected following the medical review, it is essential to get advice from a local community legal clinic (1-800-668-8258 or 416-979-1446 during regular business hours) on whether to appeal the decision to the Social Benefits Tribunal. ODSP benefits should continue until the appeal is heard.
It is also important that community mental health programs document the experiences of their clients who receive notices of medical reviews and provide as much assistance as possible in order to ensure that their DDP is completed on time.
Read more about the medical review process on MCSS’s website.
For further information, view Income Security Advocacy Centre’s information sheet that describes the ODSP review process, what affected individuals should do now, and what concerns some organizations have about the process.
1 To be eligible for income support, a person must meet all eligibility criteria under the Ontario Disability Support Program (ODSP) Act. When a determination of disability is made under section 4(1) of the ODSP Act, a medical review date may be assigned under section 5(1) of the regulatory authority unless there is no likelihood of improvement of the person’s disability. If following a medical review, the person is no longer a person with a disability; or if the person fails to submit the medical review Disability Determination Package within the prescribed 90-day time frame, the person is no longer eligible for income support and benefits.