Struggling to find out how to write an appeal letter for disability benefits properly? If so, you are in the right place! In this article, we overview a simple yet complete process for writing an appeal letter for CPP disability and long and short-term disability. We also included a CPP disability appeal letter sample and a short and long term disability appeal letter sample.
At this point, we suggest you STOP. We know you are antsy about starting to write your appeal letter. But before you do, we highly recommend reading our articles on what qualifies for long-term disability in Canada and how to appeal long term disability denial.
These articles contain important details on the information you need to know and the steps you need to take before writing your appeal letter. Once you’ve finished steps 1 through 6, laid out in the aforementioned article, you can start writing.
And if you’re appealing a CPP-D denial, we encourage you to check out our how to appeal CPP disability decision guide and our article giving CPP disability approval letter advice.
Disclaimer: The information provided in this article, including the appeal letter samples and guidance on how to write an appeal letter, is intended for general informational purposes only. It does not constitute legal advice and should not be relied upon as such. Every disability case is unique, and using the appeal letter samples or following the outlined steps does not guarantee the success of your appeal. For personalized advice and to ensure that your rights are fully protected, we strongly recommend consulting with a qualified disability lawyer before submitting your appeal.
How to write an appeal letter for disability
Writing an appeal letter can be one of the most challenging parts of the disability benefits appeal process. Many people worry that if they don’t write a good disability appeal letter, their claim could be denied again.
Let me set your mind at ease. In the vast majority of cases, the appeal letter has almost no bearing on the decision. At this stage, the benefit provider makes its decision based on the medical records and doctors’ opinions. So, your appeal letter only needs to do three things: request the appeal, attach the required documents, and arrive before the deadline.
Ideally, you would review the key facts and then apply the law to show why they should approve your claim. But we recommend against trying this on your own. Writing this type of appeal letter is hard — especially if you aren’t a disability lawyer.
You are better off avoiding legal analysis and focusing on writing about any information gaps. This could include:
- Clarifying any misunderstandings about your medical treatment or employment
- Reviewing all the things you did to try and stay at work
- Discussing how your symptoms affected your duties
- Identifying and explaining updated medical records
Now that you know what your appeal letter should focus on, let’s walk you through the steps to writing it.
1. Figure out what kind of appeal letter you need to write
There are two types of appeal letters you can submit. The first one is a notice of appeal (or reconsideration request for CPP-D), and the second is the actual appeal letter. The notice of appeal is exactly what it sounds like. A letter notifying the provider that you plan on appealing the denial. This kind of appeal letter is very useful when you are waiting on documents and aren’t sure if you are going to meet the appeal deadline. It can also be effective if you want to let the benefits provider know in advance that you plan on appealing the decision.
However, in some cases, this type of appeal letter isn’t necessary. For instance, if you are well ahead of the deadline and have all the information you need for your appeal, you can get straight into writing your actual appeal letter, which we will overview the process of in the following paragraphs.
Now that you know what kind of appeal letter you’re writing, let’s overview how to actually write it!
Please note: If you are planning on submitting a notice of appeal for CPP disability, you don’t actually have to write a letter. Instead, there is a standardized form that can be filled out online. Here’s the link: Request for Reconsideration of a Canada Pension Plan Disability. Keep in mind you must submit this request in order to submit a reconsideration appeal.
2. Input the letter heading
Before jumping into the body of the letter, you first need to fill out the letter heading. The letter heading, which is typically found in the upper left-hand corner of the page, introduces you to the recipient and includes important contextual information such as your name, return address, phone number, email, and date.
The information you should include in this section will differ depending on what type of disability benefit you are appealing the denial of.
For instance, if you are appealing a CPP-D denial, you should include the following information in your letter heading:
- Your Full-Name
- Your address
- Your SIN
- The Date
- Your Contact Info
However, if you’re appealing a denial of long or short-term disability benefits, you should include the following in your letter heading:
- Your Name
- Your Address
- Date
- Contact Info of the Insurer and claim representative.
3. Greetings and Regarding
Now that your letter header is filled out, let’s jot down a greeting and send your regards. For the greeting, all you need to say is “To whom it may concern” or “Dear [NAME of the claim representative if you know it].
Along with that, your letter should also have a clear subject. So, in as few words as possible, indicate what the purpose of the letter is.
4. Introduction
The first paragraph of your letter should provide a short introduction and a reason for the letter. Make sure your introduction is as concise as possible. Long, complicated sentences will only make your letter more difficult to understand. All you need to do is explain why you are appealing the decision and briefly outline what you will discuss in the letter.
5. Confirm any new or overlooked information you are attaching
If you are planning on appealing a denial, you most likely will need to provide new medical information — or at least information you believe was overlooked. So, after your introduction, you should briefly explain what medical information you are attaching and will be referencing throughout your appeal letter. See our appeal letter examples to see how we formatted this section.
6. Cite one or more reasons for your denial and point out how new or existing evidence overcomes it
Now it’s time to get into the meat of the letter. In this section, you are going to reference the reasons for your denial and explain why new or existing evidence supports your eligibility for benefits. For example, if your reason for denial was “a lack of objective medical evidence,” you could explain how new blood tests confirm your diagnosis.
Alternatively, if your denial letter cited that you weren’t participating in treatment, you could expand upon the testimony from your doctor that shows you are doing all recommended treatments for your condition. Keep in mind you actually need to have this evidence. You can’t just refute the benefit provider’s reasons for denial without the corresponding medical records. If you aren’t sure how to word this section or want to see an example, download our sample appeal letter linked below.
7. Conclusion
The final paragraph of your disability benefit appeal letter should restate the reason for your letter and thank the claim representative for considering your request.
For example, you could say the following:
“I appreciate your consideration and ask that you approve my appeal based on this new information.
Sincerely,
Jeremy”
CPP disability appeal letter sample
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CPP disability appeal letter example
Kermit the Frog
145 Lilypad Way, Calgary, AB T1W-T4B
385 972 476
May 20, 2024
(705) 111-1111
Dear Sir/ Madam,
Re: Denial of Canada Pension Plan Disability Benefits
Further to my notice of appeal dated April 11, 2024, I am writing to provide new information for my appeal. This relates to my appeal of your decision dated March 12, 2024.
Please find attached the following new medical information:
- Dr. Honeydew’s clinical notes and records from January 1, 2017, to May 1, 2024
- Dr. Honeydew’s letter to CPP-D dated April 20, 2024
In your denial letter dated August 11, 2024, you indicated the reason for denial was that I was not participating in the recommended treatment for my chronic pain.
In the attached letter from Dr. Honeydew dated May 9, 2024, he discusses in paragraphs 4 and 5 how I am now participating in Cognitive Behavioural Therapy (CBT) and am working with a pain clinic in my local area. He also states that the only reason I wasn’t participating in treatment was because I was wait-listed for CBT and the pain clinic. Given that you lacked this information when you initially reached a decision regarding my claim, I believe it could be relevant to include it at this time.
I appreciate your consideration and ask that you approve my appeal based on this new information.
Sincerely,
Kermit the Frog
Short term and long term disability appeal letter sample
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Long term disability appeal letter example
The following is an example of a long term disability appeal letter. However, those who are on short-term disability can also use this example as a reference.
Kermit the Frog
145 Lilypad Way, Calgary, AB T1W-T4B
May 20, 2024
Acme Insurance Attn: Sally Smith
50 Acme Street Toronto, ON A1A 0R4
Dear Ms. Smith,
Re: Group Policy No. 123456 Claim No. 654321 Appeal of Claim Decision
Further to my notice of appeal dated April 20, 2024, I am writing to provide new information for my appeal. This relates to my appeal of your decision dated March 12, 2024.
Please find attached the following new medical information:
- Dr. Honeydew’s clinical notes and records from January 1, 2017, to May 10, 2024
- Dr. Honeydew’s letter to Acme dated May 9, 2024
In your denial letter dated March 12, 2024, you indicated the reason for denial was that the medical information on file did not indicate restrictions and limitations which would prevent me from being gainfully employed.
In the attached letter from Dr. Honeydew, dated May 9, 2024, he discusses my restrictions and limitations in paragraphs 4 and 5. He states that these restrictions are severe and cause me to be unable to work in my own occupation.
You will also see that Dr. Honeydew discusses my impairments in his clinical notes from my visits to him on October 1, 2022, December 15, 2022, January 5, 2024, and March 5, 2024.
Also included in Dr. Honeydew’s records is a report from my neurologist, Dr. Beaker, dated November 2022. This report discusses the results of my EMG testing, which shows impairment with nerve conduction in my right arm and hand.
I appreciate your consideration and ask that you approve my appeal based on this new information.
Sincerely,
Kermit the Frog
You don’t have to do this on your own
Our disability lawyers at Resolute Legal have accumulated years of experience handling long term disability claim appeals. So, let us help you get back the money you are rightfully owed.
Get started today—call (888) 480-9050 or click on the button below to schedule a free case evaluation.
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