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I disagree with a decision about ODSP income support. What can I do about it?

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I disagree with a decision about ODSP income support. What can I do about it?

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Reviewed: 
November, 2016
Answer

You may be able to appeal to the Social Benefits Tribunal (SBT) if you get a decision from your local Ontario Disability Support Program (ODSP) office or from the Disability Adjudication Unit:

  • refusing to give you income support
  • reducing the amount of income support you get
  • cutting off your income support
  • saying that you have an overpayment

To appeal means that you ask the SBT to decide that the decision is wrong.

The SBT is not part of ODSP and has the power to make a different decision.

Asking for an internal review

Before you can appeal a decision about ODSP income support to the SBT, you must ask for an internal review of the decision. If the decision was that you’re not a person with a disability, you ask the Disability Adjudication Unit for an internal review. For other decisions, you ask your local ODSP office.

In an internal review, someone in the office that made the decision reviews it and decides whether or not to change it. This is a different person than the one who made the decision that you disagree with.

1. Complete your application and get the decision

When the Ontario Disability Support Program (ODSP) makes a decision about your assistance, they’re supposed to put it in writing. This is called a Notice of Decision.

The Notice of Decision is supposed to include the reasons for the decision.

The Notice of Decision comes from:

Being refused for financial reasons

Your local ODSP office decides whether you qualify financially for income support.

If they say that you don’t qualify financially and you appeal that decision, you should still go ahead with the next step in your application. You can do this while you wait for the Social Benefits Tribunal to decide about your appeal.

Completing the Disability Determination Package

For most people, the next step in their application is completing the Disability Determination Package. You do this to show that you’re a “person with a disability”.

You get a Disability Determination Package from the ODSP worker. The forms have to be completed and you have to send them to the Disability Adjudication Unit.

It’s important to do this. If you win your appeal about qualifying financially, you might be able to get income support from the date that the Disability Adjudication Unit received your completed application.

But if you’re someone who does not need to prove that they meet the ODSP definition of a "person with a disability", you don’t have to do this. This is because your application is complete when you give the local ODSP office all the information they need to decide whether you qualify financially.

Getting help

For help and advice about appealing, contact a community legal clinic.

Reviewed: 
December, 2016
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2. Ask for an internal review

Before you can appeal to the Social Benefits Tribunal (SBT), you must ask the office that made the decision you disagree with to do an internal review.

This will be either the local Ontario Disability Support Program (ODSP) office or the Disability Adjudication Unit.

Deadline to ask for an internal review

You must ask for an internal review within 30 days from the date you got the decision.

If the local ODSP office or the Disability Adjudication Unit mails its decision, the rules say that you get it 3 days after they mail it to you. So your deadline is no later than 33 days from the mailing date.

There should be a mailing date stamped on the envelope by Canada Post. It might not be the same as the date on the letter.

Always keep the letter and the envelope so you can prove when you got a letter or notice.

If you miss the deadline

Step 4 talks about what you can do if you miss the deadline.

How to ask for an internal review

You write to the office that made the decision you disagree with and ask them to do an internal review. The address is in the Notice of Decision.

You can use this form to ask for internal review. Or, you can write your own letter.

What information to include

Make sure to include:

  • your name and address
  • the date on the Notice of Decision
  • the date you got the Notice of Decision
  • your member identification number, which has 9 digits and is on the Notice of Decision

Say that you want an internal review.

It may be helpful to give reasons why you don’t agree with the decision. But meeting the deadline is more important than giving detailed reasons.

You can also include new information or documents that help show why you disagree with the decision.

A community legal clinic may be able to help you ask for an internal review.

Reviewed: 
December, 2016
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3. Deliver your internal review request by the deadline

Sign and date your written request for an internal review. Make sure you keep a copy.

You can send your request by fax or mail. The address is on the Notice of Decision.

And, if your request is going to the local Ontario Disability Support Program (ODSP) office, you or someone else might be able to take it there.

Proving when you made your request

If you fax your letter, get a report from the fax machine to show the date the fax was sent.

If you mail it, make a note of the date you put it in the mail.

If you take the letter to your local ODSP office, ask for a receipt to prove when you delivered it.

Reviewed: 
December, 2016
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4. Take steps if you missed the deadline

You have 30 days from when you get the decision by the local Ontario Disability Support Program (ODSP) office or the Disability Adjudication Unit to ask for an internal review.

If you miss the deadline, ask for an internal review as soon as you can.

Explain why your request is late and ask for more time.

Explaining why you missed the deadline

If you can show that you have a good reason, you might still get an internal review.

Here are some examples of good reasons for missing the deadline:

  • You were in the hospital or in jail.
  • You contacted a lawyer or legal clinic and were waiting to get legal advice from them.
  • You have problems with reading or writing.
  • The local ODSP office or the Disability Adjudication Unit mailed its decision and it took longer than 3 days to reach you.

 

Reviewed: 
December, 2016
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5. Find out if you can appeal to the SBT, after asking for an internal review

Some decisions about income support from the Ontario Disability Support Program (ODSP) can be appealed to the Social Benefits Tribunal (SBT). 

But even if you can appeal to the SBT, you have to first ask for an internal review. See Step 2.

Decisions you can appeal

You can appeal to the SBT if the decision is about:

You can also appeal other types of decisions that affect you, such as whether:

Decisions you cannot appeal

You cannot appeal to the SBT if the decision is about:

  • giving you a date for a medical review to check if you still qualify for income support as a “person with a disability”
  • getting “discretionary benefits”, such as paying for a funeral
  • making payments to someone else, for example, if ODSP decides to pay your rent directly to your landlord
  • refusing to give you extra time to ask for an internal review

If a decision cannot be appealed

Even if the law says that a decision can’t be appealed, you can still ask for an internal review.

Explain why you think the decision should be changed and include any information that supports your reasons.

If you were refused extra time to ask for an internal review, talk to a community legal clinic about other things you might be able to do.

If you’re not sure

If you’re not sure if you can appeal the decision, you can still start an appeal.

Talk to a community legal clinic if you want to appeal a decision but aren’t sure if you can.

Reviewed: 
December, 2016
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Learn more about this topic
CLEO (Community Legal Education Ontario/Éducation juridique communautaire Ontario)
CLEO (Community Legal Education Ontario/Éducation juridique communautaire Ontario)
Hamilton Community Legal Clinic / Clinique juridique communautaire de Hamilton

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