Personal Injury Blog

ODSP System Reform: Red Flags, Backlogs & Barriers to Appeals

In November 2020, the Ontario government’s Ministry of Children, Community and Social Services launched a multi-year initiative to overhaul administration of the Ontario Disability Support Program (ODSP) and Ontario Works (OW) under the title, “Recovery and Renewal: A Vision for Social Assistance Transformation”.

In collaboration with municipal governments, this transformation aims “to create an efficient, effective and streamlined social services system that focuses on people, providing them with a range of services and supports to respond to their unique needs and address barriers to success so they can move towards employment and independence.” The first step – implementation of online, automated application processes – has been introduced. Over the course of several years, day-to-day case management and provision of services will be assumed by the municipalities.

The official release from February 11, 2021 prioritizes “employment, financial resilience, independence and well-being” as a core principle to achieve what it calls “life stabilization” for recipients of social assistance in Ontario. The stated goals include: “… to get people back to work and help Ontario’s COVID-19 economic recovery.” While these goals are certainly worthwhile and consistent with Ontario Works’ longstanding mandate, they do not satisfactorily address the concerns of Ontario’s disabled residents or the current deficiencies plaguing the ODSP. Despite its promises of a more streamlined, responsive system that caters to the needs of individuals, the government’s vision aims to offload its own COVID burden onto the municipalities at the expense of these vulnerable individuals.

Automating the application process will certainly save costs. However, even setting aside the fact that many of these applicants will have limited access to technology, and/or experience profound cognitive, mental and psychological challenges, it is unclear how this innovation “focuses on people”. Per the government release, it will employ a “risk-based model that can automatically grant most cases while flagging the complex cases that require in-depth review”. However, evaluating disability requires the exercise of judgement. It should not be simply a matter of identifying impairments, but an appraisal of the functional limitations resulting from them. Reserving this appraisal for “complex cases” commits an injustice to the remaining applicants, each of whom deserves to be treated with respect and compassion.

This makes the proposal seem disingenuous, as the automated process is likely to automatically reject as many cases as it grants. For these reasons, it is unclear that relying on an algorithm will result in fewer ODSP appeals going forward.

Alarmingly, nothing in the government’s plan addresses the overwhelming backlog of ODSP appeals currently underway with the Social Benefits Tribunal either.

In the 2019/20 fiscal year, ODSP eligibility appeals accounted for more than 93% of the tribunal’s cases. Although approximately 7,500 cases were heard, at the end of that year more than 9,000 appeals remained outstanding with wait times reaching 18 months. Despite the obvious need for additional resources, the number of tribunal adjudicators has been reduced dramatically since the last election. By January 2021 there were 19 adjudicators (10 of whom are part-time members), versus 34 in March 2018 (with 19 full-time members).

According to the 2019 Auditor General’s Report, the Social Benefits Tribunal ruled in favour of the applicant in over 60% of ODSP eligibility appeals. In the interim, these disabled applicants typically are limited to the $733 per month available through OW for their survival. Because this is only 1/3 the amount available through ODSP, the government has no fiscal incentive to reduce the ever-increasing backlog or process the appeals more expeditiously. Unfortunately, the system seems to provide incentive for the opposite.

As the transformation is completed over the next several years, the municipalities will assume responsibility for provision of case management services to existing ODSP recipients as well as those processed under the new initiative. To date, no details concerning potential funding for these services have been released. Presumably, the municipalities will be forced to carry a significant part of the costs. This will place additional strain on their COVID-depleted resources and will likely lead to underfunding of the envisioned case management program. As well, the case workers hired or trained to assume the existing ODSP caseload and assimilate current applicants will lack specific expertise in dealing with the program, particularly its complex interactions with the insurance industry and medical, rehabilitative and legal professions.

Clearly, these changes to ODSP administration will have a drastic impact on both new applicants and existing recipients of social assistance under the program. If you have been injured in a car accident resulting in a disability and have questions about these issues, your accident benefits claim or a potential lawsuit, contact us for a free, no-obligation consultation. Put Campisi LLP to work for you – we are champions with heart!

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