The Ontario Disability Support Program needs a serious overhaul.  Many things need to be changed.  But the program’s definition of disability is not one of them.

Late last year, November 22nd, announced a few of the changes she and her government had in store for ODSP over the following 18 months.  Lisa MacLeod, the Minister of Children, Community and Social Services, spoke about the changes and then took questions from the press.

Two of the changes were particularly troubling.

After holding the previous Liberal government responsible for failing to provide the support adult Ontarians with disabilities need, Minister MacLeod went on to announce they will be leaving more money in people’s pockets by modifying how ODSP treats employment income earned by people on the program, which I wrote about last month.  The other major change she discussed was aligning ODSP’s definition with the federal government’s.

The ODSP’s definition of disability determines who qualifies for the program’s benefits.  You are required to provide medical information, which is evaluated against the program’s definition of disability.  If your disability meets ODSP’s definition, you are entitled to receive income and health benefits, provided you satisfy the financial eligibility criteria as well.

Inevitably, tinkering with ODSP’s definition of disability changes who would qualify for benefits and who wouldn’t.  Broaden the definition, more people could qualify.  Narrowing the definition, shuts down access to people who might need them.

Why change the definition at all?  Is there a serious issue with the current definition?

If the Ford government believes the program’s definition of disability has issues that need to be solved, they have not explained what those problems might be. MacLeod claimed the change would, “…allow [them] to provide clarity and consistency and help to target support to those whose disability precludes them from entering the workforce.”  That was the extent of the explanation and we haven’t heard much during the five months since.

ODSP does not exist simply for people whose disability precludes them from entering the workforce.  It is for people with disabilities who are in financial need.  Many people with disabilities, including those with significant impairments, have the ability to work.  Their disabilities are not the reason they are not working, at least not the only one.  An employer needs to hire you to get a job and, as we all know, finding a job is much easier said than done.  Finding and maintaining sustainable employment becomes even more challenging when you need accommodations because you have a disability.

Changing the definition in the name of clarity and consistency is a good thing…or is it?  Clarity of what, exactly?  Will aligning the definition with the federal government’s definition somehow make it easier to determine who has a disability and who doesn’t?  Arguing that assertion would be tough.

The application processes for both the Disability Tax Credit Certificate (DTC) and Canada Pension Plan Disability benefits (CPP-D) have been under fire in recent years.  In 2017, a slew of people with diabetes were shocked when their attempts to renew their DTC status were denied, even though the definition had not changed.  The government reversed these decisions after a serious backlash was reported by the press.  Not exactly a reflection of clarity or transparency.

If ODSP ends up mirroring the federal government’s definition, I guess you could say that’s consistency.  But when did consistency become an inherently positive attribute?

Ottawa does not have a definition of disability.  It has many.  The federal government administers several disability programs and they do not rely on the same definition.  And for good reason, which the federal government realizes.

Disability is a complex phenomenon, reflecting an interaction between features of a person’s body and mind and features of the society in which they live. A disability can occur at any time in a person’s life; some people are born with a disability, while others develop a disability later in life. It can be permanent, temporary or episodic. Disability can steadily worsen, remain the same, or improve. It can be very mild to very severe. It can be the cause, as well as the result, of disease, illness, injury, or substance abuse.

Because of its complexity, there is no single, harmonized “operational” definition of disability across federal programs. (Federal Disability Reference Guide, page 2.  2013)

To qualify for CPP-D, your disability must be severe and prolonged. According to the government’s webpage for CPP-D, severe, “means that you have a mental or physical disability that regularly stops you from doing any type of substantially gainful work.” (my emphasis). Prolonged, “means that your disability is long-term and of indefinite duration or is likely to result in death.”  The CPP-D definition rules out many people with severe, episodic conditions, but are not prolonged.  It also rules out people whose disability stops them from being able to work.  Being unemployed does not necessarily mean you are not able to work.  You must demonstrate your disability is the reason for your unemployment.

The DTC insists your disability must be prolonged, but their definition of the word differs from CPP-D’s.  For the DTC, you must demonstrate your, “impairment has lasted, or is expected to last for a continuous period of at least 12 months.”  But your disability must, “be present all or substantially all the time (at least 90% of the time).”  Again, this disqualifies many people with episodic disabilities…disabilities that may not affect them everyday, but are severely debilitating when things flare up.

ODSP’s current definition dictates that a person has a disability for the purposes of the program if, “the person has a substantial physical or mental impairment that is continuous or recurrent and expected to last one year or more.” Unlike the DTC, ODSP more readily accepts people with episodic (i.e. recurrent) disabilities.

You also do not have to demonstrate you are not able to work because of your disability.  ODSP is not disability insurance.  ODSP is a safety net that provides income and benefits for people with disabilities who are in financial need, regardless of the reason.

Regardless of the exact definition of disability the Ford government imports from Ottawa, it will be more difficult to qualify for ODSP benefits.

There are many people on ODSP who have failed to qualify for the DTC or CPP-D. But there are few who have qualified for either of these federal programs yet failed to meet ODSP’s current definition of disability.

In fact, under current rules, if you have been approved for CPP-D, you automatically satisfy ODSP’s definition of disability.  It does not work the other way around, though. If after you are approved for ODSP and then apply for CPP-D, you still need to provide evidence of your disability.

Facing questions from the press, MacLeod was unwilling to speculate on how many people would not qualify for ODSP because of the new definition of disability, but she didn’t outright deny the change could result in fewer people on the program.  When asked if the new definition would apply to those currently on ODSP, she stated those presently on ODSP would be grandfathered and continue to be evaluated using the present definition.

If a new definition would benefit those in need of ODSP, why grandfather current program recipients, if not to ease their fear of losing their entitlements?

There has been a stream of cost-saving initiatives flowing from the Ford government. Some in the name of saving money and others disguised as efforts to clear wait lists or put an end to supposed “failing” programs like the Basic Income pilot.

Defining who has a disability should not be stripped of all context.  The definition must align with and support a program’s purpose and reason for being.  It is the program and its intent that should shape the definition.  Not the other way around. Replacing ODSP’s definition of disability with one from CPP-D or the DTC, undermines the program’s purpose.

This is not a decision made in service of people with disabilities.  People will be hurt.  This is an effort to reduce government spending.  But in my mind, it is penny-wise, pound-foolish.

Those who won’t qualify for ODSP because their conditions don’t satisfy a narrower definition, will still have significant disabilities.  They will still have needs that are greater than others.  Yet they will have to turn to Ontario Works for income assistance which provides even less support than ODSP.   As they sink even further, they will end up in the healthcare system because the social assistance supports won’t sustain them.  This is where the costs will really escalate.

Caring for somebody in the healthcare system is far more expensive than providing reasonable supports through social assistance channels.  A single person with no dependents on ODSP receives $1,169 per month.  Even a short stay in a hospital costs several thousands of dollars.

ODSP is in disrepair. There is so much work to be done to improve the program.  We should look for cost savings, but not with quick-hit tactics that threaten long-term fiscal stability, particularly at the expense of people who are constantly treading water.