Step 2: Do I qualify because of my disability?

To get income support from ODSP, most people must meet the ODSP definition of a “person with a disability”.

This means that an approved health professional, such as a doctor, confirms that:

you have a physical or mental health problem that is expected to last a year or more, and
your health problem limits your ability to work, look after yourself, or do daily activities at home or in the community.

The law also says that your health problem must be substantial and it must limit your abilities in a substantial way.

Filling out forms about my health

There are forms for you to fill out and forms that your doctor or another health professional has to fill out.

The forms must be completed and sent to the Disability Adjudication Unit (DAU) in Toronto within 90 days from the date they were mailed or given to you.

The Disability Adjudication Unit is a part of the Ministry of Community and Social Services. It decides whether people meet the ODSP definition of a “person with a disability”.

The Health Status Report must be filled out by one of the following:

a family doctor or a specialist
a psychologist or a psychological associate
an optometrist
a registered nurse or a nurse practitioner

The Activities of Daily Living Index must be filled out by one of the following:

a family doctor or a specialist
a psychologist or a psychological associate
an optometrist
an audiologist or a speech language pathologist
an occupational therapist or a physiotherapist
a chiropractor
a social worker
a registered nurse or a nurse practitioner

The 2 forms that you fill out yourself are:

Consent to Release Medical Information
Self Report

The Consent to Release Medical Information gives your health professional permission to send the Disability Adjudication Unit all the medical information that supports your application.

This might include reports from specialists, psychological or other assessments, x-ray reports, and test results.

You must fill out, sign, and send in the Consent to Release Medical Information.

The Self Report lets you give more information about how your health problems affect you.

You do not have to fill it out. But you must sign it and send it in, whether you fill it out or not.

If I miss the 90-day time limit

If you do not send the forms in within the 90 days, the ODSP office closes your file.

This means that you will have to start again from the beginning to apply for income support.

If you cannot send your forms in within the 90 days, you can ask the Disability Adjudication Unit to give you more time. You will have to prove to them that you have a good reason.

For example, if you could not complete the forms because you were in hospital or in jail, they should give you more time.

But if they refuse to give you more time, you will have to begin your application again.

If I am on Ontario Works (OW) when I apply for ODSP

If you are on OW when you apply for ODSP and you miss the 90-day deadline, you will have to start meeting the OW rules about income and assets. You might also have to start looking for a job.

The OW office can give you more information about this.

What happens after I send the forms to the Disability Adjudication Unit?

The Disability Adjudication Unit decides whether you meet the ODSP definition of a “person with a disability” and qualify for ODSP income support.

They will let you know by sending you a letter in the mail.

If they decide that you do qualify, they will also let your local ODSP office know so that ODSP can start paying you income support.

What are medical reviews?

Even if you qualify for income support, the Disability Adjudication Unit may give you a medical review date.

This means that they want to check your disability or health status in the future. They do this if they think your health might improve. They want to check if you still qualify as a “person with a disability”.

When they are ready to do your medical review, they will send you a Medical Review Package.

You have to get the forms filled out and send them to the Disability Adjudication Unit within 90 days.

Medical Form Part A

Medical Form Part A is already partly filled in with information about you. This includes information about your medical conditions from the last time you had to show ODSP that you qualified as a “person with a disability”.

Medical Form Part A must be completed by one of the following approved health professionals:

a family doctor or a specialist
a psychologist or a psychological associate
an optometrist
a registered nurse or a nurse practitioner

To keep getting income support as a “person with a disability”, you must send in a completed Medical Form Part A.

Medical Form Part B

You do not need to send in Medical Form Part B unless you have a new medical condition that is not listed in Part A.

Even if you have a new condition, you do not have to complete Medical Form Part B if the health professional who completes Medical Form Part A says:

the physical or mental health problems listed in Part A have not gotten significantly better, and
the medical conditions listed in Part A are likely to stay the same or get worse.

But there are times when it can be helpful to have a health professional complete Medical Form Part B, even if it is not necessary.

For example, it might be helpful if you have a new medical condition that is:

not listed in Medical Form Part A,
more serious than the medical conditions listed in Medical Form Part A, and
not going to get better.

To find out if completing Medical Form Part B is a good idea for you, talk to your health professional. You may also want to get legal advice. See How can I get legal help and information?

Medical Form Part B has 2 sections:

Health Status Report
Activities of Daily Living Index

The Health Status Report must be filled out by one of the following approved health professionals:

a family doctor or a specialist
a psychologist or a psychological associate
an optometrist
a registered nurse or a nurse practitioner

In the Health Status Report, your health professional lists any medical conditions you have that are not listed in Medical Form Part A.

The health professional must say whether a medical condition is likely to:

improve
stay the same
get worse

Or, they can say that they do not know.

And they must give information about:

how a medical condition affects you, for example, how it limits your activities or stops you from doing certain things
how long they expect the condition to affect you
whether you are affected by it all the time or some times

The Activities of Daily Living Index must be filled out by one of the following approved health professionals:

a family doctor or a specialist
a psychologist or a psychological associate
an optometrist
an audiologist or a speech language pathologist
an occupational therapist or a physiotherapist
a chiropractor
a social worker
a registered nurse or a nurse practitioner

In the Activities of Daily Living Index, your health professional describes how much your health problems limit your ability to:

work
look after yourself
take part in activities at home and in the community

The Activities of Daily Living Index does not have to be filled out by the same health professional who fills out the Health Status Report.

For example, your family doctor may be the best person to fill out the Health Status Report. And your occupational therapist may be the best person to fill out the Activities of Daily Living Index.

Consent to the Release of Medical Information

The Consent to the Release of Medical Information gives your health professional permission to give the Disability Adjudication Unit any medical information that supports your application.

This might include reports from specialists, psychological or other assessments, X-ray reports, and test results.

You must fill out, sign, and send in the Consent to Release Medical Information.

Self Report

The Self Report includes questions about:

your education
your work history
how your health problems affect you in your daily life

You do not have to fill out the Self Report. And if you do not have to send in Medical Form Part B, there is no reason to fill out the Self Report.

If you want to send in the Self Report and you need help to fill it out, try to get someone who knows about your health problems to help you with it.

If you miss the time limit

If you cannot send your forms in within the 90 days, you can ask the Disability Adjudication Unit to give you more time. Explain why you need it.

For example, you might need more time because you were in the hospital or in jail. Or you might not have been able to find a health professional who could complete the forms in time.

What happens on a medical review?

The Disability Adjudication Unit decides if you still qualify as “a person with a disability” based on the information in the completed Medical Review Package.

You will continue to get income support while the Disability Adjudication Unit does its review. If they decide that you no longer have a disability, you will be cut off after 3 more months of income support.

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