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The Ontario Disability Support Program (ODSP, formerly Family Benefits Allowance) is a program for those who have both a proven disability expected to last greater than one year, and financial need. The program can provide both financial benefits as well as prescription drug coverage and some dental and optical benefits. The program is asset-tested; thus only those applicants who have financial need and no other available financial resources will qualify. Applicants must demonstrate that their budgetary requirements exceed their income.

While many people with HIV are intimidated by speaking about their problem, it is important to remember that in order to get answers, you have to ask questions. If you have questions that aren't answered below, it would be a good idea to contact the Ontario Disability Support Program directly, using the information we give at the end of this chapter.

To apply, you must be 18 years of age or over, but under the age of 65. Applications are received from individuals, couples, single parents, or families. You must have legal status in Canada, and be able to provide all the applicant information necessary to verify your immediate and on-going eligibility. You may be eligible if you

have a substantial physical or mental impairment that is expected to last one year or more, and there are substantial restrictions in your activities like personal care, functioning in the community or functioning in the workplace,
demonstrate financial need with your budgetary costs exceeding any income and assets.

monthly financial assistance,
an Ontario Drug Benefits Card that covers medications listed in the Ontario Drug Benefits formulary,
basic dental care,
vision care and hearing aids,
medical transportation,
Assistive Devices Program,
back to school allowance for dependent children,
Community Start-Up benefits for those leaving an institution or setting up their home,
special diet costs (if you are eligible after applying)

ODSP also offers a variety of supports and incentives for those considering a return to work. This can include training and upgrading, continued benefits while receiving funds from the Ontario/Federal Student Assistance Program (student loans) to attend College or university, and special incentive calculations for earned income. Participation in the ODSP - Employment Support Program is 100% voluntary.

The amount received (or, ODSP Income Supports) is based on two calculations: a basic allowance and a shelter allowance. The basic allowance amount is determined by the size of your family, and the shelter allowance amount is based on the size of your family to a maximum amount, including rent, mortgage, utilities, taxes, Condo fees, apartment Insurance.

For you to qualify for ODSP, two separate criteria must be met. As with Ontario Works, applicants must verify financial need through a financial intake at their local ODSP office. As well, applicants must complete medical information (the "Disability Determination Package") and have this adjudicated and certified by staff at the Disability Adjudication Unit in Toronto. Once both criteria have been met, the applicant is granted ODSP Income Supports.

The Disability Determination package or Application for Ontario Disability Support Program contains:

Health Status Report (HSR) an dActivities of Daily Living Index (ADL) (yellow): This documents health facts and limitations in functioning independently in personal care, community participation and employment. Your Family Doctor or Specialist, a Psychologist, an Ophthalmologist/Optometrist, or a Registered Nurse “in the Extended Class” can complete it. Any of the above or your Chiropractor, Audiologist or Occupational Therapist/Physiotherapist may complete the ADL portion.
Consent to the Release of Medical Information (CRMI): This is completed by the Applicant or Trustee and allows ODSP to follow up on any additional medical information required.
Consent to the Disclosure, Transmittal or examination of a Clinical Record under subsection 35(3) of the Mental Health Act (where appropriate): This is completed by the Applicant or Trustee (only when applicable) and allows ODSP to follow up on any additional medical information required.
Self Report (SR) (pink): The Applicant or Designate completes this form. This is the opportunity where the applicant may document in their own words what is happening with their health and how it affects their ability to work, or check off the box indicating they choose not to complete the Self Report form. Either way they must sign and date this form.

The original Health Status Report and Activities of Daily Living Index form must be submitted. Photocopied forms will not be accepted.

ODSP will carefully review your past income (when, how much, etc.) and your assets. Liquid assets include savings, stocks, bonds, RRSPs, investments and some assets that can be readily converted into cash. Exempt assets include one principal residence, one vehicle, prepaid funeral, awards for pain and suffering up to $100,000, trust fund derived from an inheritance or a life insurance policy up to $100,000, and the cash surrender value of a life insurance policy up to $100,000. The combined total of the trust and cash surrender value of a policy cannot exceed the $100,000 asset limit.

The allowable asset level for ODSP is higher than Ontario Works, recognizing both the extra costs of living with an illness/disability and the potential long-term need for this income program. The allowable asset level is $5,000.00 for a single person, $7,500 for a couple, and an extra $500 for each dependent child.

Applications for ODSP will either be accepted through an Ontario Works intake (those who have an immediate financial need) or through a local ODSP office intake. Check the blue pages of your phone book under the Province of Ontario section, or contact your local Member of Provincial Parliament (MPP).

Your last source of income (when and how much)
Eligibility for other income programs
Liquid (savings, RRSPs, stocks, bonds) and acquired assets (property, vehicles, life insurance policy)
Marital status and family composition
Rent/housing charges/mortgage/utilities/Condo fees/property taxes
Status in Canada
Debts and monies owed to you

You will meet with the ODSP worker at their office, (unless you are house or hospital confined and they will visit you), and will require proof and documentation to support your application. This will include identification, proof and value of all liquid and acquired assets, all housing related expenses, all documentation related to any other sources of income, family composition and proof of attendance in school for dependent children. You will be given the Disability Determination Package and asked to return this to the Disability Adjudication Unit (DAU) within three months (the sooner the better) for adjudication. Once certified at the DAU, the ODSP worker will re-review your financial situation, and grant your monthly entitlement. You might receive a back payment for some or all of your entitlement to the date your completed application was received by the DAU, or the first day of the month after the day your application was received, depending on whether or not you are getting OW while you wait.

To receive ODSP, you must demonstrate that you have a substantial physical or mental impairment that is expected to last one year or more, and causes substantial restrictions in your abilities for self care, functioning in the community or functioning in the work place.

However, recent changes in the definition of impairment (changed April 30/03) for people living with HIV/AIDS has made being medically certified to receive ODSP much easier. Now, any applicant who has a positive HIV test as confirmed by ELISA and the Western Blot test will be considered disabled, and will not be given any medical review date.

The time process from intake to final granting of ODSP can be a minimum of 6 months, and depends on:

Those presently receiving Canada Pension Plan - Disability Benefits will be "fast tracked" onto ODSP, only needing to meet financial eligibility criteria and not prove their illness or disability through the Disability Determination Package as their disability has already been proven in order to be granted Canada Pension Plan - Disability Benefits. Only the difference between the full ODSP entitlement and the amount they get from CPP-D payment will be paid by ODSP.

In addition to an intake for ODSP you will need to fill in a Disability Determination Package (DDP). A portion of the DDP needs to be completed by your physician.

For information about the kind of help you may get and how to apply for the Ontario Disability Support Program (ODSP), the following guides are available from ODSP:

If your health recovers and you return to work or if you acquire a new source of income, such as Canada Pension Plan, you must inform ODSP. If your income exceeds your monthly benefit entitlement, you will stop receiving financial assistance but may still be eligible for drug coverage (called Extended Health Benefits) is you can prove you have high monthly medication costs. ODSP offers a variety of assistance and services for people who are considering a return to work, such as skills upgrading, training program, job search assistance, etc. You can work and continue to receive ODSP benefits. You must report all income. A calculation is made to determine how much your benefits will be reduced because of your income. You keep the first $160 you earn (for a single person). After that, 75% of the rest is deducted from your cheque dollar for dollar.

The Certification and Adjudication process can take several months, and you will be notified when you have passed each step of the way. Once granted ODSP, your monthly cheque can be mailed/picked up/directly deposited at the end of that calendar month. You will also receive your Drug Benefits and Dental card with each monthly cheque.

It is your responsibility to notify ODSP of any changes in your circumstances. Failure to do so could result in an overpayment recovery, suspension or termination of benefits. If you disagree with a decision regarding your case, you can appeal this decision to your worker, by requesting an internal review within 10 days of receiving the decision. If you still disagree with the worker's decision, you can appeal to the Social Benefits Tribunal. Appeal forms are available by calling (416) 326-0978 or Toll Free: 1-800-753-3895, or at www.sbt.gov.on.ca

Q: I'm HIV+ but my health is okay. Don't I qualify for ODSP based on my HIV status?
Yes. A person who has been diagnosed HIV+ and has confirming blood tests, is considered to have a substantial disability and is medically eligible.

Q: I'm on Employment Insurance. Can I still apply for ODSP?
If you think you qualify for ODSP, apply for it right away. You can receive EI payments while waiting for your ODSP to be approved. EI benefits are often larger than ODSP benefits. You wouldn't start receiving benefits until your EI benefits run out, unless your EI is less than what ODSP would pay you. However, you might qualify for a Drug Benefit Card. Many people apply for EI and ODSP at the same time. If you are approved for ODSP while receiving EI benefits, you will have to report the EI benefits as income.

Q: I'm not sure how long I'll be sick. Should I still apply for ODSP?
If you aren't sure, it's a good idea to apply. If you get approved and don't need it, you can turn it down. If your health changes in the future, you'd be "fast-tracked" for benefits. That means you could start receiving benefits within the same month you re-apply.

Q: Is there a way to get extra money from ODSP?
Yes. If you are receiving the basic entitlement from ODSP you may be eligible for additional monthly benefits. ODSP is pretty much approving everyone with HIV infection for some amount of the nutrition benefit. Beyond wasting, weight loss, diarrhea, trouble with solid foods, unique dieteary needs, etc., HAART alone is recognized as compromising nutritional absorptioin. Ask your worker for a Special Diets Application Form, have your doctor complete it and submit it. You can receive up to $240 extra per month. As well, there is a Mandatory Special Necessities Benefit Request form that may help with medical related transportation, diabetic supplies, surgical supplies and dressings. It needs to be completed by your doctor. It is a good idea to get a quote for the cost of the supplies needed from your pharmacy on their letterhead to submit with the request..

For more information on services and resources for people with disabilities, visit the Disability WebLinks Internet site:
www.disabilityweblinks.ca

We hope this information provided by the Ontario AIDS Network answers all your questions. If the section does not answer all your questions, and you have HIV/AIDS or are an individual or organization supporting someone living with HIV/AIDS, let our Benefits Expert answer your question. All responses are confidential. Click HERE to send your question.