AI-Assisted Medical File Review for Disability Benefits

Eligibility & Public Benefits

What it collects that can identify you

Sensitive personal information

Identifiable data

Medical files from the PTDR and MSCA SharePoint Repositories, containing health and disability information submitted by CPPD applicants. This is sensitive personal information about individuals' medical conditions and functional limitations.

Also collects operational data, which is anonymized data.

Run by: Employment and Social Development Canada (ESDC)
Where: No fixed location
Kept: Not stated by the Helpful Places.
Shared with: Accountable organization
Your copy: You cannot see the data it holds about you. What you can do

What it is for

Eligibility & Public Benefits

This system uses artificial intelligence to help government employees review medical files for Canada Pension Plan Disability (CPPD) applications. It organizes documents, identifies key information, and provides summaries to support human adjudicators — the AI does not make eligibility decisions itself. Applicants whose files are processed through this system should know that AI is used to assist, not replace, the medical adjudicators reviewing their case.

What it collects and what happens to it

Data taken in

Sensitive personal information

Identifiable data

Medical files from the PTDR and MSCA SharePoint Repositories, containing health and disability information submitted by CPPD applicants. This is sensitive personal information about individuals' medical conditions and functional limitations.

Operational data

Anonymized data

Administrative and case management data from the PTDR and MSCA SharePoint Repositories, including document inventories, file organization metadata, and application records used to structure and navigate the adjudication workload.

Processing

Search & Retrieval

Retrieval-Augmented Generation (RAG) is the core processing technique, enabling the system to find and surface relevant passages from medical files in response to adjudicator queries. This is combined with NLP for understanding document semantics and OCR for digitizing scanned records.

Language Models

Large language model capabilities underpin the EVA Domain Assistant infrastructure, enabling natural language understanding of medical file contents and generation of document summaries and overviews for adjudicators.

What it does

Understanding (Semantic AI)

Human decides

The system uses Natural Language Processing and Retrieval-Augmented Generation to understand medical file content, identify key documents, and surface relevant information through citation reference links. Human adjudicators review the AI-produced summaries and make all adjudication decisions.

Creating (Generative AI)

Human decides

The system generates overviews and summaries of medical file contents to assist adjudicators. These AI-generated summaries are advisory inputs for human decision-makers, not binding determinations.

Sensing (Perceptive AI)

Human decides

Optical Character Recognition (OCR) is used to read and extract text from scanned medical documents, converting them into structured content that can be processed and retrieved by the system.

Outputs

Generated content

Anonymized data

AI-generated overviews of medical file contents, identification of key documents, and citation reference links, presented to medical adjudicators to support their review. These outputs are informational aids, not decisions.

A recommendation or prediction

Anonymized data

The system surfaces prioritized and identified key documents within a medical file, effectively recommending what an adjudicator should focus on. These are advisory outputs — the human adjudicator retains full decision-making authority.

Run by

Employment and Social Development Canada (ESDC)

Employment and Social Development Canada is the federal department deploying this AI system to support medical adjudication of Canada Pension Plan Disability applications.

Government of Canada AI Register — EVA Smart Assist for Medical Adjudication

Built by

Government of Canada

The Government of Canada's AI Centre of Excellence manages the EVA Domain Assistant infrastructure that underlies this system, including the Retrieval-Augmented Generation and Natural Language Processing components.

Government of Canada AI Register — EVA Smart Assist for Medical Adjudication

Kept for

Not stated by the Helpful Places.

Shared with

Available to the accountable organization

AI-generated summaries, document identifications, and citation links are available to medical adjudicators at Employment and Social Development Canada who use the system for CPPD file review.

Not available to me

The AI-generated file summaries and document rankings produced by the system are internal adjudication tools available only to ESDC employees; applicants do not have direct access to these outputs.

Stored

Not stated by the Helpful Places.

How to read the colours

Can it identify you?

Anonymized data: Data about people with the link to who is broken. Stripped of identifiers, blurred, aggregated, or noised so this system can’t reasonably tie a record back to an individual.
Pseudonymous data: Each person’s data is tied to a token (hash, ID, template) that lets this system recognise the same person across events, but the token itself doesn’t reveal a name. Reidentification is possible with extra information.
Identifiable data: The data either contains a direct identifier (name, address, account name, recognisable face or voice, plate number) or carries a token this system uses to look up legal identity during processing.

Who completes the loop?

Human decides: This mode suggests; a person decides what to do next. The AI is always advisory — a human is in the loop on every decision. Example: a triage tool ranks cases for a clinician who chooses which to see first.
Human executes: This mode decides; a person carries out the result. Example: an optimizer plans the day’s trash-collection routes, and drivers run them.
Autonomous: This mode decides and acts on its own. No person reviews each decision or carries out the resulting action.

Definitions from the DTPR standard. Amber is about your data, violet about who decides. The fuller the shape and the deeper the colour, the more identifying the data or the less a person is involved.

What you can do

Ask about this system

Questions go to the Helpful Places, not the vendor.

Your rights

Right to Be Informed of AI UseThe Government of Canada discloses that AI is used in this process (AI use disclosed to users: Y). Applicants should be informed that AI assists in organizing and summarizing their medical file for review by a human adjudicator. For questions, contact Employment and Social Development Canada.
Right to a Human ReviewAll adjudication decisions for Canada Pension Plan Disability applications are made by qualified human medical adjudicators. The AI system is used only to assist with document organization and information retrieval; it does not make eligibility determinations. Applicants may contact Employment and Social Development Canada to learn more about the review process.

Risks and safeguards

Reputational harmThe system may surface or emphasize incorrect or misleading information from medical files, potentially influencing an adjudicator's perception of an applicant in ways that could harm their disability claim.Safeguard: Human adjudicators retain full decision-making authority; the AI is advisory only. AI use is disclosed to users, and citation reference links allow adjudicators to verify information against source documents.
Psychological harmApplicants with disabilities may experience anxiety or distress knowing that AI systems are involved in processing their sensitive medical information during an already vulnerable period.Safeguard: AI use is disclosed to users (AI use disclosed to users: Y per the register), preserving trust and informed consent. Human adjudicators remain responsible for all decisions.