Thank you. There's a distinct difference in how an injured citizen and a veteran are supported. The citizen may apply to workers' compensation facilities, and assistance in various forms is provided. The veteran cannot apply to this entity for assistance. VAC is the workers' compensation system for veterans. The veteran should at least receive equal treatment and compensation for injury as that given to civilian workers.
Within VAC, there's been real progress since the deputy minister has brought his leadership to the department, and there's clear evidence that change is occurring. The major factor in the delay of VAC delivery of service is the lack of documentation about injuries in veterans' records and files. Some delays occur at the VAC scanning centre in Matane, Quebec.
Archives Canada has reported that Canadian Forces members' records of service, including medical and personnel documentation, are not being archived in a timely fashion. They advise that DND has embarked on a new method of digitizing and preserving records, and delays of several months are being encountered when these records are requested. We're aware that the personnel resources of the department are being adjusted to repair personnel reductions and that a reallocation of resources to case management is occurring. Case managers are the front line of Veterans Affairs Canada's service delivery. These changes are most welcome.
Desired outcomes, not just treatments and compensation, were the goal of the new Veterans Charter when it was introduced. Unfortunately, what we experience today is a continuance of layering of regulations and policies that make it difficult for veterans and even VAC staff to come up with an appropriate action. There doesn't seem to be a focus on outcomes, but rather a development of a quick prescription to solve problems. The department needs to focus on outcomes, not repairing and adjusting the labyrinth of programs and regulations.
In some NATO nations, there is a focus on the release process, so much so that the releasing veteran is examined holistically by empowered medical staff to document the medical condition of the veteran. In so doing, the lengthy and very frustrating process in post-release applications for disability awards is diminished or avoided.
I'll use some acronyms, so I'll introduce them. SISIP is Service Income Security Insurance Plan, and LTD is long-term disability. On complexity, not including mental health, disability applications, and the issues related to long-term care disability provisions, there are signs that some processes of VAC are being streamlined. SISIP is a CF-wide compulsory insurance policy. This warrants further examination by your committee so that the impacts of long-term disability by SISIP on VAC services are clearly understood.
A veteran applying for a disability award will be processed using the date of initial application as a reference point. If the application was made before March 2006, the Pension Act is used as the adjudication for an award. For applications after March 2006, the Canadian Forces Members and Veterans Re-establishment and Compensation Regulations Act, referred to as the new Veterans Charter, is used. If there's a negative decision under the Pension Act, the member can request any number of departmental level reviews and/or appeals to the Veterans Review and Appeal Board, with set limitations. Under the new Veterans Charter, only one application per departmental review is authorized, and the option thereafter is to go to the Veterans Review and Appeal Board. Why is there a difference?
The existing VAC service standards for departmental level reviews and for the Veterans Review and Appeal Board appeals are not promulgated. We have been advised by the Bureau of Pension Advocates that there is a backlog of cases and that they have personnel shortages.
In regard to wait times, because of the lack of documentation, internal and external to the department, delays in decisions occur. In client satisfaction data, we can find no reference to the achievement of the service standard of 16 weeks in rendering a decision on disability awards. The reasons for the timeline are not provided. Perhaps the reasons are document retrieval and a shortage of adjudication personnel. This should be examined further.
Decision times to allocate personal care have improved, but further improvements can be realized.
There is a lengthy process to obtain aids for living such as wheelchairs, walkers, canes, hearing aids, lift chairs, and the like. The present system is not timely and is rather cumbersome. The VAC service standard is three weeks, but delays can and do occur when financial approval of the needed service is delayed for months as the veteran's entitlement to service is studied.
As for complexity, the more complex the case, the longer the adjudication takes. Factors such as privacy concerns, gaining the testimony of physicians and medical specialists, the effectiveness of the case managers and service officers, and internal processes are all linked to delays.
We realize that service personnel generally do not apply immediately for a disability award for injury while serving. The “suck it up, boys” attitude still prevails in the military and some stigma is attached to reporting and recording an injury while in the service.
Another issue is the VAC claimed benefit of the doubt. It's our experience that without a Canadian Forces 98 report on injury, or without the testimony of a witness, veterans' claims are not ruled upon favourably.
The number of trained case managers has increased and this will surely benefit veterans over time. The training and placements of these managers is redressing a long-standing need. The days of the walk-in trade are past and most applicants now apply for assistance from VAC by telephone or by the Internet. Some veterans still need active case management, and they require visits by the case manager to their homes.
Regarding partnerships with National Defence, since the promulgation of the Neary report that led to the creation of the veterans charter, there remains a quest to have a stronger relationship between VAC and DND. The initial aims were to have VAC hire more ex-military personnel and to provide timely counselling to releasing Canadian Forces members. Much progress has been achieved. The creation and joint staffing of the joint personnel support units are achieving superb results, and we note that further initiatives in this partnership are being trialled and examined.
At the federal and provincial levels, some good regulations and policies are in place for hiring veterans, both able and disabled. However, despite what is written as policy, the public service unions seem steadfastly against any priority hiring or employment being given to veterans. Policies have been announced, but more needs to be done. Ministers, VAC, and DND could lead and set an example and set realistic goals and demand adherence. For instance, setting a goal of hiring one veteran per ministry per month would send a powerful message to all the other ministries. Another suggestion would be to do what the U.K. government does, in stating that Her Majesty’s government will not do business with any firm that fails to have an active veterans hiring practice in place.
As for regional offices, modern clients communicate with VAC through the Internet and telephone. However, since several veterans rely on the office people to assist them, we support having VAC offices across Canada. The matter of providing VAC services to rural areas is easily solved using the advertisement and arrival methodology previously practised.
The initiative wherein Service Canada personnel are to provide assistance and services to VAC will benefit veterans across Canada. However, the complexity and the construct and linkages of the VAC programs are such that present Service Canada personnel are not capable of rendering a one-stop shopping solution for today's vets.
There are differences in the quality of medical care across Canada and in rural and urban centres. The quality of care that a veteran receives depends on the circumstances of the health care process where he lives. Special needs people residing in rural areas need more help.
Dedicated VAC counsellors greatly assist veterans in addressing their needs. Most VAC offices are staffed with nurses and occupational therapists who can refer the veteran to the appropriate medical system. Once a referral is made and costs are involved, it's our experience that with the exception of prescribed medical aids, claims are repaid in a timely manner.
In the case of mental injuries, once treatment is prescribed by a specialist, including group therapy sessions, the veteran is compensated in a timely manner. We note that RCMP veterans diagnosed with PTSD may receive treatment by specialists, and compensation is provided by VAC. This service should also be provided to veterans and their families.
As for mental health services, Canada has a shortage of mental health specialists, and DND and VAC are taking actions to try to resolve this. Operational stress clinics go a long way towards solving and addressing these issues.
With respect to rehabilitation, VAC has disbanded the program evaluation directorate, under which VAC would remain unaware of program satisfaction trends without conducting a client satisfaction survey, and there they would only get partial answers. VAC has a lot of data available, but staff to analyze the data are not present. We consider that the criteria for access to rehab programs should be re-examined. The SISIP, in which long-term disability recipients receive little or no VAC support until the two-year assessment period for a long-term disability is completed, needs to change. Once the long-term disability period has expired, veterans and releasing military personnel have appropriate access to rehab services.
As for long-term care, we're aware of the plans concerning St. Anne's in Quebec, but access to long-term care facilities for veterans across Canada has been and will be necessary for a long time. The present construct does not facilitate the co-location of the veteran and the spouse in a VAC-funded facility. In addition, depending on the province of residence, there is no guarantee that the veteran will be located in a facility close to his family. This situation is a matter of availability of beds, and VAC could provide enticement to the provinces to realize this simple need.
The veterans independence program is an excellent program. We consider it a model for the treatment of aged, stay-at-home persons for the consideration of provincial jurisdictions. VAC uses a telephonic tool to determine the amount of VIP assistance that the veteran may be entitled to. For some veterans this tool would be of benefit to VAC and to the veteran. We have complained to VAC that this tool is not useful for some veterans who have hearing disabilities or for those who are frail. We recommended that this tool not be used in assessing the needs of these veterans. Unfortunately, our criticisms were not heeded. We can attest to a number of cases where a veteran has been granted two hours per week of housekeeping. I could go on to explain that, but I won't. It's our considered opinion that the minimum should be three hours per week. Another matter is that, while VIP services are extended to the spouse at the time of death, the percentage of the deceased veteran’s spouse disability benefit is diminished.
I've already spoken about the handling of claims, and I said that most of them are done in a timely fashion.
At the Veterans Review and Appeal Board, there are staffing issues and delays. The service standard for the delivery of VRAB services should be reviewed. Some cases take a long time to resolve. During this time, veterans are denied benefits and they become frustrated. We're aware of the past transgressions by VRAB in law and practice, and the quest for change is noted. The practice of appointing members through political patronage, as well as the embarrassment of failing to heed directions of the Federal Court of Canada, has angered veterans to the point that many have lost confidence in this appeal process. Nonetheless, veterans must have an appeal process.
We're most grateful for the opportunity to provide this testimony. We realized that you were well into the information-gathering phase and that you'd soon be doing investigation and analysis before rendering your report. The CPVA stands ready to assist you and respond to your requests as needed.
Thank you very much.