Delays to Veterans' road to wellness

Ottawa, ON - December 7, 2016

Today I’m writing about an issue that I’ve been raising for some time with Veterans Affairs Canada (VAC) without success. It is an issue for which I receive many calls from frustrated Veterans and an issue that highlights an important inconsistency between the Pension Act and the New Veterans Charter (NVC).

There is an unfairness in the Veteran Health Care Regulations in how VAC reimburses Veterans for their treatment expenses related to their illness or injury. Veterans eligible for a pension under the Pension Act are reimbursed for all expenses they incur, from up to 90 days before they even apply for a Disability Pension. Veterans covered under the NVC who are eligible for a Disability Award are only reimbursed for expenses as of the date that VAC decides to approve a Disability Award. This is a significant difference, and one that is compounded further by the fact that VAC is currently working through a backlog of Disability Award applications meaning that decisions can take up to nine months.

This means that a Veteran who applies for a Disability Award for hearing loss, for example, may wait months for a decision from VAC, and during this time, he or she may have to purchase a hearing aid or pay for other treatment out of their own pocket, without reimbursement from VAC. The Veteran can only begin to submit their expenses to VAC for reimbursement after their application for a Disability Award has been approved, and only for those expenses that were incurred after the approval.

This inequity was acknowledged after the implementation of the NVC as an unintentional consequence of changes in how the Disability Award was administered compared to the Disability Pension. VAC’s Evaluation of Disability Pensions and Awards in 2010 noted the inequity and recommended that treatment benefits be reimbursed retroactively, to the date of application. I have also recommended in two of my reports: Veterans’ Right to Fair Adjudication (2012) and Veterans Right to Fair Adjudication:  The Follow-Up Report (2014), that the Minister of Veterans Affairs remedy this inequity. Specifically, I asked that the Minister “put forward the necessary legislative and regulatory amendments to allow Veterans to be compensated retroactively to the date of application” under the NVC.

Since the beginning of my mandate, I have raised this issue and it has yet to be addessed. It has become further exacerbated now by the steady lengthening of turnaround times for Disability Award decisions. VAC is fully aware of this problem and has repeatedly promised to address it at the right time, but the right time never seems to arrive. VAC must move forward to correct this issue and to prevent further delays for Veterans on their road to wellness. Our Veterans and their families deserve no less. 

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Comments

G.G RCAF CWO (Ret'd) said:

I have appealed my denied applications for hearing loss 4 times now and VA still refuses the recommendation from an ear specialist. I have even asked this doctor to put the wording VA wanted, " hearing loss can be directly attributed to working on and around a noisy aircraft environment." The VA experts don't seem to get that hearing loss can get worse over time due to these noisy environments. I am on my last appeal and hope this time is positive.

December 10, 2016 11:09 AM

Office of the Veterans Ombudsman

CWO, I encourage you to please contact my Office for assistance at 1-877-330-4343.

December 16, 2016 3:39 PM

Solovic said:

Franchement, je suis sidéré de constater que le Bureau responsable de l'étude des requêtes déposées les ont retirées sans m'en aviser préalablement que certains documents manquaient. Pourtant, l'agente des pensions avait tout vérifier et confirmer que toutes ces requêtes étaient complètes. Ce qui a eu pour conséquence que les requêtes déposées en 2013 et 2014 ne sont toujours pas traitées et qu'elles ne le seront peut-être pas avant le printemps ou l'été 2017. Je suis désolé de constater que malgré de nombreuses plaintes à cet égard, que le Bureau de l'Ombudsman refuse d'intervenir car ces causes sont en Cour. Si le Bureau de l'Ombudsman et celui du Ministre ne font rien pour réparer ces injustices envers les Vétérans : Qui le fera?

December 8, 2016 6:26 PM

Pain Waiting said:

Now that VAC has passed on many services to MediBlue, the service provides no common sense versus pigeon holing people and their personal situation. Due to not living in a urban city and not having the diverse facilities a Veteran is penalized. Example; If you get chiropractor services at one clinic and get cold laser therapy at another chiropractor office, they are lumped into the same hole. If one asks for extended visits, so must the other and each explain why the treatment is necessary. if you live in a urban city, you can get the cold laser done by a massage therapist or physiotherapist that has the qualifications and thus no problem... They say you cannot cure stupid and this is truly the case when common sense does not prevail... I have spoken to VAC, Mediblue and the Ombudsman office for 2 years and you think this does not have a major impact on someone who also suffers from PTSD??? Now I will be in the appeal process to simply get treatment and keep the medication to a minimum...

December 8, 2016 5:33 PM

Mario said:

I am 78 years of age and a veteran of 30 years service. While grateful to the RCL and VAC for recognition and acknowledgement of hearing loss a few years ago, other related health issues presented themselves and an application for benefits was submitted accordingly. Much time passed and the application was rejected. An appeal was made and denied. This was followed by two other appeals and upon the last appeal was informed that no further appeal would be available to me with the exception of resorting to the Federal Court. Research indicated that I would likely need about $10,000 for legal and other fees to pursue my claim and that in all likelihood the court would probably defer to the VAC "experts" anyway. I don't know of many veterans who can afford or risk losing that amount of money or more - I certainly can't! Back in early August of this year, the RCL service officer referred me to a well known and respected orthopaedic surgeon who performed a thorough and in depth examination of my physical problems that confirmed all other medical information previously submitted by my family physician. I was informed by the service officer that if lucky, I might hear from VAC in about four months. Simple math shows I am now in my fifth month and still waiting for a reply. Not only that, but looking back to the date of the initial application I am now approaching the FOURTH year of waiting. Incidentally, earlier this year I forwarded my complete file to the Ombudsman's Ottawa address with a complaint application. With the exception of one phone call from a rep from that office, I have never heard anymore since.

December 8, 2016 2:10 PM

Office of the Veterans Ombudsman

Mario, I encourage you to please contact my Office for assistance at 1-877-330-4343.

December 8, 2016 3:30 PM

scaryterry22 said:

Bonjour, I feel the Veterans Ombudsman compliant process is also in-need of revision. I made numerous attempts to make a complaint by telephone and could not reach anyone. I then made an online submission via the website and did not receive a reply. I then sent my complaint via email and only received an autoreply that my email had been received. It has been weeks since my complaint has been received by the Office of the Veterans Ombudsman and all I have received is the email autoreply that I suspect did not involve any human interaction. Due to the stated time sensitive nature of my complaint, I am concerned that others with more serious issues are not receiving timely assistance. Most respectfully, st22

December 8, 2016 11:40 AM

Office of the Veterans Ombudsman

Encountered delays are very unfortunate but please note that complaints and queries directed to my Office are assigned in priority sequence and I can assure you that members of my team are doing everything possible to respond to complainants and provide assistance as fast as possible.

December 9, 2016 10:03 AM

John C Greenfield said:

I congratulate you on you continuing to get answers from VAC on that subject and on others that you have looked into. Can you imagine the frustration of the Veterans when they keep getting the run around on their questions.

December 8, 2016 11:24 AM

Office of the Veterans Ombudsman

Thank you for your encouragement. We will keep working until we get the right outcomes for Veterans and their families.

December 8, 2016 11:39 AM

Greg said:

I have this exact problem currently, and have had in the past. I started physio for an injury that my health care practitioners say are a consequential result from my service injuries (already pensioned). I quickly went through the $500 allowed by Sun Life and I had to stop, I just can't afford 2 physio/week plus massage. My application to recognize this injury as consequential has sat for months (with all the proper documentation, been on this rodeo before), all the while I do not receive treatment. I have no doubt that VAC will deny me, as they have everything else only to be granted after Departmental Review or Appeal. Either way, no treatment, lots of pain. Awesome system.

December 8, 2016 11:06 AM

Office of the Veterans Ombudsman

Greg, if you have not already done so, you should submit a complaint via our website or if you prefer, contact us as 1-877-330-4343.

December 9, 2016 10:07 AM