ISSUE: A 91-year-old widowed Veteran received a favourable Pain and Suffering Compensation (PSC) decision upon appeal to the Veterans Review and Appeal Board. However, the Veteran passed away just three days after receiving the PSC notice from Veterans Affairs Canada (VAC) and did not have the opportunity to elect the lump sum instead of the default monthly payment of the benefit. VAC initially refused to pay the more than $75,000 balance to the Veteran’s estate because the Veteran died prior to electing the lump sum, and lump sum payments in these circumstances are only payable to a spouse or dependent child.
ACTION: The Office of the Veterans Ombud (OVO) determined that the outcome was unfair. Specifically, despite the Veteran’s age and rapidly declining health, which the daughter had informed VAC about on several occasions, VAC failed to fast track the decision even though the Veteran qualified as a “Red Zone” applicant; “Red Zone” is for Veterans who are medically at risk, palliative, or over 80 years old. Additionally, the favourable PSC decision letter did not include the lump sum election form that is standard practice for Red Zone applicants. At the request of the OVO, VAC reviewed the file and confirmed that there had been an administrative error in this particular case. VAC subsequently notified the Veteran’s estate of the error and authorized the lump sum payment.
RESULT: VAC issued the PSC lump sum to the Veteran’s estate in full.
This case is similar to another complaint we received that prompted our 2024 report on Full and Fair Payment of Pain and Suffering Compensation. Read the full report and its two recommendations here.