Featured Cases

A Veteran was initially denied coverage for noise sensitivity treatment related to their service-connected tinnitus, despite expert medical evidence. After the OVO's intervention, VAC reviewed the case, clarified its policy, and reimbursed the Veteran for the previously denied treatment, resolving the issue over a year later.

A Veteran with an autoimmune disorder was denied coverage for a new medication not included in VAC's standard formulary, despite suffering severe side effects from the previous treatment. After the OVO's intervention, VAC’s Exceptional Benefits Unit quickly approved the medication, granting the Veteran retroactive coverage within a week, ensuring timely access to the necessary treatment.

A Veteran was initially denied coverage for fertility treatment due to a misclassification of her application under the wrong VAC coverage category. After the OVO identified the error, VAC reconsidered the application under the correct category and reimbursed most of the treatment costs, ensuring the Veteran could pursue her goal of starting a family without further delay.

A single parent Veteran, caring for three children and their mother with dementia, was supported by the OVO after being denied full reimbursement for dependent care expenses during a 45-day rehabilitation stay. The OVO determined the Veteran was not informed of the child care reimbursement limits and successfully advocated for full reimbursement from VAC.

A medically released Veteran experienced a five-month delay in receiving a decision on their VAC rehabilitation application, resulting in a loss of income replacement benefits and rehabilitation treatment. After an OVO review determined the delay was unfair, VAC accepted the OVO's recommendation to adjust the decision date and provide retroactive payments for both income replacement and medical expenses.

A Veteran diagnosed with end-of-life heart failure was initially denied Red Zone status for two disability applications despite the severity of their condition. After the OVO's intervention, a second medical opinion confirmed the Veteran still met the medically at-risk threshold, leading to VAC's approval of their Red Zone request for expedited adjudication.

A Veteran sought help after Veterans Affairs Canada (VAC) withdrew applications for the Attendance Allowance and Caregiver Recognition Benefit (CRB). Upon review, it was discovered that the CRB application was mistakenly withdrawn, and following intervention by the Veterans Ombud, VAC approved the Veteran’s CRB retroactively.

A Veteran facing declining health contacted the Veterans Ombud after Veterans Affairs Canada (VAC) denied coverage for a critical medication, despite medical documentation from a specialist. After the Ombud's intervention, VAC reviewed the request and approved the drug therapy, ensuring the Veteran could access the treatment she needed.

Eligible Veterans can apply to have home support and personal care services covered through the Veterans Independence Program (VIP).

Sometimes an OVO investigation finds unfairness in VAC’s decision process for medical expenses. How a policy is interpreted can lead to denial of coverage for treatments that otherwise might be covered. This was the case of a Veteran who contacted our office.