Featured Cases

Different definitions of “full-time student” were at the heart of a recent Veterans Affairs Canada (VAC) decision to deny a Veteran an additional disability pension for his child who is attending university. The student has special needs, and in September 2015 reduced his course load to two courses totalling six hours a week.

In August, a Veteran experienced a four-day delay in receiving a drug prescribed by an Emergency Room (ER) physician for an acute condition. The ER doctor prescribed a drug that the Veteran learned, after two pharmacy visits, required special authorization from Medavie Blue Cross (MBC). Unable to afford the up-front medication cost, the Veteran contacted the Office of the Veterans Ombudsman for help.

The son of a 101-year-old frail Veteran called the Office of the Veterans Ombudsman (OVO) seeking assistance in appealing VAC’s denial of a prescribed therapeutic nutrient for the Veteran. This Veteran was suffering from a decreased appetite and weakness for two weeks, and after hospitalization, was prescribed Glucerna meal replacement to supplement the Veteran’s daily food consumption. The Veteran was also suffering from a broken wrist, diabetes and other serious health conditions.

A Veteran contacted the Office of the Veterans Ombudsman because he was unsatisfied with the initial (interim) assessment of 28 percent that he had received for several major injuries sustained as a result of an IED explosion. The Office contacted Veterans Affairs Canada’s Head Office Senior Medical Advisor and through discussion was able to have the injuries evaluated holistically (as opposed to each in isolation). This resulted in an increase in the assessment from 28 percent to 72 percent.

A Veteran contacted the Office of the Veterans Ombudsman because he was feeling unsure about the career path Veterans Affairs Canada had selected for him and was worried that the Department was on the verge of closing out his Vocational Rehabilitation Plan. This Veteran had served as an air traffic controller and a trucker in the Canadian Forces. The Department’s vocational service provider had sent the Veteran to a custom broker training program, but the Veteran did not feel that this was a suitable gainful employment career path for him.

A Veteran pensioned at 100 percent had been waiting for a year for approval of home gym equipment to help alleviate the pain to his condition caused by excessive car travel. This Veteran is required to do a six hour return trip three times a week to the nearest town to get physiotherapy treatment. The Veteran had submitted to Veterans Affairs Canada a prescription from his doctor and a written recommendation from his physiotherapist for the home gym equipment, but it had not been approved by his Case Manager.

A Veteran applied to the Rehabilitation Program and at the same time submitted an application for the Permanent Impairment Allowance (PIA). The PIA application was declined because the Rehabilitation Program request had not yet been approved – a requirement of PIA application. When the Rehabilitation Program was approved, the PIA was not considered. The Veteran contacted the Office of the Veterans Ombudsman seeking help to get his PIA application approved. By intervention of the Office, this Veteran will receive all the PIA benefits for which he is eligible.

A Veteran contacted the Office of the Veterans Ombudsman because he had an outstanding ambulance bill that had been sent to a collection agency. The Veteran had submitted the bill to Veterans Affairs Canada for payment, but the Department denied payment due to insufficient information. Our Office intervened with the collection agency and asked them to put it on hold while we investigated the issue. After proving to the Department that the ambulance service was incurred as a direct result of the Veteran’s pensioned condition, it agreed to pay the ambulance bill.

A Veteran contacted the Office of the Veterans Ombudsman about his difficulties in obtaining approval for additional chiropractic treatments, beyond and above the number of treatments allowed by the Department. Every year, for the past eleven years, the Veteran requested approval for additional treatments, which were needed to maintain his present mobility, and prevent his condition from deteriorating. One year he would get approval from the Department, and the next year, his request would be declined.

A Veteran asked for our assistance in obtaining reimbursement for a medical procedure. On two previous occasions, the Department had reimbursed the Veteran for the cost of the medication as well as the cost of the injection that was done by his doctor. The last time the Veteran requested reimbursement, the Department agreed to reimburse the Veteran for the cost of the medication but did not authorize the reimbursement of the medical procedure.