Introduction

Over the past year, we have heard from both Veterans Affairs Canada (VAC) and from the Office of the Auditor General about the time it takes for disability benefit decisions to be made. The Department’s published service standard is 16 weeks for decisions to be made on a completed application. In our study on wait times in 2018, we found that wait times significantly exceeded the service standard for most applicants, and, on average, female and francophone applicants waited the longest.

In their May 2022 report, the Auditor General found that during the period April 2020 to September 2021, female and francophone applicants still waited longer than their male and anglophone counterparts. The Auditor General also found that Royal Canadian Mounted Police (RCMP) applicants waited longer than Canadian Armed Forces (CAF) applicants. We have continued to monitor the Department’s progress on reducing both the backlog of claims awaiting decision and the time that Canadian Armed Forces (CAF) Veterans, serving CAF members, and current and former RCMP members have to wait for those decisions.

In this update, we reviewed the wait times, disaggregated for service, sex and language, for the fiscal year 2021-2022. We found that while there has been notable improvement over the past year, VAC is still far from meeting their service standard: on average, applicants across all of these groups are still waiting far too long for disability decisions. Excessive wait times continue to be the most common complaint that we receive. We also found that while VAC has resolved the inequity in wait times for female applicants as compared to their male counterparts, there is still inequity for francophones, and male francophones are now waiting the longest. Finally, we found that RCMP applicants have seen a notable improvement in wait times for their disability benefit applications.

We applaud the Department’s efforts to not only reduce the backlog, but to level the access to disability benefits among all applicants regardless of service, sex and language. However, while progress has undoubtedly been made, there is still work to do for francophone applicants. And, the fact still remains that CAF Veterans without access to health care are most impacted by the wait for disability benefit decisions to open the gateway to treatment benefits. We will continue to urge VAC to meet their service standard for deciding disability benefit claims and to implement our 2018 recommendation to proactively triage applications based on unmet health needs.

Methodology

We requested statistical reports from VAC on disability benefit turnaround times¹ for the last three fiscal years (2019-2020, 2020-2021, and 2021-2022), as well as a quarterly breakdown of those numbers for fiscal year 2021-2022. Our request was for first decisions (i.e., excluding reviews and reassessments), and excluded Red Zone² to ensure that our analysis of wait time averages would reflect the experience of most applicants, as Red Zone applications are processed faster and may skew the average. We requested this information be disaggregated by sex and language.

Findings

Finding 1: Wait times continue to significantly exceed the service standard

While there has been a decrease in the average wait time, and process improvements appear to be having a positive impact overall, wait times continue to significantly exceed the service standard, which remains unchanged at 16 weeks. On average in fiscal year 2021-2022, disability benefit decisions for CAF applicants took 43 weeks, and for RCMP applicants, 39 weeks. Both of these are more than twice the service standard. We note as well that the average wait time for CAF applicants has in fact deteriorated significantly since 2018: we had reported that based on a sample of 300 CAF files, the average wait time for CAF applicants was 29 weeks. In 2021-2022, the average CAF wait time was 14 weeks longer than that.³

It must be noted that VAC received 18,000 more applications in 2021-2022 than in the previous year. Despite this significant increase in workload, VAC managed to reduce the average wait time by 3 weeks for CAF applicants and 14 weeks for RCMP applicants in 2021-2022 compared to the previous fiscal year. This is evidence that process improvements are having an impact and trends are moving in the right direction.

Finding 2: Female applicants did not wait longer than male applicants in 2021-2022

The gap between male and female wait times appears to have been closed in 2021-2022. Whereas our 2018 report found female CAF applicants waited on average almost four weeks longer than male CAF applicants, in 2021-2022, the average wait time for CAF female applicants was equal to their male counterparts. RCMP female applicants waited one week longer on average than their male counterparts in 2021-2022, but this was an improvement from the previous year in which the average wait time of female RCMP applicants exceeded that of their male counterparts by five weeks.

These improvements were seen primarily in the third and fourth quarters of 2021-2022; during this time, female applicants on average received faster decisions than male applicants. In the third quarter, female CAF applicants waited four weeks less, and in the fourth quarter, they waited about two weeks less than their male counterparts. Female RCMP applicants waited slightly less time in the third quarter, and slightly more in the fourth quarter than their male counterparts.

The likely reason for these significant improvements for female applicants in the latter half of 2021-2022 was the creation of a dedicated team in September 2021 that processes claims only from female applicants (Minister of Veterans Affairs [MVA], 2022). This team appears to be achieving its objective of resolving the inequity in wait times for female applicants.

The OVO will continue to monitor wait times for female applicants to ensure that this success is enduring.

Finding 3: Francophone applicants continued to wait longer than their anglophone counterparts, and male francophone applicants waited the longest

Francophone applicants experienced shorter wait times in 2021-2022 than in the previous year. However, this improvement was largely consistent with the overall improvement of average wait times for all applicants. The inequity for francophone applicants remains unresolved.

Francophone applicants, particularly male francophone applicants, still face inequitable wait times compared to anglophones. On average, CAF francophone applicants waited 8 weeks longer and RCMP francophone applicants waited 12 weeks longer than their anglophone counterparts in 2021-2022. Overall, CAF and RCMP francophones waited longer than anglophones in every quarter of 2021-2022. Male francophones waited the longest in 2021-2022: male CAF francophone applicants waited about 3 weeks longer and male RCMP francophones waited about 19 weeks longer than their female counterparts.

The Department has a dedicated unit and several bilingual teams that focus on French applications (Office of the Auditor General [OAG], 9). It is not clear why these teams and dedicated unit have not had the same success as the unit dedicated to female applicants. We understand that VAC has recently hired more bilingual and French adjudicators to increase its capacity to process French disability applications and ultimately to rectify the inequity in the wait times between francophone and anglophone applicants.⁴ The Department must improve wait times for francophones, both overall and compared to anglophones to achieve equity and fairness.

Finding 4: RCMP wait times improved

The 2022 Auditor General’s report found that RCMP applicants waited 14 weeks longer than CAF applicants for a decision from April 2020 to September 2021. Our analysis of VAC wait times indicates that RCMP applicants waited four weeks less than CAF applicants on average in 2021-2022, which is an improvement from the previous fiscal year in which RCMP wait times exceeded CAF wait times by six weeks. It appears that there have been improvements in wait times for RCMP applicants and we look forward to seeing how the Auditor General’s recommendations may further improve wait times for this group.

Outstanding Recommendation

On April 1, 2022, VAC implemented a new Mental Health Benefits initiative that provides mental health treatment coverage for Veterans with specific mental health claims while they wait for a decision (VAC, 2022). This initiative will lessen the impact of the wait for those who qualify for this new initiative.⁵ However, Veterans waiting with physical injuries needing treatment, will continue to experience the impact of the long wait. This is unacceptable.
To diminish the impact of long wait times, we urge VAC to implement our 2018 recommendation to expedite claims proactively for those applicants with unmet health needs or who are paying out-of-pocket for treatment.⁶ While Veterans will receive reimbursement after their application has been processed, lengthy wait times can lead to financial distress when Veterans are forced to pay out-of-pocket for expensive treatment, or they can worsen health conditions when Veterans forego treatment while waiting.

Wait Times for VAC Disability Benefit Claim Decisions Tables

The tables below present the average and median weeks to decide disability benefit first application claims for the fiscal year 2021-2022. The datasets exclude applications categorized as Red Zone, War Service, reassessments and departmental reviews.

*Data provided by Veterans Affairs Canada Statistics Directorate, Finance Division
*Average weeks to decision were rounded to whole weeks prior to making comparisons.

References

Minister of Veterans Affairs. (2022). Veterans Affairs Canada Response to the Standing Committee on Veterans Affairs Study Fairness in the Services Offered to Veterans: Francophones and Anglophones, Men and Women, and the LGBTQ+ Community. Charlottetown, PE: Government of Canada.

Office of the Auditor General of Canada. (2022). Report 2—Processing Disability Benefits for Veterans. Government of Canada. https://www.oag-bvg.gc.ca/internet/English/parl_oag_202205_02_e_44034.html

Veterans Affairs Canada. (2022). Mental Health Benefits FAQ. Charlottetown, PE: Government of Canada. https://www.veterans.gc.ca/eng/financial-support/medical-costs/treatment-benefits/mental-health-benefits

Footnotes

Footnote 1

The wait time is calculated in weeks from the Service Standard Start Date to the date of decision. The Service Standard Start Date is the date the Veteran submitted a complete application, including all required supporting medical and other documents.

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Footnote 2

Red Zone applications are processed on a priority basis due to medical risk and in some cases financial risk.

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Footnote 3

This sample did not include RCMP applicants. 

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Footnote 4

The new adjudicators will be assigned to process the oldest applications first, and therefore VAC does not expect to see an immediate closure of the gap between French and English processing times.

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Footnote 5

Following the end of the 2021-2022 fiscal year,  in May 2022 VAC senior management approved a change in the  Mental Health Benefits eligibility determination process to allow for every CAF Veteran and eligible still serving member who applies for disability benefits for any mental health condition to also be made eligible for Mental Health Benefits. The basis for this change is that applicants may not have a diagnosis or know exactly what condition they have at the time of application, and their condition may potentially be among those defined in the regulations. Benefit of the doubt is given to the applicant in making this eligibility determination.

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Footnote 6

Recommendation 3 from our 2018 Meeting Expectations report urged VAC to triage applications upon receipt based on health and financial need.

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Footnote 7

The median is the mid-point in a range of data or the point where 50% is above and 50% is below.

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Footnote 8

Application totals by Sex and Language will not match totals from Total Applications as they exclude Unknowns.

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MESSAGE FROM THE VETERANS OMBUD 

The core of our mission is to ensure that Veterans and their families are treated fairly by Veterans Affairs Canada (VAC). Every member of our team is dedicated to this mission. It means listening to concerns of Veterans or family members, gathering the facts and identifying potential unfairness. It means understanding the legislation, regulations, policies and processes relating to the programs and services offered by VAC, including the limits on their authorities. Our team also has to know about other services and supports for Veterans and their families so that they can be directed to the help they may need. I am incredibly proud of the work of each of our team members in their pursuit of fairness.

In early 2022 two of our key leaders retired: Sharon Squire, Deputy Ombud, and Michel Guay, Director of Intervention Services. For many years both of these individuals played a significant role in our work to support fairness for Veterans and their families. We thank them both for their service.  

We were fortunate to welcome two very strong leaders to our team: Kirsten Johnson as the new Director of Intervention Services and Laura Kelly as the new Director of Strategic Review and Analysis. Both Laura and Kirsten have a strong understanding of VAC programs and services. They will strengthen our ability to review individual complaints and systemic issues to ensure fairness for Veterans and their families.

Highlights

Fairness is important – Veterans and their families may have a lifelong relationship with VAC. After serving their country they want to feel supported and receive the programs and benefits they need for service-related illness or injury. As illustrated in our featured stories, our team advocates tirelessly every day for fairness: from assisting a Veteran to obtain Income Replacement Benefits, to untangling process issues that saw a Veteran’s application for benefits unfairly withdrawn. Our team works to resolve unfairness by engaging with VAC to help explain the unfair impacts of some decisions and seek a correction. Our goal, ultimately, is to connect or reconnect the Veteran and their family with VAC. 

While we dedicate significant resources to individual complaints of unfairness, we recognize that unfairness can be systemic and require broader action including amending legislation, regulations, policies or processes impacting the delivery of a program or service. In 2021-2022, we published a systemic review focusing on Peer Support for Veterans who have Experienced Military Sexual Trauma. As well, we published a systemic review of the Additional Monthly Amount payment calculation. Due to these reviews we made four new systemic recommendations to the Minister.

Furthermore, to learn more about women Veterans of the Royal Canadian Mounted Police (RCMP) and the Canadian Armed Forces (CAF), we completed and published a scoping review, which made clear that more research on women Veterans is needed to understand their unique needs and experiences.

Year Ahead

The Covid-19 pandemic has left many people disconnected. Over the course of the next year, we will be reaching out in person to the Veterans community to hear their concerns and share the work of our office. We will also be reconnecting with each other after a long period of remote work. 

We expect to increase our capacity to review individual complaints and improve our service response times.  

We will assist Veterans and their families by publishing information to help them navigate VAC programs and services; for example we will publish a Care at Home Guide in the Fall of 2022.  

Through our systemic reviews we continue to identify gaps in VAC programs and services that result in unfairness to Veterans and their families. Next year we have an ambitious workplan: updating our 2018 Timely and Transparent Decisions review; reviewing how sexual dysfunction claims consequential to psychiatric conditions are adjudicated; complete our review of care at home supports available to Veterans and their families; and review the VAC non-disability decision appeals process.  

We will complete the redesign of our website to make our work more accessible to Veterans and their families.

Most importantly we will continue to advocate for fairness for Veterans and their families.

Colonel (Retired) Nishika Jardine

Veterans Ombud

OUR ORGANIZATION

Our organization is made up of the:

• Veterans Ombud
• Deputy Veterans Ombud and Executive Director
• Intervention Services Directorate
• Corporate Services Directorate
• Strategic Review and Analysis Directorate
• Communications Directorate

The Office of the Veterans Ombud (OVO) has offices in Charlottetown, PEI, and the National Capital Region. We currently have 33 employees. Due to the COVID-19 pandemic in March 2020 we began working remotely. During this time we have continued providing uninterrupted frontline services to individual Veterans and their families, reviewing systemic issues, and engaging with Veterans and stakeholders.

SERVING VETERANS AND THEIR FAMILIES

WHY SHOULD VETERANS CONTACT US?

Everyone seeking or receiving services or benefits from VAC has the right to be treated with respect, dignity, fairness and courtesy. 

The Veterans Bill of Rights sets out their right to fair treatment by VAC.

If they feel that any of their rights have not been upheld or a decision is unfair, they have the right to make a complaint to the Veterans Ombud.

WHO WE ARE

The OVO investigates complaints and challenges the policies and decisions of VAC where we find individual or systemic unfairness. We strive to be an independent and respected voice for fairness and a champion for the well-being of Veterans and their families.

WHAT WE DO

We operate independently of VAC and we are impartial:

• We listen to our clients
• We review their files
• We walk them through the process

If we start a formal review of a complaint, we will explain how that works, evaluate how
a client was treated, how the process was followed and whether the outcome is fair.

Our Priorities

• Building trust: Meet regularly with the Veterans community and provide excellent service to everyone who brings an issue to us.
• Better outcomes for the Veterans community: Recommend changes to the VAC programs and services that improve the health and well-being of Veterans and their families.
• Fair and timely access: Identify unfair, inefficient and overly complex elements in the administration of VAC programs and services.

FEATURED CASES

Getting it Right: Correcting a Veteran’s Income Replacement Benefit Calculation

The Income Replacement Benefit (IRB) provides a taxable monthly amount to Veterans in the VAC rehabilitation program and to Veterans whose permanent physical or mental health condition prevents them from working. 

A Veteran who had served in the Reserve Force contacted us because she believed that her IRB had been incorrectly calculated. In reviewing her file, we discovered that her IRB had been determined using the salary she was receiving decades earlier when she had been injured, instead of her significantly higher pre-release salary. 

VAC policy states that when a Veteran continues to serve after an injury has occurred, the IRB should be calculated based on the period of service that has the highest monthly military salary. This policy is the result of a 2020 report and recommendation by our office that addressed an unfairness in the way VAC calculated IRB for reservists. 

We asked VAC to review the Veteran’s file and her IRB calculation. VAC corrected the error in accordance with their updated policy, and the Veteran’s IRB was increased to its proper amount; the Veteran also received a retroactive adjustment.

Untangling a Knot: Client’s Mistakenly Withdrawn Application is Processed

A Veteran reached out to us for help after VAC withdrew multiple applications for benefits. 

The Veteran, who needed the support of a caregiver, had been informed by VAC that his application for Attendance Allowance was withdrawn because he did not have the required Disability Pension of at least 1%. The client then applied for the Caregiver Recognition Benefit (CRB) and was advised that his application was being withdrawn because he had an entitlement under the Pension Act, even though this was assessed at 0% and did not qualify for any payments. 

We asked VAC to review the decisions to withdraw both applications in case the rules had not been properly applied. Thanks to our involvement, VAC found that the CRB application was withdrawn in error, and the Veteran’s submission was processed and approved retroactively.

A Long Road to Redress: Overpayment issue resolved and pension restored

A Veteran who was experiencing a decline in her pensioned health condition contacted us for help getting access to a much-needed medication. The Veteran had been receiving a specific drug treatment aimed at managing her serious condition. 

When her health began to deteriorate, her doctor prescribed a new drug to be taken in combination with her previous treatment to help stabilize the situation, but VAC denied this drug request despite supporting medical documentation from a specialist. 

Unable to pay out of pocket for the medication and facing the prospect of worsening health during the lengthy appeals process, the Veteran expressed her concerns to our office. 

In an early intervention, the OVO contacted VAC’s Program Management team and asked them to review the request on a priority basis. In consultation with Health Professionals, the VAC team approved the new drug therapy and notified the client, who was then able to receive the treatment she needed. 

OUR CLIENTS

As in previous years, the complaints we received from Veterans and those advocating for them related primarily to Veterans’ health supports and the wait time associated with disability benefit application decisions. We were able to meet or exceed our service standard by investigating 83% of complaints within 60 days, responding to 85% of information requests within five days, and making 87% of referrals within 10 days.

Intervention by the Numbers

INVESTIGATING SYSTEMIC ISSUES

Our Strategic Review and Analysis team identifies and conducts reviews into systemic issues that could impact many Veterans. These issues come to light through individual complaints, stakeholder engagement, and reviews of VAC programs and policies. 

The reviews provide information about important benefits and services for Veterans and their families, highlight gaps and fairness issues in those programs, and may include recommendations to the Minister of Veterans Affairs. 

In 2021-2022, the OVO published two systemic reviews and made four new recommendations. We also completed a scoping review of research about Women Veterans of the CAF and the RCMP.

Publications

Peer Support for Veterans who have Experienced Military Sexual Trauma - Investigative Report

This systemic review examined whether Veterans who have experienced Military Sexual Trauma (MST) have access to Veterans Affairs Canada’s (VAC) peer support programs. The OVO launched a review after receiving a complaint from a Veteran that they had been referred away from the peer support program provided by VAC because they had experienced MST. This review found that this was not an isolated case. 

Veterans who experienced MST did not have access to VAC peer support programs as compared to those who suffered from other military-related injuries or trauma. The review also found a lack of program monitoring, data collection and analysis, making it impossible for VAC to fully measure the effectiveness of the program outcomes and ensure the needs of all Veterans are met. The review made three recommendations: 

1. Provide a funded peer support program that meets the needs of Veterans who have experienced MST.
2. Publish the Gender-Based Analysis Plus for the establishment of a funded peer support program for Veterans who have experienced MST.
3. Establish a performance measurement system and report annually on all peer support program outcomes to ensure that the needs of Veterans and their families are addressed.

Women Veterans of the Canadian Armed Forces and Royal Canadian Mounted Police: A scoping review

This scoping review was published in the Journal of Military, Veteran and Family Health in October 2021. The review examined academic and non-academic literature about women Veterans of the CAF and the RCMP. 

Through it we learned that women Veterans are more likely to have experienced sexual misconduct and gender discrimination than their men counterparts and tend to leave the CAF and RCMP with fewer years of service. We also learned that women Veterans of the CAF experience higher rates of chronic pain and gastrointestinal disorders and are more likely to have suicidal thoughts or die by suicide than women in the Canadian general population. 

The research also showed that women Veterans have lower employment rates and lower incomes post-release than men Veterans. They more often have a difficult military to civilian transition and experience different issues with transition, such as feeling tension between different social expectations of them in and out of the military. 

The review concluded that more research is needed about Canadian women Veterans and their intersecting identities, particularly for RCMP women Veterans, as virtually no research is focused on their needs and experiences.

Additional Monthly Amount - Micro-investigation

From 2006 to 2019, VAC financially compensated CAF members and Veterans for service-related disabilities through the Disability Award—a lump sum payment. 

In 2019, VAC replaced the Disability Award with the Pain and Suffering Compensation (PSC)—a monthly payment for life. For more than 45,000 Veterans, the Disability Award received was less financially valuable than the Pain and Suffering Compensation if it had been available at the time. 

To compensate these Veterans, VAC pays them an Additional Monthly Amount (AMA) every month. The calculation of the AMA is complex. Overall, we found that the AMA is fair until Veterans reach a certain age. At that time, we found two fairness issues 

In response, we made the following recommendation: Correct the financial unfairness between the two benefits at the crossover point. Increasing the Additional Monthly Amount payment to the same rate as the Pain and Suffering Compensation payment for Veterans who live beyond their crossover point would be one way of achieving this.

SHARING, LISTENING AND CONNECTING 

Connecting with Canada’s Veterans, their families and other stakeholders is critical to our success. This connection helps guide our work and ensure it is relevant to those we serve. We use a mix of virtual and face-to-face engagement to educate our target audiences about the OVO’s services and to hear about issues impacting Veterans and their families. 

Reaching Out to Our Audience Virtually

Due to the COVID-19 pandemic the OVO relied heavily on virtual engagements to connect with Veterans and their families. Through phone, email, our online complaint form, and social media, we have been able to connect with Veterans and their families. Through virtual outreach we have helped them understand VAC programs and benefits and advocate against unfair decisions made by VAC.

Veteran and Stakeholder Engagement

The OVO has always placed great importance on outreach to Veterans, Veterans groups, stakeholders and decision-makers. Due to the COVID-19 pandemic, engagement strategies had to be adjusted to a virtual environment. Although not ideal, the Ombud and the OVO were able to connect with Veterans and stakeholders to remain abreast of Veteran’s issues and concerns. 

The Ombud and staff look forward to resuming in-person engagement in the coming year. Insights gained from the virtual meetings over the past two years will help shape the OVO engagement strategy, and the Ombud’s strategic priorities in the coming years.

VETERANS OMBUD'S ADVISORY COUNCIL (VOAC)

VOAC advises the Veterans Ombud on matters related to the OVO’s mandate. VOAC members bring to the table the diverse perspectives found within the Veterans community. Through their expertise
and knowledge, Council members identify emerging issues and provide advice on how to address them. VOAC members also raise awareness within the Veterans community about the role of the OVO.

Members 2021-2022

Pierre Allard
Heather Armstrong
Jane Hall
Jacquie Hannigan
Brigitte Laverdure
Heather MacKinnon
David MacLeod
Brian McKenna
Jay Milne
Rebekah Mitchell
Shauna Mulligan
Tim O'Loan
Albert (Al) Rivard
Paul Rutherford
Kimberley Unterganschnigg
Steve Walker
Christine Wood

VETERANS OMBUD COMMENDATION AWARDS

The annual Commendation Awards honour outstanding individuals and groups who demonstrate their commitment to the Veterans community through their selfless hard work. Recipients have been nominated by their peers for their exceptional contributions and dedication to improving the lives of Veterans and their families. 

2021 Recipients
 

Lifetime Contribution

Helen Escott
Dr. John Whelan

Individual Contribution

Jacqueline Zweng
Kyle Scott
Terry Malchuk

Local Organization

Heroes Mending on the Fly – Nova Scotia

National Organization

Canada Company: Many Ways to Serve

FINANCIAL STATEMENT

As per the 2021-2022 Departmental Plan, the Veterans Ombud planned spending was $5.6 million for fiscal year 2021–2022. The actual authorities at the end of fiscal year 2021-2022 were $4.3 million.