Published April 2022
Megan Poole, Program Review Analyst, Office of the Veterans Ombud
INTRODUCTION
THE OFFICE OF THE VETERANS OMBUD (OVO) investigated whether there is a sex-based bias in Veterans Affairs Canada (VAC) decision-making processes for sexual dysfunctions related to psychiatric conditions.
Veterans may experience sexual dysfunction related to their service, specifically as a result of psychiatric conditions like PTSD and the medication used to treat them. VAC disability benefits compensate and provide treatment benefits and services to members and Veterans who have a permanent service-related injury or disease.
What We Found
OUR REVIEW found systemic unfairness for female Veterans in certain VAC decision-making
processes. We also found serious limitations in the availability of accurate VAC client data.
KEY FINDINGS AND RECOMMENDATIONS
VAC streamlines applications for erectile dysfunction caused by medications to treat psychiatric conditions. Sexual dysfunction applications for female Veterans have no equivalent process.
Recommendation - Eliminate the sex-based bias in the VAC adjudication of sexual dysfunction claims consequential to a psychiatric condition.
The VAC medical questionnaire for sexual dysfunction contains a checklist that includes
male sexual dysfunctions, but there is no checklist of female sexual dysfunctions.
Recommendation - Update the PEN 68e Medical Questionnaire to equitably capture sexual dysfunctions affecting all clients.
There are two impairment ratings in the Table of Disabilities for male sexual dysfunctions and only one for female sexual dysfunctions.
Recommendation - Update the Table of Disabilities to include impairment ratings for all
sexual dysfunctions listed in contemporary diagnostic manuals to standardize the adjudication process for all clients.
Female Veterans are more likely to experience desire and arousal disorders that VAC adjudicates as decreased libido, which is not clearly defined in the Entitlement Eligibility Guidelines.
Recommendation - Provide clearer guidance for adjudicating female sexual dysfunction claims consequential to a psychiatric condition by defining decreased libido in the psychiatric Entitlement Eligibility Guidelines.
VAC does not adequately collect data related to sexual dysfunction claims.
Recommendation - Refine the granularity of the data collection system in order to fully capture the nature of sexual dysfunction claims.
CONCLUSIONS
OUR RECOMMENDATIONS focus on the processes used by VAC to adjudicate claims for sexual dysfunctions related to psychiatric conditions. Amending those processes could assist decision-makers to ensure clients with sexual dysfunctions other than erectile dysfunction are not waiting longer or experiencing unfair outcomes.