Disability Benefit Wait Times Update - September, 2022

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 times^{Footnote 1} 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 Zone^{Footnote 2} 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.^{Footnote 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.^{Footnote 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.^{Footnote 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.^{Footnote 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.

Claims submitted by CAF Members and Veterans - Fiscal Year 2021-22
Category	Average Weeks to Decision	Difference from Average	Median^{Footnote 7} Weeks to Decision	Total Applications^{Footnote 8}
All Applications	43	0	30	35,223
Male	43	0	30	28,775
Female	43	0	29	6,346
Anglophone	42	-1	29	28,942
Francophone	50	+7	41	6,238
Male Anglophone	42	-1	29	23,621
Male Francophone	51	+8	41	5,136
Female Anglophone	42	-1	28	5,263
Female Francophone	48	+5	39	1,082

Claims submitted by RCMP Members and Veterans - Fiscal Year 2021-22
Category	Average Weeks to Decision	Difference from Average	Median Weeks to Decision	Total Applications
All Applications	39	0	29	8,955
Male	39	0	29	7,262
Female	40	+1	27	1,689
Anglophone	39	0	28	8,592
Francophone	51	+12	47	358
Male Anglophone	38	-1	28	6,962
Male Francophone	54	+15	55	296
Female Anglophone	40	+1	27	1,627
Female Francophone	35	-4	16	62

*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