September 28, 2017
Boardroom 1403, 14th floor, 66 Slater Street,
Ottawa, Ontario
In Attendance
Policy Advisory Committee Group Members:
- Brian Forbes, National Council of Veteran Associations in Canada (Co-chair)
- Commodore (Retired) Andrea Siew (Co-chair)
- Major (Retired) Mark Campbell
- Master Warrant Officer (Retired) William MacDonald (by phone)
- Rear-Admiral John F. Newton, Canadian Armed Forces (by videoconference)
- Luc O’Bomsawin, Aboriginal Veterans Autochtones
- Brigadier General (Retired) Joe Sharpe
- Brad White, Royal Canadian Legion (by phone 9-10)
Minister’s Office:
- Cyndi Jenkins, Chief of Staff to the Minister (Visit)
- Paul McCarthy, Director of Policy
- Laurel Chester, Stakeholder Relations
- Bernard O’Meara, Stakeholder Relations
Veterans Affairs Canada Officials:
- Bernard Butler, Assistant Deputy Minister, Strategic Policy and Commemoration (VAC Co-chair)
- Faith McIntyre, Director General, Policy and Research
- Katherine Spencer-Ross, Director, Stakeholder Engagement and Outreach
- Karen Rose, Senior Analyst, Stakeholder Engagement and Outreach
Presenters:
- General Jonathan Vance, Chief of the Defence Staff, Canadian Armed Forces
- Mary Nicholson, Director, Health Care and Rehabilitation Programs, Service Delivery Branch (via videoconference)
- Libby Douglas, Director General, Service Delivery and Program Management (via videoconference)
- Tracy Cudmore, Senior Policy Analyst (via videoconference)
Observer:
- Sharon Squire, Deputy Ombudsman, Office of the Veterans Ombudsman
Regrets:
- Michel Houle, Veterans UN-NATO Canada
Opening Remarks
The Veterans Affairs Canada (VAC) co-chair opened the meeting and introduced General Jonathan Vance, Chief of Defence Staff (CDS), National Defence and the Canadian Armed Forces, and thanked him for coming to share his views on transition and care of members and Veterans.
General Vance spoke about the recently released Defence Policy and the change around the value of people and improving support to Canadian Armed Force (CAF) members and their families from recruitment through to retirement and beyond. He talked about ensuring that men and women in uniform are prepared and equipped to succeed on operations in an unpredictable security environment. He noted the importance of the family and that to date the role that families play in the health and recovery of ill or injured CAF members has not been totally valued. He indicated that he now has the mandate to increase support to families, modernize family support programs and better support families when members are deployed or during periods of absence.
The CDS discussed professionalizing transition and transforming the process to better support CAF members and their families whether returning to active duty or transitioning out of the military. He talked about the creation of a new transition group with over 1,200 personnel including specialized staff and holding positions for ill and injured service members. The Transition group will work in collaboration with VAC.
He addressed Service Income Security Income Program (SISIP) and the need for the CAF to have access to insurance for its service men and women. He noted that the alternative would be a public program which may not be effective or efficient and places all the risk and cost of the insurance program with the Canadian taxpayer. He indicated that while he would be open to improvements to SISIP, he does not want to eliminate it.
Finally, he expressed concern with a move towards a graduated compensation/career progression scheme as a policy approach to compensation for ill and injured releasing members, as benefits could provide incentives for military members to take their release and benefits rather than take the steps to recover and return to work.
General Vance was asked if ill and injured could be left at the unit level rather than being moved to the Joint Personnel Support Unit (JPSU) as is the current practice. He noted that every option is on the table as long as it can be appropriately administered. He provided an example of a member that needs medical care, and the importance getting him or her the right kind of medical care to expedite recovery.
It was agreed among members that the CAF needs insurance like SISIP for serving members but they expressed concern about the role of SISIP in transition and vocational rehabilitation, noting it needs to be fixed. SISIP and VAC with multiple programs, different eligibility requirements and different benefits and services creates confusion and barriers to successful transition for ill and injured members and Veterans.
There was some discussion on how to manage the complexity of career progression for ill and injured members. The CDS reinforced his position that a solution could be policy based with guidelines that allow for customization on a case by case basis. As an example, a seriously injured master corporal, unable to work inside the CAF or find a civilian career, would need a plan that includes the best medical care available and an income. The solution could be achieved through the new CAF transition group where a plan could be customized to meet his specific needs.
The VAC co-chair thanked the CDS for his insights and taking the time to attend the Policy Advisory Group meeting.
Following the departure of the CDS and throughout the day the members spoke to some of their concerns with the CDS perspective on SISIP Long Term Disability (LTD) and Vocational Rehabilitation and graduated compensation.
The Group’s advice is that the SISIP LTD and VOC REHAB program be eliminated and placed under VAC for all service attributable and non-service attributable medical releases – one program/one service delivery model. The Policy Advisory Group’s (PAG) advice is that that the Career Impact Allowance (CIA) provision with respect to projected loss of future earnings should reflect the standard of compensation – “What would the veteran have earned in the veteran’s military career had the veteran not been injured?”
Diminished Earning Capacity
The Director of Health Care and Rehabilitation Services and the Director General, Service Delivery and Program Management presented on the Diminished Earnings Capacity (DEC) process. This was a follow-up to the August 23rd teleconference as members asked for details on any proposed changes to the DEC, given that it is the gateway to financial security benefits such as Earnings Loss (ELB) and the CIA.
DEC was previously known as Total and Permanently Incapacitated (TPI) and means that a Veteran is incapacitated by a permanent or physical or mental health problem that prevents the Veteran from performing any occupation that would be considered suitable gainful employment. Suitable and gainful employment means employment for which the Veteran is reasonably qualified by reason of education, training or experience and that provides a monthly rate of pay to at least 66 2/3% of the imputed income of the Veteran.
A DEC determination provides the Veteran access to certain financial benefits and may provide eligibility for the Veteran’s spouse/common-law partner to the Rehabilitation Services and Vocational Assistance (Rehabilitation) Program. The health problems and impairment must be permanent, meaning they are expected to persist, despite rehabilitation.
A DEC decision must be based on evidence in relation to the health problems for which the Veterans is eligible for the Rehabilitation Program and include the prognosis regarding the program eligible health condition and the impact on functional capacity and employability. Best practices to evaluate these factors were reviewed including a Medical Questionnaire on Employment Capacity (VAC671) and/or other medical reports, a Functional Capacity Evaluation (FCE) tool and the Employability and Earnings Capacity Assessment (EECA). The FCE and the EECA are completed by VAC’s national vocational rehabilitation provider. It was also explained that there is a DEC review two years following the initial decision to determine if a Veteran still meets the criteria for DEC. A review can also be conducted if there is a change in circumstances.
It was noted that the FCE is a tool that is used broadly in the rehabilitation field and that it provides a comprehensive assessment of an individual’s capacity to dependably perform work and routine daily activities. The EECA is a more comprehensive test that is used to consider all the medical and vocational assessments and provide clear recommendations on the employability and the earning capacity of the person. The use of the EECA is considered a best practice by VAC. The VAC case manager is the delegated decision maker for DEC and determines what evidence they need to make an informed decision to support their assessment. The tools and when they are used is considered on a case-by-case basis. It was agreed that a copy of the tools would be shared with the members.
Changes to the current process are being considered by the Policy Tiger Team. Advisory group members noted that regardless of changes being considered consistency across the country will be important and given that the DEC is the gateway to future financial security it is very important that the Department get it right. Members also encouraged the Department to allow for exceptions to any type of mandatory evaluation, as common sense is the only factor to consider when it is readily apparent due to the nature of the injury that employability is not a consideration. They highlighted the need for streamlining, timeliness, quality control of decision making, and a mechanism to reach out to the cohort that are not actively case managed. To provide appropriate feedback the members felt that they need a better understanding of the new test, who is administering the test, who is making the decisions, and the appeal process.
The members advised that the approach proposed by the department for the implementation of DEC appears to be extremely restrictive and will positively impact only a limited number of disabled veterans. The Advisory Group stated that this is significant as the DEC represents the gateway to the extended ELB and CIA.
The Department was clear that what is being currently considered is not about reducing the number that qualify, but about ensuring that people are accessing the benefits they need.
Chief of Staff (COS) Visit
Cyndi Jenkins, Minister O’Regan’s Chief of Staff, visited the advisory group meeting. Following roundtable introductions, Ms. Jenkins spoke briefly of her new role supporting the Minister and that she is currently becoming familiar with the various files. The members noted that the previous Minister had met with Advisory Group co-chairs and a meeting with the new Minister to address their work and priorities was requested. They also asked that she bring to Minister O’Regan’s attention the letters they had sent to former Minister Hehr on the group’s priorities. She confirmed that she had the letters and would bring the meeting request to the Minister’s attention.
Pension for Life
The Department reviewed with the group the pros and cons of the Pension for Life - pain and suffering award models currently being considered. The Advisory Group was clear that the lifelong pension proposed under the Mandate Letter must be more than just an apportionment or a reworking of the Disability Award into a monthly benefit. The VAC co-chair acknowledged their point and indicated that apportioning the Disability Award through a monthly payment over the life of an injured Veteran is not a model being considered. The VAC co-chair spoke to the challenge in reframing the pain and suffering element to make sense of it as a monthly payment. Many factors influence what makes financial sense for each individual, including age, the amount paid for pain and suffering based on degree of disability combined with the other income replacement benefits.
The discussion included the wording/language in the Government’s commitment to “re-establish lifelong pensions as an option for Veterans.” Some members felt that the Government promised a return to the former pension system with the use of word re-establish.
It was noted that feedback from the PAG is shared with the Tiger Team and options being proposed for Veterans are looked at through many lenses. The Tiger Team includes representatives from Central Agencies who bring the whole of Government perspective and consideration of any potential impact that changes to Veterans programs and benefits may have on other Government of Canada programs and services.
The members indicated that in accordance with one of its guiding principles as presented at the 2016 Stakeholder Summit, one of the major objectives of the lifelong pension must be the resolution of the significant disparity between the financial compensation available under the Pension Act and the New Veterans Charter – in essence, the Advisory Group underlined the fact that, in accordance with the “one veteran – one standard” principle, the lifelong pension must have significant applicability in ensuring that no veteran under the New Veterans Charter would receive less compensation than a veteran under the Pension Act with the same disability or incapacity.
The members noted that economic support needs be fair and based on need. How career progression will be calculated is an important factor in the financial security piece. The members cautioned the Department and the Minister that an economic benefit based on a Diminished Earning Capacity (DEC) assessment which is only payable to a very small group would not be supported by the Veteran community.
Members were told that further details about Pension for Life will be announced this year, as promised in Budget 2017.
Progress Update and discussion – Convergence
It was noted that convergence constitutes more than addressing SISIP and the ELB but also includes the closing the seam initiatives as well. The work is ongoing and will continue through this current fiscal year.
Various ideas were generated around SISIP including if it is not eliminated as recommended by the advisory group. Suggestions included using service related and non-service related as the split between whether VAC or SISIP who would be responsible to provide the service.
Review of Priorities
The meeting ended with a review of the PAG’s priorities using the presentation deck from the Stakeholder Summit in October 2016 with a review of the status following the meeting’s discussion.
There was agreement that there is some alignment with the options presented by the Department and the PAG priorities. The PAG asked for more clarity around how the financial security piece will be packaged, including DEC and additional information regarding the tools.
It was recognized that the input from the group is valuable and useful. The Minister’s Office acknowledged that the PAG’s position remains as presented at the Stakeholder Summit in October 2016 and in a letter to former Minister Hehr.
Members cautioned that the Veterans community has an expectation of much more financial support than is currently being considered by the Government. The members also noted that the Minister needs to be prepared to address the issue of the group’s Chapter Two recommendations - One Veteran and One Standard - that no Veteran under the NVC should receive less compensation than a Veteran under the Pension Act with the same level of disability or incapacity.
Next Steps
The members noted that over the next few months they will be in a wait and see holding pattern until details of Pension for Life are available at which point, the group will be in a better position to determine its next steps.
In the interim, PAG members will send a letter to the new Minister and advance its Chapter Two recommendations and other issues.
The meeting was closed by the VAC Co-chair.