This report presents the findings, conclusions and recommendations from the evaluation of the Office of the Veterans Ombudsman (OVO).
1.1 Mission, Mandate and Role
The mission of the OVO is to be an agent of positive change to advance fair outcomes for Veterans and their families. The mandate of the OVO is set out in the Order in Council P.C. 2007-530. The OVO works to ensure that Canada's Veterans, serving members of the Canadian Armed Forces (CAF) and the Royal Canadian Mounted Police (RCMP), their families, and other clients of Veterans Affairs Canada (VAC) are treated in accordance with the Veterans Bill of Rights, and receive the services and benefits that they require in a fair, timely, respectful and efficient manner. As shown in the OVO’s fairness triangleFootnote 1, the OVO aims to provide a fair process, a fair treatment and a fair outcome to Veterans/clients and their families.
The core responsibility of the Veterans Ombudsman is to provide an independent and impartial review of complaints and issues related to programs and services delivered by the Veterans Affairs Portfolio and uphold the Veterans Bill of Rights (Source: Departmental Results Framework).
The OVO fulfils its mandate by:Footnote 1
- Assisting and informing those who contact the OVO, by providing necessary information and facilitating referrals to service providers who can best help them;
- Investigating complaints from those who believe they have been treated unfairly by VAC or other service providers;
- Conducting systemic investigations leading to recommendations to address systemic issues than can potentially affect many other Veterans and their families;
- Providing advice to the Minister of Veterans Affairs and Parliamentary Committees on issues of importance to Veterans and their families.
The OVO, by mandate, cannot do the following:
- Review Veterans Affairs decisions that can be reviewed or appealed to the Veterans Review and Appeal Board (VRAB). It should be noted that the VRAB provides an independent appeal process if Veterans are not satisfied with a decision made by VAC under the Pension Act jurisdiction and part 3 of the Veterans Well Being Act. The Board also provides the final level of appeal for War Veterans Allowance claims.
- Review legal advice, court decisions and the decisions of a judge.
- Review matters in the exclusive jurisdiction of the RCMP.
- Review matters that are confidence of the Queen’s Privy Council for Canada.
It should also be noted that the OVO’s role is limited to addressing Veterans’ complaints on only those decisions made both outside the jurisdiction of VRAB and after departmental review. Furthermore, the OVO has a mandate to review a limited number of VAC decisions related to:
- Services under the Veterans Health Care Regulations, e.g., Health Care Benefits, Veterans Independence Program, Long Term Care (note the role and extent of action is partial under these regulations); and
- Services under the Veterans Well-Being Act, e.g. Education and Training Benefits, Career Transition Services, Rehabilitation Services (but not Disability Awards), Income Replacement Benefits, which include Career Progression Factor and Diminished Earning Capacity Determination, Caregiver Recognition Benefits and Canadian Forces Income Support Benefits.
Accordingly, the limitations contained in the mandate have a direct effect on the volume and types of complaints that the OVO can investigate. The following chart provides an indication of the potential number of decisions that could result in a complaint.
Diagram 1: Areas Where Decisions are Made and Transactions Occur (2018-19)
Diagram 1: Areas Where Decisions are Made and Transactions Occur (2018-19)
This diagram breaks down the number of decisions made across VAC programs, VRAB, and the Federal Court. It also shows BPA and OVO caseload. The graphic is broken into three sections: Disability Entitlement and Assessment; Tribunal System; and Eligibility, Process and Transactions.
The diagram indicates that complaints to the OVO are related to either Disability Entitlement and Assessment or Eligibility, Processes and Transactions.
Disability Entitlement and Assessment
The diagram provides the following information on VAC Entitlement and Assessment decisions:
| 1st Application | Reassessments | Departmental Reviews | Decisions Completed |
|---|---|---|---|
| 22,860 | 16,063 | 2,860 | 41,783 |
It also shows that disability entitlement and assessment decisions have a redress path through the Tribunal System.
Tribunal System
The diagram indicates that the VAC Tribunal System is composed of two entities: BPA ($8M budget, 100 FTEs) and VRAB ($12.4M budget, 101 FTEs). A third entity, the Federal Court of Canada, lies outside the Veterans Affairs Portfolio. The diagram indicates that Reassessment and Departmental Review decisions led to the following caseload at BPA:
| Total Referrals | Counseled out | Referred back to VAC for Departmental Review | Brought case before VRAB |
|---|---|---|---|
| 10,037 | 5,212 | 2,222 | 2,603 |
In 2017-18, VRAB rendered the following number of decisions in the following areas:
| VRAB Review | VRAB Appeal | VRAB Reconsideration | WVA Appeal | Total VRAB Decisions |
|---|---|---|---|---|
| 2,017 | 375 | 71 | 3 | 2,466 |
Nine decisions were rendered at the Federal Court level.
Program Eligibility, Process and Transactions
The diagram indicates that VAC’s Service Delivery Branch rendered the following number of decisions that fell within the OVO mandate in 2018-19:
| Rehab | ETB | CTS | ELB | DEC | CFIS | CRB | VIP | LTC |
|---|---|---|---|---|---|---|---|---|
| 4,041 | 3,119 | 1,776 | 3,535 | 4,741 | 61 | 1,520 | 9,384 | 2,473 |
The Department’s Service Delivery area also rendered decisions for CIAS (3,171) and RISB (321). These benefits were eliminated in subsequent years.
The diagram indicates VAC rendered decisions in the following areas which do not fall under the OVO mandate:
| AA | CIB | EIA | WVA | Edu. Assist | Clothing |
|---|---|---|---|---|---|
| 1,458 | 252 | 313 | 200 | 128 | 277 |
The Department also rendered 6,162 CIA benefit decisions. The CIA benefit was in the OVO mandate in 2018-19, but was not the following year. In total, the Department rendered 45,349 decisions.
The diagram indicates that 2,064 decisions were appealed to first level appeals (N1LA), while 363 decisions were referred to second level appeals (N2LA). It also indicates that 634,474 treatment authorizations were made in 2018-19.
Finally, the diagram shows that the Office of the Veterans Ombudsman ($5.5M budget, 38 FTEs) received 2,001 contacts resulting in 1,153 investigations and 628 valid complaints.
When the approval rates for decisions are taken into consideration (positive decisions don’t generally generate a complaint) and the OVO’s valid complaints are shown, the OVO has limited influence when the total potential for complaints is considered. The following chart illustrates this and shows that in 2018/19, the OVO’s investigations and recommendations resulted in changed outcomes for 45 Veterans, approximately 7% of the valid complaints.
Diagram 2: OVO Valid Complaints (2018-19)
Diagram 2: OVO Valid Complaints (2018-19)
This diagram replicates Diagram 1 in appearance with the exception of an additional box labeled Veterans Hiring Act. Two additional layers of information are overlaid on the diagram:
- favourable/unfavourable decision rates for VAC benefits/programs and appeals, VRAB cases, and Federal Court cases; and
- the number of valid OVO complaints by program/benefit and appeal level.
| Program | Favourable % | Unfavourable % |
|---|---|---|
| Disability Benefits (1st application) | 82 | 18 |
| Rehab | 97 | 3 |
| ETB | 75 | 25 |
| CTS | 88 | 12 |
| ELB | 99 | 1 |
| DEC | 95 | 5 |
| CFIS | 69 | 31 |
| CRB | 45 | 55 |
| VIP | 86 | 14 |
| LTC | 97 | 3 |
| CIAS | 48 | 52 |
| RISB | 80 | 20 |
| AA | 83 | 17 |
| CIB | 4 | 96 |
| EIA | 71 | 29 |
| WVA | 22 | 79 |
| Education Assistance | 69 | 31 |
| Clothing | 77 | 23 |
| CIA | 80 | 20 |
| Appeal Level | Favourable % | Unfavourable % |
|---|---|---|
| VRAB Review | 44 | 56 |
| VRAB Appeal | 29 | 71 |
| N1LA (first level appeal) | 20 | 80 |
| N2LA (second level appeal) | 16 | 84 |
| Federal Court | 22 | 78 |
| Complaint Area | Valid Complaints |
|---|---|
| Disability Award | 453 |
| Disability Pension | 42 |
| PSC | 8 |
| Rehab | 10 |
| ETB | 11 |
| ELB | 5 |
| CIA/CIAS | 15 |
| CFIS | 2 |
| CRB | 6 |
| VIP | 6 |
| LTC | 2 |
| CIB | 1 |
| Veterans Hiring Act | 2 |
| Treatment Authorization | 48 |
| Service Delivery | 15 |
| VRAB Review | 1 |
Finally, the diagram indicates outcomes changed for 45 Veterans as a result of contact with the OVO (2,001 initial contacts, 1,153 investigations, 628 valid complaints, 45 changed outcomes).
Even if the complaint is valid the following chart shows that the OVO has not been able to resolve every case. Resolve doesn’t necessarily mean that a decision was changed. It can mean that time and circumstances have evolved to the point that the complaint no longer requires OVO intervention or that the OVO has explained the situation to Veteran in a manner that the Veteran no longer has a complaint.
Diagram 3: Actual Number of Complaints Received by OVO (2018-19)
Diagram 3: Actual Number of Complaints Received by OVO (2018-19)
This diagram shows:
- the number of decisions and transactions VAC completed that present an opportunity for complaint:
- the number of actual complaints to the OVO;
- the number of complaints that were deemed valid and invalid;
- the number of valid complaints directed towards the disability benefit process;
- the number of valid complaints directed towards program and service delivery processes and decisions; and
- the outcome of the these complaints (resolved/unresolved).
The diagram indicates that VAC generated 750,000 decisions, processes, or transactional opportunities for complaint broken into the following categories:
- Disability benefits entitlement and assessment (process only)
- 41,783 decisions total
- 8,790 negative decisions
- 10,037 perceived negative decisions
- 41,783 decisions total
- Program and Service Delivery (decision and process)
- 45,349 Eligibility, process, and transactions decisions
- 9,312 negative decisions
- 8,500 within mandate
- 634,474 treatment transactions
- Service Delivery processes
- 45,349 Eligibility, process, and transactions decisions
The 750,000 opportunities for complaint resulted in 1,570 actual complaints to the OVO. Of these complaints:
- 417 complaints were closed at intake, with 319 being referred back to the review process;
- 405 complaints were non-validated;
- 120 complaints are being reviewed; and
- 628 complaints were deemed valid.
Of the 628 valid complaints:
- 505 were directed towards disability benefits
- 213 were resolved (207 related to turnaround times)
- 292 are unresolved (all related to turnaround times)
- 123 were directed towards programs and service delivery (116 resolved, 7 unresolved)
- 103 directed towards eligibility, process, and transactions
- 99 resolved
- 4 unresolved
- 48 directed towards treatment transactions
- 48 resolved
- 15 directed towards Service Delivery
- 15 resolved
- 103 directed towards eligibility, process, and transactions
1.2 Target Populations
The OVO investigates individual complaints from:
- Veterans of Second World War and the Korean War;
- Veterans (Regular and Reserve) forces and serving members of the CAF;
- Veterans and serving members of the RCMP; and
- Clients: Immediate family members and caregivers of above-mentioned groups and survivors of Veterans.
1.3 Governance
The Ombudsman reports directly to the Minister of Veterans Affairs, but the OVO operates independently and at arms-length from VAC. Direct support is provided to the Ombudsman and the OVO from the Deputy Ombudsman and the Legal Advisor. The key organizational areas in the OVO include:
- Strategic Review and Analysis;
- Intervention Unit;
- Communications Operations; and
- Corporate Services.
Coordination within the OVO is facilitated by:
- Strategic (Strategic Committee) meetings monthly (with situational awareness summaries at each meeting); and
- Operational (Operational Committee) team meetings weekly.
The working relationship between the OVO and VAC is defined through a Memorandum of Understanding (MOU) and Service Level Agreements (SLAs), and is operationalized through a set of regular meetings:
- The Ombudsman meets with the Deputy Minister on a monthly basis;
- The Ombudsman and Deputy Ombudsman meets with VAC’s Deputy Minister and Assistant Deputy Ministers (ADMs) individually on a monthly;
- The Ombudsman and Deputy Ombudsman hold a quarterly meeting with VAC Senior Management (DM, Associate and ADMs); and
- The Director Corporate Services and Charlottetown Operations can meet with Director Generals (DGs) quarterly, as needed.
The Veterans Ombudsman has established an advisory body, as allowed for in the Order in Council. The Veterans Ombudsman Advisory Council (VOAC) provides advice to the Veterans Ombudsman on issues related to his/her mandate; and, assists in promoting the well-being of all Veterans and their families by identifying emerging issues of importance to the Veterans’ community and by providing advice to the Ombudsman on how to best approach those issues. The Council is comprised of individuals that represent a broad range of views and experience from the Veterans community, as well as from related professional areas (e.g., research and health care). The Council meets at least once per year to provide advice. The selection of members and terms for membership on the Council are determined by the Ombudsman and publicly available.
1.4 Resources
When established in 2007, the OVO and VAC were allocated the following resources for 2008-09 and ongoing. This included 10 full time equivalents (FTEs) for VACFootnote 2 and 30 FTEs for the OVO, as well as corporate services to be provided by VAC (Information Technology/Information Management, Human Resources, Finance, Audit & Evaluation):
| Item | 2008/2009 ongoingFootnote 3 |
|---|---|
| Salary | $3,458,000 |
| O&M | $1,700,860 |
| Total | $5,158,860 |
As of March 2019, expenditures (as per OVO financial statements) by functional area for the last five years are presented in Table 2 below.
| Item | 2014/2015 | 2015/2016 | 2016/2017 | 2017/2018 | 2018/2019 |
|---|---|---|---|---|---|
| Salary | $2,622,266 | $2,701,840 | $2,533,894 | $2,770,321 | $2,791,738 |
| O&M | $526,125 | $627,181 | $699,047 | $572,344 | $492,265 |
| Total | $3,148,391 | $3,329,021 | $3,232,941 | $3,342,665 | $3,284,003 |
1.5 Stakeholders
The OVO has many external stakeholders that provide input into the OVO’s work, including third-party service providers (e.g. numerous large and small Veterans’ organizations such as the Royal Canadian Legion (RCL), RCMP Veterans’ Association, National Council of Veterans Associations in Canada, VETS Canada, NATO Veterans Organization of Canada, Afghanistan Veterans Association of Canada, etc.). Other stakeholders include research institutions (e.g. the Canadian Institute for Military and Veteran Heath Research - CIMVHR), and the Veterans Ombudsman Advisory Council (VOAC). The OVO also participates as an observer on Ministerial Advisory Groups and makes presentations to Parliamentary Committees.
1.6 Expected Results
The OVO’s vision, as stated in the 2017-2019 Integrated Business Plan is “to be a centre of excellence in the use of ombudsman best practices that advances the fair treatment of Veterans and their families”.
For the OVO, ‘fairness for all’ of its Veterans is the key goal which can be viewed through the lenses of the fairness triangle (see Section 1.1): fair process, fair treatment and fair outcome.
The stated outcomes and performance indicators for the OVO, based on the VAC Departmental Results Framework (DRF) are listed below:
Outcome 1 (Ultimate): Veterans and their families have access to a timely review of complaints about the programs, services and support delivered by the Veterans Affairs Portfolio
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Outcome 2: Issues about the programs, services and support provided to Veterans and their families by the Veterans Affairs Portfolio are identified and addressed
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In the summer of 2019, the OVO updated its performance information which included updating the DRF and the OVO Performance Information Profile (PIP), along with a new logic model. The logic model located in Annex 1 provides an updated overview of the activities, outputs and expected outcomes for the OVO. Based on these updates, the 2020/2021 DRF has been amended with the following expected outcomes and indicators (changes noted in bold):
Outcome 1 (Ultimate): Veterans and their families have access to a timely review of complaints about the programs, services and support delivered by the Veterans Affairs Portfolio.
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Outcome 2: Issues about the programs, services and support provided to Veterans and their families by the Veterans Affairs Portfolio are identified for resolution.
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