Rehabilitation Related Expenses - Other Than Training

This policy replaces the following VPPM 5 policy: 3.1.9 Rehabilitation Related Expenses – Other than Training.

Purpose

This policy provides direction for primary decision makers for the pre-authorization and reimbursement of expenses, other than training, incurred by individuals when accessing rehabilitation and vocational assistance services.

Policy

Context

1. The pre-authorization of expenses is a two-step process when developing rehabilitation plans. The first step is the identification of the services necessary to address barriers to re-establishment and to achieve the plan's outcomes (see Rehabilitation Program Plan).  The second step is to determine if the participant's ability to achieve the rehabilitation plan's outcomes will be impeded if the participant must assume the associated rehabilitation related expenses.
   
   Rehabilitation services are broad and flexible in scope with plans designed to actively address barriers to re-establishment. Similarly, reimbursement decisions need to be broad and flexible to facilitate the individual's access to these services. Reimbursement decisions need to balance the individual's needs, given his or her unique circumstances, with the principles and objectives of the associated rehabilitation service. These decisions may require consultation with other individuals or groups (e.g., but not limited to, Client Service Team, Regional Rehabilitation Officer, interdisciplinary team members, or other subject matter experts).
   
   Ultimately, decision makers have the flexibility and discretion to determine the need to pre-authorize reimbursement of any rehabilitation related expenses to facilitate the participant's access to services in order to achieve his or her plan's outcomes.

Definitions

2. Rehabilitation related expenses: for the purpose of this policy, are the costs listed under paragraph 15(1)(b) and subsection 15(2) of the Veterans Well-being Regulations (VWR) identified as transportation, accommodations, meals, travel outside the country, health needs/escort, and additional dependent care. These expenses may be incurred by the participant in accessing departmentally authorized rehabilitation or vocational assistance services, other than training related expenses

General

3. As per paragraph 15(1)(b) and subsection 15(2) of the Veterans Well-being Regulations, the Department may authorize the reimbursement of rehabilitation related expenses to facilitate a participant’s participation in medical, psycho-social, vocational rehabilitation or vocational assistance services approved under a rehabilitation or vocational assistance plan.
4. Decisions to authorize rehabilitation related expenses are to be based on the participant’s unique needs and are to be documented with a supporting rationale.  The authorization decision is not to be an arduous process and is made in collaboration with the participant.
5. The same decision making approach as used in authorizing the rehabilitation service is applied when authorizing the payment or reimbursement of rehabilitation related expenses. Decisions should be holistic and reasonable resulting in the participant achieving the desired outcomes.
6. Reimbursement of rehabilitation related expenses may be authorized in order to facilitate the participant’s participation in authorized rehabilitation or vocational assistance services that are covered or paid through other plans or programs. (e.g., but not limited to, travel to psycho-social services paid through provincial/territorial health care plans)
7. The decision to pre-authorize payment must be supported by a rationale explaining the need to reimburse or pay the related rehabilitation expenses. The rationale will also be documented in the rehabilitation or vocational assistance plan.

Rehabilitation Related Costs of Transportation, Accommodations and Meals

8. The Department will reimburse transportation, accommodation or meal costs, when failure to do so by the Department, will impede the participant’s ability to achieve their rehabilitation or vocational assistance plan’s objectives. This approach is different than that used to reimburse transportation costs under the authority of the Veterans Health Care Regulations (VHCR). The VHCR specify the terms and conditions under which transportation costs are reimbursed, whereas the Veterans Well-being Regulations are less specific and broader in scope as to when reimbursements may be paid. The needs-based approach is intended to provide decision makers discretion and flexibility to address participants’ unique circumstances, as well as, have participants assume some responsibility in meeting objectives identified under a rehabilitation plan.
9. Transportation costs must be verifiable in order to meet the Department’s requirements in satisfying section 34 of the Financial Administration Act.

Basis of Payment

10. As stated in subparagraph 15(1)(b)(i) of the Veterans Well-being Regulations, transportation, accommodation and meal costs will be reimbursed in accordance with the rates set out in the Treasury Board Travel Directive, as amended from time to time.
11. Transportation costs will be based on the most economical or reasonable means of transportation between the participant’s residence and the place where the rehabilitation services are provided. These costs are subject to the following conditions as per clauses 15(1)(b)(i)(A) and 15(1)(b)(i)(B) of the Veterans Well-being Regulations:
    1. if the means of transportation is a taxi, $5.00 shall be deducted from the cost of each trip unless the person’s mobility or cognition is severely impaired or the deduction would severely impede the person’s ability to access the services. If the five dollar deduction is waived, the reason(s) and decision will be documented, or
    2. if the means of transportation is an automobile other than a taxi, the costs of transportation shall be paid at the rate applicable to employees of the public service of Canada who have requested the use of their own automobile plus 2 cents per kilometer and shall include the costs of parking. Parking will only be paid with respect to the time that the participant is at the facility providing the service.

Travel Outside of Canada

12. In accordance with subsection 15(2) of the Veterans Well-being Regulations, if a person receives rehabilitation services or vocational assistance in a country other than Canada, the costs set out in paragraph 15(1)(b) of the Regulations, "are payable at the same rate and are subject to the same conditions as the rates and conditions established for former members of the armed forces of that country for similar costs, or, if no such rates are established, at rates that would be payable if the person were a resident in Canada."

Health Needs/Escort

13. When a participant is unable to drive or take public transit alone due to physical, psychological or cognitive problems, the participant may be accompanied by an escort. The costs of the escort's meals, transportation and accommodations will be covered if pre-authorized.
14. The payment of an escort fee is considered an eligible expense when the escort is not a spouse, common-law partner, dependent or any other member of the participant's household.

Additional Dependant Care

15. A maximum of $75 per day for additional dependent care, as per subclauses 15(1)(b)(i)(A)(iv) of the Veterans Well-being Regulations, is an eligible expense where the following conditions apply:
    1. the Rehabilitation/Vocational Assistance Program participant normally provides unpaid care to a minor child, disabled adult or elderly person on a regular basis;
    2. the care is essential to ensure the personal safety or health of the individual for whom the care is provided or to maintain their activities of daily living;
    3. the substitute care is required when the client or spouse is participating in the Program;
    4. the participant has the responsibility for arranging for paid temporary substitute care;
    5. the cost incurred is additional to the cost of any paid care that is already provided to the dependent. For example, the participant may already be paying for full day child care program and be able to participate in rehabilitation services while a child attends that program so that no additional costs are incurred.
16. Dependent care may be provided by friends, relatives or a professional provider as the circumstances require.

Completion of Rehabilitation or Vocational Assistance Service

17. When the authorized rehabilitation or vocational assistance service is completed, no additional rehabilitation related expense will be authorized for reimbursement or payment.

Reimbursement Period

18. A claim for reimbursement must be made in writing within one year after the day on which the expenditure is incurred and must include proof of the expenditure.

References

Veterans Well-being Act, sections 6 to 17

Veterans Well-being Regulations, paragraph 15(1)(b) and subsection 15(2)

Financial Administration Act, section 34.

Veterans Health Care Regulations

Treasury Board Travel Directive

Rehabilitation and Vocational Assistance Services - General