November 24, 2016
1430 – 1600 (ATL)
Teleconference
In Attendance
- Joseph Burke, Canadian Aboriginal Veterans and Serving Members Association
- Sylvain Chartrand, Canadian Veterans Advocacy
- Deanna Fimrite, Army, Navy & Air Force Veterans in Canada
- Mark Gaillard, RCMP Veterans’ Association
- Charls Gendron, Royal Canadian Legion
- Bruce Henwood, National Council of Veteran Associations in Canada
- Captain (Retired) Dennis LeBlanc (Member Co-chair)
- Captain (Retired) David Mack
- Corporal (Retired) Bruce Moncur
- Lieutenant-Colonel Jamie Morse, Canadian Armed Forces Liaison Officer to Veterans Affairs Canada
- Michel Doiron, Assistant Deputy Minister, Service Delivery (VAC Co-chair)
Regrets
- Marie-Claude Gagnon, "It’s Just 700"
- Bev Hawton, Assistant Deputy Minister, Business Improvement Division, ServiceOntario
Observer
- Sharon Squire, Deputy Ombudsman, Office of the Veterans Ombudsman
1. Welcome and Opening Remarks
The Co-chairs provided brief opening remarks. The focus of the teleconference on the disability application and decision-making process is to give members a common understanding of it for their work ahead.
Disability benefit application processing remains a challenge for the Department. Despite ongoing changes to improve processing times, the Department does not meet the 16 weeks service standard. Recommendations from the Advisory Group will be appreciated.
2. Presentation: The Disability Adjudication Process: How it Works
Rick Christopher, Director General, Centralized Operations Division and Cheryl Murnaghan, National Program Manager, Disability Adjudication delivered an overview of the disability adjudication process. Topics covered included:
- Disability Benefits
- Legislated eligibility tests
- Insurance principle
- Compensation principle
- Who qualifies?
- Disability claim process
- Decision makers
- Disability decision
- Entitlement
- Assessment
- Decision making tools
- Reviews and Appeals
- Departmental Review – can be requested on entitlement or assessment decision with new evidence or an error in fact or law.
- Veterans Review and Appeal Board
- Program statistics
Highlights:
- Disability applications submitted through regular mail system and/or My VAC Account are sent to the appropriate Disability Benefit Unit.
- The Department does not have a list of trades that are generally associated with certain disabilities.
- Six stream-lined decision-making models were introduced in 2015 to improve processing times for disability benefit decisions. These models recognize the inherent risk involved in some specific trades within the Canadian Armed Forces (CAF) and allow non-nurse adjudicators to render decisions involving straightforward cases where less evidence is needed to determine the relationship between the condition/disability and service, provided there is no contradictory evidence. These include some musculoskeletal conditions, cumulative joint trauma (these deal with osteoarthritis claims of weight bearing joints), hearing loss, tinnitus, post-traumatic stress disorder and other psychiatric disorders (Generalized Anxiety, Major Depression and Adjustment Disorder) as a result of Special Duty Service or high-risk peacetime trade.
- VAC considers the CAF Military Occupational Classification Task Statements, which outline the physical aspects of a trade, when rendering a disability benefit decision. Information regarding trades and task statements that no longer exist with the CAF can be accessed via the CAF Liaison Office to VAC.
- Disability applications related to illness are usually more complex and require additional review before a decision is rendered.
- An applicant's statement regarding why a disability or illness is related to service is a very important piece of evidence considered.
- VAC's service standard target is to render 80% of disability benefit decisions within 16 weeks. Current average service standard is 17.5 weeks, including consultation with a VAC Medical Advisor, if requested.
Proposals/Observations:
- Consider removal of the compensation principle and move to 24/7 coverage for all CAF members.
- Consider removal of partial entitlement in disability benefit adjudication (removal of fifth's)
- Move disability adjudication model to a Canada Revenue Agency model - grant benefits quickly and then evaluate applications after to determine who should/should not have been approved.
- Provide a link to the applicable legislation and/or chapter in the Table of Disabilities in the decision letter so the individual knows exactly what was considered when the decision was made.
- Program statistics provided by the Department can be very misleading. As of March 31, 2016, it is recorded that 84% of the first application decisions rendered were favourable, however, the claim may only be partially approved.
Action Item:
- Provide Advisory Group members with disability application process/procedure and/or manuals to increase their understanding of the process.
3. The Way Ahead
The group proposed a face-to-face meeting in Charlottetown in the New Year for an onsite review of the adjudication process. The group will consider identifying areas where VAC can change versus further streamline or tweak existing processes. The group will be provided with access to a toll-free teleconference number for in-camera meetings.
4. Closing Remarks
Members were thanked for their interest in understanding the adjudication process. Recommendations and input from the group on forms, letters, and/or process improvements would be welcomed and appreciated.
The Co-chairs thanked everyone for their participation and options will be explored for a face-to-face meeting in Charlottetown in the New Year.