Disability Benefit Processing – Summary Report
Quarter Three of Government Fiscal Year 2020-2021 (ending 31 December 2020)
*This report will be updated with new quarterly statistics within 90 days of the end of each quarter.
What's on this page
Overview
More and more Veterans, Canadian Armed Forces (CAF) and Royal Canadian Mounted Police (RCMP) members are coming forward to get the benefits and services they need to improve their well-being. Since 2016, first applications for disability benefits have increased by more than 75 percent. Campaigns to raise awareness of My VAC Account, the growing need for mental health services, and improvements to our benefits and services appear to be driving this increase.
To process the larger number of claims, we have hired more staff, made improvements to the application process, and simplified decision-making for some medical conditions. Recently-hired employees have completed their initial training and began making decisions in January 2021.
Our most important priority continues to be providing more timely decisions on disability benefit applications. In June 2019, we released our plan to address the long-standing issue of decision wait times. While we implement this plan, we will continue to inform Canadians about our performance by proactively sharing the information below.
Statistics
In the past four years, we processed more than 152,000 applications. In fiscal year 2019-20, Veterans Affairs Canada delivered $2.3B in disability benefits to Veterans. Below, you'll find data on the number of applications received, completed and pending, as well as average wait times and approval rates for decisions.
| RECEIPT OF DISABILITY BENEFITS |
|---|
| 129,286 |
* including RCMP
Disability benefits are payments made to individuals for a service-related disability in one of two ways:
What is the backlog?
| TOTAL APPLICATIONS IN THE BACKLOG |
|---|
| 16,346 (13,459 individuals) |
A complete application that has been waiting longer than our service standard is considered to be in the backlog.
Note on service standards: Service standards are our commitment to a measurable level of performance which clients can expect under normal circumstances. Our service standard target for disability benefits is for 80 percent of decisions to be made within: 16 weeks for First Applications and Reassessments; and 12 weeks for Departmental Reviews.
What is the total number of pending disability benefit applications?
| INCOMPLETE APPLICATIONS THAT NEED MORE INFORMATION | APPLICATIONS AWAITING ASSIGNMENT* | COMPLETE APPLICATIONS WAITING FOR A DECISION - WITHIN SERVICE STANDARD | COMPLETE APPLICATIONS WAITING FOR A DECISION - OUTSIDE SERVICE STANDARD | TOTAL | |
|---|---|---|---|---|---|
| AS OF 31 MAR 2019 (Q4) | 13,564 | N/A | 9,862 | 16,879 | 40,305 (29,964 individuals) |
| AS OF 30 SEPT 2019 (Q2) | 18,330 | N/A | 3,074 | 23,260 | 44,664 (30,367 individuals) |
| AS OF 31 DEC 2019 (Q3) | 20,995 | N/A | 4,980 | 20,233 | 46,208 (33,320 individuals) |
| AS OF 31 MAR 2020 (Q4) | 22,545 | N/A | 4,533 | 22,138 | 49,216 (39,240 individuals) |
| AS OF 30 JUN 2020 (Q1) | 12,125 | 9,244 | 2,355 | 21,572 | 45,296 (33,464 individuals) |
| AS OF 30 SEPT 2020 (Q2) | 12,739 | 9,467 | 3,678 | 19,633 | 45,517 (33,388 individuals) |
| AS OF 31 DEC 2020 (Q3) | 14,446 | 9,647 | 4,227 | 16,346 | 44,666 (32,949 individuals) |
*Note: As part of our wait time plan, we continue to improve the accuracy and transparency of our statistical reporting on disability benefits applications. Incomplete applications include those where essential information is missing, such as proof of identity, signed forms or confirmed diagnosis. Applications awaiting assignment are complete applications ready to be assigned for a decision.
Note: Data for Q1 2019 was not available due to upgrades to our application tracking software.
There are three types of pending applications:
1) Incomplete applications
Incomplete applications may be missing information such as proof of identity, signed forms or required questionnaires. Applications at this stage either require information to be submitted, are being validated for completeness or are being prepared as a package for the next step.
As of 31 December 2020, we had 14,446 incomplete applications.
2) Applications awaiting assignment
During this stage, most of these applications are waiting to be assigned. An administrative decision-maker looks at the application to determine whether or not the claim is straightforward. If it is, they will make a decision. If the condition is more complex, the application is moved to a nurse decision-maker.
Our wait time plan includes the hiring of 300 employees dedicated to processing applications. With the recent investment of $192 million, our goal is to significantly reduce the backlog, and improve how we make decisions to ensure that we maintain productivity beyond 2022.
As of 31 December 2020, we had 9,647 applications awaiting review.
3) Complete applications waiting for a decision
For these applications, we have the required information and the files are working through the process.
As of 31 December 2020, there were 20,573 complete applications ready for a decision.
Incomplete applications + Complete applications = 44,666 applications pending (as of 31 December 2020)
Historical summary - Applications received and processed
Chart 1: Disability Benefit Applications by Quarter (2017-2020)
Note: Data for Q1 2019 was not available due to upgrades to our application tracking software.
| FIRST APPLICATION | REASSESSMENT | DEPARTMENTAL REVIEW | TOTAL | |
|---|---|---|---|---|
| 1 JAN 2019 - 31 MAR 2019 | 9,173 | 4,834 | 1,274 | 15,281 |
| 1 APR 2019 - 30 JUN 2019 | 10,855 | 4,577 | 1,264 | 16,699 |
| 1 JUL 2019 - 30 SEPT 2019 | 12,289 | 3,785 | 1,045 | 17,119 |
| 1 OCT 2019 - 31 DEC 2019 | 10,187 | 3,543 | 1,053 | 14,783 |
| 1 JAN 2020 - 31 MAR 2020 | 10,062 | 3,584 | 886 | 14,532 |
| 1 APR 2020 - 30 JUN 2020 | 5,702 | 2,217 | 235 | 8,154 |
| 1 JUL 2020 - 30 SEPT 2020 | 6,693 | 2,875 | 259 | 9,827 |
| 1 OCT 2020 - 31 DEC 2020 | 8,285 | 3,590 | 587 | 12,462 |
Individuals applying for a Reassessment have previously received a favourable decision for the same disability. This allows them to access treatment benefits, which provide coverage for things such as prescriptions, medical equipment, nursing services and appointments with specialists.
If the Veteran disagrees with the decision on their First Application or Reassessment and has new evidence to present, or there is an error in fact or law, they may request a review (Departmental Review) or appeal.
| FIRST APPLICATION | REASSESSMENT | DEPARTMENTAL REVIEW | TOTAL | |
|---|---|---|---|---|
| 1 JAN 2019 - 31 MAR 2019 | 5,429 | 4,6424 | 806 | 10,877 |
| 1 APR 2019 - 30 JUN 2019 | 6,777 | 4,328 | 559 | 11,664 |
| 1 JUL 2019 - 30 SEPT 2019 | 7,210 | 4,537 | 429 | 12,176 |
| 1 OCT 2019 - 31 DEC 2019 | 5,826 | 2,563 | 516 | 8,905 |
| 1 JAN 2020 - 31 MAR 2020 | 5,519 | 3,325 | 666 | 9,510 |
| 1 APR 2020 - 30 JUN 2020 | 5,987 | 3,293 | 270 | 9,550 |
| 1 JUL 2020 - 30 SEPT 2020 | 5,130 | 1,351 | 899 | 7,380 |
| 1 OCT €“ 31 DEC 2020 | 6,840 | 2,774 | 1,290 | 10,904 |
When we have made a decision on an application and the Veteran has been informed, the application is considered finalized.
| FIRST APPLICATION | REASSESSMENT | DEPARTMENTAL REVIEW | |
|---|---|---|---|
| 1 JAN 2019 - 31 MAR 2019 | 81% | 75% | 83% |
| 1 APR 2019 - 30 JUN 2019 | 85% | 73% | 79% |
| 1 JUL 2019 - 30 SEPT 2019 | 85% | 78% | 81% |
| 1 OCT 2019 - 31 DEC 2019 | 78% | 57% | 78% |
| 1 JAN 2020 - 31 MAR 2020 | 76% | 63% | 76% |
| 1 APR 2020 - 30 JUN 2020 | 76% | 77% | 82% |
| 1 JUL 2020 - 30 SEPT 2020 | 85% | 69% | 89% |
| 1 OCT 2020 - 31 DEC 2020 | 85.7% | 74.3% | 76.2% |
| ASSESSMENT LEVEL | 0-20% (LOW) | 20-40% | 40-60% | 60-80% | 80-100% (HIGH) |
|---|---|---|---|---|---|
| 04 Jan 2021 | 46.3% | 23.2% | 13.3% | 7.9% | 9.3% |
Once we determine a confirmed disability is service-related, we look at the severity and impact on quality of life. Using this information and the Table of Disabilities we assign an assessment level ranging from 0-100%.
For example, a Veteran assessed at 100% may have a disability that is severe and impacts their quality of life significantly. A Veteran may also have a combination of disabilities that amount to a 100% assessment level.
Above is a summary of how many Veterans are currently receiving disability benefits based on different assessment levels. As the table shows, about three quarters of Veterans are assessed at levels of disability less than 40%. Less than 10% of Veterans are assessed at 80% or above.
Average wait times
Please see our Wait time tool for wait times across various programs, updated weekly.
Note: To start counting the wait time, we must first have all the required information from the applicant.