Ladies and gentlemen of the committee, thank you for giving me the opportunity to address the committee and to address an issue that hopefully you may have no experience with and that I, sadly, have decades of dealing with.
I'm going to discuss a form of trauma that is devastating in its impact on veterans: institutional betrayal and the way the new Veterans Charter and VRAB are leading to a situation in which suicide has a 45% greater prevalence in the veterans community than it has in the general population. That number comes from a document that you have in the Library of Parliament.
I am Captain (Retired) Medric Cousineau, and I wear Canada's second highest award for bravery, the Star of Courage, which is awarded for an act of conspicuous courage in circumstances of great peril. It is what ended my military career and led me to being here today.
Let me put this into context for you.
I joined the military in 1979 and by 1983 had graduated from the Royal Military College of Canada. I went on to receive my air navigator's wings and joined HS 443 Squadron. In October of 1986, while a member of HMCS Nipigon's HELAIRDET, I was involved in a dramatic air-sea rescue that resulted in my being awarded the Star of Courage.
Sadly, those events changed my life forever. Within weeks the words post-traumatic neurosis and ultimately post-traumatic stress disorder would appear in my medical documents.
What I want to talk about is the institutional betrayal. The single largest wound that I received happened as a result of the actions of a department of the government of a country that I would clearly and demonstrably have died for. Institutional betrayal can be defined as the wrongdoings perpetuated by an institution upon individuals dependent upon that institution, including failure to prevent or to respond supportively to instances such as traumatic exposures committed within the context of the institution. Please keep this in mind as my story unfolds.
In 1991 I left the forces on a voluntary release, struggling with issues and addictions, knowing I had problems but unaware of what they were. In 1996 I found myself in the emergency assessment unit of the Nova Scotia psychiatric hospital. Clearly, you do not wind up there because you're having banner mental health days.
Subsequent to my release, I was taken by an old salt to visit the Department of Veterans Affairs. Subsequently I applied for and received my medical documents. Perhaps the single most devastating day was to read that my diagnosis from the Nova Scotia psychiatric hospital had been in my out-routine medical documents and had never been actioned or disclosed to me. The institutional betrayal shattered me. I would have died for Canada and I had been betrayed. The “we will take care of you” ethos that we in the military believed in was clearly not there.
But I wish it had ended there. Sadly, it gets worse, much worse.
Eventually VAC ruled that I was pensionable at a five-fifths entitlement, since my injuries were clearly connected to my rescue. But the issue of assessment is a whole different story. The VAC doctors assessed me at 70%, and I was awarded 30%. I appealed and went through another entire poke-and-prod process. This process alone is nothing but an exacerbation of the trauma. This set of doctors stated a minimum of 50%, the board noted the 70%, and I was awarded 40%.
How does this happen? The numbers and the facts do not lie. I was nothing more than a file, and every award of less than my entitlement and assessment was just a cost-saving measure.
In 1999 I applied to the military and had my release item reviewed. It was determined that I should have been a 3(b) medical release. When I applied to VAC to have my benefits reinstated to my release date, I was told, basically, “Too bad, so sad, you never contacted us until 1996.” But had my release been handled properly, I would have been treated in 1991 and would have seen VAC. I was damaged by the errors of others.
It was not until 2006, after I had a full psychotic break, that my assessment was finally moved to 70%, after 10 years of fights, denials, appeals, and abuse by a system put in place by a government department of a country I would have died for.
By then, my doctors had pegged me at 90% to 100% disabled and were documenting major depressive disorders. I was done, shattered, ruined, and I no longer trusted anyone or anything. Why would I? I was withdrawn and I lived in isolation from my family, because the anger management problems were so severe that I was afraid I was going to hurt them in a fit of rage. I battled depression, anxiety, panic, suicidal ideation, addiction, and suffered from dissociative episodes, cut off from family, friends, and society.
In 2007, while heavily medicated, I had a visit from somebody from VAC. I don't remember what happened or even who I met with, and it was my last contact with the department until September of 2012. By then a friend had made me aware that there were things called case managers and benefits and programs that I should have been entitled to and involved with. By late October of 2012, I finally had a case manager who, I must state, is the best thing to happen in my recovery as far as my dealings with VAC go.
I went from some time in 2007 until I contacted the department five years later with no follow-up and no help. I was not entered into the rehab program at that time, but it took my case manager very little time to enrol me in the program. It was very clear where I should have been. The five-year hiatus with no contact is documented in my case file and was discussed with me by my case manager.
But even this would not have happened without my service dog, who then helped train me with my PTSD and improve my social functioning. Sadly, my service dog is yet one more example of the institutional betrayal that permeates my case file. If I was blind and Thai was a guide dog, I would receive an allowance for her care and upkeep. Even though she was acquired with resources outside of VAC, she is to assist me in my daily living, and my medical care team is thrilled with the impact she has had on my life. So I applied for that same care and upkeep allowance since she is for my pensioned condition. It was denied with a statement that there was no evidence supporting her efficacy in rehabilitation outcomes. I was going to appeal, so I requested a definition of rehabilitation outcomes. I was subsequently told there is no definition and that rehab program outcomes are handled on a case-by-case basis.
So I was denied a benefit for standards she supposedly cannot meet for something that VAC cannot define for me. I truly think that the department was going to say no just one more time.
I will carry the scars of what happened that night in the middle of the north Atlantic to my grave. There are things you do not unsee, unsmell, unhear, and untaste. There are things that can be so deeply imprinted on your psyche that no amount of treatment will ever completely deal with them. However, I have several specialists who have noted two very important points.
One, my long-term recovery was put in jeopardy by lack of early intervention and adequate treatment. The period of abandonment from 1991 to 1996 is evidence of this.
Two, the injuries that resulted from my institutional betrayal are going to be a huge if not insurmountable obstacle in my long-term recovery. VRAB—political appointees making decisions based on legal, medical, and military service who clearly do not have the adequate qualifications to deal fairly with veterans who appear before them—has ensured that I will never ever trust the government of a country that I would have died for. Look at the woeful record, which the OVO points out, at Federal Court after appeals have been exhausted at VRAB.
My wife is very quick to point out that had I not been pensionable under the Pension Act, my family would have been destroyed. The lump sum award under the new Veterans Charter would have been gone in the war I fought battling addictions as I tried to deal with the much damaged reality that I perceive.
So, ladies and gentlemen, if I were going to change just three things, what would they be?
One, the lump sum award would be abolished and replaced with a lifetime income that the ill and injured could not outlive. Their injuries last their lifetime as a result of their service to their country. So too should the government's obligation to care for them.
Two, VRAB in its current form would be dismantled and would be replaced with a system that is geared to dealing with section 39 of the act, which says that, barring evidence to the contrary, the board is to rule in favour of the veterans. Clearly, given the number of appeals, this is not happening.
Three, in the war on PTSD, suicide and homelessness are two outcomes that, along with destroyed families, impact on society financially, and most importantly, morally. We cannot let this happen. These need to be dealt with immediately.
Given what has happened to me personally, I would say that it's not out of the question to ask for a full ministerial inquiry into my file at VAC. There are so many issues that, sadly, have impacted not just me. My wife and children have borne the brunt of that institutional betrayal. If it is not owed to me, then it certainly is to them, for they never signed up, and they deserve better from this country.
Sadly, I am one of many heroes and veterans who have been institutionally betrayed by the departments of the government for which veterans would have died. These wrongs must be righted. For if they're not, we will not know peace, and if they cannot find peace, many may make terminally irreversible decisions.
The institutional betrayal is a national disgrace.
First off, I'd like to thank everybody for inviting VETS Canada to the committee. I'm going to talk a little bit about myself, and then jump into what it is that we do as an organization, which will subsequently illustrate why I'm here.
With 32 years of service, I, too, have PTSD in my medical file. I'm a veteran of the Afghanistan task force. About 18 months ago, I was approached by Jim Lowther to assist the organization, and since that time I've gone on to become their executive director.
At VETS Canada, Veterans Emergency Transition Services Canada, we are the only ones that go out into street and the shelters, we find homeless and at-risk veterans, and we help facilitate their transition back into a safe and normal lifestyle. I would like to tell you that I'm not busy, but that would be a lie.
I'd like to talk about three of our clients in a very general format, which will lead me into my final statement. The first one was a man in his 50s; he had PTSD. He received the lump sum, did all the right things—spent it on his home and bills—and got himself financially secure. He's a good news story. He actually got married, and he now volunteers with VETS Canada. That's where the good news story stops.
The second story is of a younger man with PTSD. Again, he received a lump-sum payment. He tried to do the right thing—he spent it on bills, on getting himself out of debt—but unfortunately, he had a marital breakup and he's now left with absolutely nothing.
The third story, again, is of a younger client. This gentleman had some significant addiction issues. He was also a recipient of a lump sum payment. He reached out for help. We tracked him down, and we provided that help. We got him into an addictions program, and it looked like he was straightening out and heading in the right direction. He had a relapse, so he was back on the street. He actually had two relapses and he's currently on the street right now with no money.
The issue of a lump sum payment needs to be re-examined from our perspective. I say that because it's giving large quantities of money to people who are suffering from PTSD. As I'm sure you all know, PTSD can have a significant impact on your mental ability to make conscious decisions properly. By giving out a lump sum payment, you run the risk of that particular individual making the wrong decisions. I understand it's a personal decision, but try to remember that they're not making accurate decisions because of their PTSD. So they make decisions that are probably not the best ones to make, and they wind up on the street with no money—again, these are clients of ours.
What would be good, and what would probably go a long way towards solving the problem of homelessness among our veterans, is to go back to a monthly payment versus a lump sum payment. That way, if something happens in the individual's life, he hasn't spent all his lump sum, and he actually has a monthly income coming in.
That's all I have.
Mr. Chairman, thank you very much
To Barry and Medric, thank you both very, very much for coming here. I personally want to thank both of you.
Medric, thank you for your Paws Fur Thought, and the tremendous work your organization and you have done in getting service dogs for veterans across the country, because as you so rightfully claim, for every single person who receives a service dog the suicide number is zero.
To Barry, and especially to Jim Lowther and the boys down in Nova Scotia, it's a tremendous job you do, on a shoestring, looking for the homeless veterans and assisting them to reintegrate into some form of normalcy as they try to get on with their lives.
My question to you is on the lump sum itself. In 2005, when these were all discussed, the lump sum payment was for pain and suffering at a certain amount which was to be determined by either VRAB or the government in that particular regard. It was to determine the extent of the injury you had, either mental or physical, or a combination of both, and to give you enough moneys in that regard as compared to a workmen's compensation benefit, or something on a provincial level, or basically on an insurance level.
The key to it, though, the selling point of this, was that this wasn't the only payment they were supposed to receive. If they were permanently impaired or had ongoing issues, they could apply, or their family could apply, for a permanent impairment allowance and an earnings loss benefit. But what we have found, unfortunately, is to apply for those additional benefits and to receive those additional benefits over and above the lump sum was very difficult to achieve.
Now, you're correct. A 21-year-old getting $200,000 would be a mistake in my personal view, but a 58-year-old receiving that amount of money may be something they want to look at. What we've been arguing for is making the lump sum possibly optional, but to ensure the fact that if there are additional payments to the veterans, they should be followed for immediately upon consultation and furtherance with the doctors, and with the individual in that case.
I'd like you to elaborate just a bit more on the additional payments, because bear in mind the previous payment was just a certain amount of money per month, and that was it. It was found in many cases that it was nowhere near enough to look after the veteran and their family in terms of what they received.
I'd like you to follow up on that just a bit more and I thank you both very much for coming here today.
The organization that my wife and I co-founded is a thing called Paws Fur Thought. We raise money and advocate to place service dogs with disabled veterans. By very definition, 100% of the people that we deal with are suffering from OSIs, primarily post-traumatic stress disorder.
In the year that we've been doing this we've either placed, have at the fully certified level, or in training, over 30 dogs. That gives us a cohort of 30 veterans.
One of the common themes, in terms of what you were talking about, is care for our most seriously injured. Many of the people that we deal with are dealing with very complex mental injuries. They're elbows and eyeballs deep in the mental health system, which unfortunately is beyond the scope of this committee. But that poses some serious challenges because oftentimes after you leave the military and you are a veteran, because of our training, because of our operational tempo, because of a variety of different things, we are very misunderstood in the mental health care world. That poses some challenges.
The other part of it is that, in terms of service delivery and support for the families, oftentimes these people that we're dealing with, when they initially come to us, are not capable of dealing with a lot of the complexities, the paperwork, for a variety of things. Probably the My VAC portal frustrates just about everybody. I don't know of anybody who has that thing working right. I know I gave up. I just called my case manager and said, "Send it to my wife. Whatever you want to deal with, send the paper to her because I don't get it."
I reiterate, in full support of what Barry says, that to expect people who are suffering from serious mental health challenges to behave rationally and follow a set of guidelines that would be laid out, you might as well try to push Niagara Falls uphill with a paper clip, that's about how useful it would be. It just isn't going to work. I think there has to be a real understanding that the nature of the..., especially the complex mental health injuries, really have to be looked at in terms of the service delivery model and how we make it more user friendly to people who are struggling within that system.
Like I said, I was reading what Mr. O'Toole said last week about the lump sum and the payments for transition. He made a link between those things.
He said, and I will read the last part:
[...] veterans' independence program supports within their own home, often, depending on their status [...] long term lifetime assistance with home-based modification needs, health... None of those are available in a civil court context veterans will receive [...]
Mr. O'Toole seemed to say that the lump sums granted by civil courts is superior to what Veterans Affairs Canada offers. He said that in order to make an adequate comparison, one would have to add the other services offered by the department, a statement with which I of course do not agree. Indeed, the rationale behind that comment is that one can combine non-monetary compensation offered because of suffering with financial aid. This has nothing to do with the lump sum issue.
According to Mr. O'Toole, the government will not be increasing the lump sum, but it will offer other services which will have to be taken into account. He stated that overall the current sum was adequate.
I feel like I'm watching a bad translation of the film Back to the Future and that we are going back to a time before the Dennis Manuge case, when all these things were lumped together. I do not think that this is how things should be done.
The issue of the lump sum is distinct from these other services, it has nothing to do with compensation. It should have no repercussions on the sum offered for that purpose.
Moreover, the government often adds up the lump sum and the SISIP compensation payments. However, Veterans Affairs Canada does not offer compensation for the loss a limb. There is compensation which members of the forces pay for out of their own salary deductions, to a group insurance plan. I think it is important that this be mentioned at this point in the study.
As for the matter of the other services offered by civil courts, this is a red herring, in my opinion. I checked myself with the Quebec workmen's compensation commission, and I was told that in the case of a worker who is injured, that person receives compensation for losses or suffering. The commission also offers transition services to those who can no longer do the same work. However, there is no link between the two. I think consequently that the government is mistaken when it says that all of these amounts should be combined and that the lump sum should not be increased.
What do you think of all that?
Thank you very much for your courtesy, sir.
Thank you very much for being here. I want to tell you that I have a lot of sympathy for what I heard and witnessed.
For the purposes of the six minutes that I've been offered, I'll address myself to Mr. Cousineau, if you don't mind.
Mr. Cousineau, later if I have a minute left, I'll ask about your first name. I'm intrigued by it.
I want to commend you for the action you've taken in order to raise awareness of the therapy benefits of service animals. Your walking expedition has demonstrated incredible patience, perseverance, and persistence.
Now, from all corners of the veterans community, many people—veterans groups, advocacy groups, and individuals—are vocal about the Veterans Charter and the services provided by Veterans Affairs Canada. Many of these intervenors were involved in lengthy consultations with the Government of Canada then in office in 2005, when the charter was written.
I'm just going to leave you with an open-ended question, sir. You're a veteran who is actively engaged in making an impact in the veterans world. I'm interested to know how the Department of Veterans Affairs can make improvements in the way that they do business.
The floor is yours, and I'll forgive you for not wearing a tie.
Everybody makes mistakes. There is not a person in this room who has not been party to a mistake. The true hallmark of greatness is what you do after you've identified that mistake.
The history of the new Veterans Charter and the enhanced new Veterans Charter and whatnot, it's well known. It's a matter of history, and I think what you're hearing from the witnesses and what you're hearing in the street from other veterans' advocates and from veterans themselves is that there are issues. There are a lot of issues and they need to be addressed. There are strengths and there are weaknesses to parts of those programs, and this committee can hopefully take the steps to address some of the weaknesses so that those mistakes that were made become a thing of the past and veterans, as they move forward, realize that their service is acknowledged and valued and is not marginalized.
With regard to the lump sum payment, there's a very well-documented case of a veteran who lost a portion of his brain. We assigned a dollar value to that, and we gave it to him. I don't even know how the hell you deal with that. What's part of your brain worth? Is it worth so much for a month? A year? Five years? Ten years? As long as you live? I'm thinking the answer is as long as you live, and I think that the benefit stream has to be commensurate with the sacrifice that was made.
People in the military are asked to do things and they do them. I don't think any of us regrets our service. The regret comes when we feel that we've been marginalized by a government that doesn't value that service, and that's where it becomes incumbent upon Veterans Affairs to make sure that the veterans never feel that betrayal.
How do they that? Well, for starters, they make sure that veterans live out the remaining days of their lives secure in the knowledge that they're never going to run out of money, that the old pension act—as long as you live—it's there. I think that is something that you've heard time and time again. If the earnings loss benefit was universal and applied and continued forward, that would take away some of the dollar value issues, the monthly income stream. But it's hard to fathom how you arrive at—what is it now, $298,000? Oh, we're all the way up to $301,000! Woohoo, go us!
Being 100% disabled nets you $301,000. At 5% interest, that's $15,000 per year in taxable interest. Even at a 27% marginal rate, what are you looking at? That's a thousand dollars a month, if you manage to invest at all. That's not much for a lifetime of pain and suffering at 100% disabled, is it?