Mr. Chair, committee members, thank you for inviting me here today and for providing me with the opportunity to share the results of our 2019 Office of the Veterans Ombudsman Report Card.
As mentioned, I'm joined here today by the deputy ombudsman, Sharon Squire.
Excuse me if I go back a bit to first principles, as this is my first time to appear before you. As you're aware, the Office of the Veterans Ombudsman has really a two-part mandate, and the first and most important part of that mandate is to respond to individual veteran's complaints, or complaints raised by spouses or survivors. The second part of our mandate is to recognize and identify issues that may be affecting more than one veteran, therefore representing perhaps a systemic issue. Under our mandate, we have the opportunity to investigate those issues and, where appropriate, make recommendations to VAC to improve programs and services. That's really where the report card comes in and that's why we're here today.
This is the third year that our office has released the report card. It was first released in 2017. The report card is a tool for us that allows us to capture, track and report publicly on recommendations that our office has made to Veterans Affairs Canada to improve programs and services.
The report card allows us to do a couple of things as we report publicly. The first is to acknowledge progress that's been made, and in fact to celebrate where changes have been made to programs and services to the benefit of veterans and their families. More importantly, from our office, it allows us an opportunity, on a regular basis, to shine a light on areas that we think still need some attention, and that's what the report card this year does.
I'd just like to share a few highlights with you, if I may.
Three areas where we've seen progress this year, progress that we believe will be well received by veterans, are as follows. The first is that veterans will now be able to retroactively claim reimbursement for treatment costs to the date of application as opposed to the date of decision for disability award and now pain and suffering compensation applications, which we believe is a significant improvement. The second is that, at the age of 65, all veterans who have a diminished earning capability assessment will now receive 70% of their income replacement benefit, which is very important in terms of financial security post-65. The third is that it's good to see movement on issuing of veterans' service cards, which the veterans community has been calling for, for quite some time.
We do like to acknowledge and recognize these improvements that have been made.
As I said, it's also an opportunity for us to shine a light on areas that still need some attention. As of the point of reporting this year, there are still 13 OVO recommendations that have yet to be addressed. The majority of those recommendations relate to the two areas that we hear about most commonly in complaints from veterans. They are in the areas of health care supports and service delivery.
In releasing the report card and sharing it with the minister, I took the opportunity to highlight three of those recommendations that we think would warrant attention as a matter of priority. They are as follows.
The first is expanding access to caregiver benefits, which is something we hear and continue to hear about on a regular basis from veterans groups and veterans advocates.
The second is covering mental health treatment for family members in their own right. Having had the opportunity in my first few months to meet with a number of veterans, and spouses in some cases, and to hear about some of the circumstances and challenges that family members, and in particular children, face when dealing with having a parent who was injured or is severely ill as a result of service, makes me wonder whether or not we're doing all we can do to support children and families. We think that's an important area.
The last is to provide fair and adequate access to long-term care and, to a lesser extent, the veterans independence program.
Those are three areas that we believe are important and I highlighted those to the minister. We will continue to follow government's actions in response to our recommendations and will continue to report publicly to you, the committee, and to Canadians on progress as needed.
As I mentioned earlier, I'd also like to take this opportunity to share my priorities with you, after having spent six months on the ground now and having had the opportunity to speak to a number of veterans, a number of veterans groups and advocates. We've taken some time to identify the priority areas that we think need to be addressed next. Again, these aren't ideas that we came up with sitting and talking amongst ourselves. This is what we hear from veterans who phone our office and from veterans groups and advocates. I'd like to share those priorities with you briefly.
The first priority, from my perspective, goes back to the key component in our mandate, and that's providing direct support to veterans and their families when they believe they've been treated unfairly. We're still a fairly young office, and our front-line staff have done very good work to this point in time. However, based on what we've heard from veterans and what we hear through our client satisfaction surveys, we have some work to do to make sure that we deliver an even better service and that we clarify what our mandate is, what we do and what we don't do, so that veterans who need our help will actually come to us. This is a significant priority for me and our number one priority.
Additional priorities include health care supports. As I mentioned earlier, this is the area that we receive complaints about the most. I'm led to believe that this area has not been looked at in quite some time, so we want to help move things forward in this regard by taking a broad look at VAC health care supports to identify areas we think might need some attention.
Third would be transition. I think we're all well aware of the importance of the transition process and ensuring that veterans and their families are well set up for post-service life. This is an area that continues to, thankfully, gain a lot of attention. We're particularly interested in looking at the area of vocational rehabilitation and the programs and services that help veterans find purpose in post-service life.
As we do this work—and we've also heard this through engagement over the last number of months—there are a few groups that we believe need to be considered a little more closely and a little more deliberately. They include women veterans. I've had the chance to speak to a number of women veterans and women's advocates. It's clear that a number of the programs and services they have access to were not designed specifically with women service members in mind or women veterans in mind. This is an area that we think is going to require significant focus going forward.
Second are veterans of the reserves. We've received a number of complaints, again related to specific programs. In looking into those complaints, it's become clear that, while the program is well intended, well designed and works well for regular force veterans, that's not always the case for reservist veterans. We think there's enough of an issue there to broaden that scope a bit and make sure the programs and services that are being provided adequately take into account the unique nature of reserve component service.
The last priority—and I mentioned this earlier—is families. Just in the brief amount of time I've been here speaking with veterans and families, we believe that this is another area we need to look at a little more closely to make sure we understand what the impacts on families, particularly children, are and that we have programs and services that adequately take this into account.
The last piece I would mention is just a bit of ongoing work that we initiated a number of months ago in terms of conducting a financial analysis of the pension for life. That work is more than just a financial analysis. We're going to monitor the implementation, and we are monitoring the implementation with a view to producing a report sometime late this year or perhaps even early 2020, after we've had time to watch it be implemented and get a sense of what the impact is on the ground.
Thank you very much for the opportunity to share an overview of the report card and also speak to some of our priorities going forward.
I'd be happy to take any questions, if there are any.
In general terms we did not receive the anticipated degree of calls from veterans related to pension for life. The majority of our calls were related to seeking to understand the program, particularly for those who were transitioning from the Veterans Well-being Act to pension for life.
We did receive a number of complaints related to the timeliness of the payout for the supplementary relief benefit, and we're looking at that.
We did receive a couple of concerns about perhaps some unintended consequences of changing programs from non-taxable to taxable and how that may impact a number of veterans, but we haven't worked those cases through with them.
I've met with Mr. Cousineau and I would say, first off, that the information he has shared is accurate and I think it corroborates what the Parliamentary Budget Officer has reported in terms of the financial comparison of the three benefit regimes that are now in existence, and it aligns with the work we've done in our financial analysis to date.
I would say that it almost defies simple comparison from one benefit regime to another benefit regime. In our work early on, we did note the implication for the most ill and injured veterans who, under pension for life, as it is written today and is being implemented today, would be less well off financially than they would have been under the Veterans Well-being Act.
I would also say that when I look at the three benefit regimes now, it's pretty clear that we have veterans under each of those benefit regimes who are not being treated the same way, even though they might suffer the same level of injury and they might have similar needs. That's certainly an issue that we'd like to see addressed moving forward.
We conducted some work, an analysis, into wait times late last summer because it was the number one complaint we did receive, and it's still the number one complaint. That report and work resulted in a number of recommendations to Veterans Affairs, particularly in relation to francophone veterans and women veterans and the fact that their wait times appeared to be longer. It's clearly an issue and clearly it's not acceptable for anybody, let alone veterans.
We hear two things. The first thing we hear from veterans is not necessarily about the amount of time they wait, but that they would like to be given a clear answer when they apply as to how long it will take for their case to be adjudicated. I met with a veteran last week who's been waiting 18 months, and his file has been at the same level for over a year, with no real information being provided. There's a frustration component.
From my perspective, I think the most important thing—and our office has stressed this for a while—is treatment. While the file is being adjudicated and there's a delay for whatever reason, some veterans will be able to access treatment, while others won't, for a variety of reasons. It could financial. There could be a number of reasons. We'd like to see veterans having access to treatment as soon as possible. Perhaps we need to look at providing treatment from the date of application and not placing that burden of adjudication and how long it takes on the backs of the veterans. Put it on the back of the system and allow the veterans to access treatment as soon as they apply.
In terms of the approval rates, if you look at mental health diagnosis as an example, or PTSD, you'll see that first-time applications are approved at a rate of about 96%, and then those that might not be approved, that go to the Veterans Review and Appeal Board, are approved at some 40% on the first time through, and then 22% on the second. You could ask why we don't just approve 100% right away, and then look at perhaps an audit function at the other end.
There may be some risk in finding a way to allow veterans to access treatment right away, but I think the risk of having them wait far outweighs that.
Thank you both for being here.
I apologize for being a little late and missing some of the content. Hopefully my questions make sense.
First of all, under “Health Care and Support”, we're talking about this having been achieved to allow veterans to be compensated retroactively to the date of application under the Pension Act and the re-establishment of the compensation act. We know that the number of people waiting for decisions has ballooned to over 40,000. There are least 3,000 cases that are very serious scenarios and they haven't received responses yet.
I've heard from a number of them who were concerned. They wanted to get their applications in before April 1 to get care. Of course, April 1 was when the new pension came in and we're aware now that there are some issues around getting the same amount of support as before in different ways.
Did you hear any feedback from veterans about concern that, basically, there was no retroactive opportunity? They put their request in, but they don't qualify under the new system.
Yes, it's clearly a very big issue and one that nobody would accept.
I would just highlight a recommendation that we have made to VAC, among a number of recommendations, around triage. It is that, when veterans apply, cases be triaged to determine who is most in need, so that veterans who need immediate access to care or might be in financial difficulty or might be aged or might be terminal, in some cases, get the support they need as quickly as possible.
VAC has done some good work in that regard, but we think that triage needs to be taken a little further and it needs to be clearly explained to the veterans community so that when they apply, they share all the information they can share that might help them avail themselves of a quicker process if it's needed.
I'll defer to VAC, and I know they have testified before you on the stats and the reality with the number of increased applications, the increased production. That's their story to tell and I'll let them tell it. But clearly I have nothing more sophisticated or intelligent than to say that we need to find something disruptive or it's not going to change. We'll be at the whim of the number of applications that come in.
The one thing I think we should look at, and I mentioned it earlier, is granting access to treatment right away. When you look at the approval rates for the disability claims that VAC processes, they're very high and the PTSD one jumps out at me. If we're at 96% or 98% after reviews are taken into account, why do we have a six- eight- or 10-week process? If you have the diagnosis, it's clear and you have that medical assessment, you should get immediate access to treatment.
I don't know what that would look like. We haven't done any work in that regard, but I think treatment would be the most important thing for veterans to get access to, so that they don't become more unwell.
Yes, I could give you an example. There is the income replacement benefit, which is a very good program, formerly the earnings loss benefit. The education and training benefit is another one.
There are certain eligibility criteria for those programs. The time of service is calculated differently for regular force members and reserve force members. We've received a couple of complaints related to what is now the income replacement benefit that suggest that, not intentionally but when those eligibility criteria were developed, they ultimately resulted in what is an unfair scenario for reservists.
I can give you a quick example. For regular force members who are released medically after 30 years of experience and are eligible for the income replacement benefit, that income replacement benefit will be calculated based on their salary at the time of release.
In the case of some reservists who go on and come off of different classifications of service, different types of service, which is very complicated, they may suffer an injury.
For that regular force member, that initial injury may have been suffered 15 or 20 years previously, but may have been aggravated to the point where they could no longer serve and there might be diminished earnings capacity.
For a reservist, that individual may have suffered an injury 15 or 20 years earlier at the rank of corporal, and may have released at the rank of chief warrant officer because they were no longer able to serve. Their income replacement benefit is based on rank and salary at the time of injury. You advance 15 years and you have a wife and two kids, a mortgage and perhaps are putting kids through school and those types of things.
That's one example of a really good program for which it appears, in the cases that have come before us, that we'd probably need to look at the eligibility criteria.
Thank you, Mr. Chairman.
I'm going to be blunt because this is a report card, and to me, this is a failing report card.
I want to thank the ombudsman for making these recommendations, but I just find it very disheartening to see that—I'll give credit where credit is due—50 out of 63 have been implemented or partially implemented, but in the category of health care and support for veterans, eight out of 10 are not implemented. To me, that is incredibly tragic. Our veterans, our service men and women, put their lives on the line, put their physical and mental health at risk to serve our country. We need to make sure that we are doing better.
In looking at some of the areas where improvement is needed, Mr. Ombudsman, you said earlier that you believe it's the capacity to manage the change at the department. That is partly why some of these things that seem incredibly simple and logical lead me to ask this question. We see so many other parts of this report being addressed adequately. Why is it that when it comes to health care and support, we are lagging behind? Why is that not a priority in terms of making sure that, for example, veterans don't have to wait in the 40,000 backlog of cases. Why, for example, are they not getting the same access to dental care as they would under the public health care plan? Why is this not being prioritized?
To me, it's one of the most important things, to make sure that veterans and their families get the supports they require when it comes to their health and well-being after they have served.