:
Mr. Chairman, members of the committee, I'd like to first start by introducing my director general of operations, Gary Walbourne, who of course is here to answer all the hard questions.
Thank you for allowing me the opportunity to appear before you and to contribute to the great work this committee does for our veterans and their families.
[Translation]
I have been following with interest the activities of the Standing Committee on Veterans Affairs and the testimonies offered by a variety of witnesses who talked about a wide range of issues.
For my part, I would like to focus my presentation today on the present-day challenges and barriers to the delivery of front line services faced by our veterans and their families.
[English]
As the veterans ombudsman, I represent upwards of 800,000 Canadian Forces and Royal Canadian Mounted Police veterans and their families. My team is dedicated to ensuring that these veterans, including the 216,000 who are clients of Veterans Affairs Canada, are treated fairly in accordance with the Veterans Bill of Rights.
I would like to start by offering our interpretation of “fairness”, which we see as both a value and a measurable outcome. We measure fairness according to three criteria:
Adequacy: are the right programs and services in place to meet the needs?
Sufficiency: are the right programs sufficiently resourced?
Accessibility: are eligibility criteria creating unfair barriers, and can services and benefits be accessed quickly and easily?
Let us look at some challenges and barriers through that lens of “fairness”.
Budget reductions may have an impact on the sufficiency of programs delivered to veterans. Since October 2011, I have been publicly requesting that Veterans Affairs Canada be exempt from the government's budget reduction plan. This would be in line with the actions taken in other countries, such as the United States and the United Kingdom.
Payments made to veterans or their family members are not handouts or welfare benefits but remittance of a debt incurred by the Government of Canada, which agreed to compensate citizens who have chosen the military or federal police service as a career. At the very least, we must ensure that any cost-cutting activity does not affect the quantity and quality of services received by our veterans. There must be a guarantee that sufficient resources, both human and monetary, will be there to support programs.
[Translation]
We must ensure that any cost-cutting activity does not affect the quantity and quality of services received by our veterans. There must be a guarantee that sufficient resources, both human and monetary, will be there to support programs.
[English]
If economies can be realized to increase efficiencies in the process, any available funds should be redirected to areas that are underfunded, such as the funeral and burial expense program.
Veterans Affairs Canada and the Department of National Defence need to be better prepared for the future. We anticipate that missions will likely lead to an increased number of injured veterans because of the multiplicity of tours and more complexity in case management due to a higher number of psychological injuries. The cost of dealing with the impact of the mission on deployed personnel, in terms of the rehabilitation and care of the injured, should be an essential part of up-front mission planning and should be a joint effort between the Department of National Defence and Veterans Affairs Canada.
[Translation]
The transition from military service to the civilian community brings up many issues related to the adequacy and accessibility of programs. Many of the witnesses you have heard from in the last few months have indicated that some veterans are experiencing difficulties in transitioning from a close-knit, interdependent military culture to an open, independent civilian community.
[English]
I believe it's not what these veterans are facing but rather what they are leaving behind that is the greatest challenge. They lose an identity and a sense of belonging. As the release interview is not mandatory, only those veterans who know they will require help post-release generally are interested in doing one.
If a Canadian Forces or RCMP member suffers service-related injuries that manifest themselves after release, the key documents required to access VAC benefits will be proof of service and medical records. These essential documents are readily available at the point of release, but are subsequently transferred to the Library and Archives of Canada. A mandatory release interview for all, including reservists, where releasing members agree to have service records and health records transferred to a VAC database, as well as the issuing of an ID card reflecting the veteran's file number, would ensure prompt access to benefits in the future. Furthermore, if such a card is subject to periodic renewal, it would provide the basis of a tracking system, whereby all veterans can be reached, including reservists.
In one of the previous hearings, it was mentioned that financial security is an important determinant of health. One challenge some reservists face is that in contrast to the regular force veteran, they are not entitled to the $40,000 earnings loss benefit, as introduced by the improvements to the new charter. So if two privates, one a reservist and the other a regular force member, working alongside each other are injured in the line of duty and are permanently incapacitated, the regular force member will be guaranteed an income of $40,000; the reservist will only be guaranteed an income of $24,000. This is in conflict with the fact that the impact identified in the regulations governing changes to the new Veterans Charter clearly indicated that the absolute minimum salary for an individual to sustain a decent living while undergoing a vocational rehabilitation program is indeed $40,000.
Issues and gaps in the delivery of health care services also relate to the adequacy of programs. The highest number of complaints received by the ombudsman's office relate to health care. These complaints cover a wide range of issues, including reimbursement of travel expenses, limitations on treatment protocols, and the cumbersome approval process. One clear gap is that the long-term care program does not include a strategy to incorporate the Canadian Forces veterans who may require long-term care down the road in priority placement. There seems to be an apparent gap between programs to keep veterans and spouses at home as long as possible and the provisions of a bridging measure, such as subsidized access to assisted living facilities.
[Translation]
Another barrier to adequate health care is the fact that all of the operational stress injury clinics that were put in place do not cater to veterans who are in crisis; veterans must be stabilized and free of addiction before gaining access to their own clinics. In a system where programs are based on needs, this is hardly fair.
[English]
The complexity currently built into the program's criteria and processes creates an overarching barrier to program accessibility. Over the years, veterans have been categorized by where, when, and how they served, which explains why there are 18 veteran client groups used by Veterans Affairs Canada. Since sailors, soldiers, airmen, and airwomen, as well as members of the Royal Canadian Mounted Police, do not question where and when they must serve, for Veterans Affairs Canada to determine that the level of programs and services provided will be based on the type of service rendered is an injustice of the first order.
Access to benefits should be determined by injuries and illnesses related to service, and should be the same for all veterans, regardless of the nature or the location of their service. Categorization has led to the fact that even within the veterans community there are those who do not consider themselves veterans when compared to our war veterans. My office has chosen to adopt the theme of “one veteran” for the duration of my mandate. We do not provide consideration to veterans based on when and where they served but recognize them based on the fact that they served honourably.
One further challenge, and an added layer of complexity, is that the onus to prove service-related causes for an injury or illness is left to the veteran or his representative, when in fact the custodian of the evidence is the Government of Canada, either Library and Archives Canada or the Department of National Defence. When files are obtained by Veterans Affairs Canada, the information contained within it is reviewed and forms the basis of the decision, but it is not provided to the applicant.
In addition to the challenges I've just highlighted, my office is working on systemic reviews aimed at identifying gaps and challenges in specific areas, such as the review of procedural fairness throughout the benefits delivery system, the application process, accessibility and program delivery of mental health services, long-term care strategies, and the programs available to families.
In closing, I would encourage members to support the exemption of Veterans Affairs Canada from the government's budget reduction measures. In the interest of fairness for our veterans and their families, I would ask that the committee work towards ensuring that any budget exercise does not affect the quality and the quantity of benefits available to our veterans, and that they remain sufficiently funded, both in terms of finance and human resources.
[Translation]
Further, I would ask the committee's members to address the unfair issue of differential treatment of reservists under the provisions of the Earnings Loss Benefit. I firmly believe that those who sustain similar illnesses or injuries while serving their country should have access to the same benefits, regardless of the nature of their service and where and when they served. It's a matter of fairness and I ask for the committee's support in this matter.
[English]
Finally, I would humbly suggest that the committee consider the three pillars of fairness as they continue their work of the committee. Are the right programs and services in place to meet the needs? Are the right programs sufficiently resourced? Are our eligibility criteria creating unfair barriers, and can service and benefits be accessed quickly and easily?
Thank you again for the opportunity to speak to you.
Thank you, Mr. Chair and committee members, for the opportunity to meet here today.
I'd like to introduce Mr. Raymond Lalonde, who's my director general responsible for our network of operational stress injury clinics across Canada.
Over the past few months you have heard substantial testimony from qualified, credible expert witnesses who spoke passionately on the subject of Canadian Forces members transitioning to civilian life. My goal today is not to repeat the information already presented but rather to summarize some key points and to address any outstanding questions you may have.
Veterans Affairs Canada is fundamentally changing the way we do business. Our vision is to become equipped to serve veterans and their families better, faster, and in more convenient and modern ways.
[Translation]
In fact, the Minister of Veterans Affairs outlined quite a few details of the more recent service improvements when he presented the main estimates to the committee a few days ago.
[English]
We've been strengthening our relationships with shareholders, working collaboratively in gathering intelligence from our veterans, partners, and advocates, and the department is responding to this information. We are on the right track for modernizing our services and our benefits.
Certainly, there is a lot of work left to be done. It is important to remember that improvements take time, but progress has been and will be steady.
We work in collaboration with the Office of the Veterans Ombudsman. An example of this collaboration is the Benefits Browser, which was first developed by the Office of the Veterans Ombudsman, has since been adopted by the department, and is now available for use across our offices.
[Translation]
An example of this collaboration is the Benefits Browser which was first developed by the Office of the Veterans Ombudsman and has since been adopted by the department. It is now available for use in all our offices across the country.
[English]
The benefits browser quickly displays and sorts information, thereby improving the capacity of our front-line staff to respond faster and provide veterans with the relevant information they need.
We are developing a second tool for use by Canadian Forces members, veterans, and their families.
Thank you, Mr. Chairman. Those are my opening remarks.
Sir, your paragraph says “As a Department, we are on very solid footing....” It goes on a bit more. And then it says, “Our responses and actions are well thought out and appropriate.”
I just want to give you four examples. Then you tell me, if you can, if they're appropriate.
Ninety-seven-year-old Louis Dionne of North Vancouver is in a hospital getting a pacemaker. His wife is 89. He was told by DVA that they would have an answer for VIP service, if they get it, within 16 weeks. That's number one.
Number two, 87-year-old David Kurts in two years was denied four different times for various benefits. He's a World War II and Korean War veteran.
Ninety-year-old Sarah Atwood served in World War II but not overseas. She didn't dip her toe in the Atlantic. She was denied a bed at Camp Hill Hospital even though she's in the final stages and about to cross the bar, and even though beds are available at Camp Hill.
Ninety-year-old Ted Shiner was denied VIP service and efforts for his footwork. He is 90 years old.
Do you think, sir, that is an appropriate and well-thought-out position, when services for these elderly World War II and/or Korean War veterans are either denied or delayed? Wouldn't their age alone tell the local staff in those offices that they should be able to go in there and help them immediately with their concerns?
I just ask you that question.
:
Mr. Hillier, I thank you for that. There isn't one person on this committee, at least as long as I have been on this committee, who would disagree with the sentiment that for VAC employees, when they wake up every day and go to bed, their number one thought is how they can help those veterans and their families and improve their lives. That is absolutely true.
I just gave you four cases, among hundreds, if not thousands, of cases I've worked on since I became a member of Parliament, in which this has been all too common. Art Humphreys, 87 years old, was denied a lift into his basement. He was told that he no longer needed to go there. This is a typical example, and it goes on and on. To say that your actions are well thought out and appropriate.... In some cases, yes, they are, but in many cases, they're not.
I say that with great respect. We need to do better in ensuring that a 97-year-old doesn't wait 16 weeks to get an answer. You'd think it would be a no-brainer to get in there and help the person and fill out the paperwork later. As a good friend of mine, and a member of this committee, said, why don't we just give everyone their benefit and then chase the other 2% or 3% after that.
Mr. Parent, I was wondering if you can answer the question regarding your work with the DND ombudsman and the kind of liaison you have.
I thank you, Mr. Hillier, for your time.
:
Thank you very much, Mr. Chair.
I'm so glad to have this time, because I have a significant number of questions.
I want to go back to the problems facing modern-day veterans, and the issue here is the meetings they have with the veterans review board.
When a veteran applies for a disability, frequently they're denied on the first application. Then they appeal. They go to the appeal board, and they may be denied again.
The problem that's been identified—and I think you've identified it too—is the mountain of paperwork that is required. For most veterans it's just overwhelming, particularly if they are suffering from mental health concerns. They feel as though they can't possibly manage; they can't fight for themselves. One of the realities is that in my community, and in a number of communities, too many of these veterans end up on the street. They're homeless. In some situations, they slip through the cracks.
In Halifax, we met with Jim Lowther and David MacLeod. They've been doing work on the ground. They've actually found 13 veterans who were homeless and have managed to support them and get services for them and get homes for them. Their complaint was that Veterans Affairs hadn't been able to find them. Mr. MacLeod and Mr. Lowther found these men, but Veterans Affairs wasn't able to. They're operating their support services and shelters with their own money. They're not receiving any funding.
This reminded me very much of what's happening in my own home community. We have a number of veterans. There's been some attempt to study and determine how many there are, but still there is this sort of missing piece in terms of Veterans Affairs pursuing this issue of homelessness for very vulnerable people.
I have to say I've met some of them, and they're very fragile. They need support. They need help. I was wondering, if you were able to make a recommendation around Veterans Affairs and its interaction or support for homeless veterans, what would that be?
:
Thank you very much for the question.
I think homelessness for veterans has probably been an issue since the office was introduced, in the last couple of years. Certainly my predecessor's campaign triggered a lot of projects within Veterans Affairs Canada, and I'll stay away from funding and budget and all that. I'm sure Mr. Hillier can address that aspect of it.
Our biggest concern with the homelessness program at this point in time is the absence of a national strategy for homeless veterans in Canada. There are a lot of individual projects that work with different approaches, and I think all of them have proven to be of some benefit. I just recently went to Vancouver and dropped into the drop-in for homeless veterans in Veterans Memorial Manor, a very good project there as well. But again, we keep talking about projects.
We think that regional inconsistencies in Veterans Affairs Canada are in themselves unfair, because we do have inconsistencies, and veterans should not suffer or be treated unfairly because they have chosen to live in a certain place in our country. It should be the same across the board.
That's the one thing that we see is lacking: a national strategy. The thing is that these projects should now be helping to inform some kind of a national strategy for homeless veterans. Again, I think most of the ones that are in place right now are working, but there is more work to be done at that level.
I would certainly like to take this opportunity to commend the Royal Canadian Legion for the work they do for the homeless population, because I think everywhere we've gone, we've seen that those projects are being helped by the Royal Canadian Legion.
:
First of all, there are no time limits on services that are available to veterans as it relates to the rehabilitation program.
With many of these people, and I have been to Toronto and other places across the country, and some of these people, sadly, are suffering from addiction issues. Getting them into rehabilitation programs.... The programs that we have available are, for example, retraining, where someone can get a new skill. The reality is that if they're having issues with addiction or with anger management, or if they're having issues of social adjustment, in every case the case manager sits down with the veteran and his or her partner, as the case may be, or a military friend, whoever they may want to bring to the interview, to try to set some realistic objectives for them, with a goal to getting them off the street.
I can tell you, it's a very fragile exercise. Many of these people do not trust society, and it takes a long time. I was talking with one of the caseworkers in Montreal just recently, and they had been working for eight months with a veteran to try to get the person's trust so that they could move that next step forward to be able to get the treatments they need, because before you can get into services and benefits, you really have to deal with the particular issue. As one of my caseworkers said to me at the IPSC in Gagetown, New Brunswick, we, as average Canadians, sometimes have difficulty understanding how these people live. To a homeless person, their major priority is the next meal.
:
That's a good question, Mr. Chair.
On that particular issue, in every meeting with the minister it's certainly a subject that we talk about. We have been told they were working on it. Again, this is easily understandable, at this point in time, for the financial aspect of this program.
However, as I said before, some recommendations of the report have nothing to do with finance. They have to do with the administration of the benefit. For instance, people have to go to a coupon-cutting exercise. There are only so many dollars for flowers, so many dollars for caskets, so many dollars for the minister or the priest. People who are mourning at that point in time shouldn't be subjected to that aspect of it.
The approach from DND is that all of that is submitted as one, and then they pay for a certain amount and that's it. That was one of the things.
One of the recommendations had to do with recognizing the impact of cumulative or numerous injuries on the body over a period of 40 to 50 years. It would be certainly fair to recognize that as the cause of death, rather than to be specific on what actual injury caused death.
We're more disappointed with the inaction on those recommendations than the ones that have to do with the financial aspect. But we'll keep working with the minister to try to get some movement on that, and hopefully this committee will as well.
:
Yes. It's a very good question.
In fact, Mr. Chair, I've expressed that position before the office. We think to look strictly at the assumption that the population will diminish and there will be less requirement for resources is wrong, because there are other populations that will increase the number of clients of Veterans Affairs.
I know for a fact, after a career in the forces—and many people will probably support me on this—that many people who are suffering right now in service are not declaring their injuries because they would be, again, subject to the universality of service and kicked out. When all of these people retire, they will be declaring their injuries and therefore accessing benefits from that.
There are people now who are retired from the armed forces and who have not yet exhibited symptoms of PTSD or other psychological injuries, but they will in the next few years, especially if you look at the number of people who were in Afghanistan. So that will also increase some of those clients of Veterans Affairs Canada.
To date, there are still some people from World War II who are applying for benefits, who have suffered in silence for many years. All of a sudden they realize that they've been limping since 1947, so maybe it is because of their service, and they're still applying for benefits.
To assume the population is going to be smaller.... Yes, we realize it's the reality that we lose 1,200 veterans of World War II every month. But, again, with all of these other things in the hamper and the complexity of the modern cases that have to do with co-morbidity and very intricate case management aspects, this will certainly increase the workload.
:
Mr. Hillier, you indicated that Canada is one of the few jurisdictions that gives a client a lawyer if they need legal assistance in order to adjudicate their case before the board.
I find that quite sad, to be honest with you. One, it's expensive; two, it's time-consuming; and three, in most cases people just give up after the first or the second denial. It's rather challenging, when someone has to wait almost two years or sometimes three years, get a lawyer, and go through VRAB to get a hearing aid or a stairlift for their home, or VIP services.
This is the type of frustration that I express on behalf of those individuals. If the benefit of the doubt were applied from the very beginning....
For example, Marshall Demetrician of Edmonton has a psychiatrist's report from an individual who studied psychiatry for many years indicating that there is a high probability, in the doctor's opinion, that his concerns have been affected through military service. VRAB denied him.
I know you can't answer that, but that's the type of frustration people have: they go to the doctor, they spend hundreds of dollars of their own money to get a report—which is not reimbursed, by the way—only to be denied, in many cases by people who have never worn the uniform.
That, sir, is the frustration. And those very good people you talked about, those wonderful front-line employees, should have the authority, with peer-reviewed medical evidence, to make the decision, based on the medical evidence and the benefit of the doubt, to immediately grant access to the benefit and services they require.
I believe, sir, that if we worked in that way, not only would you be able to achieve what you really wish to do—and I know you attempt to do it all the time—which is to provide speedier or faster resolution to the services, but many more veterans wouldn't need a veterans ombudsman. When you think about it, when you have an ombudsman, you have a problem. Isn't that right?
I say that just by way of advice and regard. I want to thank you again for your tremendous service over the years, because I know, sir, that on a personal level you do a very good job. You obviously have to abide by the legislation and the regulations that you work under.
But in my personal view, working on this file for over 14 and a half years, there are many ways in which we can streamline the process to make it much faster, give the true benefit of the doubt off the bat, and not let veterans and RCMP members feel that they need to have a lawyer or feel that they're actually begging for something, because in many cases this is what we hear from them. When a veteran gets a benefit right away, they're ecstatic. They love you; they think it's great.
:
Mr. Chair, I would like to respond, because I think there are some clarifications that are really important here for the benefit of all members.
First of all with regard to the Veterans Review and Appeal Board, they do not hear any appeals for health: issues of health services, treatment, and benefits are not in the purview of the Veterans Review and Appeal Board. I want to very clear: there are levels of appeal, but they are not with the Veterans Review and Appeal Board.
With regard to the issue of adjudication, again I want to point out that 73% of the incoming applications for a disability award or disability payment actually get a yes the first time. There's a team of adjudicators, approximately 60 people, who are extremely well trained, and they are supported by a team of eight medical specialists. The law requires them to give the benefit of the doubt to the veteran; there is no question about that.
In some cases, unfortunately, there is no benefit of the doubt to be given. If the information is missing, or if in fact.... In the system that we have, we are never going to be at 100%, because there will be some claims that won't be valid. That's the reality of a claims system. I think we need to work to make sure that the veterans get every benefit and every service they are entitled to.
With regard to the lawyer, 73% get through, and actually with the help of a lawyer. The fact that the Government of Canada pays for a lawyer to make sure to go that extra mile, to make sure the veteran gets everything they can.... I think we as Canadians should be very proud of the fact that we are going to do that for our veterans.
Just as an indulgence, Chair, if I may, since we talked about.... I thank you very much for your comments about me. I missed the estimates meeting on Tuesday. Unfortunately, I had a medical situation. It was the first time in 14 years that I haven't been here for the estimates.
I may be dating myself.
I would just like to put things in perspective a little bit. My colleague mentioned that he gets a lot of his business from health claims. Last year we processed 13.5 million health claims through the system. As part of that, last year we filled 5,386,000 prescriptions. We processed 174,126 dental claims. I give you these figures to provide a sense of the volume.
The ombudsman fulfils a very important function, because sometimes things go the wrong way, one might say, but I wanted to give you a sense that we're in the business of hundreds of thousands and millions of transactions. I'd like to think that every one is done perfectly, but we don't live in that world, and we have an ombudsman who can come forward and say that somebody didn't get the benefit or service in the manner we might expect.
:
That's a very good question, Mr. Chair.
We used to say in the military that the military is not a career, it's a way of life. You're surrounded by a culture of interdependency in the forces. A lot of things are provided for you, without you having to queue in line or anything like that. The best example of that is a doctor for the individual. A doctor is provided by the service on a day-to-day basis. If you don't feel well, you go to the infirmary, and you're looked after by a doctor right there and then. For the annual medical it's the same thing.
Well, the individual who now transitions into the civilian community now has to get used to all that. Where do you go for a doctor? What's a walk-in clinic? All of these things are unknown to the military person, because these things have always been looked after for him.
Another example would be salary negotiations, unions—all of these things. They're non-existent for the individual.
So you go from a world of interdependence to one of complete independence. Somebody has to explain to you how it works, and there's a stigma attached to it when you're not.... Of course, some people do very well if they have the ability to do things for themselves, but a lot of people in the forces are really living the culture. They feel that all of a sudden they've been abandoned by the system.
I think it's necessary to have somebody in the joint personnel support unit say to the healthy veteran, “Okay, now you'll be going into civilian society. Is there anything you're concerned about? Is there anything we can do to help you out?”