Interventions in Committee
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Craig L. Dalton
View Craig L. Dalton Profile
Craig L. Dalton
2019-06-10 15:36
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.
Daniel Dubeau
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Daniel Dubeau
2016-10-20 15:31
Thank you so much, Mr. Chair, and members of the committee.
First of all, I'd like to thank you all for your ongoing examination of benefits afforded our serving and retired members of the RCMP who have been injured on duty and for your invitation to be here today.
As the chair noted, I'm deputy commissioner Dan Dubeau. I'm here in my role as chief human resources officer. Steve is here in his role as assistant commissioner and assistant CHRO, but also as our national mental health champion, and Mr. Lebrun is here in the role of director general, national compensation services, which takes care of all our compensation benefits administered through VAC.
As Canada's national police force, the RCMP provides front-line policing services at the municipal, provincial, territorial and international levels, working in urban, rural and remote locations.
In many communities the RCMP is the primary and at times the only first responder. RCMP members are called upon to respond to a variety of situations, including criminal incidents, traffic accidents, fires, medical emergencies, and search and rescue efforts. By virtue of their duties, our members are continuously engaged in police operations and are regularly exposed to a multitude of hazards, including physical, chemical, biological, and psychological hazards that put them at risk for various occupational injuries and diseases.
These injuries may manifest themselves in the form of hearing deficiencies, operational stress injuries, and musculoskeletal injuries such as back and knee injuries. These injuries are attributed to, for the most part, hazardous occurrences resulting from assaults and violent acts from members of the public, falls, lifting and exertion, motor vehicle accidents, training-related accidents, and exposure to harmful substances and environments.
In this regard, based on Veterans Affairs Canada statistics for 2014 to 2016, the top four medical disabilities for RCMP clients are hearing loss, tinnitus, PTSD, and lumbar disc disease.
Furthermore, the RCMP has since undertaken an in-depth analysis of incidents causing injuries to its members. One of the tangible actions resulting from this analysis was the implementation of a risk-prevention program.
It is therefore an area of primary concern for the RCMP in our efforts to support the health and well-being of our members and to address this complex issue.
Our work is focused on prevention as well as providing support for members who are injured. In this regard, since the launch of its mental health strategy in 2014, the RCMP has undertaken considerable work to reduce stigma around mental health and to implement concrete strategies to promote wellness within its workplace.
At the core of our efforts, we continue to rely on our mental health champions, identified nationally, Stephen White, and in every division. Since appointed in July 2014, they have become leaders and supporters for rolling out national initiatives, for providing consistency, and for implementing local activities to respond to their distinct needs. Our approach of leading from the top and ensuring commitment and engagement from senior leaders demonstrates to employees that mental health is a key priority for this organization.
The RCMP recognizes that when its members fall ill or are injured, case management activities must take into account the very specific physical and psychological demands of police work as well as the variable nature of the policing environment. RCMP officers must regain a physical and psychological level of function that exceeds what is required for most members of the public. In this regard, under Assistant Commissioner White's leadership, the RCMP is investing in an enhanced disability management program for its members.
The program reflects industry practices in disability management, and in particular, a focus on early intervention activities to support members in their recovery and maintain their connection to the workplace. Once fully implemented in April 2017, this program will be supported by 30 disability management advisers across the force who will work proactively with members, supervisors, and divisional occupational health teams to coordinate support for early intervention and the return-to-work and accommodation planning process.
The RCMP is also in the process of acquiring disability case management and business intelligence software that will support case management activities in accordance with privacy requirements. This software will also provide ongoing program evaluation and trends analysis. This will inform prevention and wellness activities to support members' health.
For serving members and former members with an operational stress injury, Veterans Affairs Canada provides assessment, treatment, and support services through operational stress injury clinics. The RCMP has also entered into a partnership with the Department of National Defence so that the RCMP may access a DND network of clinics called operational trauma and stress support centres.
Former RCMP members who have an operational stress injury, or OSI, can access the network of operational trauma and stress support centres of Veterans Affairs Canada. RCMP members also have access to the assistance services of Veterans Affairs, which provides mental health services 24 hours a day, 365 days a year.
Furthermore, VAC offers a wide variety of programs of choice to former RCMP members, such as aids for daily living, dental services, medical services, medical supplies, occupational therapy, and psychological counselling, just to name a few.
On June 7, 2016, the Veterans Ombudsman released a report entitled “Supporting Ill and Injured RCMP Members and their Families: A Review”. This report contains an extensive list of benefits currently available to our serving members, our veterans, and our RCMP families. In addition to identifying the full spectrum of currently available services, the ombudsman indicated that, according to his projections, over the next five years the number of serving and discharged VAC RCMP clients is expected to increase by 20% and the number of RCMP members' survivors is expected to almost double. We thank the ombudsman for shedding additional light on the evolving needs of our RCMP veteran population.
In addition, the ombudsman stated in a press release, “Working conditions for RCMP members can be extremely challenging, and often dangerous. This can result in physical and psychological injuries, illness or death.”
In other words, our members, contrary to those of other agencies, are continuously deployed throughout their service, and that increases the risk of workplace accidents.
The ombudsman's report allows us to better identify the gaps between the services currently available and the needs of our serving members, our veterans, and their families. We have begun this review and we are working in close collaboration with our colleagues at Veterans Affairs Canada to determine whether changes need to be made to the support and services provided to RCMP members, veterans, and families.
The RCMP has also engaged its veterans' association in assessing the current service offering and to ensure that the needs of RCMP veterans are met. The RCMP has established an advisory committee with our veterans, and they have already begun identifying their priorities. Our veterans are closely examining how the recent mandate letters from our Prime Minister to the ministers of Veterans Affairs, Public Safety and National Defence affect them, and together we are identifying how we can best recognize the sacrifice made by our first responders and our veterans.
In addition, for our serving members, the RCMP's occupational health services offer a broad range of workplace health-related services that contribute to a safe and healthy workplace. These services are delivered by a team of professionals, which includes physicians who are our health services officers, psychologists, and nurses. This multidisciplinary team contributes to health evaluations of our members, participates in disability case management, and supports service delivery of our programs that have a health component. The health services officers and psychologists support the professional services in their respective scope of practice, including the review of medical information and acting as liaison with community providers when external examinations are required or with a member's own caregiver when health information is required in regard to the administration of occupational health programs.
With respect to health evaluations, the periodic health assessment is first conducted at the recruitment stage, and then at specific intervals, ranging from yearly for high-risk positions to every three years. These assessments are conducted to ensure a member is medically and mentally fit to safely perform his or her duty in a capable manner without harm to himself or herself or undue risk to other members and the public. Other health assessments are conducted in relation to specific assignments or as part of the disability case management process. The health services officer provides recommendations with respect to a member's medical fitness for duty and may include limitations and restrictions, in addition to providing return-to-work planning and input into the accommodation process.
While our psychologists actively contribute to the disability management process, they also proceed with follow-up and requests for employer-mandated psychological assessments, and are involved in determining accommodation needs when return to work is planned.
RCMP psychologists provide oversight on all psychological services provided to members by external providers. Finally, they are at the forefront of the post-critical incident debriefings and interventions.
The RCMP is continually trying to improve its programs and activities in order to reduce the incidence of mental illness and injury among its members, and to mitigate the harmful effects on their families and on police operations.
As an employer, the RCMP needs to know how it can mitigate and reduce operational stress injuries. In this regard, the RCMP is proposing a longitudinal research study that will examine the primary mental health diagnoses impacting our members, identify the root causes and competing organizational factors, and evaluate the effectiveness of evidence-based interventions.
This approach will allow the RCMP as an employer to identify areas within its sphere of influence and control, to adopt strategic and targeted interventions with the maximum potential to meaningfully and positively mitigate the contributing factors to PTSD and associated mental health conditions impacting our officers. I dare say when RCMP officers do fall ill or injured, it is critical for their recovery.
That means doing everything reasonable to help the officer recover and remain at work or return to duty as soon as it is safe to do so. This is not an easy task. Case management activities for RCMP members must take into account the very specific physical and psychological demands of our work as well as the variable nature of the complete environment. Police officers must regain a physical and psychological level of functioning that exceeds that required of most members of the public. Strong occupational health and case management activities are therefore required to support their recovery.
To support this goal, we are enhancing our disability case management activities, which are critical to supporting members' recovery and return to work. A primary focus of our efforts will be on early intervention. We want to reach out to our members early on to ensure they are able to access services, that we maintain a member's connection to our workplace, and that we facilitate the appropriate exchange of information required to accommodate a member's ability to remain at or return to work as soon as it is safe to do so.
Finally, we are in the early stages of assessing general duty constable tasks for hazard exposure, with the intent of identifying corrective measures to mitigate and eliminate those hazards, where possible. We have implemented the national standard of Canada for psychological health and safety in the workplace in our health and safety program. This standard includes psychological health and safety hazards in the workplace.
Prevention, support, and care are key to supporting our workforce. While the RCMP is cognizant of the financial cost of absence, our main focus remains on the human cost. As a police service, we need to ensure our members are healthy and fully operational so that we can deliver on our mandate and keep Canadians safe.
Thank you for this opportunity to participate in your discussions today.
We would be happy to answer your questions.
Thank you, Mr. Chair.
View Robert Kitchen Profile
Let's say we're dealing with an individual who indicates they're in dire need. They've made an application that may be denied or may have actually been delayed. They're probably, or may have been, suffering from PTSD or an operational stress injury, and they've just been released from a treatment program. All of a sudden they come to us, as members of Parliament, and say to us, “Help me with this.”
When I hear that scenario, I'm thinking that's a cry for help. Often when we talk about this term “cry for help”, we express it after the tragedy has happened. We've talked a number of times about a suicide hotline of that manner being made available ASAP. Can you make any comments on that for us?
Gary Walbourne
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Gary Walbourne
2016-06-07 12:36
It keeps going back to access, access, access. It's no good to have a problem if there's no access to relief for that problem.
Suicide hotlines are available in just about every community across the country. We do have the ability to interject into issues if there are compelling circumstances in which we feel there would be harm to the member or others. We can very quickly get the chain of command's attention. I can tell you that once something of that magnitude is brought to their attention, they engage, and they engage very quickly and very heavily.
The Veterans Ombudsman's office is another opportunity. They have the ability, in compelling circumstances, to bring resources to bear. I think it goes back to educating people. I was surprised, when I first went across this country, at the number of people who didn't know they had an ombudsman. It was an office that had been in existence for 15 or 16 years, and people didn't know that we even had an ombudsman.
It comes back to education and having things readily accessible and available. I think that's where we are.
Gary Walbourne
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Gary Walbourne
2016-06-07 12:37
As long as you promise to give me top cover with my minister, I'll put this out there.
If you have a member who is in a crisis moment, call our office. Get hold of us. We can bring resources to bear that you might find a little more difficult to get access to. If there is no other venue available to you, call the ombudsman's office, most definitely. Have the member call us. You can call on the soldier's behalf. We can reach out. We have resources.
Guy Parent
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Guy Parent
2016-03-08 11:04
Thank you, Mr. Chair.
Mr. Chair, committee members, thank you for inviting me to appear before you as you begin your study of service delivery at Veterans Affairs Canada.
Delivering high-quality services on a timely basis to veterans and their families is a key component of the responsibility of Veterans Affairs Canada. For you to take up the study of service delivery at the beginning of your mandate speaks to the importance you place on it.
You now have the opportunity before you to not only influence today's service delivery and standards for Canada's ill and injured veterans and their families, but to also shape tomorrow. To get it right I encourage you to set your sights on the big picture, the outcomes, and the interrelationships of other support elements in VAC's arsenal.
You may ask why I am emphasizing outcomes. Two weeks ago I spoke to the Senate subcommittee on veterans affairs about the importance of keeping a laser-like focus on outcomes. The reason is that understanding the outcome we are trying to achieve should be the starting point rather than the end point. If you use that approach you will find the root causes of problems and be better able to solve them.
Let's start with the question of why some veterans and their families are still struggling. Simply put, benefits are too complex, not only for veterans but for VAC staff as well. After decades of layering regulations and policies one on top of the other, with no apparent regard for how such overlapping would affect veterans and their families, a system has been created that is difficult to administer on the best of days.
Everyone involved in veterans' issues recognizes these problems, but they still remain. They need to be solved as quickly as possible because every day they cause frustration to ill and injured veterans and their families.
To right the situation and give veterans the services that they deserve, it is time to start focusing on outcomes for veterans and not outcomes for programs.
Veterans programs typically only measure program outcomes. They do not measure the effect that a particular program has on veterans. For example what does giving a veteran a $500 a month benefit accomplish in terms of creating a better life or a better outcome for that veteran? It is true they will have a little more money, but did it make a difference in their lives?
When looking at outcomes for our current programs, we need to ask the hard questions. What does it mean to provide financial stability? What does it mean to meet the basic needs of veterans? What does it mean to improve veterans' wellness? How do we measure success with those outcomes? What does the service experience feel like to the veteran? We struggle to answer those questions. If we cannot answer them, how do we know we have it right? How far do we still need to go?
Let me take this a step further. Did you know that there is no benchmark defined for a fair level of financial compensation to veterans for either income replacement or pain and suffering? There are benchmarks for individual programs, but we do not understand the overall outcomes we are trying to achieve with these benchmarks. At the Office of the Veterans Ombudsman, we look at these programs and services through the lens of fairness measured by the accessibility, sufficiency, and adequacy of programs. If we do not have an agreed-upon comparison point, how can we measure whether our efforts are being effective?
What is the added value of applying an outcomes focus to veterans’ service delivery? Let me give you an example of how we could shape tomorrow. What if the desired outcome was a veteran-centric, one-stop shop approach to VAC service delivery? This could mean that at the beginning of the release process, Veterans Affairs Canada would conduct a file review and adjudicate any and all benefits to which the veteran would be entitled. The veteran would then be presented with the results without having to apply for a single benefit.
The key question is this. If this were done in a timely manner, would it better prepare the veteran for transition, reduce workload at Veterans Affairs Canada, and increase trust in the system? I believe it would. I also believe that Veterans Affairs Canada should be proactive, so veterans don’t have to be experts in navigating its complex system.
What about veterans with mental health conditions who complain about how they are continually traumatized by having to tell their stories again and again to justify why they should receive benefits? With a veteran-centric one-stop shop model, veterans would only have to tell their story once to a health care professional. As well, we know that service contributes to certain conditions, so why do we put the veteran through the hassle of proving a service relationship when common sense says there is one?
For example, would it be unreasonable to assume that a soldier working around large-calibre guns may have diminished hearing, that an air force search and rescue technician with hundreds of parachute jumps may have injured knees, or that a submariner working in cramped quarters may have back problems?
There are some who are going to balk at these ideas because this is not the way we do business today. But I say to you that the way we do business today is not working as well as it should. If it were, we would not have as many frustrated, ill and injured veterans as we do.
Let's go beyond today's ideas, look at the outcomes, the end results that we want to achieve, and figure out the steps needed to achieve that optimal result for veterans and their families. It only makes sense that intervening early with a one-stop shop approach would likely result in better outcomes for veterans. From a national security perspective, such an approach would better support recruitment and retention than the current stream of veterans' bad news stories. From a VAC service delivery perspective, front-loading the benefits could eliminate the bureaucracy of determining eligibility at the point of need. From a veteran's perspective, needs would be met in an effective and timely manner.
If I had a magic wand, what would I do to transform the current state of affairs? I would start with a clean sheet of paper and I would list all the outcomes that we need to achieve to support veterans and their families, such as financial security for life, the best possible health care, fair compensation for pain and suffering, a successful transition to civilian life, and a veteran-centric service delivery with timely decisions.
Then, I would design the benefits and administrative processes to achieve those outcomes, because without a clear understanding of veterans' outcomes, tinkering with existing benefits is a recipe for complexity and disappointment.
Now let me take just a moment to share with you our analysis of the current status of the ACVA recommendations. Some recommendations have been addressed, and you will find as an annex an updated chart of their progress. However, some of the major substantive recommendations have yet to be implemented. As my office has reported previously, increased earnings loss benefit, better permanent impairment allowance grade determination, and compensation for family caregivers need to be addressed, because the implementation of these recommendations will significantly improve outcomes for veterans and their families.
In conclusion, as you travel across the country, please take the time to meet and listen to veterans and their families, as well as to VAC front-line workers, and see their challenges through their own eyes. If you combine that experience with evidence-based analysis and an unyielding focus on outcomes, you may be able to accomplish what others tried to but could not achieve in the almost 100 years since the Pension Act came into existence.
If you do, as a veteran with over 50 years of service to Canada, I will be at the front of the line to congratulate you.
In the meantime, my team and I stand ready to help you achieve your goal.
Thank you, Mr. President.
View Irene Mathyssen Profile
Thank you very much, Mr. Chair.
Merci beaucoup, Monsieur Parent. I want to thank you for the time you've spent briefing us, individually and here today.
I wanted to come back to one of the briefing notes you've provided, help for veterans. What percentage of contacts do you get specifically from the five different groups? I'm also wondering what percentage of your contacts from veterans are resolved and your definition of a resolved case. First, what percentage of the contacts does the ombudsman get from wounded veterans?
Guy Parent
View Guy Parent Profile
Guy Parent
2016-03-08 11:27
On average we get 5,000 calls a year. That all comes in different ways: email, website, electronic form. What's been increasing in our contacts is that we do more intervention than we did before. A lot of our calls are informing or guiding people through the process, helping them to navigate the complexities. Then the other one is resolving cases.
In the last few years the number of interventions has been increasing. We have to engage Veterans Affairs Canada to resolve a problem. The majority of those issues have to do with health care regulation. We spoke earlier about reimbursement for travel to attend health care treatment. It's these kinds of problems, people not being reimbursed fast enough or not to the level they expected.
View Irene Mathyssen Profile
You referenced health care.
Any idea how many of those health care questions would be with regard to mental health issues, including PTSD?
Guy Parent
View Guy Parent Profile
Guy Parent
2016-03-08 11:28
We don't have mental health issues as a category of complaints. They're all related to health care. It would be very hard for me to....
Mr. Chair, I can send the committee some of the data that we have on the type and number of complaints we get, if that would be useful to the committee.
View Irene Mathyssen Profile
Would you say that, of those 5,000 calls per year, a significant number are resolved? What's your definition of a resolution to a case?
Guy Parent
View Guy Parent Profile
Guy Parent
2016-03-08 11:31
Again, that's a good question, but it's a matter of perspective, I think. We advocate for fairness. We don't advocate for the veteran or Veterans Affairs Canada. We're an advocate for fairness.
Some complaints are legitimate. Some are not. We have to accept that. We have to tell people that sometimes there are reasonable expectations, and then there are other expectations. We have to draw the line sometimes and say, “Yes, you have been treated fairly. You might not be happy with it, but you have been treated fairly.”
In a lot of those cases though, by keeping an eye on those complaints, we can identify systemic issues even if we don't resolve a particular case.
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