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View Irene Mathyssen Profile
NDP (ON)
One of the things that we've been hearing from veterans is in regard to the forms. They are confronted with very complicated forms that look back at them when they try to fill them out. Have you heard this from your members? Are they finding that process is a barrier, that it's a challenge in terms of the kind of access that they need to have?
Pierre Lebrun
View Pierre Lebrun Profile
Pierre Lebrun
2016-10-20 16:02
I can't say we've heard that specific criticism. However, we do have one national association, the RCMP Veterans' Association, that's very proactive and does offer fantastic services to our members. Maybe that's one reason we're not hearing that complaint. I can't say I've heard that particular complaint.
We also have a very proactive liaison officer out of Charlottetown who will take a lot of time on the phone with the membership to fill out forms and guide them, either through the VAC process or through the Veterans Review and Appeal Board process. We are working very.... I can't say I've heard any complaints in that regard.
View Robert Kitchen Profile
CPC (SK)
Thank you, Mr. Chair.
Thank you all for coming today; we greatly appreciate it.
As you're aware, we are doing this study on service delivery. We can look at what's been there, what we can and can't do, and recommendations we can make for improvement.
Mr. Mac Culloch, you mentioned a little about health care and providing services for your veterans. I'm a chiropractor, and I spent many years providing services for veterans. I went into practice and I learned from the school of hard knocks. I would send a bill to Blue Cross and they'd send it back, saying I hadn't filled it out right, and then I'd finally figure out how to fill out the paperwork and get it sent in. Other than the length of time getting payment, there was never any issue as to someone in Blue Cross saying yea or nay to what was requested. That may be because the veterans I was serving didn't have complicated files; I buy that.
A lot of health care practitioners aren't trained in how to deal with veterans. We go through school, we learn diagnosis, we learn how to treat, we learn how to make prognostic assessments, but we're not given the paperwork, in many cases, on how to do the actual administrative work of providing those services. I see that as being of value in providing that service. Can you comment on that and what you see? Would it be of value? Mr. Gannon, as well, after Mr. Mac Culloch, do you see that as being of any value?
Wayne Mac Culloch
View Wayne Mac Culloch Profile
Wayne Mac Culloch
2016-10-18 16:20
I see it as having quite a bit of value because, as you rightly point out, it is simply the school of hard knocks, and it is the same for the veteran as it is for the health practitioner. A lot of the forms are easy to understand if you're a bureaucrat, but quite confusing to those who only have to deal with them every now and again. If there were a simple example, a sort of follow-the-numbers example, along with perhaps a self-study package, I think it would be of great value.
Carl Gannon
View Carl Gannon Profile
Carl Gannon
2016-10-18 16:21
I mirror that as well. It's somewhat of a shame that we lost our old system, because one of the big areas now where health practitioners will more than likely have to be extremely proficient is in understanding Veterans Affairs' archaic legislation.
Unless you understand the legislation and what a person is entitled to and you have a person who can mitigate some of the really tough legislation that doesn't sometimes seem to make sense.... That's why things worked a lot more smoothly before: it was because you had a public servant who could step in and say what you were missing. They were willing to work with the practitioner to try to approve it.
That's not how it works anymore. Now if you don't have what you need, it's just denied; that's it. You're sent off a denial letter and you start again. Right now, what we're seeing is that a lot of providers don't want to deal with Veterans Affairs anymore.
Veterans are on a fixed income when they're paying for these services and hoping to get reimbursed later on, which is tough for them.
Gary Walbourne
View Gary Walbourne Profile
Gary Walbourne
2016-10-06 15:32
Thank you, Mr. Chair, and good afternoon to all.
It's my understanding that this committee has taken great interest in the two recent reports I have released, “Determining Service Attribution for Medically Releasing Members” and “Simplifying the Service Delivery Model for Medically Releasing Members”. Both reports contain recommendations to the Minister of National Defence, and I have been invited here to speak to them today.
Our military personnel from across the country have voiced their concerns over a number of critical issues related to their service from recruitment through to retirement, but none more frequently than those pertaining to the subject of transition between military and civilian life.
Every year, over 50% of the complaints that come to my office have to deal with this very issue. Whether they are releasing from the Canadian Armed Forces for medical reasons or non-medical reasons, what they face is a complex system that I believe needs to be fundamentally changed. Tack on the additional administrative burden of applying for benefits and services at Veterans Affairs Canada, and I think we have reached a tipping point for our members.
From our engagements with the men and women in uniform across the country on issues surrounding medical release from the Armed Forces, my office has produced a number of reports containing evidence-based recommendations aimed at solving these issues. Our reports are a call to action.
I believe that the government has a tremendous opportunity to fix the system that too often allows vulnerable people to slip through the cracks. We have provided plenty of evidence supporting the need for real change in key areas. We do not need to commission more studies. We need decisions.
Some of the decisions that need to be made may not be popular and some may not be as politically palatable as we would like, but they are the right ones for the men and women who serve or have served this country.
I can assure you that many of the tragic circumstances that occur in your constituencies and that often reach national public attention can be avoided.
I'd like to summarize for you today what I have recommended to help protect the members of the Canadian Armed Forces from undue hardship. There is a fundamental disconnect between the Canadian Armed Forces and Veterans Affairs Canada wherein a member must navigate departure from one before entrance into the other. Most of this has to do with the determination of attribution of service and the current service delivery model.
On May 18, I delivered a report to the Minister of National Defence in which I recommended that the Canadian Armed Forces determine whether an illness or injury was caused or aggravated by a military service and that the determination be presumed by Veteran Affairs Canada to be sufficient evidence in support of an application for service or benefits. I made this report public on September 13 and copies have been provided to the committee.
In conducting their adjudications under the new Veterans Charter, Veterans Affairs Canada as the administrator considers mostly documentary evidence generated by the Canadian Armed Forces. The evidence consists largely of the member's medical records and possibly other career-related records. This begs the question of why a protracted bureaucratic process is required for VAC to review records prepared by the Canadian Armed Forces when it is possible for the Canadian Armed Forces to determine whether a medically releasing member's condition is related to or aggravated by military service.
Given that the Canadian Armed Forces has control of the member's career and has responsibility for the member's medical health throughout their career, such a determination can and should be presumed to be evidence in support of a member's application for VAC benefits.
I believe that my recommendation of having the Canadian Armed Forces determine service attribution in conjunction with the change to the service delivery model would reduce wait times by 50% or more on the current 16-week service delivery standard. This standard does not include the time it takes to get medical records from the Canadian Armed Forces or if the member has to submit any other pertinent documents.
You may think that the development of a new service delivery model would require intensive study that would take months or even years to complete. On August 12, I submitted a report to the Minister of National Defence containing a potential new service delivery model. I made the report public last week. Again, copies have been provided for the committee.
My report recommends that the Canadian Armed Forces retain medically releasing members until all benefits and services, including Veteran Affairs, have been finalized and put in place prior to releases; that one point of contact be established—if you will, a concierge service—for all medically releasing members to assist in their transition; and that the Canadian Armed Forces develop a tool that is capable of providing members with information so that they can understand their potential benefit suite prior to release.
These are three strong, evidence-based, member-centric recommendations, ladies and gentlemen, that I believe are game-changers.
My three recommendations do not require new legislation, nor do they require the implementation of my recommendations surrounding attribution of service. I know that they are closely aligned, and anything we will do further would be enhanced by the Canadian Armed Forces' determination of attribution to service.
As we all know from their mandate letters made public, the Prime Minister has asked the ministers of Veterans Affairs and National Defence to reduce complexity, overhaul service delivery, and strengthen the partnership between the two. Both ministers and the chief of the defence staff have publicly acknowledged that the system needs fixing. The time is no longer to study, but to fix.
On Monday, it was reported that Veterans Affairs Canada has a backlog of 11,500 applications for benefits and services. I strongly believe implementing my recommendations to have the Canadian Armed Forces determine attribution of service and to restructure its service delivery model to ensure that no member is released before all benefits from the CAF and VAC are in place would greatly reduce the complexity leading to those delays.
As you may know, I spent nearly four years as deputy veterans ombudsman. I can tell you there has always been a backlog at Veterans Affairs Canada, and the size varies over the year. It still numbers in the thousands. Even when operating cuts were made to the department, the numbers did not change in any significant way.
Ladies and gentlemen, that indicates to me that this is a process issue, not a people issue. I am not recommending patchwork. I am recommending a fundamental shift in the way business is done. The Canadian Armed Forces and Veterans Affairs are currently exploring options to close the seam. By having the Canadian Armed Forces implement my recommendations to take care of the members at the front end, Veterans Affairs will have a simplified environment in which to do its important work.
Ladies and gentlemen, I firmly believe we are at an opportune moment for the members of the Canadian Armed Forces and veterans in this country. There is a large contingent of veterans groups in Ottawa this week participating in the Veterans Affairs stakeholder summit, which wrapped up today. I attended as an observer. I had a chance to catch up with many of the leaders in the veteran community, and I can tell you both reports were received very positively. Many of them wished that my recommendations had been implemented when they were releasing, and their hope now is that they will be implemented for those releasing in the future.
The common theme from my engagements with these groups this week has been a need to fundamentally change the current service delivery on both the Canadian Armed Forces and Veterans Affairs sides, and I couldn't agree more. I believe my recommendations offer the government a path forward. Our people should be our top priority, our true no-fail issue and, as they say, it's go time.
Thank you, Mr. Chair. I stand ready for questions.
View Bob Bratina Profile
Lib. (ON)
If there's a reasonable predictability, we should have the resources in place, knowing that these numbers are going to be coming out.
On the backlog, is there a variety of cases—and I'm thinking on the notion of a concierge. For instance, if you're in the lineup for security at the airport and you're not getting through in time for your flight, somebody asks, “Is anybody on the six o'clock flight?” Would there be a way of eliciting simpler problems that may not require all of the assistance? In a “take a number” situation, you just have to wait your turn. I'm not suggesting that others with more complicated issues would have to wait longer, but perhaps another scenario could be created along the concierge line that could expedite simpler cases versus obviously more complicated ones.
Does that resonate at all?
Gary Walbourne
View Gary Walbourne Profile
Gary Walbourne
2016-10-06 16:05
That's where the efficiency and effectiveness would come from this program. Once you've gone through a repeated pattern a few times, you should be able to pick up the commonalities.
With the commonalities, then, let's attack that commonality. What is causing that malady? That's for the Canadian Armed Forces to go back and review, but what do we need to do now to make the process easier going into Veterans Affairs Canada?
I know they do it for tinnitus now. They have a process that helps get those programs through very quickly. I think all that's required is an audiogram.
They can do that, but I think we're going to have to show patterns and where things are happening. I do believe Veterans Affairs Canada could react very quickly to a streamlined service for that particular line.
Fred Doucette
View Fred Doucette Profile
Fred Doucette
2016-10-04 15:43
Thank you.
It's great to be able to present on behalf of the veterans and soldiers who are still serving about some of their concerns. I spent 32 years as a soldier, and then I was employed by the operational stress injury social support program for 10 years. I've seen service delivery before and after the new Veterans Charter. I can say that it's a bit different.
One of the biggest things I noticed with soldiers who are transitioning out of the military into the civilian world, and who are entitled to veterans services, is the lack of knowledge they have of those services once they are out of there. A lot of the information is passed between veterans, and so on. The transition briefings are not up to speed as to what they should be. A lot of the soldiers who are leaving are either physically or mentally injured, and they're not receptive to the changes they're going to go through. A lot of the information that is passed on to them goes over their heads, especially with those who are going out with a mental health concern. The information or education shouldn't just be done in one shot as they transition out. There should be a managing of the individual for maybe up to a year while that veteran accesses all the services that are provided by Veterans Affairs.
Another thing I noticed from the change recently to having Blue Cross take over the service delivery and a lot of aspects of the veterans benefits is that the veterans I know feel they're just dealing with an insurance company, which they are. Before that, when it was managed by case managers, service officers, and so on, it was a lot easier to get stuff across when they were talking to someone face to face. A lot of the veterans feel they're dealing with an insurance company, as if they worked for GM.
One of the biggest things for the vets is what's available and what they may be entitled to. Most of that is handled between veterans. Tonight I'll be attending a support group for a soldier with operational stress injury, PTSD, and there's on average 10 to 15 soldiers at those meetings. The bulk of the discussion is about how to access certain services, because people are not being kept up to speed on things.
The system, as we feel it is now, is more on a pole between pushing stuff forward and the vets who are pulling stuff out to try to get access to it. The delays, the paperwork, and the timeliness of trying to get things done is frustrating for our veterans, especially for those with mental health concerns. I visited vets when I was a peer support coordinator, and I asked them about what was going on with their claims, and did they get a letter or anything. They would say, yes, and that it was on the fridge. I'd go and look at the fridge and there were maybe 10 envelopes unopened there, and I would open them up. The reality between the corporate end of things and the person on the ground is that there's a big void.
Another thing that's frustrating for the veterans is the second-guessing of what they're entitled to. They'll jump through the hoops, it'll go forward, it'll be adjudicated, and then it will be denied for whatever reason. A prime example is about accessing medication that a soldier was receiving in the service when he got out. The classic answer from Blue Cross is, “We don't fund that drug”. It's an approved medication. Now the vet has to work through that to get access to the drug, and so on. During that phase, who knows what's going on with the lack of the medication the vet needs because DND doesn't give you a bag of meds to give you six months once you're out of the military. You're going out cold turkey.
Over the last several years since the new Veterans Charter came in, two things that have happened are the downsizing and the opening of new offices. To my mind, you need the actual person-to-person interaction to get things done. Dealing with the 1-800 number just doesn't work. In fact, if anything, it's going to get a young soldier flagged for being aggressive by arguing with some lady at a call centre. They don't swallow that very well.
The case managers should be involved with every veteran. As they transition through, the ones who have ongoing concerns and problems should remain attached, because not every veteran heading out the door has a ton of problems. Myself, I transitioned quite easy. I waited for things, they came through, and I moved on. It's the troubled cases. A guy is getting out of the military, and by the way, he's getting divorced because of his PTSD and the problems it caused, and now he's trying to split up a household while trying to access benefits. Some of them end up in hospital, plain and simple.
This is another burning point. We have traditional vets and we have the CF veterans, the new veterans. To me, a veteran is a veteran, and the naming of things is wrong. But the new vets, if you want to call them that, understand the Internet. They know how to access documents, websites, and go searching for things that they feel are lacking, that they feel entitled to, or that they're confused about. When they present this stuff, sometimes they're seen as aggressive by dealing with it themselves. People are afraid of the new vets, I think, especially at some of the VAC offices, just because of that. They come in, they want to see somebody, they want to talk about it, and they get shoved off to the system. They have to climb through it and then access the advice they need.
The service delivery across Canada is not consistent. A lot of the vets know guys out in Vancouver, and they'll be on the phone or the Internet talking about service. The Vancouver guy might say he applied for something and got it, no problem, while a guy in St. John's says he did the same thing and they turned him down.
I know there are probably nuances that make a difference. Overall, though, when I was working for Veterans Affairs and DND with OSISS, I noticed a difference in processing between larger centres, smaller centres, and rural areas. The application of the charter is interpreted by the individual dealing with the case. When you start interpreting things, somebody always interprets something in a different way from somebody else down the hall. That adds frustration to the veteran's day-to-day life.
To finish off, what we need is a proper handover from DND to VAC, which is not happening. It's scandalous. They're not realizing that they're dealing with sick and injured soldiers. It'd be nice if they kept you in the military until you were 100% healthy when you walked out the door, but it doesn't work that way. Some people are just starting in therapy, some people are still waiting for operations. It's not the way to hand over a soldier to Veterans Affairs.
There should be detailed briefings, not just one but several over time, as a soldier transitions out and then after he transitions out, on what he's entitled to, what services are available, and how to access them. There should be more case management, face-to-face. The timeliness of initiating or getting the services out to the individual is important. There are some horrible numbers on how long it takes to get something done, and this just adds to the frustration and the feeling of insecurity as the soldier is transitioning out. He wonders how he's going to survive. He wonders about this, and then about that. That's some of the digs in there.
The next thing to see about is the amount of paperwork involved. If we're supposed to be a paperless society, I think we made a wrong turn. It's amazing the amount of paperwork, including the paperwork a soldier has to get signed off by doctors.
I'll tell you now, doctors don't like filling out forms. They like seeing paying customers, not the $50 or whatever it is they're getting to sign a form. The amount of paperwork is ridiculous within the system.
There are a lot of good people working in the veterans world. They're overworked, and they're making things work. When you hear “making things work”, that's not the way it should be. It should be just out there.
The consistency across the country has to be there. You have to start handing out what soldiers or veterans are entitled to.
Trevor Bungay
View Trevor Bungay Profile
Trevor Bungay
2016-10-04 17:01
I would think the biggest complaint we hear would be the standard Veterans Affairs Canada, “No, that's not good enough. Try again”.
I can tell you right now, one of the claims I put in, a legitimate claim, was being in war. I'm not lying to them, but they're calling me a liar. It really hurts. Then I had to go back. For one of my claims, I had to go to a hospital 10 times. The first time they called me and said they sent the paperwork to me. In the letter, they said they would send it to the doctor. I called a couple months later and they said I was supposed to bring it to the doctor. I said I was going to scan them a letter and send it to them right away. I did that and she apologized. She sent it to the doctor. They ended up losing the paperwork anyway. This claim has been going on forever. It's still not dealt with.
These are the situations that veterans get into, and they wonder why the veterans are so frustrated. You're leaving the military, losing your family, losing your job. You just lost 75% of your friends because you're not in there anymore, and now the one entity that is supposed to be looking after you is giving you the runaround. That's where the frustration is.
View Alupa Clarke Profile
CPC (QC)
Mr. Bungay, would you say that the delay-and-deny response is based on reality, or that it's more perception?
Trevor Bungay
View Trevor Bungay Profile
Trevor Bungay
2016-10-04 17:03
No, it's reality. I can tell you that I've heard it a thousand times from case managers.
View Alupa Clarke Profile
CPC (QC)
Would you say it's based on a problematic administrative process, or on some intentional workings?
Trevor Bungay
View Trevor Bungay Profile
Trevor Bungay
2016-10-04 17:03
I really can't answer that question. All I know is my case manager told me I was supposed to put this in, get it back, and then put it back in again. What?
Andrew Garsch
View Andrew Garsch Profile
Andrew Garsch
2016-10-04 17:03
I'd have to say that it's overly impersonal. When guys meet with their case manager, they wind up retelling the same story or they get shuffled from one case manager to another. There's a lack of concern.
Also, when the individuals want to start moving forward with some retraining, before they can participate in the Voc rehab, they're forced to stay in this psychological realm until they're deemed healthy by their case manager. I know a few guys who have said that.
View Robert Kitchen Profile
CPC (SK)
Thank you very much.
Thank you for the chance to ask you again.
We heard it from Mr. Doucette, and comments from all of you.... The comment was about second-guessing by VAC after DND has made decisions on health care issues. Is that a common consensus from the people you talk to?
Trevor Bungay
View Trevor Bungay Profile
Trevor Bungay
2016-10-04 17:11
Is that in regard to injuries in the military being diagnosed and then refused afterwards?
Trevor Bungay
View Trevor Bungay Profile
Trevor Bungay
2016-10-04 17:11
Yes, it happens all the time. I think it's DND's duty to make sure they know everything that's wrong with those soldiers. Who better to know what's wrong than the doctors who have been watching them for their whole careers? They do have first-hand experience.
Depending on what CU, and that's the hospital care delivery unit.... You know, I had the same doctor for five or six years. When it was all said and done, at the end he knew exactly what was going on. He watched me deteriorate, and he tried to help as much as he could. At the end of the day, when he wrote his report, he said, “This is what he's going through, what he's been through, and this is what needs to happen.”
For me, I wasn't letting it go, and I was going to get what I wanted. But the frustration with veterans is the no, no, no. They know that most of them are going to go, “I can't handle this. I'm out of here.”
Fred Doucette
View Fred Doucette Profile
Fred Doucette
2016-10-04 17:13
A lot of people give up on the system.
You'd be surprised at how many veterans out there made that initial access, were refused, and just walked away from it. The anxiety, frustration, anger, and all that, didn't weigh enough to carry on with pursuing whatever it was they were trying to get.
This is common, even with World War II vets. When my dad was refused the war veterans allowance, he said, “Well, the government said....” That's what he said. I said, “Well, no, try it again.” He eventually did, but it was that attitude.
With the mental issues the guys have, they just say, “I don't need this anymore. I don't want it. I don't care what comes with it.”
View Alupa Clarke Profile
CPC (QC)
You say that veterans talk to you. I am not blaming the department but, very often, veterans complain to the committee that their relationships with the department are quite horrible. Those are usually complicated cases.
What are the comments you most often hear from veterans about the problems they are experiencing, about the documents they have to complete and, in some cases, about the transition steps they need to take?
Nancy Dussault
View Nancy Dussault Profile
Nancy Dussault
2016-09-29 15:55
Most of our veterans, our clients, have post-traumatic stress disorder, one of the symptoms of which is anger. We have heard some comments about veterans. It is important to understand that people diagnosed with depression are often going to be haunted by the past whereas people with anxiety will be haunted by the future. Our role is to bring people back into the present. We don’t really dwell too much on comments they may make.
We also see that, for some veterans, returning to civilian life is difficult. Simply getting things done, like going to an appointment for a blood test or to see a doctor, can be very difficult and cause a lot of anxiety. For some, simply picking up the telephone and making a call disorients them. They often need the help of a professional in our organization just in order for them to do that. So you can imagine that, for a veteran who has to call Veterans Affairs Canada, starting all those steps and filling in all those documents for various procedures can be a major source of anxiety.
View Alupa Clarke Profile
CPC (QC)
Are you and your colleagues prepared to help veterans to fill in forms or do paperwork?
Nancy Dussault
View Nancy Dussault Profile
Nancy Dussault
2016-09-29 15:56
At La Vigile, our role is to develop people’s independence. So we are there for them, but we do not do the work for them. For example, if they have appointments, we can do part of what needs to be done, but the goal is really to develop their independence and not to act for them.
View Alupa Clarke Profile
CPC (QC)
Along those lines, do you believe that it would be a good idea for the department to fill in forms for veterans or, conversely, do you believe that it is good to leave that task to them, even those with sometimes complex mental health issues?
Nancy Dussault
View Nancy Dussault Profile
Nancy Dussault
2016-09-29 15:57
The role of a support worker is to develop independence. If we adhere to that principle, I would say that it is better for them to do it themselves, but some veterans are not capable of doing so. So, perhaps for some clients, it is necessary to help them, but for others, the goal is to develop their independence.
View Irene Mathyssen Profile
NDP (ON)
Thank you, Mr. Chair.
We've been talking about family as client and family as advocate. I wonder if you have any insights or advice with regard to veterans who don't have that family network. How are they supported? Is there something that VAC should be doing in terms of making absolutely sure that this lone veteran is supported?
Nora Spinks
View Nora Spinks Profile
Nora Spinks
2016-09-22 17:01
I think the challenge here is to try to balance between the “high touch” and the high tech. We have lots of high-tech solutions and strategies and information resources and forms online and those kinds of things. High touch is about the trust, the personal, and the respectful relationships. If we marry those two, then we will be much further ahead and we will be able to realize greater efficiencies than if we just rely on one or the other.
View Irene Mathyssen Profile
NDP (ON)
Thank you. I think that's an important recommendation, and it leads me to ask what other recommendations you would make. We're writing a report. What would be your top recommendation?
Nora Spinks
View Nora Spinks Profile
Nora Spinks
2016-09-22 17:06
I would say family-centred, individual-focused, and a blend of high touch and high tech.
View Alupa Clarke Profile
CPC (QC)
Ms. Lowther, when you said that policy proposals are above your pay grade, it's not true. Policy proposal belongs to all Canadians, so if you have some, there's an email and there's a clerk here.
Colonel Mann, I will have to move along very quickly, unfortunately.
Even if the culture of denial at Veterans Affairs is a myth, it seems that the trust has been broken.
Do you think the members of our committee are influenced by the people they meet who are in complex situations, people who are in a state of panic or crisis? Do you think the vast majority of veterans believe in that myth?
Russ Mann
View Russ Mann Profile
Russ Mann
2016-09-22 17:20
That is an excellent question.
It is like the myth that all military and veterans' families are strong and resilient. That angers families. One day, my wife might be very strong, confident, and able to deal with various situations, but not be able to do so the next day.
She's a bag of worms and doesn't know what to do because too many impacts, both social and due to lifestyle, have piled up at one time. What we've done is create an environment where families never feel they can come forward because they always have to adhere to the myth of being strong and where veterans never come forward because they adhere to the myth that Veterans Affairs doesn't care, that it's faceless.
As Madam Spinks has said, we need more high touch to go with the department. The department needs a face. The department needs to become personal. When we say care, compassion, and respect; care and compassion are what veterans need to feel. When they feel that, trust will be restored. I think they feel it with case managers. Policy and program is not a case manager thing.
I'll leave it there.
View Alaina Lockhart Profile
Lib. (NB)
I always like to ask this question because sometimes when we look at change we throw the baby out with the bathwater, so to speak. From each of your perspectives, what should we not do? What is working well that shouldn't be changed?
Nora Spinks
View Nora Spinks Profile
Nora Spinks
2016-09-22 17:22
I think there are enormous commitment, passion, and conviction from the people we've come in contact with in the research community, at VAC, at DND, and within the veteran community. We don't want to minimize, diminish, or water down that passion, enthusiasm, and commitment by overburdening people or by over-focusing on policies, programs, and systemic stuff.
I think we have to make sure that the relationships—the personal side of the service—don't get watered down, but in fact get enhanced and brightened and do not become either over-focused or bureaucratized with respect to policies and programs. We have to make sure that we really find ways to facilitate and strengthen those relationships, to highlight the success stories, to dispel the myths, and to find the nuggets of knowledge and the pockets of excellence and really build on those. There are some extraordinary experiences, and we need to figure out what it is that made them so extraordinary and replicate that. There are a lot of those stories out there as well.
View Irene Mathyssen Profile
NDP (ON)
Thank you.
I think it's more of a comment than a question. I'm very taken with what you have said, Madam Spinks, about finding those pockets of excellence. They must be there.
I'm looking at the report from the DND ombudsman, Monsieur Walbourne. He said in his report that the bureaucracy is just so overwhelming and there are so many hoops to go through that veterans end up frustrated, and they just don't know what to do because of stress and depression, which lead to, I guess, that lack of trust. If we're looking for those pockets of excellence, can you help us find them? If you can, we'd be very grateful.
Nora Spinks
View Nora Spinks Profile
Nora Spinks
2016-09-22 17:25
Yes, absolutely. I think this goes back to the comment earlier about being veteran-centric as opposed to system-centric. Instead of having the veteran try to find a way within the bureaucracy, have the bureaucracy designed in such a way that it meets the needs of the veteran, so that the veteran doesn't have to try to figure out the mass of service supports, but rather, it goes in the other direction.
That sounds like a little thing, but that is a very big thing. It starts with respect, trust, recognition, individualization, and customization instead of trying to find these unique and complex individuals a spot in a box that doesn't necessarily exist.
Russ Mann
View Russ Mann Profile
Russ Mann
2016-09-22 17:26
A specific example happened just this week. The ombudsman published that transition process for regular forces and for reservists, and it's a wonderful thing. It must have taken months to do.
However, if a veteran or a veteran's family is looking at that and does not relate, you've created expectations that cannot be met. Even though you had great care, compassion, respect, and intention, the way it's perceived on the other end is that they have to fit into those boxes, that they have to fit into that cookie cutter.
I can tell you that everybody I know who has transitioned has not followed that process the way it's mapped, so the message becomes...the big term would be “cognitive incongruence”. If I have mental health issues and I'm not working through those boxes the way I need to, I'm in trouble. I may even be triggered. I might disengage.
Great intentions, great work, and important work must be done behind the scenes, but that's not what you want to present to families. An individual, family-centred, and veteran-centred process has to be the way to go, not a cookie cutter and boxed process.
Jerry Kovacs
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Jerry Kovacs
2016-06-14 17:16
Thank you, Mr. Chair, and members of the veterans affairs committee.
My name is Jerry Kovacs. I have been engaged in veterans advocacy work for the past five years. Although I have a relatively short military career compared to some, such as Reverend Zimmerman, as an infantry officer, many of the things I learned and saw remain with me decades later.
My civilian career as a lawyer and educator has taken me to Ukraine, the Democratic Republic of the Congo, and Palestine. I spent four years in the former Yugoslavia, two of them in Kosovo. My work often involved collaboration with other civilians, police officers from Canada, and individuals involved in helping people in post-war countries under reconstruction.
During the past five years, I have heard numerous times the comments and complaints that you are hearing now for the first time. As the military ombudsman said in Ottawa on June 7, there have been many studies and reports, many proposals, and many recommendations. It's time for decisions.
It is commendable that this committee is travelling to hear from individual veterans who live outside Ottawa or veterans who are not members of any veterans organization. There are approximately 800,000 veterans in Canada. Of that number, only 100,000, or 12.5%, are members of any veterans organization. It's important to hear the views and concerns of the other 700,000 veterans, or 82.5%, who are not members of any veterans organization. They too are defined as stakeholders by the department. Perhaps now, or in the future, they may receive benefits and services from Veterans Affairs Canada.
Twenty years ago, from 1995 to 1997, the veterans subcommittee of the national defence committee undertook an extensive two-year examination of issues related to the quality of life of veterans. The agenda was open. There were no time limits on speaking. Members of Parliament actually visited veterans in their own homes. The final report was issued in 1997. In addition, the MacLellan report, the Stow report, and Joe Sharpe's Croatia Board of Inquiry had wide mandates to examine how military members and veterans were being treated.
Neither Veterans Affairs Canada nor the Standing Committee on Veterans Affairs, formed since then, have ever had full public hearings into the services and benefits and policies and programs offered to veterans.
On March 8, the veterans ombudsman talked about the importance of outcomes before this committee. Outcomes, in Professor Barber's view, relate to his “deliverology” theory. Are services and benefits being delivered to clients effectively? Are the value and benefits of existing services and resources being fully utilized by veterans, the RCMP, and their families?
Services and benefits must be delivered in a timely, effective, and efficient manner. Veterans Affairs employees should continually ask veterans, through customer satisfaction surveys, whether they are satisfied with the manner in which they are being treated. A comprehensive survey is also warranted. To save taxpayers money, it could be done through SurveyMonkey.
In improving services and benefits to veterans and the RCMP and their families, this committee should divide them into three categories: one, things the Minister of Veterans Affairs can do immediately without parliamentary approval; two, things the departments of Veterans Affairs and National Defence can do immediately without parliamentary approval; and three, things that require parliamentary approval where Treasury Board approval is required, such as the federal budget.
The process for the transition from military to civilian life needs to be simplified. It needs to be made clear well in advance of the release date. Mechanisms need to be in place to ensure that on the release date, the veteran and the veteran's family have everything needed for a smooth move, or a seamless transition, from a career that ended voluntarily by retirement or involuntarily as the result of a medical release.
Too often in the past I have heard veterans say, at this veterans affairs committee, that they were not fully aware or informed of the services and benefits available to them. The department must take primary responsibility to ensure that veterans and their families know what services are available to them.
Medical and personnel records should be easily and quickly transferred, whether by paper or electronically. A copy should be in the possession of the veteran on release day.
Identification cards are long overdue, and the veterans' names should be in a database, cross-referenced with the service number so that their location is known.
Provincial health cards could identify an individual as a veteran. If the word “veteran” can be printed on a provincial licence plate, it can be printed on a driver's licence or health card so that health care professionals would be aware of any military conditions that a veteran in their care may have.
There should be a comprehensive application form for services and benefits. Eligibility for services and benefits should not require proving multiple times that an injury has been sustained. If a veteran is missing one, two, or more limbs today, chances are the same veteran will not have those limbs two years from now.
On service excellence, training in customer service should be delivered to Veterans Affairs staff on a continuous basis. Feedback on service delivery from the veteran and service agents or case managers is essential.
The committee should also provide a timeline for when things are accomplished. Being in the military involves timings. Veterans who are used to timings—what will be done, what day it will be done, what time it will be done—will want to know, as veterans, when services and benefits will be made available to them. Veterans want to know when the mission will be accomplished.
In closing, I wish to comment on a few items.
The first is the new Veterans Charter versus the Pension Act. During the 2015 federal election, the Liberal Party promised to return to the Pension Act. It has yet to occur. This is viewed by many veterans as a crucial benefit and an election promise made but not yet delivered.
Second, the Equitas Society lawsuit should not be viewed as an obstacle to making needed changes regarding services and benefits for veterans. If the changes are made, the reason for the existence of this lawsuit disappears entirely when the plaintiffs' demands are satisfied. The abeyance agreement ended on May 15. A new one could have been written. The existing one could have been extended. At any time, the parties can continue settlement negotiations via a settlement conference pursuant to rule 9-2 of the British Columbia rules of civil procedure. The parties should continue settlement negotiations. The Equitas lawsuit should not be used as an excuse for anyone to hide behind the words “No comment. It is before the courts.”
The work of this committee, Parliament, the department, and the minister can continue to improve the services and benefits for veterans, as Reverend Zimmerman said, while this lawsuit is ongoing.
Third, the expression “sacred obligation” has been publicly used, misused, and thrown about indiscriminately. I suggest “sacred” be replaced by the word “unconditional”. The duty, commitment, or responsibility to our veterans is an obligation based on their unlimited liability to Canada. An unlimited liability from them should be an unconditional obligation to them in return.
In Anne Cole v. Attorney General of Canada, a decision by the Federal Court of Appeal dated February 25, 2015, Mr. Justice Ryer, speaking on behalf of the court, said:
Parliament has mandated that a liberal interpretation of the Pension Act must be given with a view to ensuring that our country’s obligation to members of the armed forces who have been disabled or have died as a result of military service may be fulfilled.
The Federal Court did not feel the need to use a religious adjective to define the word “obligation”. It exists. In plain language, an obligation is an obligation.
This was confirmed in a Federal Court decision on May 31, 2016, two weeks ago, in Ouellette v.Canada (Attorney General), where the Federal Court extended the whole analysis to physical conditions. These two court decisions, last year and two weeks ago, are consistent with section 2 of the Canadian Forces' Members and Veterans Re-establishment Act, also known as the new Veterans Charter, which talks about, “recognize and fulfil the obligation of the people and Government of Canada to show just and due appreciation to members and veterans for their service to Canada.”
In addition, section 3 of the Veterans Review and Appeal Board Act states:
The provisions of this Act and of any other Act of Parliament...conferring or imposing jurisdiction, powers, duties or functions...shall be liberally construed and interpreted to the end that the recognized obligation of the people and Government of Canada to those who have served their country so well and to their dependants may be fulfilled.
Fourth, the failure of the Department of Veterans Affairs to always recognize this obligation has resulted in a growing cottage industry during the past few years. This cottage industry consists of individuals and organizations that are generating money from private donations and public funds. They are not all volunteers. Some of them are profiting from helping veterans. The abrogation by, or absence of, the government in meeting its obligation has created the vacuum for this to occur.
Fifth, this committee will perform a great service to veterans, the minister, and his department if it can identify barriers that prevent existing benefits from being improved and effectively delivered, and new ones from being implemented.
The words “one veteran, one standard”, “care”, “compassion”, and “respect” have been repeated all too often. Let's ask Petter Blindheim, a 94-year-old veteran living in Halifax about these words and what they mean to him and his family. He is a veteran; he is a Canadian. Veterans Affairs recently denied him a bed at Camp Hill Veterans' Memorial hospital in Halifax, where there are 13 beds vacant, because he does not need specialized care. I challenge you to name a 94-year-old veteran who does not need some sort of specialized care either today or in the future.
The sections of the statute that I just enumerated plus the two recent court decisions show that there is an obligation, an unlimited obligation, to deliver services and benefits to veterans and not to deny them. Care, compassion, and respect are needed in the decision-making process when granting the services and benefits earned by veterans.
There are three kinds of people in the world: people who make things happen, people who watch things happen, and people who don't know what's happening. It's time for Canadians to make things happen for veterans.
Thank you.
Walter Callaghan
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Walter Callaghan
2016-06-13 17:16
Thank you.
I'm going to read a statement I prepared. It may be easier instead of my going off on a long-winded, antagonistic rant.
To members of the Standing Committee on Veterans Affairs, thank you for this opportunity to provide a statement regarding service delivery to veterans by Veterans Affairs Canada.
My name is Walter Callaghan, and I served in the Canadian Forces from March 2001 until my medical release in August 2010. I suffer from chronic pain due to a severe back injury and struggle daily with the psychological distress symptomatic of my post-traumatic stress disorder diagnosis. Currently despite my injury, I am a Ph.D. student in medical anthropology at the University of Toronto, with my research focused on the subject of the experience of PTSD.
Despite being classified as permanently disabled several years ago, I still have to face constant paperwork to obtain approval for treatment of my condition. As an aside, I received a huge bundle of paperwork this morning that I have to fill out once again. It's aggravating.
I was taken off the rehabilitation program in January 2015 because my pension condition was deemed to have “reached the maintenance stage”. In other words, no further improvement was expected. The letter I received notifying me of this also stated, and this is a direct quote from the letter: “As your participation in the rehabilitation services and vocational assistance program is completed, your earnings loss benefit under the financial benefits program is no longer payable”.
In effect, I was told that because my injuries were permanent and that no further improvement was expected, I was no longer eligible for a key benefit. However I was not informed of the extended earnings loss benefit, which I was eligible for, because I was deemed permanently injured. This lack of information caused extreme anxiety, something that I think most of you have heard or can understand, is to be avoided when you have PTSD.
However, I would suggest that even having had access to the rehabilitation program in the first place makes me one of the lucky ones. I say this because I managed to get VAC to approve my claims for benefits, albeit it was a lengthy and arduous fight to obtain those approvals: it took four years for the back condition to be covered, and seven years for the major depression; and they're still not acknowledging the PTSD despite numerous reports and clinical material on it that have been sent to them.
Instead of the benefit of the doubt being applied, many veterans, especially those like me who served in the reserve force, face an adversarial bureaucratic system that amounts to little more than an insurance-minded scheme of denial by design.
A key example of this is that reserve force veterans almost immediately have their claims questioned as to the connection of their injuries to military service on the basis that the medical reports that are submitted with their claims are predominately written by civilian doctors. This being because reservists are largely unable to access doctors within the Canadian Forces, instead being required to use the civilian medical system.
Judgments frequently made by Veterans Affairs Canada in denying these claims is that the very nature of the supporting documents having been completed by civilian doctors indicates that the injuries are due to non-service incidents, because if the incidents were service-related, then a military doctor would have signed off on the documents.
Even when claims are finally approved in favour of the veteran after lengthy appeals and reviews and reapplications, they are generally done so at a lower level on the fifth scale, with the argument being made that the injuries weren't fully due to military service; that there was some factor from our non-military life that played a role in our injury, even when there is nothing to indicate this. This is particularly prevalent in cases of operational stress injuries and post-traumatic stress disorder.
Associated with this and aggravating to veterans with PTSD is the challenge of malingering or non-compliance when the veteran chooses treatment modalities other than pharmacotherapy. The reality is that the side effects of pharmacotherapy are often worse, both subjectively and objectively, than the condition for which they're being prescribed. When the veteran, in consultation with their clinical team, decides to opt for alternatives to being drugged up, this seems to be an immediate red flag for Veterans Affairs Canada, which then challenges the severity and even the reality and authenticity of the veteran's injury.
This argument has also been used to deny initial claims for benefits, asserting that since the veteran is not on medication, then the veteran does not have a claim condition or that a condition is not severe.
Given that many veterans, again especially reservists, are required to pay out of pocket for any medications prescribed until their claims are approved, and with the awareness that the initial diagnosis, if it can even be called that, is done through a very brief assessment, frequently by a non-specialist medical doctor, generally not a psychiatrist or psychotherapist, it should not be at all surprising that many veterans, particularly with an operational stress injury, do not have the extensive records of pharmacotherapy when applying initially to VAC for benefits.
These systematic forms of denial by design impact the physical and psychological health of far too many veterans. In the cases of PTSD or other operational stress injuries, these denials tend to occur at a time of increased vulnerability, when the veteran has finally reached out, likely while in a state of near crisis. To have the authenticity of one's claims questioned at such a time does little more than aggravate the level of psychological distress, potentially increasing the severity of that psychological distress to the point that suicide occurs.
In the end, it doesn't really matter what programs or benefits are available if the veteran cannot access them. It is incredibly problematic that a key barrier to access is this failure by Veterans Affairs Canada to operate under the auspices of benefit of the doubt instead of relying on an insurance-minded bureaucratic culture of denial by design.
Thank you for listening to me.
View Alaina Lockhart Profile
Lib. (NB)
Both of you bring really interesting perspectives, and I hope we get to touch on both as we continue.
Mr. Callaghan, I would like to thank you for your service to begin with, and also for articulating so easily all of the things that we have been talking about over the last little bit.
If I had check boxes, you kind of hit a lot of them when we're talking about service delivery, paperwork being one. With regard to receiving a letter, for instance, when there's a change in your benefits, or notification that you're not going to receive benefits, do you think it would be helpful if you had one-on-one contact with a case manager or what have you, to walk you through this process, rather than receiving documentation in the mail?
Walter Callaghan
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Walter Callaghan
2016-06-13 17:36
Here's the funny thing: the documentation was signed by my case manager. This is a case manager that because of the overload that each case manager is handling, I hear from maybe once every six months. Previous case managers broke the rules by actually providing me with their phone numbers or their email to make it easier for me to contact them when something was happening.
The rules within Veterans Affairs require me to call a 1-800 number that is only operating from 9 a.m. to 4 p.m. eastern standard time. Even if the people on the other end of the phone are in B.C., if the call is from Toronto, they cut it off.
I have to leave a voicemail message because she's so busy that she's never available to take a call, and then I have to wait for her to call back, which of course uses up the minutes on my phone. I'm not exactly wealthy enough to have a high-end plan, so I ration out the 200 minutes a month that I have.
The My VAC thing that's being set up is so problematic that I've never actually managed to sign in through it. I have a case manager. She could have been able to put this through one on one with me. It was when I freaked out and went through the entire system and managed to get a hold of her—thanks also to the ombudsman's office who helped intervene—that I found out I was not actually being cut off of benefits; I was being shifted. This was a form letter that was sent out.
View Alaina Lockhart Profile
Lib. (NB)
So for you this could have gone much better had you been able to meet with your case manager either by phone or personally, to walk through what the decision was and to talk about what future benefits you were eligible for. Is that fair to say?
Walter Callaghan
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Walter Callaghan
2016-06-13 17:38
If I could have contacted her immediately by phone or by email and actually been able to get an immediate reply instead of spending a weekend freaking out. I say this because I believe the letter arrived on a Friday, so good luck actually getting someone then.
View Alaina Lockhart Profile
Lib. (NB)
Maybe we could fix that. Not knowing creates a tremendous amount of anxiety as well. I can appreciate that.
Walter Callaghan
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Walter Callaghan
2016-06-13 17:38
Had the case manager signed it, it would still have been a disaster having that happen.
View Alupa Clarke Profile
CPC (QC)
Mr. Callaghan, you said you received a bunch of papers each year.
Walter Callaghan
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Walter Callaghan
2016-06-13 17:51
Sometimes it's yearly, sometimes it's every few years. Because I'm a reservist, this is a whole other complicated ball game that I don't know if I'll have time to get into, the way that our benefits are done. Because I was permanently injured, I'm still on SISIP, but because of the changes that occurred last year with Bill C-58 and Bill C-59 , I'm also receiving financial benefits from VAC. Because I was deemed permanently injured, the provision of stuff like psychotherapy or the approval for psychotherapy, massage therapy, physiotherapy, all those go through VAC. So I'm receiving annual documents from SISIP, much like Paul Franklin being told that he must prove he has no legs anymore. In my case, I'm having to prove that I still have a demon haunting every living moment, and my back injury is still here.
With VAC, the package I got this morning contained the documents for the two-year mandatory review of permanent status. My original classification as permanently disabled with VAC occurred in 2012-13, so it's not even two years. There's a discrepancy on when they're sending out documents, but because I was removed from the rehab program, to maintain my weekly massage therapy and physiotherapy, both of which are used for pain management, and the biweekly psychotherapy, we're having to submit documents every four to six months saying I'm still injured, I still need this help. It is getting ridiculous.
View Alupa Clarke Profile
CPC (QC)
That was my next question, whether your paper work was from SISIP or the ministry—
View Alupa Clarke Profile
CPC (QC)
My wife is an anthropologist. I just wanted to ask, is it hard to fill out the papers as a Ph.D. candidate?
Walter Callaghan
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Walter Callaghan
2016-06-13 17:55
It is bloody overwhelming at times, with some of the basic paperwork. There's one annual form that we get from Veterans Affairs just to confirm that you're still alive, to confirm that you're actually receiving benefits, that you haven't been buried or anything. That one's the easiest. It's a check and a signature, and that's fine. But the ones to apply for new or different claims, the ones to continue claims, the ones to continue receiving benefits, I'm overwhelmed by.
View Alupa Clarke Profile
CPC (QC)
Are those all part of the bunch you received this morning, for example?
Walter Callaghan
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Walter Callaghan
2016-06-13 17:55
Yes. I looked at them. The ones from this morning I'm supposed to take to doctors to get filled out. But of course, I have to work back with them. They're all based on whether you are able to go back to work. Also, there's a disconnect on what “work” actually is. That could be a whole other rant of mine. But even looking at those, how am I going to communicate these issues and these barriers to a doctor? Thankfully, I think my psychotherapist understands it well enough to help fill in that paperwork.
View Alupa Clarke Profile
CPC (QC)
You said also that you find there's a lack of information coming from VAC to you, but they ask you for a whole load of information.
Walter Callaghan
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Walter Callaghan
2016-06-13 17:56
They ask probing questions, sometimes questions that don't even seem appropriate. But it's more on your end of their actually trying to go, “You know what? You should be on this. You should be eligible for this.” There are case managers who do go out of their way to let us know. There are also some case managers who don't tell us anything.
Again, in a lot of how I've been speaking, except for some of the personal experiences, when I speak of “we”, I do that in my role as an anthropologist who is studying people like me, studying other veterans, working as an observer-participant, doing ethnography with them. I've heard so many horror stories coming back over the last five years, ever since I started grad school. This is not just me. This is problematic across the board.
View Alupa Clarke Profile
CPC (QC)
The only problem is that the common force of veterans is weakened as a result of the fact there are so many groups going their own way, but that's the reality.
You talk about denial by design. I would like you to maybe talk about that a little bit.
Walter Callaghan
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Walter Callaghan
2016-06-13 19:27
Effectively what I mean by denial by design.... I'm sorry, my tongue is getting tied in knots. I've dissociated several times already because of all this.
By denial by design, what I mean is that the very system itself is operating in a manner that is purposely trying to find any and every reason to deny benefits, to deny applications, to not grant the benefits, the claims, or the treatment. They're trying to use any possible reason.
Instead of the giving the benefit of the doubt, which is how Veterans Affairs is supposed to work, all things being equal—well, things are never actually equal—if there's any doubt at all, we should be believing the veteran. If there's any problem at all, if there's any question that can't be easily resolved, we should be believing the veteran. Instead, the moment any doubt or unanswered question comes up, that becomes the thing that gets targeted, the thing that Veterans Affairs drives into the wall to say, “Sorry, you're not getting your claim approved. You're not getting this benefit. You're not getting this treatment.”
That's what I mean by denial by design. It is an insurance-minded scheme that is purposely meant to limit financial liability and to not actually pay out.
Veterans affairs should not be operating as an insurance company. The moment we start doing that, there goes the sacred obligation, the words that I know all of you have heard before. The moment you act as an insurance company or under insurance company principles, boom, the sacred obligation, the social obligation, is the first thing that's dropped on the floor and scrounged into the dog poop.
View Alupa Clarke Profile
CPC (QC)
So if the system is designed to find any possible way to deny the benefits, that means there is an unofficial rule, implicitly. Is that what you're suggesting?
Walter Callaghan
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Walter Callaghan
2016-06-13 19:30
That is what I'm suggesting.
View Alupa Clarke Profile
CPC (QC)
Also, you talk about the disgusting practice like there being no stamp. I agree with you. I would be very, very mad if I had to add a stamp to send my information to the government, even more in the case of a veteran. Could you share with us other practices that you find disgusting?
View Alupa Clarke Profile
CPC (QC)
The most common ones that you see often. There's the stamp.
Walter Callaghan
View Walter Callaghan Profile
Walter Callaghan
2016-06-13 19:30
The stamp is a really small, trivial one that is disgusting because it is so banal.
Walter Callaghan
View Walter Callaghan Profile
Walter Callaghan
2016-06-13 19:31
To me, ultimately, the worst one is the denial by design, which is why I focused on that in my statement. There were so many other aspects I could go after.
One that does occur, and I have given conference papers on this, is the way we use some of the language on operational stress injuries. This is associated with the stigma as well. When we refer to it as “mental illness“ or “diseases of the brain”, this itself is a stigmatizing form of language that ignores what has actually happened, which is that we have been hit with an injury.
Fundamentally, what is the difference between someone who has had a limb blown off and someone whose sense of self has been so fractured that their life seems like it is coming to an end? This is my challenge toward the very way that psychiatry, and the industry of providing support and care, has become dehumanized in a way that, through its biomedical drive and through the principles it uses, dehumanizes the patient, dehumanizes the person who is injured, and in a way almost blames them, or that is how it is perceived by many of us with operational stress injuries. We are being blamed as not being worthy enough.
“Oh look, you caught the flu of the mind”, is almost what it feels like. “Hey, it's okay. Just take some time. You'll get over it.” It is this idea of illness instead of an injury. We can learn to cope. We can learn to come back. We can find new ways of being with these injuries. When we talk mental illness, it immediately implies a cure. When those cures don't happen, that strikes us even harder. When we come in expecting that CBT will help us, it is only good or takes 6, 10, 12, 20 weeks take effect, and yet three years later we are still scratching the surface. It is not a cure. It is a way of coping.
The very language that we use—that Veterans Affairs and psychiatry use—turning around and implying mental illness, creates a situation of expectations of “outcomes”, to use the wording that Brenda used. Those outcomes can never actually be met. That cascades further. When we keep having those dark, demonic moments, we are not able to come out of them.
We end up blaming ourselves, but then we end up wondering, is it really real? Then other people turn and go, “Oh, you are not better yet. Are you really that sick? Are you faking it?” Then you add in the pharmacotherapy, which is the first line. When those don't work.... I also referred to the way you end up on one drug and you need another drug to treat the symptoms of the first one. It is the Pfizer wheel of death. You need drug after drug after drug just to handle the side effects, and it just keeps getting worse and worse and worse, with the expectation that we are going to be cured.
Even if the medications are working immediately on the symptoms, it is not curing. All it is doing is masking the distress that is happening. It zombifies us. It does not actually help.
You can tell that is one of my really passionate areas of....
View Alupa Clarke Profile
CPC (QC)
I have the stamp, denial by design, language use, and stigmatization from this language. Are there any other practices you have in mind that you want to share today, right now?
Walter Callaghan
View Walter Callaghan Profile
Walter Callaghan
2016-06-13 19:35
Off the top of my head, no. My brain feels like Jell-O right now, after going into that last one.
Walter Callaghan
View Walter Callaghan Profile
Walter Callaghan
2016-06-13 19:59
How much time do I have?
Voices: Oh, oh!
Mr. Walter Callaghan: I think I've gone on quite a bit. There's not really much more that really needs to be added. Well, of course there actually is, but I think everyone wants to go off after this.
I do want to reiterate one of the fundamental things that has to be shifted. Again, these are the closing remarks that I had in my initial statement. I will repeat them as my final remarks.
In the end, it doesn't really matter what programs or benefits are available if the veteran cannot access them. It is incredibly problematic that a key barrier to access is the failure by VAC to operate under the auspices of the benefit of the doubt, instead relying on an insurance-minded bureaucratic culture of denial by design.
Thank you for the time.
Gary Walbourne
View Gary Walbourne Profile
Gary Walbourne
2016-06-07 11:01
Thank you for the invitation to be here today to give my perspective on the delivery of service to veterans.
As ombudsman to the Department of National Defence and the Canadian Armed Forces, my office is completely independent of both military and civilian chains of command, reporting directly to the Minister of National Defence. As an evidence-based, neutral organization, we do not advocate for any particular group. However, we do advocate for fairness, to ensure that any process or policy inside the department treats the members, both military and civilian, fairly.
Part of my constituency base is former members of the Canadian Armed Forces. If their issues involve the Canadian Armed Forces, they utilize the services of my office. If their issues have to do with receipt of benefits or services from Veterans Affairs, they utilize the Office of the Veterans Ombudsman.
As you would expect, with overlapping constituents, our two offices work well together. In fact, several members from my office have worked at the ombudsman's office and vice versa, including me. I spent three years there as deputy ombudsman.
Of the approximately 200,000 veteran clients at Veterans Affairs, we don't hear from all of them. We hear from the ones who slip through the cracks. Seamless transition for most ill or injured military members who require benefits and services remains a concept, not a reality, and is fraught with painstaking challenges.
Efforts to reduce complexities in service delivery have not provided the desired outcomes. Many of the available programs and services are overlapping. Others are frustratingly hard to navigate. For example, the Department of National Defence and the Canadian Armed Forces, Veterans Affairs Canada, and SISIP, the insurance provider, all have their own case managers and their own vocational and rehabilitation programs.
Some of the offered programs become inaccessible through the sheer lack of awareness of the eligibility criteria. It would be best to have one knowledgeable point of contact that you can trust for the entire journey.
It is no secret that there are endless forms and long delays in adjudication. Paperwork, and lots of it, remains the primary method to obtain services and benefits from Veterans Affairs. At present, a file is transferred from the Department of National Defence to Veterans Affairs and then goes for adjudication while the member waits. In some cases, this could be for an extended period of time if there are complexities or nuances with the file. As far as adjudication goes, it is not, in my opinion, acceptable that there is a 16-week service delay.
I believe that all the evidence we need for the determination of attribution of service sits within the Canadian Armed Forces. Before they release a member, they work with them for an extended period of time, depending on the injury or malady. We know where, when, and how the soldier has become ill or injured. In my opinion, everything should and can be done before the member leaves the service.
One step to make life easier would be to start with the determination of service attribution. I think the biggest stumbling block, if we want to talk about ease of transition and access to care, probably starts right there.
I firmly believe that the Canadian Armed Forces are responsible to the member while they wear the uniform. I do believe that if the Surgeon General's office determines the service attribution, Veterans Affairs can deliver their programs based on the needs of the client, considering the injury or malady and the impact on quality of life. I also believe that there will always be a need for adjudication services inside Veterans Affairs Canada, especially for operational stress injuries, which many times manifest themselves later in life.
I routinely ask my staff and challenge them about what a service delivery model would look like. Why do I do that? Because as bureaucracies we have a tendency to search out process-centric solutions vice veteran-centric needs. For example, on the Veterans 20/20 project, the problem is that we're so focused on the project that we're failing to look at the outcomes.
As for ease of transition, as I just mentioned, I'm aware that the department is working very closely with Veterans Affairs Canada on their Veterans 20/20 project, now known as “Care, Compassion, Respect 20/20”. I know that many task forces have been formed and that representatives from both entities participated. I do believe that these types of conversations will help, but I also believe that we're going to have to go back to the basics, back to the core way we do business. A fundamental change to the service delivery model is what is required.
There has been much fanfare about the reopening of offices and hiring additional staff, but I believe we should place as much effort, if not more, on changing the delivery model. Doing the same thing over and over again, as we have in the past, will not provide better results. We must challenge the status quo methods of operating within departments.
My office is engaged in this effort and is currently considering what a new delivery model could look like from a transitioning member's perspective. This product may be of assistance to this committee and should be ready within the next six to 10 weeks.
The last comment I'd like to make, Mr. Chair, concerns the families of these transitioning members. I believe that we can and should do more, whether in it's access to mental health care, respite, or some sort of financial help to assist those who are helping our members to transition. It should be considered in anything we do going forward.
I stand by for your questions.
View Robert Kitchen Profile
CPC (SK)
Thank you.
I'm a chiropractor by trade, and I've been involved in many organizations. Over the years acronyms are on everything. It seems to me that every time we have a budget, we have an acronym change for every program we provide. Is that confusing to veterans?
Gary Walbourne
View Gary Walbourne Profile
Gary Walbourne
2016-06-07 11:09
I think it's confusing to everyone.
Voices: Oh, oh!
Mr. Robert Kitchen: It's confusing to me, so....
Mr. Gary Walbourne: We ourselves also have to reset our clocks and make sure we're aligned with the new terminology. The Veterans 20/20 project is now Care, Compassion, Respect 20/20. It confuses not only those of us who work and live in the environment but also those who are trying to access benefits and services. They run up against it, yes. It's a minor issue, but it does cause grief.
View Colin Fraser Profile
Lib. (NS)
View Colin Fraser Profile
2016-06-07 12:38
Mr. Walbourne, I'm wondering about the one veteran, one standard model. I'm wondering how you would characterize that standard and what it would be like as part of a one-stop shop. Could comment on that and tell us what you think it would look like?
Gary Walbourne
View Gary Walbourne Profile
Gary Walbourne
2016-06-07 12:39
Well, it's probably a question best left to my colleague Mr. Parent, the ombudsman for Veterans Affairs.
However, I would say that if we talk about one standard, there should be one route of access. There should be one engagement. There should be one form to fill out. We need to get down to one. At Veterans Affairs Canada, there are now 15 different forms for 15 different types of services and benefits. We want to get down to one.
When we talk about one veteran, we're not just talking about everyone being treated equally; we're talking about one access. How do people get access to services and benefits? I believe there's a lot that can be done.
I believe, first of all, that a soldier is a soldier. If we started there, we wouldn't have these classes and types of veterans when we get to the other end. You can be class B your whole life and never see a theatre of operation, yet still be hurt in the service of this country. Probably your access to services and benefits is going to be a little different from that of a regular force member, even though the malady may be exactly the same.
I'll leave it at that, but it's a good question for the veterans ombudsman.
Joseph Burke
View Joseph Burke Profile
Joseph Burke
2016-06-02 11:04
With respect to the Veterans Affairs transformation plan, the veterans under the new Veterans Charter report there are problems with the documents they receive from VAC. Confusion and anger are caused by phone calls from unknown VAC staff members rather than letters that clearly state the actions or decisions made by VAC. There is confusion with their My VAC Account, particularly at the start. Their banking information is the very first thing they have to enter, rather than at a later time when they more familiar with the program.
Richard Blackwolf
View Richard Blackwolf Profile
Richard Blackwolf
2016-06-02 11:05
The VAC transformation plan, launched to reduce the complexity of service delivery, has made progress over the years. One example is the reduction in form length, and the simplification of forms. It also includes the establishment of the online My VAC Account, and the new use of telehealth services to contact veterans for VIP and veterans in isolated or rural communities. The adoption of operation codes linked to common injuries that are associated with military occupations is the most progressive step implemented by VAC in current times.
Joseph Burke
View Joseph Burke Profile
Joseph Burke
2016-06-02 11:10
The process is not simple and flexible for the average person. We consider the process unduly complicated, and help is often needed.
Gordon Jenkins
View Gordon Jenkins Profile
Gordon Jenkins
2016-06-02 11:21
It means when I sign the paper and put on a uniform—and it's probably very similar in the RCMP, I'm not sure—I'm willing to give my life. I'm willing to do my duty as a Canadian to go to some place for Canada and be shot at, killed, maimed, or wounded, and that is what I signed up for. When you sign and you put on a uniform, that's the unlimited liability clause.
With regard to recommendation 1, the legislation is just not balanced. I'm not saying that they all should be carbon copies of each other, but there should not be this difference between this gentleman, a World War II veteran, and somebody who is post-Korea, like me. I was in Egypt, Gaza Strip, and Beirut. A veteran is a veteran, and all veterans deserve to be treated equally. That was the first one.
The second issue is transition. I got out mid-career. I said never again would I leave my wife and kids at Trenton railroad station as I did three times. The first time was for a year, and I had been married for four months.
A veteran transitions from military life to civilian life. You must remember that a veteran is different from a politician and from a civilian. There are probably three different cultures. Being a veteran is like being a policeman. It's teamwork. You depend upon the person beside you. You depend upon the people in that tank. You depend upon teamwork of the gun crew. There's no competition. Then, all of a sudden, wham, you're, what, competing in a competition. It's two different concepts. Competing means that I'm going to do the best I can to beat these two or three.
DND is now working with VAC, so it's not all negative, but there's somebody else missing from the table, probably the Public Service Commission. There are other people missing from the table, people like me, and I have a person who is I won't say how many years junior to me, who was in Afghanistan. He got out for the same reason I did, mid-career, because of family, and he's transitioned. We could teach them some of the tricks of transitioning, even the psychological ones, because PTSD might surprise you. It's not an Afghanistan phenomenon.
I suffered from whatever you want to call it when I came back after three tours in the Middle East. Anyway, get the people who have successfully transitioned involved. That is my only suggestion there. It's hopefully a positive suggestion.
Along the same lines is my point about bureaucracy, which you mentioned. Bureaucracy has gone to the point of.... Until lately it's been a lot of macho males. It's not that we're in the sharp end. It has changed now, but it is not in the nature to go on sick parade. You just don't do it. Why don't you do it? You would be taken off duty. You're looked upon as what they used to call “MIR commandos”. You're branded, so you don't go.
Unfortunately, if it's not in a medical file, it never happened. That's the state of things. When you are going for a disability.... Many mental issues don't happen immediately. They happen, the studies are showing, two years, five years, ten years afterwards.
View Cathay Wagantall Profile
CPC (SK)
First of all, thank you so much for coming today. All of your presentations have been very targeted and clear, which is very beneficial and helpful to us.
We're hearing a lot of the same things we heard previously, which should give us good fodder to come up with some really good recommendations for how to improve the delivery of services, which is basically the focus of our study here. Thank you very much. It's appreciated.
I've heard a recurring theme of mental health and the concern over how behind we are in taking care of those needs in our veterans.
I appreciated, Mr. Jenkins, your speaking to the truth of the fact that our veterans from the First World War and whatnot definitely experienced the same challenges that our current veterans are experiencing; however, I don't think it was acknowledged in any way. I know that from my own step-grandfather.
This is something that we definitely need to deliver much more effectively to our veterans. As you said, it's so key to their ability to transition, to feel valued, and be able to function well in their transition and after they have transitioned. I really heard you on those issues.
I'm just wondering if you could share a little more. I heard the term and concern about VAC culture and that it is impacting the delivery, denial, and delay in services.
Could you expand on that, maybe Richard and Joseph, a little bit for me from your perspective of what needs to be done there so that delivery is better?
Richard Blackwolf
View Richard Blackwolf Profile
Richard Blackwolf
2016-06-02 11:41
We have a broad range of veterans, of course. Many of them are dealing with Veterans Affairs. One of the problems is that there is this delay and denial. They put in a claim and 18 or 20 weeks later they get a reply back that their claim has been denied. It's so frustrating for them. Some of them try again. We've had many who said they've put in three claims and then they got nothing. Then they quit, they give up.
It's a process designed so that, if you don't stick with it.... We've heard of people who've put in five claims, and they finally get a result, so it's a system of delay and denial. It's quite an awesome thing.
You wouldn't think that when you hear somebody had a successful claim that you would actually congratulate them. We do. We say that they've really accomplished something there. They're almost like stars.
Gordon Jenkins
View Gordon Jenkins Profile
Gordon Jenkins
2016-06-02 11:42
I agree with Richard, and I'd go one further. That's what they're stuck with. What am I trying to say? The legal emphasis is on medical record approach, and that has to change. That was my third recommendation. Thank you for letting me get it in.
Compassion is not written into the legal act or regulations. A paratrooper has jumped out of a plane 50 times and puts in a claim 20 years later. There's nothing on his medical record, so he is denied.
There's this funny word “compassion”, and the odd thing is, I was speaking to the chairman of the Veterans Review and Appeal Board, and it's got to start working down. He has seen so much of this. How does he work it into the legal? The bureaucrats, the people at VAC say it's not their fault; they have to go to this regulation for the RCMP, that regulation for post-Korea, or another for the modern day vet.
It must be very frustrating for them, because they have to go by the law.
View Cathay Wagantall Profile
CPC (SK)
I have never seen what a denial letter looks like. You mentioned you sometimes get a cellphone call, that it's not in writing. Do you have one?
Joseph Burke
View Joseph Burke Profile
Joseph Burke
2016-06-02 11:44
I thought I did. I likely do in my bag. They're very—
View Cathay Wagantall Profile
CPC (SK)
What does it look like? Is there information that explains very clearly why there's a denial?
Joseph Burke
View Joseph Burke Profile
Joseph Burke
2016-06-02 11:44
No, and that's what the problem is. I have about a dozen at home, so I can ship you a couple of them. I spent years in the infantry, 23 years in total.
It's quite crass. It is one page. It says “Dear Mr. Burke” at the top. It's all form. I've even had the wrong name sent to me a couple of times. Then it says, “With regard to your claim number....” and then it will say....
I'll use my teeth as an example. Here's a good one for you. I was accepted, and after the implants were put in and paid for, Veterans Affairs sent me a letter and said “We are hereby denying your claim for your teeth, number....”. That was it. “Please return the money”. I'm still waiting to go to court on it, but no one has ever come and collected the teeth, thank God, but that's how point blank it is. “We are no longer covering this. Please return the money”, done.
View Irene Mathyssen Profile
NDP (ON)
Thank you for your presentations. You've touched on so many things, and I want to follow up on some of them.
Mr. Burke, you talked about the fact that you received a denial letter with regard to dental work. Would it have been helpful and is it something that we should suggest or recommend that with these letters there's something from VAC that shows you the way to get the benefit, some support? I'm thinking of it saying something to the effect that you've filled in the form, that this or that was wrong, and you need to provide this extra proof. Would that make a difference?
Joseph Burke
View Joseph Burke Profile
Joseph Burke
2016-06-02 11:53
The dental one blindsided me. As I said, the cheque was already cashed, the teeth were already in my mouth. All of a sudden I go to the mailbox and there's the.... I suffer from Brown Syndrome. It sits there for three days before I can open it. But anyway.... And they don't explain it.
There are other instances: with regard to your right knee it's been denied because four years ago you said you were walking okay and now you're not walking okay. It's denied because you had three sprained ankles and your sprained ankle caused your knee injury. That is a very common thing to happen, by the way.
Or it's denied because, in the example of the teeth, they say they're no longer covering teeth for whatever it was. There was none of that in the letter, and none of the letters I have on my file state why. It just states “denied” and it's left up to me.
In the follow-up to that, the problems come from the fact that a lot of our veterans were dealt with by the medical services of the Canadian Armed Forces from start to finish. The one thing Veterans Affairs will ask for is more evidence. We have no control over our files. Veterans Affairs talks to medical services. Medical services has all the files. Where are they going to get more evidence?
Donald Leonardo
View Donald Leonardo Profile
Donald Leonardo
2016-05-19 11:05
Thank you very much for this invitation to speak to the ACVA committee on service delivery.
I'd also like to say hello to my colleagues and friends in the room.
The study on delivery of service to veterans suggested questions, so I polled the 8,000 members of Veterans Canada on three of these questions. I'll go over those polling results.
The first question that we submitted to the membership was as follows:
According to your organization and the veterans you represent, would you say that wait times for decisions have been reduced? If so, can you provide concrete examples or evidence in this respect?
Ninety-seven members responded to this question, and 90% of them said no.
I'll give you some of the live quotes that came from them. Here is one: “The answer would be a definite no.”
I can only refer to the veterans I personally have served with in my own case, which was a year or more ago.
The second quote was, “I can only speak about the apparent policy of Veterans Affairs to refuse claims outright, then hope that the person claiming will give up and go away. I'm presently in my fifth month of wrangling for medical benefits and see no clear end in sight.”
These are the responses from that first question.
I'll go on to the second question of that part, which was as follows:
Given that the primary reason for processing delays is incomplete applications, are you aware of any new initiatives to help veterans ensure their applications are complete?
One hundred and two people responded, and again 90% said no.
Here are a couple of the answers to that question.
One reads “I believe the staffers in offices often take the easiest route by returning files deemed incomplete, even though sufficient information was provided by the applicant to answer or act on the request.”
The second says, “I asked the advocate for help in filling out the application because I'm not competent in representing my medical situation. I told her I knew a doctor who is, but was denied permission to negotiate with him for his expertise. I feel as a result my claim will be negatively affected.”
Again, my response to this is that there appear to still be problems with incomplete applications, and as I have stated before, assistance used to be provided by the Bureau of Pension Advocates.
My suggestion once again is to return to the pre-1996 practice and have them hire full-time veterans to assist with applications once again. Please remove the Legion from access to back files, since we recently learned that that has been a problem. The Legion can still provide their service without accessing back files.
I'll go on to the next question, which was as follows:
Since delays can also be related to the transfer of medical records between the Department of National Defence and Veterans Affairs Canada, are you aware of any changes in the way these transfers occur?
One hundred members responded. Ninety per cent said no or that it was not applicable after release.
Here is one of the answers: “In my opinion, DND is prompt and efficient in forwarding retiree files. Time is lost when DVA delays assigning staff to review the file once received. DND should also transfer its existing clients' VAC files to both VAC and the veteran automatically, so those that have already released from DND and their files haven't been transferred, both should be automatically transferred.”
Now I'll go on to the next question, which was as follows:
Have you witnessed improvements in the way veterans with complex needs can interact with their case manager?
There were 102 responses, and 90% said no.
Here is one answer: “No. I was informed by the caseworker that she had done everything she could for me and would therefore no longer handle my case. Veterans Canada members have noticed that they have lost their case managers in the last few months to veterans service agents, even though they have complex needs and injuries.”
The second part of that question reads:
For veterans whose needs are not sufficiently complex to warrant the involvement of a case manager, do you think that the number of veterans' service agents, and their competence, is sufficient?
There were 108 responses, of which 90% said no and 10% said yes.
I'll go on to a quote from that one: “No, veterans service agents do not have enough training or understanding to help a veteran.”
Here's a second quote: “The service agents that I have encountered fill out the forms and process paper. There is no consultation on probability factors, questions, and otherwise any discussions with the veteran. There appears to be two standards and two classes of veterans.”
Do I still have time, Mr. Chairman?
View Alaina Lockhart Profile
Lib. (NB)
Thank you.
Thank you to all of you for your presentations today. You have given us really balanced information to consider, and I appreciate all the different perspectives.
One of the areas I've been focused on with previous witnesses we have brought in has been that transition period. You have each brought up some interesting points.
One of the things we've been talking about, which seems like an easy fix but comes up in every scenario, is paperwork and how overwhelming that is for veterans.
Could you tell me what the most common issue is, and whether you have any quick or easy fixes or suggestions?
I'll start with Mr. Leonardo.
Donald Leonardo
View Donald Leonardo Profile
Donald Leonardo
2016-05-19 12:09
Thank you very much.
Every year I get a multitude of paperwork. I pay child support for my disabled 33-year old son, so I get an additional pension amount for my son. Every year I have to prove that I pay this child support, even though I go through the Alberta maintenance enforcement program. This paperwork comes in every year, and I have to fill out this paperwork proving I paid the child support, even though they don't cover the full cost of $435. They only pay $100-and-something, but they still want me to prove it every single year. With all this extra paperwork, I have four Rubbermaid bins full of Veterans Affairs Canada paperwork.
If you have some extra money in the budget, could you send some help to file this for me?
View Alaina Lockhart Profile
Lib. (NB)
Thank you. This is one of the things I've been thinking about. We've talked about additional caseworkers, and you brought up veterans service agents and the training they're receiving. Do you have any suggestions on how those two groups could work together to provide better service, and maybe assist with some of this paperwork?
Donald Leonardo
View Donald Leonardo Profile
Donald Leonardo
2016-05-19 12:11
We need to go back to the idea of case managers going to meet the veteran and filling the needs. This morning, I was told that a lot of this paperwork occurs because sometimes a veteran dies and Veterans Affairs doesn't know it. That's why they send out this paperwork. I think that if they had more contact with the veteran, they wouldn't have to send out the paperwork.
Kimberly Davis
View Kimberly Davis Profile
Kimberly Davis
2016-05-12 11:09
Hello, everyone. This is now the third time I have addressed you, one in paper form last May, and once last April.
The Canadian Caregivers Brigade was started because we found that families were struggling to locate resources. We don't receive any funding from any government or organization. What we have done is provide a website showcasing various resources for caregivers and their families, creating a one-stop resource site.
We hear from and work personally with many families, helping them navigate through Veterans Affairs. We are not here for accolades, awards, or medals. We are here to help improve the quality of life for families that are dealing with disabilities and make it a smoother transition for them. If they have difficulty locating something, we are here. We know how; we have been through the system.
I will give you my background, just so you can understand why I am so passionate about working with this organization and how long I have been living with my injured husband.
I met my husband in 1991. I was 17 years old. He was deployed in 1993 to Bosnia, when I was 19, at which time he was 21, with no rank and no combat training. Oh, sorry, he was sent to Quebec for one month to learn how to use a gun to protect himself.
I married him in 1994, when I was 20. I am now 43 years old. I have been dealing with his psychological condition for 23 years; that is over half my life. It has taken almost that time to get him to recognize he has a condition. When he was released, he was released normal category, even though the paperwork from the doctor said that he was being released for stress and anxiety.
I actually had DND overturn his release and release him disabled. I fought for that so that he could get his pension. When they are released without pension, they have no money and they struggle.
One of the issues we have found, which you will hear from every organization, is paperwork. The answer to the question of whether there have been any changes with regard to improvements in paperwork is no. Even though the number of pages in the paperwork has been reduced, the process of completing the paperwork is still a challenge.
Unless these veterans were clerks in the CF—and I know some of the clerks still have issues trying to figure out the paperwork—they did not fill out much in the way of paperwork. Now the department is asking them, as injured veterans, to complete numerous applications. I know; I have helped fill them out.
The other challenge with these applications is the questions that are asked. The quality-of-life questionnaires may seem like a great idea to gauge how the veteran is doing on a day-to-day basis. Unfortunately, these are not filled out by medical professionals but the veterans themselves, and they are being used to determine the severity of a medical condition. In other words, veterans are asked to medically diagnose themselves. These applications should be filled out with a medical provider in order to help the veteran understand the wording or the question in general.
That is the veteran's side. Now let's talk about the provider's side.
Believe me, I get an earful from my husband's providers. Physicians are being inundated with paperwork, which is monopolizing the appointment time that should be focused on getting the patient better. There are many physicians I have personally spoken to who are now turning away veterans because they don't have the time or the patience to deal with them. I can read right from a doctor's note on my husband's file. Very briefly, it states,
I am treating several patients with similar DVA-related issues and my head is sore from “brick wall” trauma!
He also says in his letter:
I am proceeding with a bite plate with the understanding that the DVA will see sense, in terms of reliving pain and saving themselves money. I do hope to receive the appropriate professional reimbursement before I am too old to enjoy it.
That is on my husband's file, and you are all welcome to see it. It is a letter from his orthodontist.
The provincial health care departments are now attacking providers who are treating veterans. I have spoken to a few family physicians who have received audit review decisions from the department of health in their provinces, and they are now being penalized for general appointments, such as prescription renewals, which are very basic.
The Department of Health is saying that they should be billing VAC. These physicians have now received penalties in amounts over $15,000 for treating veterans. Again, why are practitioners turning away veterans?
Let's talk about wait times. Which one is more important? Is it the initial application approval for health care services? What about the wait time for an assessment? These veterans and their families don't have time to wait. The interruption in health care services can mean the difference between less pain or more pain, between life and death.
Health care providers are filling out extension-of-benefit forms and waiting 30, 60, and 90 days for approvals to continue treatments, causing a break in medical treatment. I spoke with one of my husband's providers. They say that interruption in care can cause more harm to the veteran than good. Providers have told me that a break of more than 21 days can cause regression and require the treatment plan to start from scratch, so how is the department saving money?
The other one is financial security. Veterans do not have financial security, I can tell you that. Right now, I'm living it. I have two kids going into post-secondary education and I'm home. I'm a primary caregiver of my husband. I had to leave a $60,000-a-year job to take care of him because he was calling me from the roof of our house and wanting to jump off.
I have to find some way of paying for my kids' education, but that's not all of it. We also have veterans out there who can't apply for mortgages because by the time they receive any lump sum their credit is so messed up that no one's going to look at them. They don't have financial security. The lump sum payments that are awarded are like a lottery win. Anyone who has worked in the financial sector knows that when a large sum of money is given, the spending habits of that person match the amount of money they've received.
Under the new Veterans Charter, there are a few issues with regard to these lump sums, and every organization that comes in front of you is going to tell you that. One, you are awarded the lump sum. Now yes, there are options, and I do have to agree because I read it on the paper. You can consult a financial adviser; they will pay $500 for that. Yes, you can request that it be broken down in a monthly amount. However, the veteran can also say no to both.
Some veterans, when they receive this money, are in extreme financial distress. Sometimes they're on the verge of bankruptcy or have already gone bankrupt. VAC needs staff that can sit down—similar to a consolidation loan officer—and help these veterans get their finances back on track, because some of them don't know what to do. I'm dealing with one veteran whose wife left him after 40 years of marriage. He doesn't know what to do with his finances. He's gone through three cellphone companies already because he doesn't know when to pay or how to pay. It's something that he's fighting with and struggling with.
As the primary caregiver for my husband, yes, I had to leave my career, where I was making close to $60,000 a year. My income was there for my children to help with their education and their recreational activities, and now it's gone. As for that family caregiver relief benefit, yes, we received it, or I should say that my husband received it, because it's in his name. It goes to him; it doesn't go to me. I don't have a file number. It is for him to access support services if I choose to seek respite. This award does not come in my name. Even though we have a joint bank account, it's his money.
I'm going to refer to the report that I submitted to this committee on May 27 about a three-tier system for caregivers. There is one. The first one starts with DND. There is an attendant care benefit that is provided. A CF attendant care benefit is provided to those who are deemed caregivers of their spouse. They can receive an amount that is a maximum of $100 a day for 365 days a year, which amounts to $36,000 a year. Then you have the old attendant allowance, for those who are on the old charter. That can amount to a maximum of $21,000 a year—if they qualify. Then there's us, under the new Veterans Charter. I get $7,200 a year. Well, my husband does.
But it doesn't stop there.
When I get to the age where I qualify for CPP, or should qualify for CPP, I'll have no income to qualify for that. I've been without work for the last three years taking care of my husband. CPP is based on your last five years of employment on the date of application, not the last 20, so I don't qualify.
Matthew Harris
View Matthew Harris Profile
Matthew Harris
2016-05-12 11:20
Good day, everyone. First, I would like to thank you all for allowing me to attend this. It's very humbling.
As you said, my name is Matt Harris. I'm an administrator for the 31 CBG Veteran Well-Being Network.
I want to be clear on something. Our group receives no money from any government agency or department, nor do we want any. We're all volunteers. It's a social networking group that began by serving soldiers looking for other soldiers who may have fallen through the cracks. We limited ourselves to veterans who were located in the 31 Brigade area, stretching from Sarnia and Windsor through London to Hamilton and the Niagara region in Ontario.
It was a way for us to look after each other. We thought at first it would be 80 people or so. So far, it's expanded to over 1,200. We were the first to try this model using Facebook. Now it has expanded to all the other brigades as well, as we're witnessing.
A colonel and lieutenant colonel, our leaders, essentially started this. Then they added some sergeants, and away it went. I can only guess that they started it because they would ask, “How is so and so doing? He/she just came back from Afghanistan a few months ago”, and the answers were far too often, “I don't know”, “I don't know where they are”, and “We don't know what they're doing.”
With suicides in the news daily, we wanted to look after ourselves, look after our battle buddies, as we felt that no one else was at the time.
I have no doubt that there were people who did care and who wanted to help, but the feeling was there nonetheless.
Our sole goal is to help out veterans, whether to help someone move, comfort them, guide them to services such as the Royal Canadian Legion or health professionals, or set up an account, for instance. We can guide them to all these various places and help them with paperwork for Veterans Affairs.
Many believe that only soldiers can understand other soldiers. Soldiers can't be weak in front of civilians, as we are taught to be strong in front of them, to protect them, and to face their dangers for them.
“Leave no one behind” quickly became our motto.
I'm not here to complain. I'm just here to pass on some concerns and issues that some of our members have had or are currently experiencing. These are issues that we see on our Facebook page or that are being messaged to us privately.
I'm not a super-educated guy. We don't have malice towards any organization that wants to help us. I just want to give you, in layman's terms, some idea of what the real or perceived issues are.
An example I'll share happened only a few months ago, in February. I think we can all agree that a judge is an educated person with quite a bit of life experience. When a judge speaks, people listen. Now, this judge, while sentencing an ex-soldier who had survived an IED explosion in Afghanistan and ended up being dismissed from the military, told him to “suck it up”.
Yes, the soldier had problems and did something stupid, and he is paying for what he did, but the point here is what the judge said. He spoke to him about the Greatest Generation, a term used to describe, in part, those who fought in the Second World War. He went on to say that many of these veterans came home likely suffering from PTSD-like symptoms, but that they sucked it up as they returned to work, got married, had families, and lived productive lives.
Well, let's look at some of these numbers. Out of a population of 11 million Canadians, 1.6 million went on to serve during World War II.
Out of a population of about 36 million people today, only about 40,000 Canadians served in Afghanistan. Many of those went on multiple tours, unlike in World War II, when they went and stayed until the war was over.
As you can see, the brotherhood was much larger at the time those guys came home. They were able to find a job—there were a lot of jobs out there—support a family, and most importantly, work with fellow vets and help each other out with any issues they had. They understood each other.
When soldiers get out now, they try to get a job in places all over the country run by people they don't understand and who fail to understand them.
The organizations may have a “support the troops” sticker on their windows, but they certainly don't want one moving in next door or representing their organization, because they believe soldiers have problems and issues. Just ask that judge.
We believe that all soldiers have sucked it up in some very intense situations, situations I'm sure that judge has never encountered. Maybe it's time for others to suck it up and help these veterans.
The government, via VAC, has said that they want to set the standard and hire veterans. I haven't seen any numbers regarding this. Is it successful? Is it working? Are veterans actually being hired throughout the federal public service? From what I've been seeing, the answer is, unfortunately, no.
Some soldiers want to continue to serve, both with the Primary Reserve as well as through a federal government job, believing they can do both. There is a military paid leave in the system, so they can still go and train and not lose a lot of money, but that is not always the case. Even our own government departments that support the troops are refusing to provide military leave with pay. Once again, this shows the soldier that his support is now dwindling. Soldiers are feeling pushed aside, and they believe they must suck it up. Sucking it up means to shut up and bury your emotions deep inside, and that in turn appears as an explosion of uncontrolled vented emotion, because they get a little frustrated.
For veterans who have released from the military, as well as those with a medical release, who would like to go into the federal public service, we are seeing their pensions stopped because they are in the federal public service. It seems that their pensions stop because they go into the federal public service. I'm not sure if that's accurate, and I'm not sure how it all works, but it's something that we're coming across quite often. It doesn't seem fair.
Also, there is a strong need to speak to other vets and not get some impersonal letter from VAC denying their claim, as they feel that someone is calling them a liar and that their honour is being questioned by a civilian, or so it seems to them. Reality doesn't matter if perception is so strong that it becomes your reality.
This all comes together for the service delivery. A decision needs to come quickly with regard to benefits, without a doubt, but it needs to be more personal, with a phone call at the very least. Speaking with other veterans and having a good transition with the help of other veterans will help keep the issues smaller so they don't turn into an explosion of vented emotion. They deal with every issue, navigating the paperwork and helping at every stage, as it is the duty of the soldiers to help other soldiers and to leave no one behind. That's the service. I think a lot more veterans could get good jobs at VAC.
Something else that comes up is the perceived difference with regard to reservists getting help. I have class A reservists. They're part time, and as for the support and transition they require, I'm not aware of any class A reservists in a JPSU. Essentially, when the time comes, they're gone. If they were class B or class C, they get pushed to class A, and then there's no support for them. It should be one standard and one veteran, but they are quickly put on category and then released.
My last point is one that came up just recently. It's that the children of soldiers who were KIA in Afghanistan apparently don't get free post-secondary education. This has come as a surprise to many who believe that if a soldier is killed, his or her kids are provided with an education and taken care of.
We have one right now, a kid whose father, my friend, died in Afghanistan. He's struggling financially through university and is being told that he's not covered at all. As a matter of fact, the claim this university had was that they supported veterans' kids through some kind of donations. I think it was called “Project Hero”. They reneged on that.
Veterans Affairs Canada did give him some money, through quite a lot of jumping through some hoops—or, rather, it paid for his education; they didn't give him a cheque. It wasn't enough, but even that money is causing issues now. He got a letter from the Canada Revenue Agency saying that it was income and he has to pay back $1,400. There's something wrong here. He did call the Canada Revenue Agency and they told him to call back. He's a 19-year-old kid. He's the oldest of his two brothers. His brother is going to go through this very soon.
His mother can't talk for him anymore because he's an adult, and he's obviously frustrated with paying back over a thousand dollars to the CRA when he was told by VAC at the time of his father's death that his schooling would be taken care. He does not have a case manager. He should. He doesn't understand the system. To top it off, he has joined the military. He's a class A reservist like his father. He's a smart and kind young man who now finds himself unable to pay for university. His brother and stepsister will undoubtably go through this mess as well.
Adding to this disappointment, he and his brothers don't have any medical coverage. I don't know why that is.
I certainly hope that this statement is surprising to you. Was it because his father was a reservist, or class C? Was it because paperwork was missing? Was it because a mistake was made by VAC? I hope so.
Their father was killed by an IED. Their father was brave, dedicated, and honourable. He was my friend.
I know that like myself, he would be shocked to find out what is happening to his kids. If it is true that kids don’t get medical and dental coverage if we are killed overseas, then we need to know that before we go over so that we can properly plan for things like that. I certainly hope that this is not the case and that this will be fixed. If there is one thing that I would like to see change immediately, it is for the kids of the fallen to be looked after.
To the Canadian people, he was a hero. To most, he is a picture, a name on the wall. He was more than that to his kids. He was a hero to them since they were born. He was their father, who loved them very much, and now he is gone forever.
In conclusion, I will say this.
Soldiers have the ability to step off on that patrol or go on that mission knowing the dangers that lie ahead. They do it knowing—or rather, believing—that if anything happens to them, they and their families will be taken care of. If that belief isn’t there, then soldiers may be more reluctant to go, not because they are afraid—they are afraid regardless—but because they need to protect their families.
VAC is supposed to be the saviour of soldiers, not an endless quagmire of paperwork and seemingly impersonal personnel, which is likely due to being overworked. It is like the other members here.... Everybody we have talked to has been nice, but this is just difficult. When soldiers and ex-soldiers need help, like all humans, they need other like-minded humans to talk to; another soldier would be great.
That is all I have.
View Sherry Romanado Profile
Lib. (QC)
Thank you.
Dana, I don't know if you'd be willing to share with us a bit about the experience of the transition from an active service member to a recipient of veteran care. Could you talk to us a bit about any of the issues that came up in terms of the transition, please?
Dana Batho
View Dana Batho Profile
Dana Batho
2016-05-12 11:51
It's not a problem. Just to clarify, I actually don't get a normal pension. I didn't serve for 10 years. I served for seven, so that doesn't entitle me to any kind of pension.
Currently, I'm on long-term disability for the first two years. After that, I'm really not sure what's going to happen or whether I'll be able to work. Nobody has really explained fully how that gets assessed. The connection between SISIP, Manulife, and VAC is really unclear to me even now.
Basically, when I released I went to the SCAN seminars. You learn a lot of things. I was posted to the JPSU for my last year of service, and they help you speak to some VAC officers there. They helped me with my disability award, and I received that before I released. I think I only got 10%, because apparently living with chronic pain that's never going to get better is less severe than losing a limb that you learn to work around, so I'm not quite sure how those tables are working. Right now I literally live across the street from this conference centre. I was barely able to cross the street. That's how bad my neck injury is, and it's getting worse, so, yes, those tables for the disability award are a little messed up. I'm not sure who decided on those.
As for the transition, I specifically remember being told by the JPSU VAC officer that anything to do with my disability claim would be completely covered, so all my medications and all of my massage therapy would be completely covered, no question. At the time I was paying $3,000 a year for my own massage therapy. On a second lieutenant's income, that's a lot of money, but that was literally the only therapy I was getting because of the inconsistency in treatments. I was getting 10 sessions of something, and then a break of six months waiting for approval for more, and then 10 sessions. It was pointless. I got so frustrated I had to give up because I just couldn't mentally cope with it anymore, and it wasn't physically helping me.
When I was releasing, I thought, “Okay, well, at least that stuff is going to be covered. At least now I don't have to pay out of my own income for my massage therapy or whatever else I need.” Then, when I released, I was told I was entitled to, I think, about 10 to 20 massage appointments a year and that medications may be covered. It's really confusing. I'm still learning how to do things.
My previous case manager approved unlimited massage for me up until June, so I was going to see the massage therapist. When he retired, the new interim case manager called me and said that I had had 89 massages that weren't authorized, and that those were $100 each—
View Irene Mathyssen Profile
NDP (ON)
Thank you, Mr. Chair.
I would like to thank everyone for their testimony. I can hear some real frustrations. I would like to start with you, Kim.
You said, “This is the third time I've come to give this testimony”, and you were here as recently as a year ago. Am I correct in hearing genuine frustration, genuine despair at the fact that this is the third time that you've told this story and at the number of times you have to tell it?
Kimberly Davis
View Kimberly Davis Profile
Kimberly Davis
2016-05-12 11:55
Well, that's the question. If you go back and look at the list, how many of us have been witness to these meetings? How many more meetings do we have to be witness to?
Last year, I was flown up there. I sat in front of the committee and told them my story. I told them the stories of families that were going through situations similar to the ones my family was going through, if not worse ones. What are we supposed to do?
Then I was asked to comment on Bill C-58 for the committee. I drew up a report and submitted it electronically to the committee. I never heard anything about it. I never heard why it wasn't considered. Why did we still end up getting the $7,200 family caregiver relief benefit when it was broken down? Why are we doing algebraic equations for a retirement income security benefit?
You are asking veterans, some of whom can't fill out applications because just reading one question sets them off, to calculate an algebraic equation as to what they are going to get when they are 65. How does that make sense?
That's not to mention my algebraic equation if my husband passes, and what I might get. Well, first you have to calculate 75% of this, minus this, plus this, and oh, then divided by this. Really? It doesn't make sense. Why can we not make this stuff simple? It is not rocket science. It is not brain surgery. It is taking care of the veterans that this country sent overseas to give us our rights and freedoms. Why does it have to be so difficult?
Dana was talking about her 10, 20, and 80 sessions. I go through that every 20 sessions with my husband. His physiotherapist, his chiropractor, his massage therapist.... This is all for pain management. The pain is never going away. It is management. He goes through his granted 20 sessions in the first part of the year. He is going to two to three appointments a week. Well, how long do 20 sessions last if you are going to two to three appointments a week? They might last seven to 10 weeks in a 52-week period. The providers have to complete five to eight extension requests in order to properly treat their veteran.
A year ago, I asked the department to review my husband's paramedicine file, look at how many physiotherapy, chiropractic, and massage therapy sessions he has gone through in the last three years, and please grant him the amount that would help him manage his pain instead of having this break in treatment.
I know exactly what Dana is going through, because I go through this frustration with my husband every seven to 10 weeks.
Kimberly Davis
View Kimberly Davis Profile
Kimberly Davis
2016-05-12 11:58
It is frustrating to deal with it, and for veterans to deal with it on their own? Good luck. You are setting them up to have a rage.
View Alaina Lockhart Profile
Lib. (NB)
Thank you.
I'd just like to point out that you've all formed groups to support veterans, and we certainly appreciate that. Clearly, it's because of a need.
I only have a couple of minutes, so could you each tell me quickly what the most common gap is that you see?
Kimberly Davis
View Kimberly Davis Profile
Kimberly Davis
2016-05-12 12:27
One of the largest issues we have is that once the paperwork's in, it's not getting processed or it's getting bounced back. We have veterans and their families going to specialists. These specialists have umpteen years in their field, yet their reports are being negated. They're being dismissed as, “Oh, well, they don't know what they're talking about.”
How can a veteran get through the system when, as my husband's orthodontist said, they hit a brick wall because you're not listening to these specialists? They have the experience and the education, yet they're being negated by the system. They're being negated through their first application, their second application, and the Veterans Review and Appeal Board. They're being negated and dismissed. They're told, “Oh, well, that's not related to your service”, yet they have a specialist who says that it is.
Why are we hitting these brick walls? That's the issue we keep hitting.
Carla Murray
View Carla Murray Profile
Carla Murray
2016-05-10 11:44
Thank you so much for the opportunity to speak to you today, and a special thanks to Dr. Kitchen and Ms. Wagantall for restoring my faith in the political system, at least a little bit.
Veterans Affairs Canada: that name strikes fear and anger into many, many injured veterans and families. The only thing that is consistent about Veterans Affairs is how consistently broken it is in so many areas. As you have heard from veterans in past meetings, they are unhappy, desperate, and abandoned—yes, abandoned. There are so many basic structural flaws in the system that picking a starting point has taken most of my sleep since I have been asked to appear.
How can you run a multi-million dollar department with nothing written down on what success is? What are the goals? Where is the data? Even the suicide data is flawed. If you owned a business or a corporation, you would never operate without a set goal in mind. Really, they're just flailing around in the dirt, because there is no set plan and nothing written down on what a successful veteran looks like two or three years after release.
Veterans feel like criminals before they even start. The burden of proof needs to be on VAC, not on the injured vet. They're not capable. These are disabled and hurting vets. They're going through all kinds of trauma, and the last thing they need is to be treated like a criminal and have to do research. It's horrific. In the U.S., their burden of proof is on the department, not on the veteran.
When did Veterans Affairs Canada stop filling in the paperwork for the veteran? This will show you how basic the structural flaws are at VAC. Many people with post-traumatic stress disorder are not capable of filling out paperwork. They see the blanks on the forms and they see it all at once. They can't pick out one blank and answer it and then the next blank. They see it all at once.
This was told to me by a psychiatrist and proven to me when my husband—a helicopter mechanic with 23 years, 223 days—couldn't fix a pedal bike for about the first four years after release. He just didn't have the cognitive power. But they have to fill out the paperwork to access the help, and that is just a huge obstacle.
One has to ask how the very department that's taking care of veterans with PTSD doesn't realize that veterans have a problem with this paperwork and those forms. These are the people who are supposed to be responsible for it. They're supposed to know this stuff.
The problem with Veterans Affairs is that it's been broken for many years. My dad was a World War II vet, and he looked my husband in the eye and said, “In the eyes of the government, the only good vet is a dead vet.” So now you know: it isn't only the new veterans telling you that it's broken. Poor treatment of veterans isn't new, nor is it unique to Canada, but it still isn't right. It has to stop.
The men and women of our military take great pride in their career and are willing to sacrifice their lives for the protection of our freedoms and our way of life. They do this with full gusto, believing right to their core that the government has their backs and their families' backs if they are injured. It's quite the shock when they realize that isn't the case. They're not adequately providing support and help to the injured veterans, and these veterans have to claw, fight, and beg for any benefit they may receive, or Veterans Affairs offloads the entire burden on the caregiver. It's unbelievable the burden that is, as Jenny will probably tell you too.
Dealing with VAC is a trigger for me; it's a trigger for my husband; and I bet it's a trigger for Jenny and her husband too. The very fact that the caregiver is given no support or education like wound care, surgical packing, or proper lifting techniques—now you're starting to give it, but it's much too late.
I see that you've had quite the journey. I've been watching some of the past meetings. I think you realize just how desperate veterans are and that things aren't quite hunky-dory. When you hear from the witnesses, particularly from the powers that be, I think you need to realize that sometimes the figures and quotes are somewhat sanitized, and you need to do the digging to find out what the real truth of the matter is.
I loved it that some of you guys went and tried to do some of the forms, or tried to access the VAC website. In the rural area, we cannot access the VAC website. We cannot access the Blue Cross website. The Legions are no good to us. Yet, every time I hear your meetings, you're talking about how wonderful the Legion is and what a help they are, or how these websites are wonderful. Well, if we can't access it, it's not much good.
The unfortunate truth is that we have absolutely no more time for study, committees, re-evaluation, and consultation. In Saskatchewan, times are beyond desperate. They're desperate. We have no psychiatrists for our veterans.
We were blessed with two of the top doctors in their fields, psychiatrist Dr. Greg Passey and psychologist Dr. Susan Brock, and now they're gone. Both doctors tried so hard to find replacements, but mental health professionals are so few and far between, and they understand the administrative burden that VAC puts on them, and they know how tough it is to deal with veterans with PTSD.
We don't have a psychiatrist for veterans in Saskatchewan. We haven't had one since November, so some of these veterans have missed five to ten sessions, and we all know a veteran who's one or two sessions away from a crisis. We need help here. I've phoned the federal government, I've phoned the provincial government, and I've phoned the Colleges of Physicians and Surgeons. The federal government blames the provincial government, and the provincial government blames the federal government. Meanwhile, the veterans here are desperate.
Please, can you do something? Set up an OSI clinic or something here. You've set up these beautiful centres in places that already have practitioners. Why wouldn't you set one up where we have none? You would answer all our prayers. We have, what, two bases here? We have RCMP training, and that would be a lot.... Also, there are all the RCMP people who serve in Saskatchewan. T.C. Douglas would be rolling in his grave if he knew what health care and mental health care are like in his beloved province of Saskatchewan.
The other problem with getting practitioners in Saskatchewan is that the government tends to pay about two-thirds of what the rest of the country pays, so it's not like our Saskatchewan weather is going to make them come here. We need to at least be on a fair and level playing field, and VAC insists on paying provincial rates. I think that needs to be studied and looked at, because once again we are sitting here with no practitioners.
I have another couple of comments that I'd really like to get in.
A lot of veterans have been losing programs and benefits. The sad part is that not one veteran who has lost a program can understand why. I believe that if you're going to do something as devastating as removing the ELB or the rehab program, you need to have a face-to-face with that veteran and his family so he understands why you're taking away his benefits. Every single one of these people who have complained about losing benefits still to this day does not understand why they cut the benefit. I understand that there's a two-letter process and it's 60 days, but if they don't hear from them, they just cut them off. We need more face-to-face contact with Veterans Affairs.
Veterans Affairs has been setting up to be more distant. When you walk into a Veterans Affairs office, it's a horrible feeling. It's not welcoming. It's closed. It's almost a lockdown on the doors. Nobody feels like going into Veterans Affairs, because the whole environment doesn't feel very welcoming.
We need more one-on-one direct contact with veterans. You could go into their homes like you used to do; I don't know if you still do. You need to be able to see what environment they're in and what kind of state the family is in. They're probably not going to tell you until they start trusting you, and unfortunately there just isn't much VAC credibility with veterans. The flaws are so structural that I almost wonder if it's worth throwing all these good ideas and good money after bad. Maybe they should be blown up and started from scratch, and maybe we should even change the name, because “VAC” is such a trigger for everybody.
This is major work that needs to be done. I imagine that it's a huge job you're looking at, but please listen to the veterans and the caregivers. The caregivers are doing the bulk of the work and getting no resources. I'm sorry, but $7,000 a year does not replace a $60,000-a-year career. If my husband dies before me, do I have to live in poverty? All my best earning years are gone because I'm at home taking care of my husband, and gladly so, because he's much healthier for it.
How much time do I have left?
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