Human Resources Committee on Dec. 4th, 2018

[The Chair, Liberal, Bryan May]

Good morning, everyone.

Pursuant to the order of reference of Friday, November 2, 2018, and the motion adopted by the committee on Tuesday, November 20, 2018, the committee is resuming its study of M-192, on episodic disabilities.

Today, the committee will be hearing from witnesses, but before that, I have a quick announcement. The vice-chairman of the China Disabled Persons' Federation and the ambassador of China to Canada have expressed interest in meeting with members of this committee. The Canada-China Legislative Association is hosting this meeting on Thursday at 10:55 a.m. in room 8-53, 131 Queen. I will be attending, and I invite any members of the committee to join.

Appearing as an individual today we have Michael Prince, Professor of Social Policy, Faculty of Human and Social Development, University of Victoria. Welcome back, sir. We also have John Stapleton, Principal, Open Policy. Welcome.

From the Disability Tax Fairness Alliance, we have Lembi Buchanan, Founding Member. Welcome.

From the Multiple Sclerosis Society of Canada, we have Patrycia Rzechowka, Ambassador and Spokesperson.

From Neurological Health Charities Canada, we have Deanna Groetzinger, Manager, and Deborah Lovagi, Representative.

Thank you to all of you. You're each going to start with seven-minute opening statements. Don't panic if you go too long. I'll just wave at you politely, but you don't have to stop immediately. You just need to wrap up your comments.

We're going to start this morning with Michael Prince. The next seven minutes are all yours, sir.

[Prof. Michael Prince, Professor of Social Policy, Faculty of Human and Social Development, University of Victoria, As an Individual]

Thank you, sir.

Good morning, everyone. It's nice to be back, although I say that somewhat ambivalently, coming from Victoria. The weather is a bit of a waker-upper.

I'm going to focus in my opening remarks specifically on the employment insurance sickness benefit program. I'm happy to talk about other programs and other issues later on.

I want to make five basic points around EI sickness benefit, not only in terms of people with so-called episodic disabilities, but also for other Canadians with whatever kinds of disabilities we may wish to call them, who are working.

The first point is to extend income protection. As members know, there's a 15-week maximum duration period for EI sickness benefit. That's been unchanged since the benefit was first introduced in 1971. Unlike almost every other feature of EI, including all the other special benefits, which have had their periods extended or durations expanded, this one has been left unchanged since 1971.

Canada also has one of the shortest periods of sickness protection among industrialized countries. In fact, there are only a few countries with such a modest coverage of protection. As members know, approximately 35% of EI sickness benefit clients each year exhaust or use up all 15 weeks of their benefit. That represented about 135,000 people in 2016-17, which is the most recent figure available.

The first point is to improve program coverage by extending coverage to the equivalent of 26 weeks, as with other special benefits.

The second point is to enhance accessibility and program flexibility in the take-up. This is to again recognize the episodic or recurring, cyclical nature of disabilities to allow eligible claimants to access their entitled benefits over a longer time period than one year, and to access them in chunks of time, over say, a two-year period.

The third point is to give greater emphasis on individuals. This means more of a client-centred approach to the delivery of services—what we sometimes call a case management approach—providing continuity of service to clients. This would include a greater emphasis by the EI program on early assessment, identification of health conditions, and the consideration of supports and interventions earlier rather than later.

Where appropriate within the EI and ESDC mandates, it may also more likely involve referral on health issues earlier on to other, more appropriate authorities—federally or provincially—to alleviate longer-term problems or prevent them from getting more serious. This could also involve advice to employers on job accommodation and workplace adjustments. The focus there would be on both the capacity of the individual—not just on their inability—and on the trajectory of their likely episodic or other disability conditions.

The fourth point is to encourage work capacity or potential: keeping people employed when appropriate and where possible, with on-the-job supports. This would also involve perhaps reviewing the 50% marginal tax rate on earnings that people experience while they're on EI sickness benefit. Above the so-called “earnings threshold”, any money earned right now is deducted dollar for dollar. That's a 100% marginal tax rate.

Clearly, we can send a different signal of work incentives and encouraging employment where possible. It's shifting the emphasis of the program from looking at the inability and incapacity to work, to recognizing the intermittency of their conditions and the periodic capacity to work.

The fifth and final point would be to review the medical certificate used in the EI sickness benefit program and the policy and procedures around it. This would include, to be very specific, paragraph 18(1)(b) of the Employment Insurance Act and section 42 of the EI regulations.

This would also include looking at the content of specific forms. I'm sure my colleague Lembi will be talking about the forms around the DTC later on.

The concept of probable duration, where a physician or other medical practitioner has to give their best professional opinion as to what the probable duration is of the incapacity to work due to illness or injury, needs a review if we're truly going to incorporate the concept of episodic disabilities into the medical assessment and certification. The medical certificate also gives emphasis to the language around inability to work, as opposed to partial capacity to work and intermittent capacity to work.

I think if we shift the culture, we shift the attitudes and we signal stronger work incentives.

Clearly, that kind of review of the medical certificate would involve consultations with health professional bodies in this country, disability organizations, and EI program staff of course. It would also draw on the research and analysis branch of the Department of Employment and Social Development Canada.

That's it for EISB. I'm happy to talk about other policy tools within the federal government's tool kit around how to advance better equity and opportunity for Canadians with episodic disabilities.

I'll leave it there. Thank you.

[The Chair, Liberal, Bryan May]

Thank you very much, Mr. Prince.

Now we go to Mr. John Stapleton, principal of Open Policy. You have seven minutes, sir.

[John Stapleton, Principal, Open Policy, As an Individual]

Thank you very much. I appreciate the opportunity to be here, Mr. Chairman, members, staff and fellow guests.

I'm going to talk about disability income programs this morning. I will look at 10 programs, or 10 systems. I'll say them slowly, in no particular order: one, the RDSP, with which you're all familiar; two, the Canada workers benefit; three, the disability tax credit; four, EI sickness; five, the Canada pension plan disability; six, social assistance in all the provinces, with special programs for people with disabilities; seven, workers' compensation; eight, veterans programs, for which there are large programs in place for veterans with disabilities; nine, workplace programs that are paid for by the private sector, so programs that are not government programs; and, finally, number 10, which is auto insurance.

If we look at the income security landscape from 10,000 feet, we see that there are 10 different systems. I wouldn't even call them programs. More and more—and I think we saw it just a couple of weeks ago—disability income programs have tended to reimburse or pay for a disability, as opposed to looking at the whole person and providing income support for people with disabilities.

It's a subtle distinction. We used to talk about “the disabled”. We no longer do that. We talk about “people with disabilities”. That's when we can start to think more comprehensively about the idea of episodic disabilities and how they fit. In other words, you may be asymptomatic one day, and you might be in a wheelchair and unable to walk the next day.

Disability income programs have had trouble with that over the years and over the decades. They want to see that permanent, significant disability that's in place for a prolonged period of time, for at least a period of several years. This means that a lot of people with episodic disabilities actually don't qualify for benefits, because they can't meet that standard.

That's particularly what I want to recommend today. We really need to look at it holistically. I wouldn't just restrict my comments to federal programs. Let's look at federal, provincial, and also at the private sector. Let's look at what they do. Rather than having 10 different complicated definitions of disability, let's look at trying to have some convergence so that we can bring coherence to these programs.

It's easily said, but not easily done. However, if we had the type of review of disability programs that I'm calling for, we would be able to look at those definitions that particularly leave out people with episodic disabilities.

There are three attractions for what we call a guaranteed annual income or a basic income for people with disabilities. The first is that programs would not be work-triggered. In other words, we would look at programs as a matter of right. Second, we would not place time limits on them. One of the attractions of a basic income is that it's not time-limited, regardless of how all these experiments have gone. Third, they would be adequate.

Right now, most disability income programs are not permanent. They have time limits, like employment insurance, as Michael just said. Workers' compensation generally restricts itself to two years. Veterans programs are not necessarily permanent, and certainly workplace programs that used to observe a much longer period of time generally restrict themselves to two years.

Disabilities are not on any schedule. They don't observe time limits, but our programs do, and that's where we need to be more flexible.

Most disability income programs are triggered by work. You have to get them based on work. That's EI, CPP, veterans, workplace programs and workers' compensation. They all get paid after you've worked. If you haven't worked, you don't get them.

Not everyone has worked, so they can't get these programs, and in many cases they must go on social assistance. Social assistance over the years and even now is becoming the largest single set of programs that people with disabilities have to rely on. In many cases, that's unfair. They have to deplete their asset; they have to deplete their incomes. You might hear a bit more of that this morning.

People who get work-triggered programs often get inadequate benefits, because if you're a person with a disability, you likely have not paid the maximum into that system over the years, so you're going to get much less money. That's why people are attracted to a basic income, as it's not work-triggered.

I know we've talked a lot about Bill C-81 for the last little while, but I am going to mention in closing Bill C-87, which has now received first reading, but I'm just going to mention it in closing. It targets 20% poverty reduction by 2020, and that's going to be done. I think the government will meet its targets by changes that have been put in place for seniors, with the guaranteed income supplement, and for children through the Canada child benefit.

Over the next 10 years, we have to reduce poverty by 50%. We use a swimming pool analogy. We talk about shallow poverty, and we talk about deep poverty. That's when we're going to have to get into the deep end. It seems to me that Bill C-87, as a poverty reduction act, is cause for a comprehensive review, which I would call for in terms of people with disabilities. We need to remove them from poverty by 2030 and be able to marshal the resources into all of the programs, all of those 10 systems, to bring about the sort of change that we could get. It would be inclusive of people with episodic disabilities. There's no way we're going to get to that 50% by 2030 without having that as a big part of the process.

Thanks very much.

[The Chair, Liberal, Bryan May]

Thank you.

Next, from the Disability Tax Fairness Alliance, we have Ms. Lembi Buchanan, founding member, for seven minutes, please.

[Lembi Buchanan, Founding Member, Disability Tax Fairness Alliance]

Thank you very much for the opportunity. I want to thank all of you for your interest in this subject. I see pretty much a full table. I think that's important in terms of the interest in disability issues.

The Disability Tax Fairness Alliance is a coalition of more than 25 members. We're committed to ensuring that the administration of the disability tax credit reflects the realities of the people with disabilities, as well as the parliamentary and legislative intent of the tax credit.

I'm also a member of the disability advisory committee established by the Honourable Diane Lebouthillier last year. Our mandate is to advise the Canada Revenue Agency on interpreting and administering tax measures for Canadians living with disabilities in a fair, transparent and accessible way. This disability advisory committee existed in 2005-06. I was a member also. Unfortunately, it was disbanded at that time and now it has been reinstated.

For more than 20 years, I have advocated fairness for individuals living with chronic and persistent psychiatric disorders, where individuals are markedly restricted in their mental functions all or substantially all the time, as required by the Income Tax Act, even though the external signs and symptoms may be perceived to be intermittent or episodic.

People living with so-called episodic disabilities face unique barriers qualifying for the DTC, largely because the disabling effects of their conditions are not well understood by policy-makers.

In 1998, my husband, Jim, severely impaired by bipolar disorder, was denied the DTC. The reason was that the federal government did not recognize that people living with mental illnesses could be as severely impaired as those with physical impairments. I successfully appealed on his behalf to the Tax Court of Canada, and that decision was upheld by the Federal Court of Appeal.

Although psychiatric disorders are chronic medical conditions, many individuals benefit from drug therapy and are able to live well. Still, a small percentage continue to be vulnerable to a wide range of symptoms affecting the way they think, feel and relate to others. The unpredictability of symptoms of the condition, which is always present, can create marked restrictions on their mental functions.

CRA defines the phrase “all or substantially all of the time” as being at least 90% of the time. Even though this arbitrary guideline is not supported by legislation or jurisprudence, CRA enforces its narrow and technical interpretation of the Income Tax Act with impunity, making it virtually impossible for many individuals living with episodic diseases to access the tax credit.

Numerous Tax Court of Canada cases indicate that the 90% threshold is not a suitable guideline for complex medical conditions, where the expressions of symptoms may be perceived to be intermittent. I will share two of them with you, and there are more in my submissions. You can find additional Tax Court cases regarding the subject on my personal website, www.fightingforfairness.ca.

In Bruno Maltais v. The Queen, Judge Alain Tardif recognized that individuals living with mental impairments did not exhibit these symptoms continuously, stating the following:

The vulnerability for a relapse was always present even though the outward signs are not always visible or apparent. Moreover, a person who has such a disability may break down at any time without there being any indications or warning signs.

In Peggy Doe v. The Queen, Judge Gerald J. Rip also noted in his ruling the special circumstances of an individual diagnosed with epilepsy as well as a number of psychiatric disorders, including PTSD:

When a person does not know from one moment to another when a seizure will occur—but knowing a seizure will occur, even with medication—that person's ability to perform any activity, including an activity of daily living, as defined, is markedly restricted.

In recent years, eligibility for the DTC has enabled Canadians with disabilities to access numerous other federal and provincial income support programs, including the registered disability savings plan.

However, the loss of DTC eligibility means not only that the RDSP must be terminated, but also that all grants and contributions made by the government in the previous 10 years must be repaid. The majority of individuals living with so-called episodic diseases are required to reapply for the DTC every five years. Thousands of these reapplications have been denied without a valid reason, even for individuals who have been receiving the tax credit for 20 years or more. The cumulative total repayment of government contributions since 2010 is $52 million—$52 million has been clawed back. Such a practice is unconscionable.

Our alliance has two recommendations. First, address the systemic problems and inequities in the administration of government income-support programs for people living with chronic and persistent mental impairments, to ensure parity with physical impairments, even though the signs and symptoms may be perceived to be intermittent. Second, amend the terms of RDSP withdrawals for Canadians with disabilities who are denied the DTC, in order to prevent clawback of contributions made by the federal government in bad faith.

Thank you very much for this opportunity to share our concerns and recommendations.

[The Chair, Liberal, Bryan May]

Thank you very much.

From the Multiple Sclerosis Society of Canada, we have Patrycia Rzechowka, ambassador and spokesperson. The next seven minutes are all yours.

[Patrycia Rzechowka, Ambassador and Spokesperson, Multiple Sclerosis Society of Canada]

Good morning. I would like to thank MP David Yurdiga for sponsoring motion 192, and I'd like to thank this committee for taking the time to study and create recommendations to improve the lives of Canadians living with episodic disabilities such as multiple sclerosis.

My first real experience with MS came at a young age. I remember seeing my neighbour out walking every day. Some days she would be walking perfectly normally, other days with a limp, and some days she had to use a cane. I couldn’t understand it. One day I saw her with the cane, and I asked my parents what had happened to her, whether she'd broken her leg. They told me she had MS. At that time, it didn’t mean much to me, other than that it was something awful that I didn’t really want to think about, so I didn’t. It wasn’t until about 15 years later that I really understood what I saw and what my parents told me. Every day she went for her walk, she made a choice to fight MS. And all those years later, sitting in an emergency room blind in my left eye, I had to make that same choice.

I knew something was very wrong when I began to lose vision in my left eye. It went from soreness to blurriness to blindness, all within a few days. After a visit to an emergency eye specialist, and one more eye specialist after that, the diagnosis was optic neuritis. Optic neuritis is often but not always one of the first symptoms of MS. I was told I needed to get an MRI, but it wouldn't be until three months later. I managed to get on a cancellation list and got an MRI a few weeks later. A few days after the MRI, I saw a neurologist and I was told I have MS. My world has not been the same since.

I had spent so much time hoping for the best but preparing for the worst that, when I finally heard those two letters, I want to say I was ready for it, but I wasn’t. All I could do was think, “What now? What do I do now? What is my life going to look like now?”

Who I am today may not be who I wanted to be, or thought I would be, but I am who I am today because MS changed my path. MS, if you can believe it, has given me many opportunities, like sitting right here in front of you, but it has also come with many struggles—struggles physically, struggles psychologically, and all the struggles that come with having an illness that is not well understood. It took five months for me to fully regain my vision, but other times it’s taken two weeks. MS is often invisible and always incredibly inconsistent.

Many of my struggles with MS have been as a result of other people not understanding it. I get that—MS is so unpredictable. Sometimes, though, this lack of understanding can mean something like the difference between getting a job or not. When I applied to become a police officer, the police service tried to disqualify me because I disclosed my diagnosis. I had to fight to even be allowed to apply. I had to fight at every stage to be the best, and in the end even my best wasn’t good enough. Meeting every single standard, and often far surpassing it, was not enough, all because of the fear of what could happen to me. I was seen as a liability, even when all of my qualifications and test results should have made me be seen as an asset. I was a woman with a criminology degree who had previously worked for both the RCMP and Edmonton Police Service. I was fluent in Polish and had volunteered all my life. But none of this was enough.

It is detrimental to anyone’s quality of life and mental health to want to be productive and contribute to society, to want to use their skills, education and talents, but not be allowed to do so—not because of anything they did, not because of anything they can control, but because there is a chance that they might be temporarily disabled for a short period of time. When I was diagnosed with MS, I really didn’t want anyone to look at me or treat me differently. However, this was out of my control. I want to feel useful; I don’t want to feel like a burden. I’m lucky I have my family to rely on in case I ever need help, but I want to be able to take care of myself.

I am also incredibly fortunate that my current employer didn’t think twice about hiring me, and has not hesitated to keep me. But having MS has forced me to make decisions about jobs that are based on having to play it safe because I need the medical coverage and I need the health benefits. Even if I wanted to take a risk, I couldn't. What if something happens and I can't work for two weeks? How would I pay my mortgage, my car payments, my insurance and everything else? I have previously worked through blurred vision without telling anyone, because I was terrified that I would lose my job before I was permanent.

I pay for everything on my own. I cannot get the proper amount of funding for the physio, massage and exercise that helps keep me healthy and off the $16,000 medications that I qualify for. I have no additional support. I have many hard days when it would be so easy to give up, but I make the choice to fight MS every day.

“Get up, Patrycia. Just get up. All you have to do is get up.” This is almost every morning for me. I am totally exhausted no matter how much I sleep. I have trouble falling asleep because my legs are restless or because I am in pain. You would think the fatigue from working a full day, exercising and volunteering would be enough to knock you out, but even after a long day, I have a difficult time falling asleep.

You may wonder what gets me up. It's knowing that I have somewhere to be, knowing that I have responsibilities and that I have purpose. I can’t imagine if my ability to work were taken away, all because I might need a little extra support. I have fought through fatigue, through tremors, muscle spasms, brain fog, numbness and tingling, unbearable pins and needles, blindness and much more. I can fight through many things, but the fear of the unknown is something that will always be one of the most debilitating symptoms of MS.

The changes as a result of this motion can help make those unknowns much more manageable.

I want you all to think about the last time you did something that scares you. Usually we think of something like skydiving, bungee jumping, roller coasters or touching a spider or a snake. Now, for a moment, I want you to imagine that the scariest thing you have to do is go to bed at night, not knowing if you’re going to be able to see when you wake up, or walk, or speak, or eat or even have the energy to get out of bed. This is the reality for many people living with MS. Waking up each day is an adrenaline rush. Waking up knowing that you will be supported no matter what would make going to sleep at night not nearly as frightening.

I applaud this committee for studying this motion. This will increase awareness of episodic disability in Canada. By viewing the policy and legislation through an episodic disability lens and recommending important changes, we will achieve better equity in the supports for Canadians living with episodic disabilities.

Thank you so much for the opportunity to speak.

[The Chair, Liberal, Bryan May]

Thank you for being here.

Up next, from Neurological Health Charities Canada, we have Deanna Groetzinger, Manager; and Deborah Lovagi, Representative.

You have seven minutes, please.

[Deanna Groetzinger, Manager, Neurological Health Charities Canada]

Thank you very much.

Thank you for the opportunity to present on behalf of Neurological Health Charities Canada. NHCC is a coalition of organizations that represents millions of Canadians living with brain disease, disorders and injuries. I am sharing this time with Debbie Lovagi, who has an acquired brain injury.

I will make some overall comments and recommendations, and Debbie will speak about how a brain injury has affected her life and her ability to work.

Brain conditions are the largest cause of disability worldwide. One in three Canadians will be affected by a brain or nervous system illness, disorder or injury, including mental health conditions, within their lifetimes. Disabilities that develop as the result of a brain condition can occur at any point along the life course, and a number of them are episodic in nature. This means, as you've heard from all of the witnesses, that there are periods of worsening that can vary in severity and duration. Remissions can happen, but the periods of worsening and remission persist for the lifetime of the individual. Examples of brain conditions that are episodic are dystonia, epilepsy, migraine, multiple sclerosis, Parkinson's disease and conditions such as depression and other mental health disorders.

As you have heard from the other witnesses, current programs such as the Canada pension plan disability and the disability tax credit are not flexible enough to assist most individuals who have episodic conditions that worsen. In most cases, the language of “severe and prolonged” disqualifies those whose conditions may not be considered prolonged enough.

Some other jurisdictions have recognized that disability can be episodic. British Columbia’s disability eligibility definition states that “the person’s ability to perform daily living activities” can be restricted either continuously or “periodically for extended periods”. Ontario’s definition states that a disability is “a substantial mental or physical impairment that is continuous or recurrent, and is expected to last one year or more”. Sadly, Ontario appears to be moving away from this definition toward the more restrictive Government of Canada definition.

NHCC is encouraged that Bill C-81, the accessible Canada act, recognizes that a limitation can be permanent, temporary or episodic in nature. We applaud this language and hope that this will help ensure equity in government policy and programs that support Canadians living with all types of disabilities. I hope the committee's study today can help push that along.

More immediately, NHCC urges the committee to consider the following recommendations, some of which you have heard from the other witnesses. First, modify the eligibility definition for the Canada pension plan disability benefit to include disabilities that are episodic or recurrent in nature; modify the eligibility definition for the disability tax credit to make it clear that persons living with episodic disabilities can be eligible for the credit; increase EI sickness benefits from 15 weeks to 26 weeks, with expanded flexibility for partial work and partial benefits for individuals who can work episodically.

On a longer term, use the recommendations you heard from the witnesses so far—Michael Prince, John Stapleton and Lembi Buchanan—as well as an excellent report by the Institute for Research on Public Policy, “Leaving Some Behind: What Happens When Workers Get Sick”, to work with other governments, employers and insurance carriers to revisit definitions of eligibility and establish a comprehensive approach to address the needs of Canadians living with episodic disabilities.

I will now turn the remaining time over to Debbie.

[Deborah Lovagi, Representative, Neurological Health Charities Canada]

Good morning.

In 2015, within a short period of time, I suffered two acquired brain injuries. The first one happened when a display board fell on my head when I was at a contract job. Five weeks later, I had a second ABI, acquired brain injury, when my car was rear-ended.

I lost my balance. I had no depth perception. I had pressure and ringing in my ears, a severe stutter, severe depression and now PTSD. I could not walk a straight line. I couldn’t read or write without nausea. I couldn’t stand alone. I couldn’t speak without stuttering.

I lost my job. My family and some of my oldest and dearest friends did not understand my brain injuries or PTSD. I heard over and over again that I was not in the military, so how was it possible for me to have PTSD?

Some days are better than others, but a good day can be followed by a bad week, sometimes months. I found a system navigator who helped me find the Vista Centre, an organization that helps people with disabilities find employment. I need an income, but I still have many symptoms from the two brain injuries. I have yet to find suitable employment.

However, through hard work, determination, pure tenacity, my new team and teamwork, I am slowly improving. Every day I tell my brain not to stutter, to walk a straight line, to try to remember more than five things. I am working on these messages, and I will continue until I have completely trained my brain.

I have come far from where I was over three years ago. I have found ways to function. I take many breaks. I try to be mindful through nature. I have potted flowers and vegetables. The plants and the dirt keep me grounded. I enjoy walking again. There are things I still cannot do, but I have not given up on change. I am allowing my brain to reprogram.

I have tried to accept that I am different. I need other people to accept me now for who I am. I have an invisible disability that affects every facet of my life, but I am determined to be the best Debbie I can be.

Thank you.

[The Chair, Liberal, Bryan May]

Thank you very much.

Thank you to all of you.

We're going to start with MP Diotte for six minutes of questions.

[Kerry Diotte, Edmonton Griesbach, CPC]

Thanks to everybody for coming here, and especially for some of the heartfelt, personal stories. I know that it's very difficult, but it helps us to understand so that we can get the best result here.

Mr. Prince, you talk a lot about some of the benefits, including EI. We're talking about extending it from 15 weeks to 26 weeks. Can you just explain the typical problems that people with episodic disabilities have right now when they apply for EI? What's the biggest stumbling block?

[Prof. Michael Prince]

I don't think we really know, to be honest. First of all, the category of episodic disability is a very multi-dimensional one, a very complicated one. There are a variety of trajectories. For some people with episodic disability, their experiences of progressive trajectory have declined. Others are actually experiencing a trajectory of recovery. Others are stable. Some are visible. Some are invisible.

In that regard, sir, it might be a function of what the interaction is between the person and his or her physician: whether the person has a family physician or obtains a medical practitioner who will complete the certificate, and the understanding that this professional has of what the person's condition may or may not be. I think we heard some testimony here this morning about how sometimes that's not always readily apparent or readily at hand.

Many professionals do not understand these conditions—not just policy-makers, governments or bureaucrats, but medical practitioners. We see that with the DTC. We've seen that for many years. I think part of it is the awareness not only of employers and employment, but also of the people who are gatekeeping at the front door of these programs who assist individuals in completing the necessary documentation.

People could have a range of experiences in trying to explain what it is that they have, get it acknowledged, and then awkwardly try to squeeze their very complicated, multi-dimensional experience into some forms. That's why I think the devil's in the details. Part of it is looking at how we experience that encounter across the so-called “front desk”, as we used to call it, on service delivery, whether it's online forms or what have you.

That's a vague answer, but I think part of it is that we don't have a solid enough understanding of that experience beyond various organizations' members and anecdotally. In terms of good statistical analysis, that work is being done and is yet to be done.

[Kerry Diotte]

When people walk in—say, they do explain—and they say, “I could be good this week and bad next week,” is the program suited to them right now, or is it again a push toward saying, “You're either disabled or not disabled?”

[Prof. Michael Prince]

The EI sickness benefit is probably the most flexible of the ones we're talking about, because it's focused on the short term. It probably has the least onerous medical assessment procedure, compared to the disability tax credit. It is certainly far less onerous than the Canada pension plan disability program. Its definitions are far more open that way.

In many ways, what I've been making a pitch for here this morning is that these are to benefit Canadians across a range of disabilities, not just specifically episodic. Where we see the episodic disability experience perhaps benefiting from these reforms is in more flexibility in being able to draw down the benefits: not just in a 15-week chunk of time, but to extend the benefit to 26 weeks, and extend the window of being able to access or draw down those benefits in more flexible chunks of time, over a longer period of time, to recognize that recurring or cyclical element.

It won't fit for everybody, because of the great diversity of episodic disabilities, but it will go some measure toward responding to the lived experience of a lot of people.

[Kerry Diotte]

Just on that, John, you talked about how most of the disability programs are work-triggered. What do you envision as the solution? I think you're leaning toward assured annual income. Is that correct?

[John Stapleton]

I'm not so much leaning toward it, but just trying to impart the understanding of why it's so popular.

When you have programs where the only way you can get them is to have worked, it means that probably for a good part of your life you have been disability-free and then you've had a later-onset disability. I'm trying to point out that even with those programs—EI sickness, which Mike talked about, CPPD, workers' compensation, veterans programs, workplace programs and the like—if you're a person with episodic disabilities, and that's what we're talking about here today, you probably spend a good period of time off work, more than the average person would, due to sickness.

These programs are mostly contributory. When you have to contribute to them, there are two ways you get to the maximum benefit. One is that you work a considerable number of your work years, and you also contribute at the maximum amount throughout that period. What that means, therefore, for people with episodic disabilities, is that when they actually come to benefit from these programs, they haven't paid enough into EI. They haven't paid enough into CPP. They haven't paid enough into a workplace program to get any type of adequate benefit from that.

The case I would make is that once we recognize episodic disabilities, we have to think up new ways to make the benefits adequate.

[The Chair, Liberal, Bryan May]

Thank you very much.

MP Long, go ahead, please.

[Wayne Long, Liberal, Saint John—Rothesay, NB]

Thank you, Mr. Chair.

Good morning to everybody, and good morning to our witnesses. It's very informative. Thank you for your courage in coming this morning.

Mr. Prince and Mr. Stapleton, these first questions will be targeted to you. In this study, every time we talk about expanding EI or CPP benefits, my Conservative friends say that we're increasing payroll taxes. These programs have to be funded from somewhere.

Would you classify payments to contributory benefit programs as payroll taxes, Mr. Prince?

[Prof. Michael Prince]

Yes. That's a pretty traditional definition of social insurance program premiums or contributions. What's interesting is that often Canadians themselves don't see them as taxes but as contributions or premiums like those to a life insurance program, but in social insurance.

If I can be very specific on the idea of expanding EI sickness benefits from 15 to 26 weeks, we're looking perhaps at a financial cost of somewhere between $50 million a year and $100 million a year. The sickness benefit right now is over $1.5 billion a year. It's part of the larger EI program, which is a magnitude order larger than that. We're looking at an incremental additional cost of perhaps 4% or 5% to the overall budget.

It would also be an investment in early interventions and job retention, so that these people would not be opting out of the labour force. They would be continuing to work and making some premium contributions.

Again, in that analysis, the harder numbers need to be done, but this is actually a sound investment. It's not a big ask in terms of a fiscal hit to the program.

[Wayne Long, Liberal, Saint John—Rothesay, NB]

Mr. Stapleton, go ahead.

[John Stapleton]

Once again, I would like to look at the larger picture. In terms of gross domestic product, Canada has north of a $2-trillion economy, and the total amount of money that's paid out in income security benefits of all types is somewhat north of $180 billion, meaning that we spend about 8% of our gross domestic product on benefits of various sorts.

When you compare that with other OECD countries, we're somewhere around the middle. We're certainly not overspending in that way. When you take the programs that you specifically noted, our contributory ones, we have three of them. We have workers' compensation, where the levy is on employers; EI, where it's on employers and employees; and CPP, where it's on employers and employees.

In fact, those payroll taxes are the largest single source of our income security programs—as you say, where the money comes from—with federal taxes being next, and then provincial taxes after that.

Do we need to increase the amounts? We've gone through the last 25 years where EI premiums have actually moderated and stayed down. CPP premiums certainly have not increased over the last many years. I would simply say that, on both programs, we have the room to make moderate increases so that we can actually meet people's needs.

[Wayne Long, Liberal, Saint John—Rothesay, NB]

So you would both agree that it would be worth increasing the premium, if needed.

[Prof. Michael Prince]

Yes, I would.