Veterans Affairs Committee on Nov. 16th, 2010

[Ben Lobb, Conservative, Huron—Bruce, ON]

Simply to close here, I hope that as the study goes along you provide us with some examples, because I know that's what this committee is interested in. We want to be reassured that these bureaucratic levels are not causing some of the issues that we're studying.

[The Chair, Conservative, Gary Schellenberger]

Thank you. We have to move on.

We have three more questions, but then we are going to terminate this part of the meeting at quarter after. I have a little bit of committee business that we have to do, so I ask that we try to stay within the five minutes.

We move now to Mr. Stoffer, for five minutes, please.

[Peter Stoffer, NDP, Sackville—Eastern Shore, NS]

Thank you, Mr. Chairman.

I notice on page 19 that there are no clinics shown on your map in Saskatchewan, Newfoundland and Labrador, and northern Ontario. The territories are understandable, I guess. I was wondering why that would be.

Also, you talk about Brad here, which is not his real name. On the back it says that “VAC will be there to provide support, when needed, for as long as it is needed.”

I have a gentleman who had to leave Halifax because he couldn't afford to live in his home any more. He was seeking psychiatric assistance through DVA. Because he now lives in Truro--he doesn't drive a car, because he can't--DVA won't assist him in getting to his psychiatrist in Halifax. They say that he has to pay for that himself. I'm just wondering whether you are aware of this. What can I do to pursue that? I've spoken to the regional director, and they've said no, it's for that area. They don't supply transportation from an area like Truro into Halifax, which is about 50 miles, which is not much.

I just bring that up as a case.

Also, Mr. Lobb talked about and you talked about those forms. Can you send us a copy of all the forms they have to fill out so that we can have a look at them? I know that some of them are quite cumbersome.

One thing that is very therapeutic for veterans is massage therapy. In Halifax, some therapists charge $70 to $75 per session, but DVA's limit is only $58. I've seen the forms these massage therapists have to fill out. It takes a long time to fill out that form to get the $58, even though they charge $70 or $75. They were told that they cannot claim the additional difference. If their rate is $70 an hour, and DVA only pays $58, they cannot get the extra $12 from the client. They're told that. I'm just wondering if that is indeed correct.

Second, if they're not downtown but they're in an outside area and their rates are a little higher, why wouldn't DVA meet the rate of what a massage therapist charges, if that's the going rate in that particular area? Is it just a blanket rate they receive?

[Janice Burke]

I could start on some of the questions, and certainly you can respond, Raymond.

[The Chair, Conservative, Gary Schellenberger]

Again, you have about two and a half minutes to finish.

[Janice Burke]

I'm not an expert in health-related travel, but I do know that the policy exists and the benefit exists for veterans if they have a disability benefit relating to service and they have a requirement to travel for their medical appointment or treatment. So we'll certainly look into that.

I obviously can't speak to specific cases.

[Dr. Tina Pranger]

They pay, and then they're reimbursed.

[Raymond Lalonde]

Maybe I could clarify. It's the closest available suitable therapist. If he can get the service in his area, we will not pay for him to travel to another city.

[Peter Stoffer, NDP, Sackville—Eastern Shore, NS]

This is just it. His psychiatrist has been working with him for a while. For him to go to a new psychiatrist would set him right off-kilter again. The psychiatrist and the patient develop a relationship of trust. To ask him to go see another one because he lives next door to one puts a burden on that individual, don't you think?

[Janice Burke]

It's certainly something we can look into. Continuity of care and support for veterans is very important. We'll certainly look into the issue you've raised around health-related travel and will also get the copies of the forms you would like to see.

In terms of the rates for massage therapy, again, that falls under the treatment program. I don't have expertise in that, but I do know that they follow the general kinds of basic rates one would have in provinces and what the reasonable rate would be in that geographic area. We can certainly look into that and get back to you on that particular benefit.

You can speak to the clinic piece, Raymond.

[Raymond Lalonde]

Why there are no clinics in Saskatchewan and Newfoundland is a matter of the number of clients. To sustain a clinic, you need a minimum number of clients. If it's too small, you cannot justify having a psychiatrist or a psychologist.

As I explained, using Telehealth, the client may come to Calgary and then go back to Regina and get treatment, either by Telehealth or from a local psychologist. That can be supported by the clinic. It's the same thing in Newfoundland, where we're starting to have a number of clients from Newfoundland being treated by the clinic in Fredericton.

[The Chair, Conservative, Gary Schellenberger]

Thank you.

Mr. Vincent.

[Robert Vincent, Bloc, Shefford, QC]

Thank you, Mr. Chairman.

I would like to raise a completely different problem. What is the procedure for handling the request of a veteran who comes to you seeking care? I know you have to complete a lot of documents. We also know that these people have to appear at a review hearing before the tribunal to have their post-traumatic stress recognized.

How many post-traumatic stress-related applications have to be submitted to the review board? In addition, what is the delay between the moment when the application is submitted and when care is provided?

[Janice Burke]

I can respond to your question from a departmental perspective.

For an example, just in this last year, for all of the claims and applications we received for disability benefit relating to PTSD, the favourable rate has been over 80%. The favourable rate is quite high in comparison to all of the general conditions, which is around 70%.

In terms of the processes that we have put in place, when you look in your deck at the increase in claims, the favourable rate, and the number of clients since 2001--we put those protocols in place in 2001 to simplify the application and to reduce the burden around evidence that someone would have to provide to demonstrate trauma--I think you'll see that the trend has changed considerably.

What we don't know is in fact what the rate is in terms of any of the 20% that didn't get approved at the departmental level, what percentage of that went to VRAB, the Veterans Review and Appeal Board, because not all of the cases go, and then what percentage of that would have been favourable. But we can certainly try to obtain that statistic for you.

[Robert Vincent, Bloc, Shefford, QC]

The waiting time between—

[Raymond Lalonde]

It's currently 24 weeks, but it will be reduced to 16 weeks. However, that doesn't mean the person can't receive service in the meantime.

[Robert Vincent, Bloc, Shefford, QC]

All right.

[Raymond Lalonde]

We receive these people at our clinics, conduct an assessment, reach a diagnosis and send it to the district office. We continue treatment pending the outcome of the decision process.

[Robert Vincent, Bloc, Shefford, QC]

But when a person's case is accepted, some compensation is attached to that.

[Raymond Lalonde]

In a disability case, yes.

[Robert Vincent, Bloc, Shefford, QC]

There's a risk that a person suffering from post-traumatic stress disorder will be suicidal. The fact that that person has no income increases the likelihood of suicide.

Do you have any statistics on suicide among individuals whose cases have been dismissed? We're talking about 20% of cases here.

[Janice Burke]

To address the very issue that you said, in terms of delays in the pension process for people who really need it and need the treatment, because of the new Veterans Charter, we don't have to put people through the disability process in order to get them into treatment. We can get them into treatment immediately, into our rehabilitation programs, into the clinics. So we don't have to wait for a disability award decision. And that's what changed with the new Veterans Charter. You don't have to have a service-related disability. You're medically released or--

[Robert Vincent, Bloc, Shefford, QC]

To a certain degree, I understand, but as Mr. Stoffer said, treatment can be provided 50 km or 75 km from the home of the person who is suffering and that person may not have a cent. If that person has to travel for treatment which is not yet recognized by the board and, in addition, has no money to pay for that travel, what do you do in that case?

[Janice Burke]

Maybe I didn't quite phrase it properly, but that particular veteran doesn't have to wait to get their treatment and to get their treatment paid for while they're waiting for a disability pension or a disability award.

[Dr. Tina Pranger]

Or their travel....