Veterans Affairs Committee on Feb. 14th, 2011

[John D. Larlee]

First of all, the disability must be established by credible medical evidence, and that comes from physicians, whether it's independent physicians, whether it's.... It would be in the file. The representative of the applicant would present that evidence.

As far as the members are concerned, we receive our directions from the Federal Court on how to assess a credible medical opinion. We have cases that have given the tribunal directions on how to determine a credible medical opinion, and that would be that's it from a qualified medical physician; that it's based on as full and complete a medical history of the individual as possible; and that there is a conclusion based on that medical information where the physician provides an opinion.

Perhaps there are multiple medical opinions in the file. It is the obligation of the tribunal to review all that material. With this evidence, together with any witnesses and the applicant's own testimony, we make a finding of whether to vary the decision that was previously made by the department.

[The Chair, Conservative, Gary Schellenberger]

Mr. Stoffer.

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

Thank you, Mr. Chairman.

Folks, thank you for coming out today.

Again, how many members are on the Veterans Review and Appeal Board?

[John D. Larlee]

Currently we are a complement of 24 members.

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

And how many have a military, medical, or policing background?

[John D. Larlee]

We have six members who have military and medical...and that would be made up of five military, one of whom has medical. In addition, we have one individual who has a medical background, in nursing.

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

So 18 out of 24 have no medical, military, or policing background. Am I correct? Okay.

You also said....

Is that right?

[John D. Larlee]

Well, yes, but I mean, policing....

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

What about an RCMP background?

[John D. Larlee]

No, we don't have anyone with RCMP background at the moment, although we have the spouse of a serving RCMP member on the board.

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

You also said there were 4,100 review cases and 1,400 appeal cases that you do.

[John D. Larlee]

That's correct.

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

If my math is right, that's over 15 a day—15 a day that 24 people deal with, and 18 of them have no medical, military, or policing history.

I ask because one of the biggest things that VRAB does is adjudicate in terms of the “benefit of the doubt” clause. In over 600 cases that I've seen since 1997, right across this country, from World War II, Korean, etc., I have yet to see a case where the benefit of the doubt actually applied. If there is, I'd sure love to see it.

You talked about the medical evidence, and you're absolutely correct. We have seen time and time again World War II veterans suffering from post-traumatic stress disorder 60 years after the fact being denied their case because there's no medical evidence stating that in their file. They were denied. The benefit of the doubt would only assume that this would apply.

As you know, there are 750,000 World War II, Korean, RCMP, spouses of these folks, but DVA looks after only 220,000 of them.

Of the 432 cases of PTSD that you reviewed, how many did you review in favour of the client?

[John D. Larlee]

With PTSD cases, our favourability rate is greater than our average rate with respect to our cases.

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

Which means what?

[Dale Sharkey]

It's about 68% at review, and 42% at appeal.

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

So 68% at the review process are in favour of the client. Am I correct?

[Dale Sharkey]

That's for PTSD and major depressive.

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

In the management world or private world, if 68% were in favour of the review, then why were they denied earlier?

You see, my problem is--

[John D. Larlee]

But on the way the system works, at each level you have an opportunity to bring forward more evidence. At review, before our board, it's the first time the veteran, the member of the military, or the member of the RCMP has an opportunity to appear and give oral evidence. We are provided with all the additional information that was not necessarily available at their application to the department.

In other words, we have the benefit of that extra information to provide an opportunity to grant when it hadn't been granted before.

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

Right. I say this with great respect, but an awful lot of veterans who apply and are denied don't even bother trying again. Many of them just say, “Well, I tried, and they wouldn't do it.”

Many of them have supplied the medical evidence at the first stage. I've spoken to many of the lawyers who are advocating on behalf of these veterans, because DVA supplies them. The evidence they have in many cases I've seen is no different from what they've already been given. There's no additional information. They have two doctors who say they have this particular condition, and everything else, and there's nothing new to say.

I guess my problem is that if two medical doctors--and this is consistent now, because I advise all the veterans to do this--state and agree that a particular individual has this problem, and then VRAB denies them, how can VRAB not apply the benefit of the doubt when medical evidence already says that the individual has these concerns?

Can you walk me through that process? If you're an officer, and you see the medical evidence from the doctors, and yet you still deny them, how does that happen?

[John D. Larlee]

Keep in mind that when they come before the Veterans Review and Appeal Board they've already been to the department, and the department has given them a negative decision or a decision that's not as favourable as they would like it to be. Sometimes it's because they're not happy with the result and they want a greater entitlement or greater assessment. Because there are no time limits and representatives are provided for them at no cost, they bring cases before us.

To answer your question, when the case comes to the board the tribunal looks at everything--the oral testimony, the documentary medical evidence, and any witnesses. From that it determines whether there is sufficient evidence to establish the link between military service and the disability the person is claiming. Therefore, in every case, section 39 says they have to apply benefit of the doubt. If there is a doubt from all the material in there, they have to rule in favour of the veteran.

But in some cases there isn't sufficient evidence in the total of everything that's been received, unfortunately. We all consider and know the dedication and determination that all our Second World War veterans and Korean veterans committed for this country, as well as our serving military now. You won't find people who are more committed to the veterans than those on the Veterans Review and Appeal Board. It's a matter of having to operate within the legislation provided by Parliament, and we do what we can. We understand that there are cases where we are unable to rule favourably.

[The Chair, Conservative, Gary Schellenberger]

Thank you.

Mr. Kerr, please.

[Greg Kerr, Conservative, West Nova, NS]

Thank you very much.

It's nice to see you again.

There are a couple of things. I know evidence has come up, and this is one of the issues. Certainly the department has gone through a rather trying year, with a lot of questions and good suggestions coming forward on how business can be done better. You remind us that the appeal percentage is quite a small part of what the overall look is by the department. The majority go through without any difficulty.

There are two things here. One is what we call the traditional older vets. Have you found much of a difference in the availability of evidence from the older traditional vets compared to the modern vets--the ones who were in recent combat, and so on? Is it becoming a better process for availability of information, evidence, records, and that type of thing?

[John D. Larlee]

In general terms, I think the availability of service records are more detailed in the present day than they were for the Second World War vets.