Veterans Affairs Committee on Feb. 14th, 2011

[The Chair, Conservative, Gary Schellenberger]

Very short.

[Brian Storseth, Conservative, Westlock—St. Paul, AB]

It has to do with our modern vets' cognizance of the paperwork. They see the frustration of former vets who, say, jump off a truck, sprain their knee, and continue to soldier on; down the road, they are denied their claims because they don't have the proper paperwork.

I think that's something we really do need to work on. We've heard a lot of that in these hearings with our veterans. I hear a lot of that on the ground.

You know, the paperwork can be very burdensome, if you actually want these guys to continue to soldier on.

Thank you for your time.

[The Chair, Conservative, Gary Schellenberger]

Thank you.

Mr. André, for the last question, please.

[Guy André, Bloc, Berthier—Maskinongé, QC]

Good afternoon. I will be quick, since we have to be quick on the draw around here.

What are the major reasons for rejecting disability claims related to operational stress? What are the most common reasons?

[John D. Larlee]

One of the most common reasons is that there is not enough evidence.

There's insufficient evidence on which the tribunal can establish that there should be a different result from what was obtained at review.

[Guy André, Bloc, Berthier—Maskinongé, QC]

Despite medical expertise? If I have the medical expertise, can I be rejected? If, for example, I can give an operational stress diagnosis based on my medical expertise, and my claim has been rejected once, can it be rejected a second time?

[John D. Larlee]

Yes, it is possible, because not all medical expertise is credible.

The tribunal, being a quasi-judicial tribunal, weighs all the evidence. If there are multiple medical reports...or even not multiple medical reports; the tribunal members evaluate all the evidence, including medical reports. They also, as I stated earlier, have received instructions from the Federal Court on how to determine whether the medical opinion is credible.

That's not to say that they're questioning the doctor's ability to provide an opinion, that they're questioning the doctor's ability; it's whether or not the opinion addresses the necessary criteria. There may be more than one in an individual file, and therefore, with that and the other evidence in the file....

When I talk about “evidence”, I'm talking about documentary evidence, I'm talking about oral evidence, I'm talking about expert evidence.

[Guy André, Bloc, Berthier—Maskinongé, QC]

I have met with a number of veterans, because we have received a few claims like that. They are becoming completely discouraged with the system.

First, there is the refusal rate of first-time claims. I'm relying on the percentages you provided today. I'm guessing they are true, but we have seen much higher refusal rates.

As my NDP colleague said, these people often just end up giving up. People with PTSD feel vulnerable. You must be familiar with the issue of low self-esteem. They are in a very vulnerable position and they feel like they have to fight a whole system, a huge organization. That's quite something! They need lawyers, they need to be able to defend themselves.

As a way of self-evaluation, an evaluation of your own practices, could you make any recommendations to improve the system so that it is less overwhelming for those who are trying to get disability benefits?

You talked about the training of the board members. Could we go beyond that and develop new tools, gain more expertise to be able to tell whether the person before us has a diagnosis, a history? Do you understand what I'm trying to say? The refusal rate should be lower.

What are your recommendations to improve the effectiveness of your work? I think we can question it. I am looking at the numbers and I think that we can question the degree of effectiveness. Couldn't we be more effective?

[John D. Larlee]

With respect to the way the tribunal deals with all applicants, and especially those with mental health issues, we are conscious of trying to make it more comfortable for them. We work with their representatives to be accommodating to their needs at the hearing. We also try to obtain as much information as possible about their individual situations, because each case is dealt with on its own merits. Therefore, we're always working at ways to become more efficient.

[Guy André, Bloc, Berthier—Maskinongé, QC]

Yes, but 40% of claims are rejected.

[The Chair, Conservative, Gary Schellenberger]

Keep it short, Mr. André.

[Guy André, Bloc, Berthier—Maskinongé, QC]

I have always wondered whether it was a question of how competent the board members were or a question of political will in order to reduce disability, to cut access, as it was done in the case of social assistance and in other sectors, to make profit and save money.

[John D. Larlee]

It's not at all a question of competency of members.

[Guy André, Bloc, Berthier—Maskinongé, QC]

So it is a question of political will.

[John D. Larlee]

We interpret the legislation and do our best to review the decisions of the department to the benefit of the veterans. That's our role within that framework.

We understand the frustrations of veterans. We're committed to improving our own methods to provide them—

[Guy André, Bloc, Berthier—Maskinongé, QC]

So 30% or 40%...

[The Chair, Conservative, Gary Schellenberger]

Hang on.

[Guy André, Bloc, Berthier—Maskinongé, QC]

Please let me finish.

[The Chair, Conservative, Gary Schellenberger]

We've already gone over six minutes.

[Guy André, Bloc, Berthier—Maskinongé, QC]

There are 30% to 40% refusals. If we got down to 5% the first time and somewhat improved our... It seems to me that we could be more effective.

[The Chair, Conservative, Gary Schellenberger]

The chair wants to get clarification on one thing.

VRAB does not decide if a client has PTSD or not, correct? You don't decide whether or not that client has PTSD. That's done by a medical expert beforehand, and that comes to you. When that person comes to you as a PTSD patient, you already know that.

[John D. Larlee]

Normally there would be a diagnosis in the file. It would have gone to the department. The department would have made a decision on whether or not to accept that the individual had the condition.

If they are not satisfied with the decision of the department, that could come to us. We're not bound by the department's decision. We would have a fresh look at it with whatever other evidence is out there, whether it's an additional medical opinion to confirm or whatever. And we could overturn it.

[The Chair, Conservative, Gary Schellenberger]

Okay.

Thank you for your testimony today.

With that, the meeting is adjourned....

Yes.

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

Mr. Chair, just before you hit the gavel, I have a point of order.

The individuals, the two folks in question, said something that I thought was quite incredible for this committee today--namely, whether or not the medical evidence was credible. We heard that there's only one, maybe two, on the board with any kind of medical experience. I didn't hear the word “doctor” there.

I'm wondering if it's at all possible for the director general to provide us with a list of the 24 names and their backgrounds. I find it rather incredible, and I'm sure your office has gone through this as well, that when you have two medical doctors, in a file for a veteran, sending it to the Veterans Review and Appeal Board, and their medical evidence.... They're being questioned by people who have no medical practice.

I just find it a little bit incredible that they...and they actually admitted that; they said they have to question the credibility of the medical evidence. The only people who can do that are other doctors, in my opinion; but I'm not a doctor, so I don't know. It would be very helpful for the committee if we could get the list of all the names and their backgrounds. For myself, I just find it rather incredible that people with no medical background can question doctors' medical evidence.

[John D. Larlee]

We can provide Federal Court decisions to that effect, Mr. Chairman.