Veterans Affairs Committee on April 20th, 2010

[The Chair, Conservative, David Sweet]

Bonjour à tous. Good morning, ladies and gentlemen.

Welcome to meeting number eight of the Standing Committee on Veterans Affairs regarding the new Veterans Charter.

We have two witnesses with us today: Sandra Pickrell Baker and Wolfgang Zimmermann. I'm going to call on them in a moment, but I want to just do some housework prior to that.

In our last meeting we had some concerns regarding documents. I promised I would look into it. I have just a couple of things I want to bring to your attention.

When witnesses are confirmed, they are sent a confirmation letter, which is called a confirmation of appearance, and it is explained very specifically—and by the way, it's also explained in both official languages—that if they have briefs that are necessary for their testimony, they must get them to the clerk ahead of time, and in fact a minimum of five days and a maximum to 10 days for the translation.

Also, from our Procedure and Practice manual, from the 2009 second edition, let me just read something to you:

The public has the right to communicate with a parliamentary committee in either official language, as stipulated in the Constitution Act, 1982 and the Official Languages Act.[575] However, Members sitting on a committee are entitled to receive documents in the official language of their choice. Committees usually adopt a routine motion to ensure that all documents distributed to committee members will be in both official languages. When a committee receives a document in one official language, the clerk of the committee has it translated into the other official language before it is distributed to committee members. Some committees specify in the motion that witnesses are to be advised of this rule.

And of course I've just read to you that in fact they are, but in writing, in the confirmation of appearance.

Some committees further prescribe that only the clerk of the committee is authorized to distribute documents to committee members.[576]

And of course there's a sample of that motion.

Section 4 of the Official Languages Act...and section 17 of the Constitution Act, 1982...give everyone the right to use either English or French in their dealings with Parliament. However, the right to submit a document does not include the right to have it distributed and examined immediately. Howard P. Knopf, who appeared before the Standing Committee on Canadian Heritage on April 20, 2004, took legal action against the Speaker of the House on this point. Mr. Knopf maintained that his rights had been violated when the Chair of the Committee, in accordance with the Committee rule requiring that any document distributed to members be bilingual, refused to distribute the documents that he had submitted in English only. The Federal Court ruled on June 26, 2006, that Mr. Knopf’s linguistic rights had not been violated and that the work of the Committee was protected by parliamentary privilege. Mr. Knopf appealed the decision to the Federal Court of Appeal, which dismissed it on November 5, 2007. He then appealed to the Supreme Court of Canada, which also dismissed it on March 20, 2008.

Quite simply, what was said last time is that individual citizens have the right to communicate with their member of Parliament in the official language of their choice. Members of Parliament have the right to retain those documents and carry them within the precinct as they choose. But when it comes to committees, if there's a document that the witnesses want to be distributed, it must go through the clerk, it must be translated, there must be five to 10 days allowed for that translation, and then it'll be given to every member equally in both official languages.

In regard to the document in question that started this whole process, I've been advised that by Thursday morning you will have the translation of that document from Captain (Retired) Sean Bruyea, and subsequently you can decide in a business meeting when you would like to have Mr. Bruyea return.

Yes, Monsieur Vincent.

[Robert Vincent, Bloc, Shefford, QC]

Mr. Chair, I'd like to ask you a question. I understand your decision and I feel that it is justified. However, as we were saying, when we are dealing with a document sent in by a witness, the document must absolutely be translated. We can't let in by the back door. We cannot do indirectly what we are not allowed to do directly. For instance, instead of sending documents to the clerk, sending them to members through the Internet. The outcome of that is that only some members would have the document. I would just like to say that witnesses are not to send documents over the Internet but they really are to send them to the clerk. I wanted to make sure that things will be done properly.

[The Chair, Conservative, David Sweet]

Again, Monsieur Vincent, that goes to--rather than the practice and procedure of the House--the freedom that a Canadian citizen has to send information to an MP who represents a riding, whether it's their riding or any riding in the country.

Your comments are noted, though, that we try to ensure, in terms of a collegial agreement, that all documents are funnelled toward the clerk and then made available to everybody as best as possible. I would consider that a notice of professional courtesy, there's no question about that.

If there are no further comments, I will move to my second point for the meeting today.

Our researcher did a great job of sending a second document as well as briefing notes, which are entitled “Study of the Implementation of the New Veterans Charter: Progress Report”. He has indicated some places where more evidence is required.

I hope that today, just as I mentioned last time, you try to focus your questions on the new Veterans Charter. More specifically--for our analyst--try to focus on the areas where there are some gaps so that we can have a fulsome and robust report when we've finished all of our inquiry.

Without any further delay, we will....

Madam Sgro.

[Judy Sgro, Liberal, York West, ON]

Thank you, Mr. Chair.

Last week there was reference made to 260 recommendations that had been made via the Veterans Charter. I had asked that it be distributed to the committee.

Can you make sure that we get that in time so that we can look at the recommendations as we ultimately go through this document?

[The Chair, Conservative, David Sweet]

The analyst has offered his service in the sense that rather than sending 260 recommendations, which would be very confusing, he would do the work of trying to put them into categories. He would send them out to us in that way.

[Judy Sgro, Liberal, York West, ON]

Terrific.

[The Chair, Conservative, David Sweet]

That will take a bit more time, but it will give us some us logic to the formation.

[Judy Sgro, Liberal, York West, ON]

That's a great idea.

Thank you.

[The Chair, Conservative, David Sweet]

I take it, Madam Pickrell Baker and Mr. Zimmermann, you both have opening remarks--obviously having different subjects.

We will go to Sandra Pickrell Baker first, for opening remarks of 10 to 15 minutes.

Then we'll go to Mr. Zimmermann, executive director of the National Institute of Disability Management and Research.

Madam Pickrell Baker.

[Sandra Pickrell Baker, As an Individual]

First, thank you for inviting me.

I am a graduate of Mount Saint Vincent University in family studies, and I am presently a graduate student in social work at Dalhousie University. I completed my thesis on the experience of the female partners of male military veterans diagnosed with post-traumatic stress disorder. That was defended and passed last summer.

I wanted to study veterans with post-traumatic stress disorder because I have a daughter who struggles with the complications of it and I was aware firsthand of the challenges the family faces in dealing with this. I was struck by the fact that if the parental relationship struggles, I couldn't imagine--and was interested in discovering--what it would be like in an intimate partner relationship.

I interviewed women whose partners had been diagnosed with post-traumatic stress so I could understand what they were experiencing and how they were navigating their experience. I had hoped to find how they were resilient, what they were using as coping mechanisms and strategies, so in some way I would be able to duplicate that or, in hearing the story, bring to life the realness of this situation. But what I found was not the resilience I had hoped to find in these families. I heard stories of extraordinary hardship.

One of the most striking things for me was that most of the participants didn't know there were resources available to them; that OSISS has outreach support, and they could get support through Veterans Affairs. There was one family that had been able to access support through the VA. All of the other families did not know they were able to do this. So I was able to put them in touch with that support, which was helpful if they weren't in a rural location. When they were rural families, that access was not possible.

As I said, the devastation I heard about was difficult, but I think in hearing their stories I realized the importance of what these families are going through and how it needs to be more broadly known what they're struggling with.

One of the big things I was struck by was ambiguous loss. These women would talk about grieving the man who went off to war and didn't come back; that a different person had returned with a different personality, a different way of coping, and a different way of being in the family; and how the family had to adapt and adjust around that, and the strain that put on the families. Most of the families didn't survive staying in the same marriage. They weren't able to adjust and find a way of being. So the redefining of the relationship just stretched it beyond their capacity to function.

One of the researchers I studied extensively was Charles Figley. You probably all know of him. He said the most important thing in an intimate relationship where somebody is diagnosed with an operational stress injury or post-traumatic stress is that the intimate partner is able to maintain good boundaries and good self-care. In most cases these women were also responsible for all of the family rearing and the functioning of the family, so maintaining self-care and personal boundaries was not an option. That led to the detriment of the family itself.

I had a few recommendations that came out of the study. The first, of course, was that the intimate partners need to know there are resources available to them. They can't be reliant on the veteran seeking support and bringing home the knowledge that they can receive support. It's just not widely known that they can go through OSISS or get support through the VA.

One of the women desperately wanted to seek out psychotherapy. They lived in a rural town. The only way they could get psychotherapy eventually was because her mother passed away and left them an inheritance. His diagnosis didn't happen before he was released from the military, even though he had been in Bosnia three times. She was working full time to try keep the family functioning. Because he hadn't received his diagnosis until after he was released, he wasn't receiving a disability pension. Financially they could only afford psychotherapy for him once her mother passed away. They used that inheritance for him to receive private therapy. The forms he needed to fill out to access a disability pension sat on the counter for six months because he wasn't able to function well enough to fill them out and get them in.

One of the recommendations I have for these families is that after letting them know there is support available, they need a case worker. They need somebody who can work with them to make sure that the forms are filled out, that they know there is access to support, and that these things are out there. The sooner they can get support, the less entrenched in the family system this will become, and the less likely it will lead to the devastation of the family.

A whole other area that needs to be explored is the children who are dealing with parents who are suffering with this complication. It changes everything in the family. It is not and was not a happy story. There were no happy endings. There were families dealing with significant loss on all levels.

There were two families. One was still struggling to find a new balance; the other one had found it. They had been married for a long time before he developed PTSD, and I think for her it was coming to an acceptance of the new person who was. She said she was able to fall in love with the new man, but the person she married was no longer. I don't think we can undervalue that loss, that grief, of the person who was and the person they became.

On family support, I'm not sure how you navigate it or make these families aware of the warning signs without becoming hyper-vigilant and leading to the possibility of the lay person misdiagnosing their partner as having PTSD when they're just having a bad day or a bad week. There needs to be more awareness and less stigma around mental illness in the military and in society in general, of course. But in the research I did it seemed to be specifically difficult for these men who went away.

One woman said, “If he had come back missing a leg he would have been seen as a hero, but because he came back unable to come out of his bedroom for three days at time, everybody just thinks there's something wrong with him, that he just needs to suck it up.” That is sad, because the injury is as valid as losing a leg or a limb.

We need to listen to the families express what they need. All families are individual, just like we are, and they need to know that the resources are there. But they all had specific needs, depending on the ages of the children and whether the partner had been diagnosed before he left the military. A lot of them needed to go through to get that diagnosis.

One family actually had to sue to get the medical records. The husband had been diagnosed before he left the military but was never told. They only found out that he had been diagnosed after they sued to get his medical records, where it had been documented. That made a difficult situation even more difficult for them.

That's all I have to say for now.

[The Chair, Conservative, David Sweet]

Thank you, Madam Baker.

Now we'll go to Mr. Zimmermann.

[Wolfgang Zimmermann, Executive Director, National Institute of Disability Management and Research]

Thank you, Mr. Chairman, honourable members of the committee, ladies, and gentlemen.

First, I'd like to express my sincerest appreciation for the opportunity to be here before you and to offer some thoughts on expected rehabilitation outcomes for disabled veterans. My comments today are structured into four basic elements: personal experience, consideration of the disability context, what we can achieve with effective return-to-work interventions, and potential opportunities I think you may wish to consider going forward.

My personal experience with a permanent disabling injury dates back to June 1977, when as a 20-year-old graduate from a polytechnical institute, I joined the workforce of MacMillan Bloedel, then Canada's largest forest products company and British Columbia's largest employer. I was given a power saw and a pamphlet showing how to fall trees and was told “good luck”. The fifth day on the job, a 50-foot alder tree I was cutting split and came down on me. It broke my back and left me with a significant spinal cord injury.

Whether causation is a result of military service or some other industrial accident or is not related to an occupation, the impact on the individual and the individual's family and the required rehabilitation measures are identical. This brings me to the overriding outcome we are trying to achieve for the individual, namely, maximizing participation of the disabled individual in all aspects of our society, economically, socially, and recreationally. I was most fortunate to have been given that opportunity, and hence I'm privileged to be here with you today.

While I understand most of the contentious elements of the current Veterans Charter, since I have had the privilege of being chair of the premier's council for persons with disabilities in British Columbia and spending over six years on the board of the B.C. Workers' Compensation Board--not dissimilar to Veterans Affairs, as the occupational injury carrier for disabled veterans--my comments should not be seen as a reflection of current circumstances, although I'd be most happy to comment on them, but rather as a standard for future development that you may wish to consider.

Key to my rehabilitation was my almost immediate ability to continue productive participation in the workforce, a result of the company accepting full responsibility for the accident and collaborating with the union to develop a creative opportunity for my ongoing employment relationship, even though I was in a wheelchair and there was no precedent for doing this in a logging camp of 450 workers on the west coast of Vancouver Island.

This being said, having strategies aimed at immediately maintaining the ongoing economic and social productive capacity of the disabled individual is critical for both the employer, in this case the Government of Canada, and the disabled veteran. There is an overabundance of national and international evidence to support the strategy specifically if the conundrum of successfully maintaining an ongoing employment relationship is solved. Many of the associated corollary psychosocial issues, whether they be long-term mental health concerns, dependencies, or other social challenges, will be largely mitigated.

Hence, there needs to be a clear understanding from our perspective that the Government of Canada is the employer of disabled veterans and that it has an unequivocal responsibility for their continued employment. In our opinion, there's absolutely no valid reason, given the scope and scale of government operations, for not accommodating the overwhelming majority of disabled veterans within the diverse range of government departments.

Having been employed by MacMillan Bloedel and Weyerhaeuser Company, which purchased MacMillan Bloedel in 1999, for the past 34 years--I'm currently on an executive secondment to the National Institute of Disability Management--I can assure you that the challenge for private sector companies, even large ones such as Weyerhaeuser, is significantly greater when it comes to successful accommodation of disabled workers.

Effective return to work and disability management interventions for disabled veterans require strict adherence to substantive adoption of three core principles. Creativity: no two situations are ever quite alike. Collaboration: successful reintegration of disabled veterans requires absolute participation by all stakeholders. Commitment: leadership at all levels and full acceptance of responsibility is key. Without this being spelled out clearly, nothing will happen.

When this was made as a requirement across our North American operations for Weyerhaeuser, it was due to the leadership of the chief executive, who said every one of our workers deserved the dignity of participating in the workforce and being a full and complete member of society, and we had at that time 65,000 employees in North America.

Honourable members, I would suggest that the above core principles, and for that matter all of the presentations, be measured against the overriding objective; namely, how do current policies, procedures, and actions contribute towards maximizing the human and productive capacity of disabled veterans, how do they optimize their continued successful participation in all aspects of our society, and what evidence is being presented to you to support achievements towards this objective? Failure to support and ultimately achieve these objectives forces many disabled veterans, not unlike disabled individuals in general, to the margins of society economically and socially, with all the inherent tragedies, which are well documented around the world.

We know from the U.K. that the suicide rate for individuals who are disabled and unemployed is 40 times that of the average population. Significantly lowered employment participation rates compromise personal and family circumstances and bring much higher reliance on our health care system and significant psychosocial compounding of existing physical impairments.

Incidentally, these issues are not limited to disabled veterans but broadly apply to people with disabilities generally in Canada and around the world, which is why I'm personally very pleased that Canada recently ratified the United Nations Convention on the Rights of Persons with Disabilities.

Going forward, my specific suggestions to you are: recognition by the Government of Canada of its employer responsibilities for disabled veterans; commitment towards implementation of best practice return-to-work and disability management programs, using internationally recognized and adopted optimum practice standards; optimizing holistic rehabilitation outcomes when internal accommodation may not be possible, through, I'm suggesting to you, creative partnerships--for example, with the Canadian Council of Chief Executives for the hiring of disabled veterans; raising awareness on the issue of disabled veterans, for example, by working with the Canadian Labour Congress to allow them to understand the issues faced by disabled veterans in trying to re-establish themselves; and using the rehabilitation departments of provincial workers' compensation boards, whose staff have intimate jurisdictional knowledge of all relevant issues relating to optimizing successful rehabilitation potential for disabled workers.

To reinforce this point, WorkSafeBC, on whose board I had the privilege of serving for over six years, annually deals with 1,500 to 2,500 permanently disabled workers and employs almost 100 professional rehabilitation staff whose primary mandate is optimizing the long-term successful integration of disabled workers. This process is already being used for federal government employees generally and is governed under the Government Employees Compensation Act administered by Labour Canada, and there seems to be no reason why this could not continue.

In summary, honourable members, I would like to thank you for the opportunity to speak. I encourage you to take all necessary steps in ensuring that, for those individuals who have suffered a disabling condition while serving our country, this unfortunate stroke of fate does not relegate them to the margins of our society in perpetuity.

Thank you very much.

[The Chair, Conservative, David Sweet]

Thank you, Mr. Zimmermann.

Now we'll go to our rotation of questions. The first round is seven minutes.

Mr. Oliphant.

[Rob Oliphant, Liberal, Don Valley West, ON]

Thank you both for being with us today in this study we're doing.

I find it interesting, and I think, Mr. Zimmermann, you're going to the heart of what the new Veterans Charter was meant to accomplish: moving towards a reintegration into the workplace, into family. That's the core of what it's meant to do, and Ms. Pickrell Baker, you are pointing out that the implementation of it may not be working. The motivation is there, but we may have to work out some practicalities.

So I have two questions. The first one has to do with case management, which is really I think what you were talking about at the core of your remarks. We met earlier with the Canadian Association of Occupational Therapists, who talked about their model of case management being holistic, bringing in a variety of caregivers and professionals, including TT, healing therapy and touch, which I know you are involved with, social workers, medical workers, and pain management people.

Is that what you are pushing towards, some centralized forum where a family knows they have one caseworker to go to, and that it is very locally administered? I don't want to put words in your mouth, but is that what you're going towards?

[Sandra Pickrell Baker]

I think the interdisciplinary approach is certainly what the medical model is moving toward.

My internship this year has been with an interdisciplinary approach in the school systems. One caseworker brings the case, and if necessary the family as well, to this round table discussion, because not everybody needs the same things. But the resources are there, and there's no longer the turf war of this being mine or that being yours or they need this, and then they slip through the cracks. If everybody comes around the table and says, “Here's the case, and I can look after this, if you can look after that,” it's more likely that their needs are going to be met in a more efficient way, rather than putting resources in place that aren't needed, and being able to use resources that are. Does that make sense?

[Rob Oliphant, Liberal, Don Valley West, ON]

Yes, and you seem to be looking for a more proactive approach vis-à-vis the spouses and families. It couldn't be a reactive approach. We need a better system of proactivity.

Is that it?

[Sandra Pickrell Baker]

The more proactive we are, the less likely that the dysfunction in the system becomes so entrenched and that we lose the whole family system, that the family falls apart.

The biggest thing about whether the family can continue functioning is whether they are able to adapt and adjust. How they are able to adapt and adjust is completely related to what resources are available to them, not just internal but external.

Not every family's need for resources is going to be the same. I think that's where we need to allow them to identify what they need: Is it that they need a caseworker to help them fill out these forms so they can get the proper diagnosis and access for the partner to receive support? Is it that they need somebody to come and give respite so that the children and the mom can go away, or that the children and the dad can go away for a few days and get some alone time to build on their relationship, rather than always being in that crisis management with someone who is in crisis, especially with a mental illness?

[Rob Oliphant, Liberal, Don Valley West, ON]

Right.

There has been a move to more work in larger regional centres, as opposed to smaller community centres, and I think that's problematic.

Unless we have professionals in all those communities, kind of like EAP does, it seems to me we need a much more regionalized system, as opposed to large centres where people are phoning and getting frustrated.

[Sandra Pickrell Baker]

As I said, the one family I had that was specifically very rural couldn't access the support. Financially, it meant they would have had to drive an hour and a half to Halifax to access this support, pay for the support, and then drive an hour and a half back.

He couldn't drive himself and she had to work. So it becomes--

[Rob Oliphant, Liberal, Don Valley West, ON]

Anecdotally--I don't have data on this--I suspect that members of the Canadian Forces disproportionately come from smaller communities and rural areas. They may return to those areas after service.

I don't have data on it, but I just sense that's the case. So our system needs to honour that.

[Sandra Pickrell Baker]

That's where they're going to get the most support, where their family is accessible. They're going to need to be in an environment where that resource is available to them. However, in this case, it limited the resources available through the military system.

[Rob Oliphant, Liberal, Don Valley West, ON]

Mr. Zimmermann, a big part of the new Veterans Charter has been to move towards a lump sum payment for disability, with the goal to lessen dependence in the model. The minister has repeated several times lately that it's meant to be twofold: a lump sum payment and a pension while they are experiencing the rehabilitation part of their program.

Could you comment? If we're looking at best practices in disability management, at reintegration into society, socially, economically, recreationally, and culturally, what are your thoughts on our relatively small lump sum payment compared to, let's say, Britain, and our current system with that income replacement model?

[Wolfgang Zimmermann]

In terms of the lump sum, workers' compensation boards tend not to do that. I'll obviously speak from the British Columbia experience, where the agency is very large, but they all have roughly the same structure across the country. We only commute up to 5%. That means an individual can only get a lump sum if the pension assessment is at 5% based on the physical or the impairment chart. That level has been set simply because at 5% it's considered to be not critical to the continued economic existence or--

[Rob Oliphant, Liberal, Don Valley West, ON]

It could be a partial hearing loss or something.

[Wolfgang Zimmermann]

It could be those kinds of things. That's exactly right.

Even major insurance companies such as the insurance company of British Columbia, for example, have moved towards structured settlements, and those are the ones we are seeing.

Some other jurisdictions do have lump sum payments. The Australian workers' compensation boards, for example, still have lump sum payments, but they are always paid out as structured settlements, because there's overwhelming evidence that...it's almost like winning the lottery for a lot of individuals. All of a sudden the resources have been used up and all of a sudden you come into a whole lot of money. It's just the reality of our world that if you have a lot of money, you're going to find a whole lot of friends who are going to help you spend it. That's just the nature of how this is going to work. That's why that approach is not being used. There are some very fixed targets around that aspect.

In terms of rehabilitation and return-to-work expectations, I had the privilege of being involved with the design of the Veterans Charter. In many instances I use my own personal experience, and from my perspective, if I hadn't been able to get back to work six months after my accident, even though there were a horrendous number of challenges, I just wouldn't be here. It is absolutely vital for the individual to be able to maintain a place in society where they can deal with their friends and colleagues and where they can forget about that. I think the point that Sandra made is absolutely key in terms of the family. I found that being able to work and to continue and not to sit between your own four walls had a huge impact on all aspects of health, whether psychological health, social health, or involvement in recreation.

I carried on for a year with physiotherapy while I was working, and that was accommodated. You can imagine that 33 years ago, the notion of accommodation didn't really exist, especially in a logging operation on the west coast. Accommodating somebody who has a broken back--well, nobody had ever heard of that before. I think that is where this is absolutely vital. From our point of view, it's that immediate link, because all of a sudden you're dealing psychologically with a significant life altering disability. This is not something that's going to go away; it's something, to be crass, that you go to bed with and you get up with in the morning, and to face a significant level of economic loss on top of that of course compounds it. If you have essentially what this amounts to--hope of being able to participate, of being able to support your family, and in some measure of being able to continue in society as a contributing member--it's key to your mental well-being as well as your economic well-being.