Veterans Affairs Committee on Feb. 26th, 2015

[Sylvain Chicoine, NDP, Châteauguay—Saint-Constant, QC]

If I understood correctly, the number of consultations is limited.

[Michel D. Doiron]

We are talking about 20 sessions. The person can call the 1-800 number. We work in partnership with Health Canada.

[Sylvain Chicoine, NDP, Châteauguay—Saint-Constant, QC]

Suppose an individual is entitled to medical care on the military base and is released for medical reasons related to his service. I imagine that in that case, the individual no longer has any access to the resources provided by your department.

Is there some kind of follow-up involving the professionals treating that person?

[Mélanie Witty]

The Montfort Hospital has a centre where active members of the Canadian Forces are treated. There are six case managers and six nurses. When a member's case is assigned to them, they get in touch with us directly. When a member whose case is considered complex by National Defence is releasing and the release date is not known, we are invited to take part in a case conference with the psychiatrist, the psychologist and everyone in the department who is involved. We supplement the care team.

We take part until the individual is released. There are excellent hand-offs and the Canadian Forces team at the Montfort is our main partner. We are in touch with the people on that team on a daily basis because we share the same clients. They see that the release is coming and they are concerned. They need Veterans Affairs Canada to take over managing the case.

[Michel D. Doiron]

If an individual with special needs lives in Ottawa, Quebec City, Montreal, Halifax or Fredericton, it is much easier to find appropriate care for him than if he lives in, say, Edmundston, New Brunswick, which is not my hometown, but the city where I grew up.

The Canadian Forces hand off cases to us, but in some instances, our partners in the Canadian Forces have supported us, even though the person was no longer a member of the forces. In the case of Fredericton, for example, the province could not provide a psychologist, so the psychologist at the base in Fredericton looks after veterans. Our partners in the Canadian Forces help even in the case of people who have been released.

In short, people have the right to live in the regions, but it is more problematic.

[Sylvain Chicoine, NDP, Châteauguay—Saint-Constant, QC]

I imagine that a soldier's medical file is automatically transferred to you when the soldier becomes a veteran.

[Michel D. Doiron]

It is not automatic.

[Sylvain Chicoine, NDP, Châteauguay—Saint-Constant, QC]

I know that in several cases, people said they had been medically released. The Canadian Forces doctors had readily recognized the injury, which was then denied by Veterans Affairs. I have heard of several similar cases. In fact, if you don't have the medical file, I imagine that it becomes impossible, because you don't have the Canadian Armed Forces doctor's diagnoses. I'm very concerned about that.

I'd like you to comment on that. I think it is sad that a veteran should have to fight to have an injury recognized when the Armed Forces doctors recognize that injury and the fact that it is service-related.

[Michel D. Doiron]

In my opinion, the most common problem is not recognizing that there is an injury, but the relationship with the individual's service. If the doctor tells us that Michel tore the ligaments in his knee, we'll accept that. If we really have doubts, we'll refer the file to the doctors who work for us to find out what the X-ray shows.

That is generally not the problem. The problem is determining whether the injury can be considered service-related. Often that is the biggest problem. Sometimes, even if someone says they have a certain illness, we have three different opinions. That can happen. I'm not saying it never happens. Often, it is the service relationship.

We try to say “yes” as much as possible. People think we have a negative philosophy, but that's not true. People really try to get to “yes”, but the law is very clear: the injury must be service-related. Unfortunately, some soldiers of a certain generation don't document their files. You can ask the Canadian Forces. Often when we study a case, it seems reasonable, but when we delve a little deeper, we realize there is no documentation. Then there are serious problems.

[The Chair, Conservative, Royal Galipeau]

Mr. Hayes, you have the floor.

[Bryan Hayes, Conservative, Sault Ste. Marie, ON]

Thank you, Mr. Chair.

You have my permission, sir, to please stop me at my six-minute point. I will respect that. Thank you kindly.

Madam Witty, you obviously have a lot of experience. Given your experience, can you answer whether you think SCAN should be mandatory?

[Mélanie Witty]

I know for a fact that if they are mandatory, a great deal of the clients I help can still not attend.

[Bryan Hayes, Conservative, Sault Ste. Marie, ON]

That being said, do you think, given your experience, that they should be mandatory? I am not asking whether it is possible for them to be mandatory, because in certain circumstances I understand that this is probably not possible. Given your experience, would it be beneficial, in your opinion, that this be mandatory?

[Mélanie Witty]

This is a good-to-know.

[Bryan Hayes, Conservative, Sault Ste. Marie, ON]

Okay. Thank you.

[Mélanie Witty]

If DND wants to make it mandatory, it's up to it.

[Bryan Hayes, Conservative, Sault Ste. Marie, ON]

You wouldn't be disappointed.

[Mélanie Witty]

You know what? I presented on Friday, and we had 300 participants. I am presenting next week, and we'll have just as big a crowd.

[Bryan Hayes, Conservative, Sault Ste. Marie, ON]

I want to get an understanding, Mr. Doiron, of the transition exit interview. I have never experienced it, and I'm sure probably my sister, her husband, and my father did. I really don't know. What happens at an exit interview? What do you discover through an exit interview? Are there signals that would...? I think you know where I'm going with this.

[Michel D. Doiron]

Absolutely.

During what we call “the tran”, the transition interview, that's when a client service agent will sit with the CF member—they're still in CAF—and go through a questionnaire with them and ask them certain things, and try to establish their risk. We'll ask if they've been injured. We like it when they bring their health files, but they have to request them. We can't. We can go through the process with them.

It's outside the SCAN. There are 300 people at the SCAN. Mélanie talks to a crowd. That transition interview is a one-on-one interview with the individual. Hopefully you bring your family. We encourage strongly, but some do, some don't. So you go through it.

If the client service agent realizes...Medically releasing, it's a case manager; for all the other regular forces, it's a client service agent. So the case manager will go into much more depth with the medical releasing, because we already know you're releasing because you can't meet universality of service. There's already a premise for your leaving. In the other cases, we don't know, so we're going to look at it, and as Mélanie discussed in the SCAN, we're going to ask what do they want to do once they're released.

If you have 35 years of service and you're 50, 52, 53 years old, you may be very happy to take your pension. However, in the case that Mélanie was showing, which is someone with nine years of service, you do have to live and support your family, so employment becomes very important. We ask those important questions: around the family, as Mélanie highlighted, around health, around their career—what they want to do. We encourage them to apply for rehab. Everybody should apply for rehab within that 120 days. It keeps their rights open long term, so we encourage them to apply for rehab. They have that discussion.

If it's not medically releasing and they realize this person's at risk based on what they're saying—stress injuries or mental health injuries—there are signals, and I'm not a health care professional, but the health care professionals can recognize them—they will refer that individual, even if they're not medically releasing, to a case manager to go more in depth and to ensure they have a case manager.

We are working...and you made recommendations on the ACVA report on transition. There's also a joint steering committee on ACVA that I co-chair with General Millar, where we are really trying to eliminate that seam, because there is still a seam, and I know our two ombudsmen are also looking at transition currently: how can we facilitate that for the member, from a member's perspective, not from VAC's perspective. At the end of the day it's not VAC, it's for the retiring veteran. For regular forces that is mandatory.

[Bryan Hayes, Conservative, Sault Ste. Marie, ON]

Much is focused on a medically releasing veteran, especially when you talk about rehab, or vocational rehab. That to me is to find a new vocation. So if you're not medically releasing, are you entitled to voc rehab and tuition training and education?

[Mélanie Witty]

The rehabilitation program has two gateways. The first one, the straightforward one, you're 3(b) releasing, whether it's for diabetes or gout.

[Bryan Hayes, Conservative, Sault Ste. Marie, ON]

What's 3(b)?

[Mélanie Witty]

Medically releasing. You're automatically eligible for this program, whether it's for diabetes or gout or high blood pressure.

[Bryan Hayes, Conservative, Sault Ste. Marie, ON]

If you're not medically releasing?