Thank you, Mr. Chair.
I'm speaking to you both as a client of VAC and a former secretary of the career medical review board for non-commissioned members. Serving on the board provided me with knowledge and experience of how the military determines the nature and extent of any medical condition and how it affects military careers. Ultimately, the board decides whether to retain or release military personnel and it was my job to inform those people affected by the board's decisions.
The board is composed of personnel, known as career managers, who were responsible for assigning personnel to jobs and ensuring that the Canadian Forces had enough people to do its work. The board was advised by a medical doctor who could translate medical information into layman's terms. If the board's recommendation is that the member is expected to be released from the forces, the board ceases consideration of the case and issues a notice of intent to the member via the chain of command. The member has 14 days to respond, and it is normal for a member to be granted more time to respond if needed. The member has three main inherent rights within the procedure: notification, the right to know what is happening; disclosure, the right to see all material that the board has; and representation, the right to respond to the board's decision.
It is important to understand how the board works because it significantly differs from the VAC process. When I was diagnosed with PTSD in 2000, I was subject to a review board for officers. The severity of my condition warranted a medical release because I was not in compliance with the universality of service requirement, being severely ill or injured. Members with permanent limitations who do not comply with the universality of service principles, and who are severely injured or ill and have complex career transition needs, may be retained in the CAF for a period of transition of up to three years. These members work one-on-one with the multi-disciplinary transition team to develop a tailored and flexible plan that features comprehensive health care and social and career transition support. In preparation for release, the member is entitled to a range of transition services and benefits available through various CF agencies.
This is what it is today. It wasn't true in 2000. In 2000, I worked with a transition team here in Ottawa to prepare for my retirement. This included applying for citizen benefits from both VAC and SISIP. It seemed that my transition would be relatively smooth at first. I was enrolled in a training program with SISIP and started to receive financial benefits to augment my military pension. My first indication that there was a problem was when I was informed of my level of disability by VAC. It was quite a shock to learn that my medical condition was said to be minor. Based on the VAC assessment, I could still work with some limitations. This was clearly at odds with the military assessment of severe disability. I checked with my good friend and former colleague, Sean Bruyea, who advised me that I was experiencing the common process practised by VAC, known as low-balling, in which clients are given a much lower disability level than they deserve.
For example, the usual threshold for operational stress injuries is 25% to 30% despite the fact that VAC recognizes that OSIs are difficult to assess and their severity may fluctuate drastically based on a wide variety of factors. A veteran may exhibit anything from rare signs of distress to over-evidence of the disease, chronic psychotic illness. One of the major problems in determining the severity of a condition is that there is too much subjective assessment and a lack of standardization in methodology. Professional therapists are aware of the challenges. The lack of appropriate services for people with serious mental illness is increasingly recognized as a systemic problem.
So began a very traumatic battle to change my disability assessment, which is still ongoing today after more than 15 years. In my opinion, the appeal process is horrific, and regardless of what medical conditions a client may have had, during the appeal process they can develop a traumatic condition. Why is it so traumatic?
Well, this is the perception of VAC:
What we found in the pension system was it was a kind of perverse system, in effect, because we had quite a large number.... We took a number of files between 1998 and 2002 and looked to see how many people were coming back to us for additional pensions. People were making this their life's work. We had people coming back anywhere from 9 to 17 or 18 times, looking to boost a pension.
That was testimony given by the former deputy minister Jack Stagg to this committee.
It has taken me years to change my disability level, during which I have been hospitalized three times, arrested several times under the Mental Health Act of Ontario, and have actually been ordered to leave the Ottawa VAC district office or be arrested. I have been denied the services of the VAC lawyers and exhausted the appeal process. I am left with one option, which is to challenge VAC in a federal court, which could cost $25,000 or more. In addition, my client information has been shared by VAC employees, contrary to the Privacy Act. All of these experiences have contributed to the worsening of my condition.
Of note is that SISIP assessed me as permanently disabled, based on my military medical file, long before VAC grudgingly determined that I was totally and permanently impaired. There has to be a better method employed by VAC to ensure that there is continuity in the determination of the nature and severity of the medical conditions of every client before the end of the three-year transition period.
My recommendations are the following:
VAC and DND must collaborate to ensure that the medical assessments of both departments are similar and that the client is aware of the level of disability. The client must be satisfied that they have been properly and thoroughly assessed before the end of the three-year transition phase.
VAC should not be allowed to determine whether or not a medical condition is a result of military service; only DND should make such assessments.
It should never be necessary to confirm severe medical conditions like the loss of legs. Once a client is assessed as having a permanent condition, then it should only be necessary to record any worsening of the condition.
VAC must change its appeal process. Too often, clients are denied a departmental review and instead are referred directly to VRAB when the client submits their first appeal. The first level appeal should be handled by the district office and involve the VAC assessor, who should have to defend their assessment.
VAC should not be allowed to deny services and to intimidate clients, as I was. Benefit of the doubt, dignity, and respect should always be given to the client.
VAC should also provide the following: front-line approval authority in an experienced case manager's hands, not a bureaucratically labelled case manager; comprehensive, tailor-made programs developed before the last day of release and executed soonest after release; a civilian medical team, lined up and providing appointments before release; thorough education development provided by rehabilitation specialists and psychologists on what the member and the family can expect when dealing with transition, disability, and bureaucratic obstacles and requirements.
Moreover, opportunity with security should mean exactly that: no diminishment in salary for as long as the member pursues a successful vocational rehabilitation program, with plans for more than just trade courses or community college, but full university educations, with post-graduate follow-on if successful, as well as funding and thorough education for starting up businesses.
In summary, the transition should be seamless, allowing the client to concentrate on coping with the transition and adjusting either to a new career or retirement. There should never be a long-term battle to gain and then maintain support from any agency. For many clients, it's hard to concentrate on draining the swamp when you're up to your neck in alligators.
Thank you.