Veterans Affairs Committee on May 26th, 2015

[Frank Valeriote, Liberal, Guelph, ON]

Tell me what $139 a week buys them.

[The Chair, Conservative, Royal Galipeau]

He doesn't have to answer.

[Bernard Butler]

I'll quickly point out, Mr. Chair, in response to the question, that this benefit was designed to provide relief based on an assumption of need of 30 days in a given year. That's how the amount was calculated. This, I should point out, was not intended to be an income replacement for those providing care. It's a different program concept. This is based on the 30-day requirement for support for relief over the course of a year.

[Frank Valeriote, Liberal, Guelph, ON]

Okay.

[The Chair, Conservative, Royal Galipeau]

Thank you very much.

Mr. Hawn.

[Laurie Hawn, Conservative, Edmonton Centre, AB]

Thank you, Mr. Chair, and thank you to our witnesses.

I want to follow up on that a little. I think we're confusing the purpose of these benefits. Every benefit doesn't necessarily apply to every veteran. Every benefit, especially these new ones, is designed for specific circumstances and to close gaps this committee, among others, identified. It's not that this applies to everything. We can be cynical if we want, but the simple fact is we have closed a number of gaps.

The critical injury benefit is not intended to compensate for the long term, because we have the disability award for that, but it is intended to compensate for the short term for those people it applies to. So it does fill a gap. It's the same thing with the caregiver benefit. It is not designed to be an income replacement, because the veteran is already getting full-time care by whatever mechanism. It is simply designed to compensate, not on an income replacement basis, and give some relief to the family caregiver.

I don't want to put you in too much of a spot, but is it fair to say that the purpose of all these benefits is very specific? It came from this committee. My opinion is we can always do more and we always will try to do more, but these benefits have been designed and are going to fit the purpose identified by the gaps identified by this committee.

[Bernard Butler]

Thank you for the question.

Mr. Chair, if I go back to the ACVA report, the committee was very clear in identifying that the most seriously injured were those that should be accorded priority in the move forward in terms of veterans programming in support of veterans. You're absolutely right. These benefits have been designed to try to address that gap, to try to meet the need of those who are most seriously injured as a result of their service, and to provide some related support to family members.

[Laurie Hawn, Conservative, Edmonton Centre, AB]

I want to switch gears here and talk about the extra case managers and benefit adjudicators. Do you have any sense of timing of that in terms of the rate of those folks coming online?

[Michel D. Doiron]

Yes, thank you for the question, Mr. Chair.

We already have gone out with the requests. We have 600 applicants on the case manager side and 600 applicants—and I'm generalizing the number, rounding off—for our CSAs and adjudicators. Once the bill is approved, we're hoping to start to bring in some case managers as early as July and the same thing with the adjudicators. We're in the final parts of the interviews for case managers. This is over a number of years for the case managers. As the demand increases, or the number of case-managed veterans increases, we will bring in the case managers to meet that and to meet no more than one in thirty.

[Laurie Hawn, Conservative, Edmonton Centre, AB]

Obviously, they're going to be targeted to locations and situations.

[Michel D. Doiron]

The case managers will be targeted across the country in our offices or in IPSCs, some of our integrated personnel units. For the adjudicators, there will be some in Charlottetown, but there will also be some here in Ottawa to be embedded. There are 23 resources that will be embedded with our CAF partners to accelerate and eliminate the backlog.

[Laurie Hawn, Conservative, Edmonton Centre, AB]

Are we pushing the decision-making down to the case manager level in more simple situations?

[Michel D. Doiron]

Yes. We've already started to do that in reviewing our eligibility criteria. Some of the stuff has already been pushed down to the field for accelerated decision-making.

[Laurie Hawn, Conservative, Edmonton Centre, AB]

Okay.

I want to talk about the purpose clause for a bit. That's been a sticking point, because it was, as you said, omitted for whatever reason when the legislation came into effect in 2006. But in de facto terms, has not every government of every stripe since 1917 tried to live up to that clause, whether written or not? In my view, every government—Liberal, Conservative, it doesn't matter—has tried to do the best they can.

I mean, the clause is nice. If it gives people comfort, that's great; it makes it more clear, more specific. But de facto, have governments not been trying to live up to that forever, basically?

[Bernard Butler]

I think that's a rather broad question to ask of a witness from Veterans Affairs. I would certainly say, in terms of how the Department of Veterans Affairs endeavours to apply the legislation, that we certainly endeavour to do that really all the time in adjudication of benefits and eligibility for services and so on.

I think you're right to that extent: this has always been the approach of Veterans Affairs. This simply very clearly codifies what that responsibility is.

[Laurie Hawn, Conservative, Edmonton Centre, AB]

Thanks.

I'd like to go back to eligibility for a second. It came up around the caregiver benefit. We addressed it generally, but can you be a bit more specific on eligibility? That's always an issue. One of my issues has always been lowering the burden of proof, easing the access to benefits.

Can you discuss the eligibility for that particular benefit?

[Bernard Butler]

Yes. Thank you.

If you refer to the legislation itself, it basically says that if the veteran has a disability award, and as a result of the disability for which that disability award was approved they require ongoing care, in other words, there has to be a link between the disability award and the need for care, and if a person who is 18 years of age or older is playing an essential role in the provision or coordination of the ongoing care in the veteran's home for which the person receives no remuneration, then the veteran would be eligible for the benefit.

If you look at the provision, proposed paragraph 65.1(1)(d) states:

the veteran meets the prescribed eligibility requirements.

That's the further caveat. Basically, in terms of the regulations that will be fleshed out, it will refer to the need for, again, a fairly high level of care, in other words, the most seriously disabled veteran, that we've been directed to address.

[The Chair, Conservative, Royal Galipeau]

Mr. Rafferty.

[John Rafferty, NDP, Thunder Bay—Rainy River, ON]

I'd like to thank you both for being here.

My questions revolve around the transition of members from the Canadian Armed Forces to Veterans Affairs. For benefits to work, there has to be a seamless transition. I believe, in fact, the minister has said that's one of his goals, to ensure that there is a seamless transition.

I have three different areas that I would like ask about. The first is physician assessment. You may know that in question period yesterday there was a question brought up—there was no answer, but there was a question brought up—about a member who was assessed by the Canadian Armed Forces physician as having severe PTSD. The Veterans Affairs physician said it was simple anxiety that the member had. That's a big disconnect.

Can you tell us what progress has been made in the seamless transition of physician assessments, from one to the other?

[Michel D. Doiron]

First of all, I want to clarify that Veterans Affairs accepts the diagnostics from CAF doctors. We do not provide diagnostics. We have doctors who may review a diagnostic to say, “Do we understand exactly what the medical doctor is telling us?” It would be the same thing from the private sector, not just CAF. So we do accept the diagnostic from the doctor, and from there, that's where we base our eligibility.

I do not want to talk about individual cases; I know very well about this case, but I do not want to, absolutely, for confidentiality purposes. But we do accept them.

When the minister talks about transition, there has been—I don't know for how long—a transition interview, but it was not as complete as it could have been. What we want to do now is ensure that this seam is eliminated, meaning that when the individual is to leave the forces, a fulsome interview occurs, and occurs long enough in advance, not two weeks in advance. This act gives us the authority to do that interview upstream, when they're still serving, so that we can look at the medical records, go through the medical records, and determine what the needs are. We can identify needs, employment, and various issues to help ease that transition.

For some soldiers, it's “I'm retiring”. It's easy. For other ones, it's a lot more complex to try to get them the care and the help they need when they leave the forces.

[John Rafferty, NDP, Thunder Bay—Rainy River, ON]

Thank you for that.

Can I assume then that if the CAF physician's assessment is accepted by Veterans Affairs, it's pretty seamless? Although there seem to be some problems still in that transition. I'm sure you're aware and continue to work on that.

The second area is the seamless transition of case workers. I know that you're hiring more, but does that necessarily mean there's going to be a seamless transition from one to the other?

[Michel D. Doiron]

Yes, I guess is the short answer. But we have to understand that on the CAF side, case managers are nurses, so it's medical case management.

When you come to Veterans Affairs, it's psychosocial case management. We look at not only your physical and mental health, but can you get a job. At psychosocial we do all the aspects. I'm not a professional in case management, but we look at more.

Yes, we want the handoff to be seamless. You may have a case manager from CAF, but that handoff would happen while you're still in the forces to a case manager from Veterans Affairs.

[John Rafferty, NDP, Thunder Bay—Rainy River, ON]

How about the member's family in that transition?

[Michel D. Doiron]

We always invite the member's family to come to the interviews. It is the member's choice if the family member attends or not. We strongly encourage it, because the member may tell us there are no issues, but the spouse may give us a different story.

[John Rafferty, NDP, Thunder Bay—Rainy River, ON]

Is there a place for compulsory participation?