Veterans Affairs Committee on Dec. 5th, 2017

[The Chair, Liberal, Neil Ellis]

I call the meeting to order.

Pursuant to Standing Order 108(2) for our comparative study of service to veterans in other jurisdictions, this morning we have a witness from the Federal Ministry of Defence in Germany. Brigadier-General Bernd Mattiesen, medical corps, will appear via video conference from Berlin.

Good morning, sir. Thank you for joining us and being patient while we get started here. You have up to 10 minutes for your testimony.

[Brigadier-General Bernd Mattiesen, Medical Corps, Federal Ministry of Defence - Germany]

Thank you very much, sir.

Good morning. I am very pleased and very happy to have the ability to give my view, our view, from Germany to Canada on the support for mission-related traumatized personnel.

First let me say that I'm very happy to give this testimony. I had the great chance to visit Canada in the months of September and October for the Invictus Games and for your seminar on Warrior Care in the 21st Century, where I was very pleased to have the ability to participate.

Second, let me give you a little foreword. I am talking in a foreign language, which means that normally I say what I want, but sometimes I only say what I can. If I use a wrong term, please ask me a question about it. I would be very happy to correct it.

I could normally give my presentation in French as well, but since English is a more technical language, I will give it in English, even though I know that French and English are Canada's two official languages.

Germany, since the year 1992, has been participating in international missions. On the mandate of the German parliament, the German Bundeswehr has been participating in multinational operations at the international level since 1992. A prominent operation in the past has been to participate in the international support and stabilization force of ISOF in Afghanistan. However, today the most significant are the two operations in Mali, in addition to the ongoing participation in the Resolute Support training mission in Afghanistan.

After multinational support operations began in 1992, an adapted system of compensation and benefits had to be developed. Let me say that in the past we had them only in the civilian system in Germany, which was used for soldiers also, and now we had to develop from the start a special military system.

I have to admit that the Federal Republic of Germany does not have a separate veteran support system. In contrast to the case in the anglosphere, where the term “veteran” is frequently used, in Germany the use of the term Einsatzgeschädigte is common, which means personnel with deployment-related trauma. By that, we understand a service member suffering from a health impairment caused by deployment, so I tell you the noun “veteran” has not yet been established in Germany. There are still discussions going on about what “veteran” means, so I will not use the word “veteran”, but I very often mean it.

From its foundation, the Federal Republic of Germany has had elaborate and well-developed civilian health care, as well as a well-developed pensions and benefits system. For many decades, the Bundeswehr members were treated and compensated after the end of their service period in accordance with applicable domestic regulations, which meant civilian regulations. Only with an increasing number of losses in Afghanistan, from 2002 onward, was there a growing understanding for the need for an adapted regulatory system for the armed forces, which is now based on four pillars.

The first pillar was created in 2004. This was the so-called Special Foreign Assignments Benefits and Pensions Act, which was amended and ameliorated in the year 2011. A very important law was created in 2007, the Law on the Continued Employment of Personnel Injured on Operations, with subsequent amendments, which is a very necessary law now for our soldiers. It was amended with the deployment-related accident regulation in 2012, which gives an easier way for our soldiers to go into this aforementioned law on continued employment of personnel.

For standardization purposes, responsibility for the pensions offices was transferred from the 16 federal states to the federal government in 2013. In 2015, the cut-off date for eligibility was shifted back, thus enabling equal treatment of all personnel with deployment-related injuries. As you can see, only from 2015 on have we had equal rights and equal compensation for soldiers who participated in missions.

The next slide, although a little complicated and a little busy, shows you how we have pensions and we have continued employment of personnel injured in operations.

Concerning the Law on the Continued Employment of Personnel Injured on Operations and the Special Foreign Assignments Benefits and Pensions Act, it is worth mentioning that any service member suffering from deployment-related trauma is eligible for what we refer to as a protection period. In this protection period, he or she may not be discharged on grounds of unfitness for service without his or her consent. Second, as required, the service status of a temporary career volunteer is extended while they receive medical treatment and vocational training. Third, a former service member may, upon request, be re-employed by the Bundeswehr as a temporary career volunteer with a special service status.

We take back injured soldiers in the armed forces for education and medical care. Temporary career volunteers with deployment-related trauma and re-employed temporary career volunteers with a degree of disability of more than 30% can become a career service member under simplified conditions, and that means lifetime. The Military Pensions Act, in combination with the Federal War Victims Relief Act, governs the financial entitlements of traumatized personnel and surviving dependents.

Initially, service members with deployment-related trauma are granted a relatively low basic pension of between 150 euros and 800 euros, according to the degree of disability, based on domestic legislation. Additionally, temporary career volunteers can receive a loss of earnings compensation upon termination of their period of service. Additionally, further entitlement for medical treatment and prosthetics can be granted.

On the next slide, we go to the Military Pensions Act, which provides more. All recognized service members with deployment-related trauma receive a non-recurring compensation of 150,000 euros if the degree of disability is higher than 50% and if the impairment is of a permanent nature.

Career service members impaired by having deployment-related trauma and whose degree of disability is higher than 50% may, upon request, be discharged and receive 80% of the pay award that is two pay grades above the current one. If we sum this up, it means that an impaired soldier and service member, after his dismissal, gets the same payment as he got before as an active duty soldier.

In contrast with that, temporary career volunteers with deployment-related trauma are entitled to receive a compensation in accordance with their period of service in the armed forces. It means that they get roughly 500 euros for every month they were in the armed forces.

For legislation governing the consequences of deployment to be applied, evidence of service-related health impairments has to be provided in every single case. This has turned out to be difficult, and was, I have to admit, a political matter or concern, in particular with cases of mental disorder such as PTSD.

Now, with the Deployment-Related Accident Regulation, an instrument was developed that under certain circumstances provides a possibility of applying some of the legislation governing the consequences of deployment based on a sufficiently high probability. That means that there's no need for evidence, but there must be a sufficient probability of the person having been traumatized in mission, and then they can benefit from the regulation.

Sirs and ladies, you have asked about an ombudsman. There you see the team of the ombudsman and the commissioner, with the two ombudsmen on the right and left. You see my two civil servants, two lady jurists, who have a very big impact on my work. In the level below, you see the three military assistants, who also do also great work, and one of them was with me in Canada for the Invictus Games.

Ladies and sirs, this concludes my presentation. I'm very open to questions you might put.

[The Chair, Liberal, Neil Ellis]

Great. Thank you.

We'll start with our first round of questioning of six minutes. Go ahead, Mr. McColeman.

[Phil McColeman, Conservative, Brantford—Brant, ON]

Thank you, Chair.

Thank you for the testimony here today outlining your system.

I'm very interested in the Law of Continued Employment of Personnel Injured on Operations and in getting a little more information about that from you, if we could. Based on the charts, I noted it had changed in more recent years.

With regard to the concept behind it, if you're injured, is there a certain degree of injury that must occur, a certain percentage of disability that has to be achieved? Essentially my understanding is—and I'm looking for you to better explain it conceptually to me—that a person in the service, a soldier, can stay employed in the military if the injury is attributable to their service, and also someone who has left the military can come back and apply and be rehired.

Do I have the general concepts correct?

[BGen Bernd Mattiesen]

Yes, that's correct. Every soldier who is injured on a mission, be it physically or psychologically, can stay in the armed forces only for medical treatment and education, notwithstanding the degree of disability. If he's a career soldier, it's not a problem, because he remains in the military. If he's a time-restricted soldier, then he might stay over the end of his career within the armed forces as long as he needs medical treatment or education. Once he has left the armed forces, he might apply to come back and become a soldier again as a means of getting medical treatment and education for a new job. Even with a disability of 30% or more, he might become a career soldier—not because he fits as a soldier, because of being traumatized—but he must be able to fit his position.

Let me give you a very simple example. We have a soldier who has lost both his legs, so he cannot be a normal soldier. He cannot run around. He cannot fight in wars. However, he might be a very good IT technologist. He can become a career soldier as an IT technologist, but he must be able to fit this position. This you can approach as a psychological question. If he's above 50%, he gets an extra benefit of 150,000 euros.

[Phil McColeman, Conservative, Brantford—Brant, ON]

Do you have numbers that you could share with us of individuals in this category?

[BGen Bernd Mattiesen]

Yes, I do.

Let me start with a preliminary remark. Numbers are always very difficult because it depends from whom you get them. If you get them from the physicians at the hospital, you get numbers that are different from the ones you get from the administration.

[Phil McColeman, Conservative, Brantford—Brant, ON]

We know about that.

[BGen Bernd Mattiesen]

I believe most in the administration numbers, and I'll give you their numbers because I have the theory that every soldier who has become traumatized shows up one day at administration to ask for benefits.

Roughly 3,000 soldiers from the beginning of our missions in 1992 have applied under both laws. Of these, roughly half, 1,500, are now back in the armed forces as normal soldiers or have left the armed forces because they are cured.

We have roughly 500 soldiers in the special service. We have about 700 soldiers overall who are now under this Law of Continued Employment of Personnel Injured on Operations. Up to the end of November, there were 106 career soldiers in this situation.

These are the rough numbers I can give you.

[Phil McColeman, Conservative, Brantford—Brant, ON]

Okay.

To make sense of these numbers, how many people are active in the military in Germany?

[BGen Bernd Mattiesen]

We have roughly 180,000.

[Phil McColeman, Conservative, Brantford—Brant, ON]

Thank you for that.

Let me be sure I understand the person who receives the 150,000 euros. To be in that category, someone must have a disability assessment of 50% or more. Is that correct?

[BGen Bernd Mattiesen]

Yes.

[Phil McColeman, Conservative, Brantford—Brant, ON]

How many more benefits would they receive from a monetary point of view? Would they be eligible to receive more than the 150,000 euros? Is that the maximum?

[BGen Bernd Mattiesen]

You might discuss the law, and we do in Germany. There's a rough cut-off at 50%. Below 50%, there is nothing, and being above 50% doesn't get you more. This was decided in the past. There has been thinking about it, but it's still the law. It's still in force at to this date.

This creates some problems. If you have 40% and you are a psychologically traumatized person, what do you have to look forward to? You're looking forward to 50%. This gives a bit of a problem in curing or healing the disease. This is what we talk about a lot with our jurists and psychiatrists, but for the time being, it's like that.

[Phil McColeman, Conservative, Brantford—Brant, ON]

That's where I'm having a difficult time, because everybody between zero and 50% is receiving nothing. Only the people over 50% get what I would consider to be a very generous benefit of 150,000 euros.

How do you determine the categories, particularly with a PTSD diagnosis, to refuse someone who perhaps is not able to function very well? Is it all based on medical criteria that a doctor assesses? Is that how it's determined?

[BGen Bernd Mattiesen]

Let me make one remark first. Even those who do not get the 150,000 euros might be re-employed in the armed forces and getting their normal payment as a sergeant, let me say, or as a master sergeant or whatever, and they get a regular little monthly pension. It is not too much, but it's a little bit. If they are not in the armed forces, they can get a lot of different civilian benefits.

On the second question you asked, it is like that. We have a team of medical doctors, medical officers. Four of them are psychiatrists from the psychiatric hospitals. From their knowledge and with their ability to do the work, they estimate the grade of the disability.

Indeed, you're correct, in that there are sometimes complaints about that situation. We are a very open state and we have a good legal system, so some lawyers have a good time living on that.

[The Chair, Liberal, Neil Ellis]

Thank you.

Speaking of lawyers, Mr. Fraser, you're up.

[Colin Fraser, Liberal, West Nova, NS]

Thanks very much, Mr. Chair.

Brigadier-General, thank you very much for your appearance today. It's very much appreciated.

I'm pleased to hear that you were able to go to Toronto for the Invictus Games this year. I wonder if you can talk for a minute about your experience at the Invictus Games and why you think that is an important aspect for our veterans.

[BGen Bernd Mattiesen]

Yes. Thank you very much. I am very pleased to give you the answer.

I had a big chance to participate even beforehand, in the Warrior Care in the 21st Century symposium, where I had contact with your surgeon general, with whom I had long talks about our medical systems in our armed forces. After that, I participated in the Invictus Games and was able to see our German team, consisting of 17 soldiers from Germany.

From my point of view, it is the biggest appreciation you can give to soldiers who went to a foreign country and fought, who maybe were not understood in civilian life by their families and relatives, and who came back traumatized or even critically injured. They got a big chance to go into the community of the soldiers of the world through sport, and to be very highly appreciated by Prince Harry, for example, and by your Prime Minister Trudeau, whom I saw at that meeting.

They had the ability to go to a foreign country to make a 1,500-metre run, let's say, and to be applauded by a lot of people. It is the biggest possibility for taking care of our soldiers who sacrificed some of their health on their missions.

[Colin Fraser, Liberal, West Nova, NS]

Thank you, sir.

In your presentation, you touched on employment, but I didn't hear a lot—perhaps I missed it, and I apologize if I did—on training and education benefits and what would be available for an ill or injured soldier who wants to go back to school or receive training that would allow them to go back into the workforce. Can you describe for me the benefits available for ill and injured veterans?

[BGen Bernd Mattiesen]

Yes, I can. I just touched on it very briefly by saying that they were able to get some education within the armed forces.

If a former soldier or a temporary career volunteer whose time has expired stays in the armed forces or is re-employed in the armed forces, they have the possibility, depending on their psychological and mental fitness, of taking part in education. For this a time of five years is accepted, which might be extended to eight years. In those eight years, they are fully paid at their rank by the armed forces and may go to whatever: a school, an apprenticeship—as we call it in Germany—an industry education, or whatever. They are very free. The only thing is that they must be psychologically and physically fit enough to do this.

This is even more the aim of our re-employment. Normally we don't want to keep them in the armed forces until the end of their active life, but get them educated so that their problems and the damage caused to them in the mission are going to be equalized, you might call it, by a good education, so that they are at the same standard as they would be if they had not been traumatized in a mission.

[Colin Fraser, Liberal, West Nova, NS]

You mentioned that they have to be psychologically well enough to go back to school or whatever. Are the mental health services in place to allow someone to receive those mental health services at the same time as they go back to school or training? If so, who provides those mental health services?

[BGen Bernd Mattiesen]

As long as you are a soldier in the armed forces, you are entitled to go to the psychiatric service of the four Bundeswehr hospitals. You also have an outpatient psychiatric clinic. In this you can have the service of psychiatrists who are very experienced in the civil standard of care.

Today and tomorrow we have a big psychiatric conference here in Berlin. I just left it to come to this conference with you. If you go to my presentation, slide 13 shows the hospitals. We have four big ones and a smaller one, which is in Westerstede.

The psychiatrists take care of the soldier. They advise them on what kind of occupation they're able to perform and whether or not they're able to be educated.

[Colin Fraser, Liberal, West Nova, NS]

Thank you, sir.

Are we able to get a copy of that presentation?