Veterans Affairs Committee on Feb. 27th, 2020

[Michel Doiron]

As the deputy mentioned, we're looking very closely at what the Australians are doing. We don't call it automatic approval. We call it more presumptive because with automatic approval people think they're going to say they're hurt and we're going to say yes. We do have to be a little careful because they need a disability diagnosis. A doctor needs to say they have a disability, a permanent condition, and they need to have served. We need to confirm their service and that their injury is service-related to some extent. That it's linked to service is easy, so that's why you'll notice the deputy talks about presumptive.

I talk about presumptive as opposed to automatic, because in people's mind if you say “automatic”, they say things like they jumped out of a plane, hurt their knee and they should get a DA. Yes, okay, we agree that it's service-related but to what extent? We still need to make that determination.

We will not be spending a lot of time at the front end asking if it's related to their service or not. It's very clear if they are a search and rescue technician and come forward with a bad knee we shouldn't be spending a lot of time trying to determine if that's service-related or not. We should be spending the time on the level of their injury, its complexity and then get it to you as fast as possible. We want to get you in treatment, because the end game is how fast we can get you in treatment.

We've been working closely and my policy friend is looking at how you rework some of those sections in the legislation to ensure that it's clear, that people understand it and we don't get in trouble.

[Steven Harris, Assistant Deputy Minister, Strategic Policy and Commemoration, Department of Veterans Affairs]

As part of the work we're doing, we are looking at what changes would be required to our legislation. Our legislation regulations compel us to do certain work as we adjudicate claims. We're trying to make sure that's as streamlined as possible, recognizing there may be opportunities for this kind of presumptive approach.

Also, with the work we're doing, related to the last question on international research and what we can learn from our allies in how they're approaching it, respecting the fact that there are different federal, provincial and territorial set-ups for our allies to be able to work through that model, my research shop is looking through our own data to try to better understand what leads to other things. If we have a sense of one injury leading to another, and there can be work to do to help prevent that by providing some upfront intervention, we want to try to do that too. That's another opportunity to move that forward through research.

[Gen (Ret'd) Walter Natynczyk]

May I add to that?

[The Chair, Liberal, Bryan May]

Very briefly, sir.

[Gen (Ret'd) Walter Natynczyk]

We're trying to bundle services. I'll use a tragic example. If someone has ALS, we know the outcome and we're bundling the services so if they come forward with a diagnosis, we automatically approve everything in one package deal to make it easier and accelerate decision-making right to the end.

[The Chair, Liberal, Bryan May]

Thank you very much.

[Darrell Samson, Liberal, Sackville—Preston—Chezzetcook, NS]

Thank you.

[The Chair, Liberal, Bryan May]

MP Desilets, please.

[Luc Desilets, Bloc, Rivière-des-Mille-Îles, QC]

I'm going to come back to the matter of processing times and the ombudsman's findings. According to the report, the most common reason veterans complained was the amount of time it took to process their claims.

Earlier, we were talking about the online system. Do your systems communicate with one another, or are they connected somehow? Is there any communication at the claims level? That's the first part of my question, which shouldn't be too difficult to answer.

[Michel Doiron]

I'm not sure I know what you mean by communicate or connected.

Our systems communicate with one another, but they certainly don't communicate with those of the Canadian Forces. They aren't integrated because the technologies aren't the same. We have systems that date back to the 1970s, and we've just launched ones that were created in 2019. Some technologies are based on the programming languages COBOL and Fortran, which those of us who are older, like myself, used in university. Other technologies are web- or cloud-based, and that's a whole other ball game.

However, to reduce the time it takes to receive veterans' files, we have an agreement with the Canadian Forces, which grants us access to their health information system. Now, instead of requesting the transfer of a veteran's medical records, our adjudication office can simply look at them online. We still don't have the capability to transfer the file to our system, but I'm not ruling out the possibility that we could at some point.

[Luc Desilets, Bloc, Rivière-des-Mille-Îles, QC]

From what I gather, then, efforts are being made to connect or pool the databases.

[Michel Doiron]

That's correct. There is something else I should clarify, though. Some databases can't be shared because of the Access to Information Act. The person's privacy always comes first, and in some cases, they have to provide consent so that we can access their records.

[Luc Desilets, Bloc, Rivière-des-Mille-Îles, QC]

Once you have that consent, can you obtain any medical records you want?

[Michel Doiron]

Yes, we can, for as long as the individual authorizes us to do so.

[Luc Desilets, Bloc, Rivière-des-Mille-Îles, QC]

Last week, I was at the Veterans Appeal and Review Board, and what I saw really struck me. The same person was filing different complaints or, rather, different applications for review. As I listened to him, it sounded as though he had been asked to submit the same report umpteen times. I have a problem with that. Logically, things should be a wee bit more advanced than that.

You answered my initial question quite well. However, it's difficult for a veteran who has experienced trauma and is suffering from post-traumatic stress to return to the country and have to sit down and prepare a claim. I know there are people in your department and in community centres who can help with that, but wouldn't integrating the systems save these people some trouble?

[The Chair, Liberal, Bryan May]

Very briefly. I did not mention when I called you up that this round is only two and a half minutes, so please be very brief.

[Michel Doiron]

I agree with you. We try to keep that from happening. If the person has submitted their medical records once, we shouldn't be asking for them again, unless the person is still on active duty and their situation has changed.

[The Chair, Liberal, Bryan May]

Thank you.

MP Blaney, please.

[Rachel Blaney, NDP, North Island—Powell River, BC]

I have a million questions. I want to get a little more clarity.

You talked about automatic approvals. I understand that doesn't mean everybody is going to push a button and automatically get it, but I'm wondering where you are. When I look at some of these wait times, they're for hearing loss and some of these things that are more basic, so I'm wondering where you are. When do you see that being implemented? Do you have any sort of projections about the impact on the wait times?

[Gen (Ret'd) Walter Natynczyk]

We are reducing the wait times with every phase of this digitization march that we've been on. We're on phase five of digitization. When we did the disability top-up back in 2016, we did it digitally. When we went to the earnings loss benefit of 90%, we did it digitally. When we implemented the career transition service education and training benefit, we did it digitally.

The big step was the pension for life. All of that was foreshadowed by the advent of the My VAC Account. Every one of these steps has made us a little bit more efficient. That's why we're getting up to 5,000 decisions a month.

The next step is huge. We've created an innovation hub in the department. We brought in the same kind of masterful talented people who helped us land the pension for life in 15 months. We transitioned 80,000 folks to a digital platform, and it was pretty quiet.

We're trying to take that same kind of group of talented individuals and say, "We want to leverage artificial intelligence. Let's try hearing and tinnitus first and get to this turbo vet in order to accelerate decisions on the most simplified things”.

That team is working together now. Whether it be My VAC Account or disability, all of those things are done digitally to accelerate decision-making. The next step is how we leverage AI. We're working towards a pilot project in order to figure out how your audiogram is accepted digitally. Someone looks at it for approval and it goes out the door.

That's the next step. That's 37% of our business. It may not be all 37%, but it's a lot of it.

[Rachel Blaney, NDP, North Island—Powell River, BC]

What is the projection? Do you have a time frame at all at this point, or are you just going through the process?

[Gen (Ret'd) Walter Natynczyk]

Soon.

[Rachel Blaney, NDP, North Island—Powell River, BC]

“Soon” is your general time frame.

The other thing is that we heard from the veterans ombudsperson—and I did mention this before—that there's a longer than average turnaround time for francophone and women claimants. I'm just wondering why.

[The Chair, Liberal, Bryan May]

Please be brief.

[Michel Doiron]

On the francophones, that was true. Actually, in both cases, it was true. I'm going to rephrase that.

On the francophones, it's because we did not have enough bilingual francophone adjudicators. I've studied in pre-med, and the medical terminology in French is very different from medical terminology.... Just being bilingual.... I'm not talking bad about anybody who is bilingual, just to be clear.