Thank you very much for this opportunity to address the committee.
My background is that I'm a veteran. I served 22 years in the Canadian military as a doctor, and later as a psychiatrist. I'm an expert internationally and nationally in post-traumatic stress disorder. I currently have about 133 veterans on my caseload in Vancouver. I've assessed and treated hundreds of veterans, as well as serving members in Saskatchewan, Alberta and British Columbia. As such, I've had a lot of experience dealing with VAC offices and have a long clinical and corporate history with them. I've served on two separate veterans affairs committees that are listed in my paper that I've given to you.
From the late 1990s until about 2010, the PTSD claims that I put forward were typically awarded within six weeks. There has been a significant degradation of VAC service and an increase in denial decisions, starting about six years ago, especially in the year prior to the 2015 election, when funds were cut to VAC. Even since that time, VAC decisions and Veterans Review and Appeal Board decisions now can take as long as 18 months. Of even greater concern to me is the increased level of denial of claims, up to and including the last level of appeal at the Veterans Review and Appeal Board.
In regard to the caregiver allowance, I've listed seven different items in my speaking notes: one, lack of adequate VAC resources to provide timely service, decisions and support to veterans; two, inconsistent application of the eligibility criteria, resulting in some applications being approved and others with the same level of disability being denied; three, lack of flexibility when applying the eligibility criteria, with a seeming bias against mental health diagnoses and disability, especially in our young veterans; four, overly restrictive eligibility criteria; five, excessive time to review the application, and the appeal system is likewise slow and inconsistent; six, lack of any VAC quality assurance program, first recommended by the VAC-Canadian Armed Forces advisory council in 2000, and to date, nothing has been done in regard to this; and seven, lack of any ability for veterans or their family members to give appropriate feedback to VAC in their interactions.
I've given you two separate examples of veterans, and I'm going to quickly run through one.
Regarding veteran A, I stated in July 2018 that the veteran should not be left alone at home for more than a few hours. Despite this, the caregiver allowance was not awarded.
In November of that year, I stated that the veteran actually had significant deficits meeting the majority of the ADLs listed in the denial letter. He had problems with his balance and fell easily. He might not be able to get up by himself. He was unable to shave himself partly because of osteoarthritis in his fingers and because he typically will cut himself, so his wife had to shave him. He had to be reminded to shower. He couldn't wash his lower limbs because of restricted flexibility. He often wouldn't eat or remember to eat even when it's premade. He had difficulties outside the house on uneven ground and had fallen easily a number of times. His wife did not like to leave him alone for any significant amount of time because she did not feel that he was safe on his own. He could leave the stove on and start a fire because he would forget when he's trying to cook.
At that time, again, I stated he was incapable of safely staying by himself for more than a few hours, and I recommended caregiver recognition benefits. Again, it was denied.
I noted on April 23, 2019, that the veteran had fallen on more than one occasion and had not been able to get back up by himself. This put him at considerable risk for his physical safety, especially if it occurred outside. Again, my opinion was that he was no longer safe to be left alone, and his wife likewise confirmed this. Again, it was denied.
Finally, in January 2020, he revealed to me that he had felt suicidal after VAC rejected any increase in his PTSD award and rejected the caregiver allowance. He made a serious attempt at suicide, and by pure luck, he didn't hit the tree square on; otherwise he would have died.
In March, I noted that he had fallen at the end of January, fractured his left elbow, had a hairline fracture by his right ear and left eye, and he had no memory of the event.
He remained quite angry at the VAC, because of all the denials of various claims. He basically remains home alone a lot. Finally, after over two years, this veteran was awarded the caregiver allowance, despite all my letters and only after fracturing his elbow and having two skull fractures in January 2020.
This is one of many denials. He's an older veteran from the 1960s and 1970s. The other veteran is younger. His wife has written a letter that you can read.
There are ongoing problems with the entitlements and decisions within Veterans Affairs. We need to find ways to correct this. It cannot go on like this. We're losing too many people, and we're not tracking all the suicides.
Thank you.