Veterans Affairs Committee on Nov. 18th, 2020

[The Chair, Liberal, Bryan May]

I call the meeting to order.

Welcome to meeting number 6 of the House of Commons Standing Committee on Veterans Affairs. Pursuant to Standing Order 108(2) and the motion adopted by the committee on October 27, the committee is resuming its study of the backlog of disability benefit claims at the Department of Veterans Affairs.

Welcome to all the witnesses who have taken the time to join us. Thank you for being here with us virtually.

I'll introduce each of you and then give you an opportunity to speak. Each group will have five minutes. Both during that time and during the questions, I will signal at the one-minute-left mark. Don't panic. A minute is a long time to finish your thoughts. I tend to give people a little bit of latitude in this committee to finish, as they are all here to contribute to our good work.

To begin the introductions, we'll start with the Royal Canadian Legion. We have joining us virtually Steven Clark, national executive director; Raymond McInnis, director of veterans services, Dominion Command; and Chad Wagner, provincial executive director, Saskatchewan Command.

Welcome to all three of you gentlemen.

From the Union of Veterans Affairs Employees, we are joined today by Virginia Vaillancourt, national president; and Mike Martin, communications. From Wounded Warriors Canada, we have Scott Maxwell, executive director, joining us.

Again, thank you to all of you for being here.

We are going to start with the Royal Canadian Legion.

I believe, Mr. Clark, you're going to start us off. The next five minutes is all yours, sir.

[Steven Clark, National Executive Director, Royal Canadian Legion]

Mr. Chair, thank you very much. Mr. McInnis will speak on behalf of the Legion, but thank you for that invitation.

[The Chair, Liberal, Bryan May]

Fantastic.

Mr. McInnis, go ahead.

[Raymond McInnis, Director, Veterans Services, Dominion Command, Royal Canadian Legion]

Honourable Chairman and members of the parliamentary Standing Committee on Veterans Affairs, good afternoon. It is a great pleasure to appear in front of your committee once again.

We support your study of the backlog of disability benefit claims at Veterans Affairs Canada. In a minute I'd like to share some evidence-based advice. First, I want to outline fairly briefly how we are equipped to give such advice.

As you may know, the Legion has been assisting veterans and their families since 1926 through our legislative mandate in both the Pension Act and the Veterans Well-being Act. We are the only veterans service organization in Canada that can help veterans and their families with representation to Veterans Affairs Canada and the Veterans Review and Appeal Board Canada. We do it through our trained professional and government security-cleared command service officers and their assistants.

To give you a sense of how busy we are, last year our command service office prepared and represented disability claims on behalf of over 4,000 veterans to VAC and over 300 reviews and appeals to the review board. We also counselled more than 1,100 veterans for various reasons.

In addition to our Legion command service officers, every branch has an active and trained volunteer service officer to respond to the challenges facing our veteran community. We have 1,400 branches across Canada. You can see that our branch service officers offer an essential network of support. They do not complete applications to VAC, but they are often our first line of contact, our boots on the ground.

When we assist a veteran or family member with a first application or a departmental review, it is a very thorough process, and we monitor our veteran's file for life, inclusive of reassessments.

We don't send VAC applications unless they contain a confirmed diagnosis, and I can tell you it's a lot of work, yet we take great pride in it.

Here is what's changed significantly. The majority of our complaints are now about the backlog. When we are asked daily about the status of applications, this is even after veterans have visited their My VAC Accounts and used the wait-time tool. They still call us. Why? They call us because the wait-time tool is not accounting for the thousands of applications we have to process before we can get to their application. The tool provides information on averages over the last 90 days, not what they can realistically expect based on the current backlog and when their own application was submitted.

For example, today you'll get a 44- to 66-week processing estimate for a single condition, depending on the type of condition. That estimate is not realistic, considering that the department is currently working on claims from November 2018.

We would like the department to be more transparent and modify the wait time tool to reflect reality. Not only do we receive many unnecessary calls, we can't even tell veterans with any degree of accuracy when their claim will be processed and a decision rendered.

We understand the backlog is huge. We do applaud the department for trying to streamline the decision process with veteran benefits teams, limiting the transfer of files and providing the authority to the teams to make the decisions rather than requiring medical advisory consultation. They can also triage claims for disability benefits to expedite applications for veterans at higher risk. We are also supportive of the department in combining conditions that historically have been a consequence of the initial condition, as long as there is a confirmed diagnosis for it. It will be crucial to implement such measures as soon as possible.

I have been with the Legion for over nine years and I have never seen so many applications. We have reached out to other veterans organizations, including the Canadian Armed Forces and the RCMP, to advertise our services. As a result we have seen a steady increase in applications and departmental reviews right across the country. The increase is also due to the change in the partial entitlement policy, which the department quietly changed in February 2018. The change benefited veterans who have received partial entitlements from previous years and can now apply to receive full entitlement for causation, and forfeits for aggravation cases.

This one change alone resulted in many more departmental reviews than appeals. As an example, historically the Legion would complete approximately 80 departmental reviews in a year. However, from August 2018 to December 2018, we completed 552. In 2019, we completed 601.

In the end, we believe the department needs to further simplify its processes and get rid of some of the layers that may no longer be needed.

Finally, I'd like to share a couple of important points about the Legion's work, which may be good background for your own work with our veterans.

Currently, the Legion offers a free one-year membership to all still-serving military members, retired military, RCMP and retired RCMP who have not yet joined the Legion. It is called the veterans welcome program. It is an opportunity to stay connected to the military and policing family, to honour and support those who served and sacrificed, and to strengthen the community.

Through our poppy fund we raise and distribute close to $17 million annually to support programs such as the Leave the Streets Behind program and to meet the essential needs of veterans and their families who have limited financial means. The poppy fund is available at all levels of the Legion and is accessible to veterans in need, including still-serving members and their families. We work in close partnership with VAC and other funders to ensure our veterans and widows have a complete solution, so they do not have to go without.

I will end on this thought. There is no quick fix to this major backlog. We do not see any end in sight. In fact, we believe that when the new transition groups are fully operational, more released personnel will be applying for benefits. There is a danger of the backlog becoming longer. We want to help the department avoid this disastrous scenario with some of the ideas presented earlier. We stand ready to help further.

Chairman, we thank you for the opportunity to make this presentation. We'd be happy to take any questions.

[The Chair, Liberal, Bryan May]

Thank you, Mr. McInnis.

Up next we have, for five minutes, Mr. Chad Wagner, provincial executive director, Saskatchewan Command. The floor is yours, sir.

[Chad Wagner, Provincial Executive Director, Saskatchewan Command, Royal Canadian Legion]

Thank you, Mr. Chair. I'm going to echo what Comrade Ray has just talked about. I did have some speaking notes here, but some of it is things that he has already said. I'm not going to waste everyone's time regurgitating things. I'm more of a “get 'er done” type of person and don't keep beating things to death.

We have seen an increase in claims. We've been doing as much as we can to help them through the adjudication process, but I think some of the challenges that we see can be remedied by empowering the front-line staff of Veterans Affairs. As I said before, this is about a get-it-done mentality. There is no reason that our front-line staff, whether it's the VSAs, the case managers or the field nurses, don't have the capacity to approve applications that are fairly clear. With hearing loss, tinnitis, where we have an audiogram, where we have a physician who says there's hearing loss related to service, why does it have to go through all the levels of adjudication? Not only transparency, but proficiency and efficiencies are really what's needed.

With things such as chronic pain, a lot of chronic pain applications are usually favourable. It's fairly clear in their medical records that they have an injury due to service. Nothing is strange about it, yet it still takes 19 or 20 months to approve a knee injury.

A quick, easy solution might be to have them able to give a limit, whether it's 5% or 10%, whatever the number is, able to approve some of these supports right off the bat. Get them the treatment. The treatment is almost more important than the overall benefit. If we can get them into the treatment immediately, with a bit of support right away, that's going to at least get them where the problem doesn't exacerbate over time. There are some things on a proficiency level, on an efficiency level that we can look at, taking a look at mainstreaming some of the processes. I'm just going to reiterate whatever Ray has mentioned in terms of the backlog.

One of the challenges we see that would be of great help is for those who have to go to an OSI clinic for the first or second time. Some of these guys don't have the ability. They can't afford to go, so either they don't go or they're relying on us. That's a dangerous barrier for them to succeed. For them to admit that they can't afford something and they need help, that's not going to be successful. If they don't have the funds to get to the OSI clinic, they're just simply not going to go. There have to be ways that we can provide them with accommodations, provide them with the ability to travel, but without any barriers to them being successful on achieving their outcomes.

I'm just going to leave you with a quick story on how we operate here in Saskatchewan. We are front line. I have two service officers here who work with veterans every single day and I liaise with them. I talk with them. We have the ability to do some things at our level that might not be as easy at a federal level, but one of the things we do here is that we can have a veteran come into our office at 10 in the morning in need of shelter, food or medical attention. Throughout our various networks, whether those are social services, Legion branches or various service groups, we can have housing established, food provided, usually a stream of income through social services, medical appointments set up, and start the process for Veterans Affairs benefit claims, all by the end of the day. That's one day. I'm sure we can do better than 19 months. The target was 19 weeks. We can do better than that. It's all in the process and removing barriers, and it starts with empowering the front line.

Mr. Chair, I'm going to turn it back over to you. Thank you very much for your time.

[The Chair, Liberal, Bryan May]

Thank you, Mr. Wagner; and thank you for the front-line work you're doing. It is an astounding fact that you guys can pull that all together within one day, and yes, we definitely are likely able to learn from you guys in that regard.

Now we'll go over to the Union of Veterans' Affairs Employees. I believe Virginia Vaillancourt, the national president, will be speaking.

The next five minutes are yours.

[Virginia Vaillancourt, National President, Union of Veterans' Affairs Employees]

Thank you, and good afternoon.

The Union of Veterans' Affairs Employees is a component of the Public Service Alliance of Canada. We represent over 2,800 employees within Veterans Affairs, including most of the front-line staff who deal with veterans and their families every day.

We would first like to give you an update about the challenges faced by case managers within Veterans Affairs.

We remind you of the commitment since 2015 to reduce case-manager ratios to 25:1 in order to allow for more time and focus on the needs of veterans and their families. We told you in March that the department has failed to meet that target. We are disappointed to tell you that nothing has changed. In fact, with the pandemic, things may be worse for case managers and other staff, and we know that things have not improved for our veterans and their families.

Case managers continue to carry caseloads of 40, 50, and even over 60 cases. That is not just a workload issue. These are real veterans and their families who are not getting the services they deserve, the services they have earned. It is not just case managers. The situation remains troubling across the country.

In April, UVAE carried out a survey of our members regarding their work with veterans and their families. We asked them to not only identify issues and problems, but to make suggestions for improvements. We have provided a full report from that survey in our brief to the committee. If you want a fuller picture inside Veterans Affairs from ground zero, we ask you to read the brief.

We will highlight some areas for your information. In the survey, we covered everything from initial assessment and processing of applications through to helping veterans navigate the systems. We also focused on mental health services for veterans and their families, and support for the UVAE members who work in this area.

The bottom line from this survey is that there is a high level of frustration among UVAE members, who are trying their best to serve veterans and their families. This includes frustration with having to use multiple incompatible systems, an excessive workload, and lack of communication between sections. Not surprisingly, there are many pleas, urgent pleas, for additional mental health training and support.

In intake and assessment, which is the first place the veterans access about their benefits, there are problems, including inadequate resourcing and training, and duplication of work. This is causing many problems for veterans and their families. It was even triggering mental health symptoms in some veterans as they had to explain their problems over and over again.

In first-contact resolution, where initial difficulties are supposed to be resolved, there are backlogs and delays in processing requests. The tools that staff are using also assume a certain prevalence of provincial support that is not always available in rural areas. All of this means longer wait times for veterans and the information provided is not always accurate. That, in turn, causes more delays.

With Medavie Blue Cross, the main benefit service provider for veterans, staff reported significant delays, preventing veterans from getting their medication, services or payments. This is not only an unacceptable way to treat veterans, it also negatively impacts the relationship between veterans and our staff. Our members also asked, who is in charge of benefits, Veterans Affairs Canada or Medavie Blue Cross?

One concerning finding from the survey is that about half of the staff whose work involves mental health services for veterans felt that they have inadequate resources to do their work. They noted that referrals take too much time and that resources in rural areas are very limited. Over two-thirds of those surveyed said there are delays in getting veterans access to mental health services.

Our members made numerous recommendations to improve services to veterans and their benefits. We urge the committee to take note of those. We have provided the results of this survey to senior officials at Veterans Affairs, but to date, we have yet to receive an official response. We will continue to press for positive changes for veterans and the people who have the honour to serve them.

Going back to the backlog of disability claims and the department's plan to deal with this issue, we welcome the additional resources that are coming, directed towards this problem, but there are two basic flaws with this particular plan.

First of all, it is proposing another temporary solution to a permanent problem. We have been through this process of putting in temporary or surge resources to address problems in one area and hoping to reduce the pressure on the system.

Some have called this a band-aid solution. We would agree, but our veterans and the issues they face are permanent, ongoing and growing. In fact, we refer to the current approach to dealing with the backlog as whack-a-mole: Reduce the pressure in one section and it pops up in another. Even if the backlog in disability claims could be resolved, the system would be overloaded at every other stress point in the system.

In our view, it's time to stop the public charade of announcing the next big fix to whatever backlog is in the media and deal with the systemic issues at the department. We call again for a permanent solution to all of the issues at VAC and to provide permanent and secure funding for veterans and their families. That change has to be systemic, permanent and one that accepts the reality that Canada has a growing veteran population with complex needs that requires our collective support. Our veterans deserve better. Our union and our members stand ready to do our part to make that happen.

Thank you, Mr. Chairman.

[The Chair, Liberal, Bryan May]

Thank you.

Now we will hear from Wounded Warriors Canada, Mr. Scott Maxwell, executive director.

You have five minutes, please.

[Scott Maxwell, Executive Director, Wounded Warriors Canada]

Good evening.

Thank you, Mr. Chair, all members of Parliament, and all those who have spoken thus far. I really just want to echo so much of what has been said, and not to repeat it.

Wounded Warriors Canada, for those who don't know, is a national mental health service provider that specializes in clinically facilitated group-based trauma therapy programs for our injured veterans, first responders and their families. When it comes to veterans, we're supporting just over 1,000 members every year through our services. In terms of how we fit in this discussion, while we don't support members' claims directly, what we see and deal with, through the members we're supporting with our services, are the downstream effects and consequences of the disability backlog.

I'm trying to figure out why. It seems that over the years that I've come to present here at committee, we have continued to talk over and over again about very similar things that just aren't being rectified. The consequences of that are having a significant impact on our veterans, their physical health, their mental health and their families. I'll talk a bit about that later on.

One thing I've noticed through our organization that is a bit of a challenge, and which might speak to some of the problems we're seeing in getting this work done and rectifying these significant gaps, is that we have not had stability at the ministerial level at VAC in the last 10 years. Since 2010 there have been nine Veterans Affairs Canada ministers—nearly one every 12 months. I reference this, as it goes to my point about what might be holding this up.

I understand that the department is there. It's doing what it does every day. There's leadership in other places, but let's just be honest. I don't know if anyone here has run their own business or has been part of a business, but can you imagine, if the CEO of a business changed nearly every year, what kind of effect that would have on your operations, with new policies, new implementations, new programs? Obviously, it wouldn't be very effective or efficient at all.

It's something we've felt very strongly here in our work, in trying to do more of it and trying to work collaboratively with the department. It's been very difficult having to go in to meet new people, tell the same story, and highlight the same issues over and over and over again. That's just something I wanted to draw your attention to.

Obviously, the subject is about security, dignity and respect. I was listening to the veteran you had at your previous committee meeting, Veteran Thomson, talking. It was very powerful. At times, for me, it was agonizing testimony that summed up the impact this backlog has had on him, the veteran community at large and, by extension, their families. I really only want to echo his comments and say that this is exactly what we hear and have heard for years from Canadian Armed Forces members transitioning to civilian life.

What's more, we've heard that the transition from DND to VAC must be seamless in an effort to help ensure that our members are healthy and well in civilian life. Similarly, this is something that's been talked about, seemingly, over and over and over again. Given how much work needs to be done in this particular area, as highlighted by those who have spoken before me, I would rank disability benefit claims at the very top of the priority list when it comes to making a seamless transition a reality in Canada.

From our perspective, one thing I want to remark on that might be a bit unique is the impact this is having not only on the members themselves but also on their family members, that often silent support behind the Canadian Forces and our veterans: their spouses, partners and kids. Through our programming supporting those people—couples, spouses and children of our injured veterans—it's important to note that added stresses and pressures of disability claim wait times are compounding the impacts and effects of operational stress injuries, such as PTSD, on both the individual members and their families.

I'm sure that everyone has read the literature review undertaken by the veterans ombudsman on veterans' spouses, which was released in September, which really chronicles all of this research: the impact, what's been written, what's been discussed, and ultimately the findings from those members and the families themselves. It was interesting and profoundly impactful that spouses are suffering negative impacts to both their physical and mental health prior to, during, and following medical release. This is consistent with our experience and something that we definitely feel needs to be rectified.

I'm not sure whether you've had a veteran's spouse appear before the committee, but it might be a suggestion for future presentations on the matter we're talking about and the impact that we're trying to address.

I look forward to having an ongoing dialogue with everyone here this evening. I thank you for your time.

[The Chair, Liberal, Bryan May]

Thank you very much, sir, and thank you as well for the work you're doing on the ground to help veterans. It's amazing to see. I thank you for being here and taking this time to help us with the study.

We are going to get right into the first round of questions. Up first we have MP Brassard for six minutes.

Sir, the floor is yours.

[John Brassard, Conservative, Barrie—Innisfil, ON]

Thank you, Mr. Chair. I want to get right into it.

Madame Vaillancourt, it's hard within five minutes to summarize what's in a 36-page report, so I want to give you the opportunity.... I read the report in its entirety. Several things in it stuck out for me. One thing we've been talking about, and I want to get your opinion on it, is the issue of some suggestions for improvement saying to simplify, simplify, simplify, and to stop using multiple systems.

One thing we're hearing consistently throughout the course of this study is that it's not necessarily the money that is thrown at the problem; it's not necessarily the people who are thrown at the problem; it's the process itself, whether it's an attribution to service within the CAF, the disconnect that exists between VAC and CAF....

The minister often talks about digitization of records and making sure those records are distributed to VAC. I'm wondering whether you can comment on the process system itself and how it can improve, in your opinion.

[Virginia Vaillancourt]

Thank you.

Because there are many layers to the process of veterans applying, it would be very hard in this amount of time to sink it down to one.

[John Brassard, Conservative, Barrie—Innisfil, ON]

I know.

[Virginia Vaillancourt]

The biggest concern is that there are too many layers, too many processes and procedures being put in place. If you put one in place today, something will change tomorrow, and you have to try to re-learn the process and keep moving forward.

The biggest thing we keep hearing from our members across the country, then, is that the processes themselves in their entirety need to be simplified, from the time a veteran makes their application right through to the time they deal with Medavie Blue Cross and are able to get their services paid for.

[John Brassard, Conservative, Barrie—Innisfil, ON]

You say in the report that it would be a much simpler process if veterans—and I've talked about this before—were guided through the process, preferably by somebody with experience who has gone through the process, because oftentimes they become frustrated or perhaps can't deal with the level of paperwork that's required to have their claims adjudicated through VAC.

Maybe you could touch on that for a minute.

[Virginia Vaillancourt]

I am going to refer to my communications person, Mike, who collected all of the data. He has more background in this.

Mike?

[Mike Martin, Communications, Union of Veterans' Affairs Employees]

Thank you, Mr. Brassard.

There are a number of suggestions throughout the brief, based on the survey we conducted with members across the country. As Virginia noted, we need a simplification of the process. People find that there are many new benefits, but there are many different avenues that people go down. We need to find ways to streamline the process so that when people access it, they have an easy pass to get in and then can move smoothly along.

There's a real backlog at the beginning as people are trying to get into the process, and additional resources need to be put in at the front end. Then, the resources need to follow the people along.

The idea of having a guide or guides to help people through it is a great suggestion. There used to be more people doing this inside the department, but now what we found from the survey is that there are fewer people doing it, because they are developing processes and reporting on the processes, and we have ourselves all tied up in knots when we really just want to try to help the veterans.

[John Brassard, Conservative, Barrie—Innisfil, ON]

Thank you so much. I know we only received the report today, but for those members who have an opportunity to read it, it's a very compelling report with a lot of solution-oriented issues in it.

Mr. Maxwell, I know you often speak about the downstream effect of this. You and I have had conversations in the past about transition and the impact it has on veterans. How can we simplify the process specifically?

[Scott Maxwell]

Echoing what I just heard, I think that doing as much as we can before somebody releases is something we've talked about for years now.

Imagine a day if all the claims could be adjudicated. The veteran, at that time, would understand every avenue of what's coming as part of the transition to civilian life throughout the release process. For those whom we're supporting, once they were medically released, everything would be crystal clear in front of them, not only for themselves, but for their family members.

Look at this report in September from the ombudsman. Look at the chronicling of how much these stressors are compounding injury—injured people who served our country. I find it almost horrifying that paperwork and process could be....

There is a great term called “sanctuary trauma”. Look it up. This is a very profound term. It is what happens when someone has served and done all they can for their country, and then when they reach out and expect the support to be there for them, they are confronted with another battle. That's what we hear: It's another battle.

Do whatever it takes. Frankly, I'm not a master for that, necessarily, but I can tell you that what we hear is the following: Can we get as much as possible done up front before they release.

[John Brassard, Conservative, Barrie—Innisfil, ON]

Right.

[Scott Maxwell]

If we can do that so they hit “civvy street” as they always say, or civilian life, with the knowledge and understanding of what's coming, what support they're going to have and then actually have those supports at once, I think that would be a profound difference from where we are today.

[John Brassard, Conservative, Barrie—Innisfil, ON]

Thank you, Mr. Maxwell.

[The Chair, Liberal, Bryan May]

Thank you.

[John Brassard, Conservative, Barrie—Innisfil, ON]

It's important to remember, too, that as we talk about the backlogs, they're not backlogs. This is about veterans and their families.

Thank you for sharing that information.