e-4686 (Veterans' affairs)

       1. Extended wait times and inconsistent service delivery standards have a significant adverse impact on the physical and mental wellbeing of the Veterans of the Canadian Armed Forces and both past and present members of the Royal Canadian Mounted Police.

       2. Despite service standards calling for processing of disability claims within 16 weeks of first application, veterans routinely wait over 40 weeks. 

Between 2015 and 2023, Veterans Affairs Canada experienced a 61% increase in the number of applications received for disability benefits. Veterans Affairs Canada’s capacity to address the processing time issue has been a challenge due to the steady increase of applications.

Budget 2023 announced $156.7 million to support an increase of appeals processing capacity for the disability benefits program at the Bureau of Pension Advocates and Veterans Review and Appeals Board.

In addition, to keep pace with the rise in demand, the Government committed to a series of temporary funding measures for resourcing and automation. On November 3, 2023, the Government announced additional funding of $164.4 million. Part of this investment will ensure that Veterans Affairs Canada is able to retain existing temporary employees, dedicated to processing disability benefit applications, for an additional two years, beyond March 2024.

Reducing the processing times for disability benefits remains a priority for Veterans Affairs Canada. Service standards are Veterans Affairs Canada’s commitment to a measurable level of performance which clients can expect under normal circumstances. Veterans Affairs Canada’s service standard target for disability benefits is for 80 percent of decisions to be made within: 16 weeks for first applications and reassessments (review as to whether the condition has worsened); and 12 weeks for departmental reviews (review to confirm or change an original decision). For the year 2022-2023, Veterans Affairs Canada met the established service standard for first applications 55% of the time.

For the first three quarters of fiscal year 2023-2024, 68% of Disability Benefits first applications were completed within the service standard. Broken out by quarter, Veterans Affairs Canada’s progress consistently improved from 61% in quarter one, to 71% in quarter two to 73% in quarter three. 

Since 2020, with additional temporary employees, Veterans Affairs Canada has reduced the backlog by 77%. As of December 30, 2023, there were 5,054 applications over the service standard (i.e., backlog). There were more than 17,000 fewer cases over the service standard than on March 31, 2020.

Veterans Affairs Canada is modernizing its Entitlement Eligibility Guidelines. The improvements to the Entitlement Eligibility Guidelines will allow adjudicators to make more rapid decisions on the entitlement aspect of a Veteran’s application. New Entitlement Eligibility Guidelines for certain conditions will streamline decision-making.

• Veterans Affairs Canada is modernizing the Table of Disabilities to reflect the most current health evidence and best practices in assessment to support Veterans. The modernization of the Table includes:
  • Ensuring it is up to date to reflect health medical evidence and practices;
  • Simplifying sections within the Table of Disabilities, making it more user friendly; and
  • Planning for digitization where possible to improve processes. 
• A Gender Based Analysis Plus will be applied to the modernization of the Entitlement Eligibility Guidelines and Table of Disabilities chapters to ensure that these tools consider the diverse health related experience of Canadian Veterans. 

A new Service Health Records search tool was developed. It reduces the time taken to search through thousands of pages of material, presenting decision-makers with only the information and evidence pertinent to a specific disability benefit application in one Portable Document Format (PDF) called an evidence bundle.

• The tool is used in processing first applications for the following conditions:
  • Hearing Loss and Tinnitus
  • Four Knee conditions - Arthrosis, Internal Derangement, Osteoarthritis, Patello-Femoral Syndrome
  • Mental Health conditions – Post Traumatic Stress Disorder (PTSD), Anxiety, Depressive and Adjustment Disorders  
• The tool has been further developed to use handwriting recognition when searching digital images to create evidence bundles and automatically uploads the evidence bundle when the claim is moved from Intake to Claim Preparation. It also lays the foundation for future development for other conditions.

Veterans Affairs Canada has made progress and has a better understanding of the challenges in processing disability benefits, and is continuously looking for ways to accelerate the decision-making process. Veterans Affairs Canada is currently focused on completing its oldest claims.

       3. There are incidents in which terminally ill Veterans pass away while waiting for claims to be adjudicated.

Veterans Affairs Canada is working to reduce processing times for disability benefits.

Applications are fast-tracked for those who are medically at risk (e.g., palliative, advanced age, etc.) or who have an immediate, unmet health need related to their claimed condition.

Survivors and dependent children of a deceased Veteran/member may be eligible to continue with an application pending a decision at the time of the applicant's death and/or apply for a benefit for which the deceased member or Veteran could have applied for.

       4. Veterans suffering from service-related injuries face a lack of access to medical coverage and benefits and wait for extended periods to be reimbursed for out-of-pocket expenses incurred because of limited or no service access.

Veterans Affairs Canada provides financial support to qualified Veterans for a variety of health care services or benefits, including: medical, nursing and related health care; aids for daily living; special equipment; prescription medication; as well as dental, audiology, or vision services.

The extent of coverage will depend on a number of factors, including how the Veteran qualified, their health needs and individual circumstances.

Veterans who apply for a disability benefit are encouraged to keep receipts for health care services or benefits related to the conditions for which they have applied for. If the decision is favourable, Veterans may submit these receipts to Medavie Blue Cross within 18 months from the date of the treatment or benefit for possible reimbursement.

In addition, since April 1, 2022, Canadian Armed Forces Veterans who apply for a disability benefit for certain mental health conditions – as well as those who had already applied and were awaiting a decision – are automatically qualified for the Mental Health Benefits coverage. Mental Health Benefits provide coverage for the treatment of certain mental health conditions including, anxiety disorders, depressive disorders and trauma-and-stressor-related disorders. It is available as soon as a Veteran applies for Disability Benefits for one of these mental health conditions. 

Coverage continues for two years from the date Veterans Affairs Canada receives the completed Disability Benefits application or until the Veteran receives a favourable Disability Benefits decision. The Veteran will then be covered as part of the Treatment Benefits program for as long as they need if they receive a favourable decision.

      5. Inadequate, timely communication from Veterans Affairs Canada on the status of their application creates uncertainty and needless stress.

• Veterans Affairs Canada continues to work to improve the information available to Veterans concerning the status of their claim and has made improvements to the My VAC Account Status Tracking for Disability Benefits applications.
• The?Track your applications?tool in My VAC Account allows users to view the status of their applications for the following VAC benefits: 
  • Additional Pain and Suffering Compensation 
  • Career Transition Services 
  • Caregiver Recognition Benefit 
  • Critical Injury Benefit 
  • Disability Benefits (Pain and Suffering Compensation/Disability Pension) 
  • Education and Training Benefit 
  • Income Replacement Benefit for Veterans 
  • Health Benefits Program (PSHCP) 
  • Priority entitlement - Medical release attributable to service determination 
  • Rehabilitation Services and Vocational Assistance Programs for Veterans 
  • Veterans Independence Program 

In 2022, the tool was updated to include additional sub-steps for Disability benefits applications. The aim is to give Veterans additional information to better understand the status of their application throughout the process. Users can also click on “What does this mean?” to get more information about what happens at that specific step. The status tracking information is updated automatically as the application moves along Veterans Affairs Canada’s systems. 

• Additionally, the Wait Time Tool provides Veterans and their families with a general estimate of when they can expect to receive a decision on their applications for benefits. This is based on the category and type of benefits and the condition they are applying for so they can have a more accurate expected wait time.
• A consideration that can impact the processing time for a disability benefit application is the complexity of the condition that is being applied for. Applications can be considered complex for various reasons. Some conditions can be easily identified as complex such as a rare cancer, while other conditions which may seem straightforward are deemed complex because of the medical details or evidence related to the condition, the circumstances surrounding the relationship to service or how the claimed condition presents amongst previously entitled conditions. Complex applications require decision makers with a medical background and take more time because they require more analysis and may need an opinion from a medical advisor (i.e., a physician within Veterans Affairs Canada).