VAC Client Card - 'A' client vs 'A&B' client

[Towards_the_gap]

Hello all,

I've already fired off a secure message to VAC to try and shed some light on this, but recently a coworker and I (both veterans) were chatting about VAC and the treatment benefits post-release. The client card came up, which I had never really thought about or bothered looking into except to pull it out for prescriptions now and then, and I noticed an odd thing:

This coworker, who had an only partially attributable injury from non-overseas service (non-SDA) was an A&B client. I, on the otherhand, with a fully attributable injury due to enemy action in an SDA, was only an A client.

I got my rosetta stone out, cut open a goats entrails and burned incense in an attempt to decipher the hieroglyph that is my treatment and benefits booklet, and unless I am wrong, an A&B client is better off, treatment wise, than an A client?

Does anyone know why this is? Am I wrongly decoding the VAC manual?

Any and all help appreciated.

Cheers

TTG

 

[Teager]

This the difference I found from the VAc site http://www.veterans.gc.ca/eng/services/health/treatment-benefits/tb-health-card

I'm guessing this is what you may have found as the explanation.

A - If an "A" is indicated under a Program number, then treatment benefits obtained in Canada or elsewhere which are directly related to your disability benefit condition(s) may be covered by VAC. Many benefits require pre-authorization by VAC. Ask your provider to contact us.
B - If a "B" is indicated under a Program number, you may be eligible for treatment benefits obtained in Canada based on a demonstrated health need. However, your provider must first bill the appropriate provincial health program for the portion of the benefit that is covered by your province. If you also have private health insurance, either you or your providers(s) must submit your claim for payment through this insurance. VAC is considered to be the last payer and will cover any remaining amounts.
A and B - If "A" and "B" are listed under a Program number your eligibility for this treatment benefit will depend on several factors such as your disability benefit condition(s) and provincial and private health coverage.
No letter - If neither "A" nor "B" appears under a Program number, you are not eligible for this treatment benefit.
Veterans Independence Program - when "VIP" appears below "Group" it indicates that you have qualified for additional services through the Veterans Independence Program.

Still not clear if "A" and "B" coverage is better as it seems more complicated and more hoops to jump through but may cover you more?

 

[ArmyGuy99]

This is a very good post, and an excellent question.

Like most things VAC related.  Only God MIGHT know the  true answer.

6/15 are A/B for me the rest are B

I was told that if you had an SDA you got straight B's indicating that VAC would cover you for any remaining amount after your Provincial Health Care and Private Insurance has been billed.  "A"means that VAC is the Primary agency to be billed, WRT any services for your claimed disabilities.  A/B basically means that you are always covered under that item. 

Eg. So you have A for your disablity Under #10, Prescription drugs (ie. You take anti-depressants) but you need antibiotics and have no health insurance. So VAC picks up the Tab because you have B under #10 as well. If you didn't have "B" you would have to cough up the $$ for the Prescription.


All I know is that VAC pays for all of my Prescriptions and my Specialists Appointments WRT my disabilities.  And my now measly VIP check comes in twice a year.

So, based on my very BASIC (and maybe flawed) understanding, yes A&B is better than just A or Just B.

Does anyone else have a headache yet?  :nod:

 

[Towards_the_gap]

The question remains as to who/what decides who gets A&B, and what reasoning there is behind it?

No doubt it either involves a dartboard or a witches cauldron  brimming with newts tongues.

 

[Teager]

This is more confusing. I like TTG have an SDA injury and have only "A" coverage. So MedTech 32 whomever told you that SDA injuries are "B's" is wrong, mixed up the letters, or is right and TTG and I have incorrect letters.

TTG let us know what VAC has to say whenever a reply is sent. Hopefully you won't need a wizard to decipher the response or be left with more questions.

 

[Towards_the_gap]

To add to the confusion:


Dear Mr *****:

Thank you for using My VAC Account and our secure email services.

Your A coverage refers to health care benefits that directly
relate to your pensioned condition.

B coverage could be associated to the approval of VIP when the
need is linked to a disability as a result of injury in a special
duty area. However, you have not been approved for the Veterans
Independence Program.

If you have any further questions or concerns, please contact
again via My VAC Account or our toll free number 1-866-522-2122.

Sincerely,

***** *****
Veterans Affairs Canada


Ummm...thanks VAC????

 

[ArmyGuy99]

Geese,

Could that reply be anymore open ended? :facepalm:

Anyone know a good witch doctor who could figure this out? :brickwall:

I bet if you asked VAC for an official answer on what color was the sky you couldn't get one.  oi

Teager,

I wouldn't be surprised if I was fed bad intel on this. I get the feeling no one knows the real answer.  ESPECIALLY anyone over at Veterans Affairs. 

Craziness I say.  TGP you should apply for the VIP program, why not? 

 

[maniac]

SDA/SDO + VIP = B client

You remain an A client regardless if you don't have VIP.  You can still have VIP with non sda/sdo but you will remain a A Client

 

[Towards_the_gap]

So riddle me this - how then does an non-sda/sdo injury rate for VIP/A&B client status?

 

[maniac]

A Client is Still eligible for VIP.  The real difference is the client status.  A Client is injury specific,  foot injury gets you orthotics, etc....

When you are SDA/SDO (declared on decision letter) you are an A Client until you apply and are accepted as needing VIP (needs based), at that time you become a B Client.  If this is the case for you and still have not recieved a new card, call VAC and get it sorted out.
B Client status is coverage for related injury and anything above and beyond injury like CPAP machines for apnea, etc;  (post exhausting all other sources like insurance). Moral of the story is at least apply for VIP to extend your coverage because later in life,  it will matter!  If you can get B client status, you should apply for VIP without further delay.

I don't work for VAC, I just took the time to get this figured out sometime ago.  Don't shoot the messenger,  it is what it is and it's used to provide coverage from Blue Cross (contracted INSURANCE Company).

 

[bigcletus]

Slightly off-topic, but i think relevant never the less:

Yesterday I testified at the VRAP board for an increase.  My Advocate, VAC lawyer, was reading to the board the VAC policy on a specific item.  She had to read it 3 times..and the board members were astounded.  It was so vague, you could drive a semi thru it. They asked her if that was in fact a verbatim copy of the policy, she replied affirm.  Both she and the Board just shook their heads.  But she then glanced over at me, smiling.  Perhaps she detected a frustration in the Board w/VAC.  Maybe, just maybe, I may win - by default.

 

[maniac]

Here's a excellent example of the difference between A & B Coverage (BTW once you have B, A is no longer relevant).

Keep in mind that VAC has a list of approved medications that they cover.  Let's assume you are a A Client.  If you for example have PTSD and you're prescribed and approved medications are changed by your doctor to a different medication.  You go to the pharmacy and find out that VAC will not cover that, you then must present yourself to VAC with prescription for your CM to bless the prescription and coverage as prescribed by your doctor(which is always approved).  If you were a B Client,  none of that is necessary. Believe me, when suffering from acute symptoms, this can be a very frustrating situation which only serves to aggravate the symptoms.  No wonder there's a glass barrier at VAC.

It certainly does beg the question as to why is this practice in place?  Is VACs mandate to question a doctors prescription or is it to pay for it?

 

[Towards_the_gap]

Exactly my point. you have to apply for VIP in order to get the better coverage (A&B), therefore VAC can easily keep costs down by denying VIP coverage, because nowhere is it equivocally stated which injuries rate VIP and which don't, it's seemingly arbitrarily decided by some staffer in VAC.

I dunno.... I applied for VIP anyways, we'll see where that goes.

 

[maniac]

Another related, little known fact.  All of those decisions can be appealed.(like a Case manager denying VIP).  I have a freind who was sent to the VAC doctor who approved VIP based on the veterans condition and it was later denied by the Case MANAGER.  Why then do they have doctors on payroll as SME's and then a Case Manager overrides their recommendations? 

Substantiated by a doctor and then denied by a case manager, PRICELESS!!!!!!!  The  veteran appealed and won.

 

[blackberet17]

Exactly my point. you have to apply for VIP in order to get the better coverage (A&B), therefore VAC can easily keep costs down by denying VIP coverage, because nowhere is it equivocally stated which injuries rate VIP and which don't, it's seemingly arbitrarily decided by some staffer in VAC.

I dunno.... I applied for VIP anyways, we'll see where that goes.

My understanding of VIP is it covers services which your pensioned/awarded medical conditions prevent you from doing yourself.

For example, if you have degenerative disc disease lumbar spine, you may have snow removal and grass cutting expenses covered by VIP.

On the other hand, if you have hearing loss, it doesn't exactly prevent you from shoveling snow and washing your windows.

 

[maniac]

You are absolutely correct Blackberet but it also hinged to B Client status which is additional benefits for SDO/SDA injured vets.  Using your example, if you have someone living with you capable of doing the work you can no longer perform or live in a condo where it is included,  you will not get VIP based on "NO NEED". 

Where you will suffer is on the additional benefits given to those whom do have SDA/SDO who are getting VIP as in all other categories listed on your card.  The criteria to get B Client status is directly linked to VIP, should it be? Translation,  regardless if you are SDA/SDO you remain an A Client until you apply and are approved for VIP.

My opinion, any injury related to theatre of ops sanctioned by the gov't in writing (which they do in CANFORGEN SDA/SDO), should be a B client regardless of VIP.  I'm sure this is going to be a much more interesting story in the future as the CYPRUS/RWANDA/BALKIN/SOMALIA/ETC... era veterans age and start to see some get B Client and some don't, they are A Clients.  Then there will be another war with VAC be cause they will (justifiably) feel discriminated against based on their need for VIP services (and that can boil down to where, how, and who you live with).

 

[blackberet17]

Sorry, maniac, yes, I forgot to mention if you have a partner (spouse, relative, etc.) who can perform the task, VIP will invariably be denied.

Information from the web site is ... minimal at best.

http://www.veterans.gc.ca/eng/services/health/veterans-independence-program
http://www.veterans.gc.ca/eng/services/health/veterans-independence-program/services

I went through my two policy manuals (one for Pension Act, the other for New Charter), and found nothing by way of guidelines, criteria, etc. I'll ask around, see if I can get my hands on something I'm allowed to post here.

 

[evanr67]

I know that there is also some consideration for VIP given to clients that are feeble (lacking physical strength, especially as a result of age or illness) and doesn't have to be related to a pensioned condition or an award.

 

[reccecrewman]

I can shed some light on this topic.  I am a 13 year medically released Veteran who ended up working for VAC as a CR4 post release.  The A clients are those who have received a pension for an injury sustained in Canada.  Example; a soldier is out in the field and falls off a vehicle injuring his back.  He applies for a pension and it's granted, when he releases, be it an expiration of contract, retirement or medical, he will get a VAC card with A's under the benefits to which he is entitled.  Those benefits will ONLY be for those related to his pensioned disability. There are 14 categories on the VAC card and he will have an 'A' under each number to which benefits he is entitled to coverage for.  His file will indicate REG FORCE pension.  This does NOT mean he is a Reg Force member, it simply means the pensioned condition was incurred in a non SDA. (Special Duty Area)

The B client is the tricky, and often cloudy one, but it is the Cadillac of benefits.  You will NEVER see a card with a few sporadic B's on it.  B's run the full 14 slots on the VAC card because the B client is entitled to VAC coverage on ALL benefits, regardless of his pensioned condition.  The client MUST have at least ONE pensioned condition from an overseas injury.  Example; A mechanic in Afghanistan is lifting a LAV wheel and ends up slipping a disc in his back.  He applies for a pension and it is awarded.  His file will denote that it is an SDA pension. Now, this does not mean when he releases, he will automatically get B client status.  He will initially receive A client status for his pensioned condition.  He then must apply for the VIP program and be granted benefits of the VIP program.  If his application for the VIP program is because he needs help doing household chores and groundskeeping work at his home (shovelling/lawnmowing) because his back condition prevents him from doing these tasks, THEN, he will become a B client.  VIP approval based off the SDA pensioned condition is what flips the A status to B status.  This is the ONLY way a Veteran becomes a B client.

Now, as a B client, he is entitled to absolute coverage through VAC, even if it's not related to his pensioned condition.  For example, our slipped disc mechanic ends up requiring hearing aids when he's 72 due to natural hearing loss, he can go to VAC to pay the $4,000.00 bill for 2 hearing aids, DESPITE the fact that he doesn't have a hearing loss pension because he's  a B client.  Any and all travel that he needs to take for any reason, he can submit health related travel claims to get reimbursed his gas mileage and meals (if he went over a designated meal time).  The benefits available to the B client are long and extensive and I would end up writing a novel here.  The short story is, the B coverage is the best VAC has to offer and there are specific requirements to kick that B coverage in.

A final note, an A client can still apply for the VIP program and get approval, it just won't kick in B coverage when he gets it.  Our first example soldier who tweaked his back in the training area may not be able to do household chores and groundskeeping due to his injury, so he may still apply for, and get approved VIP benefits for housekeeping/groundskeeping.  I hope this clears some of the muck for some people here.

Regards

 

[reccecrewman]

On Evan's note above my last point, he is correct.  The term is "frailed".  A Veteran can be "frailed" to award benefits if he lacks the required SDA pension, and is often done to help old Veteran's who need the help.