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VAC Ombudsman Urges More Information to Veterans on Disability Benefit Decisions


Army.ca Veteran
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Feds are keeping veterans in the dark on disability decisions, ombudsman finds

December 1, 2015   

Veterans deserve to know what information the government is using to determine their disability benefits, the Veterans Ombudsman says. And right now, the Ombudsman says, they don’t — despite a report four years ago recommending the government make those records available. Story continues below

None of the hundreds of decision letters ombudsman Guy Parent reviewed explains how the government calculated an injury’s “quality of life” impact, even though that plays a critical role in determining whether someone gets benefits. A third of the letters had no explanation at all. The system is too complicated for the government to expect vets to intuit for themselves the reasons behind a benefits decision, reads the report, released Tuesday afternoon. In other words: Show your work, Veterans Affairs.

“Veterans need to know what information is used to make a disability decision in their cases,” Parent said in a statement Tuesday. “They need to know how decisions are arrived at; they need to have the results clearly communicated to them; and, they need to understand the impact. “By failing to do so, Parent said, the government is neglecting its legal obligation to veterans.

Red tape and bureaucratic barriers have been identified as a key factor stymieing veterans who need help. So when vets who’ve been hurt or suffer from mental illness can’t even figure out the reasons behind a departmental decision, the ombudsman says, that makes things worse. Affairs Minister Kent Hehr what he thinks of the report; we’ll post his response as soon as we get it.

Hehr pledged last month to dramatically change the way Ottawa deals with veterans, giving them the benefit of the doubt when making claims instead of placing the onus on veterans to prove their need. Ottawa has only followed through on two of the eight recommendations the ombudsman made four years ago, the report finds.

The ombudsman’s 2011 reports made eight recommendations; the government has only followed through on two of them. (Four are in progress; two haven’t even begun, this report says.)The ombudsman reviewed 308 disability benefit decision letters assessing the five most commonly claimed medical conditions: Post-Traumatic Stress Disorder, hearing loss, osteoarthritis of the knee, tinnitus, and lumbar disc disease.

None of the letters included information about how Veterans Affairs determined a disability’s “quality of life” impact, which is one of two metrics used to calculate the benefits a veteran gets. The other is a person’s level of medical impairment.

That’s a problem, the report reads, because “the Qualify of Life Rating is a critical factor in the determination of a Veteran’s disability assessment. “But even if you disregard that quality of life measurement, only 38 per cent of letters gave “sufficient” reasons behind their decisions, the ombudsman found. A third of them gave no reason at all. Sixty-two per cent of letters didn’t explain the assessment or how the evidence available led to the decision, the report finds.

This report is only the latest indication of an information vacuum when it comes to Canada’s veterans: A Canadian Forces study of military suicides only looked at Regular Force members — the stats for veterans who’ve re-entered civilian life just aren’t there.

That study’s findings were sobering on their own, however: Army members are three times more likely to kill themselves than other Canadian forces members.


December 1, 2015

Ottawa, Ontario – Veterans Ombudsman Guy Parent released today ( see below) an assessment of Veterans Affairs Canada’s implementation of the eight recommendations put forth in his 2011 report, Veterans’ Right to Know Reasons for Decisions: A Matter of Procedural Fairness and in his 2012 report, Veterans’ Right to Disclosure: A Matter of Procedural Fairness. The two reports identified areas of improvement needed to ensure transparency and fairness in Veterans Affairs Canada’s disability application and adjudication process.

“Veterans need to know what information is used to make a disability decision in their cases; they need to know how decisions are arrived at; they need to have the results clearly communicated to them; and, they need to understand the impact,” said the Ombudsman. “As a priority, I urge the Minister of Veterans Affairs and Veterans Affairs Canada to provide applicants with a copy of their Service Health Records and all other information that will be considered by adjudicators in rendering disability benefit decisions.”

“Not providing adequate reasons for decisions is contrary to legislative requirements under both the Pension Act and the Canadian Forces Members and Veterans Re-establishment and Compensation Act“, said Mr. Parent. “Furthermore, in terms of how evidence is retrieved, by not ensuring the applicant has a copy of the evidence collected on the applicant’s behalf, the Department is infringing on the applicant’s legislative obligation to substantiate their claim.”

So far, the Department has partially implemented four recommendations made in the 2011 Report, while two of the recommendations in the 2012 Report have been fully implemented, and two have not been implemented at all.

“This assessment is a snapshot in time,” said Mr. Parent, “While Veterans Affairs Canada continues to make improvements, there is more to do. I am hopeful that through Veterans Affairs Canada’s new Veteran-centric Communications Task Force, which is examining how the Department communicates with Veterans, the concerns identified in my Follow-up Report will be addressed in full. This would result in fairer treatment for Veterans and fewer decisions being subject to time-consuming and costly appeals.”


Veterans' Right to Disclosure and to Know Reasons for Decisions: The Follow-Up Report

Download or read the report at link.

Report Summary

In Veterans' Right to Know Reasons for Decisions and Veterans' Right to Disclosure, the Veterans Ombudsman made recommendations to VAC relating to issues of procedural fairness in the disability application and adjudication process. Together, these two reports made a total of eight recommendations that were based on an examination of disability benefit decision letters and an analysis of legislation, regulations, policies and business processes relating to Veterans' disability benefits.

This Follow-up Report is an assessment of the implementation of these recommendations with the purpose of evaluating whether or not they have been addressed and, if so, to what degree.

To carry out this evaluation, the OVO reviewed a statistically-valid sample of 342 disability benefit decision letters on the top five claimed medical conditions (Post-traumatic Stress Disorder, Hearing Loss, Osteoarthritis of the Knee, Tinnitus, and Lumbar Disc Disease) dated between January 2013 and January 2015. Additionally, the OVO reviewed VAC's policies, procedures and business processes related to the processing and adjudication of disability benefits as they pertain to decision letters and the disclosure of evidence used to render those decisions.

This Follow-up Report found that of the eight recommendations made in the original two reports, two have been fully implemented, four have been partially implemented, and two have not been implemented. While progress has been made, the Ombudsman is hopeful that through the Veteran-centric Communications Task Force, which is examining how the Department communicates with Veterans, the concerns identified in this report will be addressed and the recommendations fully implemented. This will ensure that Veterans are aware of the information being used to make a decision and will provide them sufficient reasons for the decisions being rendered on their disability benefit applications. These changes would also be consistent with the Government of Canada's commitment to a Veteran-centric approach to disability benefits and excellence in service delivery.



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meh I don't know. This is a report on the past, the current gov't could care less as it will only become more fodder for "See how badly Harper treated vets!"

There are going to be a lot of moving parts in VAC, for the next 6-12 months especially, as new people get (re)hired, offices (re)open and pension legislation goes forward. The nuts and bolts parts like decision letters being in more plain language, and actually having reasons for approval/denial and whether or not what chapter injuries fit under will all come out in the wash.

Just for the record, my preference of importance of things to fix:
1) Pensions
2) Adjudication
3) VRAB (any PC appointees asked to step-aside in the letters this week?)