It's a pleasure to be here again in front of this committee. My name is Bernard Butler. I am the director general for policy in the policy, communications, and commemoration branch at Veterans Affairs Canada.
I am joined here today by my colleague, Rick Christopher. Rick is the director of program management in the service delivery branch of Veterans Affairs.
[Translation]
Our objective is to support your review of the processes and activities of the Veterans Review and Appeal Board, including any recommendations that could improve the current appeal process.
[English]
Essentially, our objective here today is to support your review of the processes and activities of the Veterans Review and Appeal Board and to assist you in any recommendations that could improve the current appeal process.
Today, we, Veterans Affairs Canada, will provide you a technical briefing on the disability benefit application, decision-making, and redress processes that take place with regard to a disability benefit application at the departmental level. We will endeavour to help the committee better understand the department's processes and at which point a departmental decision could make its way to the Veterans Review and Appeal Board for review.
Mr. Christopher will start with a high-level overview of the department's disability benefits adjudication process, and he will conclude with the departmental review process and how that links with the Veterans Review and Appeal Board, including the role of the Bureau of Pensions Advocates in the redress process.
After that, we'll be happy to answer any questions you may have.
I'll now turn to my colleague Rick.
:
Thank you, Bernard, Mr. Chair, and committee members.
As Bernard said, my name is Rick Christopher. I'm the director of program management at Veterans Affairs Canada, or VAC. My role is to oversee management of the department's disability benefits programs.
Today I'm going to describe for the committee the process that a disability benefit application goes through. I'm going to talk about the support systems in place at each stage of the process, as well as the legislated authorities the department uses as a basis for decision making. I'm going to speak about our own redress mechanisms, including some of the statistics, and finish off at a point where the disability benefit decision could potentially make its way before the Veterans Review and Appeal Board.
I'm going to start with a brief description of the disability benefit application process. When a veteran, serving member, or RCMP member believes that they have a service-related disability, they must first submit a formal application to the department. This application can be found online, at VAC offices, or any of the 600 Service Canada locations across the country.
VAC's authority to provide disability benefits is found in the Pension Act and the Canadian Forces Members and Veterans Re-establishment and Compensation Act, commonly referred to as the new Veterans Charter.
There are two criteria that a veteran, Canadian Forces member, or RCMP member must meet in order to receive a disability benefit, which are essentially that they suffer from a disability and that the disability be related to their service. Evidence that an applicant meets these two criteria is often a combination of medical documentation, military service records, and testimonials from colleagues, commanding officers, or others.
Support is available through the department's team of disability benefit officers who work in area offices across the country. These are individuals who work one-on-one with the applicant to ensure that his or her claim is as complete as possible before it is submitted. This can include a gathering of service records from DND and health records from health care providers.
I'd also be remiss if I didn't note that an applicant can get help with completing the application from the Royal Canadian Legion or other veterans' organizations. Service Canada can also review application forms to ensure that they are completed appropriately before they are forwarded to Veterans Affairs for adjudication.
The next step, once an application is completed and submitted, is to assign it to one of our 46 trained disability adjudicators.
These adjudicators assess the information against a predetermined set of criteria laid out within authorizing legislation to determine whether the individual is entitled to disability benefits. These decisions are based on the merits of the case and the weight of the evidence. However, in the absence of compelling evidence to the contrary, the benefit of the doubt always flows in favour of the applicant.
The benefit of the doubt is applied when there is an equal amount of supporting and non-supporting evidence. This means that in those cases, the decision is made in favour of the veteran.
Once entitlement is established, an assessment is made as to the extent of the disability, based on the degree to which the condition impacts health and quality of life. Assessments are made according to the table of disabilities. It's one of a suite of tools that ensure effective and consistent decision-making. With entitlement and eligibility guidelines and the table of disabilities, the adjudicator is provided with a well-defined evidence-based system with which to make decisions.
Once the assessment is completed, a monthly or lump sum payment is processed.
[Translation]
Decisions are communicated to veterans in writing. Our decision letters have already improved—15 of our high-volume disability benefits letters have been redesigned, reworded in plain language, and are already being used. That will benefit approximately 19,000 clients this year. We continue to improve our efforts in terms of plain language by cutting red tape and reducing complexity.
I will now speak about redress measures.
As I mentioned earlier, both favourable and unfavourable decisions are communicated by letter. The letter outlines the reasons for decision, redress rights, possible next steps and the support available for exercising these rights. Veterans who are dissatisfied with a decision of the department have two options available to them.
One of those options is a departmental review. When a departmental review is requested, a new adjudicator is assigned to the case to ensure a fresh set of eyes and to avoid any bias in the process.
[English]
Departmental reviews can be triggered in two ways. Either an error in fact or law is found, or there is new evidence to be considered. The departmental review can be requested by the applicant or be initiated by the department itself.
The second option is that the applicant may wish to forgo the departmental review process and proceed directly to the Veterans Review and Appeal Board. In these cases the final decision-making authority is permanently removed from the department. This means that in the event of an unfavourable decision at the VRAB level, the individual may not re-enter the departmental review process, as the department would no longer hold jurisdictional authority.
Leading up to the review or appeal by the VRAB, the department provides access to legal advice from an advocate in our Bureau of Pensions Advocates. The Bureau of Pensions Advocates is a unique nationwide organization of lawyers within Veterans Affairs Canada. The bureau provides free legal help for veterans who are not satisfied with the decisions about their claims for disability benefits. All advocates at the BPA are experienced in disability benefit matters. They are considered specialists in the area of claims for disability benefits. The solicitor-client privilege relationship between the veteran and the advocate ensures privacy is fully protected.
The bureau is very active in outreach programs that provide information and education to stakeholders. The BPA represents between 90% and 95% of veterans who appear before the Veterans Review and Appeal Board. The remainder choose to represent themselves, acquire private counsel, or seek representation from the Royal Canadian Legion or others.
That concludes the portion leading up to the point where an appeal or review before the VRAB would start.
I'm going to read a few statistics into the record.
In 2011-12, total expenditures for disability pensions and awards were $2.05 billion. Annually, we process more than 20,000 first applications for disability benefits. VAC has a service standard for first disability benefit applications being processed within 16 weeks 80% of the time. We are currently standing at 83%. I'm also pleased to advise that in fiscal year 2011-12, 73% of total applications reviewed were assessed as favourable and a payment schedule was initiated. The turnaround service standard for departmental reviews is 12 weeks 80% of the time. Last fiscal year, there were 2,213 departmental reviews conducted, 81% of which were completed within the 12-week window.
We're continuing to work to improve processing times and programs while cutting red tape and reducing program and policy complexity. I understand that my colleague, Maureen Sinnott, will be appearing later this week, and she'll speak to you about some of those.
I'll stop there, as I understand that Mr. Larlee and his associates from the Veterans Review and Appeal Board will be called upon shortly to provide their own briefing.
This concludes my briefing. Bernard and I are open to any questions that you might have.
I'm trying to wrap my head around the math and the who, what, where, when, and why. If your department deals with 20,000 applicants every year and you have a 75% success rate, that would be 15,000 a year that are approved right off the bat, and 5,000 would go to VRAB. It's my understanding that about 65% of those come back in favour of the veteran. We've looked at 20,000. Now we're down to 1,250 that have actually been rejected. Annually, we spend $11.5 million on VRAB's budget. I'm going to guess that we probably spend that much again on the Veterans Affairs budget to go through all these. We're spending somewhere in the neighbourhood of $20 million to get this done.
As a taxpayer, with fairness to veterans, where has the process gone wrong and how can we improve it? We're spending all this money, yet literally more than 80% of them actually get approved. What can we do to improve the process? Where are we going wrong that so many are turned down and then overturned?
:
Thank you, Mr. Chair, and thanks to both of you. I'm sorry I had to step out.
Mr. Butler, I say this with great respect. You talked about the generosity of the program. In fairness, the generosity comes from the men and women who serve. It's their sacrifice and it is their families who give their generous lives to our country in order for us to do the things that we're able to do.
I think there are a lot of veterans—not necessarily in this room, but across the country—who would think that the service is not that generous. On the Agent Orange ex gratia payment, there are a few hundred thousand people, I think, who would question that. I just say that as a comment.
I do have one case for you that came up with me recently. I know that you can't talk about a specific case, but you can talk about the generalities of it.
I have a gentleman—Blair Davis is his name—from Nova Scotia who applied for a benefit because of bruxism. Bruxism, as you know, is the grinding of the teeth due to suffering from post-traumatic stress disorder. He was denied. He took his case to VRAB. He was denied. He took it again, and he won his case.
The Veterans Review and Appeal Board actually agreed with him. The problem is that the legislation says there's no benefit for you. The officials at VRAB agreed with him that, yes, he now has bruxism. It's causing him a huge problem in his quality of life, but unfortunately the legislation says there's no benefit for him.
I'm wondering if you're aware of that. That's just one of many questions I could ask you about, but with the time I have, I can't. To me, this is a concern. Probably many other people have applied across the country.
Are you aware of that problem? Also, is there any possibility that we can change it to ensure that men and women who suffer from bruxism due to PTSD can actually get a benefit when they win their case through VRAB?
:
Perhaps I'll speak to that quickly. It's a very good question.
Of course, as you know, the department is engaged in many initiatives right now around transformation and trying to improve service delivery, improve our communication to veterans, and improve our policy framework so that adjudicators have easy access to updated, clear-speaking policies. We're doing a lot of things internally to help facilitate the adjudication process.
That said, there is a lot.... One has to understand the reasons cases are dealt with favourably at the Veterans Review and Appeal Board and have a different outcome from what they do at the departmental level.
A lot of those reasons relate to basic things, such as new evidence. The advantage of the system currently is that at the departmental level, a departmental adjudicator, as Mr. Christopher has referred to, will look at the evidence available, make a decision, and provide very clear reasons to the veteran as to why he or she is not qualifying. Those can be very simple things. It can be because there is not clarity around what the medical diagnosis is—in other words, what is the disability? There may be very little evidence on the record to show that this individual in fact had a service-related injury, for any number of reasons.
At the Veterans Review and Appeal Board level, the difference is that at their first level, which is called a review level, the veteran, for the first time, has the opportunity to actually appear in person before a review panel and provide oral evidence with respect to the issues that were identified by the department.
That's the first time in the process that the veteran is actually present. He can look in the whites of the eyes of the tribunal members and give clear evidence to fill in the gaps. Clearly, at that point, it's a new perspective. There is new information. There is a better opportunity to assess the credibility of the witnesses in terms of their recollection of events and so on.
That's a simple example of why, at the review level of the Veterans Review and Appeal Board, a fixed percentage of cases are favourable. If we did that at the front end, the problem or the challenge is that you would then delay the first adjudication for many veterans, particularly those for whom the outcome is very clear and who make up the 75% favourable cases that Mr. Christopher refers to. There is always a balancing process in these administrative types of decision-making, and one is challenged to find the best one, the one that works most favourably to the veteran.
There are always opportunities for improvement, but right now this is the system. We're trying to reduce the processing times at the front end. As Mr. Christopher says, we're making good headway there, and as a function of that, in a certain number of cases you are going to find that there is simply not enough evidence; however, if there is another opportunity to come back, that may change.
Hopefully that helps.
:
Thank you, Mr. Chairman and honourable committee members.
[Translation]
Thank you for inviting me today. I am joined by members of my management team: Dale Sharkey, the board's Director General, and Kathleen Vent, Acting Director of Legal Services.
We are here today to talk about the board and to bring you up to date on the improvements we have made since our most recent appearance, last March.
[English]
The three main areas of improvement since our last appearance in March are faster decision-making, clearer decisions, and the way we are listening to veterans.
First I would like tell you about the board. The board's primary role is to support veterans, members of the Canadian Forces, members of the RCMP, and their families in obtaining benefits for service-related disabilities. We do this by providing an independent avenue of appeal for disability benefit decisions made by Veterans Affairs Canada.
Our independence is crucial. It means that we are not bound by the department's decisions or policies. At board hearings, veterans have the opportunity to tell their story, bring forward new information, and be represented at no cost by lawyers from the Bureau of Pensions Advocates or by service officers from the Royal Canadian Legion.
The hearings are not adversarial. No one is arguing against the veteran. Board members take a fresh new look at the information and will award new or increased benefits to veterans if there is credible evidence that satisfies the legislation.
To come to the board, veterans need only be dissatisfied with their departmental decision. The reality is that many veterans are satisfied and never come to the board. Only 10% to 15% of the decisions made by the department each year are appealed to the board. Last year we issued a total of 4,900 decisions for veterans and other applicants. We are pleased that we can change a large number of decisions to favour veterans. For a small tribunal, this is a high-volume workload, especially since we deal with the most complex and challenging cases.
Veterans who come to the board have access to two levels of independent redress: a review hearing and, if they remain dissatisfied, an appeal hearing.
The review hearing is often a pivotal moment for veterans. It is their chance to finally appear before decision-makers and be heard. Our board members take considerable care to conduct the hearings informally, with compassion, and in the interest of giving the veteran the last word. Last year the board granted new or increased benefits to veterans in half of its review decisions.
If applicants are not satisfied with their review decision, they can appeal it. The appeal hearing is an entirely new proceeding, conducted by a different panel of board members. The legislation does not permit oral testimony at the appeal level. Rather, it is another opportunity for veterans, through their representative, to submit new information and arguments in support of their case. Last year the board granted new or increased benefits to veterans in one-third of its appeal decisions.
These success rates tell us that veterans and their families benefit from the opportunity to appeal their decisions to an independent tribunal, yet despite this generous system, not every case can succeed.
While we know that some veterans will disagree with our decisions, we are committed to dealing fairly and efficiently with their applications. This means getting their cases heard at the earliest opportunity, conducting full and fair hearings, issuing clear decisions, and treating them with respect and dignity.
[Translation]
I would now like to talk about three aspects of our program where we have made improvements in order to ensure that veterans and their families are well-served.
First, we communicate decisions to veterans more quickly. Thanks to new technologies and other improvements, the board processes requests for review about 20% more quickly than five years ago. We have reduced processing time by 50% in the case of appeals. We are also looking for other ways to set hearing dates more quickly, and that includes providing veterans with the option to have their hearing by videoconference. As I told you in March, the board is currently carrying out a project for restructuring the business processes in order to find ways to reduce red tape and make the process faster and easier for veterans.
[English]
A second area of improvement I want to talk about is our focus on issuing fair and well-reasoned decisions for veterans. This begins with the board's merit-based selection process, which ensures new members are qualified to hear and decide cases. The criteria include a preference for members with a military, medical, policing, or legal background, in recognition of the work we do and the people we serve. Our two newest members, appointed last year, are CF and RCMP veterans.
Our excellent training program for new members combines practical teaching and support from experienced staff. All members also receive ongoing and specialized training from medical, legal, military, and lay experts on a variety of topics. In fact, as part of our annual training, later this week we will be hearing from Rear-Admiral Andrew Smith, chief of military personnel, and other serving members about military culture and operations at CFB Greenwood.
We have also taken swift action to address recommendations from the Veterans Ombudsman and suggestions from our stakeholders. For example, we have established a team to improve the quality of decisions by ensuring they are well organized, clearly expressed, and written in plain language. We will implement these improvements by the end of the year.
Our third area of focus is in working to serve and honour veterans by listening to them and acting on their feedback. Veterans have told us they want greater access to our decisions. In May, we began publishing the board's most relevant and instructive decisions on our website. These noteworthy decisions help veterans and the public better understand our work and make applicants aware of decisions made in cases similar to their own. We are also committed to building and maintaining our communications and partnerships with our stakeholders.
In short, we are listening. We know there is more work to do. We are determined to make it happen, and as soon as possible.
[Translation]
Before I wrap things up, I would like to invite all the members of the committee to attend a review hearing at one of our locations, in one part or another of Canada. Two of your honourable colleagues, Mr. Stoffer and Mr. Casey, have already accepted that invitation. They have told us that it was a useful and rewarding experience.
Mr. Chair, I want to thank you for the opportunity to speak today about the board's commitment and about serving our veterans, Canadian Forces and RCMP members, as well as their families.
Thank you.
[English]
I'm prepared for your questions.
:
I don't have all of the details with me, but I note that since 1998, when I started with the board, we had a peak of between 9,000 and 10,000 decisions a year. It would go down to 7,000, back up to 8,000, down to 6,000, so over time it has decreased. As I said, we're at 4,900 this year; last year it was approximately the same. There have been a lot of peaks and valleys.
Much of the volume depends very much on the number of first applications that are made with the department. For example, last year they rendered between 35,000 and 40,000 decisions that were appealable to the board, and we received about 10% of those.
It's also difficult to predict volume because veterans need only be dissatisfied, and there's no time limit within which they must appeal. They may decide to appeal 25 years after they've received a decision or they may appeal within a year. They don't have to come to the board and prove they have an error in fact or law, or bring new evidence; they need only be dissatisfied. I think that's part and parcel of the fluctuation, but it greatly depends on the volume at the department. It also depends on how representatives deal with the applicants in terms of counselling them in or out, based on the strength of their cases.
Another element that's played into the decrease in numbers is that a larger proportion of our cases, the more straightforward ones, go to a departmental review. I believe Mr. Butler probably spoke about the departmental review, an administrative redress mechanism within the department. I think over 2,000 cases were done at departmental review; in years past they might have done a few hundred, and those cases would have been at the board. It's a better process for them to go to the department. They get all of their appeal rights if they're still dissatisfied.