How Benefits are Determined
Once you submit your completed application we will:
- review your service records that we ordered;
- review your application, medical reports and service documents; and
- let you know if there is anything else required to complete your claim.
After this, your application will be reviewed by an adjudicator, a trained decision-maker who specializes in disability applications. The adjudicator independently examines the evidence you submitted.
Some of the questions the adjudicator needs to answer in order to reach a decision include the following:
- Is there a disability?
- Is your disability related, or partially related to, your service?
- What is the extent of the disability
Throughout this process, it is important to understand that every decision we make:
- must be based on evidence. This is why it is so important that you provide us with as much information as possible (refer to the "What You Need to Apply" section); and
- is guided by laws and policies that outline who is eligible and how claims are assessed.
If it is established that your disability is related to your service, the next step is to determine the extent or severity of your disability so that we can assign an assessment level. This assessment level is based on how your disability impacts your overall physical and/or mental function and your quality of life.
Once the adjudicator reaches a decision on your claim, you will receive a decision letter. The letter will let you know the decision regarding your application, what evidence was used to reach the decision and, if favourable, the level of your entitlement and assessment.
If you receive an unfavourable decision, your decision letter will explain the reasons why and provide the name and telephone number to call if you wish to discuss the decision further. The letter will also explain your appeal rights.
Insurance Principle and Compensation Principle
If you are serving in a Special Duty Area (SDA) or Special Duty Operation (SDO), any resulting disability or death will be covered through the Insurance Principle which provides coverage 24 hours a day while serving.
If you are serving during peacetime, you will be covered through the Compensation Principle which provides coverage for any disability or death that is directly related to your service.
When to Expect a Decision
We are committed to providing a decision to you as soon as possible. In most cases, a decision will be made within 16 weeks of the Department receiving all the information required from you in support of your application.
If the disability for which you are receiving VAC benefits worsens and medical evidence can support that there has been a change in your condition, you can request a reassessment. If the reassessment confirms that your condition has worsened, your disability benefit, will be adjusted accordingly-unless you are already receiving the maximum assessment as set out in the Table of Disabilities. If that is the case, no additional amount can be provided.
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- Career Impact Allowance
- Disability Benefits
- Disability Pension
- Disability Award
- Exceptional Incapacity Allowance
- Related Allowances
- Applying for Benefits
- How Benefits are Determined
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- Reviews and Appeals
- Frequently Asked Questions
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