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Evaluation of the Disability Benefits Redress Process Summary

Evaluation of the Disability Benefits Redress Process Summary

Veterans Affairs Canada - March 2022

Evaluation results

Relevance and Need

The Disability Benefits redress process is responsive to the needs of its targeted population and aligns with government roles and responsibilities.

There is a continued need for the redress process demonstrated through a steady ongoing demand for Disability Benefits, with forecasted increase of 2.1% from 2020-21 to 2024-25.

Performance and Efficiency/Effectiveness

There are opportunities to improve the effectiveness and efficiency with the Disability Benefits redress process.

The evaluation identifies opportunities relating to:

  • increased communication and collaboration between those involved in the redress process (Centralized Operations Division, Bureau of Pensions Advocates, and the Veterans Review and Appeal Board);
  • systems and data capture improvements;
  • the identification and monitoring of performance metrics for the redress process;
  • improving the consistency and standardization of regional practices.

Recommendations

Recommendation 1 Management responses and action plans
It is recommended that the DG, Centralized Operations Division work in collaboration with the Director, Strategic and Operational Support at the Bureau of Pensions Advocates to modify the existing Disability Benefits Program Performance Information Profile to include performance indicators (expected outcomes, targets and indicators to measure achievement) related to Departmental Reviews and BPA’s responsibilities in the VRAB Review, Appeal and Reconsiderations Processes.

The Performance Information Profiles (PIPs) outlines the Program outputs and outcomes and identifies a number of indicators that will be used to measure those outcomes. These profiles also establish targets indicating the level of performance that the Program plans to achieve within a specified time period. Service Delivery’s Centralized Operations Division adjudicates the first option in the redress process, Departmental Reviews (DRs). The Bureau of Pensions Advocates (BPA) regularly receives requests from Veterans for an ‘appeal’ of their first decision that is more appropriate to be reviewed by the Department (Departmental Review). The Bureau’s publicly communicated service standard to have a case prepared for the VRAB is 21 weeks from the date of first contact. Currently, the PIPs related to the Disability Benefits Program do not include indicators related to DRs, or BPA’s responsibilities in the VRAB Review, Appeal and Reconsiderations Processes.

The Performance Information Profiles (PIPs) outlines the Program outputs and outcomes and identifies a number of indicators that will be used to measure those outcomes. These profiles also establish targets indicating the level of performance that the Program plans to achieve within a specified time period. Service Delivery’s Centralized Operations Division adjudicates the first option in the redress process, Departmental Reviews (DRs). The Bureau of Pensions Advocates (BPA) regularly receives requests from Veterans for an ‘appeal’ of their first decision that is more appropriate to be reviewed by the Department (Departmental Review). The Bureau’s publicly communicated service standard to have a case prepared for the VRAB is 21 weeks from the date of first contact. Currently, the PIPs related to the Disability Benefits Program do not include indicators related to DRs, or BPA’s responsibilities in the VRAB Review, Appeal and Reconsiderations Processes.

Recommendation 2 Management responses and action plans
It is recommended that the DG, Veterans Review and Appeal Board improve on the data collection at the Board, including the development of a standardized process and request required system changes (via VAC Systems Priority Committee) in order to improve tracking and reporting. Specifically, that the Board capture data on reasons for decisions and, upon availability of this data, share with VAC for potential opportunities for improved policies, processes, quality assurance, etc.

VAC is engaging with the Board in developing the redress GCcase system. Disability redress processing will be captured in this new system. The work is set to begin in April 2022. Progress is dependent on VAC resources to develop and implement the system changes. Given limited resources and the move to GCcase by VAC, the Board has decided to focus on the development of this new system for redress, rather than invest in the legacy technology.

As this system is developed, the Board will undertake to include, in the new GCcase redress system, indicators that will enable data capture of reasons for decisions. The Board will collaborate with VAC in determining the data decision points to be captured. Once implemented, the Board will regularly share the data reports with VAC.

Recommendation 3 Management responses and action plans
It is recommended that the ADM, Service Delivery work in collaboration with the ADM, Strategic Policy & Commemoration, the Chief, Bureau of Pensions Advocates, and the DG, Veterans Review and Appeal Board to establish a formalized approach to communication and information sharing, which could encompass: changes to Disability Benefits policies and processes; trends and decision reasons relating to Disability Benefit redress claims; information sharing on system/tool changes and associated innovative solutions; and consultation regarding internal and external reviews related to the Disability Benefits Program. In addition, it is recommended that the committee request regular updates from the Veterans Ombud for information related to Disability Benefits systemic reviews and complaints.

While the various areas involved in the Disability Benefits redress process have informal meetings, currently there is no formalized approach for communication and information sharing that encompasses the Service Delivery Branch, the Strategic Policy and Commemoration Branch, the Bureau of Pensions Advocates, and the Veterans Review and Appeal Board.

To establish a more collaborative environment, Service Delivery will arrange more formalized meetings involving these areas that will take place three times per year. These meetings will include the Director General level and the applicable directors from each area and will be documented through the use of agendas and records of decision. Periodically, these meetings will include updates from the Veterans Ombud regarding information related to Disability Benefits systemic reviews and complaints.

Recommendation 4 Management responses and action plans
It is recommended that the Chief, Bureau of Pensions Advocates review the variance in cases sent for DR or VRAB review/appeal between regions to ensure standardized processes are in place across the country, where appropriate.

The Bureau of Pensions Advocates is structured regionally. This has created some regional variance in practices. To some degree this is necessary to allow lawyers to practice law as they deem appropriate. Departmental reviews represent an area of legal practice that overlaps between a lawyer's personal preference, and administrative standardization in process.

With respect to the differing numbers of Departmental Reviews in the western region, the main reason for this is the backlog of French Departmental Reviews at Centralized Operations Division, thereby moving non-western region files to hearing at VRAB instead for faster service to the client.

However, The Bureau of Pensions Advocates agrees that there is room for improvement in standardizing the approach for which files move to Departmental Review, and which ones are heard by the Veterans Review and Appeal Board.

Program Description

  • VAC Disability Benefits provide recognition of service-related illness and injury. The payment amount depends on the degree to which the medical condition is related to service (entitlement) and the severity of the condition, including its impact on quality of life (assessment).
  • Clients who are not satisfied with a Disability Benefit decision from VAC (entitlement and/or assessment) have a legislated right to review or appeal. They can seek Departmental Review at VAC or bring their decision to the Veterans Review and Appeal Board (VRAB), an independent, arm’s length administrative tribunal.
  • Clients who are dissatisfied with a Disability Benefits decision are encouraged to contact the Bureau of Pensions Advocates (BPA), a nation-wide organization of lawyers within Veterans Affairs Canada providing free legal advice and representation for this purpose. The BPA team will review the file and may recommend the client apply for a Departmental Review through VAC or take their case to the Veterans Review and Appeal Board (VRAB). The BPA assists clients with preparing Departmental Review applications and written submissions and can represent the client at the VRAB. Clients may also choose to represent themselves, engage private representation, or seek help from Veterans Organizations like the Royal Canadian Legion.
  • At the VRAB, the first step is a Review Hearing. If the client is not satisfied with the Review decision, they can request an Appeal.
  • If the client has exhausted all redress options at VAC and the Board and remains dissatisfied, they have the right to apply to the Federal Court of Canada for a Judicial Review of the decision (outside the scope of this Evaluation).

About the Evaluation

Scope and Methodology

  • This evaluation had been conducted in alignment with the 2016 Policy on Results where departments periodically evaluate organizational spending on the programs and services of the department.
  • In addition, this evaluation has been conducted as an identified area of risk/need. Further, an evaluation of VAC's Ombud's Office (2019) noted complexities and challenges in the review and appeal process and recommended that VAC review the various complaint and redress streams available to Veterans.
  • The evaluation was conducted between September 2020 and January 2022, and included document reviews, file reviews, data analysis, and key informant interviews.
  • Evaluators assessed the relevance, performance, effectiveness, and efficiency of the DB Redress process over the period April 1, 2015, to March 31, 2020.
  • With the onset of the global COVID-19 pandemic in 2020, the Evaluation team also looked at some of the impacts of the pandemic on redress in an effort to provide a fulsome and up to date review of the process.
  • The purpose of this evaluation was to ensure the Disability Benefits redress process is relevant and meeting Veterans' needs, while determining if there are opportunities to improve its effectiveness or efficiency. It is anticipated that this evaluation will provide strategic and timely information to support program, policy and operational areas as they continue to improve the delivery of benefits and services to Veterans and their families.
  • For the purpose of this evaluation, the evaluation team focussed on BPA's involvement in the redress process and not redress applications initiated by Veterans themselves or with the help of the RCL or with private representation.
  • Areas out of scope for this evaluation include:
    • Appeals for the War Veterans Allowance Program;
    • Appeals for the Critical Injury Benefit;
    • Disability Benefits/Pain and Suffering Compensation and claims processing;
    • Reviews for all other VAC programs

Constraints and Limitations

  • As a result of restrictions imposed by the global COVID-19 pandemic, the evaluation team relied on virtual interviews and observations in lieu of in-person meetings and discussions.
  • The evaluation team did not speak directly with Veterans who accessed the redress process. As a mitigation strategy, the team spoke directly with BPA employees and VRAB Members and staff who communicate with Veterans. In addition, the team reviewed data received from BPA's client satisfaction questionnaires and VRAB's Review Hearing Exit Surveys.
  • The Redress process is currently undergoing a migration process from its existing system of the Client Service Delivery Network (CSDN) to a new system called GCcase. In addition, VRAB has their own client management system which is separate from the CSDN (the VRAB Scheduling Application). Furthermore, BPA has not been able to secure its own client management system and, prior to the pandemic, relied almost exclusively on paper files. As a result, it is a challenge to track the whole process from start to finish given the different systems involved.

Evaluation Report