Evaluation of Pain and Suffering Compensation - Summary

Recommendation #1:

It is recommended that the Assistant Deputy Minister, Service Delivery, in collaboration with the Assistant Deputy Minister, Chief Financial Officer and Corporate Services develop a Disability Benefits strategy that will enhance the efficiency and experience of the program for both Veterans and employees and build program sustainability. A corresponding action plan will include actions that:

• (a) Streamline workflows and business processes.
• (b) Review and update process requirements, as appropriate, with consideration of the administrative burden on clients, employees, and the Canadian Health Care system.
• (c) Enhance processing through an innovative technology solution that can address disability benefit applications from intake to payment through a single window interface for users.

To best position the Department to meet ongoing demand for Disability Benefits within service standards*, a two-phased approach will be initiated:

* As of July 2024, the date when the evaluation was substantially completed, Veterans Affairs Canada’s service standard for disability benefit applications was 16 weeks for first applications 80% of the time.

Phase 1: A cross-functional team will complete a critical analysis of the current state of Disability Benefits administration and develop recommendations for an effective, efficient, and stable future state that is in alignment with Veterans Affairs Canada’s strategic plan and the projected growth in demand for Disability Benefits. This analysis will result in a strategy in alignment with departmental service modernization efforts led by the Chief Digital Service Modernization Office.

Phase 2: In consultation with the Chief Digital Service Transformation Office, an action plan will be developed to address the issues identified in the strategy to include deliverables, timelines, and resource requirements. The plan will reflect the intent of Service Modernization Strategy and the Service Modernization Workplan. Implementation efforts will be contingent on the outcomes of Budget 2025 and the Refocusing Government Spending exercise.

Recommendation #2:

In conjunction with Recommendation 1, to ensure smaller scale pressures on the disability benefits program are addressed, it is recommended that:

• (a) The Director General Centralized Operations Division, in collaboration with the Director General, Service Delivery and Program Management and the Director General, Information Technology, Information Management, Access to Information and Privacy (ITIMAP), ensure system related process improvements are identified, communicated, and prioritized to support efficient delivery of disability benefits.
• (b) The Director General, Centralized Operations Division continue to invest in adjudicator training and monitoring of medical advisory requests with a view to ensuring only necessary conditions are sent for a medical consult.
• (c) The Director General, Health Professionals Division ensures that the appropriate processes and resources are available to both reduce the current number of applications awaiting a consult, and provide a timely response to future medical consult requests.

2(a): The Centralized Operations Division (COD) in collaboration with Information Technology and Service Delivery and Program Management (SDPM) will develop and maintain a strategic system and technology vision document aligned with its operational goals and the departmental vision.

• The Information Technology, Information Management, Administration and Privacy Division in collaboration with COD and SDPM will ensure that the departmental technology vision aligns with and supports COD’s strategic vision.
• COD will create a structured framework for capturing, prioritizing and managing all COD system requests and technology-related innovations for inclusion in the departmental priority setting through the Veterans Systems Priority Committee.
• COD’s Systems and Technology Advancement Team will promote collaboration and knowledge sharing and act as the primary liaison between COD stakeholders and partners in Information Technology and Service Delivery and Program Management’s Business Integration Directorate (BID), to ensure technology solutions impacting COD are aligned with COD's strategic objectives.

2(b): The Centralized Operations Division (COD) will analyze the Medical Advisory consultation process and implement an evergreen plan to reduce both the applications currently in the consultation queue and those sent to Medical Advisory for a consultation going forward.

• Based on findings from the analysis, COD will conduct adjudicator training (with the support of Medical Advisory, as needed) and provide functional direction that will help to ensure only necessary conditions are sent for a medical consult.

2(c): The Medical Advisory (MA) team, will work with the Centralized Operations Division (COD) to support the review of the Disability Benefits process as a whole to determine where efficiencies and synergies can be gained, thus reducing the burden, backlog and referrals to Medical Advisory. Should additional resources be required, once systemic reviews have been completed, a request will be prepared for Central Agency review and consideration.

Recommendation #3:

It is recommended that the Director General, Centralized Operations Division, in consultation with the Director General, Strategic Planning, Results and Cabinet Business, develop transparent Veteran-focused service standards with consideration of the different types of applications and adjudicative processes.

Upon finalizing the DB strategy with the goal of positioning the Department to meet ongoing demand for DB within service standards (Recommendation #1), the Director General, Centralized Operations Division, will work in consultation with the Director General, Strategic Planning, Results and Cabinet Business to:

• identify Veteran-focused service standard options;
• conduct analysis to support establishing appropriate service standard commitments; and
• propose service standards (commitments and targets) that could be published for clients.

Recommendation #4:

(a) It is recommended that the Director General, Centralized Operations Division, in consultation with the Director General Strategic Planning, Results and Cabinet Business review outcomes, results and targets with a view to ensuring they are aligned with the objective of the program and are achievable.

(b) It is recommended that the Director General, Policy and Research determine why outcome achievement is significantly less for segments of the client population.

4(a) The Director General, Centralized Operations Division, will work in consultation with the Director General, Strategic Planning, Results and Cabinet Business to:

• review outcomes and results to ensure they are aligned with the objective of the program; and
• assess targets to ensure they align with the current and aspirational goals of the program.

4(b) With respect to Recommendation 2(b), the evaluation identified two questions from the 2022 VAC National Client Survey where specific segments of the population reported lower results:

• the disability benefits I receive from VAC recognize my service-related disability
• the disability benefits I receive from VAC compensate me for the effects of my service-related disability

For both of these questions, Indigenous Veterans, Veterans who were visible minorities, CAF still serving, and younger Veterans (less than 60) reported lower levels of satisfaction than other Veterans.

Action: the Director General, Policy and Research will collaborate with the Indigenous Veterans Engagement Team, The office of Women and 2SLGBTQIA+ Veterans, and Service Delivery and Program Management to understand why certain client population segments are reporting lower rates of feeling recognized and compensated. This work will include:

• (a) Conduct a detailed review of responses from these groups in the 2022 VAC National Client Survey
• (b) Conduct outreach or consultation with members of these groups to understand why these segments are reporting lower rates of feeling compensated and recognized;
• (c) continue GBA+ analysis of Disability Benefit policies which may identify gaps aligned with dissatisfied client groups;
• (d) summarize issues.

Scope and methodology

• Conducted in accordance with the directive and standards specified in Treasury Board of Canada’s 2016 Policy on Results and VAC’s 2022-23 to 2026-27 Departmental Evaluation plan.
• Objective of the evaluation was to assess program relevance and performance.
• Covers the time frame from April 2019 to December 2023 (when available and applicable, data up to May 2024 was incorporated into the evaluation).
• Multiple lines of evidence were used including document review, data analysis, observation, and key informant interviews.

Constraints and limitations

• The evaluation team did not speak directly with individuals in receipt of PSC.
• With two processing systems being used for PSC applications, data retrieval and detailed analysis from this period was more complicated. To mitigate this issue, the evaluation used pre-published statistics for the DB program where available.
• There is no official forecast of demand for the program; however, the evaluation utilized a forecast that the Department had prepared internally for another purpose that showed expected demand for the DB program.
• The evaluation was conducted while many efforts were underway to make improvements to the program’s delivery (e.g., backlog reduction efforts). Where possible, impacts of these improvements were considered.