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Record of Discussion – 11 May 2017

Thursday, May 11, 2017
0830 – 1630 (ADT)
Charlottetown, Prince Edward Island

In Attendance

  • Joseph Burke, Canadian Aboriginal Veterans and Serving Members Association
  • Sylvain Chartrand, Canadian Veterans Advocacy
  • Deanna Fimrite, Army, Navy & Air Force Veterans in Canada
  • Mark Gaillard, Royal Canadian Mounted Police Veterans’ Association
  • Bruce Henwood, National Council of Veteran Associations in Canada
  • Captain (Retired) Dennis LeBlanc (Co-chair)
  • Corporal (Retired) Bruce Moncur
  • Lieutenant-Colonel Jamie Morse, Canadian Armed Forces Liaison Officer to Veterans Affairs Canada

Regrets

  • Bev Hawton, Assistant Deputy Minister, Business Improvement Division, Service Ontario
  • Charls Gendron, Royal Canadian Legion

Office of the Minister of Veterans Affairs

  • Benoit Charland, Stakeholder Relations

Veterans Affairs Canada Officials

  • Michel Doiron, Assistant Deputy Minister, Service Delivery (VAC Co-chair)
  • Rick Christopher, Director General, Centralized Operations Division
  • Janice Burke, Director General Team 20/20
  • Paul Thomson, Director General Service Delivery Modernization
  • Kim Andrews, A/Director General, Service Delivery and Program Management
  • Janet Nichols, A/Director General, Online Services
  • Tom Heckbert, Training Coordinator, Online Services
  • Michelle Morrison, Special Projects Coordinator, Stakeholder Engagement and Outreach

Observer

  • Sharon Squire, Deputy Ombudsman, Office of the Veterans Ombudsman

1. Welcome and Opening Remarks

The co-chairs provided opening remarks and welcomed the group to Charlottetown, Prince Edward Island, location of the headquarters of Veterans Affairs Canada (VAC).

2. Walkthrough of the Adjudication Process

The Department’s Director General of Centralized Operations Division was introduced and led a discussion of the adjudication process. Advisory Group members toured the operations area where the adjudication process takes place as part of the discussion. Some of the key points included:

  • 45,000 adjudication decisions are made annually, with approximately 120 staff working on the claims. There has been an increase in the number of claims for the Disability Award as a result of more open eligibility criteria.
  • Claims are adjudicated by nurse and ‘non-nurse’ adjudicators. For conditions that are common and have a clear link to a military trade, there is an expedited rapid model of adjudication, where ‘non-nurse’ staff are able to process the claims. Nurse adjudicators address the more complex and multiple conditions claims.
  • A question was raised about the possibly of splitting a claim that includes both straightforward and more complex conditions to expedite adjudication on the straightforward conditions, while allowing for a longer timeframe to address the more complex conditions in the claim. Members were told that there is value to keeping all claims for one individual processed through one stream, in order to see the whole picture and evaluate conditions that may be consequential to other claims.
  • There is no difference in timing of the adjudication process for claims under the New Veterans Charter or the Pension Act.
  • It was noted that adjudicators work in teams that specialize in particular conditions, and claims are directed accordingly.
  • It was noted that eliminating the step of determining the “fifths” calculation (the portion of the disability that is attributable to military service), would simplify and accelerate the process, as well as recognize the additional demand of military service. (The “fifths” refers to the adjudication process where the percentage of disability is calculated based on what portion of an injury is deemed to be attributable to military service, versus what is determined to be a pre-existing condition. The Disability Award may be awarded at a lesser percentage if some of the disability was determined to be pre-existing (i.e. 1/5, or a fifth)). It was stated that if a Canadian Armed Forces (CAF) member was declared fit for service at the time of joining, then any injury in the CAF that is attributable to military service should be assessed at five fifths assuming fitness at the time of joining the military.
  • It was noted that VAC and the CAF have been working together to better align the adjudication process, with the eventual long-term goal that the adjudication process is completed prior to a CAF member’s release from the military.
  • It was suggested that it would be helpful if the CAF provided VAC with documents with the related medical release reason for the breach of Universality of Service (medical condition that led to release) which would assist VAC in making its adjudication decisions.
  • Several case examples were presented to the group, along with the corresponding claim forms that are filled out by the claimant.
  • Suggestions from the group included:
    • Eliminating the questionnaire to determine quality of life as it does not add value. Presenters agreed that there are no VAC programs specifically designated to address quality of life, and the questionnaires can be time-consuming for adjudicators to evaluate.
    • The privacy notice and declaration currently on the forms is too long. It was suggested that it be revised and modelled on what is used by the Canada Revenue Agency.

3. Disability Benefits Program Review and Action Plan

The Director General for Team 20/20 and the Director General of Centralized Operations Division made a presentation on the Disability Benefits Program Review and Action Plan. Key elements of the presentation included the following:

  • The current structure of providing disability benefits has become very complex.
  • Efforts are now underway to simplify the process. The relevant legislation is now more liberally interpreted to ensure a more informal and expeditious adjudication process, with emphasis on adjudicators providing the benefit of the doubt.
  • As part of the vision to simplify and streamline VAC processes around providing disability benefits, a “Journey Mapping” exercise was conducted by VAC in 2015-2016 to get a full picture of a Veteran’s experience during his or her interactions with the Department. The exercise included a comprehensive random review of 400 client files, and a deeper investigation of 1000 disability program client cases. The exercise included consultations with some of the Veterans whose files were examined and an inter-branch VAC Working Group that addressed the issues raised and proposed solutions.
  • Findings from the ‘Journey Mapping’ included:
    • There is currently a complex framework of policies, decision-making tools, business processes and service delivery practices.
    • There is an over-reliance on medical evidence and processes, including lengthy medical forms (40 forms totaling 290 pages) and multiple medical exams.
    • Wait times can be lengthy, with significant delays compared to other VAC programs. There are also numerous touch points for reassessments which add delays.
    • Decision letters sent to clients can be confusing and, in some cases, may be perceived as disrespectful.
  • An Action Plan is being implemented between April 2017 and April 2018 to address the following:
    • Simplified entitlement process, eligibility policies & guidelines
    • Simplified assessments, reassessments and processes
    • Simplified periodic payments
    • Simplified and improved decision letters
    • Development of new integrated Veteran-Centric approaches

The presentation was followed by a question and answer session with the following highlights:

  • Possibility of pre-approval of benefits that anticipate a client’s needs, especially for certain conditions with known trajectories.
  • Suggestion that the process for determining benefits for particular injuries or conditions should automatically activate the receipt of associated benefits for that condition (for example, health products required for amputation, or a hip replacement). It was also suggested that those items which are considered to be required on a permanent basis should not require an annual re-application.
  • VAC should strive for ‘service excellence’ not just ‘service delivery’.

4. Service Delivery Review Update

The Director General of Service Delivery Modernization provided a presentation to the group on the Service Delivery Review Implementation Plan. This presentation is a follow-up to a previous presentation to the group in June 2016, on the initial findings of the Service Delivery Review. The record of discussion from that meeting can be viewed here.

The presentation from the current meeting included the information below.

  • An overview of the current numbers of Veterans receiving services at VAC:
    • There are approximately 660,000 Veterans in Canada.
    • Since 2003, approximately 4000 Regular Force members and 3000 Primary Reserve Force members release from the CAF annually.
    • In addition to the Veterans who are served by VAC, there are also benefits provided to 52,722 War Service survivors, and 9,492 Canadian Armed Forces survivors; VAC also administers benefits on behalf of 13,214 RCMP members or former members and their survivors.
    • VAC Veteran clients comprise approximately 18% of the overall Veteran population in Canada.
    • The majority of released members adjust well to post-military life, and about 25% report a difficult adjustment.
    • A vast majority (86% of Veterans) report being satisfied with life. (Information above current as of March 2017).
  • The Service Delivery Review was comprehensive and included many elements such as:
    • Assessment of all service channels – online, in-person, mail, telephone.
    • Site visits conducted to regional offices across the country.
    • Mapping of the Veteran experience and discussions held with groups of Veterans.
    • Partnerships and contractual arrangements reviewed.
    • Review of VAC’s performance measurement framework and service standards.
  • Key issues raised from the overall review included:
    • The VAC Service Model is too complex, siloed and fragmented, with a gap for Veterans with moderate needs.
    • VAC infrastructure is not aligned to support the service delivery vision.
    • VAC external communications are complex, overwhelming and often ad-hoc, and outreach is not meeting needs.
    • VAC employees do not have all the tools and resources they need to serve Veterans effectively.
  • The Service Delivery Review formulated 31 recommendations and 91 measures grouped under the following four themes in support of achieving service excellence:
    • Align program, policy and corporate functions.
    • Invest in business tools, technology and training.
    • Develop a more integrated, simplified and user-friendly service delivery model.
    • Strengthen external communications, information sharing and outreach.
  • In general there is a paradigm shift required for service delivery to move from a “program centric” approach to a “veteran centric” approach.

The presentation was followed by a group discussion with the following highlights:

  • Recipients of Special Duty Area benefits receive a broader array of benefits than others in accordance with legislation, and this can seem unfair.
  • Services and benefits should be coordinated by the department for Veterans, rather than have a Veteran try to navigate the various options and application processes him/herself.
  • The Veteran experience should be the measure of success of service delivery.
  • Proactive communications is so important to the Veteran experience; if there are delays then it is important to let people know the reasons.
  • Provide answers and decisions in a more timely manner.

5. External Service Standards Review

The Acting Director General of Service Delivery and Program Management made a presentation on the Review of External Service Standards. This is one of many initiatives emerging from the broader Service Delivery Review implementation plan. The purpose of the presentation was to solicit feedback to determine if the service standard statements currently being considered are meaningful. Elements of the presentation included:

  • A service standard was defined as “a public commitment to a measurable level of performance that clients can expect under normal circumstances”. The focus of the discussion was on existing service standards, and potential service standard statements, for the following VAC programs/services:
    • National Contact Centre Network
    • Case Management
    • Disability Benefits
    • Health Care (Treatment) Benefits
    • Rehabilitation Program
  • The existing service standard statements were presented for each program. For example, for the National Contact Centre Network, the current service standard statement is “When you call our National Contact Centre Network, you can expect to be connected with the next available analyst within 2 minutes.”
    • Proposed alternatives were presented to the group and feedback was given on each of the proposed external service standard statements. Some key considerations discussed related to what callers can expect when contacting the general information line. The group noted that providing a time estimate of when they will be answered is important, as well as being connected to the appropriate area. It was suggested that there could be an option to request a call back from their case manager. It was noted that presently there is no caller identification when VAC contacts Veterans by telephone, and suggested that this would be helpful to change.
    • The presenter noted that the feedback provided was very helpful.
    • The new service standards will be implemented using a phased approach, beginning in April 2018.

6. My VAC Account

The Acting Director and Training Coordinator of Online Services provided a comprehensive demonstration of the My VAC Account tool, starting with a short video that gives an overview of this tool. This video can be found here. It was noted that there has been a large uptake of My VAC Account, with 2000 new accounts opened each of March and April 2017. Advisory Group members see My VAC Account as a very positive initiative of VAC and offered the following comments:

  • It would be useful to have a training account option, where members of the Advisory Group and Veteran advocates would be able to use this as a demonstration tool for Veterans they may be assisting.
  • In response to a suggestion about the possibility of having a ‘chat’ option, the presenters indicated that they are looking at ways to make the tool more responsive.

7. Closing Remarks and Next Steps

The co-chairs thanked everyone for their participation. Members agreed that it was a productive meeting, and they will have a teleconference in the coming months for follow-up.

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