Proceedings of the Subcommittee on
Veterans Affairs
Issue No. 3 - Evidence - March 23, 2016
OTTAWA, Wednesday, March 23, 2016
The Subcommittee on Veterans Affairs of the Standing Senate Committee on National Security and Defence met this day at 12:03 p.m. to study the services and benefits provided to members of the Canadian Forces; to veterans; to members and former members of the Royal Canadian Mounted Police and their families.
Senator Joseph A. Day (Chair) in the chair.
[English]
The Chair: I call this meeting of the Subcommittee on Veterans Affairs of the Standing Senate Committee on National Security and Defence to order.
Before I introduce our guests for today, honourable senators, I have some bad news to bring to the subcommittee, and that is the untimely death of Jim Hillyer, Member of Parliament for Medicine Hat—Cardston—Warner. He died this morning in his office. Out of respect for him and his family, I'd ask you to stand for a moment of silence.
Honourable senators then stood in silent tribute.
It is particularly poignant that he died serving his country, and that is exactly the area of particular interest to this Committee on Veterans Affairs. We deal with a lot of Canadians who have died or been injured serving their country.
That leads me to introducing our witnesses for today.
[Translation]
We are continuing our study on the services and benefits provided to members of the Canadian Forces, to veterans, to members and former members of the Royal Canadian Mounted Police and their families.
[English]
The Veterans Review and Appeal Board is one of the organizations that serve these groups as it offers review and appeal processes for Veterans Affairs Canada decisions on disability benefits. I'm very pleased to welcome two representatives of the board: the acting chair, Mr. Thomas Jarmyn; and the director general, Ms. Dale Sharkey.
Thank you both for being with us here today. We look forward to learning more about your activities and the evolution of the board, which I understand was created in 1995-96, in that time frame, amalgamating two other boards that existed prior to that. Your presentations and answers to our questions will be very helpful to us as we reflect on the services and benefits available to our veterans and their families.
Mr. Jarmyn, you have some introductory remarks, and then I'll go to Ms. Sharkey after you. You have the floor, sir.
Thomas Jarmyn, Acting Chair, Veterans Review and Appeal Board: Thank you, Mr. Chair, honourable senators. Thank you for proceeding with these hearings in what is no doubt a difficult time.
[Translation]
Mr. Chair, honourable senators, thank you for inviting me here today to speak to you about the Veterans Review and Appeal Board, and how we are serving Canada's veterans. Joining me is Ms. Dale Sharkey, the board's director general.
[English]
To share a bit about myself, I'm a veteran of more than 18 years of service in the Regular and Reserve Force as a naval officer. I'm also a lawyer with more than 20 years of experience and graduate degrees in administrative law and ethics.
I am very proud to be in my current role, leading the board in ensuring fairness in the disability benefits systems for veterans and their families. The board provides veterans, members of the Canadian Armed Forces and the RCMP and their families with an independent appeal program for disability benefits decisions made by Veterans Affairs Canada. Our mission is to ensure they receive the benefits they are entitled to under law through timely, respectful hearings and fair, plain-language decisions.
I'd like to start by explaining how our process works. If a veteran is dissatisfied with a departmental decision on disability benefits, they can apply to the board for redress. Of about 30,000 veterans who sought assistance or entitlement from the department last year, about 10 per cent of those came to the board for a decision. Their cases tend to be the most complex and challenging, as the department was not able to grant entitlement at the first stage.
When a veteran comes to the board, they have access to two levels of redress: first the review hearing and then the appeal. Review hearings are conducted by panels of two board members in locations across Canada. To my knowledge, we're the only tribunal in Canada that has an even number of members on its tribunal. The reason for that is that as long as the veteran convinces one of the two members of the merits of their claim, they succeed, and that is consistent with the benefit-of-the-doubt provisions in the legislation.
At these hearings, veterans can bring forward new evidence. They can give oral testimony and have their case presented by lawyers from the Bureau of Pensions Advocates or service officers from the Royal Canadian Legion. These hearings are non-adversarial, which means no one argues against the veteran and no one opposes the veteran.
The review hearing is an important opportunity for veterans. It's their first and only chance to appear before decision makers to tell their story face to face. Their testimony is often significant, as it can help them establish the required link between their disability and service.
If the veteran is dissatisfied with their review decision, they can request an appeal hearing. Appeals are heard by panels of three board members who are not involved in the case at review. While the legislation does not permit oral testimony at this level, the appeal provides a further opportunity for the veteran, through their representatives, to submit new information and make arguments in support of their case.
Last year the board issued more than 2,700 review decisions and over 1,000 appeal decisions. As a result, almost 1,800 veterans received new or increased disability benefits from the board.
Let me take a moment to talk about the board members. These are the people who conduct the hearings, decide the cases and write the decisions. As independent decision makers, board members are not bound by previous decisions made by the department. They approach each case with fresh eyes. When they hear a case, board members consider the department's decision, service files and medical records, medical information provided by the veteran, the veteran's testimony and the representative's arguments to determine whether new or increased benefits should be awarded.
As acting chair I've been reaching out to military leaders about their role in encouraging serving personnel to report their injuries, to get treatment and to document nagging conditions. I cannot overstate to this committee how important it is for CF and RCMP members to document events, often which occurred many years ago, so they can reconstruct them later on when it comes time to bring forward an application for benefits.
[Translation]
I am often asked who our board members are and how they are chosen. Our members are motivated and dedicated Canadians who qualified for appointment through a merit-based selection process.
Today, 13 of the board's 20 members have military, RCMP, police, or health care backgrounds. Veterans and stakeholders have told us that all board members should have a good understanding of military and RCMP work and culture, and we agree entirely.
[English]
All members receive training from serving personnel. They also have hands-on visits to Canadian Forces bases where they learn about the physical and mental challenges that are inherent in the various trades. Members also receive continuous training on common and emerging medical conditions related to veterans' disabilities.
Let me turn now to the work we are doing to serve veterans better. Over the last years, the board has made great strides in improving the appeal program. First we made it a priority to improve decision writing. We have put significant effort into member training to ensure that decisions are written in plain language and that reasons clearly explain what has been decided and why. These efforts have yielded results. At informal feedback sessions coordinated by the Royal Canadian Legion, serving members and veterans have told us that our decisions are clearer and easier to understand. Our decisions are the most important communications tool we have, and improving those decisions will continue to be our focus as we move forward.
We've also increased access to our decisions by publishing all appeal decisions and many review decisions on the Canadian Legal Information Institute's website, or CanLII.org, a well-known online legal resource. As of this morning almost 1,850 decisions are available in their entirety for the review. This increases transparency in our decision making. It allows veterans to see how the board applies the law in cases similar to their own and shows Canadians that we are fulfilling our obligations in accordance with the statute. I encourage you, all veterans and people interested in our business to visit the CanLII website and read some of our decisions.
In addition to ensuring that hearings are fair and decisions are clearly expressed, we are mindful of the need to provide timely service or, as our legislation states, to be as expeditious as the circumstances and considerations of fairness permit. We've demonstrated our commitment to a timely process by establishing service standards for the time within our control, and we meet those standards for the vast majority of cases. We know there is room for improvement — there always is — so we will continue to focus on reducing time frames through flexible scheduling practices and close monitoring of our work.
[Translation]
When it comes to improving the service we provide, we value the perspective of those we serve. The board has established an ongoing exit survey to get feedback from veterans who have had a review hearing. This exit survey has confirmed that the vast majority of veterans have a positive experience at their review hearing.
[English]
Of particular importance is that 95 per cent of veterans have told us that board members treated them with respect during the hearing process. Additionally, 93 per cent have told us that board members listened to what they had to say, and 91 per cent told us that board members have made efforts to put them at ease. The exit survey also gives veterans the opportunity to give us genuine and instructive feedback, which we have been using to further improve the hearing experience.
We're also looking to improve our operations through modernization. We're working towards paperless hearings and equipping our members with the tools, technology and training they need to fulfill that process and produce decisions in a more timely manner. All of this supports our goal of issuing timely, fair and well-reasoned decisions for veterans.
Finally, we're continuing our focus on plain language in our communications and expanding our outreach with the CAF and RCMP, veterans' organizations and other groups dedicated to supporting veterans and their families. Ultimately we want veterans to know their rights. We want them to come forward if they are dissatisfied to tell us about their situation, to know they have been heard and to have confidence in our decisions. Most of all, we want them to receive all the benefits they are entitled to under law.
[Translation]
With that, Mr. Chair, I would like to thank you for allowing me to talk to you today about the important work we do on behalf of Canada's veterans. I would be happy to answer your questions.
[English]
Thank you very much.
The Chair: Thank you very much, Mr. Jarmyn. We appreciate your comments, and I'm sure there will be some questions flowing from them. First we'll go to Ms. Sharkey.
Dale Sharkey, Director General, Veterans Review and Appeal Board: I don't have any remarks. I'm here to support Mr. Jarmyn with any questions you may have.
The Chair: You're happy with his comments?
Ms. Sharkey: Yes. I helped him prepare them.
The Chair: Excellent. That's very helpful.
[Translation]
I will begin with a senator from Quebec, Senator Dagenais, who is the deputy chair of the subcommittee.
Senator Dagenais: I thank our guests for their presentation. I have acquainted myself with your work, and I noted that close to 50 per cent of the review or appeal applications are rejected, which is high.
When it comes to stress, medicine is a rather imprecise science. Why does the board reject requests for reviews or appeals? What is the main reason that would lead to a review?
[English]
Mr. Jarmyn: Usually the decision maker at the departmental level sets out in fairly clear format what is required and what the gaps are in the decision that was made. The veteran then brings their case forward to our board at review, and the legislation sets out the requirements that the veteran has to meet, and those have been interpreted by the Federal Court of Canada.
Often there is a broad range of circumstances. In some cases the veteran is unable to establish the relationship between the claimed condition and service. In other circumstances, there are issues about the diagnosis of the claim. But I would say the vast majority of cases are that the veteran has been unable to establish the relationship between the claimed condition and his or her military or police service.
[Translation]
Senator Dagenais: Are the decisions explained enough so that veterans have a good understanding of the grounds you have just set out?
[English]
Mr. Jarmyn: We've spent a great deal of time over the past few years, and indeed through training sessions — we completed a session just last week — in emphasizing the importance to members of very clearly setting out what they decided and why. You can read our decisions on CanLII.org. I think our decisions now clearly explain, in language accessible to the veteran, why we have or have not granted. It's important as well not just for the individual veteran but also for people who may be similarly situated.
If I have a knee claim that I want to bring forward, I want to be able to look at other decisions about knee claims so that I know what I have to prove and establish before I come forward to the board, or even before I come forward to the department. That's one of the reasons we've emphasized this publication process too.
[Translation]
Senator Dagenais: Are there any doctors on the board? If so, do you have a reference guide for your decisions?
[English]
Mr. Jarmyn: We have two health care professionals, both nurses: one an occupational health nurse and one a psychiatric nurse. There are commonly accepted medical documents that we use. There are standardized documents like the Merck manual and the Mayo Clinic documents. As well we have some of our own standardized resources that have been developed with respect to particular medical conditions, such as hearing loss or osteoarthritis, and that are now commonly used by the board and the department and are available to everyone online, so they can look at them prior to showing up at a hearing. There's a broad range of resources that board members draw upon in order to make those decisions.
The Chair: On that point, Mr. Jarmyn, just for clarification, is it Veterans Affairs Canada that determines what medical conditions might or might not be covered? Is it up to the board members and your board to determine a relationship between particular activities that might have led to the condition?
Mr. Jarmyn: Typically what will happen is the veteran comes to Veterans Affairs Canada first. Veterans Affairs looks at the fact situation and the veteran's claim and attempts to crystallize a diagnosis that most adequately reflects medical the condition the veteran is suffering from. They then attempt to ask, is that related to service?
If the veteran is not successful before the department and wants to appeal, the entire file comes forward to the Veterans Review and Appeal Board to answer that question again, hopefully with new evidence, either testimony or medical, based upon the gaps that the department identified in the initial application. We work from the starting point of the department's initial review.
The Chair: Let me be a little more specific in the question so that it can be clear to us all. Exposure to Agent Orange at the Gagetown base — it's service related. A soldier was exposed during his or her time on the base. The question is to the medical condition that that particular veteran has developed. Could that have been caused by Agent Orange? Is there a connection? The United States medical authority and Department of Veterans Affairs say yes. In Canada, we say no. Who makes that decision?
That is the kind of detail I'd like. I'd like you to tell us who makes that relationship.
Mr. Jarmyn: The first thing that the veteran does is bring forward the claim, saying, "I've been exposed to Agent Orange, and Agent Orange caused the following medical condition.''
Even in the United States, that's what they do as well. It just isn't exposure to Agent Orange and, "I have a claim.'' It's exposure to Agent Orange, and Agent Orange caused it.
Let's use one of the most common conditions that seem to be related to Agent Orange, prostate cancer. They would come to the department and say, "I was exposed to Agent Orange, and Agent Orange caused the prostate cancer.'' We have accepted, in accordance with various medical journals and the like, that that relation is well established.
The question before the department then is, was the veteran exposed to Agent Orange? That often is the fact situation that's in question, and the question is often before the board. It isn't that Agent Orange exposure causes prostate cancer. It is whether or not the veteran can establish that he was exposed to Agent Orange.
Senator White: Thank you both for being here.
I know you manage the RCMP disability process as well. Have you done any research as to the length of time it takes, kind of womb to tomb, for an application to be processed and dealt with from the RCMP members' side?
Mr. Jarmyn: About 8 per cent of the claimants who appeared before us in the past year are RCMP officers.
Senator White: Eight.
Mr. Jarmyn: Eight per cent. From our perspective, we look at the point where the Bureau of Pensions Advocates or the advocate on behalf of the veteran says, "We are ready to proceed with a hearing.'' Typically, there is not much difference between an RCMP file and the average veteran. Right now we're looking at, from the time a file is ready to schedule to a decision at review, about 112 days.
Senator White: So there is no difference in the level of support whether they're a Department of National Defence veteran or an RCMP veteran? They receive the same support?
Mr. Jarmyn: Yes. In fact, we've seen RCMP and DND claims presented by the Bureau of Pensions Advocates. We've seen them presented with assistance from the Royal Canadian Legion out of both groups. I would say in terms of the movement or the operations of those claims, there's no discernible difference.
Senator White: As you probably know, 3,800 officers, who are not members of the RCMP, have served overseas in 66 different operations for the RCMP in international scope. They're members of municipal or provincial police agencies in this country. They're not eligible under the disability legislation even though they are agents of the RCMP overseas and, in fact, might come back with a disability, often OSI or PTSD, as a result.
Have there been any appeals or attempts from any municipal or provincial police service to try and engage your department in trying to access some of the same benefits that RCMP officers receive?
Mr. Jarmyn: I have no knowledge of the initial contacts with any of these claimants or indeed of veterans in general with Veterans Affairs.
Senator White: So you deal with them later on.
Mr. Jarmyn: Yes. We're off to the side. We're independent, and we're kind of the next step after someone has got through the door of Veterans Affairs. I think that question would be better directed to either the minister or the deputy minister.
Senator Mitchell: Thank you for this presentation. Mr. Jarmyn, you mentioned at one point in your presentation that veterans and stakeholders have told you that all board members should have a good understanding of military and RCMP work and culture. I'm wondering how you would assess that. Do they or don't they?
Mr. Jarmyn: I think generally we do. Right now, 11 of the 20 members are either military or police in background. We have a broad range of serving backgrounds as well, from general duty officers, the RCMP, to chiefs of police who have worked their way up the chain of command and from all three services.
When members are appointed to the board, there is about a 10-week training period. That training is really tailored at the background of the individual, so people from more of a military background are likely to get more training in things like procedural fairness and medical. People from a medical background get more training about the cultural components and legal. Similarly, lawyers will get the two.
As well, by sitting in panels of two, we develop a lot of those partnerships that go on where you see a military member and someone with a different background. Most panels have people with those backgrounds on them. You learn by sitting with your colleagues. You learn about the environment and the nature of the documents you can see.
Senator Mitchell: One of the concerns that many have — and I've certainly had for some time — is the relationship between — I'm not saying it's pervasive necessarily, but it's not insignificant — cultural issues in the RCMP and PTSD, harassment and PTSD. I'm wondering whether you have a sense of the number of claimants who appear before you owing to PTSD or claiming that they have PTSD because of harassment, sexual or otherwise, in the RCMP.
Mr. Jarmyn: No. I can't really come up with that figure. Of about 2,700 first-level files, only about 8 per cent of those would have been from the RCMP. We're talking then about effectively a number of about 210 claimants total a year. Within that, we've actually got a very low number of PTSD claims.
I can't give you a significant proportion to that. Again, I think that question probably would go better to Veterans Affairs as sort of the first-level receivers of applications.
Senator Mitchell: Why would there be only 8 per cent RCMP? Is that because of just overall numbers, although the RCMP isn't 8 per cent as big as the military, or is it because the RCMP isn't as aware of the service?
Mr. Jarmyn: I can only speculate. The RCMP is probably about one third the size of the military. They have a specific sick leave regime that is unique to them, is different from the military, so that might well have some input to that as well.
We have no direct sort of feedback as to why those claimant numbers are lower. Again, I think the department may answer some of those questions in greater detail than I have.
Senator Mitchell: If you found in favour of that claim and it were harassment or related to some organizational cultural issue, would you be in a position to make recommendations about how that might be corrected?
Mr. Jarmyn: No. We're not in that role. We're simply looking at the one decision with respect to the particular case, and panellists very rarely make specific findings of harassment. Generally they're asking a different question, which is whether these events either contribute to or cause the claimed medical condition. Whether or not those events elevated to the level of harassment is not really before the panel. It's simply whether or not the events that the applicant maintains happened to them during their service, either in the military or the RCMP, caused the claimed condition.
Senator Lang: Welcome to our guests.
I noticed in your opening remarks you stated that last year the board issued more than 2,700 review decisions and over 1,000 appeal decisions. From my quick calculations that means there were roughly 10 decisions made every day in order to meet those numbers that you gave us.
Could you perhaps tell us how the number of hearings you've had relates to the past five years? Are we seeing an increase in hearings?
Mr. Jarmyn: No. In fact, we're seeing a decrease in the number of hearings on a year-over-year basis. Our workload has generally gone down, for any one of a number of reasons. I think there has been a tendency that favourability at the first-level decision makers in the Department of Veterans Affairs seems to have gone up, which is one of the reasons I think our workload has gone down.
Senator Lang: Perhaps I can follow up on that. Has the number of hearings at the first level increased over the course of the last number of years?
Mr. Jarmyn: I think the first application numbers at the departmental level seem to have been up slightly, yes, from what I know.
Senator Lang: I just want to pursue one other area, and it has to do with the question of retroactivity for medical treatment. The Veterans Ombudsman recommended that veterans who receive a favourable decision from the board be compensated retroactively for the medical treatment they needed effective to the date of their original application to Veterans Affairs Canada.
What progress has been made on that recommendation, if any?
Mr. Jarmyn: I think the ombudsman has done a follow-up with respect to that and clarified it. That recommendation really isn't something that is in the power of the board. The board has the capacity to make a decision and make an effective date, and what the department does with that decision is governed in accordance with the legislation. We really only have the capacity to interpret and apply the legislation given to us. There may well be a need, if they're going to give effect to that, for legislative change, but the delivery of medical treatment and when medical treatment comes forward isn't something the board has authority over.
Senator Lang: To clarify for the record, I want to get a pragmatic example of how this would work. If a veteran comes forward and does not agree with the initial decision by the review board and it goes to the appeal board, then your mandate, if you give a positive appeal to the individual, starts on that day? It doesn't go back to when the individual initially put in his or her application?
Mr. Jarmyn: We have potentially two questions for us: one under the Pension Act, one under the New Veterans Charter. Under the Pension Act we set an effective date in accordance with section 39, which is the later of the date of application or three years prior to the date of the decision. That's what the statute requires us to do.
We can make a retroactivity award above and beyond that of up to a further two years where there have been administrative delays beyond the control of the member.
Under the New Veterans Charter, the effective date, because we're making an award, is simply a date of decision, whether or not there are medical benefits, which we don't look at. We don't have the issue of whether or not particular forms of treatment should or shouldn't be covered — for example, physiotherapy or medications, anything like that. None of that is before the board. It's simply whether this condition is related to service and whether the veteran is entitled to an award under the New Veterans Charter.
Senator Lang: That clarifies it for me. Just one other area, and I want to refer to the House of Commons Standing Committee on Veterans Affairs that recommended in 2012 that Veterans Affairs Canada and the board be more proactive in explaining to veterans what is required in terms of evidence to appeal a department's decision on disability benefits. I could see a situation where a veteran may be dissatisfied with the initial decision but still doesn't quite understand the evidence that has to be provided to support his or her appeal.
Do you provide support to that particular individual, if asked, to at least help him or her know exactly what information you will need in order to consider his or her case?
Mr. Jarmyn: No, we don't, but from a process perspective there are a couple of things that happen. I wasn't on the board in 2012, but what I've seen in the past two and a half years is the Department of Veterans Affairs is writing fairly detailed decisions that explain what documents they've reviewed in coming to the decision, what they've decided and why. That becomes the road map for the veteran as they go forward.
The Department of Veterans Affairs Act also provides that any veteran can have free legal advice from the Bureau of Pensions Advocates. The veteran can then go to the Bureau of Pensions Advocates with their decision. The bureau has access to the entirety of the veteran's file and can figure out how best to present the case at the next level and what further evidence needs to be augmented and provided to the board in order to come to a decision in their favour.
Senator Wallin: I have a quick clarity question right at the beginning before I go on. Thank you, if you will indulge me.
I didn't see it anywhere, but in terms of technology, can a veteran appear by FaceTime, Skype or anything, or must they be physically present in front of your two members?
Mr. Jarmyn: We hold hearings in one of three ways: They are physically present, and that's the vast majority of cases — I would say almost 97 per cent. Some proceed by teleconference; we have had a number of cases where a mobility-challenged veteran has appeared with advocates in the room with the panel and we just dial in the veteran. And sometimes we do our hearings by video conference — not by Skype, but where they go to a local Veterans Affairs office and they use the usual government video conferencing system to appear before our review panel.
Senator Wallin: Your presentation was very clear, and I appreciate that. I would like to ask both of you to take a step back because what we keep hearing here, and Senator Lang went at some of the issues as well, is your assessment of why it is and how it is that people land on your doorstep.
We have heard from an awful lot of people that what we need to do is kind of de-layer the system of rules, regulations and policies. We keep coming up with new stuff, we keep layering that on top, and it gets so complicated for the veteran and even for the system itself. I think I'm quoting the ombudsman when he said it was a Byzantine and complex system.
Do you two see a way to streamline the system before we get to you? Who should make decisions about "attributable to service''? Should that be a surgeon general or someone else? Who does an informed assessment? Do we have enough people across the country to do it? Once veterans are in civilian life, how do they come back and access the system? Do they still have access to free legal advice, all of that? Where is the problem, even though your workload is going down? Why is it that so many people have to go and see you?
Mr. Jarmyn: Where we are now, I'm going to say about 10 per cent of applicants end up coming to see us on the initial applications for review.
These matters are complex. For anyone who has been in the service, Senator White would know, the medical files generated over the course of a veteran's life are substantial documents. Just the documents associated with the annual health assessments are dramatic, in and of themselves, never mind for people hurt during service. That is a complicated aspect of the matter.
With respect to the initial adjudications, it is important that we get the files and get them digitized in an appropriate manner. The system seems to be getting better at that, at generating those electronic files so that we can move things from place to place very quickly. I think in the past year or so definitely the decisions I've seen indicate that adjudicators are moving pretty quickly on files. I sit on reviews fairly regularly, and I'm seeing decisions on applications that were made in early 2015 that the department has rendered sometime in mid-2015. The applicant has taken that decision away, gone to BPA, gotten legal advice with respect to the file, put the case at ready to schedule, and we've rendered a decision. The decision hasn't gotten out the door, but we heard the case last week, and the decision will go out the door probably in the next five or six weeks.
Senator Wallin: Is there somewhere in the system, though, and where a lot of this evidence is anecdotal, that there might be more than 10 per cent coming to you if they weren't frustrated or hadn't given up? It's hard to deal with that, I know.
We hear this on a range of issues, that members of the CF, and I'm sure it's true of the RCMP, when they are active have trouble accessing medical care. Certainly once they're injured it becomes more complicated, depending on where they live. We just don't have the number of people who can even perform adequate assessments, given what we all know about how complicated things like PTSD are, and delayed onset and all of those issues.
I'm trying to figure out where there's one place we could fix that would move that along.
Mr. Jarmyn: I think there are two separate issues there. First of all, there is the issue of assessment, and I have a sense that, particularly with respect to psychiatric conditions, there is a degree of frustration about that.
Often what ends up happening now is that the department is making a finding with respect to entitlement in order to bring the person into the system, which means they give an interim assessment but the condition hasn't fully stabilized. In other words, the department is convinced that the veteran has the condition, wants to treat it but isn't convinced of the full extent of the condition, or they know the condition hasn't stabilized.
They get the veteran in the system, get them treated, and then let treatment play its course. We see that as a fairly regular matter of people wanting to appeal those interim assessments, which were made solely for the purpose of getting the person in the door, getting them treatment.
There is some of that frustration going on. Then there is, I think, anecdotal evidence that's dated. As I say, my impression now is that cases are moving on pretty quickly; particularly the musculoskeletal cases are moving along quickly.
The Chair: So far you are doing okay, Mr. Jarmyn. Ms. Sharkey doesn't want to intervene at all.
Mr. Jarmyn: That's because she prepped me.
[Translation]
Senator Dagenais: When you are sick and need care, the delays are always too long for the person who is ill.
In addition, the House of Commons Standing Committee recommended in 2012 that the board try to reduce the delays in rendering its decisions. I do not know if you attained the objective set by the parliamentary committee. If for some reason the objective was not met, what prevented you from meeting that objective?
[English]
Mr. Jarmyn: This year 87 per cent of our decisions have been promulgated within our 42-day service standard. That's an improvement over our previous year, but even then we're meeting our service standard as well.
I think we're going to keep on doing that. Some cases are more complex, where follow-up information is required and follow-up analysis. We have business processes in place to make sure none of those files slips through the cracks, because even a complex file we want to move along as quickly as we can.
One of the reasons we're focusing on improving our technology in the switch to a paperless process is I have members who sit in hearings across the country, and members in eight different physical locations. If I have to be couriering paper back and forth, I could potentially lose 4 of those 42 days with files in the hands of a courier. If I can get a conversion over to a paperless process, hopefully in the next year, I think we'll be able to make that 87 per cent figure better, but right now we are meeting our service standard, and we are going to continue to meet it.
[Translation]
Senator Dagenais: You substantiate things very well, Mr. Jarmyn. Thank you for your answers.
[English]
Senator Lang: I wanted to follow up on Senator Wallin's question on the mandate you have through your legislation at the present time. Is there anything that could be done legislatively that would allow you to do your job more efficiently? If so, what is it?
Mr. Jarmyn: I think legislatively we have the tools. Our mandate is very clearly set out in all three pieces of legislation, those being the Veterans Review and Appeal Board Act, the New Veterans Charter and the Pension Act. We have before us two very limited questions, which are finding a relationship to service and assessing the extent of the impairment.
I think we have the mandate that's necessary to answer those questions. If Parliament chose to bring other issues before us, then that would be Parliament's decision, and we would ask ourselves how we need to do that. Right now I'm comfortable that we have the legislative tools necessary to answer the questions before us properly in the statutes.
Senator White: You triggered a question, actually. You talked about the ability to gather all the information for a veteran so that the appeals board could do their job. That has been pretty easy for military and RCMP up until now because the files of the RCMP and the military are actually kept by the agencies or the departments that manage the employees.
The RCMP have now switched over to OHIP in Ontario, so now they're actually managed by local medical authorities, so no longer are they necessarily tracking the same. In fact, I understand there will be a change for all RCMP members and that they'll be dealt with by the local compensation boards instead of being managed by the RCMP itself.
Do you see that as being more challenging for you in the future to access all that information? I served 19 years in the Arctic and didn't even know we had access to Veterans Affairs and had to go to health centres to track down any information I needed. It was challenging if I had an issue at that point. With 22,000 sworn officers, do you not see that as being a challenge down the road for you as well?
Mr. Jarmyn: I noticed, even before the transition to the new sick-leave regime for the RCMP, that there was a definite difference in the nature and quality of the files related to the RCMP and the military. The RCMP had some degree of a centralized filing system, but not nearly as well controlled as the military seemed to have.
When I spoke to the staff relations program last year, I spoke about these changes. I emphasized to them that it's important for them to get out to members of the RCMP that they need to be the custodians of their own medical files, move these things from place to place with them and ensure that they get from doctor to doctor as they go from location to location.
It is going to be a challenge, and, as I would say even for a military member, they need to know what's in their file. I think RCMP members are going to have to take positive control of that, and I think that's a message the SRR Program could get out.
Senator White: By the way, the SRR Program is gone. It's now defunct. They have no representation at this point.
Mr. Jarmyn: Whoever ends up substituting in that environment, I think it's a message that management needs to get out and that members need to take control of as they go from point to point.
The Chair: Could we have a clarification on the acronym?
Mr. Jarmyn: Staff Relations Representative Program.
Senator White: If I can point out that the staff relations program has been taken away by the RCMP as a result of a Supreme Court decision. Nothing is in place to represent the 22,000 RCMP officers, and in fact I'm not sure that we're going to see much of an improvement when it comes to worker's compensation programs fulfilling the need that the RCMP used to fulfill. Thank you for that, Mr. Jarmyn.
The Chair: What would your equivalent be within in the Armed Forces in terms of obtaining information from the staff and members' points of view?
Mr. Jarmyn: In the military there is a much more centralized and controlled health care system. When I posted from base to base, I would do my out routine and with that, when I signed off on the out routine, the base orderly room would get my medical and personnel files, put them together and send them to my next unit. In that next unit, those things would be broken apart and sent to the appropriate medical facility or the appropriate orderly room for maintenance, and then on the next posting the whole process repeats itself.
It's a much more centrally controlled system than the RCMP seems to have.
The Chair: Senator White was pointing out that is not the case, and in fact it's getting less centralized in the RCMP.
Mr. Jarmyn: That would be my impression.
The Chair: Does that pose some difficulties for the member who might be seeking some relief from you?
Mr. Jarmyn: We don't need documents. That's not the only way of establishing a claim. However, the reality is for all of us — I mean, I can barely remember what I was doing this time last year, let alone what I was doing this time 25 years ago. If I have my documents related to either my unit employment record or my medical record, that triggers memory. Documents are a helpful thing in doing that and even in triggering testimony about what ended up happening and giving that colour that panel members find so important in deciding whether or not entitlement can be granted.
The Chair: Can you remind us? You said about 20. What is your authorized strength of hearing officers?
Mr. Jarmyn: We're authorized a complement of 25 board members, and we presently have 20.
The Chair: You have 20. How many of those 20 are actually able to do work and how many are off on some sick leave situation?
Mr. Jarmyn: Everybody is doing work right now. We have periodic things — knee operations and those sorts of things — where people are off for a couple of months, but we have 20 people who are ready and sitting.
The Chair: Do you handle your cases through a case manager who chooses who is going to be on these various panels?
Mr. Jarmyn: No. What ends up happening is — for example we have a panel sitting in Montreal today. We assign the panel there. It's the Bureau of Pensions Advocates who puts the case on the docket, and that docket is then sent to our scheduling unit, I think, two weeks prior to the panel actually arriving up. We make sure that everything is ready to go, and then the cases are heard. Typically in a week a panel sits, they hear 19 cases across the week sitting Tuesday, Wednesday, Thursday, Friday, going five, five, five, four.
The Chair: These are various cases that are managed by the Bureau of Pensions Advocates?
Mr. Jarmyn: Well, managed isn't quite the right word. They are assigned to the docket. It's the Bureau of Pensions Advocates, ultimately, like any lawyer, who puts a file on a docket and who has to say, "Yes, we're ready to proceed with the hearing.'' They will note a case as being ready to schedule, and we will then have a panel in that location, but they will ultimately put the individual case on a particular panel's docket about two weeks prior to the panel sitting.
The Chair: Who lines up the veteran?
Mr. Jarmyn: The Bureau of Pensions Advocates. When they put the case on, they have confirmed that the veteran is ready to proceed.
The Chair: They've got all the evidence they need.
Mr. Jarmyn: Yes, and that they're going to be able to testify or proceed by teleconference.
The Chair: Who makes the arrangement for the hearing room?
Mr. Jarmyn: We have standard hearing rooms in almost every location. We use Veterans Affairs premises in most locations, and in places we visit less often we use hotel rooms, and we book those facilities with Commissionaires to provide security.
[Translation]
Senator Dagenais: When I was the president of the Quebec Provincial Police Association, I represented the police officers of the Sûreté du Québec. Some of the police corps had worked on missions with RCMP officers in Haiti, among others, and I believe there are still police officers in Haiti who are working with MINUSTAH. One of our police officers had issues related to post-traumatic stress.
We had an employee assistance program. As president of the association, I had to make sure that the police officer received all of the treatments the employee assistance program could provide. The police officer mentioned that he wanted to be admitted to the veterans' hospital. I replied that he could not benefit from both systems, since he already had access to the employee assistance program. That program provided psychological care, and there was also the health insurance plan, which was managed by the association. I told him that he could not request admittance to the veterans' hospital, because he could not access both insurance programs.
Are there similar cases involving municipal or provincial police officers who would have liked to access services offered to veterans, but could not do so because of duplication, as there were services offered by the police corps? Did you ever come across any cases like that?
[English]
Mr. Jarmyn: No, I have not. Typically the veterans who appear before us are either RCMP or military veterans of some specific sort. There are very small subgroups, Merchant Marine, et cetera, who may appear before us — or family members of those people. I don't know to what degree Veterans Affairs provides programming for people who didn't fit into those groups. The deputy minister would probably be better to speak to that.
The Chair: Mr. Jarmyn, I'd like to get back to that 20 to 25. You have 20 hearing officers on now. Are they all based in Charlottetown?
Mr. Jarmyn: No, they're not. We presently have, I believe, six in Charlottetown, including myself. We have one member in Halifax, a couple each in Quebec City, Montreal and Ottawa, two outside of Toronto, and one each in Edmonton, Vancouver and Victoria.
The Chair: The House of Commons report suggested training, and specifically with respect to the culture of the RCMP and the military. What have you done to implement that training that wasn't being done before, which prompted that recommendation by the House of Commons?
Mr. Jarmyn: A couple of things: One, we have improved our representation on the board of RCMP and military officers, and that's been a definite benefit with respect to addressing that issue. We also, in the course of our annual training, basically break it down into two elements. There are the medical and cultural types of issues, which really do go together, and then there are the strictly legal issues.
For example, last week, out of a four-day training session I would say probably a day-and-a-half of it was in relation to matters related to the military, and PTSD and harassment issues in particular. That's where we break it down in our annual training sessions, and it's part of our annual introductory training at the beginning, when a member comes onto the board.
The Chair: You mentioned in your remarks that the introductory training was for a period of how many days?
Mr. Jarmyn: About 10 weeks in Charlottetown.
The Chair: With one person in Halifax, two in Ottawa, and so on, have you experienced any difficulty in team building when you have people spread out like that? Or do you get them together frequently enough that they would develop the spirit of the board?
Mr. Jarmyn: First of all, we do have monthly processes — monthly teleconferences — with respect to issues before the board where everybody is brought up to speed. We have an annual training conference, as well, where folks come together to work on these issues.
There is also the fact that we all sit with each other on an ongoing basis. There might well be some challenges if people were sitting alone, but we try to keep a decent rotation up among members so that they're sitting with their colleagues and they're getting a little sense of the tone of what's going on, and I think the introductory training process addresses some of that too.
The Chair: Thank you for that. I'd just like to finish off with a question I was asking you earlier about where the decisions are being made.
A veteran applies for benefits because he's suffering from what he believes to be exposure to Agent Orange, and he's developed a particular type of leukemia. That effect from exposure to Agent Orange is not recognized as one of the potential outcomes of being exposed in Canada, but is in the United States. He's refused in Canada because there's no nexus, no connection, between them; but it is recognized in another jurisdiction that there possibly is a connection.
Who makes the decision? What has to take place to break this wall?
Mr. Jarmyn: There would be two questions asked with respect to that veteran's case, one being whether he was exposed to Agent Orange.
The Chair: I asked you to assume that.
Mr. Jarmyn: Assuming that, the other question is whether there is medical evidence to support that claim. With respect to that veteran, one would expect that if he has leukemia, he probably has a treating physician of some sort who could provide us with an opinion that the leukemia is related to the Agent Orange exposure that happened in 1966 or 1967, and issues that may well be relevant with respect to that; of course there's the period of time between the exposure and the onset of the leukemia, and the virulence of the symptoms. Hopefully, his treating physician would be able to provide us with medical evidence with respect to that.
If a veteran is able to provide credible medical evidence of any question, and it's not contradicted, then they will establish entitlement.
The Chair: Who would go out and get the contradiction? Would you do that?
Mr. Jarmyn: We don't solicit evidence one way or the other on a claim. When I say "contradicted,'' often, particularly in more complex cases, there are a number of medical opinions on file. We have to weigh those and determine whether there are contradictions or they line up; and then we balance them out if there are contradictions.
The Chair: Applying the statutory requirement that you give the benefit of the doubt to the veteran, if a medical opinion is that it can't be said definitively that the leukemia was caused by that, and assuming there was exposure to Agent Orange, which you will assess, that could be one of the possible outcomes?
Mr. Jarmyn: If a medical opinion said it's probable that the Agent Orange caused or likely caused leukemia, then "may'' becomes a questionable thing. "May'' is a statement of possibility. We would have to assess the actual quality of opinion to come to an answer on that.
The Chair: You know how difficult it is for an 80-year-old veteran to chase after a very busy professional medical person to write the kind of opinion that would satisfy you.
Mr. Jarmyn: That's why the Bureau of Pensions Advocates is so helpful to veterans as it's their job. They provide that representation like I did to workers compensation clients when I was in private practice. They provide that degree of representation. They frame the question for the doctors so that the answer is as favourable as possible.
The Chair: Colleagues, are there any questions arising from that?
Senator White: What is your test — the balance of probabilities, beyond a reasonable doubt? What is the tipping point where you agree?
Mr. Jarmyn: The Federal Court of Appeal has said that the veteran has to establish the facts in support of a case on a balance of probabilities. In a subsequent decision in Cole, they said that all they have to do is find a significant relationship.
Senator White: So it's a lower level than a balance of probabilities.
Mr. Jarmyn: It's more than 1 per cent lower than 49, using the numbers of that the Federal Court of Appeal stated.
The Chair: Would it help you to meet your deadlines if you had those other five positions filled and operating?
Mr. Jarmyn: No. We meet our deadlines in the vast majority of cases. In the cases that we don't, there is something about the cases that needs more time to be handled. A greater level of analysis needs to happen. Maybe there's some follow-up information that the panel thinks needs to be provided after they deliberate, and they want to give the veteran an opportunity before they come to a decision.
At the end of the piece, I'm satisfied because we look at these cases every two weeks — every case that is over service standard at any stage of the process we ask why. I'm satisfied that in most cases that is a reason. We want to reduce those time lines as much as possible, and we're going to keep on working on that. But sometimes we need that other information, so sometimes we can't meet the 42 days as a result.
The Chair: Colleagues, is there nothing further?
On behalf of the Subcommittee on Veterans Affairs of the Standing Senate Committee on National Security and Defence, we would like to thank you, Mr. Jarmyn and Ms. Sharkey, for being here, and for your presentation and the work you're doing for veterans and their families. We appreciate it. Keep up the good work.
Mr. Jarmyn: Thank you very much.
The Chair: Colleagues, the meeting is now concluded.
(The committee adjourned.)