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Veterans Affairs Canada - have they lost their way?

You are correct. This is a scan of a letter I got from 23 Health Svcs Wpg (some names removed).


PROTECTED A

23 CF Health Services Centre
PO Box 17000 Stn Forces
Winnipeg, MB R3J 3Y5

6680-1-B (CO) CF 2034

31 August 2006

Nicole Caron-Goulet, M.D., F.C.F.P.
Senior District Medical Officer
Manitoba District - Winnipeg Office
PO Box 6050
610 - 234 Donald Street
Winnipeg, MB R3C 4G5


Dear Dr. Caron-Goulet:

RE: DISABILITY PENSION AND DISABILITY AWARDS
PENSION STREAMLINING INITIATIVES - CF STILL SERVING CLAIMS


Further to the direction received in the VAC memorandum of 22 March 2006 from Nancy McRae, Director Operational Guidance and Direction, and an e-mail from Violet Parker on 1 May 06, 23 CF Health Services Centre is no longer required to complete correspondence as requested by Veterans Affairs Canada.

It is DND's responsibility to provide medical diagnoses of any health problems facing still serving members. In response to your letter of 11 August 2006 regarding the subject member, 23 CF Health Services Centre will provide the member's medical records for review by your Organization once an authorization to release information form has been received. Please ensure that the member has signed this form within the last 12 months.

If you are unable to find a specific medical diagnosis on the medical records, please inform the client as outlined in the memorandum of 22 March 2006. The DND physicians may then investigate the member's health problem in order to determine a diagnosis. The member can inform you if and when the medical investigation is completed and the member's medical records can be requested by your Organization at that time.

Should you have any questions, please contact ----------, Health Records Management Team Leader at (204) .

Yours truly,



Major .
Commanding 0fficer
(204) 833-2500 ext 4161

cc: -----------

In May I attempted to get another letter for a final appeal. Although I have not received a written reply, the Doc ( same Doc, civilian contractor)reafirmed the policy - negative, no letter, his hands were tied. On 12 May I sent the following email to (some names removed) with the scaned letter. Cmdre Kavanagh was the then CF Surg Gen.
-----Original Message-----

Sent: May 12, 2007 12:29 PM

To: KAVANAGH.MF@forces.gc.ca; Thompson, Greg - M.P.;
Deputy_Minister@vac-acc.gc.ca
Subject: VAC Appeals and Primary Health Care Provider - Still Serving
Members

The attached letter subject is:

DISABILITY PENSION AND DISABILITY AWARDS PENSION STREAMLINING
INITIATIVES - CF STILL SERVING CLAIMS

I do not know the intent of the CF and VAC with regard this issue, but I
do know the results. There is no streamlining, and no initiative. At the
coal face there is consistent run-around and catch 22.

As a still serving member of the CF, CF H Svcs is my primary health care
provider. I cannot see a civilian health care provider except after duty
hours or in an emergency. VAC requests a specific assessment (other than
current medical records) pertaining for example, to a documented injury
that occurred during past CF service, CF H Svcs refuses to comply,
referencing the subject of the att letter.

Where is a still serving member of the CF to obtain this information to
substantiate/amplify a injury claim? CF H Svcs will not comply. All
medical records are held by CF H Svcs. Still serving CF members are
subject to:

MEDICAL SERVICES EXCLUDED FROM ENTITLEMENT

Unless specifically required by the CF, eligible persons will not be
entitled to coverage for the following items:

a. any examination or service which is not curing or preventing illness,
and, in particular:

I. passports, visas, driving licenses, medicals for non-CF related
activities (VAC ??);

c. any examination, appraisal, testimony, or certification required by a
member or a third party ..... or for any litigation instigated privately
by a member, except in the following circumstances:

ii. a medical-legal examination of a member injured on duty, or related
litigation arising from events occurring while on duty; from events
occurring while on duty.

Would extract c. ii. from the CF H Svcs web page not include complying
with VAC requests?  Litigation is a claimant utilizing a lawyer from the
VAC Bureau of Pension Advocates as a representative at the Veterans
Review and Appeal Board.

I will retire in Aug 07 with 45 years of service to Canada. This whole
process of dealing with VAC has been degrading and frustrating. I am
disgusted with jumping through VACs' hoops at every turn, the enormity
of the bureaucracy, and exhausting time line. Compounding this is
obtaining medical information from the CF.

Cmdre Kavanagh, I request that unequivocally, the CF policy with regard
to cooperation with still serving CF mbrs/VAC/CF H Svcs be communicated
to all CF mbrs.

Minister Thompson, Deputy Minister Tining, my one point, at this time is
to request VAC consider the situation that still serving CF mbrs are in,
and the benefit of the doubt be given to the Veteran. Other points to
follow when my appeal process, Jan 04 to ?? is completed.

Received several replys ( emails, phone) from the Ministers office, including a statement that a reply would be sent in 3 weeks.
On 15 Jun I sent the following to the same cast of characters, incl the new CF Surg Gen, BGen Jaeger:

It has been 34 days, and a reply has not been received. I was contacted by VAC who stated I would receive a reply in 3 weeks. Reply not received. Nothing from the military.

I am still in the catch 22 situation, as are many other serving members.

What will be done to resolve this? Time marches on.

Received a phone call from the CF Surg Gen office. The Surg Gen will not change the policy I was told. (and there are good reasons namely lack of Doctors in the CF, which we all know about.) Also received emails from Ministers office. Reply coming.

This is long (cut and paste). VAC knows about this as all of the staff and Advocates have been briefed. So I will wait to see what the Ministers office will say. I DO NOT blame the CF Health Svcs. They have have a focus/mission. My opinion.



























 
284_226 said:
The explanation given to me was that Medical Officers were finding more and more of their time being taken up by writing these letters, and it became too time consuming to support.

God forbid we should take up too much of their time dealing with our injuries... this is after all what they are there for.    ::)

And conflict of interest?  How does confirmation of a diagnosis equal disloyalty to the employer?  This statement implies that it is the Doctors duty to not diagnosis a patient as it might be detrimental to the residing government departments.  Bah! The government knows the doctors have a responsibility to the patient as part of their training and education when they hired them.  Its like saying that Doctors hired by the province shouldnt diagnose patients because the province might have to treat them.  Legal jibber-jabber....
 
Rifleman62 said:
I will retire in Aug 07 with 45 years of service to Canada. This whole
process of dealing with VAC has been degrading and frustrating. I am
disgusted with jumping through VACs' hoops at every turn, the enormity
of the bureaucracy, and exhausting time line. Compounding this is
obtaining medical information from the CF.

Cmdre Kavanagh, I request that unequivocally, the CF policy with regard
to cooperation with still serving CF mbrs/VAC/CF H Svcs be communicated
to all CF mbrs.

Minister Thompson, Deputy Minister Tining, my one point, at this time is
to request VAC consider the situation that still serving CF mbrs are in,
and the benefit of the doubt be given to the Veteran.

I thought I'd comment on this quote-it sums up the frustration that so many have.  The part about being given the benefit of the doubt is key.

I know this point has been mentioned elsewhere in this forum but... Subsection 5(3) of the pension act provisions states that, "in weighing uncontradicted, credible evidence, any doubt shall be resolved in the applicant's favour".

VAC demands so much "evidence" and so much medical documentation to support claims that I can buy the argument that it may create an unreasonable demand upon health care professionals-be they CF doctors or civilian.  I can't believe that the new policy is part of a conspiracy or conflict of interest.

The fault rests with VAC and the infernal, neverending requests for more and more "proof". It also is a result of laziness- more to explain my thoughts on that later.
Since 2001, I've been subjected to one consult after another- all at the request of VAC.  I went from neurosurgeon to neurologist to neuropsych to neuro-opthamologist; even though my MRI shows "uncontradicted credible evidence" of scarring from bleeding in my brain which would explain all the symptoms I experience.

Why I needed multiple specialists to "back up" my symptoms- after all the initial consults and treatments/hopitalizations were complete-why they needed medical professionals to "back up" my claims- when all the information was on my medical file- just became clear to me as I read the letter provided by Rifleman earlier: One sentence  from that letter:

"If you are unable to find a specific medical diagnosis on the medical records, please inform the client as outlined in the memorandum of 22 March 2006. The DND physicians may then investigate the member's health problem in order to determine a diagnosis. The member can inform you if and when the medical investigation is completed and the member's medical records can be requested by your Organization at that time".

My take on this (could be wrong, of course) is that the CF is tired of doing the work for VAC. Not many people apply for disability awards for conditions that aren't already well established and documented. Again, I'm assuming.  The letter states quite clearly that CF medical will do the work if a diagnosis can't be found.
Another released CF member that I spoke with- released for bad knees- received a letter from VAC requesting a letter from a physician which clearly stated a diagnosis for the claimed condition.  This after four surgeries and numerous consults for the condition- all which were easily found within the medical rescords that he received upon release.

I found the diagnosis-numerous times- within this man's docs- why is it that the VAC medical staff could not?

As for my case- if they had-after 17 years of good service and an MRI and circumstances that explained my symptoms-given me the "benefit of the doubt"- I would not have had to wasted the time of busy specialists.  I had already been to them all and their reports were on file. VAC physicians have medical degrees that qualify them to make medical judegments and decisions.
If, in the bad knees case I spoke of above, VAC medical personnel (they have physicians there?) had actually read his file, done some logical thinking, deductive reasoning and appropriate decision making- he would not have had to go to another physician to spell it out for them.

I agree that the new policy is wrong.

When hit with the possibility of release from the CF due to injury/illness, it is reasonable and smart for a CF member to get the ball rolling on VAC disability issues as quickly as possible- in order to lessen the financial impact the disability will have upon release. That the CF and VAC- in the process of their bureaucratic peeing match- are making this process even more difficult for releasing members is simply another kick in the face (unemployment being the first kick- but I won't go there again).  The CF, in providing primary health services for members, can't (morally, I mean-not legally, it seems) just say go find another doc to write your diagnosis letters for you.  It's wrong.

But...I put the bulk of the blame with VAC.  Their policies and processes are faulty and it would be a shame if the CF had to hire more docs to compensate for their shortcomings. I'm sure that the doctors that the CF does manage to attract could be involved in much more important things than VAC paperwork and making the jobs of VAC staff easier.

Just my thoughts,

Bren
 
tired said:
The second bit of information is about the VAC Ombudsman.  I e-mailed the Prime Minister's Office saying that my rights, as listed on the Veterans' Bill of Rights, have been violated.  Until a VAC Ombudsman is appointed, to whom should I submit my complaint?  Also, who will the Ombudsman report to?  The answers were:  Complaints should be directed to the Minister of VAC; and, The Ombudsman will be reporting to the Minister of VAC.  So I sent another e-mail asking to whom should complaints be sent when the person I'm complaining about is the Minister (I've written to the Minister asking for help but he has brushed aside my complaints)?  My letter has gone unanswered.

Conflict of interest? Does this mean he is under the Minister of VAC on an org chart? I think there will be much more confidence in a Veterans Ombudsman if there is no direct link or connection at all between him/her and the VAC Minister- so I'm dissappointed in the response the PMO gave you.

Bren
 
I posted this info on 6 Dec 06 at http://forums.army.ca/forums/threads/54367.0.html from the Veterans Voice website http://www.veteranvoice.info/bulletinboard.htm

Veteran's Pension Survey - initial Results
By the Veterans' Survey Group

Initial stats have indicated that in 92 percent of the cases, Veterans Affairs (VAC) had overruled the diagnosed medical conditions, resulting in military Medical Releases. This is in light that the military (DND) did everything correctly and in accordance with universality of service the medical release was warranted. DND made no mistakes in medically releasing all members (Officers: Major to 2nd Lieutenant and Chief Warrant Officers to Private). DND used both military and civilian physicians, medical specialists and completed all required tests for release. However, it appears that VAC, in particular the Veterans Review Appeals Board (VRAB) either ignored or reversed professional diagnosis.

Where DND did an outstanding job in 99.9 percent of the time, VAC overruled on all cases, by using non-medical VRAB members. VAC completed no medical tests and consulted with no medical specialists (physician's, physiotherapists, etc) nor did they request any medical (or dental) tests on 92 percent of all case files. This is based on 10,000 medical files reviewed between 1982 to September, 2006. 
 
in consultation with all Colleges of Physicians and the Canadian Medical Association, it is illegal to practice medicine without a licence in Canada, even for those persons being appointed on the Recommendation of the Prime Minister of Canada such as VRAB members. VRAB members who receive very medium training are then commissioned to overrule military Medical Releases without consulting any medical authority.

Sr Analyst
VSG

VVi Comment: The Veteran Survey Research form is still available on this site at http://www.veteranvoice.info/vetsurvey.htm . VSG will continue to review survey responses adding to their continuous stats database. All veterans are encouraged to complete a survey form.

From the same website, the latest:

06 June 2007 
VVi Polls Effective 05 June 2007

As a veteran are you satisfied with VAC's services?

Answers                Votes  Percent
1.  Always                  15    2%
2.  Most of the time    79    9%
3.  Some of the time 205    24%
4.  Not often            294    35%
5.  Never                248    29%
 
How would you rate the new Veteran Charter?

Answers              Votes  Percent
1.  Good                  10      1%
2.  Fair                    64      7%
3.  Poor                828    92%
 

NEW POLL AS AT 01 NOV 2006.....Has the VRAB met your needs?

Answers                                                          Votes      Percent
1.  No                                                                89            44%
2.  Yes                                                              23            11%
3.  I gave up! Too much frustration!                    89            44%

The key here is that those who decide on your appeal are not MDs, have never served in the military except for three members.

Possibly a letter writing campain requesting a "Special Examinations" or a "Performance Audit " should be sent to :

Office of the Auditor General of Canada
240 Sparks Street
Ottawa, Ontario
K1A 0G6 Canada




 
Interesting Links:

Standing Committee on Veterans Affairs Tuesday, May 15, 2007- PTSD http://cmte.parl.gc.ca/Content/HOC/Committee/391/ACVA/Evidence/EV2946456/ACVAEV42-E.PDF

Main Site: Standing Committee on Veterans Affairs (ACVA) http://cmte.parl.gc.ca/cmte/CommitteeHome.aspx?Lang=1&PARLSES=391&JNT=0&SELID=e22_.1&COM=10802&STAC=2006440

Three most prominent uses of English on the site:
1)Related Documents-There is no data currently available for this item.
2)Meetings-There is no data currently available for this item
3)News Releases-There is no data currently available for this item.



 
3rd Herd said:
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I hate it when sites say that.  It either shows sloppy IT work (gettting things posted) or sloppy organization work(getting docs produced) - neither is good.
 
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