# 2020-223 Medical and Dental Care, Spectrum of care

Case summary

F&R Date: 2021-09-27

The grievor sought to have the costs associated with her gender affirmation surgery she received outside of Canada reimbursed.  The grievor asserted that the coverage would meet the Canadian Armed Forces (CAF) Spectrum of Care (SoC) principles. The grievor further argued that the procedure she received is not available in Canada and that it is significantly different than the procedure offered to her in Canada, which did not meet her particular needs. As redress, the grievor requested the reimbursement of the total cost of the surgery, travel, meals and accommodations.

The Initial Authority denied the grievor redress asserting that the grievor was treated in accordance with the SoC and that the decision made to deny the funding of the grievor's surgery received outside of Canada was reasonable, justified and issued in accordance with policies.

The Committee found that the medical services, which the grievor underwent outside of Canada, were not covered by the CAF SoC, and therefore the applicable policy was correctly applied. The Committee noted that, although the grievor's circumstances would have made her eligible for reimbursement of the cost of her surgery under the provincial coverage, there would have been no reimbursement for travel, accommodation or meal costs as they are excluded from that plan. The Committee also found that, due to the unique circumstances of this matter and the evolving nature of the CAF’s transgender policy, it would be appropriate for the Final Authority to authorize reimbursement to the grievor for the cost of the surgery she received (not including travel, accommodation or meals) through an ex gratia payment.