Chapter 211 - Service Benefits for Ill and Injured Members

211.005 – Interpretation

211.005(1) (Definitions) The definitions in this instruction apply to CBI Chapter 211 (Service Benefits for Ill and Injured Members of the Canadian Forces).

activities of daily living

(ADL) are defined as a set of activities necessary for normal self-care including personal hygiene, feeding, dressing, movement in bed, bowel and bladder control, transfers and locomotion activities performed in the home and/or community. (activités de la vie quotidienne)

attendant

includes a relative, or friend, who acts as a member's attendant, even if the relative or friend does not possess any special qualifications. (aidant)

authorized civilian physician

includes a relative, or friend, who acts as a caregiver on behalf of a member, even if the relative or friend does not possess any special qualifications. (préposé)

caregiver

includes a relative, or friend, who acts as a caregiver on behalf of an officer or non-commissioned member, even if the relative or friend does not possess any special qualifications.(aidant)

dependant child

means a member’s child, legal ward, or legally adopted child, who is:

  1. single;
  2. in the custody and control of the member;
  3. under 18 years of age or of any age if prevented from earning a living by reason of mental or physical disability; and
  4. dependent upon the member for support. (enfant à charge).
grounds maintenance services

means those services regularly required to maintain the grounds immediately surrounding the member’s principal residence. Services include:

  1. tilling ground to enable the client to plant a flower or vegetable garden of a reasonable size;
  2. removing snow and ice from steps, walkways and driveways to allow safe access to the principal residence;
  3. removing snow and ice from roofs and eaves troughs;
  4. cleaning leaves and debris from eaves troughs;
  5. mowing and raking lawn, sweeping leaves from pathways, trimming hedges and shrubs;
  6. pruning or removing trees ; and
  7. blocking, splitting and stacking firewood, when wood is, and continues to be, the main source of heat for the principal residence and the work was previously performed by the member. (services d’entretien du terrain).
home

has the same meaning as “principal residence” for the purpose of this chapter. (domicile) (aidant)

housekeeping services

means:

1. routine domestic tasks necessary for the upkeep of a home on a daily basis such as 

a. laundry, ironing and mending;

b. making and changing beds;

c. general cleaning, vacuuming, scrubbing, dusting,      appliance cleaning;

d. meal preparation;

 e. washing windows;

 f. errand services to purchase food, do banking and pay bills;

g. changing fuses, changing batteries in smoke detectors, etc.; and

2. certain non-routine domestic tasks if the health and safety of the member is at immediate risk, including :

a. washing walls and ceilings when environmental pollution is a factor (i.e. wood is the primary fuel source, and the member requires a relatively dust free environment);

b. shampoo / steam cleaning carpets and furniture, or professional drapery cleaning when the member suffers from respiratory conditions, skin allergies, incontinence, etc.;

c. chimney cleaning;

d. furnace and duct cleaning for a member requiring a relatively dust free environment;

e. cleaning attics, basements, and garages if an immediate fire hazard exists;

f. extermination/fumigation for the presence of rodents, infestation of fleas or ticks, etc.; and

g. industrial cleaning where the lack of cleanliness is to the point that service providers cannot, or refuse to, enter the home until it is professionally cleaned. 

While the above lists are not all inclusive, they establish the scope of those types of services that may be considered housekeeping services for the purpose of CBI 211.03 (Home Assistance Benefit). (services d’entretien ménager)

 

impairment

means the loss or abnormality of an anatomical structure, physiological function, cognitive status, or functional limitation. Impairment may be temporary (such as, after surgery), persisting during active pathology or may be permanent, continuing even after the active pathology is treated and resolved. (déficience).

 

instrumental activities of daily living

(IADL) are usual and customary activities in a domestic and/or work environment which enable self-sufficiency. Such activities include shopping, meal preparation, housework, using forms of private or public transportation and gardening. (activités instrumentale de la vie quotidienne)

member

means a member of the Regular Force or the Reserve Force, who: 

1. at the time the impairment is sustained, is entitled to medical care at public expense under paragraph (4) of QR&O 34.07 (Entitlement to Medical Care); and

2. after the impairment is sustained, remains entitled to medical care at public expense under paragraph (4) of QR&O 34.07 (Entitlement to Medical Care). (militaire)

next of kin

has the same meaning as in article 1.02 (Definitions) of the QR&O (plus proche parent)

Next of Kin Travel Benefit

i(NKTB) means the payment or reimbursement of the travel and living expenses of the next of kin and travel assistants of an ill or injured member.(prestation pour déplacement du plus proche parent [PDPPP])(aidant)

principal residence

means the place that has been, or that the member has adopted as, the place to which they intend to return when they are away from it; the dwelling the member normally lives in. (résidence principale)

private motor vehicle

(PMV) means a private motor vehicle:

  1. owned and operated by the member; and
  2. that is suitable for modifications, given the member’s impairment. (véhicule personnel)
temporary residence

means the place where the member resides while the member’s principal residence is undergoing modifications. (résidence temporaire)

travel and living expenses

has the same meaning as in article 209.01 (Interpretation) of QR&O. (frais de déplacement et de séjour).

travel assistant

means a person who in respect of a next of kin meets the requirements of subparagraphs (3)(a) or (b) of article 209.02 (Entitlements - Next of Kin) of the QR&O. (accompagnateur).

 

211.005(2) (Rule Against Double Benefit) Notwithstanding any other instruction in this chapter, no payment of a benefit shall be made for that portion of an expense for which payment is obtained by the member under any insurance plan or law or under any other plan or law. 

(TB, effective 13 May 2021)

211.01 – Home Modifications Benefit

211.01(1) (Purpose) The purpose of the Home Modifications Benefit is to reimburse an ill or injured member for payments made to modify the member’s principal residence to meet the member`s daily living requirements (ADL and IADL) based on the member’s medical restrictions. 

211.01(2) (Eligibility) Subject to the approval of the Director General Military Transition (DGMT), a member is eligible to receive the Home Modifications Benefit if it is recommended by a Canadian Forces Medical Officer or authorized civilian physician as medically necessary due to the member having sustained a permanent impairment, or a temporary impairment that seriously impacts the member’s quality of life and mobility, and is beyond the scope of the Canadian Forces Health Services Spectrum of Care.

211.01(3) (Entitlement) Subject to paragraph (2), the Home Modifications Benefit is payable for medically necessary home modification expenses incurred by or on behalf of the member.  These expenses include:

(a) building permits to facilitate the modifications;

(b) structural and other modifications to the member’s home necessitated by the home modifications being provided;

(c) equipment to facilitate access to and from the member’s home;

(d) appliances to facilitate ADL and IADL in the member’s home;

(e) construction, shipping, and installation expenses related to any of the above; and

(f) additional insurance expenses arising from any of the above.

211.01(4) (Amount) The maximum amount payable per claim is the actual and reasonable expenses to effect the home modifications and should not normally exceed:

(a) in respect of a home owned by the member, or the member’s next of kin, the fair market value of the home; and

(b) in all other situations, the equivalent of five times the annual fair market rental payment for the portion of the home occupied by the member.

211.01(5) (Additional Amounts) In addition to the amount determined in paragraph (4), the Chief of the Defence Staff, or when authorized by the Chief of the Defence Staff, the Chief of Military Personnel, personally, may authorize an additional amount for necessary home modifications if the additional expense is considered reasonable having regard for the nature of the modifications, the fair market value of the home or five times the yearly rent, and that it would be equitable in the circumstances to approve the benefit. 

211.01(6) (Medical Assessment) A Canadian Forces Medical Officer or authorized civilian physician will conduct follow-up medical assessments as required to determine whether revisions to the home modifications are required based on the status of the member’s impairment.

211.01(7) (Limitation) The Home Modifications Benefit is not payable: 

(a) if the principal residence, before modification, fails to comply with applicable federal or provincial building standards;

(b) to return the modified home to its original state;

(c) to remediate existing structural issues;

(d) to resolve litigations between the member and his/her chosen contractor(s);

(e) to modify areas of the home not impacted by mobility requirements; or

(f) when the home is deemed to be non-modifiable by DGMT, on the basis of structural or economic factors.

211.01(8) (Member’s Responsibility) The member is responsible to:  

(a) obtain all necessary authorizations to make home modifications;

(b) provide confirmation to the satisfaction of DGMT that a home is reasonably modifiable, when the purchase or rental of the accommodation is post-injury or illness;

(c) select and hire an appropriate contractor or builder to complete the home modifications; and

(d) arrange funding for all expenses related to the modifications to the principal residence.

211.01(9) (Claim for reimbursement) A member may submit a claim for the Home Modifications Benefit in accordance with established orders and instructions issued by or on behalf of the Chief of the Defence Staff. (See also QR&O article 203.05 (Delay In Submission Of Claims).

(TB, effective 13 May 2021)

211.015 – Home Modifications Move Benefit

211.015(1) (Purpose) The purpose of the Home Modifications Move Benefit is to reimburse an ill or injured member  for moving expenses incurred during home modifications  including expenses incurred while occupying a temporary residence. 

211.015(2) (Entitlement) A member who is entitled to receive a benefit under CBI 211.01 (Home Modifications Benefit) is entitled to receive the Home Modifications Move Benefit, unless the member is entitled to relocation benefits in accordance with CBI 208 Section 9 (Canadian Armed Forces Relocation Directive).

211.015(3) (Move Expenses) The Home Modifications Move Benefit is payable for the following actual and reasonable expenses:

(a) the move of household goods and effects (HG&E) from the member’s principal residence into storage or temporary residence;

(b) the move of HG&E from storage or temporary residence to the member’s principal residence;

(c) meals, lodgings and incidental expenses while HG&E are packed, loaded and delivered to:

(i) the member’s principal residence after modifications;

(ii) the member’s temporary residence; or

(iii) storage;

(d) storage of HG&E;

(e) the cost of terminating a lease;

(f) the costs associated with the sale of the member’s principal residence and purchase of a new residence;

(g) non-accountable miscellaneous relocation expenses in accordance with CBI 208.85 (Movement Grant);

(h) the boarding of household pets; and

(i) the additional costs associated with maintaining two residences, including rent.

211.015(4) (Limitation) Where a move into a temporary residence with cooking facilities is not possible and a commercial accommodation (e.g. hotel) must be used, the payment of meal and incidental expenses is limited to the similar entitlement under CBI 208 Section 9 (Canadian Armed Forces Relocation Directive).

211.015(5) (Claim for reimbursement) A member may submit a claim for the Home Modifications Move Benefit in accordance with established orders and instructions issued by or on behalf of the Chief of the Defence Staff. (See also QR&O article 203.05 (Delay In Submission Of Claims)).

(TB, effective 13 May 2021)

211.02 – Vehicle Modifications Benefit

211.02(1) (Purpose) The purpose of the Vehicle Modifications Benefit is to reimburse an ill or injured member for payments made to modify a total of one private motor vehicle (PMV) to allow the member to drive or be a passenger. 

211.02(2) (Eligibility) A member is eligible to receive the Vehicle Modifications Benefit if it is assessed by a Canadian Forces Medical Officer or authorized civilian physician that the member is unable to operate an unmodified vehicle due to the member having sustained a permanent impairment.

211.02(3) (Entitlement) The Vehicle Modifications Benefit is payable for reasonable and necessary expenses incurred by member, which are related to the modification of a PMV, or the operation of a modified PMV. These expenses may include:

(a) the  purchase, installation, and modification of:

(i) hand controls;

(ii) pedal controls;

(iii) swivel seats;

(iv) wheelchair and scooter hoists;

(v) safety devices;

(vi) vehicle body modifications; and

(vii) power assistance;

(b) additional insurance expenses for a modified vehicle; and

(c) additional costs incurred by the member  to learn to drive a modified vehicle.

211.02(4) (Limitation) The Vehicle Modifications Benefit is not payable:

(a) if the vehicle to be modified fails to comply with applicable federal and provincial safety requirements;

(b) to return the modified vehicle to its original state; or

(c) to resolve or repair any existing mechanical issues not directly related to modifications identified in 211.02(3)(a).

211.02(5) (Member’s Responsibility) The member is responsible to:  

(a) obtain all necessary authorizations to make vehicle modifications;

(b) ensure vehicle modifications are covered by insurance (additional cost covered by 211.02(3)(b)); and

(c) provide confirmation to the satisfaction of DGMT that the vehicle is reasonably modifiable, with respect to size, age, and serviceability.

211.02(6) (Claim for reimbursement) A member may submit a claim for the Vehicle Modifications Benefit in accordance with established orders and instructions issued by or on behalf of the Chief of the Defence Staff. (See also QR&O article 203.05 (Delay In Submission Of Claims)).

(TB, effective 13 May 2021)

211.03 – Home Assistance Benefit

211.03(1) (Purpose) The purpose of the Home Assistance Benefit is to reimburse an ill or injured member for payments made to look after the member’s principal or temporary residence. 

211.03(2) (Eligibility) A member is eligible to receive the Home Assistance Benefit if it is assessed by a Canadian Forces Medical Officer or authorized civilian physician that due to the member’s impairment, the member is unable to independently perform housekeeping or grounds maintenance tasks

211.03(3) (Entitlement) The Home Assistance Benefit is payable for reasonable and necessary expenses incurred by or on behalf of the member for grounds maintenance services or housekeeping services, or both, for the member’s home or temporary residence that are the member’s responsibility and cannot be performed by the member due to the member’s impairment.

211.03(4) (Amount) The maximum amount payable under the Home Assistance Benefit per calendar year is the maximum amount provided by Veterans Affairs Canada for housekeeping services and grounds maintenance services identified in the Veterans Independence Program (VIP) National Rates Table but not exceeding the annual amount identified in the table of Maximum Rates Payable for the VIP and Long Term Care Program Services.

211.03(5) (Medical Assessment) A Canadian Forces Medical Officer or authorized civilian physician regularly assesses, not less than once every three months unless otherwise prescribed, whether a member who sustained an impairment continues to be medically unable to independently perform housekeeping or grounds maintenance tasks.

211.03(6) (Limitation) The Home Assistance Benefit is not payable:

(a) to members who are eligible for benefits under the Veterans Affairs Canada VIP program; or

(b) if the member has other reasonable means for home assistance (e.g. a relative or other individual living in the member's home who is capable of providing home assistance).

211.03(7) (Claim for reimbursement) A member may submit a claim for the Home Assistance Benefit in accordance with established orders and instructions issued by or on behalf of the Chief of the Defence Staff. (See also QR&O article 203.05 (Delay In Submission Of Claims)).

(TB, effective 13 May 2021)

211.04 – Attendant Care Benefit

211.04(1) (Purpose) The purpose of the Attendant Care Benefit is to reimburse an ill or injured member for payments made to an attendant to provide non-clinical support to that member on a full-time basis. 

211.04(2) (Eligibility) A member is eligible to receive the Attendant Care Benefit if it is assessed by a Canadian Forces Medical Officer or authorized civilian physician that due to the member’s impairment, the member is unable to independently perform ADL or IADL.

211.04(3) (Entitlement) The Attendant Care Benefit is payable for reasonable and necessary expenses incurred by or on behalf of the member for attendant care services which may include:

(a) assistance with ADL or IADL; and

(b) basic supervisory functions for members who require close monitoring for health and safety reasons.

211.04(4) (Amount) The maximum amount payable to a member in respect of the Attendant Care Benefit is $100.00 per day.

211.04(5) (Duration) The Attendant Care Benefit is payable for a maximum of 365 cumulative days. 

211.04(6) (Medical Assessment) A Canadian Forces Medical Officer or authorized civilian physician regularly assesses, not less than once every three months unless otherwise prescribed, whether a member who sustained an impairment continues to be medically unable to perform ADL or IADL independently.

211.04(7) (Limitation) The Attendant Care Benefit is not payable if the attendant is a member of the Special Force, Regular Force, or Reserve Force on Class “B” or “C” Reserve Service, who is in receipt of pay and allowances.

211.04(8) (Claim for reimbursement) A member may submit a claim for the Attendant Care Benefit in accordance with established orders ad instructions issued by or on behalf of the Chief of the Defence Staff. (See also QR&O article 203.05 (Delay In Submission Of Claims)).

(TB, effective 13 May 2021)

211.05 – Caregiver Benefit

211.05(1) (Purpose) The purpose of the Caregiver Benefit is to reimburse an ill or injured member for payments made for childcare or other caregiver expenses. 

211.05(2) (Eligibility) A member is eligible to receive the Caregiver Benefit if:

(a) a dependent child physically resides with the member; and

(b) it is assessed by a Canadian Forces Medical Officer or authorized civilian physician that, due to the member’s impairment, the member requires the assistance of a caregiver to care for the member’s dependant child or children.

211.05(3) (Entitlement) The Caregiver Benefit is payable for reasonable and necessary expenses incurred by or on behalf of the member in caring for a dependent child, including:

(a) assistance with child care activities that are the member’s responsibility and cannot be performed by the member due to the member’s impairment; and

(b) supervising those daily activities of the child that would normally be supervised by the member.

211.05(4) (Amount) The daily maximum amount payable in respect of the Caregiver Benefit is the amount set out in the National Joint Council Travel Directive for dependant care expenses with a declaration or a receipt, as applicable.

211.05(5) (Medical Assessment) A Canadian Forces Medical Officer or authorized civilian physician regularly assesses, not less than once every three months unless otherwise prescribed, whether a member who sustained an impairment continues to be medically unable to independently care for a dependent child.

211.05(6) (Limitation) The Caregiver Benefit is not payable if the caregiver is a member of the Special Force, Regular Force, or Reserve Force on Class “B” or “C” Reserve Service, who is in receipt of pay and allowances.

211.05(7) (Claim for reimbursement) A member may submit a claim for the Caregiver Benefit in accordance with established orders and instructions issued by or on behalf of the Chief of the Defence Staff. (See also QR&O article 203.05 (Delay In Submission Of Claims)).

(TB, effective 13 May 2021)

211.06 – Spousal Education Upgrade Benefit

211.06(1) (Purpose) The purpose of the Spousal Education Upgrade Benefit is to reimburse an ill or injured member for expenses to improve their spouse's or common-law partner's employability.

211.06(2) (Eligibility) A member is eligible to receive the Spousal Education Upgrade Benefit if the member: 

(a) is assessed by a Canadian Forces Medical Officer or authorized civilian physician as having sustained a permanent impairment;

(b) is medically unable to benefit from any federal tuition or vocational assistance program; and

(c) has an education upgrade plan for their spouse or common-law partner that has been approved by DGMT.

211.06(3) (Education Upgrade) The Spousal Education Upgrade Benefit is:

  1. payable for reasonable and necessary expenses incurred by or on behalf of the member for their spouse's or common-law partner's participation in an educational program to obtain:
    1. an undergraduate or advanced degree, diploma, or certificate at a Canadian university or college, accredited in accordance with provincial law; or
    2. a professional certification, trade accreditation, or similar credential, issued by a recognized professional body; and
  2. limited to:
    1. application, initial testing, and enrolment fees;
    2. tuition costs;
    3. the cost of necessary program materials (e.g. books and instruments, but not paper, pens and other school supplies);
    4. mandatory fees (e.g. student union, council, licensing, certification or accreditation, library, laboratory, examination, internet, or other mandatory fees or costs listed in the course syllabus or program documentation or which is required to complete the course or program); and
    5. the cost of a tutor referred by the training facility.

211.06(4) (Amount) The maximum amount payable for the Spousal Education Upgrade Benefit is $20,000.00.

211.06(5) (Limitation) The Spousal Education Upgrade Benefit is not payable:

  1. if the education upgrade plan is inadequate for the purpose of improved employability;
  2. if the expenses are not in accordance with the education upgrade plan;
  3. if the expenses are not claimed within one year after the day on which the expenses were incurred;
  4. in respect of a course that is not successfully completed; or
  5. in respect of expenses incurred:
    1. before the member sustains a permanent catastrophic impairment; and
    2. after the member is capable of participating in any federal government tuition and/or vocational assistance program.

211.06(6) (Claim for reimbursement) A member may submit a claim for the Spousal Education Upgrade Benefit in accordance with established orders and instructions issued by or on behalf of the Chief of the Defence Staff. (See also QR&O article 203.05 (Delay In Submission Of Claims)).

NOTE

Reimbursement for expenses made under the Spousal Education Upgrade Benefit may limit additional benefits available under the Veterans Affairs Canada (VAC) Rehabilitation Services and Vocational Assistance Program.

(TB, effective 13 May 2021)

211.07 – Next of Kin Travel Benefit

211.07(1) (Purpose) The purpose of the Next of Kin Travel Benefit is to pay or reimburse an ill or injured member for the travel and living expenses of the next of kin and travel assistants.

211.07(2) (Eligibility) A member is eligible to receive the Next of Kin Travel Benefit if all of the following conditions are satisfied: 

(a) it is assessed by a Canadian Forces medical officer or authorized civilian physician that:

(i) the member has a very serious illness or injury (i.e., life-threatening); or

(ii) the presence of the member’s next of kin is immediately required at the member’s location; and

(b) the Chief of the Defence Staff – or an officer designated by the Chief of the Defence Staff – determines that there is no operational or security reason that prevents the next of kin – and a travel assistant, as the case may be – being at the member's location; and

(c) the next of kin – and a travel assistant, as the case may be – travel to the member's location.

211.07(3) (Number — Persons) The NKTB is authorized for a maximum of four persons, including travel assistants. 

211.07(4) (Travel — Duration) The NKTB is authorized for a maximum of 120 days in respect of the total number of persons who travel and as divided among those persons by the member, if the member is competent, or by the member’s adult primary NOK, if the member is incompetent. Upon the authority of the Chief of the Defence Staff, an additional period of travel not exceeding a maximum of 180 days may be authorized for one person, if in the opinion of the medical officer, additional attendance of the NOK is required.

(TB, effective 13 May 2021)

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