# 2013-088 - Disability Compensation

Case Summary

F&R Date: 2013–12–16

The grievor sustained a severe injury during an operational deployment. He submitted an application for benefits under the Accidental Dismemberment Insurance Plan of the Canadian Armed Forces (CAF) which was denied. He did however receive a disability award from Veterans Affairs Canada. The grievor acknowledged that his injury does not appear on the Schedule of Indemnities of the Accidental Dismemberment Insurance Plan. He believes, however, that the coverage offered by the insurance policy is outdated and should be revised. He therefore requested that a “competent person with the requisite authority” grant him a reasonable equivalence for his loss or that the Schedule of Indemnities be amended to properly reflect the new realities of today's injuries.

The Initial Authority, the Director General Personnel and Family Support Services, denied the grievance. He concluded that the grievor's injury did not appear on the list of body members covered under the Accidental Dismemberment Insurance Plan. He pointed out that even though he had wanted to uphold the grievance, “if only for compassionnate reasons”, he was unable to do so because governance of the Accidental Dismemberment Insurance Plan was wholly assumed by the Treasury Board of Canada.

Despite the seriousness and severity of the grievor's injury, the Committee noted that the injury was not covered by the Accidental Dismemberment Insurance Plan. The Committee therefore found that the decision of the President of Service Income Security Insurance Plan Financial Services to deny the grievor's application for benefits was in compliance with the CAF Accidental Dismemberment Insurance Plan.

The Committee also noted that since 6 December 2012, all reservists, including the Cadet Organisations Administration and Training Service, the Reserve Entry Training Plan, and the Canadian Rangers had been eligible for the same compensation as their Regular Force counterparts. In addition, the timeframe for submitting a compensation application for accidential dismemberment was increased from 90 to 365 days since the accident. Based on the above, the Committee concluded that the CAF Accidental Dismemberment Insurance Plan had evolved over time according to the need and that consequently it was impossible to conclude that it was out of date.

To determine whether the CAF Accidental Dismemberment Insurance Plan should cover other types of damage, the Committee compared it to other similar dismemberment insurance plans. The Committee found that the protection offered by the Accidental Dismemberment Insurance Plan was extremely generous and similar to that offered by the Government of Canada in other spheres of activity. The Committee found that the dismemberment insurance plan did not require amendment.

The Committee therefore recommended that the Chief of the Defence Staff deny the grievance.

CDS Decision Summary

CDS Decision Date: 2014–12–12

The CDS agreed with the Committee's findings and recommendation that the grievance be denied.