# 2022-290 Medical and Dental Care, Spectrum of Care

Case summary

F&R Date: 2023-09-11

The grievor wished to receive yearly funding for the reimbursement of capillary prostheses, accessories and maintenance expenses because of a permanent medical condition. She received $2,000, the lifetime maximum provided for under the Canadian Armed Forces (CAF) Spectrum of Care (SoC). The grievor explained that her situation had started when she was already a member of the CAF and that the permanent situation had been caused by poor care and poor treatment by specialists. Moreover, her situation was exceptional because it was permanent and not short-term.

The Director of Medical Policy, acting as a subject matter expert, confirmed that $2,000 was the lifetime maximum for the purchase of capillary prostheses under the current SoC. The Initial Authority agreed with the Director's finding, concluding that the grievor had received the maximum provided for under the CAF SoC.

The Committee found that the maximum provided for under the CAF SoC is comparable to the maximum under other provincial health care plans. Moreover, the grievor did not satisfy the exceptions that would have entitled her to an additional amount. The CAF SoC expressly provides for the reimbursement of capillary prostheses, and the grievor received the maximum amount. The Committee therefore held that the grievor had not been aggrieved by the existing policy and recommended that the Final Authority deny redress to the grievor.