Canadian Armed Forces Health Care and Transition Services

May 2016

Recommendation 1: We recommend that the CAF determine whether an illness or injury is caused or aggravated by that member’s military service and that the CAF’s determination be presumed by VAC to be sufficient evidence to support an application for benefits.

Report: Determining Service Attribution for Medically Releasing Members

November 2023

Recommendation 11: That the Government of Canada ensure that a determination of injury applicable to service from a CAF doctor or specialist be deemed sufficient for the purposes of Veterans Affairs Canada and that the veteran not require additional screening to access treatment, benefits, or supports. 

Recommendation 19: That the Government of Canada prioritize efforts to reduce the wait times for CAF members, who are being medically discharged, to have their injury attributed to service in the forces.

September 2016

Recommendation 1: It is recommended that the Canadian Armed Forces retain medically releasing members until such time as all the benefits and services from the Canadian Armed Forces, Veterans Affairs Canada, and Service Income Security Insurance Plan have been confirmed and are put in place.

Report: Simplifying the Service Delivery Model for Medically Releasing Members of the Canadian Armed Forces

November 2023

Recommendation 12: That the Government of Canada work to ensure all relevant health resources are available for CAF members transitioning to VAC the moment they are discharged from the military.:

Recommendation 13: That the Government of Canada give the Canadian Armed Forces the ability to retain medically released members until such time as all the benefits and services from the Canadian Armed Forces, Veterans Affairs Canada, and Service Income Security Insurance Plan have been confirmed and put in place.

2016

Universality of Service

Time for a change

"An approach that combines hard and soft power in global affairs is known as smart power. To borrow the concept from the field of international relations, I recommend that the Defence Policy Review consider the principle of universality of service through a smart power perspective. ...

The principle of universality of service is based on the premise that the defence of the nation depends on the ability of every single member of the Canadian Armed Forces to engage in traditional combat roles; and all military resources – human and material – to be quickly deployable anywhere in the world and to combat when called upon. That is the hard power approach. Canada’s military deployments also call for smart power because combat is only part of the mission."

Evolution in technology – both in warfare and medicine

"A medical condition that used to be career ending no longer has to be for those who are willing to continue their military service."

Costs

"We need a modern, smart power solution that does not compromise operational readiness and supports the military’s most important asset, its people."

Report: Our submission to Strong, Secure, Engaged: Defence Policy Review

November 2023

Recommendation 16: That the Government of Canada retrain service personnel who have been injured, whenever possible, rather than release them for not meeting the universality of service doctrine.

December 2017

Recommendation 1: We once again recommend that the Department of National Defence and the Canadian Armed Forces eliminate ambiguity and inconsistency in language in the policy framework for Reservists, with a focus on health care entitlements, as soon as possible, and no later than spring 2019.

Recommendation 2: We recommend that the Department of National Defence and the Canadian Armed Forces ensure compliance with the existing illness and injury reporting process so that Canadian Rangers are not inadvertently barred from accessing their health care entitlements and related benefits.

Recommendation 3: We recommend that the Department of National Defence and the Canadian Armed Forces ensure the delivery of health care to Canadian Rangers to which they are entitled by:

• 3.1 Engaging with Canadian Rangers with the view of identifying the barriers to their access to Canadian Armed Forces health care, and their health care needs within their social and cultural contexts.

• 3.2 Identifying and implementing a service delivery model for Canadian Armed Forces health care that is responsive to the identified needs of the Canadian Rangers.

Recommendation 4: We recommend that the Department of National Defence and the Canadian Armed Forces take concrete steps to ensure Canadian Rangers have a clear understanding of the importance of reporting injuries, and to improve their knowledge and awareness of the health care entitlements and related benefits available to them by:

• 4.1 Amalgamating information on Canadian Ranger health care entitlements and related benefits; distributing this information to Canadian Rangers in various languages and formats as necessary, by fall 2018.

• 4.2 Ensuring that this information is integrated into formal and any other relevant training offered to the Canadian Rangers, by fall 2018.

Report: Canadian Rangers: A Systemic Investigation of the Factors That Impact Healthcare Entitlements and Related Benefits of the Rangers

November 2023

Recommendation 22: That the Government of Canada immediately implement the following recommendations, made by the Ombudsman’s Office, and already accepted by the Government of Canada, in the reports Canadian Rangers: A Systemic Investigation of the Factors That Impact Healthcare Entitlements and Related Benefits of the Rangers, and A Systemic Review of the Compensation Options for Ill and Injured Reservists:

• “That the Department of National Defence and the Canadian Armed Forces eliminate ambiguity and inconsistency in language in the policy framework for Reservists, with a focus on health care entitlements, as soon as possible.”
• “That the Department of National Defence and the Canadian Armed Forces ensure compliance with the existing illness and injury reporting process so that Canadian Rangers are not inadvertently barred from accessing their health care entitlements and related benefits.”
• “That the Department of National Defence and the Canadian Armed Forces ensure the delivery of health care to Canadian Rangers to which they are entitled by: engaging with Canadian Rangers with the view of identifying the barriers to their access to Canadian Armed Forces health care, and their health care needs within their social and cultural contexts; and identifying and implementing a service deliver y model for Canadian Armed Forces health care that is responsive to the identified needs of the Canadian Rangers.”
• “That the Department of National Defence and the Canadian Armed Forces take concrete steps to ensure Canadian Rangers have a clear understanding of the importance of reporting injuries, and to improve their knowledge and awareness of the health care entitlements and related benefits available to them by:
  • .... Amalgamating information on Canadian Ranger health care entitlements and related benefits;
  • .... distributing this information to Canadian Rangers in various languages and formats as necessary, by fall 2018;
  • .... and ensuring that this information is integrated into formal and any other relevant training offered to the Canadian Rangers, by fall 2018.”
• “The Department of National Defence and the Canadian Armed Forces improve the governance and administration of the Reserve Force Compensation process by: a) Creating a functional authority who is accountable for the Reserve Force Compensation process, and who can reinforce the applicable policies and directives in place; b) Amending Canadian Forces Military Personnel Instructions 20/04 to provide clarity and consistency in the cessation of service due to service-related injuries and illnesses; c) Streamlining the Reserve Force Compensation process by: i) Standardizing and simplifying forms; and ii) Ensuring that units forward claims directly to the Director Casualty Support Management for adjudication, within 30 days of the time the application was commenced; and d) creating a Defence Administrative Order and Directive to codify the Reserve Force Compensation process, including service standards or a performance measurement strategy to validate the effectiveness of the entire process.”
• “That the Department of National Defence and the Canadian Armed Forces take concrete steps to improve the knowledge and awareness of the compensation options available to ill and injured Reservists by: a) Making any relevant documents, policies, procedures and forms easily accessible on the internet and on the Defence Information Network; b) committing the resources required for the development and implementation of a communications plan, including i) activities, ii) products, iii) timelines, and iii) metrics to reach and inform Reservists about available compensation options; and c) formalizing training on Reserve Force Compensation and the Government Employees Compensation Act, and defining the roles and responsibilities for all Reservists and their leadership within these processes.”.

May 2016

Recommendation 1: It is recommended that the Department of National Defence and the Canadian Armed Forces improve the clarity and administration of Reservists’ entitlement and eligibility for health care, periodic health assessments and future Reserve employment by:

• 1.1 Completing the revision of Queen’s Regulations and Orders, Chapter 34 – “Medical Services,” that has been under review since 2009, to clearly identify all entitlements to care for all Reservists

• 1.2 Incorporating the requirement for Reservists to undergo routine periodic health assessments (or to have their medical readiness determined) into the revised Queen’s Regulations and Orders Chapter 34 – “Medical Services” (along with associated policies and directives). Once this requirement is codified, ensure that the appropriate resources are in place to guarantee Reserve medical readiness

• 1.3 Confirming in Canadian Forces Military Personnel Instruction 20/04 that Reservists whose Medical Employment Limitations so allow may be eligible to obtain new employment despite the existence of a temporary medical category

Recommendation 2: It is recommended that the Department of National Defence and the Canadian Armed Forces take measurable steps to improve the knowledge and awareness of the entitlements available to all Reservists, especially those who may be ill and injured, by:

• 2.1 Making any relevant documents, policies, procedures and forms easily accessible on the internet and on the Defence Information Network, and ensuring this information remains current

• 2.2 Committing the resources required for the development and implementation of a communications plan. This would include activities, products, timelines and metrics to reach and inform Reservists

• 2.3 Ensuring that training on entitlement to health care (currently provided by the Field Ambulance Medical Link Teams) is effective and mandatorily provided to Reserve units

• 2.4 Ensuring that Reserve units have the appropriate number of training days to provide mandatory training to their members, and that such training is completed

Recommendation 3: It is recommended that the Department of National Defence and the Canadian Armed Forces strengthen the responsibility and capacity to follow-up with Reservists by:

• 3.1 Establishing a consistent and meaningful approach to contacting Reservists who are on non-effective strength; especially those with a deployment history, and document the efforts made to reach them, even if unsuccessful

• 3.2 Establishing an oversight mechanism to ensure the consistent completion of post-deployment follow-up activities at the unit level, and reiterating the responsibilities of the chain of command in this regard

• 3.3 Flagging to the chain of command when a Reservist is non-effective strength and cannot be reached

• 3.4 Ensuring that the Field Ambulance Medical Link Teams are properly resourced to effectively deliver their mandate

• 3.5 Taking the necessary steps to fill all established mental health positions, and reviewing the mental health staffing requirements for the 2016 paradigm

Report: Part-Time Soldiers with Full-Time Injuries: A Systemic Review of Canada’s Primary Reserve Force and Operational Stress Injuries

November 2023

Recommendation 23: That the Government of Canada immediately implement the following recommendation, made by the Ombudsman’s Office, and already accepted by the Government of Canada, in the report Part-Time Soldiers with Full-Time Injuries: A Systemic Review of Canada’s Primary Reserve Force and Operational Stress Injuries:

• “That the Department of National Defence and the Canadian Armed Forces improve the clarity and administration of Reservists’ entitlement and eligibility for health care, periodic health assessments and future Reserve employment by: a) Completing the revision of Queen’s Regulations and Orders, Chapter 34—“Medical Services,” that has been under review since 2009, to clearly identify all entitlements to care for all Reservists; b) incorporating the requirement for Reservists to undergo routine periodic health assessments (or to have their medical readiness determined) into the revised Queen’s Regulations and Orders Chapter 34—“Medical Services” (along with associated policies and directives). Once this requirement is codified, ensure that the appropriate resources are in place to guarantee Reserve medical readiness; c) confirming in Canadian Forces Military Personnel Instruction 20/04 that Reservists whose Medical Employment Limitations so allow may be eligible to obtain new employment despite the existence of a temporary medical category.”
• “That the Department of National Defence and the Canadian Armed Forces take measurable steps to improve the knowledge and awareness of the entitlements available to all Reservists, especially those who may be ill and injured, by: a) Making any relevant documents, policies, procedures and forms easily accessible on the internet and on the Defence Information Network, and ensuring this information remains current; b) committing the resources required for the development and implementation of a communications plan. This would include activities, products, timelines and metrics to reach and inform Reservists; c) ensuring that training on entitlement to health care (currently provided by the Field Ambulance Medical Link Teams) is effective and mandatorily provided to Reserve units; and d) ensuring that Reserve units have the appropriate number of training days to provide mandatory training to their members, and that such training is completed.”.

November 2013

Recommendation 7: Formalize the approach to provincial and territorial engagement.

Report: On the Homefront: Assessing the Well-being of Canada’s Military Families in the New Millennium

November 2023

Recommendation 31: That the Government of Canada work with provincial and territorial governments, as well as relevant other stakeholders, to ensure that all Canadian military family members have access to mental health services and supports that are both adequate and tailored to their needs.

Recommendation 32: That the Government of Canada, in collaboration with provincial and territorial governments, expedite its efforts to increase the availability of—and secure access to—affordable child care and family physicians for military families.