Army.ca Forums

The Parade Square => VAC and other Soldiers' Benefits => Topic started by: RobA on May 07, 2015, 17:44:22

Title: Critical Injury Benefit
Post by: RobA on May 07, 2015, 17:44:22
Just wondering if anyone has been contacted about this yet? O'Toole saidd VAC was going to contact eligible vets proactively, don't know if that means now, or if they need to wait until it passes in the HoC (whenever that is)

Title: Re: Critical Injury Benefit
Post by: Teager on May 07, 2015, 18:12:03
I think it will have to be passed before they contact anyone. If they contacted eligible vets and the bill never passes then they would look pretty bad. My case manager said they don't even have any info on it and they know as much as the rest of us do. Just wait out eventually things will get moving and an answer will be provided. Since Equitas is still in talks they might have some additions to come yet (or not).
Title: Re: Critical Injury Benefit
Post by: dunlop303 on May 08, 2015, 15:19:45
That would be great, but it raises so many questions. The scenario they offer is someone who was not pensioned received it. Do critically injured pensioned people receive it? What is the criteria? Does it have to fall into a category of injuries or a % of disability?

I'm sure the HoC will have the same questions. Unless I'm not seeing a full bill that others have seen.
Title: Re: Critical Injury Benefit
Post by: Teager on May 08, 2015, 15:25:40
Here is the whole Bill. http://www.parl.gc.ca/HousePublications/Publication.aspx?Language=E&Mode=1&DocId=7907037&File=29#1

As far as I know you do not need to be in receipt of a Disability award to receive this benefit. Unsure of how the specifics will be laid out when it's all said and done.
Title: Re: Critical Injury Benefit
Post by: RobA on May 08, 2015, 17:31:10
I've read the bill pretty thoroughly, and here's my take from it (just my opinion, I'm not a lawyer or anything, so don't take this as a substitute for any advice from anyone in the know)

Here's the criteria as in the bill:

1) The Minister may, on application, pay a critical injury benefit to a member or veteran who establishes that they sustained one or more severe and traumatic injuries, or developed an acute disease, and that the injury or disease:

(a) was a service-related injury or disease;

(b) was the result of a sudden and single incident that occurred after March 31, 2006; and

(c) immediately caused a severe impairment and severe interference in their quality of life.
   
      Factors to be considered

(2) In deciding whether the impairment and the interference in the quality of life referred to in paragraph (1)(c) were severe, the Minister shall consider any prescribed factors.
      
(3) The Governor in Council may, for the purpose of subsection 44.1(1), make regulations respecting the determination of what constitutes a sudden and single incident.


So, the whole "pensioned or not" thing is irrelevent. As it has to have happened AFTER March 2006, I don't think ANYone in receipt of a pension (under the old charter) would qualify, as I'm pretty sure there are no pensions given out after March 2006.

As for the actual injury, the critical thing is that it needs to be "sudden and severe". There are two words here, "sudden" and "severe" both of which have two meanings. The "sudden" requirement means there needs to be a specific event (or events) one can point too. So, a fall out of a Griffon while rappeling would count. So would an IED attack in AFghan. Busted up knees after 20 years of rucksack marching, or PTSD after a tour of Afghanistan would not.

The "sudden" requierement seems pretty straight forward. It's either a specific event, or it isnt. THe "severe" criteria is a little mushier, and one in which judgement will come into play. IMO, if one gets denied, it will be the "severe" aspect that would be attackable in an appeal. The "sudden" criteria seems much less subjective.

If you qualify in the "sudden" category, all you'll need to do is convince them that it is "severe". THat may be  based on your disability percentage (someone paid out at 100% would likely qualify merely by that fact alone). But I don't think it has to be the only factor. If youu can show that your injury was "severe" you'll prob have a good chance.

I also read this part from the top:

" The purpose of this Act is to recognize and fulfil the obligation of the people and Government of Canada to show just and due appreciation to members and veterans for their service to Canada. This obligation includes providing services, assistance and compensation to members and veterans who have been injured or have died as a result of military service and extends to their spouses or common-law partners or survivors and orphans. This Act shall be liberally interpreted so that the recognized obligation may be fulfilled."

(emphasis mine). To me, this last part suggests that the "severe" criteria will NOT be judged according to a super strict standard. The "sudden" requirement, which is much less subjective seems to be the linchpin. If you satisfy that, then the "severe" aspect seems to be a judgement call.


Title: Re: Critical Injury Benefit
Post by: Teager on May 12, 2015, 21:51:26
Seems that Minister O'Toole wants the Bill passed by June. Seems to be some politics happening between the NDP and Conservatives about passing Bill C-58 and now trying to pass it with budget implementation with Bill C-59. Feel free to have a read. I don't even know who to believe anymore.  :dunno:

https://www.facebook.com/erinotoolecpc/posts/10153271419357667
Title: Re: Critical Injury Benefit
Post by: Teager on May 12, 2015, 21:56:15
And here's a bit from the media about it.

Quote

Murray Brewster, The Canadian Press
Published Tuesday, May 12, 2015 10:15AM EDT
Last Updated Tuesday, May 12, 2015 1:22PM EDT
OTTAWA -- The Harper government has stuffed proposed improvements to veterans benefits into the omnibus budget bill, saying it needs to make sure it passes before the next election.
But the move could also silence opposition critics.
It's an unusual tactic, since Veteran Affairs Minister Erin O'Toole had already introduced separate legislation -- Bill C-58 -- to enact the changes, which include a new retirement benefit for severely disabled soldiers, a separate $70,000 injury award and a proposed $7,238 caregivers benefit, among other things.
A look at government legislation that has yet to pass the Commons
O'Toole told the House of Commons veterans committee that he doesn't trust the opposition to pass the bill before Parliament adjourns -- likely next month, with an election scheduled for October.
He pointed to an NDP motion, debated on Monday, which called on the government to recognize its social obligation to veterans and their families, as well as recent statements that the changes don't go far enough.
"It's clear you wanted to delay, and I won't allow a delay to happen when I've made a commitment to veterans," O'Toole said in an answer to a question by NDP veterans critic Peter Stoffer.
The bill was introduced in late March, but has yet to be brought before a Commons committee for detailed study, said Stoffer, who noted that his party actually "likes" the legislation.
"We in the opposition -- I cannot speak for the Liberals -- but we have never indicated a delay in Bill C-58. And to indicate that we have is simply not true," said Stoffer.
He said the effect of putting the changes into the massive budget bill is that veterans groups won't have a chance to comment before Parliament on the proposed changes.
The decision also jams opposition parties, which usually vote against budget bills. Additionally, it provides an opening for the Conservatives in the upcoming campaign to say that the Liberals and NDP voted against improved veterans benefits.
O'Toole's parliament secretary, Ontario Conservative MP Pierre Lemieux, said there's still a possiblity that portions of the budget bill affecting veterans would be open to public scrutiny and comment, but that decision would rest with the Commons finance committee.
Liberal veterans critic Frank Valeriote said he was skeptical that the stand-alone veterans legislation would make it all of the way through before Parliament dissolved, but suggested the government introduced it late in the process.
Since replacing Julian Fantino in January, O'Toole has had the monumental task of rebuilding bridges with the politically-important veterans community, which has grown increasingly outraged over a series of issues, including gaps in the veterans benefits system, regional office closures, and slights by the former minister.
Conservative MPs, who took turns lobbing friendly questions at him during Tuesday's committee meeting, repeatedly returned to the issue of under-spending in the department, which surfaced last fall.
Federal budget records show that since 2006, veterans affairs was unable to spend $1.13 billion of its budget, money that was subsequently returned to the federal treasury.
The revelation created a political firestorm, one that evidently still smarts as O'Toole responded to questions by saying the issue was used to deliberately "sow seeds of confusion" over what is a normal practice of government and emerges during a slow news cycle.
The government's defence -- then and now -- is that departments always appropriate extra funds so they don't run short, especially in service based departments like veterans.
With so many elderly veterans passing away, O'Toole said it's tough for the department to run projections.
"The estimate does not anticipate veterans passing away over the course of the cycle," he said. "We see most of the lapsed funds coming, sadly, when we're losing a large number of our World War Two and Korean veterans. In terms of lapsed funds, this is why."

http://www.ctvnews.ca/canada/tories-set-to-use-omnibus-bill-to-ram-veterans-benefits-through-parliament-1.2370163
Title: Re: Critical Injury Benefit
Post by: blackberet17 on June 22, 2015, 14:55:19
A Q&A page went up not long ago, and I thought I'd post some extracts. Reminder, this has still not passed through Parliament yet.

Quote
Q3. What is the definition of a “sudden, single and traumatic event,” and why was that chosen?

A3. The phrase “sudden single and traumatic event” refers to one unexpected incident which resulted in severe and traumatic injuries. The defining factor is that the event was singular and the effect of it was immediate; it did not evolve over time.

This benefit was designed this way to respond in part to those Veterans/CAF members who experienced severe injuries, and endured prolonged periods of inpatient care and painful and recurrent procedures where their condition improved to the point they received minimal disability benefits.

The types of events/incidents contemplated for this benefit may include, but are not limited to IEDs, motor vehicle accidents, fires, falls, etc.

Here is an example of sudden service-related illness: If a soldier was in a rollover accident and he or she suffered a deep wound and broken bones, a severe infection could set in. That requires intensive care, surgeries or intubation to recover—this benefit is meant to recognize that struggle. It’s an immediate illness caused by a sudden incident.

Quote
Q9. Would there be a time limit to apply for this benefit?

A9. No. There would be no time limit to apply for this benefit.


Q10. Why would this benefit be retroactive to April 1, 2006, while the other new benefits announced (Retirement Income Security Benefit and Family Caregiver Relief Benefit) were not?

A10. This eligibility date was chosen to coincide with the date of the coming into force of the NVC. Doing so will address stakeholder requests for additional benefits for the most seriously injured under the NVC, and will recognize the high number of severe and traumatic injuries sustained by CAF personnel in the Afghanistan War following the introduction of the NVC.


Q11. How many people are projected to receive this benefit?

A11. It is estimated that more than 120 CAF personnel could receive this benefit by 2019-2020.

Personally, I think the 120 estimate is frighteningly low.

Quote
Q15. I am a Veteran in receipt of a disability award as a result of an amputation due to a critical injury. Would I have to submit an application since you have my information on file?

A15. As part of the Department’s continued commitment to Veteran-centric care, and in order to reduce wait times, where possible, Veterans Affairs Canada employees will proactively contact Veterans who have had severe service related injuries, to discuss this new benefit.

Once enacted in Parliament, if Veterans Affairs Canada has not contacted you and you think you may be eligible for this new benefit, do not hesitate to contact the Department at 1-866-522-2122 (1-866-522-2022 in French) to ask for more information.

And it's non-taxable.
Title: Re: Critical Injury Benefit
Post by: Teager on June 22, 2015, 15:17:51
Thanks Blackberet17. Do you have a link for this?
Title: Re: Critical Injury Benefit
Post by: blackberet17 on June 23, 2015, 09:59:40
No, sorry. I forgot to mention it is internal at this time. We're still waiting on Parliament to pass the required legislation.

Anyone else notice how all the Conservative ads have the little itty-bitty writing at the bottom, "Pending Parliamentary Approval", or similar wording?
Title: Re: Critical Injury Benefit
Post by: Teager on June 25, 2015, 13:30:48
Well looks like the Bill got Royal assent yesterday so CIB and the other benefits should start to move forward.
Title: Re: Critical Injury Benefit
Post by: dunlop303 on June 25, 2015, 14:26:06
Thats great, didn't expect it to move so quickly.

What is the time frame usually to pass these once they reach this level?
Title: Re: Critical Injury Benefit
Post by: blackberet17 on June 25, 2015, 15:30:25
Nothing yet on the external VAC Web site ref Royal assent, but the internal site has been refreshed, and the Q&A I mention above has been updated. I'll read through tomorrow, and advise if I note any major differences.

Title: Re: Critical Injury Benefit
Post by: dunlop303 on June 25, 2015, 15:55:59
Interesting,

I re-educated my self on my old law classes on how a bill becomes Law. I thought it needed another step after Royal Assent but I guess it doesn't?
Im tempted to call in and get in que, but ive harassed VAC enough this week. And I am guessing it will take some time to set up there systems ect, as it is not listed as a benefit yet.
Title: Re: Critical Injury Benefit
Post by: PuckChaser on June 25, 2015, 15:59:42
Royal Assent is the last step, the GG has signed the bill into Law. Now all the bureaucratic processes need to start to get the money out to everyone.
Title: Re: Critical Injury Benefit
Post by: blackberet17 on June 25, 2015, 16:19:15
From the refreshed version.

Quote
Q6. Is this benefit available now?

A6. No, the benefit will be available once the regulations have passed.

Q7. Does a CAF member/Veteran who is already in receipt of a disability award as a result of an amputation due to a critical injury have to submit an application, since VAC already has the information on file?

A7. As part of the Department’s continued commitment to Veteran-centric care, and in order to reduce wait times, where possible, VAC employees will proactively contact CAF members/Veterans who have experienced a sudden, single incident on or after April 1, 2006 which immediately resulted in a service-related traumatic injury or disease causing severe impairment and interference with quality of life to discuss application requirements.

Q8. How will a CAF member/Veteran know if VAC is proactively determining if they meet the above stated eligibility requirements?

A8. They will receive a letter from the Department to let them know that VAC has reviewed their information and will be advised that they are entitled to this benefit. This letter will also advise them if additional information is required in order to proceed with an official decision.

Q9. I have received a letter from VAC saying that they are able to waive the requirement for me to apply and that after a review of my information I am entitled to this benefit. In order to receive this lump-sum award, it says to call this number and advise that I accept the offer to waive the application or send a message through My VAC Account (MVA). What do I do next?

A9. The next steps will depend upon how you wish to proceed. Please allow me to verify the information contained in your letter and we will determine the next steps from there

So, some of you may note, Q9 above is different from Q9 I previously posted.

Watch and shoot for more!
Title: Re: Critical Injury Benefit
Post by: RobA on June 27, 2015, 14:52:37
If anyone gets that letter, could they let us know here? So that we'll at least know they are set up to start processing claims.

I agree, I think they're seriously underestimating the number listed, and I imagine that lots of people will eentually qualify that aren't selected in the initial round.
Title: Re: Critical Injury Benefit
Post by: blackberet17 on June 29, 2015, 11:31:58
Never tried myself in the past, but there is a link here (http://www.canada.ca/en/campaign/supportforveterans/veterans.html) which allows you to subscribe to receive an update once the benefit is approved.
Title: Re: Critical Injury Benefit
Post by: dunlop303 on June 30, 2015, 12:17:50
Underestimated for sure, in my squadron of tank drivers alone, there were 12 drivers - 10 hit IED's, 2 were killed and I think only 2 didn't have an immediate injury. So 8/12 drivers who hit IED's that didn't die had some sort or medivac injury. That was one tour.
Title: Re: Critical Injury Benefit
Post by: dunlop303 on June 30, 2015, 13:43:58
I emailed vac just to see if they had a timeline set up, nothing yet:




Thank you for using My VAC Account and our secure email services.

As part of the Department's continued commitment to Veteran-centric
care, and in order to reduce wait times, where possible, Veterans
Affairs Canada employees will proactively contact Veterans who
have had severe service related injuries, to discuss this new
benefit. However, at this time we have not been provided any
time frames for this to take place. I am sure it will be publicized
or you may check back with our Department periodically.

If you have any further questions or concerns, please contact
us again via My VAC Account or our toll free number 1-866-522-2122.
Title: Re: Critical Injury Benefit
Post by: blackberet17 on June 30, 2015, 15:45:34
I read it so quickly at first I thought it was the canned response :)

There hasn't been any official word about implementation. If and when I hear something, I'll post.

This is one of those things about ministerial announcements. Looks great on paper, but getting the policies, procedures and guidelines in place takes more time than waving the magic wand, or à la Jean-Luc Picard saying "Make it so."
Title: Re: Critical Injury Benefit
Post by: RobA on July 01, 2015, 00:10:54
Underestimated for sure, in my squadron of tank drivers alone, there were 12 drivers - 10 hit IED's, 2 were killed and I think only 2 didn't have an immediate injury. So 8/12 drivers who hit IED's that didn't die had some sort or medivac injury. That was one tour.

Yup, my platoon in 2007 had 8 IED strikes seperate ly.  All told, I can think of 6 guys from my platoon alone that should qualify.

Theyre either going to have to give out a lot more then they thought or deny a lot of people.

My guess is, this whole "premptive contact" thing likely means they won't be open to applications until after the election.

I can't imagine Harper wants a bunch of vets calling the papers to talk about how they've all been denied this benefit.  At least if you tell them "wait for us to call you" they can get away with  not havi ng to outright deny ppl until after October.
Title: Re: Critical Injury Benefit
Post by: PuckChaser on July 01, 2015, 00:45:04
You guys haven't been around VAC for long, right? It'll be 6 months before the preemptive contact, then another 6 months to render a decision. You'll be lucky to see money or denials before next summer, election or not.
Title: Re: Critical Injury Benefit
Post by: Rifleman62 on July 01, 2015, 09:47:10
http://www.newswire.ca/en/story/1564605/government-of-canada-delivers-for-canadian-armed-forces-personnel-and-veterans

Government of Canada delivers for Canadian Armed Forces personnel and Veterans

Veterans Affairs Canada to begin implementing three new benefits

OTTAWA, June 30, 2015 /CNW/ - The Honourable Erin O'Toole, Minister of Veterans Affairs, confirmed today that the Retirement Income Security Benefit, the Family Caregiver Relief Benefit, and the Critical Injury Benefit for Canadian Armed Forces personnel, Veterans and their families will come into effect on July 1, 2015.

The Retirement Income Security Benefit will provide moderately to severely disabled military Veterans with continued assistance in the form of a monthly income support payment beginning at age 65.

The Family Caregiver Relief Benefit will provide Armed Forces Veterans with a tax-free annual grant of $7,238, allowing their informal caregivers some relief when they need it, while also ensuring that the Veteran's care needs are being met.

The Critical Injury Benefit will provide a $70,000 tax-free payment to recognize and compensate severely injured or ill Canadian Armed Forces personnel and Veterans.

Quick Facts 

    The Retirement Income Security Benefit will ensure that an eligible military Veteran's total annual income is at least 70% of what he or she received in financial benefits from Veterans Affairs Canada before age 65.
    The Family Caregiver Relief Benefit will provide funds to be used for a wide range of relief options such as covering the cost of having a professional caregiver come into the home or covering the cost for another family member or friend to travel to the Armed Forces Veteran's home.
    The Critical Injury Benefit is being paid to eligible Canadian Armed Forces personnel and military Veterans who have suffered a service-related sudden traumatic injury or developed an acute disease and works in concert with existing services and benefits so that there is a continuum of support from the onset of a traumatic injury or disease.
    These benefits are part of the Government of Canada's response to the June 2014 House Standing Committee report on Veterans Affairs on the New Veterans Charter. These benefits are in addition to other enhancements of benefits for part-time Reserve Force personnel, expanded eligibility criteria for the Permanent Impairment Allowance, and the hiring of new case managers and additional staff for disability benefits, previously announced by the Minister
Title: Re: Critical Injury Benefit
Post by: blackberet17 on July 02, 2015, 16:22:51
Posted online today:

http://www.veterans.gc.ca/eng/services/after-injury/critical-injury-benefit

Quote
The Critical Injury Benefit is a tax-free lump sum award.

Eligibility details

Canadian Armed Forces members or military Veterans may be eligible if they experienced a severe and traumatic injury or acute disease which:
•was service-related;
•was the result of a sudden and single incident occurring on or after April 1, 2006; and
•immediately caused a severe impairment and interference in quality of life.

Severe impairment and interference in quality of life
For the purposes of the Critical Injury Benefit, at least one of the following must apply to you:

Amputation
•An amputation at or above the wrist or ankle

Conditions of less than 12 weeks
•Admitted to intensive care for at least five days.
•Hospitalized and received complex treatment.

Conditions that lasted 12 weeks or more
•Hospitalized
•Blind in both eyes
•Paralysis of one or more limbs
•Loss of control of kidneys, bladder or bowel

Conditions that lasted 16 weeks or more
•Required assistance with three or more of the following activities: eating, bathing, walking, toileting or transferring (e.g. from bed to chair)

Before you start

First time applying for a VAC benefit

You must confirm your identity with one piece of current and valid ID.

Acceptable documents include:
•Driver's licence (provincial)
•Provincial health care card (excluding Alberta and Manitoba)
•Certificate of Indian Status or Secure Certificate of Indian Status
•Vital statistics documents: birth certificate, marriage certificate
•Employee identification card (federal, provincial or municipal)
•Canadian passport
•Other provincial identification card
•Other federal identification card

Proof of identity is also needed for any spouse, common-law partner and/or eligible dependent child who may also benefit from the program.

If you are applying in person, you can take the original of an acceptable document listed above and VAC staff will photocopy it for your file.

If you are applying by mail, please photocopy one of these acceptable documents and attach that to your application. Please write the Veteran’s service number on the photocopy. Do not send original documents to VAC.

There's an "Apply Now" button, plus the 1-866 number, a link to help you find an office, and if sending an application by mail, an address.

There is a "Rates" link, but it's a non-starter at this time.
Title: Re: Critical Injury Benefit
Post by: Teager on July 02, 2015, 20:14:39

There is a "Rates" link, but it's a non-starter at this time.

I think it's strictly $70k as long as you meet the criteria but could be wrong.
Title: Re: Critical Injury Benefit
Post by: RobA on July 02, 2015, 21:49:49
Yeah, it's $70k or nothing.

I see now why they were so comfortable giving the (seeming) ridiculously low estimated number of 100ish by 2020.

So I'm guessing that lawsuit will be back on now. This award will be given out to almost nobody, the conditions the lawsuit was founded on still exist.
Title: Re: Critical Injury Benefit
Post by: dunlop303 on July 03, 2015, 01:47:31
Well, I applied.

 I'll keep you guys posted as usual. I hit three of the "must haves below", but who knows for sure.
Critical care is open for interpretation (Role 3 in Kandahar?) as is mobility assistance / bed transferring / complex care... ect. a lot of wiggle room.

if anyone gets any kind of feed back in the meantime it would be much appreciated!
Title: Re: Critical Injury Benefit
Post by: RobA on July 03, 2015, 09:05:24
Yeah same with me.

Injured on highway #1, flown in a Blackhawk to KAF hospital.  Stayed there abkut a week.

Don't know if thats "intensive care unit" but we'll see.
Title: Re: Critical Injury Benefit
Post by: dunlop303 on July 03, 2015, 14:23:43
I was in role 3 for 7 days after being flown in via Blackhawk from panjwai ish area, then was flown to Bagram for 24hrs then to landshtule Germany for another week, and after that I was stable enough to fly but couldn't sit or walk so they sent one of Harper's little blue gov jets with a bed in it for me. Another 2 days in an Ontario hospital, the  rest at home for a few months before physio.

I'd like to hope it's a slam dunk on this benefit. But I am not getting my hopes too high.
Title: Re: Critical Injury Benefit
Post by: RobA on July 03, 2015, 19:43:59
Yeah, I don't want to get your hopes up either but yours sure sounds like a slam dunk to me. If a case like yours doesn't get it, then this award shouldn't even exist.

Mines much more borderline. If I get it, good, if not,  I'll survive lol. Not gonna lose any sleep over it either way.
Title: Re: Critical Injury Benefit
Post by: Teager on July 03, 2015, 19:58:29
I"ll keep you guys in the loop as well was in the hospital for 6 months so I think I should qualify. I"m having some issues with the PDF download never opens for me. PDF is up to date. So might have to request an application through snail mail.
Title: Re: Critical Injury Benefit
Post by: dunlop303 on July 05, 2015, 00:17:30
Might be your browser, it doesn't like anything but internet explorer. And your need to have Adobe set as your default pdf reader. I had to switch mine from bluebeam.


Thanks Rob, I'll keep u posted!
Title: Re: Critical Injury Benefit
Post by: dunlop303 on July 06, 2015, 12:52:11
Got some information regarding turnaround times on applications, interesting few calls this morning. The 1st rep I had on the phone was all snooty, Sir.. the bill hasn't even passed yet, once it does you can apply not before then. Umm, Miss, it has passed, and ive already applied threw the apply now button on your website form VAC1033.

She puts me on hold and comes back embarrassed, and says well in my defense my boss has been on vacation. - Wow. So I said thanks anyway and sent them a message asking the same question so they could have a minute to get them selves sorted out.

The turnaround target on applications is within 12 weeks. - tic tock.. One week down and the rep I spoke to didn't even know the benefit existed, lol not a good start.
Title: Re: Critical Injury Benefit
Post by: blackberet17 on July 08, 2015, 13:05:12
Dunlop303

Not surprised. There has not been an official communiqué internally on the CIB. The last we got, dated 02 JUL 15, was on the Veterans Hiring Act, and on Enhanced Transition Services.

There was information posted to the internal Web set, but not everyone thinks to look there.

Disappointing and embarrassing a rep didn't have SA on it, but info has not been passed down all the same.
Title: Re: Critical Injury Benefit
Post by: dunlop303 on July 08, 2015, 16:09:16
Yep,

I wasn't hard on her or anything I told her not to feel bed it had just come out and I had been checking it daily.
I got an odd generic message today, I double checked via secure message that they have everything they need to detrmine my eligibility since its all based on evidence used in previous physical injury awards.

And I get this:

Veterans Affairs Canada
Sent: UTC 2015-07-08 18:35
Dear Mr.

Thank you for using My VAC Account and our secure E-mail services.

You will be contacted in the near future regarding this benefit.

If you have any further questions or concerns, please contact
us again via My VAC Account or our toll-free number 1-866-522-2122.

Sincerely,

 
Inquiries Analyst
Veterans Affairs Canada


You
Sent: UTC 2015-07-07 20:56
Thank you for the follow up,

The criteria that I believe entitles me to this benefit should
already be in the possession of Veterans Affairs Canada.
They were all noted on my most recent derision letter for traumatic
brain injury regarding nursing notes from 2007, diagnostic imaging
ect.

Can you confirm that I do not need to submit any further information,
since my entitlement is based on a disability award I received
for an IED strike that caused a broken pelvis and tailbone causing
helicopter evacuation to Role 3 intensive care in Kanadhar and
transferred roughly a week later to the military hospital in
Landshtule Germany.

Thank you,
Title: Re: Critical Injury Benefit
Post by: blackberet17 on July 16, 2015, 15:53:05
The generic reply, and you "should" receive a more "personal" response soon. I think the turnaround is five business days for a response, although as it is specific to the CIB, it may take a little longer.

This information was included in an e-mail to staff today. It expands on the criteria for eligibility.

Quote
For the purposes of determining eligibility for this benefit, applicants who present evidence demonstrating that at least one of the following criteria has been met shall be considered to have a severe impairment and severe interference in quality of life:

+ sustained an amputation at or above the wrist or ankle;
+ sustained legal blindness in both eyes - meaning that their best corrected visual acuity is less than or equal to 6/60 or they have less than 20 degrees of visual field remaining - for a minimum of 84 consecutive days;
+ sustained quadriplegia, paraplegia, hemiplegia or complete paralysis of a limb for a minimum of 84 consecutive days;
+ sustained total loss of urinary or bowel function for a minimum of 84 consecutive days;
+ required the assistance of at least one person to perform at least three activities of daily living for a minimum of 112 consecutive days;
+ was admitted to an intensive care unit for a minimum of five consecutive days;
+ was admitted to a hospital for acute or rehabilitative inpatient care for a minimum of 84 consecutive days; or
+ was admitted to a hospital for acute or rehabilitative inpatient care for less than 84 consecutive days during which the member or veteran received complex treatments.

It's only a little more detail from what I shared previously. And the days (84, 112) equate to the weeks used on the VAC web site (i.e., 12 weeks equals 84 consecutive days).
Title: Re: Critical Injury Benefit
Post by: dunlop303 on July 21, 2015, 14:25:59
Anything new on VAC's end that anyone know's about? I was considering calling in for an update but thought I would check here first.
I electronically submitted my application on July 2nd. Does anyone know if they are looking at them yet?

Thanks,
Title: Re: Critical Injury Benefit
Post by: blackberet17 on July 21, 2015, 15:30:33
No word here, but I can make some inquiries of friends in Adjudication.

Note it will take some time before you receive a response. This is a new benefit, decisions will not be rushed as procedures and kinks are worked out.
Title: Re: Critical Injury Benefit
Post by: dunlop303 on July 21, 2015, 16:09:02
Thanks that would be great. I wonder (and kind of hope) its not the same adjudicators that are backlogged with Disability Claims.

Thanks again,
Title: Re: Critical Injury Benefit
Post by: blackberet17 on July 23, 2015, 10:21:22
Thanks that would be great. I wonder (and kind of hope) its not the same adjudicators that are backlogged with Disability Claims.

Thanks again,

Well, I hate to break it to you, but it inevitably is...while there is an advertised hiring process out there right now, Adjudication was also hit in the staffing cuts of the last four years. There was an advertised process back in Jan 15, which didn't bring in many applicants apparently, and then four more Disability Adjudicator/Benefit Adjudicator processes, one which just closed yesterday (sorry, I totally missed it: https://emploisfp-psjobs.cfp-psc.gc.ca/psrs-srfp/applicant/page1800?poster=823569).

The issue they are having in the hiring process is they changed the classification to NU roughly five years ago. Now, to be a Disability Adjudicator, you must have "Eligibility for Registration as a registered nurse in a province or territory of Canada." It really restricts the applicant pool when you target a specialized branch.

If you search through the archives, you'll find these same posters. Set your parameter to the VAC org, or else you'll get all the external posters.
Title: Re: Critical Injury Benefit
Post by: dunlop303 on July 23, 2015, 11:20:29
They wont get any traction with the price range ($45,886 to $63,153), I know its a Fed job with a nice pension at the end of the tunnel.
But aside from new grads, actual nurses are all mostly 70k+.
Title: Re: Critical Injury Benefit
Post by: blackberet17 on July 23, 2015, 11:34:21
They wont get any traction with the price range ($45,886 to $63,153), I know its a Fed job with a nice pension at the end of the tunnel.
But aside from new grads, actual nurses are all mostly 70k+.

Yup.

And most nurses LIKE what they do, and as they gain in seniority, they can choose their shifts and have more benefits than they would enjoy working here. And also have a nice pension at the end.

It's not a bad go for a retiring nurse, looking for a 0900-1700 type job. But it's very demanding, and there's a different level of stress up in Adjudication than almost anywhere else in the Department. If you're retiring, do you want that, after 20-plus years of it in another setting?
Title: Re: Critical Injury Benefit
Post by: blackberet17 on July 23, 2015, 13:28:19
SITREP:

Since the beginning of the week, calls are being made to CIB potentially eligible personnel. Priority 1 is on those clients who are known to already be eligible for CIB, based on the medical evidence and benefit application history. Priority 2 is on clients who submit applications.

For personnel unsure if they are eligible, direction is to call the NCCN line (866-522-2122) or send a msg through your My VAC Account. There are some delays in responding, which are to be expected, due to volume and screening procedures.
Title: Re: Critical Injury Benefit
Post by: dunlop303 on July 27, 2015, 11:57:05

I called in for an update on my application that was submitted on July 3rd for the CIB.
On July 20th, a summary was prepared for the adjudication team. The rep I spoke to today said adjudication on these is very short
as you either meet the criteria or don't so I could ideally expect a decision in the next week or two.

Anyone else have anything moving threw the system or have been called?

Title: Re: Critical Injury Benefit
Post by: RobA on July 27, 2015, 15:55:03
Still waiting. I've been waiting since early December for my PIA application though, so I'm not holding my breath.

Does seem like this is.moving faster though. Keep us posted.
Title: Re: Critical Injury Benefit
Post by: RobA on July 29, 2015, 09:58:05
Dunlop, does your application show up in  your My VAC account? I sent mine in around the same.time as you but it doesn't show up there at all.

I've also got a PIA application that isn't shown there (in the 'my applications' section). But i recently applied for voc rehab program and that shows up there.
Title: Re: Critical Injury Benefit
Post by: dunlop303 on July 29, 2015, 12:25:11
Hi Rob,

Nope Just under submitted Doc's, and I think that only applies for electronically submitted documents.
But they don't get statuses or updated at all. I applied for a EIA as well, which also just shows up in the submitted Doc's.

They are able to update over the phone though, or at least they can tell you if the CIB has been prepped for adjudication.
As for the EIA that's an odd ball process, they send the application to my regional office to review. Then they sent it back to head office to prep the letter.
Apparently its back at head office now. I don't know who writes the process's over there lol.
Title: Re: Critical Injury Benefit
Post by: blackberet17 on July 29, 2015, 13:10:37
Hi Rob,

Nope Just under submitted Doc's, and I think that only applies for electronically submitted documents.
But they don't get statuses or updated at all. I applied for a EIA as well, which also just shows up in the submitted Doc's.

They are able to update over the phone though, or at least they can tell you if the CIB has been prepped for adjudication.
As for the EIA that's an odd ball process, they send the application to my regional office to review. Then they sent it back to head office to prep the letter.
Apparently its back at head office now. I don't know who writes the process's over there lol.

EIA is slightly different as it usually requires a home visit, IOT assess your needs in person. Hence it going to the RO, then back to HO. The home visit entails the completion of the Nursing Assessment Form. I can't find an online copy, unfortunately, but it's a very comprehensive form, some eight pages in its un-filled, blank version. I've seen them run into the dozens of pages when completed.

There is also the Case Manager's assessment, which would also require the application be sent to the RO.

Chapter 7 of the 2006 Edition of the Table of Disabilities outlines part of the process.

As to the questions on what does/does not show up in MVA, I couldn't tell you. But I can certainly mention it when I'm asked to provide feedback! I've been helping with the new layout for MVA, and one thing under consideration is being able to see exactly what documents the Department used in arriving at its decision on your application, right from your account.
Title: Re: Critical Injury Benefit
Post by: RobA on August 06, 2015, 13:40:23
Anyone with any updates? I called last week and got the same answer as Dunlop: it's been moved to adjudication.  No ETA on a decision though.
Title: Re: Critical Injury Benefit
Post by: blackberet17 on August 11, 2015, 14:39:01
Nothing new to report. They are trying to move through the CIBs quickly, but there is a file backlog in Adjudication as it is.
Title: Re: Critical Injury Benefit
Post by: Teager on August 12, 2015, 19:54:26
I asked if VAC had a timeline for decisions for the CIB and I was told they are aiming for 12 weeks.
Title: Re: Critical Injury Benefit
Post by: RobA on August 18, 2015, 15:59:09
I've got an update that is just so typical VAC lol.

Applied online and you can't sign your app online (obviously ). So I submitted the form, then sent a msg thru my VAC acct, askin if that was a problem or if I should send in a hard copy. Yup, no worries they said.

And so, of course, today I get a letter with my app printed off, and a note asking me to sign it and send it back.

I'm sure this will restart my clock. ******* VAC. Is not applying THOUGHT your my vac acct the same (legally) as signing it?

So frustrating.
Title: Re: Critical Injury Benefit
Post by: Teager on August 19, 2015, 23:40:54
I've got an update that is just so typical VAC lol.

Applied online and you can't sign your app online (obviously ). So I submitted the form, then sent a msg thru my VAC acct, askin if that was a problem or if I should send in a hard copy. Yup, no worries they said.

And so, of course, today I get a letter with my app printed off, and a note asking me to sign it and send it back.

I'm sure this will restart my clock. ******* VAC. Is not applying THOUGHT your my vac acct the same (legally) as signing it?

So frustrating.

There is a note at the bottom before submitting online that says submitting through my VAC account will count as signing the form. So not sure why they would require a signature  :dunno:
Title: Re: Critical Injury Benefit
Post by: dunlop303 on August 21, 2015, 10:27:11
Jesus H-C

I'm going to print off my submitted application sign it and scan it back in so they cant play that game with me.
Title: Re: Critical Injury Benefit
Post by: RobA on August 22, 2015, 19:05:02
The only somewhat silver lining is the included envelope  had a return address went straight to the adjudicators in Montreal.

Maybe they'll keep my place in line, who knows
Title: Re: Critical Injury Benefit
Post by: blackberet17 on August 31, 2015, 13:30:59
Do you have a sitrep Rob?
Title: Re: Critical Injury Benefit
Post by: dunlop303 on August 31, 2015, 15:35:12
I called in for my bi-monthly update on my various claims / applications.

The update on CIB was interesting, I got a newer person on the phone which was nice as she did not stone wall me as much as the more experienced ones, she provided my timeline thus far:

CIB Submitted July 3rd

Summary of application prepared for adjudicators July 20th

Adjudication started in on the file on August 19th.

Te meet the service standard a decision would have to be reached by Sept 11th.

She also mentioned that no CIB's have been granted yet, although a lot have been rejected and she noted that since eligibility is so clear that rejections happen quickly.
Title: Re: Critical Injury Benefit
Post by: RobA on September 14, 2015, 13:59:13
So has anyone been approved for this yet?
Title: Re: Critical Injury Benefit
Post by: dunlop303 on September 16, 2015, 21:34:20
Same song and dance, mine was due on Sept 11th, so I called in for an update yesterday. And I got the typical - "Well... yes, you submitted everything on July 3rd, but we didn't get everything put together for adjudication until August 20th so its not technically overdue, call back in a Month". Insert Xanax here.
Title: Re: Critical Injury Benefit
Post by: dunlop303 on October 06, 2015, 14:48:26
Is it just the three of us moving through this process? Any updates from anyone?
Title: Re: Critical Injury Benefit
Post by: Teager on October 06, 2015, 15:24:22
Just spoke with VAC favourable decision made as of Oct 5th. Applied on the 14th of July.
Title: Re: Critical Injury Benefit
Post by: RobA on October 07, 2015, 01:09:07
Just spoke with VAC favourable decision made as of Oct 5th. Applied on the 14th of July.

Congrats.

Mind saying what was your specific case (minus any personal/uncomfortable details of course)?

Title: Re: Critical Injury Benefit
Post by: dunlop303 on October 07, 2015, 10:41:46
Wow, congrats indeed!

I applied on July 3rd, and they are feeding me a line because it took them until August 19th to transfer the file to adjudication my decision isnt due until November 11th. - Fitting day.
Which is odd because they had every drip of information, there was nothing to be provided.

Either way congrats again! Did you get the letter yet, or did they disclose the decision over the phone?
Title: Re: Critical Injury Benefit
Post by: Teager on October 07, 2015, 18:33:41
I had called my case manager for an update and was told that way. I have not recieved anything by mail yet so will let you know any info once I get it.

Rob most of my injuries came from a suicide bomber who also had ball bearings on a foot patrol. Multiple injuries to both legs a wound to my bowel and a ball bearing that hit me in the neck which is believed to have shocked my spinal cord and caused temporary paralysis and nerve damage. One doctor put as like having a stroke to one side of my body. Was in hospital for a total of about 5 months.

How I fit the criteria I'm guessing because of being in the ICU longer than what the criteria states and since I couldn't move for a few months required assistance in everything and afterwards required assistance at home.

Hopefully your guys decision is coming in the next few days. I was told that the adjudicators are busy not just due to the amount of work but also because they are training some of the new staff that has been hired.

However PIA is still in progress and about 2 months over due.
Title: Re: Critical Injury Benefit
Post by: dunlop303 on October 08, 2015, 01:39:11
That sounds incredibly familiar, are you from Northern Ontario?

When it's all said and done that would be great to know how long it took to process payment,!if you had to do the silly 888 forms ect.

Thanks again, glad you are getting a little extra for what sounds like something very painful
Title: Re: Critical Injury Benefit
Post by: Brihard on October 08, 2015, 05:05:54
This benefit is definitely going to present the department with problems. The criteria of 'suddenness' is going to result in some veterans receiving significantly more money than others for similar medical outcomes, because one person suffers their 'critical injury/illness' in a sudden manner whereas for someone else it develops more slowly. I know this has been brought to the attention of VAC staff at the policy making level; I'll be curious to hear once the election side show it out of the way whether this is being revisited at all. Someone who is hurt in an IED blast, by a gunshot, or in a LAV rollover is very clearly injured in a sudden enough manner, whereas someone who develops cancer over the course of a few years because of some sort of toxic exposure or who develops several back issues after years of parachute jumps is not. We will see soldiers as severely debilitated by more gradual, progressive injuries or illnesses as those who are injured or sicked much more rapidly, but only some will qualify for the benefit. We'll probably see this one go to court over something like someone who becomes ill as a result of shipboard firefighting or something like that.

Hopefully the department can reevaluate this benefit. The entire benefits package needs to be rewritten and harmonized, but the CIB 'bump to the lump' is a poorly executed plan that was meiocre to begin with.
Title: Re: Critical Injury Benefit
Post by: Teager on October 08, 2015, 11:40:53
Agreed Brihard. I believe the benefit was created simply for Afghan vets and not really those that get an illness or have serious issues that develop over the long term. I saw a member can't remember what illness he had but it was slowly deteriorating him over time where he could do less and less and eventually ended up in a wheelchair and requires daily assistance. Now the way the criteria is laid out I don't think he will qualify because it is something that has gotten worse over time. IMO those are the soldiers that deserve the benefit just as much as the guy that was seriously injured.

Dunlop not from Northern ON but closer to the GTA.
Title: Re: Critical Injury Benefit
Post by: blackberet17 on October 09, 2015, 13:51:03
A reminder to folks who receive an unfavourable decision regarding their CIB application. Those decisions fall under Part 3 of the NVC, and therefore "enjoy" (used very loosely) appeal rights to the Veterans Review and Appeal Board.
Title: Re: Critical Injury Benefit
Post by: RobA on October 10, 2015, 17:33:17
I saw a member can't remember what illness he had but it was slowly deteriorating him over time where he could do less and less and eventually ended up in a wheelchair and requires daily assistance. Now the way the criteria is laid out I don't think he will qualify because it is something that has gotten worse over time.

I would say the way the criteria is laid out, there is no way he would qualify.

Its definitely unfair. The criteria require both a "sudden" injury as well as pretty specific times for hospitalization.

I was flown into Role 4 in a black hawk off of Highway #1 outside of Kandahar and I doubt that I'll qualify, due to not being hospitalized long enough.

Well, I MIGHT if they consider role 4 an ICU, but somehow, I doubt it.
Title: Re: Critical Injury Benefit
Post by: dunlop303 on October 22, 2015, 16:32:44
Teager did you get paid yet? Anyone else hear anything?
Title: Re: Critical Injury Benefit
Post by: Teager on October 22, 2015, 16:43:09
Teager did you get paid yet? Anyone else hear anything?

Haven't even recieved the letter yet. Don't get why the letter is taking so long. Hoping it will be here tomorrow or next week sometime.
Title: Re: Critical Injury Benefit
Post by: Teager on October 22, 2015, 21:23:02
Scratch my previous. I was paid today via direct deposit. No letter as of yet tho.
Title: Re: Critical Injury Benefit
Post by: dunlop303 on October 23, 2015, 12:25:12
Oh good, so no Vac 888 form on this one then
Title: Re: Critical Injury Benefit
Post by: dunlop303 on November 02, 2015, 14:52:11
Decision is due next week, based on VAC's wonky calcs at least. I submitted the application on July 3rd, but they didn't transfer anything over to adjudication until Aug 20th or so.
I don't agree, but they state that their service standard does not start to countdown until that point. Is anyone else awaiting a decision?
Title: Re: Critical Injury Benefit
Post by: Teager on November 02, 2015, 20:31:20
Hopefully you get an answer by the time the deadline is up. I believe the only other one here waiting is RobA. Keep an eye on your bank account if your set up with VAC for direct deposit as my letter showed up a week after they deposited the funds.
Title: Re: Critical Injury Benefit
Post by: dunlop303 on November 03, 2015, 15:18:08
Will do,

Does the approved CIB show up anywhere on your "My Vac" page?
Title: Re: Critical Injury Benefit
Post by: Teager on November 03, 2015, 15:37:25
I just checked and it does not show anything other than my submitted application.
Title: Re: Critical Injury Benefit
Post by: dunlop303 on November 27, 2015, 09:43:06
Hey Teager, how about in your "payment history" section under your current benefits?
Anything show there? The departmental review that is over due in adjudication doesn't show up anywhere either for me.
Title: Re: Critical Injury Benefit
Post by: Teager on November 27, 2015, 21:41:22
I just had a look it looks like my VAC account has been re-vamped. Under "Other Benefits" it shows my payment for the CIB.
Title: Re: Critical Injury Benefit
Post by: dunlop303 on December 07, 2015, 16:49:36
Decision reached today for CIB and Traumatic Brain Injury Decision Review, wont tell me anything other the phone though.
Hope to have a (positive) update by Friday!
Title: Re: Critical Injury Benefit
Post by: Teager on December 07, 2015, 17:22:38
Excellent hope it's positive for you.
Title: Re: Critical Injury Benefit
Post by: dunlop303 on December 08, 2015, 12:17:10
No luck on the CIB, they dont consider role 3 and landshtule intensive care.

But, my re-assessment worked out, I dont know how they F'd it up so bad the 1st time. I was able to read through the tables in 30 minutes with my medical form and asses my self at double what they did.
And after their review it turns out I was right, they doubled their decision. Now im rated at exactly %100 though under the new charter. I think that opens new doors but there is not much information out there.

Sucks about the CIB though, but what can ya do.
Title: Re: Critical Injury Benefit
Post by: blackberet17 on December 09, 2015, 15:47:10
I think that opens new doors but there is not much information out there.

Earnings Loss, Permanent Impairment Allowance, etc. Best to talk to your Case Manager.

Sucks about the CIB though, but what can ya do.

Also, remember, CIB is ruled under Part 3 of the NVC, which benefits from appeal rights to the Veterans Review and Appeal Board. Before going that route, take advantage of the Departmental Review process, which the Advocates at BPA can help you with.

Title: Re: Critical Injury Benefit
Post by: Matsebula on January 25, 2016, 15:34:27
Hi All,

I'll share my experience with this so far. Had an MVA in an MSVS just outside Winnipeg. Broke my T12 and required a 5-disc spinal fusion to stabilize the vertebra. All told, I was in hospital for 13 days recovering and doing the (very) limited rehab the neurosurgeon would allow at the time.

Got sent home and was basically only allowed to breathe (no lifting more than 5 lbs) for 2 months, till the neurosurgeon cleared me to start physio. Physio took from June until the start of October.

I applied in early July and got a decision letter on Nov 10, 2015 that my claim was not approved. They cited med records from a follow-up with my military doc 2 days after my release from hospital saying that I was 'getting out every day walking' as one of the reasons for decision. I was 'getting out walking' with the physio an an aide, while wearing a hoist belt.

When I called VAC to inquire about this, I was told that there is further 'policy guidance' that defines what VAC considers 'complex' treatment. In this document, apparently neurosurgery and extended physio for rehab don't count as 'complex,' which honestly really puzzles my military doc, physio, and everyone else I have dealt with.

I'm not whining. I've got lots to be thankful for: 10 fingers, 10 toes, breathing air, no neurological compromise. However, in my view, if VAC is going to publish regulatory criteria and then negate those same criteria with concealed regulations, that violates the stated intention that the act 'shall' be liberally interpreted, generally in favour of the member, due to 'obligation.'

Anyhow, I have a request in to get the further 'policy guidance' documents, and will let you know how I get on with that. It looks like to address the decision I will have to file for a review board hearing through Bureau of Pensions Advocates.

Thanks for the thread.
Title: Re: Critical Injury Benefit
Post by: blackberet17 on January 28, 2016, 16:17:55

Anyhow, I have a request in to get the further 'policy guidance' documents, and will let you know how I get on with that. It looks like to address the decision I will have to file for a review board hearing through Bureau of Pensions Advocates.


Or request a Departmental Review by VAC, also done through BPA, before burning a level with VRAB.
Title: Re: Critical Injury Benefit
Post by: blackberet17 on January 28, 2016, 16:23:21
VAC has received some 350 applications to date of 30 Nov 15.

About 20% received a favourable decision so far, with another 130 or so in a "pending" status.
Title: Re: Critical Injury Benefit
Post by: Matsebula on January 29, 2016, 10:34:59
 Hi blackberet17,

Spoke with BPA who have advised me that I need to circle back to my Disability Award application first. They awarded 10% for broken T12 but have withdrawn the two other conditions I claimed for (spinal fusion and scarring) apparently on my behalf. I will go back and ask that they adjudicate those conditions as well. How does an adjudicator have latitude to withdraw claimed conditions? The table of disabilities lays things out pretty clearly, I think. Why do they not just follow it?

After I've gone through that evolution, BPA lawyer wants to file a Departmental Review, as you've said. Have to say, I'm having difficulty understanding any of this process. It seems as though the markers are moving all the time and that all the criteria used to judge anything are highly subjective.

Title: Re: Critical Injury Benefit
Post by: blackberet17 on January 29, 2016, 14:13:07
Did the BPA rep provide reasons as to why they withdrew the spinal fusion and scarring applications? Off the top of my head - and with the usual caveat of not knowing nor getting into too many case particulars - scarring is not in and of itself a medical, pensionable/awardable condition, unless it is part of a skin condition, or due to gunshot/shrapnel and causes some form of impairment.

I'm not 100% either on the spinal fusion as a medical condition. Spinal fusion is a medical procedure used to correct a medical condition, such as a broken T12. Any disability resulting from the fusion would be related to the original reason behind said fusion, which is the broken T12.

An adjudicator has some degree of latitude in proceeding with claims as they have (in most cases, and I don't want to get into that debate here) some degree of medical expertise, and also have access via referral to medical practitioners who can review the claim and provide a medical opinion as to a service relationship, cause, etc..

Withdrawing a claim can work in the applicant's favour, providing you with time and iguidance as to what may be required to succeed in your claim, rather than the Department denying it due to lack of information, medical evidence, etc., causing you the applicant to go through possibly unsuccessful Departmental Reviews and then subsequent review and appeal levels at VRAB, due to lack of info, etc.

Also, the Table of Disabilities is used to assess the degree of disability resulting from a medical condition, and not used as a basis for awarding entitlement to a disability pension/award. The Department uses its Entitlement Eligibility Guidelines to such an end.

If you want to discuss particulars, feel free to pm me :)
Title: Re: Critical Injury Benefit
Post by: Matsebula on February 10, 2016, 16:33:46
The scarring was considered part of the overall condition, and unless it caused impairment on its own it is included in the main condition.

Had a look at the EEGs, and they don't mention anything musculoskeletal per se, so I'm not sure what bearing they have on this condition. I know there are separate tables for lumbar and thoracic spine, and I know that my fusion touches both the lumbar and thoracic portions of the spine.

What frustrates me is that I now have 5 vertebrae fused and VAC is not keen to recognize that. Interestingly, I'm also dealing with WCB and their correspondence refers to 'burst frcture T12, post-surgical: T10-L2 fusion.' So WCB gets it, I'm just not sure I understand how VAC views it. My VAC contact mentioned she'd see if the fusion is admissible as a consequential claim following the T12 fracture, since the fusion resulted from the fracture. She is also inquiring about why the fusion was withdrawn, so we'll see what happens there.

There just must be a simpler way to manage this.
Title: Re: Critical Injury Benefit
Post by: Brasidas on February 10, 2016, 21:11:48
The scarring was considered part of the overall condition, and unless it caused impairment on its own it is included in the main condition.

Had a look at the EEGs, and they don't mention anything musculoskeletal per se, so I'm not sure what bearing they have on this condition. I know there are separate tables for lumbar and thoracic spine, and I know that my fusion touches both the lumbar and thoracic portions of the spine.

What frustrates me is that I now have 5 vertebrae fused and VAC is not keen to recognize that. Interestingly, I'm also dealing with WCB and their correspondence refers to 'burst frcture T12, post-surgical: T10-L2 fusion.' So WCB gets it, I'm just not sure I understand how VAC views it. My VAC contact mentioned she'd see if the fusion is admissible as a consequential claim following the T12 fracture, since the fusion resulted from the fracture. She is also inquiring about why the fusion was withdrawn, so we'll see what happens there.

There just must be a simpler way to manage this.

Are you doing this on your own, or have you brought a Legion service officer into the loop? They can be useful.
Title: Re: Critical Injury Benefit
Post by: blackberet17 on February 11, 2016, 16:00:23
I thought as much on the scarring. Unless it's due to gunshot wound, etc., it will almost always be included in the main condition, unless it causes impairment. Something to keep an eye on, Matsebula, in case the scarring does cause limitations in your movement or what have you down the road.

To me, the fusion is a result of the fracture (rather obvious to me, but again, not a medical professional) - the fracture required (I assume) fusioning of the vertebrae IOT stabilize the joint. The problem may be that, from a medical standpoint, the fusion is a symptom of the fracture, and not in and of itself a medical condition. Apples to oranges, but the fusion may be viewed as the congestion (symptom) of the head cold (medical condition).

It is possible a medical opinion was obtained from one of the department doctors, who recommended the fusion be withdrawn, based on what I described above. Talk to your BPA rep and see if getting a medical opinion would be a good idea, in support of your claim, such as from the surgeon who did the T10-L2 fusion?

One question you may want to ask the surgeon is, is the fusion of the verterbrae causing any limitations over and above the limitations caused by the T12 fracture? He/she should be able to describe this IOT support your claim.
Title: Re: Critical Injury Benefit
Post by: Matsebula on November 04, 2016, 14:28:35
Had a VRAB hearing yesterday on this as they don't really define 'complex treatments' very well under Criterion H. Definition 'may include but is not limited to' the examples noted. Hard to see how major spinal surgery wouldn't be considered complex, but then I don't think like VAC.

I'm certainly not holding my breath, but at least the decision from VRAB will be a real written decision based on legislation, policy, and actual reason instead of telling me I was 'getting out every day walking' when I was actually doing OT/PT in hospital with supervision and a hoist belt on.
Title: Re: Critical Injury Benefit
Post by: cdnwo on November 04, 2016, 17:01:37
Good for you challenging it! Many of us who applied both for physical and mental conditions were flat out denied. I hope they're forced to explain it far better.