When a Veteran was admitted to a long term care facility, the Veteran’s family had no idea that VAC covered these costs. They applied for a retroactive reimbursement, back to the date the Veteran was admitted, but the request was denied. After attempting a second level appeal, they contacted my Office for help. What we discovered is that to be eligible for Long-Term Care reimbursements, Veterans are expected to contact VAC the moment their needs change and before being admitted to a long term care facility, unless it’s an emergency.
Featured Cases
2017
A Veteran was rushed to the hospital after falling at home. While there, worsening dementia combined with limited mobility made it impossible for the Veteran to return home. A few years earlier, the Veteran requested a bed in one of three facilities with beds reserved for Veterans, but somehow, there was still a six-month wait. Frustrated, the Veteran’s daughter contacted my Office for help. My Office contacted VAC, and we were able to get the Veteran’s request approved, and shortly after, the Veteran was given a bed.
An elderly Veteran requested an early hearing aid replacement, and it was denied despite providing to VAC a new audiogram and a letter from an audiologist explaining why new hearing aids were needed. Due to the Veteran’s age, requesting an appeal was challenging. The Veteran contacted my Office for help saying, “I cannot hear properly, and it’s affecting my quality of life, my social interactions and my safety.”
A Veteran with a VIP Grant contribution passed away, so the spouse moved in with their daughter. The spouse immediately informed VAC of the new living arrangement, and later sent several other letters to VAC informing them that the grounds of the new home no longer required assisted maintenance. VAC, however, continued to issue payments for several years.
A Veteran with a service-related health condition needed life-saving treatments that were not available in Canada, so his specialist recommended treatment in the USA. The Veteran followed all of the required procedures for pre-approved Health Related Travel but he was still being shuffled between various VAC offices. With only one business day before his departure date and several costly trips ahead, the Veteran still did not have a decision, so he contacted my office for help.
An issue of invoices, receipts, and up-front payment
A Veteran, a single parent of four who is working towards a university degree, contacted the Office of the Veterans Ombudsman (OVO) after being denied reimbursement under the Canadian Veterans Vocational Rehabilitation Services (CVVRS).
2016
A Veteran living part-time between a men's shelter and an apartment that also housed drug dealers had an urgent requirement for housing. The location had animal feces throughout the building, police were often called, and his belongings were not secure.
VAC was advised that a Veteran, who is pensioned for PTSD, was incarcerated. He was on the Rehabilitation Program at the time. VAC immediately cancelled his rehabilitation plan thinking he would be unable to participate given that he needed to undergo mental health treatment.
The Veteran repeatedly requested assistance from VAC while incarcerated but was denied. After we intervened, he was put back into the program – while incarcerated – as he was able to find a psychologist willing to provide treatment in a prison.
Different definitions of “full-time student” were at the heart of a recent Veterans Affairs Canada (VAC) decision to deny a Veteran an additional disability pension for his child who is attending university. The student has special needs, and in September 2015 reduced his course load to two courses totalling six hours a week.
In August, a Veteran experienced a four-day delay in receiving a drug prescribed by an Emergency Room (ER) physician for an acute condition. The ER doctor prescribed a drug that the Veteran learned, after two pharmacy visits, required special authorization from Medavie Blue Cross (MBC). Unable to afford the up-front medication cost, the Veteran contacted the Office of the Veterans Ombudsman for help.