Question Period Note: DISABILITY BENEFITS PROCESSING TIMES AND ACTION PLAN

• The Government is fully committed to the health and well-being of Veterans and their families.

• In 2020, Veterans Affairs Canada released a strategy to address the long-standing issue of processing times for disability benefits decisions, and hired more than 350 additional temporary employees, dedicated to the disability benefit decision-making process.

• Between 2015-2016 and 2022-2023, Veterans Affairs Canada experienced a 61% increase in the number of applications received for disability benefits. Since 2020, we have reduced the backlog by 77%. As of December 30, 2023, there were 5,054 applications over the service standard (i.e., backlog).

• On November 3, 2023, to ensure the Department continues this momentum, the Government announced additional funding of $164.4 million. Part of this investment will ensure Veterans Affairs Canada is able to retain existing temporary employees, dedicated to processing disability benefit applications, for an additional two years, beyond March 2024.

• We have made progress and we know there is more to be done – which is why we are working to make more decisions faster and putting Veterans first.

BACKGROUND - DISABILITY PROCESSING TIMES AND ACTION PLAN
Current State (December 30, 2023):
• The average turnaround times (rounded to nearest week) for the first three quarters of 2023-2024 (April to December) are: 21 weeks for first applications; 14 weeks for reassessments; and 15 weeks for departmental reviews.
• Between 2015-2016 and 2022-2023, Veterans Affairs Canada experienced a 61% increase in the number of applications received for disability benefits. Veterans Affairs Canada has reduced the backlog by 77% since the spring of 2020. As of December 30, 2023, the total number of pending disability benefit applications was 31,577. Of this total, 5,054 are beyond the service standard (i.e., backlog).
• Applications are fast-tracked for those who are medically at risk (e.g., palliative, advanced age, etc.) or who have an immediate, unmet health need related to their claimed condition.

Veterans Affairs Canada Action:
• Reducing processing times for disability benefit applications is our number one priority.
• The Department published a Strategic Direction document, Timely disability benefits decisions: Strategic direction for improving wait times, in June 2020. This document outlined the measures we would take to improve our services to Veterans and their families by changing the way we work to make faster disability benefits decisions. Since the release of the plan, we have made progress on a number of the initiatives. The Strategic Direction document has been updated and released March 3, 2023. It outlines progress made and priorities until March 2024.
• To keep pace with the rise in demand, the Government committed to a series of temporary funding measures for resourcing and automation.
• On November 3, 2023, the Government announced additional funding of $164.4 million. Part of this investment will ensure that Veterans Affairs Canada is able to retain existing temporary employees, dedicated to processing disability benefit applications, for an additional two years, beyond March 2024.
• In the first three quarters of 2023-2024, 68% of disability benefits first applications were completed within the service standard. In 2022-2023, the Department’s service standard result for first applications was 55% which is more than twice as high as that from 2019-2020 (23%). As we work from the oldest, we expect to see even further improvements as we reduce the number of applications over the service standard. Difficulties in meeting the service standard can be attributed to the 61% increase in the number of applications received for disability benefits between 2015-2016 and 2022-2023.

When Pressed:
Q1 – What is the current number of backlog applications for disability benefits?

Between 2015-2016 and 2022-2023, Veterans Affairs Canada experienced a 61% increase in the number of applications received for disability benefits. Veterans Affairs Canada has reduced the backlog by 77% since the spring of 2020. As of December 30, there were 5,054 applications over the service standard for disability benefit applications. Our service standard accounts for the fact that some files are very complex and take longer to process. Therefore, we will always have a small percentage of applications in the backlog.
Q2 – What is the current backlog in terms of time between when an application for benefits is made and the Veteran finally receives the benefits?
Veterans Affairs Canada’s service standard for disability benefits applications is 16 weeks for first applications and reassessments, and 12 weeks for departmental reviews, 80% of the time. All turnaround times and service standard results for disability benefits represent the time between when we receive a complete application and when a payment is made (for favourable decisions).

The average turnaround time for first applications for the 2022-2023 fiscal year was 28.1 weeks, compared to 39.7 weeks and 48.8 weeks for fiscal years 2021-2022 and 2020-2021, respectively. The fiscal year-to-date (April to December) average turnaround time for first applications is 20.6 weeks.
Between 2015-2016 and 2022-2023, Veterans Affairs Canada experienced a 61% increase in the number of applications received for disability benefits. During this same period, Veterans Affairs Canada made improvements to decision-making processes and hired new staff.
Veterans Affairs Canada has made progress and has a better understanding of the challenges in processing disability benefits, and is continuously looking for ways to accelerate the decision-making process. However, it will take additional time for Veterans Affairs Canada’s efforts to reduce the backlog of disability benefit applications to be fully reflected in its processing times. The Department is currently focused on completing its oldest claims which, unfortunately, already have lengthy processing times.
Q3 – What are the statistics on wait time reduction (comparison from June 2020 to present – processing times and processing times past the 16-week service standard period)?

For 2022-2023, the average turnaround time for first applications was 28.1 weeks, down from an average turnaround time of 39.7 weeks in 2021-2022 and 48.8 weeks in 2020-2021. The fiscal year-to-date (April to December) average turnaround time for first applications is 20.6 weeks.
In the first three quarters of 2023-2024, 68% of disability benefits first applications were completed within the service standard. This is up from the previous results: 55% in 2022-2023; 46% in 2021-2022; and 30% in 2020-2021. Difficulties in meeting the service standard can be attributed to the 61% increase in the number of applications received for disability benefits between 2015-2016 and 2022-2023.
Q4 – What specific steps have been taken to address the backlog, and when was each step implemented?

Reducing the processing times for disability benefits remains VAC’s top priority. Our service standard target for disability benefits is for 80 percent of decisions to be made within: 16 weeks for first applications and reassessments (review as to whether the condition has worsened); and 12 weeks for departmental reviews (review to confirm or change an original decision). For the year 2022-2023, we met the established service standard for first applications 55% of the time. In the first three quarters of 2023-2024, 68% of disability benefits first applications were completed within the service standard. Difficulties in meeting the service standard can be attributed to the 61% increase in the number of applications received for disability benefits between 2015-2016 and 2022-2023. While the Department made progress in improving the service standard results, we realize that there is still more work to do and we are committed to ensuring that Veterans receive their decisions in a timely manner.
The Department published a Strategic Direction document, Timely disability benefits decisions: Strategic direction for improving wait times, in June 2020. This document outlined the measures we would take to improve our services to Veterans and their families by changing the way we work to make faster disability benefits decisions. The Strategic Direction document outlines four lines of effort: public service capacity, integration, process innovation and digital solutions. The Strategic Direction document was updated on March 3, 2023. It outlines progress made and priorities until March 2024.
Public Service Capacity
• On November 3, 2023, the Government announced additional funding of $164.4 million. Part of this investment will ensure that Veterans Affairs Canada is able to retain existing temporary employees, dedicated to processing disability benefit applications, for an additional two years, beyond March 2024.
• With the help of both our permanent and temporary employees, in the 2022-2023 fiscal year, we completed an average of 4,300 applications per month. This fiscal year-to-date (April to December), we are averaging 4,700 applications per month.

Integration
• The Department implemented the Veteran Benefit Teams structure to allow staff to work more collaboratively to reduce the number of times files change hands.
• A Strategic Initiatives Directorate was put in place in the spring of 2020. This Directorate is dedicated to providing coordination and oversight of initiatives.

Process Innovation
• The Department is modernizing its Entitlement Eligibility Guidelines. The improvements to the Entitlement Eligibility Guidelines will allow adjudicators to make more rapid decisions on the entitlement aspect of a Veteran’s application. New Entitlement Eligibility Guidelines for certain conditions will streamline decision-making, reducing the number of handoffs.
• Veterans Affairs Canada is modernizing the Table of Disabilities to reflect the most current health evidence and best practices in assessment to support Veterans. The modernization of the Table include:
o Ensuring it is up to date to reflect health medical evidence and practices;
o Simplifying sections within the Table of Disabilities, making it more user friendly; and
o Planning for digitization where possible to improve processes.
• A Gender Based Analysis Plus will be applied to the modernization of the Entitlement Eligibility Guidelines and Table of Disabilities chapters to ensure that these tools consider the diverse health related experience of Canadian Veterans.
• In May 2021, a Veteran consultation was launched on the Disability Benefits Application Process. This consultation was designed to help us develop solutions to make applying easier, and to create new tools to help our decision-makers process applications faster. We expect this will lead to ongoing improvements in the process, fewer incomplete applications, and improved processing times.
• In October 2021, an employee consultation was conducted to obtain feedback on ways to improve the adjudication process. The feedback was used to improve adjudication and help reduce processing times.
• In January 2022, VAC developed and implemented a new Sexual Dysfunction Entitlement Eligibility Guidelines to assist in adjudication of this claim type. This new Entitlement Eligibility Guidelines addresses gaps in guidance of gender consideration related to the adjudication of sexual dysfunction benefit applications.

Automation and Digital Solutions
• A new Service Health Records search tool was developed. It reduces the time taken to search through thousands of pages of material, presenting decision-makers with only the information and evidence pertinent to a specific disability benefit application in one PDF called an evidence bundle.
• The tool is used in processing first applications for the following conditions:
o Hearing Loss and Tinnitus
o Four Knee conditions - Arthrosis, Internal Derangement, Osteoarthritis, Patello-Femoral Syndrome
o Mental Health conditions – PTSD, Anxiety, Depressive and Adjustment Disorders
• The tool has been further developed to use handwriting recognition when searching digital images to create evidence bundles and automatically uploads the evidence bundle when the claim is moved from Intake to Claim Preparation. It also lays the foundation for future development for other conditions.

• Several other automation initiatives are in development including:
1) Prepopulating data into GCcase disability benefits decision letters to help save time by removing the duplication of entering several data fields that have already been input into system for the decision. This will also standardize the letter wording and help reduce input errors. The initial letter was for favorable condition decisions where the ruling is for one service type. Work will continue to improve the letter and expand to other decision types and various types of service.
2) We developed the VAC Healthshare platform for medical practitioners (initially audiologists) to electronically submit medical reports, audiograms, and medical questionnaires, along with their invoices for services. We began testing the platform with audiologists in October 2022, and subsequently piloting as of February 2023. This tool will allow us to receive medical documents faster, and improve consistency in the documents. We estimate this tool will save us up to two weeks of time, compared to documentation received by mail.
3) Automatic ordering of Service Health Records (SHR) which will streamline the SHR request process to enable earlier ordering of records. The goal is that we will use technology to automatically determine if SHRs, or a SHR update, are required when a new application is received.

Q5 – Why is the 16 weeks service standard 80% and not 100%?
Some files are very complex and therefore, take a longer time to process. Complex conditions require the expertise of someone with a medical background, or medical knowledge, to arrive at a decision.

Q6 – With all the improvements, are you confident you can get rid of the backlog?
The Department is working very hard to address this issue. Between 2015-2016 and 2022-2023, Veterans Affairs Canada experienced a 61% increase in the number of applications received for disability benefits. Since 2020, we have reduced the backlog by 77%. As of December 30, 2023, there were 5,054 applications over the service standard (i.e., backlog). There are more than 17,000 fewer cases over the 16-week service standard than on March 31, 2020. In addition, during this period, the total number of pending applications was also reduced from 49,216 to 31,577. Our service standard accounts for the fact that some files are very complex and take longer to process. Therefore, we will always have a small percentage of applications in the backlog.
Q7 – How many positions and how much money will it take to obtain 80% / 16 weeks?
There are a number of variables that determine this: intake, production, staff compliment, etc. On November 3, 2023, the Government announced additional funding of $164.4 million. Part of this investment will ensure that Veterans Affairs Canada is able to retain existing temporary employees, dedicated to processing disability benefit applications, for an additional two years, beyond March 2024.
Q8 – Is the number of applications stabilizing?
Intake is not stabilizing. Although the number of applications received in 2020-2021 decreased, perhaps due to the pandemic, intake in 2022-2023 increased (total received was 73,000) which was higher than the number of applications received in 2021-2022 (66,000).
In 2019-2020, intake averaged 5,200 applications per month. This dropped to 3,800 applications per month in 2020-2021, but increased to an average intake of 5,500 applications per month for the 2021-2022 fiscal year. For the 2022-2023 fiscal year, the average intake was 6,000 applications per month. The fiscal year-to-date (April to December) average intake is 6,400 applications per month.
Q9 – If there is an increase in applications and VAC has the same number of employees, how does VAC handle this?
Since the release of our plan to address the processing times for disability benefits, we have made progress on a number of initiatives. The Department continues to monitor intake and will make adjustments as needed to manage any increases.

Q10 – VAC seems to be always 6 months delayed. Late with applications, late in asking for increased funds, late in hiring and training, etc., how can VAC do a better job?
Automation and streamlining will help. Eventually, staff will focus less on administrative and repetitive tasks, enabling them to render faster decisions on the more straightforward applications. Please keep in mind that approximately 82% of the total pending applications, as of December 30, 2023, are from returning applicants for another/new condition.
Q11 – Is there a firm commitment for resources after March 2024? What resources are needed to get rid of backlog fully within two years?
On November 3, 2023, the Government announced additional funding of $164.4 million. Part of this investment will ensure that Veterans Affairs Canada is able to retain existing temporary employees, dedicated to processing disability benefit applications, for an additional two years, beyond March 2024. Since 2020, we have reduced the backlog by 77%. As of December 30, 2023, there were 5,054 applications over the service standard (i.e., backlog). There were more than 17,000 fewer cases over the 16-week service standard than on March 31, 2020. In addition, during this period, the total number of pending applications was also reduced from 49,216 to 31,577.
Historically, Veterans Affairs Canada’s capacity to address the processing time issue has been a challenge due to the steady increase of applications and lack of stable resource funding. Between 2015-2016 and 2022-2023, Veterans Affairs Canada experienced a 61% increase in the number of applications received for disability benefits.
Q12 – Broken down by fiscal year since 2015-16, what is the total number of disability benefit claims received by the department?
Below is a breakdown of the number of applications received from 2015-16 to 2023-24:
First Application Intake by Fiscal Year
Fiscal Year First Application
2015-2016 24,595
2016-2017 25,667
2017-2018 31,482
2018-2019 37,683
2019-2020 43,156
2020-2021 31,747
2021-2022 49,264
2022-2023 52,286
2023 - February 27, 2024 51,927

Q13 – Broken down by fiscal year since 2015-16, how many claims were denied by the department?

Below is a breakdown of the number of applications that were unfavourable and favarourable from 2015-2016 to 2023-2024:

First Applications Completed by Fiscal Year
Fiscal Year Applications
Favourable Unfavourable
2015-2016 17,371 3,333
2016-2017 15,413 3,291
2017-2018 17,803 3,401
2018-2019 18,765 4,064
2019-2020 20,604 4,629
2020-2021 20,833 4,399
2021-2022 33,701 7,354
2022-2023 27,740 8,106
2023-24 - February 27, 2024 27,663 8,226
Total 199,893 46,803

Q14 – How many of the claims in the response to question 13 were denied due to insufficient evidence being provided by the claimant, incomplete paperwork being submitted, and incorrect paperwork being submitted?
Veterans Affairs Canada (VAC) does not deny applications due to incomplete or incorrect paperwork, rather the application is withdrawn.
When an application is received that is missing information (e.g., missing proof of identity, medical questionnaire, signature, etc.), the Veteran/member is provided a “missing information” letter. The letter requests the missing information and explains that if the information is not received within 60 days, no further action will be taken with their application. During this 60 day period, it is counted in VAC’s total pending applications. If the information is received after the 60 days, VAC will reinstate the application.
VAC also withdraws applications that do not contain a medical diagnosis. The Veteran/member will receive a letter from VAC explaining that it is unable to proceed with a decision and their application has been withdrawn. If the information is received in the future, VAC will reinstate the application.
The following table outlines the number of applications withdrawn each year due to missing information, including those that do not have a confirmed diagnosis. Withdrawn reason codes were introduced in the fiscal year 2019-2020; therefore the information is not available from 2015-16 to 2018-19.

Fiscal year 2019-2020 2020-2021 2021-2022 2022-2023 2023-2024
Withdrawn - Failure to provide required applicant information 72 105 101 162 215
Withdrawn - Failure to provide required medical information 990 1,536 2,269 2,667 4,557
Withdrawn - Released Canadian Armed Forces (CAF)/Royal Canadian Mounted Police (RCMP) - Medical Questionnaire does not provide confirmed diagnosis 28 103 241 229 356
Withdrawn - Still serving Service and Health Records (SHR) do not provide confirmed medical diagnosis 169 580 1,291 1,190 1,533

Q15 – How many of the claims in the response to question 13 were denied due to ineligibility of the claimant?
All applications listed as unfavorable in the response to question 13 would be due to the Veteran/member not meeting one or more of the eligibility requirements. For example, an unfavorable decision could be the result of the claimed condition not being linked to service, or because the condition is not permanent.
VAC makes decisions on eligibility for disability benefits which are based on evidence and are made within the legislative authorities of the Pension Act or the Veterans Well-being Act and applicable regulations and policies. To be eligible for disability benefits from VAC, applicants must provide a completed application that includes evidence:
• of a diagnosed medical condition by a qualified health professional;
• that the condition is permanent; and
• that the condition is related to their military service.
In general, to determine that a disability exists, VAC requires a diagnosis of a medical condition. As part of this diagnosis, the medical evidence should demonstrate that the medical condition is symptomatic and generally expected to persist.
Every application for a disability benefit is reviewed by a decision maker who is specially-trained to review and make decisions on claims for a disability benefit. The decision maker must base their decision on the evidence they receive which may include medical questionnaires and the service records. The results of the decision depend on the information and circumstances of each application.