Re: Interesting change of tactics (or procedure) by VAC

by **Ppclicaper** Wed 23 Oct 2019, 20:16

Agreed .. 1 injury can be DEC . ( say 66% + )

10 % hearing loss
20% knee injury
15 % PTSD
30% Back injury
35% rotary cuff

(All examples ) cumulative of 110% .. no one injury is DEC. On paper the ability to work to gain comparable wages is there ... technically.

by Unknown Soldier Wed 23 Oct 2019, 19:36

Six-Actual wrote:Unknown Soldier said:

"So now think of Jane and Joe when they hear how many veterans are classified by the very department created to take care of them to be over 100% disability"?

There is approximately 13500 veterans deemed DEC.
Again, John and Jane Doe have no idea of this.

. But not every one of those DEC veterans is listed at 100% disability, just as there are ( how many) veterans out there that are way over 100% disability but are not classified as DEC. that term has no bearing on a veterans percentage.

by Guest Wed 23 Oct 2019, 16:26

Unknown Soldier said:

"So now think of Jane and Joe when they hear how many veterans are classified by the very department created to take care of them to be over 100% disability"?

There is approximately 13500 veterans deemed DEC.
Again, John and Jane Doe have no idea of this.

by Guest Wed 23 Oct 2019, 13:27

John and Jane Doe, haven't a clue as to what the average veteran receives. There is simply to many variables involved.
Often, vets themselves haven't got a handle on what they're eligible for.
John and Jane Doe are concerned with getting the kids to soccer practice and whether or not grabbing a Costco rotisserie chicken for dinner or Little Caesars is the way to go.

by Unknown Soldier Wed 23 Oct 2019, 13:10

Teentitan wrote:It's all about "perception" Unknown Soldier.

Look at the opinion of Jane and Joe Canadian. A 100% disabled vet in their "perception" is being paid well and medically taken care of. Not to mention Jane and Joe immediately think a 100% disabled veteran is getting every tax break from Disability tax, parking permit, CPPD etc when in reality we veterans all know each gov't department has their own definition of disability.

So now think of Jane and Joe when they hear how many veterans are classified by the very department created to take care of them to be over 100% disability?

They automatically think that as Canadians they are not treating veterans properly and they want answers. Answers from the political party in charge of Canada. Not to mention all the other government departments that have their own definition of disabled.

In the bureaucratic circles in Ottawa, and PEI, that is a situation they want kept in the dark because what would happen if there was but only one definition of disabled across ALL gov't departments? How many CUPE jobs would be lost? How much would it cost for veterans but ALL Canadians because that one definition would apply to them.

you’re right it is about perception, but in a different context, l don’t think John and Jane think a 100% disabled veteran is getting all kinds of “ perks” at all, especially when John and Jane hear about that veteran through a media headline/interview that states “ l am 100% disabled and VAC is doing nothing for me.” I feel most John and Jane doe feel that when they hear a veteran is a100% disabled that they are pretty f-Ed up ( no arms no legs comes to mind) not initially thinking “ not all wounds are visible.”, And the John and Janes I know personally find the whole over 100% disabled thing unintentionally laughable, I.e. two veterans are sitting with a civi, and the first says l have this injury and that, VAC has labeled me 70% disabled, the civi nods in compassionate understanding. The second vet informs the civi friend, I have these 5 injuries VAC has declared I’m 123% disabled, the civi scratches his head and says “ how the hell is that possible??” because they don’t understand the process. Personally I’d like to run into a John Doe who spouts that he thinks injured veterans are getting too much of anything from vac/gov...because I would knock him out!

by **Teentitan** Wed 23 Oct 2019, 12:15

It's all about "perception" Unknown Soldier.

Look at the opinion of Jane and Joe Canadian. A 100% disabled vet in their "perception" is being paid well and medically taken care of. Not to mention Jane and Joe immediately think a 100% disabled veteran is getting every tax break from Disability tax, parking permit, CPPD etc when in reality we veterans all know each gov't department has their own definition of disability.

So now think of Jane and Joe when they hear how many veterans are classified by the very department created to take care of them to be over 100% disability?

They automatically think that as Canadians they are not treating veterans properly and they want answers. Answers from the political party in charge of Canada. Not to mention all the other government departments that have their own definition of disabled.

In the bureaucratic circles in Ottawa, and PEI, that is a situation they want kept in the dark because what would happen if there was but only one definition of disabled across ALL gov't departments? How many CUPE jobs would be lost? How much would it cost for veterans but ALL Canadians because that one definition would apply to them.

by Unknown Soldier Wed 23 Oct 2019, 11:30

Teentitan wrote:Very good point 45jim but the only thing a vet needs to worry about is the approval letter of the disability.

Money wise it means nothing!

BUT approval wise means medical treatment is paid for by VAC instead of it coming out of the vets pocket.

As for the "this injury put me over 100% but they will not give me a percentage" for years, almost a full decade now, VAC has hated reading in newspapers and hearing on talk radio a veteran is over 100% disabled and VAC does nothing for me.

I was eavesdropping on about 4/5 VAC bureaucrats on the blowback if they stopped giving out percentage's when a vet hits 100. They bantered in bureucrate-ze language (tougher to learn then Wookie language) so maybe they got their wish. But again on our file in PEI the number will be there to make sure the vet does not drop beneath 100% payment until they are actually fit enough to be under 100%.

While on the subject of care for a Vet I want to make sure that if you have noticed a prescribed medication is not working like it used to find out if it's a generic brand or name brand drug from your pharmacist. Apparently VAC has only been paying for generic drugs (if available) unless the prescription says "NO SUBSTITUTE" (or No Sub) from your doctor.

VAC has also started a cap system on what they will pay for drugs. For example I was on Cymbalta for 10 years. When I went to pick up my 3 month supply I was billed $34 for Cymbalta. Asked the pharmacist and he explained to me that VAC has put price limits on drugs and the vet is to pay the balance.

This happened about 3 years ago and I asked when the price cap from VAC came into effect and he said a year ago. So that would roughly be 4 years ago.

You are probably wondering why I'm rambling but it's concerning that when I asked the pharmacist why I haven't been paying for the last year that's when the owner of the pharmacy took over the conversation. She told me that I bring in a lot of money for this pharmacy for all the meds I take, including prescriptions from my doctor for OTC (over the counter) products like rolaids, keopectate, pepto etc that she could afford to "wave" the charge for the Cymbalta.

So doing the weird math this is one of the factors in the "The gov't pays too much for Medical Marijuana" bitching from VAC. The drug companies are upset but the drugstore owner's are taking a hit from those of us who no longer need prescribed drugs while using Med Mar.

In case you were wondering the pharmacy was making about $9000 + a year from my prescriptions. My Med Marijuana comes in at around $2500 +/- a year. And here I was thinking I was doing a good thing for the tax payer by saving $6500 a year in drugs for other programs in VAC. Oh wait that's right I forgot about the yearly bonus the department head for drug approvals person probably is losing....silly me.

l don’t know, is the headline any more bearable if a veteran says “ l am 100% disabled and VAC is doing nothing for me .?”

by Unknown Soldier Wed 23 Oct 2019, 11:26

KetchupKD wrote:Interesting comments. I have one of threes claims at 74 weeks also. Were both of yours dated the same on your VAC account at step 3? I am at 50% so lots of room. Mine are for Sleep Apnea, neck and reflux.

there are charts that could probably tell you if those 3 claims will add up to if successful

by **Teentitan** Wed 23 Oct 2019, 10:49

Very good point 45jim but the only thing a vet needs to worry about is the approval letter of the disability.

Money wise it means nothing!

BUT approval wise means medical treatment is paid for by VAC instead of it coming out of the vets pocket.

As for the "this injury put me over 100% but they will not give me a percentage" for years, almost a full decade now, VAC has hated reading in newspapers and hearing on talk radio a veteran is over 100% disabled and VAC does nothing for me.

I was eavesdropping on about 4/5 VAC bureaucrats on the blowback if they stopped giving out percentage's when a vet hits 100. They bantered in bureucrate-ze language (tougher to learn then Wookie language) so maybe they got their wish. But again on our file in PEI the number will be there to make sure the vet does not drop beneath 100% payment until they are actually fit enough to be under 100%.

While on the subject of care for a Vet I want to make sure that if you have noticed a prescribed medication is not working like it used to find out if it's a generic brand or name brand drug from your pharmacist. Apparently VAC has only been paying for generic drugs (if available) unless the prescription says "NO SUBSTITUTE" (or No Sub) from your doctor.

VAC has also started a cap system on what they will pay for drugs. For example I was on Cymbalta for 10 years. When I went to pick up my 3 month supply I was billed $34 for Cymbalta. Asked the pharmacist and he explained to me that VAC has put price limits on drugs and the vet is to pay the balance.

This happened about 3 years ago and I asked when the price cap from VAC came into effect and he said a year ago. So that would roughly be 4 years ago.

You are probably wondering why I'm rambling but it's concerning that when I asked the pharmacist why I haven't been paying for the last year that's when the owner of the pharmacy took over the conversation. She told me that I bring in a lot of money for this pharmacy for all the meds I take, including prescriptions from my doctor for OTC (over the counter) products like rolaids, keopectate, pepto etc that she could afford to "wave" the charge for the Cymbalta.

So doing the weird math this is one of the factors in the "The gov't pays too much for Medical Marijuana" bitching from VAC. The drug companies are upset but the drugstore owner's are taking a hit from those of us who no longer need prescribed drugs while using Med Mar.

In case you were wondering the pharmacy was making about $9000 + a year from my prescriptions. My Med Marijuana comes in at around $2500 +/- a year. And here I was thinking I was doing a good thing for the tax payer by saving $6500 a year in drugs for other programs in VAC. Oh wait that's right I forgot about the yearly bonus the department head for drug approvals person probably is losing....silly me.

by Guest Wed 23 Oct 2019, 10:21

by Unknown Soldier Wed 23 Oct 2019, 10:20

45jim wrote:I had two claims recently completed, both granted which was nice as they sat at Stage 3 for 74 weeks!

First, these claims were Stage 3 May 2018 and the decision letter is dated October 2019. However, the decision is effective April 1, 2019. Which I found interesting as it should have been backdated to the date of application, not to the date of PFL implementation. I called VAC and I got helpful service but no discernible reason why the decision wasn't backdated to its application date. I am already assessed at 100% so there was no money involved but the date of approval can be important if you are applying for or have an application in process for other benefits or allowances.

Second, every time a claim is approved the reasons for the decision are listed along with the assessment percentages in the VAC letter. Again a change, the new letter just says that I am already at 100% and can't receive any more Pain and Suffering compensation. It does not provide a percentage assessment for these conditions at all. I think this will be a major problem going forward. Every disability claim should be viewed as unique and assessed on the documentation provided and related to the table of disabilities and quality of life ratings. Without that, it is impossible for VAC to look objectively at the cumulative effect of disabilities on a Veterans QOL. Whatever disability rating you were at prior to this claim should have no effect on how the new claim is adjudicated.

For example if a Veteran is at 80% disability and is later diagnosed with ALS (a terminal disease) which has global impacts on all aspects of health, mobility and QOL the maximum (under the new regime) would be to assess only a further 20% disability and attribute that to the ALS diagnosis. If that person were to apply for Additional Pain and Suffering compensation that 20% rating does not give adequate weight to the terrible prognosis that comes with ALS so a lower level of APS could be awarded. Had the first claim been ALS, perhaps the disability percentage could have been 80% on its own, adding that to the 80% of later claims would show the Veteran at 160% disabled. Clearly this would be noticeable when applying for APS!

Something for the Ombudsman?

l 100% agree, some veterans previously are labeled at 116%, 134% disabled etc., but policy states if veteran improves in a disability then the % is removed. A veteran could hit 100%,and then have 4 more disability claims approved at “ mystery” %, so the veteran doesn’t know where he stands. Then suppose their lower back disability improves and the veteran goes from 100% to 90% disabled, what about those 4 other “ hidden” percentages, if they were known to be 10%, the veteran would have originally been 140% disabled, and even if their back injury improved by 10%, they should still be listed at 130%..? l would try BPA before ombudsman might get faster help,

by 45jim Wed 23 Oct 2019, 09:56

I had two claims recently completed, both granted which was nice as they sat at Stage 3 for 74 weeks!

First, these claims were Stage 3 May 2018 and the decision letter is dated October 2019. However, the decision is effective April 1, 2019. Which I found interesting as it should have been backdated to the date of application, not to the date of PFL implementation. I called VAC and I got helpful service but no discernible reason why the decision wasn't backdated to its application date. I am already assessed at 100% so there was no money involved but the date of approval can be important if you are applying for or have an application in process for other benefits or allowances.

Second, every time a claim is approved the reasons for the decision are listed along with the assessment percentages in the VAC letter. Again a change, the new letter just says that I am already at 100% and can't receive any more Pain and Suffering compensation. It does not provide a percentage assessment for these conditions at all. I think this will be a major problem going forward. Every disability claim should be viewed as unique and assessed on the documentation provided and related to the table of disabilities and quality of life ratings. Without that, it is impossible for VAC to look objectively at the cumulative effect of disabilities on a Veterans QOL. Whatever disability rating you were at prior to this claim should have no effect on how the new claim is adjudicated.

For example if a Veteran is at 80% disability and is later diagnosed with ALS (a terminal disease) which has global impacts on all aspects of health, mobility and QOL the maximum (under the new regime) would be to assess only a further 20% disability and attribute that to the ALS diagnosis. If that person were to apply for Additional Pain and Suffering compensation that 20% rating does not give adequate weight to the terrible prognosis that comes with ALS so a lower level of APS could be awarded. Had the first claim been ALS, perhaps the disability percentage could have been 80% on its own, adding that to the 80% of later claims would show the Veteran at 160% disabled. Clearly this would be noticeable when applying for APS!

Something for the Ombudsman?

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