DVA Factsheet DVA03
Department of Veterans’ Affairs
Overview of DVA Benefits and Services Overview This Factsheet outlines the benefits and services provided by the Department of Veterans’ Affairs (DVA). Pensions - Income Support Service pension provides a regular income for people with limited means. A service pension can be paid to veterans on the grounds of age or invalidity, and to eligible partners, widows and widowers. It is subject to an income and assets test. The age service pension is paid to veterans earlier than the age pension paid by Centrelink, recognising that the effects of war service may be intangible and result in premature ageing and/or loss of earning power. However, the invalidity service pension may be granted at any age before the person turns age pension age. Service pension can be paid under the Veterans' Entitlements Act 1986 (VEA) to Australian veterans and mariners, Commonwealth veterans, and allied veterans and allied mariners who have qualifying service. Commonwealth veterans, allied veterans and allied mariners must also have been an Australian resident for a certain period. Income support supplement (ISS) provides a regular income additional to the war widow’s/widower's pension for Australian war widows and widowers with limited means. It is also subject to an income and assets test. Supplements and allowances which may be payable in association with service pension and ISS include pension supplement, rent assistance, and remote area allowance. For further information, please see DVA Factsheets IS01 Service Pension Overview or IS03 Income Support Supplement Overview.
Pensions - Disability Compensation Disability pension is paid under the VEA to compensate veterans for injuries or diseases caused or aggravated by war service or certain defence service rendered on behalf of Australia before 1 July 2004. The amount of disability pension paid depends on the level of incapacity suffered as a result of war-caused or defence-caused injuries and diseases.
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Overview of DVA Benefits and Services, continued Pensions - Disability Compensation, continued Higher rates of pension, such as Special and Intermediate Rates, are known as Above General Rate (AGR) pensions and are payable when the veteran is either severely incapacitated or unable to earn a normal wage because of the effects of his or her accepted condition/s on their capacity to work. The Extreme Disablement Adjustment rate may be considered for veterans who have reached 65 years of age and are not eligible to receive a Special or Intermediate Rate of pension. As the name suggests, the degree of incapacity from war or defence caused conditions must be extreme. Supplements and allowances may be paid in association with disability pension. These include: attendant allowance, clothing allowance, decoration allowance, and recreational transport allowance. For further information, please see DVA Factsheet DP01 Overview of Disability Pensions and Allowances. Pensions - War widows and widowers War widow's/widower's pension is paid under the VEA to to compensate widowed partners of veterans who have died as a result of war service or eligible defence service. The pension will be granted automatically if the deceased veteran was an ex-prisoner of war, had been receiving disability pension at the Extreme Disablement Adjustment, Special Rate, Intermediate Rate, Temporary Special Rate, or at an increased rate for a condition specified in any of items 1 to 8 of subsection 27(1) of the Veterans' Entitlements Act 1986 (VEA) – these items relate to double amputees who may also be blind in one eye. In all other cases a claim needs to be lodged with the Department and the pension may then be granted if the veteran's death is determined to have been caused by war or eligible defence service. Orphan's pension may also be payable to dependent children of deceased veterans. War widow’s/widower’s and orphan’s pensions are not affected by other income except from other compensation payments. For further information, please see DVA Factsheet DP60 War Widow’s/Widower’s and Orphan’s Pensions. Compensation following death Compensation may be provided under the Military Rehabilitation and Compensation Act 2004 (MRCA) to the dependants of deceased members and former members of the Australian Defence Force (ADF) who die or were severely injured as a result of their service on or after 1 July 2004. For further information, please see DVA Factsheet MRC44 Compensation for Dependants of Deceased Serving Members and Former Members of the Australian Defence Force.
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Overview of DVA Benefits and Services, continued Compensation following death, continued Similar compensation coverage may be available under the Safety, Rehabilitation and Compensation Act 1988 (SRCA), if the ADF member's death relates to injuries and diseases suffered as a result of peacetime and peacekeeping service up to 30 June 2004 and operational service between 7 April 1994 and 30 June 2004. For further information, please see DVA Factsheet MCS06 Benefits under the Safety, Rehabilitation and Compensation Act 1988 and the Defence Act 1903. Incapacity Benefits Incapacity benefits are payments for economic loss due to the inability (or reduced ability) to work because of injury or disease that has been accepted as service related. Incapacity benefits can be made to current and former ADF members including permanent and Reserve force members, Cadets, Cadet officers and instructors and declared members who are incapacitated for service or work as a result of an injury or disease that has been accepted under the SRCA or the MRCA. For further information, please see DVA Factsheets MRC08 Benefits for Incapacity for Service or Work or MCS08 Incapacity for Work.
Permanent Impairment payments Current and former ADF members who have an injury or disease as a result of their ADF service, and that injury or disease has left them with some permanent impairment, may be entitled to receive compensation for that impairment from DVA. This compensation is called permanent impairment (PI) payment. PI payments are paid as compensation for any permanent physical and/or mental impairment in combination with any lifestyle restrictions which the person may be suffering as a result of injuries or diseases which have been accepted by DVA, under the SRCA or the MRCA, as being related to their ADF service. For further information, please see DVA Factsheets MCS07 Permanent Impairment or MRC07 Permanent Impairment Compensation Payments. Health Care A broad range of health care and support services are available to meet the clinical needs of eligible veterans and eligible dependants. Health care and support services include: • general practitioner services • medical specialist services including pathology and radiology • allied health services, eg podiatry, physiotherapy and other allied health services • dental care • community nursing • spectacles and hearing aids DVA03 - Last updated: 5 Feb 13
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Overview of DVA Benefits and Services, continued Health Care, continued • •
care in public and private hospitals including day procedure centres home support services
• Subsidised pharmaceuticals under the Repatriation Pharmaceutical Benefits Scheme
(RPBS). • aids and appliances to assist entitled persons to remain living independently in their homes Holders of a Gold Card (the Repatriation Health Card - For All Conditions within Australia) are entitled to the full range of health care services at DVA’s expense, including medical, dental, optical care and subsidised pharmaceuticals. They are also entitled to aids and appliances to help them to remain in their home. For further information please see DVA Factsheet HSV60 Using the Repatriation Health Card - For All Conditions (Gold) Holders of a White Card (the Repatriation Health Card – For Specific Conditions) are only entitled to be treated at DVA’s expense including subsidised pharmaceuticals for their accepted service related disabilities or illnesses. A White Card may be issued to Australian veterans for the treatment of non-service related cancer, pulmonary tuberculosis, posttraumatic stress disorder, clinical depressions or severe anxiety disorders, or the symptoms of unidentifiable conditions (Gulf War veterans only), on the basis of a reported medically diagnosed condition, without the need to claim for disability compensation. For further information please see DVA Factsheet HSV61 Repatriation Health Card - For Specific Conditions (White) Allied veterans are eligible for treatment and access to subsidised pharmaceuticals for service related disabilities or illnesses accepted by the entitled person’s home country. For further information please see DVA Factsheet HSV62 - Commonwealth and Other Allied Veterans for specific information on the services available. Holders of an Orange Card (Repatriation Pharmaceutical Benefits Card) are entitled to subsidised pharmaceuticals only. For further information please see DVA Factsheet HSV69 Repatriation Pharmaceutical Benefits Card (Orange Card). DVA will pay for the reasonable costs of treatment for a veteran or eligible serving member who has an accepted claim under the SRCA or the MRCA. DVA may make arrangements for the treating doctor(s) and chemist to bill DVA directly for any medical treatment or pharmaceuticals that are required as a result of the veteran’s condition. The veteran may choose to pay for the cost of the treatment and seek reimbursement from DVA. The veteran should speak to DVA staff before obtaining any expensive treatment in case payment or reimbursement can not be made. For further information please see DVA Factsheet: MRC46 Medical Treatment Australian veterans residing overseas, whether permanently or temporarily are entitled to treatment for their accepted disability/ies (ADs) only regardless of the card they hold. For further information please see DVA Factsheet HSV65 Medical Treatment while Overseas.
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Overview of DVA Benefits and Services, continued Rehabilitation Rehabilitation is designed to assist former ADF members, cadets, declared members and reservists who have sustained an injury or contracted a disease due to their ADF service and have eligibility under the SRCA and/or the MRCA. The aim is to do everything possible to get the person back to at least the same physical and psychological state, and at least the same social, vocational and educational status as they had before being injured or becoming ill. The assistance provided might involve medical treatment, physiotherapy, or providing special equipment to help manage daily activities. The person might need vocational rehabilitation assistance to adapt in their current job or assistance to find, or to train for a more suitable job. The Veterans’ Vocational Rehabilitation Scheme (VVRS) provided under the VEA is a voluntary vocational rehabilitation scheme to help eligible veterans who need special assistance to return to paid work, to increase their work hours, or who are at risk of losing their job or are finding it increasingly difficult to maintain their employment or require help with job seeking activities. The scheme can provide assistance for those who need to upgrade their skills or undergo short term retraining to gain employment. For further information, please see DVA Factsheets MRC05 Rehabilitation or HSV108 Veterans' Vocational Rehabilitation Scheme (VVRS).
Housing Subsidised loan assistance and insurance benefits are available to eligible current and former ADF personnel. The Defence Service Homes (DSH) Scheme provides a subsidised loan of up to $25,000 repayable over 25 years to ex-service men and women (and certain dependents) who have completed a qualifying period of service in either wartime or peacetime. A Home Support Loan of up to $10,000 is also available to assist with the cost of home maintenance and modifications and other housing-related purposes. DVA administers the Defence Home Ownership Assistance Scheme (DHOAS) on behalf of the Department of Defence. DHOAS is available to current and former ADF personnel, and their surviving partners, who have served in the ADF after 1 July 2008, completed a qualifying period and accrued a Service Credit. The older Defence HomeOwner Scheme (DHOS) is also administered by DVA on behalf of the Department of Defence, and is now closed to new applications. Similar benefits to those formerly provided under DHOS (a subsidised home loan of up to $80,000) may still be available under DHOAS in some limited extenuating circumstances. Defence Service Homes Insurance (DSHI) provides economical home and contents insurance to all persons who are eligible under the Veterans’ Entitlement Act 1986 and/or the above Schemes, regardless of whether they have a DSH or DHOAS loan.
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Overview of DVA Benefits and Services, continued Counselling The VVCS - Veterans and Veterans Families Counselling Service (VVCS) is a specialised, free and confidential counselling service for veterans, their partners, and dependent children. It is open to veterans of all conflicts and peacekeeping operations. VVCS provides individual, couple and family counselling as well as group programs, case management, information and education. Call 1800 011 046 (nationally) to be connected to a VVCS Centre during business hours, or for after-hours crisis telephone counselling via Veterans Line. Further information is available at the VVCS website www.dva.gov.au/vvcs Commemoration Saluting Their Service is the Australian Government’s commemorations program. It aims to highlight the sacrifice and service of Australia’s servicemen and women in wars, conflicts and peacekeeping operations since Federation and to promote appreciation and understanding of the role that those who have served have played in shaping the nation. The program is designed to raise awareness of Australia’s wartime heritage, acknowledge the contribution of Australian servicemen and women and to encourage community participation in commemorative events. Disclaimer The information contained in this Factsheet is general in nature and does not take into account individual circumstances. You should not make important decisions, such as those that affect your financial or lifestyle position, e.g. retirement, on the basis of information contained in this Factsheet. Where you are required to lodge a written claim for a benefit, you must take full responsibility for your decisions prior to the written claim being determined. You should seek confirmation in writing of any oral advice you receive from DVA relating to complex or important matters. Other Factsheets Other Factsheets related to this topic include: • IS01 Service Pension Overview • IS03 Income Support Overview • DP01 Overview of Disability Pension and Allowances • MRC01 Overview of the Military Rehabilitation and Compensation Act 2004 (MRCA) • MCS01 Overview of the Safety, Rehabilitation and Compensation Act 1988 (SRCA) • HAC01 Defence Service Home Loans • HAC02 Defence Service Home Insurance • VCS01 Information for Veterans, their Families and Other Users of VVCS • HSV01 Overview of Health Services available to the Veteran Community • COM01 Overview of Saluting Their Service
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Overview of DVA Benefits and Services, continued Other Factsheets, continued • • • •
MRC05 Rehabilitation HCS01 About Veterans’ Home Care HSV16 Community Nursing Services HSV65 Medical Treatment while Overseas.
More information All DVA Factsheets are available from DVA offices, and on the DVA website at www.dva.gov.au. You can phone DVA for the cost of a local call on 133 254 or 1800 555 254 for country callers. Use a normal landline phone if you can. Mobile phone calls may cost you more. You can send an email to DVA at:
[email protected]. You can get more help from any DVA office.
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COMPARATIVE EXPLORATORY STUDY ON BEST PRACTICES IN THE UNITED STATES AND CANADA ON GOVERNMENTAL SERVICES AND PROGRAMS FOR VETERANS AND MEMBERS OF THE ARMED FORCES TRANSITIONING TO CIVILIAN LIFE INFORMATION DOCUMENT ON PROGRAMS AND SERVICES AVAILABLE IN THE UNITED STATES PREPARED FOR THE HOUSE OF COMMONS STANDING COMMITTEE ON VETERANS AFFAIRS
WASHINGTON, D.C., UNITED STATES 15-16 APRIL 2013
Jean-Rodrigue Paré Aboriginal Affairs and Social Development Section Parliamentary Information and Research Service 10 April 2013
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INTRODUCTION TO THE U.S. VETERANS SUPPORT SYSTEM The U.S. veterans support system is very broad and provides a host of programs to meet a great variety of needs. Consequently, this paper can provide only a brief overview of the general structure of those services. The U.S. programs are outlined below under the headings, Health Care, Transition and Professional Support Services and Monetary Benefits. The Department of Veterans Affairs also offers a range of life insurance and disability insurance services not described here. Benefits offered to the members of the Reserve and National Guard are also not addressed.1 HEALTH CARE The Department of Veterans Affairs administers the largest health care system in the United States. The system has approximately 1,500 different sites where care can be provided to veterans. With the exception of those discharged for medical reasons very soon after enrolling, veterans must have a minimum of 24 months of continuous service to be eligible for health care. A.
Program Eligibility
Every veteran who registers for the health care program is assigned to one of eight Priority Groups. Veterans in the first groups may get appointments sooner than others. To be eligible for care, veterans not receiving disability allowances (compensation or pension) must have incomes below a prescribed threshold, usually between $30,000 and $35,000 for a single individual, adjusted based on the veteran’s place of residence. They must also contribute to (“copay”) expenses (Medical Services and Medication Copays).2 Group 1: Veterans with “service-connected” disabilities rated 50% or more and/or who are unemployable due to service-related conditions. Group 2: Veterans with service-connected disabilities rated 30% or 40%. Group 3: Veterans with service-connected disabilities rated 10% and 20%; veterans who are former prisoners of war or were awarded a Purple Heart medal; veterans awarded the Medal of Honor; veterans awarded special eligibility for disabilities incurred in treatment or participation in a vocational rehabilitation program; and veterans discharged for medical reasons as a result of their involvement in combat operations. Group 4: Veterans who require the support of another person or are housebound (Aid and Attendance or Housebound Benefits) and/or are catastrophically disabled. Group 5: Veterans receiving disability pension benefits or eligible for Medicaid programs and veterans whose disability is not service-connected, but whose income falls below the prescribed threshold (approximately $30,000 to $35,000 for a single person based on specific conditions). Group 6: Veterans seeking benefits related to their exposure to radiation; veterans of the Vietnam and Persian Gulf Wars; veterans who served in a theatre of combat operations (Combat Veterans) after 1
For those programs, see Department of Veterans Affairs, Federal Benefits for Veterans, Dependents & Survivors, 2012 Edition.
2
Ibid., p. 5.
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11 November 1998 and have been discharged since 28 January 2003 (access to care limited to a period of five years after discharge). Group 7: Low-income veterans who agree to copay expenses. Group 8: Non-low-income veterans who agree to copay expenses. Special eligibility may be granted to veterans enrolled in a vocational rehabilitation program and to children of Korean and Vietnam war veterans suffering from spina bifida. Dental care is offered in accordance with a different and complex classification based on the relationship between necessary care and service, the interaction between dental care and other conditions for which veterans are being treated, enrolment in a vocational rehabilitation program, degree of disability and other criteria. In general, access is limited where dental care is not directly related to a serviceconnected injury or where a veteran is not suffering from a total disability.3 Some long-term care may be provided at home or by contract with private care centres where the veteran’s conditions so requires. Similarly, emergency care may be provided at an institution not administered by the Department of Veterans Affairs. The main information in a veteran’s medical record may be accessed through a secure website called “My Health eVet” (www.myhealth.va.gov), where veterans may renew prescriptions, make appointments with health professionals, monitor changes in certain personal health indicators, and so on. B.
Contribution to Expenses (Copays)
Veterans in Groups 7 and 8 and in certain other groups, depending on income and type of care received, will be required to pay for a portion of their care (copay). For example, Group 7 veterans must pay a lump sum of $231.20 for every hospital stay of 90 days or less, plus a $2 per diem charge. For veterans in Group 8, the lump sum amount increases to $1,156, plus a $10 per diem charge. Medication is free for all service-connected conditions. There is no deductible for non-service-connected conditions, but there is a co-insurance charge of $8 or $9 per monthly prescription to a maximum annual level of $960, beyond which medication is free. Interactions between public and private health insurance plans may be complicated.4 C.
Travel Costs
The cost of travel to medical appointments is usually covered for service-connected conditions and emergencies and where a veteran’s income is insufficient. If necessary, travel costs of a person accompanying the veteran may also be reimbursed.
3
For the classification of types of admissibility, see Department of Veterans Affairs, Federal Benefits for Veterans, Dependents & Survivors, 2012 Edition, pp. 20–22.
4
Ibid., p. 9.
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Examination Costs for Particular Conditions
The Department of Veterans Affairs maintains databases for certain specific situations:
exposure to hazardous substances during the Persian Gulf War and in Iraq that could have caused chronic health problems;
exposure to depleted uranium during the Persian Gulf War and in Iraq, or elsewhere, including Bosnia and Afghanistan;
exposure to Agent Orange or other defoliants during the Vietnam War or in the Demilitarized Zone in Korea;
exposure to ionizing radiation during nuclear tests or bombardments.
All medical tests for conditions potentially related to the exposures for which registries are maintained are free. E.
Home Care and Caregiver Programs
A number of programs are designed to provide home care or to support natural caregivers who care for veterans, in particular those with serious disabilities. Professionals may deliver at-home health care, provide respite to family members who help veterans on a daily basis and give training for natural caregivers and peer support groups for individuals who take care of veterans. In May 2010, important legislation was passed to improve these programs for veterans suffering from conditions related to service in a theatre of operations since 11 September 2001. Those whose health care is provided for needs related to service before 11 September 2001 have access to a more limited range of services.5 F.
Home Improvements
The Department of Veterans Affairs provides a maximum lifetime benefit of $6,800 for veterans with service-connected disabilities, and up to $2,000 for other veterans for home improvements to promote independence. For veterans who have suffered catastrophic service-connected injuries, a lump-sum allowance of up to $64,960 may be paid to cover up to 50% of the cost to buy or renovate an existing residence. An allowance of up to $12,992 may be paid for veterans suffering serious but not catastrophic injury. A portion of these allowances may be used to make improvements to the residence of a family member who provides a veteran with temporary accommodation. The Department of Veterans Affairs also offers loan guarantees for the purchase or renovation of a residence and, in certain cases, may offer direct loans. The eligibility criteria are complex and involve a number of categories of veterans based on location and length of service.6
5
Ibid., p. 27.
6
Department of Veterans Affairs, “Chapter 5: Home Loan Guaranty,” Federal Benefits for Veterans, Dependents & Survivors, 2012 Edition.
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Allowances are also available for improvements to a vehicle, as well as clothing allowances to facilitate the use of prostheses for certain conditions. G.
Short- and Long-term Residence Care
The Department of Veterans Affairs administers three separate residence care programs, each with its own eligibility criteria. 1.
Community Centres Administered by the Department (VA Community Living Centers)
Eligibility for these centres is limited to veterans receiving short- or long-term care for service-connected conditions, those suffering a 70% or greater service-connected disability and those who are suffering a 60% or greater service-connected disability and are unemployable. In the last two cases, the disability must be service-connected, but the residence care the veterans require need not be service-connected. 2.
Veterans Centres Administered by the States (State Veterans Home Program)
These centres are built and administrated by the states, but the Department of Veterans Affairs covers a portion of their expenses if the centre meets the department’s quality and service-variety criteria. 3.
Contract Community Residences (Contract Community Nursing Home Program)
These community centres provide veterans with long-term care near their home communities. The centres must meet the department’s quality standards, and the department compensates the centres for the types of services that veterans would have received if they had been admitted to a community centre administered by the department. TRANSITION AND PROFESSIONAL SUPPORT SERVICES The Department of Veterans Affairs administers a network of 232 community centres (Vet Centers) across the United States. All veterans who have served in a theatre of operations are eligible. The centres provide individual, group and family counselling to facilitate transition, as well as a full range of psychosocial support services for operational stress injuries or “any other military-related problems that affect functioning within the family, work, school or other areas of everyday life.”7 Bereavement counselling services are also available at these centres for the members of families of service members who have died on active duty. A.
Work Restoration Programs
For veterans enrolled in the Health Care Program, the Department of Veterans Affairs has developed a series of work restoration programs suited to specific physical and mental conditions:
under the Incentive Therapy program, veterans suffering psychological or physical injuries are able to gain experience in a work environment and receive nominal remuneration (50% of minimum wage);
35 Sheltered Workshops have been established in VA medical centres for veterans wishing to have their ability to work assessed; participants are paid on a piece-rate basis;
7
Department of Veterans Affairs, Federal Benefits for Veterans, Dependents & Survivors, 2012 Edition, p. 12.
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the Supported Employment program enables veterans suffering from mental illness to obtain suitable employment with the support of specialists; support gradually declines as the veterans enter their work environment. Vocational Rehabilitation and Employment
To be eligible for this program, veterans must have a service-connected disability rated at least 20% resulting in any degree of employment disability, or rated 10% with a serious employment handicap. A rehabilitation plan is developed and the department pays the cost of training provided under the plan. Based on the objectives pursued, the plan will be implemented on one of five tracks: 1.
re-employment with a previous employer;
2.
rapid access to employment in a work environment for veterans whose skills are readily transferable to the civilian sector;
3.
self-employment for veterans preferring this option or for whom a flexible schedule seems more appropriate;
4.
longer-term specialized training for veterans whose skills are hard to transfer or whose disabilities prevent them from using their former skills;
5.
independent living services for veterans who are currently unable to work but whose rehabilitation services will improve their quality of life.
Veterans have access to these programs for 12 years following discharge. Rehabilitation services are provided on a full-time basis for 48 months, or the part-time equivalent, and a living allowance may be paid based on workplace training needs. That allowance varies based on the veteran’s family situation and type of training. The monthly living allowance for a single person on full-time training is $567. C.
Fiduciary Program
For veterans deemed unable to manage their own financial affairs, the department may appoint a fiduciary to protect the benefits paid to them. The fiduciary is then mandated to use the funds paid by the department in a manner that corresponds to program needs and promotes the greater well-being of the veteran and of the members of his or her family. D.
Education Act and Training for Veterans Who Have Served since 11 September 2001 (Post-9/11 GI Bill)
Veterans who were discharged from service before 11 September 2001 are not eligible for this program. For all those who were released after that date and who are enrolled in full-time study, benefits are offered for up to 36 months and cover the following expenses:
tuition fees of an undergraduate university program, not to exceed the highest fees payable at a public institution offering that training in the state where the veteran resides;
monthly housing allowance;
academic supplies allowance to a maximum of $1,000 a year;
supplementary allowance of $500 for veterans from rural areas.
For service members on active duty, these benefits are transferable to family members upon approval by the Department of Defense.
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In certain cases where the cost of a program is higher than the allowable maximum and that program is unavailable elsewhere, the Department of Veterans Affairs may convince the educational institution to waive up to 50% of the tuition fees, and the department will pay the remaining 50% (Yellow Ribbon G.I. Education Enhancement Program). Other rules will come into force on certain dates specified in the legislation. All these new programs replace those in effect before 2009 for veterans discharged prior to 11 September 2001. For this group, the programs of the Montgomery GI Bill apply. This legislation is complex, involves numerous classes of veterans for the purpose of establishing eligibility and is more strict in defining eligible types of training. MONETARY BENEFITS A.
Disability Compensation
The Department of Veterans Affairs pays a monthly allowance to veterans suffering from serviceconnected disabilities. That allowance is non-taxable but reduces the amount of the military retirement pension to which a veteran may be entitled. However, some veterans may receive both military pension and disability compensation if their disability is specifically related to combat activities (Combat-Related Special Compensation). Veterans must establish a causal link between their disability and their service, except in certain cases in which that link is presumed: amyotrophic lateral sclerosis, exposure to Agent Orange and other herbicides, exposure to radiation as a result of the bombings of Nagasaki or Hiroshima or tests leading up to those bombings, certain chronic conditions associated with the Persian Gulf War and conditions that may arise as a result of having been a prisoner of war. In 2013, the monthly basic allowance for a single person varies between $129 and $2,816 based on the disability rating.8 The maximum amount of $3,088 is payable to a totally-disabled veteran with a spouse and child. The allowance is also adjusted for each additional child and for every other family member living with the veteran. In the case of severe physical or “catastrophic” disability, a Special Monthly Compensation is provided in addition to the base allowance. These additional amounts vary with the disability concerned and may be cumulative. B.
Pre-discharge Program
Under this program, which is administered jointly by the Department of Veterans Affairs and the Department of Defense, military members may file an application for the income replacement program up to 180 days prior to their scheduled separation or retirement date. The aim is for veterans to start receiving these benefits no later than 60 days before separation so that they can proceed with medical examinations.9
8
Department of Veterans Affairs, Veterans Compensation Benefits Rate Tables – Effective 12/1/11.
9
Department of Veterans Affairs, Benefits Delivery at Discharge.
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If unable to submit their application 60 days or more before separation, military personnel who are about to be discharged may nevertheless file a request for expedited processing under the Quick Start component of the program.10 For active service personnel who are to be released for medical reasons, the Department of Defense and the Department of Veterans Affairs launched a Disability Evaluation System in 2007. Under that system, military members need undergo only one medical examination, which establishes their ability to remain in service and their eligibility for monetary benefits. If service members must be released, the same medical examination will be used to establish monetary benefits to which they are entitled. There were previously two separate series of medical examinations. C.
Pension
A monthly pension may be paid to low-income veterans who have served in a theatre of operations, who suffer from a permanent and total disability, or who are 65 years of age or over. The purpose of that pension is to raise veterans’ incomes to the minimum threshold set by Congress. The maximum annual pension benefit for a single person is $12,256, which is adjusted upward based on a veteran’s family situation and home support needs. Pensions may be revised downward or cancelled for veterans whose incomes or assets increase or whose family situation changes.11 D.
Dependents and Survivors Benefits
A lump-sum amount of $100,000 is paid to the next of kin of service members who die while on active duty. Certain monetary benefits may be paid where death did not occur on active duty, but they are based on service, and where a veteran was suffering a service-connected total disability at the time of death (even if that disability was not the cause of death). The monthly base amount is $1,215, which is increased based on family situation and home support needs. An annual pension of $8,219 is payable to a survivor without children of low-income veterans who served in a theatre of operations. That pension is increased based on family situation and home support needs. E.
Burial and Memorial Benefits
The Department of Veterans Affairs pays basic burial costs for all veterans who elect to be interred in one of the 131 national cemeteries, as well as for their spouses and, in certain cases, other family members. Those costs include the site, headstone or marker, inscription, perpetual site care and a burial flag, as well as a presidential certificate. For interment in a private cemetery, the department does not pay for the site or its maintenance, and benefits are not offered for spouses or family members. Burial expenses are the family’s responsibility, but various allowances are provided. Allowances of up to $2,000 may be paid for veterans who have died as a result of service-connected injuries or illness.12
10
Department of Veterans Affairs, Quick Start.
11
Department of Veterans Affairs, Federal Benefits for Veterans, Dependents & Survivors, 2012 Edition, p. 42.
12
Department of Veterans Affairs, Burial Benefits.
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SUGGESTED QUESTIONS 1.
Under the Pre-Discharge Program, service members may file an application up to 180 days before separation or retirement. How do you determine the benefits to which veterans are entitled if a physical or psychological injury has not yet stabilized at the time of separation?
2.
When service personnel are still on active duty but know they will be released shortly, how can they obtain the medical record that they must forward to the Department of Veterans Affairs?
3.
Can the monthly amount of disability compensation be increased or reduced if the veteran’s condition changes over the years?
4.
A special monthly benefit may be added to the basic allowance in the case of certain severe physical disabilities. Why is that special monthly benefit not paid in cases of severe psychological injury?
5.
Veterans who enrol in the Health Care Program are assigned to one of eight Priority Groups. Can a veteran in Group 8 be deprived of care if resources are available to meet only the needs of veterans in Groups 1 to 7?
6.
For access to health care, the U.S. government has established a distinction between veterans who have been injured in combat and other veterans. As a result, veterans who have been discharged since 28 January 2003 have access to health care for a period limited to five years after their discharge. What are the reasons for that distinction?
7.
Veterans in Priority Groups 7 and 8 must copay for health care they receive. Can they receive care under this plan if the illness or injury treated is not service-connected?
8.
Can a member of the family of a veteran suffering from post-traumatic stress disorder obtain individual counselling at Vet Centers?
9.
Can you describe to us how the Work-Study program enables veterans taking training to work in the Department of Veterans Affairs while studying?
10.
Under the Fiduciary Program, how does the Department of Veterans Affairs determine whether veterans are unable to manage the monetary benefits paid to them?
11.
How is the process for appealing the department’s decisions on monetary benefits and health care organized?
PREPARED FOR THE HOUSE OF COMMONS STANDING COMMITTEE ON VETERANS AFFAIRS
INTERNATIONAL COMPARISON OF PROGRAMS AND SERVICES FOR VETERANS: NEW ZEALAND
Jean-Rodrigue Paré Aboriginal Affairs and Social Development Section Parliamentary Information and Research Service 30 May 2013
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CONTENTS Page BACKGROUND ........................................................................................................................................... 1 DESCRIPTION OF THE WAR PENSIONS ACT 1954 ............................................................................... 2 A.
War Disablement Pension ............................................................................................................... 2
B. Veteran’s Pension ........................................................................................................................... 2 1. Veterans 65 Years and Older ....................................................................................................... 2 2. Veterans Under 65 Years ............................................................................................................. 3 3. Additional Benefits of the Veteran’s Pension ............................................................................... 3 C. Pensions for Family Members ......................................................................................................... 4 1. Surviving Spouse/Partner Pension .............................................................................................. 4 2. Parent’s Allowance ....................................................................................................................... 4 3. Children’s Pension ....................................................................................................................... 4 4. War Bursaries ............................................................................................................................... 4 D. Other Entitlements ........................................................................................................................... 4 1. Attendant Allowance ..................................................................................................................... 4 2. Other Allowances ......................................................................................................................... 4 THE LAW COMMISSION’S RECOMMENDATIONS .................................................................................. 5 A.
General Principles and Recommended Scheme Structures .......................................................... 5
B. Elements Common to Both Schemes ............................................................................................. 6 1. Service Eligibility........................................................................................................................... 6 2. Service-Related Impairment ......................................................................................................... 6 a. Connection Between Service and Impairment.......................................................................... 6 b. Evidential Standards ................................................................................................................. 6 c. Measuring Impairment .............................................................................................................. 7 3. Decision-Making Structure ........................................................................................................... 7 a. Decision, Review and Appeal ................................................................................................... 7 b. Administration ............................................................................................................................ 7 (i) Expert Medical Panel ............................................................................................................. 7 (ii) Advisory body ......................................................................................................................... 7 C. Scheme One (Service-Related Impairment Prior to 1974) ............................................................. 7 1. Impairment Compensation ........................................................................................................... 7 2. Income Support ............................................................................................................................ 7 3. Health Care .................................................................................................................................. 8 4. Independence Assistance ............................................................................................................ 8 5. Rehabilitation ................................................................................................................................ 8 6. Family Support ............................................................................................................................. 8 a. Surviving Spouse Pension ........................................................................................................ 8 b. Children’s Pension .................................................................................................................... 8 c. Education Bursaries .................................................................................................................. 8 d. Funeral Grant ............................................................................................................................ 8 e. Psychosocial Support ................................................................................................................ 8
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D. Scheme 2 (Service-Related Impairment After 1974) ...................................................................... 9 1. Rehabilitation ................................................................................................................................ 9 2. Income Replacement ................................................................................................................... 9 3. Impairment Compensation ........................................................................................................... 9 4. Health Care .................................................................................................................................. 9 5. Independence Assistance ............................................................................................................ 9 6. Transition Assistance ................................................................................................................... 9 7. Recognition of Service for Senior Veterans ................................................................................. 9 8. Family Support ........................................................................................................................... 10
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BACKGROUND In New Zealand, programs and services for veterans were developed under the War Pensions Act 1954 (WPA). This law was a consolidation of several earlier laws, including the earliest dating back to 1866.1 Despite 30 amendments since 1954, the WPA has remained essentially unchanged for over half a century. Approximately 15,000 New Zealand veterans currently receive a disablement pension under this scheme. Veterans Affairs New Zealand is a quasi-autonomous organization whose appropriations come from two sources: the Ministry of Defence for policy development, commemoration and case management, and the Ministry of Social Development for the administration of pensions and various allowances. The administration of the WPA is the responsibility of the Secretary for War Pensions “acting under the general direction and control” of the Minister of Veterans Affairs (WPA, section 4(2)). In September 2007 the New Zealand government launched an extensive consultation process with a view to overhauling the legislative framework for veterans’ programs and services. The Law Commission of New Zealand, which is independent of the government but financed by public funds, was charged with making recommendations to the government and submitting a draft bill. The Commission presented a lengthy discussion paper in July 2008,2 and submitted its report in May 2010.3 The report contains 170 recommendations, of which 132 were accepted in whole or in part by the government.4 In October 2012, the government committed to investing $60 million (about C$50 million) over the following five years to implement new legislation. In accordance with the Commission’s recommendations, this new legislation should include two major bills, one for veterans who served before 1974, and another for those who served after 1974. The first of these two bills should be introduced in the coming months, and the government intends for these provisions to come into force on 1 July 2014.5 The choice of 1974 as the dividing year for the two schemes was recommended because of the introduction that year of universal, no-fault national accident compensation. According to the Commission’s discussion paper, “In many ways accident compensation beneficiaries receive a much better deal than war pensioners.”6 The introduction of national superannuation in 1975 was also more generous than the pension for veterans, but this discrepancy was corrected in 1989. Moreover, 1974 was after the Vietnam War in which nearly 4,000 New Zealanders served. Other grounds for the review are the same as those for most Western countries over the past two decades, such as the aging of veterans for whom existing schemes were designed and the complex disablements resulting from armed conflict. Since the WPA is set to be replaced in the near term, the following section simply provides an outline of the WPA and describes the Law Commission’s recommendations. 1
Law Commission of New Zealand, NZLC IP7 – Towards a New Veterans’ Entitlements Scheme: A Discussion paper on a Review of the War Pensions Act 1954, July 2008, p. 8.
2
Law Commission of New Zealand, NZLC IP7 – Towards a New Veterans’ Entitlements Scheme: A Discussion paper on a Review of the War Pensions Act 1954, July 2008, p. 8.
3
Law Commission of New Zealand, NZLC R115 – A New Support Scheme for Veterans: A Report on the Review of the War Pensions Act 1954, May 2010.
4
Veterans Affairs New Zealand, “A message from the Minister,” VANZ News, April 2013.
5
Veterans Affairs New Zealand, Briefing to the Incoming Minister of Veterans’ Affairs, 8 February 2013, p. 6.
6
Law Commission of New Zealand, NZLC IP7 – Towards a New Veterans’ Entitlements Scheme: A Discussion paper on a Review of the War Pensions Act 1954, July 2008, p. 8.
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DESCRIPTION OF THE WAR PENSIONS ACT 19547 The WPA closely resembles the Canadian Pension Act, which governed the veterans’ compensation scheme between 1919 and 2006. It basically contains a series of entitlements. A.
War Disablement Pension
The War Disablement Pension (WDP) is the core entitlement available under the WPA. Like the pension paid in Canada under the Pension Act, the WDP is the basis from which entitlement to many of the other benefits and allowance is derived. The WDP is awarded as a percentage based on the level of body impairment caused by one or more disabilities resulting from military service, with increments of 5% up to a maximum of 100% for all disablements. As we will see later, the maximum pension of 100% can be increased by an additional maximum of 60% in certain cases. In 2008, the maximum weekly WDP was NZ$182.02, or just over C$150 a week or C$7,800 a year.8 The WDP is paid every two weeks and is not taxable. Qualification for the WDP is determined by one of 21 War Pensions Claims Panels. The first stage of appeal is the National Review Officer and the second is the War Pensions Appeal Board. If the veteran is still dissatisfied with the decision, he or she can apply for judicial review. Temporary as well as permanent WDPs can be granted. Once a permanent pension is awarded, it is extremely rare for it to be reduced. For temporary pensions, a medical report is required after a date specified in the initial decision to determine whether the percentage of disablement has remained the same. A veteran can also ask for an increased pension if he believes his disablement has worsened. In the case of severe disablement, an additional pension may be awarded, in 5% increments up to 60% of the maximum WDP. Of the approximately 15,000 veterans who receive the WDP, around 1,000 receive an additional pension. Veterans who are aged 60 years and over and who have been awarded an additional WDP receive an extra 10% of the combined total of the WDP. As a result, the maximum amount a veteran over the age of 60 receiving a WDP of 160% in 2008 would receive is NZ$320.34 a week, or around C$270 a week or C$14,040 a year. B.
Veteran’s Pension
The Veteran’s Pension (VP) is paid to two categories of veteran: veterans 65 years and older and veterans under 65 years. 1.
Veterans 65 Years and Older
For veterans 65 years and older and who receive a WDP of at least 70% the VP is aligned with the universal superannuation to which other New Zealanders have access. Under universal superannuation, all New Zealanders aged 65 years or older, regardless of their income or assets, in 2008 received a taxable benefit of NZ$347.77 a week (around C$290) if they lived alone, NZ$264.37 (around C$221) if they were in a couple, and NZ$320.11 (around C$268) if they shared accommodation with others. There are currently around 10,000 VP recipients.
7
Information in this section is taken from the Law Commission of New Zealand, NZLC IP7 – Towards a New Veterans’ Entitlements Scheme: A Discussion paper on a Review of the War Pensions Act 1954, July 2008.
8
In the rest of the document, all amounts paid under the War Pensions Act 1954 [WPA] are from 2008.
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Veterans Under 65 Years
Veterans under 65 years of age qualify for the VP on a fundamentally different basis from those over 65 years. To qualify, a veteran must have had service in a war or declared emergency (similar except for a few differences to “special duty service” in Canada) and be truly incapable of undertaking employment permanently or for a substantial period. The inability to undertake employment does not have to result from a service-related disablement. The VP is awarded in place of the sickness or invalids’ benefit granted to other New Zealanders in similar situations (equivalent to the disability benefits of the Canada Pension Plan / Quebec Pension Plan). The rate of the VP is the same as that for veterans 65 years and older; however, it is reduced if the veteran receives employment income of NZ$80 a week or more (around C$67). 3.
Additional Benefits of the Veteran’s Pension
In New Zealand, individuals whose income is below a certain threshold are entitled to a card giving them free community services. For instance a couple without children can only receive a Community Services Card if their combined income is under approximately NZ$35,000 (around C$29,300). All VP recipients are entitled to this card, regardless of their income or age. Recipients of a Community Services Card do not have to pay the following fees:
a prescription fee of NZ$3;
a fee of NZ$15 for an after-hours doctor’s visit;
a fee of NZ$15 for a visit to a doctor who is not the veteran’s regular doctor;
glasses for children under eight years old;
emergency dental care provided by hospitals;
travel and accommodation for treatment by a specialist at least 80 km away when he or she has been referred by the family doctor; and
home help.
In New Zealand, if a person is in long-term hospital care for more than three months, their universal superannuation is reduced. There is no reduction for a veteran receiving the VP. When a recipient of the VP dies, his or her beneficiary receives a taxable lump sum payment, which in 2008 was NZ$5,102 (around C$4,268). When the spouse of a veteran dies, the veteran is entitled to a death benefit of NZ$3,890 (around C$3,255). Veterans who receive the allowance that the VP replaced in 1990 are entitled to a higher death benefit. A veteran who receives the VP and who lives alone is entitled to an additional payment of NZ$44 a week (around C$37). Where the veteran or his or her spouse is in permanent residential care, the other partner is also entitled to this allowance. Where a spouse receives the VP, the veteran may choose to include the spouse in the calculation of his or her VP. The veteran will receive an increased pension, but it is tied to the couple’s income and will be reduced if it reaches a certain threshold.
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C.
Pensions for Family Members
1.
Surviving Spouse/Partner Pension
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A pension is payable to the surviving spouse of a veteran if the veteran’s death occurred during service or if the veteran received permanent War Disablement Pension (WDP) of 70% or more. The amount of the survivor’s pension is NZ$134 (around C$112) a week. Payment of this pension ceases when the beneficiary enters into a new relationship, but it can be reinstated under certain conditions. 2.
Parent’s Allowance
Where the child of veteran is a dependent of the recipient of the surviving spouse/partner pension and is under 16 years (barring certain exceptions) a parent’s allowance may be paid. The amount of the payment is NZ$143 a week (around C$120) for the first child and NZ$23 (around C$19) for every additional child. 3.
Children’s Pension
A children’s pension is payable if one of the parents is a veteran receiving a 100% War Disablement Pension (WDP) or the veteran is deceased, on the same grounds as the parent’s allowance. The pension is NZ$8.41 a week (around C$7) and is paid until the child turns 16 or up until the child turns 23 if they are pursuing postsecondary education. An orphan’s pension also exists if both parents are deceased. 4.
War Bursaries
A war bursary may be granted to the child of a veteran who is deceased or who receives a War Disablement Pension (WDP) of 70% or more. The annual amount of the bursary for a child taking postsecondary studies is NZ$473 (around C$396). D.
Other Entitlements
1.
Attendant Allowance
An attendant’s allowance may be paid to a veteran in receipt of a 100% War Disablement Pension if the services of an attendant are determined by the Secretary for War Pensions to be indispensable to the veteran. The services covered by this allowance are similar to those offered in Canada under the Veterans Independence Program. The services are identified by a case manager and can include home help, lawn care, housework, meals and general help. The maximum allocation is NZ$337 a week (around C$282). This allowance can provide access to other benefits for long-term care. 2.
Other Allowances
Various other allowances can be paid to veterans:
medical care and equipment related to disabilities for which the veteran receives a War Disablement Pension;
clothing allowance;
decoration allowance;
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transport allowance to travel to medical visits;
travel and transport allowance for veterans with severe disablements;
loan to adjust a motor vehicle; and
a funeral grant of NZ$2,152 (around C$1,800) in addition to the death benefit.
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THE LAW COMMISSION’S RECOMMENDATIONS9 A.
General Principles and Recommended Scheme Structures
Two principles guide the Commission’s work:
As New Zealanders, veterans are entitled to all of the benefits, allowances and assistance to which every other New Zealander is entitled;
Veterans who have suffered as a result of being put in harm’s way deserve to be recompensed over and above the entitlements of ordinary citizens who are not veterans.10
The Commission identified seven key issues that highlight the need to overhaul the legislation, on which new programs and services that better suit the actual needs of veterans can be based. 1.
The WPA is outdated, and some of the changes made to it over the years do not make sense.
2.
It is focused on physical injuries and therefore poorly suited to the complex disabilities that modern veterans suffer from.
3.
The universal accident compensation allowance is more generous than the WPA, and not all veterans qualify for it. This violates one of the principles stated above.
4.
According to some veterans’ associations, current pension rates are not adequately indexed.
5.
There are unacceptable delays in the processing of claims.
6.
The Secretary for War Pensions, who is charged with the administration of the WPA under the general authority of the Minister of Veterans’ Affairs, has too much discretion.
7.
The WPA does not provide for rehabilitation, which is a critical focus in modern compensation schemes.
The Commission’s consultations and considerations led its members to recommend the introduction of two distinct schemes: Scheme 1, applying to veterans whose disabilities relate to service before 1 April 1974, and Scheme 2, which would be designed around modern principles of disability management to suit the needs of younger veterans, that is, veterans whose disabilities relate to service after 1 April 1974. In recognition of these new and unfamiliar schemes, the Commission recommended treating these new legislative measures as “living statutes” and including a provision requiring their periodic review in the legislation. 9
Unless stated otherwise, information from this section is taken from the Law Commission of New Zealand, NZLC R115 – A New Support Scheme for Veterans: A Report on the Review of the War Pensions Act 1954, May 2010.
10
Law Commission of New Zealand, NZLC IP7– Towards a New Veterans’ Entitlements Scheme: A Discussion paper on a Review of the War Pensions Act 1954, July 2008, p. 9.
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B.
Elements Common to Both Schemes
1.
Service Eligibility
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All operational service already recognized as qualifying under the War Pensions Act 1954 would qualify under the new legislation as well. In terms of future operations, Schedule Two would allow the Minister of Veterans’ Affairs, in consultation with the Chief of Defence Force, to declare other overseas deployments to be qualifying operational service. This decision would be made prior to deployment. Some military operations would be excluded if they do not correspond to a certain level of risk. 2.
Service-Related Impairment
a.
Connection Between Service and Impairment
The new legislation would continue to provide entitlements in respect of injury, illness or death that is “attributable to” or “aggravated by” service. The legislation should clearly define “attributable to” and “aggravated by” and stipulate that injury, illness or death can be indirectly attributable to or aggravated by service. Scheme 2 would exclude certain activities during a deployment that are a matter of personal responsibility, such as tobacco use. Under the previous scheme, tobacco use was considered indirectly related to service because it was expressly encouraged by military authorities during deployments. Sexually transmitted diseases would also be excluded. Injuries caused by sport would continue to be covered. b.
Evidential Standards
Most of Canada’s allies have difficulty establishing the standards of proof necessary to identify a connection between military service and a disability. Concepts such as “benefit of the doubt,” “reasonable inferences” and “undisputed facts” all imply that the person making the decision must exercise judgment in the face of the complex and wide-ranging situations that may arise. The potential for uncertainty and miscommunication convinced the Commission to include “decision-making instruments” in the legislation, which would help to rule out many of the subjective aspects of the decision-making process. Australia and the United States have already adopted similar practices, and the Commission drew from their approaches in developing its recommendations. It suggests introducing two types of instruments that would maintain a more relaxed standard of proof than other panels and would clarify the standards for causality between an injury or illness and military service:
Presumptive lists, which would set out the criteria for determining when it can be presumed that a specific illness is or is not service-related, and would greatly reduce the onus of proof for the veteran.
Statements of principles, which provide a complete list of service factors that link each type of injury or illness with service. For example, if there is a statement of principles for illness A, the veteran must meet one of the identified conditions for the claim to be accepted. For the claim to be refused, a non-service-related causal relationship must be proved beyond a reasonable doubt in the case of warlike service, and according to the balance of probabilities for peacetime service. Australia adopted this approach in 1994.
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Measuring Impairment
The Commission recommends adopting the U.S. model, which determines the level of whole-person impairment, rather than allowing disablement percentages to accumulate in excess of 100%. 3.
Decision-Making Structure
a.
Decision, Review and Appeal
The Commission recommends that claims panels be eliminated and that Veterans Affairs New Zealand make the initial decision on claims. There would be two types of review within the department, one for reviewing claims that are outside the statement of principles and another, conducted by a medical assessor, for reviewing the level of impairment. The Commission also recommends that a Veterans’ Appeal Tribunal be established, with the possibility of appeal to the High Court for matters of law. b.
Administration
(i)
Expert Medical Panel
The Commission recommends the creation of a permanent statutory panel composed of medical experts who would develop presumptive decision-making instruments and statements of principles. (ii)
Advisory body
The Commission recommends that the new legislation provide for a veterans’ advisory body to serve as a voice for veterans in dealings with Veterans Affairs New Zealand. C.
Scheme 1 (Service-Related Impairment Prior to 1974)
1.
Impairment Compensation
The Commission recommends that disablement pensions continue to be paid regularly. The maximum rate would be increased, and any new claim establishing an impairment of 80% or higher would receive this new maximum. The amount of the pension would no longer be calculated as a percentage of impairment multiplied by the maximum rate. There would be a sliding scale that would allocate a higher pension proportional to the level of impairment. The Commission also recommends an innovative approach: Once veterans reach age 80, the percentage of their disablement pension would become fixed and could not be reassessed. No new applications would be accepted for veterans aged 80 and over, but all veterans of this age group who are receiving a disablement pension, regardless of the level, would be entitled to a wide variety of medical services and independence support services. 2.
Income Support
Weekly income compensation would be available to veterans under the age of 65 who cannot work because of a service-related disability. It would be paid at 80% of the claimant’s income and would be equivalent to the universal accident compensation plan.
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All veterans aged 65 and over with qualifying military service would receive the veteran’s pension (see the section on the WPA) instead of the universal retirement pension, regardless of whether they receive a disablement pension. 3.
Health Care
There would be full coverage for all treatment costs related to accepted disabilities. All veterans aged 80 and over receiving a disablement pension would also receive broad health care assistance, regardless of whether their condition is service-related. 4.
Independence Assistance
In its recommendation to establish a Veterans’ Independence Programme, the Commission drew from the Canadian model but established different eligibility criteria. All veterans under the age of 80 and receiving a disablement pension would be eligible for all needs associated with a service-related disability. All veterans aged 80 and over would be eligible for the program, whether or not their needs are associated with a service-related disability. 5.
Rehabilitation
The Commission recommends that a full rehabilitation program be established for all service-related disabilities. 6.
Family Support
a.
Surviving Spouse Pension
If a deceased veteran was in receipt of a disablement pension, the surviving spouse would receive this pension, paid at a rate of 50%, for life. b.
Children’s Pension
The children’s pension would be maintained at the current rate specified in the WPA. c.
Education Bursaries
Education bursaries would be maintained at the current rate specified in the WPA. d.
Funeral Grant
The universal accident compensation plan covers reasonable funeral costs up to a limit of NZ$5,500 (about C$4,600). The Commission recommends that this grant be made available to the families of all veterans with qualifying operational service, whether or not they received a disablement pension or the death was service-related. e.
Psychosocial Support
The Commission recommends that a veteran’s spouse and children be able to receive psychosocial services and services under the Veterans’ Independence Programme in the year following the veteran’s death.
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D.
Scheme 2 (Service-Related Impairment After 1974)
1.
Rehabilitation
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The Commission recommends the creation of a rehabilitation program based directly on the Canadian model. As stated by the Commission, “Canada’s New Veterans Charter is the scheme that has moved the furthest towards promoting wellness. We have examined the Canadian scheme closely. We are impressed with the approach taken.”11 2.
Income Replacement
In the first year, veterans under the age of 65 who are unable to work and are participating in a rehabilitation program would receive weekly compensation at a rate of 100% of their earnings. If their requirement for rehabilitation extends beyond the first year, compensation would be paid at 85% of their earnings, while they continue to participate in rehabilitation and until they are able to return to work. Veterans eligible for income replacement for 10 years or more would also receive a lump sum retirement payment once they reached age 65. 3.
Impairment Compensation
The Commission recommends that compensation for pain and suffering related to impairment be made in the form of a lump sum payment. Currently, such payment is made under the universal accident compensation plan. One of the principles guiding the Commission’s work is that veterans should receive greater compensation than other New Zealanders, and so the Commission recommends that the lump sum be equivalent to 120% of the amount that would have been allocated under the accident compensation plan. 4.
Health Care
The terms and conditions would be the same as in Scheme 1. 5.
Independence Assistance
Scheme 2 would offer the same terms and conditions as Scheme 1 for all recipients of lump sum disablement compensation and veterans aged 80 and over. 6.
Transition Assistance
The Commission recommends that a transition assistance program be established similar to the Canadian and Australian programs. 7.
Recognition of Service for Senior Veterans
All veterans aged 65 and over with qualifying operational service would receive a veteran’s pension (WPA) instead of a universal retirement pension, regardless of whether they receive impairment pension.
11
Law Commission of New Zealand, NZLC R115 – A New Support Scheme for Veterans: A Report on the Review of the War Pensions Act 1954, May 2010, p. 193.
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Family Support
The Commission recommends the following support for families:
The surviving spouse of a veteran who dies within 10 years of the impairment being acknowledged would receive a lump sum compensation payment of NZ$20,000 (about C$16,730).
Spouses and partners of veterans whose death is service-related would receive income compensation at a rate of 60% of the veteran’s earnings. The entitlement would be extended if the spouse is caring for a dependent child under the age of 18.
The child of a veteran whose death is service-related would receive a lump sum payment of $5,000.
The children of a veteran whose death is service-related would each receive an equal share of 20% of the veteran’s earnings. The compensation would stop once the child turned 18.
The family or estate of a deceased veteran would receive the same grant for funeral expenses as under Scheme 1.
The family members of a deceased veteran would receive services under the Veterans’ Independence Programme in the year following the veteran’s death.
PREPARED FOR THE SENATE SUBCOMMITTEE ON VETERANS AFFAIRS
INTERNATIONAL COMPARISON OF PROGRAMS FOR VETERANS: CANADA AND UNITED KINGDOM
Jean-Rodrigue Paré Aboriginal Affairs and Social Development Section Parliamentary Information and Research Service 10 February 2014
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SUMMARY COMPARISON BETWEEN THE MAIN VETERAN SUPPORT PROGRAMS IN THE UNITED KINGDOM AND CANADA In the United Kingdom, veterans’ programs are the responsibility of the Parliamentary Under Secretary of State and Minister for Defence Personnel, Welfare and Veterans, the Honourable Anna Soubry.. She heads the Service Personnel and Veterans Agency, under which Veterans U.K. consolidates veterans’ programs and services. There are two separate statutory schemes for veterans. The War Pension Scheme (WPS), which applies to disability and death resulting from military service prior to April 2005, is defined within The Naval, Military and Air Forces Etc. (Disablement and Death) Service Pensions Order 2006. Most of the articles currently in force were adopted in 1947. In the late 1990s, a review of the scheme noted that a number of benefits introduced by social legislation following the coming into force of the WPS had similar objectives. It was also noted that a new scheme was needed to implement modernized support measures oriented toward increased capacity and empowerment. 1 This led to the adoption of The Armed Forces and Reserve Forces (Compensation Scheme) Order 2005, known as the Armed Forces Compensation Scheme (AFCS), which applies to disability and death resulting from military service after April 2005. The most controversial aspect of this new scheme was the creation of a lump sum disability award to replace the disability benefit. This award is paid out in accordance with a predetermined list of possible disabilities covering a range of 15 tariff levels. In 2008, the maximum lump sum award was doubled retroactively from £285,000 to £570,000 (roughly C$900,000). WPS or AFCS pensions and awards are excluded from the calculation of other government benefits. There are many interactions between the awards under the two schemes and benefits provided through other social programs. A full review of the AFCS was undertaken in 2010, resulting in recommendations on about 15 issues. The government accepted them all and began implementing them.2 During the same period, the U.K. government issued the Armed Forces Covenant, setting out its commitment to current and former service members, to which were added two other covenants: one with businesses and charitable organizations and the other with communities. The following comparisons are based on research into a large number of documents and information sources.3 Unless indicated otherwise, amounts provided were as of 2013. This comparison focusses on the key features of both countries’ programs. There are many programs that are of more limited scope or are available to veterans but not designed specifically for them. Measures specifically to support veterans’ families had to be excluded given their complex interactions with other government programs. Generally, programs for veterans are wholly or partially transferable to spouses or children in the event of death, although there are few measures, either in Canada or in the U.K., specifically geared to the family members of veterans with a disability. This document is therefore limited to providing an overview of the key programs in place based on the relevant perspectives that have shaped debate in Canada’s Parliament in recent years. Acronyms: AFCS (U.K. Armed Forces Compensation Scheme), NVC (New Veterans Charter), SISIP (Service Income Security Insurance Plan), VAC (Veterans Affairs Canada), WPS (U.K. War Pension Scheme).
1
UK Ministry of Defence, “UK Service Injury and Death Compensation Schemes,” 2008.
2
UK Ministry of Defence, The Review of the Armed Forces Compensation Scheme, February 2010.
3
All relevant references are available on request. Including them would have made the table significantly more cumbersome.
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Health Care (1) United Kingdom
Canada Comments
Before April 2005 Medical care
Mental health
Since April 2005
Before April 2006
Since April 2006
Since 2008, all veterans are entitled to preferential treatment in the National Health Service for any condition potentially related to their service. Before, only war veterans were eligible. For equivalent clinical care, veterans are seen more quickly.
All medical treatment for a condition that qualifies a veteran for a pension or disability award is covered by the federal government.
• Veterans and Reserves Mental Health Programme:
Since 1998, 17 operational stress injury clinics have opened, jointly operated by VAC and the Department of National Defence.
Veterans deployed since 1982 may, on request, be assessed by a consultant psychiatrist from the centre in Chilwell, Nottingham, who will provide any guidance required to the attending physician. • Veterans Mental Health Pilot Scheme: A project developed in six regional health centres, providing a hub of veterans’ mental health expertise when this expertise is not easily accessible locally. This allows specialists to provide guidance to local medical teams. The U.K. government signed a cooperation agreement with the community organization Combat Stress to provide local services: an emergency hotline, support and referrals, in-home services, rehabilitation centres and peer support.
For a monthly contribution, veterans in a rehabilitation program (VAC or SISIP) are eligible for the Public Service Health Care Plan, but not the Dental Care Plan.
Peer support groups. Specialty providers are starting to be developed, particularly with initial financial support from the Royal Canadian Legion.
Substantially equivalent. Provincial responsibility over health care makes comparisons difficult.
Services have been expanded significantly in Canada over the past 10 years. In the U.K., national responsibility over the health care system led to the development of a more structured community-based network.
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Health Care (2) United Kingdom
Canada Comments
Before April 2005 Medical and psycho-social rehabilitation
Since April 2005
Services are available through the National Health Service, and third-party specialist services are available if needs involve a servicerelated injury. Participation in a rehabilitation program is not required in order to qualify for income replacement measures. Recently, prosthetic services for amputees must be provided to veterans at the same quality as those provided to members of the armed forces.
Independent living
• In the U.K., there are two types of independent living support measures: 1) government services – particularly the National Health Service – available to all seniors and people with disabilities; and 2) services delivered by community agencies geared mainly to veterans. Services available vary widely, depending on the local council; it is difficult to describe them adequately. However, they are generally organized as follows: when the need involves a service-related medical condition, the government covers the cost in full, or at least at a percentage greater than for the general population. When the need is not service-related, veterans receive the same level of care as the general population, although they may receive specialized services delivered by community agencies.
Before April 2006 Before 2006, services were available on request once the disability benefit eligibility process was completed. This process had veterans focus more on proving the extent of their disability rather than promote quick rehabilitation.
Since April 2006 Since 2006, participation in a rehabilitation program is required in order to receive earnings loss benefits. Specialist services are provided by third parties listed on a national registry of authorized providers.
In 2010, following a comparison of programs in various countries, New Zealand’s Law Commission stated that Canada’s approach was the one most likely to promote veteran wellbeing.
Since the late 1970s, the federal government has been delivering services under the Veterans Independence Program (VIP), which was developed to cut long-term care waiting lists by enabling veterans to stay at home. Low-income veterans and those who qualify for a disability benefit or award are entitled to an allowance or reimbursement for grounds maintenance, housekeeping, personal care, access to nutrition, and home care. This program supplements provincial social services.
Comparison is difficult given the particulars and local variations in the British community system.
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Health Care (3) United Kingdom
Canada Comments
Before April 2005 Long-term care
Since April 2005
Long-term care in the U.K. is highly decentralized. Usually, municipalities, community organizations and private businesses have established centres in communities, and local councils are responsible for certifying that the quality of services meets national standards. The government covers the cost of care involving a service-related medical condition. Major reform of public funding for long-term care will come into effect in 2017.
Before April 2006
Since April 2006
Long-term care is covered (up to a limit) by VAC in certain provincially run facilities. Veterans of the Second World War and the Korean War can access beds set aside in some of these facilities if the need is servicerelated, or if they have severe disabilities, regardless of service. Other veterans can access community beds in provincial facilities if the need is service-related.
Equivalent
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Career Transitioning (1) United Kingdom
Canada Comments
Before April 2005 Vocational rehabilitation/ training
• Enhanced Learning Credits:
Career transition counselling
• Career Transition Partnership:
During their career, current service members earn credits for higher learning that may be used up to 10 years following release. The program provides a maximum of £2,000 per year for as many as three years to veterans with at least eight years of service, and £1,000 to veterans with at least four years of service or who are medically released. Other smaller-scale programs are also available.
Since April 2005
Before April 2006
Since April 2006
Adoption of the Armed Forces Covenant in May 2011 extended the available coverage. Vocational training and approved higher learning programs are now available free of charge to medically released veterans.
Before 2006, for veterans who enrolled after the Korean War, training and vocational rehabilitation costs were covered by SISIP up to a specific limit depending on the type of activity, and usually for a maximum of two years. Any medically released veteran, whether or not the medical condition was service-related, was eligible.
The vocational rehabilitation program introduced under the NVC prolongs the SISIP program by expanding eligibility to veterans who continued to require support following completion of the SISIP program and to veterans who were not medically released but whose needs became apparent following release. The program is administered by a third party, CanVet. The rules were relaxed in 2013, and all vocational rehabilitation expenditures are captured in an envelope up to a maximum of $75,800 for the program’s duration.
Vocational rehabilitation is included in the comprehensive rehabilitation plan for Canadian veterans since 2006. As participation in the program is an eligibility requirement for earnings loss benefits, veterans with a service-related medical condition have a greater incentive to participate in vocational rehabilitation.
The SISIP program provides professional counselling programs to medically released veterans.
The career transition program that came into effect with the NVC in 2006 was based on the U.K. program, but it has not been as successful. The contract between VAC and Right Management was not renewed in 2013. Since October 2013, veterans may apply for reimbursement of up to $1,000 for career transition services.
The extensive community support network for veterans in the U.K. and employer involvement in the Armed Forces Covenant mean more effective career transition support than in Canada.
Administered by Right Management since 1998, this program has been very successful in the U.K.. It gives all veterans access to a vast database that can match their skills with those sought by registered employers. In addition to this matching service, the program also delivers a full range of counselling and job search services.
LIBRARY OF PARLIAMENT
Financial Compensation for Pain and Suffering (1) United Kingdom
Canada Comments
Before April 2005
Since April 2005
Before April 2006
Burden of proof
The ministry must prove beyond a reasonable doubt that the disability is not service-related if the application is received within seven years following end of service.
The balance of probabilities applies to the causal relationship, meaning that the applicant must demonstrate that the disability was caused primarily by military service.
Balance of probabilities. The burden of proof falls on the veteran, although if there is nothing to contradict the veteran’s claim, the benefit of the doubt applies.
Assessment of the extent of disability
Disability table ranging from 20% to 100% based on a medical assessment.
Predetermined list of disabilities that may be caused by military service, on a scale of 15 tariff levels listing eligible disabilities.
Table of disabilities from 0 to 100%, based on a medical assessment.
Appeals process
Veterans who are not satisfied with decisions by Veterans U.K. may appeal them to the Pensions Appeal Tribunal and then further appeal on a question of law at a higher level to the Pension Appeal Commissioners.
•
Since April 2006
Veterans Review and Appeal Board (VRAB):
The applicant may first request a review by the department. Once the decision is made, a request for a review may be submitted to VRAB. Once the review decision is made, the applicant may apply to a jury of appeal, whose decision is final. If the veteran believes there has been an error of law, the decision may be challenged in federal court, which could call on VRAB to review the application. Free legal support is available up to the VRAB appeal stage.
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Financial Compensation for Pain and Suffering (2) United Kingdom
Canada Comments
Before April 2005 Compensation amount
Since April 2005
For disabilities between 1% and 20%, a lump sum payment is made based on the disability up to £10,373.
Lump sum based on one of 15 tariff levels of severity corresponding to the veteran’s specific disability.
For disabilities between 20% and 100%, a non-taxable monthly disability pension for the annual amount of £8,756 multiplied by the percentage of disability. Additional amounts may be added to the basic pension, depending on the severity of the disability, inability to work, age, and daily at-home care required. See “income replacement” below, as well as the complete list of pension and allowance amounts.
In 2008, the Ministry of Defence doubled the maximum lump sum amount from £285,000 to £570,000 (roughly C$900,000).
Before April 2006
Since April 2006
Non-taxable monthly disability benefit for disabilities of 5% or greater.
Lump sum based on the veteran’s percentage of disability.
The annual amount for 2014 is the percentage of disability multiplied by $31,400, plus $7,850 for a spouse, plus $4,082 for the first child, $2,983 for the second child and $2,355 for each additional child.
The maximum amount for 2014 is $301,275.
In virtually all cases, the lump sum paid in the U.K. since 2005 is significantly higher than in Canada.
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Income Replacement (1) United Kingdom
Canada Comments
Before April 2005 • Unemployability Supplement: For veterans with a disability of 60% or greater, a non-taxable annual amount of £5,408 for a single person is added to the basic disability pension (an additional £3,006 for a spouse; an additional £699 for the first child and an additional £822 for subsequent children). At 65, veterans must choose between continuing to receive the supplement and receiving their armed forces retirement pension. • Age Allowance: Annual supplement if the disability qualifying the veteran for the Unemployability Supplement occurs before the age of 40, 50 or 60 (£1,072, £694 and £347, respectively). • Lower Standard of Occupation: For veterans with a disability of 40% or greater that limits their vocational capacities. Support of last resort is available to low-income veterans. See the complete list of pension and allowance amounts.
Since April 2005
Before April 2006
The Armed Forces Compensation Scheme provides veterans whose disabilities are in the 11 most severe tariff levels out of 15 with an indexed, nontaxable Guaranteed Income Payment (GIP).
For medically released veterans, whether or not the condition is service-related, SISIP provides disability insurance equivalent to 75% of annual pay (minimum of $42,426) during the first two years following release. If the veteran is assessed as having a total and permanent incapacity, payments continue until the veteran is 65. If the incapacity is service-related, insurance premiums are covered 100% by the federal government, and 85% in other cases.
GIP is payable for life, regardless of any other income sources for which the veteran qualifies, and takes into account the veteran’s age and severity of disability. For example, a 25-year-old veteran with a disability assessed at one of the top four tariff levels will receive 100% of his salary multiplied by the age factor 0.909, meaning that he is guaranteed to receive a lifetime non-taxable allowance equivalent to 90.9% of his salary. A 55-year-old veteran with the same disability will receive a lifetime allowance equivalent to 72.2% of his salary.
Support measures for lowincome veterans.
Since April 2006 SISIP (see left column) • Earnings Loss Benefit (ELB): While ELB provides the same coverage as SISIP disability insurance, the eligibility criteria are more flexible. Veterans who were not medically released but later show symptoms of a medical condition possibility related to their service may qualify for ELB if they participate in a department-approved rehabilitation program. As well, veterans who, after receiving SISIP benefits for two years, do not have a total and permanent capacity but continue to have difficulties may receive ELB if they participate in a departmentapproved rehabilitation program.
If measured as lifelong compensation, Canadian SISIP/ELB benefits are generally less generous than the British GIP for severely injured veterans, particularly if they become disabled at a young age. Although the SISIP/ELB annual amount might greater than GIP for veterans with less severe injuries, eligibility ends once the Canadian veteran is able to work or turns 65, whereas GIP is payable for life to the British veteran.
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Financial Support for Severe Disabilities (1) United Kingdom
Canada Comments
Before April 2005
Since April 2005
• Unemployability Supplement (see above)
• Armed Forces Independence Payment (since April 2013):
• Constant Attendance Allowance (disability of 80% or greater)
£134/week, non-taxable and regardless of other sources of income. Eligible if GIP is 50% or greater.
Before April 2006 •
Attendance Allowance:
• Severe Disablement Occupational Allowance
This allowance is payable to any veteran receiving a disability benefit, regardless of percentage, and who is totally disabled. In other words, the veterans must have a servicerelated disability, although this disability may be minor and does not necessary have to be the cause of the total disability. The maximum non-taxable annual amount is $20,777.
• Treatment Allowance
•
For details about these allowances, see the complete list of pension and allowance amounts.
A non-taxable allowance of $16,622/yr. for veterans with a disability of 98% or greater.
• War Pensioners’ Mobility Supplement • Exceptionally Severe Disablement Allowance
Pax Insurance Scheme: optional private insurance coverage.
•
Exceptional Incapacity Allowance:
SISIP Accidental Dismemberment Insurance Plan:
Non-taxable lump sum of up to $250,000 for catastrophic physical injuries (mental disorders are excluded from coverage).
Since April 2006 • Permanent Impairment Allowance / Supplement: A monthly taxable allowance payable to veterans with the most severe forms of total disability. The annual amount varies depending on three degrees of severity, up to a maximum of $20,696. An annual supplement of $12,684 may also be payable. Eligibility criteria for the allowance and supplement are complex. • SISIP Accidental Dismemberment Insurance Plan: Non-taxable lump sum of up to $250,000 for catastrophic physical injuries (mental disorders are excluded from coverage).
Comparing the various support programs for severe disabilities is made difficult by the fact that eligibility criteria are often set out in internal policies that limit or expand eligibility. The lack of transparent eligibility criteria for the Permanent Impairment Allowance has been well documented since the NVC was rolled out in Canada, while in the U.K., many veterans have complained about restrictions in the definition of inability to work in order to qualify for the Armed Forces Independence Payment.
