Disability Pensions

Pensions

• Who Qualifies?

  The following groups of persons may apply for Disability Pensions:

  • Still serving and former members of the Canadian Armed Forces
  • Merchant navy Veterans who participated in high seas voyages during WWI, WWII and Korea
  • Civilian merchant seamen and Salt Water fishermen and other eligible civilians, who served in close support of Canada's Armed Forces in WWII
  • Still serving and former members of the Royal Canadian Mounted Police
  • Surviving spouses and dependants of the above

• Entitlement or Eligibility for a Disability Pension

  For Military Service:

  Pension entitlement may be awarded for death, disability or the aggravation of a pre-enlistment condition which:

  1. Was incurred during or was attributable to military service in -
     
     • WWI or WWII
     • Korea
     • A special Duty Area such as Egypt, Cyprus, the Persian Gulf etc., during specified period;
  2. Arose out of or was directly connected with or aggravated by military service in peacetime - Regular or Militia (Reserve);
  3. In addition to any pension awarded under a) and/or b), if the member of the forces suffers an additional disability that is in whole or part a consequence of the pensioned primary condition, a pension can be awarded for the consequential condition.

  It is important to note that the rules for establishing entitlement to a pension for wartime and Special Duty claims are different than for peacetime claims. To establish entitlement for wartime claims or for service in a Special Duty area, one only need show that the disability or condition was incurred or had its onset during wartime or Special Duty area service. This is referred to as the Insurance Principle and means that for certain periods of service, a disability resulting from an injury or disease is pensionable if it was either attributable to or incurred during that period of service.

  On the contrary, for peacetime claims one must show that the condition arose or was directly connected with or aggravated by military service in peacetime.

   

  For Merchant Navy Service

  A Merchant Navy Veteran's disability must be related to service in the First or Second World Wars or Korean War while on high seas voyage.

  From the moment a Merchant Navy Veteran, having made an agreement for service, sets foot on a high seas voyage to the point of disembarking the ship at the end of the voyage, he is covered by the insurance principle for death or disability. This includes loading or preparing a ship for a high seas voyage.

   

  Civilian War Service:

  Pension entitlement may be awarded for death, disability or aggravation of a pre-enlistment condition arising out of service during World War II for any of the following:

  1. Canadian Merchant Seaman and Salt Water Fishermen
  2. Auxiliary Services Personnel
  3. Corps of (Civilian) Canadian Fire Fighters for Service in the United Kingdom.
  4. Royal Canadian Mounted Police
  5. Royal Canadian Mounted Police - Special Constables
  6. Air Raid Precautions Workers
  7. Personnel receiving remedial treatment while serving under the National Resources Mobilization Act
  8. Members of the Voluntary Aid Detachment
  9. Overseas Welfare Workers
  10. Canadian Civilian Air Crew of the Royal Air Forces Transport Command

  The basis for granting entitlement in respect of the aforementioned is more exacting than for awards of the armed forces.

• Applications

  Initial applications or re-applications for claims which were denied prior to 1971 are called first applications and the decision is called a first decision. If the first decision is unfavourable, the applicant or his/her representative may request a review of the previous decision on the basis of new evidence.

• Assessment

  Entitled conditions will be assessed on a percentage basis from nil to 100% in accordance with the degree of disability found on medical examination and in accordance with a Table for Disabilities and medical Guidelines established.

  If the assessment is less than 5%, no monthly pension is payable but a lump sum payment is awarded based on the percentage determined. The applicant would nevertheless be eligible to receive reimbursement for all treatment needs related to the award.

• Reviews & Appeals

  An applicant, whose claim to entitlement is denied, may request a review by an Entitlement Review Panel of the Veterans Review and Appeal Board (VRAB).

  The VRAB is an independent Board which reports to the Minister of Veterans Affairs. An applicant may make a written submission to the Review Panel or appear before it, in person or by representative to present evidence, oral testimony, and arguments.

  Two members of the VRAB sit as members of the Review Panel and come to a new decision based on the evidence presented.

  An applicant may also appeal the amount of any award before an Assessment Review Panel, also made up of two members from the VRAB. The applicant has the opportunity to present evidence in support of an increased assessment.

  The Provincial Service Officer, in conjucnction with a lawyer form the Bureau of Pension Advocates, will prepare and present entitlement or assessment review claims.

  An applicant who is dissatisfied with the decision of a Review Panel may further appeal to an Appeal Panel of the VRAB. The Appeal panel consists of a Chairman and two members and it is the final authority on matters of pension entitlement, the amount of the Pension award and the interpretation of pension legislation. The panel is not limited to an examination of material already submitted in support of a claim but may consider new evidence. Argument may be presented at the appeal but no oral evidence may be given by the applicant or witnesses. Service Officers from Dominion Command in Ottawa prepare and present appeals to the Veterans Review and Appeal Board on behalf of applicants who choose the Legion to represent them at this level. While the VRAB is normally the last body of appeal, the applicant may request a reconsideration of a negative decision with presentation of new information.

• Medical Reviews

  Following a favourable ruling or concurrent with an application which results in a favourable first decision, the pensioner is examined by a Veterans Affairs Doctor or by an authorized medical examiner to assess the degree of disability and amount of pension thereby payable.

  The date of the next pension examination is normally determined by the Department. A pensioner may request a review of the assessment for his/her pensioned condition by contacting Veterans Affairs. Normally, there will be no re-examination until two years has elapsed since the last pension examination (or three years has passed since an assessment board hearing) unless there has been a worsening of the condition, confirmed in writing by the pensioner's physician. The Department may increase the assessment for the condition when it is determined that the condition has worsened. Conversely, if the condition has improved, the assessment may be reduced. However, pension policy states that when a pensioner reaches age 55 and his pensioned condition has been at the same rate of assessment for 3 years or more, then the assessment is stabilized and cannot be reduced, even if the state of the stabilized condition(s) improves.

• Additional pension for Spouse and Children

  Additional pension may be awarded on behalf of a legal or a common-law spouse (of one year or longer) and dependent children, if they are living with or being maintained by the disability pensioner and the assessment is 5% or more. Under certain circumstances, additional pension is paid to separated spouses. Additional pension for children is paid until age 18 and between age 18 and 25 if the child is in full-time attendance at school.

  A pension may be paid on behalf of an incapacitated child if the disability occurred prior to the child's 21st birthday and if the child is without adequate means to support himself.

• Additional Pension for other Dependants

  In some circumstances, dependent parents, brothers and sister may be eligible for pension.

• Survivors Benefit

  Following the death of a pensioner, married rate, together with Attendance Allowance and/or Exceptional Incapacity Allowance, is continued for one year.

  After one year, the pension is reduced to a Survivor's pension. There are two types of pensions for surviving spouses, full pension and proportionate pension.

  A full widow/er's pension is paid if the pensioner was receiving a disability pension of 48% or higher or if the death was attributable to the pensioned condition or military service.

  A proportionate pension is paid is the pensioner's disability was assessed between 5% and 47% and amount to ½ of the disability pension in pay at the time of death.

  A widow/er continues to qualify for Survivor's Widow/er's Pension even on remarriage. Prior to June 1989, pension was terminated if the widow/er remarried. As a Veterans Services Chairman you may from time to time encounter a remarried widow/er who is entitled to the restoration of pension as a result of the 1989 legislation.

  Dependent children may also qualify for survivor's benefits.

• Posthumous Claims

  The Pension Act provides for the submission and subsequent appeal of posthumous claims and the appeal of claims undergoing adjudication at the time of the applicant's death.

  A widow/er can also apply for an increase to the assessment of the late pensioner's pensioned condition.

• Imperial Veterans

  Pension enquiries should be forwarded to the Provincial Service officer, utilizing the completed Legion Claim Form.

• Other Benefits

  Other Benefits which may apply to Disability Pensioners and/or are provided under the Pension Act

  1. Attendance Allowance

     For pensioners of 1% or more and persons in receipt of POW compensation who require attendance or assistance with activities of daily living because of a disabling condition,. The amount of the allowance is based on the degree of attendance required and the disabling condition does not have to be related to the pensionable disability. Veterans in receipt of a Prisoner of War Compensation only are now entitled to receive attendance allowance, if the need exists.

  2. Exceptional Incapacity Allowance

     The Pension Act provides for the award of an Exceptional Incapacity Allowance to a pensioner who is in receipt of a 98% pension OR MORE and who is suffering an exceptional incapacity as a result of his pensioned condition(s). In determining whether the incapacity if "exceptional", the Commission must take into account four factors: helplessness, continuing pain and discomfort, loss of enjoyment of life and shortened life expectancy. Persons in receipt of POW compensation only may also now qualify for Exceptional Incapacity Allowance.

  3. Clothing Allowance

     The Pension Act provides for the award of Clothing Allowance to a pensioner who is pensioned for an amputation or a condition which requires the wearing of an appliance or causes wear and tear on clothing. Clothing allowance may be awarded with respect to soiling of clothing caused by the treatment of a pensioned condition or the pensioned condition itself.

  4. Funeral and Burial Assistance

     May be applicable when a pensioner dies.

  5. Gallantry Awards

     These are paid under the Gallantry Gratuities and Annuities order to anyone who holds any of the awards mentioned in the Order.

  6. Supplementary Benefits for Allied Veterans

     Benefits of the Pension Act may be extended to veterans with service in the forces of the United Kingdom, if they were domiciled in Canada at any time during the four years preceding WWII, or domiciled in Canada at the commencement of WWI. The same benefits may be extended to members of the Forces of allied countries under the same conditions. In each case, the veteran must apply first to the country in whose forces he/she served.

  7. Prisoner of War (P.O.W.) Compensation

     The Pension Act also provides for Prisoner of War Compensation. It covers those who were either prisoners of war or evaders in either World War I or World War II. To qualify, a veteran must have been a P.O.W. for at least 30 days. The amount of compensation paid is dependent upon the total number of days of incarceration.

  8. Treatment

     A disability pensioner is entitled to medical treatment for a pensionable disability as required. A Blue Cross Card is issued specifying which programs are available and the benefits received must relate to the pensioned condition.

     Special treatment allowances may be paid when the pensioner is an inpatient or under treatment as an outpatient for the pensioned condition.

     Treatment for conditions other than the pensioned condition(s) is not provided to a pensioner unless he/she is also qualified on the basis of income or receiving benefits under the Veterans Independence Program.

• Admission to a Contract Hospital

  Veterans have priority access to contract beds held by Veterans Affairs Canada at the following facilities:

  • Parkwood Hospital
  • Perley / Rideau Veterans Home
  • Sunnybrook & Women's College Health Science Centre
  • There are a number of priority access beds designated by VAC throughout Ontario and VAC staff can provide information on these beds.

  Admission to a contract bed is based on service and assessed level of care required. The service requirements for admission to a contract bed are the same as those required for the War Veterans Allowance Program. However, income is not a factor in determining if a veteran is eligible to enter a contract bed. Veterans are required to pay a Board and Lodging fee unless they are admitted as a result of their pensioned condition. This rate may be lower if the veteran's income and/or domestic status qualifies him/her for a reduced rate.

  Veterans who reside in a contract facility are covered for most general health benefits, which are not available under a provincial program.

  Veterans who wish to apply to Veterans Affairs contract bed should contact their local Veterans Affairs Counsellor for assistance.