INFORMATION ABOUT VAC PENSION ASSESSMENTS/MENTAL HEALTH CLAIMS

In her years of experience working with CAF members, Dr. Ellwood has been saddened to view so many pension assessment reports (through review of patient history and reassessment claims) that were done with undeniable carelessness - where the goal was clearly to have the minimum requirements of the report completed as quickly as possible. This can lead to denial of a legitimate claim because of lack of explanation of diagnosis or service-relatedness (versus other origins of onset), or an approved claim with inappropriately low associated disability rating because of lack of detail provided. It also contributes to unhelpful narratives about VAC themselves as an organization, when in reality they are so often given insufficient information to clearly understand the relationship between your mental health and your service. 

One of the main benefits of having Dr. Ellwood complete your Medical Questionnaire is that if a service-related condition is present, Dr. Ellwood provides high-quality, detailed reports that use the terminology needed for VAC to adequately understand your condition and rate your associated level of disability. A history of providing Independent Medical Examinations for use in insurance litigation has helped inform her approach. Dr. Ellwood has an excellent record for claim approval when a service-related condition is present. 

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If you have a VAC-pensioned mental health condition, you have annual coverage for psychology services. VAC can also approve you for reassessment if you feel your condition has worsened or was under-appreciated in your first assessment, usually after a specified time period following previous assessment. If you initiate a VAC mental health claim, you have two years of coverage (date specified in your letter of eligibility) that you can use for assessment and treatment. 

There are a number of things to consider ahead of scheduling an appointment for a VAC pension assessment/mental health claim/Medical Questionnaire completion. Firstly, you must have already had your claim initiation approved and received the related documents from VAC. Your assessment must be completed within your two-year eligibility period or there is no payment available for billing. Dr. Ellwood will confirm these details with you ahead of your appointment, to ensure that VAC is indeed prepared to pay for your assessment. When VAC is invoiced for the assessment and report, that makes them the primary client and Dr. Ellwood is ethically obligated to provide opinion about any presence of full-syndrome mental health condition and its relationship to your service experiences. This may also include any relevant history that was pertinent to the resulting opinion. 

Similar to any psychological assessment, it is a possibility that there is no mental health disorder present. This does not mean your service has not impacted you, but that you would not qualify for a mental health pension intended to compensate financially for regular functional impairment. All patients being assessed by Dr. Ellwood are fully debriefed about the findings at the end of the clinical interview. Even if there is no full-syndrome condition present, assessment can help identify risk factors for syndrome development, isolated symptom treatment recommendations, and guidance for any use of your benefits throughout your eligibility period. 

If you are considering opening a mental health claim with VAC, the following can be helpful in determining if you are likely experiencing a diagnosable condition (please remember VAC will also be considering the relationship to your service):

• persistent sleep loss that results in functional impairments in the areas of employment/daily activity/mood/family relationships
• persistent intrusive memories that generate significant, sustained distress or impairments in behaviour
• persistent avoidance behaviours that interfere with life satisfaction/functioning 
• persistently low mood or low motivation, lack of pleasure/positive emotion
• persistent anger issues that generate problems in your life
• persistent, overwhelming worry, nervousness, or inability to relax that generates distress or impairment in social/employment/leisure/community functioning
• regular panic attacks that inform fear of future attacks and/or avoidance behaviours
• persistent reliance on alcohol, cannabis, or another substance that generates distress or impairments and may reflect a Substance Use Disorder (these conditions in early or sustained remission can also be eligible for VAC acknowledgment)

It is normal to have memories of your service that continue to generate normative and congruent emotional responses (sadness, anger, etc.). This alone is unlikely to indicate the presence of a mental health disorder. Consider also the level of distress experienced when you're reminded, the duration of that distress and/or impairment, and whether you experience other symptoms like: mood problems, sleep problems, problems related to restricted behaviours/avoidance, irritability/anger, or hypervigilance, as some examples. 

Dr. Ellwood is happy to provide Veterans a 15-minute no-cost consultation to help determine if there are indeed symptoms present that suggest it is reasonable to move forward with a VAC mental health claim. These can be scheduled through the VPS online booking platform.

You can also find information relating to these claims and processes directly from VAC here: https://veterans.gc.ca/en/financial-programs-and-services/compensation-illness-or-injury/disability-benefits