Veterans Health Care Regulations (SOR/90-594)

• 10 (1) A treatment allowance is payable at a rate that is equal to the difference between the monthly pension paid to the client, including any additional pension paid for a spouse or common-law partner or dependant of the client, and the amount that the client would receive were the client in receipt of a class 1 pension under Schedule I to the Pension Act.

• (2) A treatment allowance is payable for a maximum of 60 days in any calendar year.

• (3) Notwithstanding subsection (2), the Minister may authorize the payment of a treatment allowance to a client for more than 60 days in a calendar year if a medical assessment indicates the client’s need for acute care.

11 and 12 [Repealed, SOR/95-440, s. 5]

Miscellaneous Benefits

• 13 (1) Where the Minister requests that a person undergo a medical examination in order to establish that person’s entitlement to any benefit, service or care, the person is eligible to receive

  • (a) reimbursement of the cost of the examination incurred by the person; and

  • (b) reimbursement of the costs of travel incurred by the person in respect of the examination, in accordance with section 7.

  • (c) [Repealed, SOR/95-440, s. 6]

• (2) Where the Veterans Review and Appeal Board requests that a person undergo a medical examination, the person is eligible to receive

  • (a) reimbursement of the cost of the examination incurred by the person;

  • (b) reimbursement of the costs of travel incurred by the person in respect of the examination, in accordance with section 7; and

  • (c) a treatment allowance payable in accordance with section 10 if the person is a client referred to in section 9 and is hospitalized in order to undergo the examination.

• (3) Subsections (1) and (2) do not apply in respect of a medical examination required under the Veterans Well-being Act.

• (4) The following clients are eligible to receive treatment benefits and supplementary benefits for a period that is equal to the shorter of one year and the total period of service of the client:

  • (a) veteran pensioners, special duty service pensioners and military service pensioners, if they take a course of training under the Pensioners Training Regulations; and

  • (b) veteran pensioners whose war-related pensioned condition is blindness, if they take a course of rehabilitative training in respect of blindness.

Mental Health Benefits

14 The following definitions apply in sections 14.1 to 14.5.

Canadian Forces

Canadian Forces means the armed forces referred to in section 14 of the National Defence Act and includes any predecessor naval, army or air forces of Canada or Newfoundland. (Forces canadiennes)

disability benefits

disability benefits means

• (a) a pension awarded under section 21 of the Pension Act on account of a disability; or

• (b) pain and suffering compensation paid under subsection 45(1) of the Veterans Well-being Act. (prestations d’invalidité)

mental health benefits

mental health benefits means the benefits referred to in section 14.2. (avantages pour la santé mentale)

mental health client

mental health client means a person who meets the requirements of section 14.1. (client en santé mentale)

• 14.1 (1) A former member of the Canadian Forces or a reserve force member is eligible to receive mental health benefits in Canada or elsewhere in respect of any mental health condition for which they submit an application for disability benefits to the extent that those benefits are not available to them as a former member of the Canadian Forces or a reserve force member nor available as an insured service under a provincial health care system.

• (2) For the purposes of subsection (1), a mental health condition means one or more of the following psychiatric conditions:

  • (a) an anxiety disorder;

  • (b) a depressive disorder;

  • (c) a trauma- and stressor-related disorder.

14.2 Mental health benefits consist of the following:

• (a) any examination or treatment provided by a psychologist, mental health counsellor or therapist, social worker or other professional approved by the Minister; and

• (b) pharmaceuticals prescribed by a physician or other person authorized to prescribe pharmaceuticals under the laws in force in the province or the country where the pharmaceuticals are provided.

• 14.3 (1) Where mental health benefits are provided in Canada, the rate at which the mental health benefits and any related administrative costs are payable is

  • (a) where the mental health benefits are fully insured health services of the province in which they are provided, the rate established by the province for those services and costs;

  • (b) where the mental health benefits are not fully insured health services of the province in which they are provided and, in respect of that province, an association of health professionals has adopted a fee schedule for treatment benefits and costs, the rate that is approved by the Minister and that is based on that fee schedule; and

  • (c) in any other case, the rate normally paid for those mental health benefits and costs in the community in which the mental health benefits are provided.

• (2) Where mental health benefits are provided in a country other than Canada, the mental health client is eligible to receive reimbursement of the actual and reasonable expenses and any related administrative costs incurred by the mental health client, up to a maximum amount approved by the Minister.

• 14.4 (1) A mental health client becomes eligible to receive mental health benefits

  • (a) on April 1, 2022, if their application for disability benefits is received by the Minister before that date and the Minister has not yet made a decision respecting the application; or

  • (b) on the day on which the Minister receives their application for disability benefits, if their application is received on or after April 1, 2022.

• (2) Despite subsection (1), if a person who does not meet the requirements of section 14.1 submits an application for disability benefits, they become eligible to receive mental health benefits beginning on the day on which they become a mental health client.

14.5 Despite section 31, a mental health client ceases to be eligible to receive mental health benefits

• (a) if the Minister makes a favourable decision respecting their application for disability benefits, on the day on which the decision is made;

• (b) if the Minister makes an unfavourable decision respecting their application for disability benefits, two years after the applicable day determined under section 14.4 or, if the Minister makes the decision after that day, on the day on which the decision is made; and

• (c) if the Minister decides that their application for disability benefits has been withdrawn, two years after the applicable day determined under section 14.4 or, if the Minister makes the decision after that day, on the day on which the decision is made.

PART IIVeterans Independence Program

Eligibility

• 15 (1) Subject to subsections (1.1) and (1.11), veteran pensioners, civilian pensioners and special duty service pensioners are eligible to receive the veterans independence program services referred to in paragraphs 19(a), (b) and (d) or, where it is not reasonably practicable for those services to be provided at their principal residence, the care referred to in paragraph 19(e), to the extent that those services or that care is not available to them as an insured service under a provincial health care system, if

  • (a) they are resident in Canada; and

  • (b) an assessment indicates that

    • (i) their war-related pensioned condition impairs their ability to remain self-sufficient at their principal residence without those services, and

    • (ii) the provision of those services would assist them to remain self-sufficient at their principal residence or the provision of that care is necessary for health reasons.

• (1.1) Seriously disabled veteran pensioners and seriously disabled civilian pensioners are not required to meet the requirement set out in subparagraph (1)(b)(i).

• (1.11) Veteran pensioners and civilian pensioners, whose extent of disability, in respect of the aggregate of all of their disability assessments under the Pension Act and the Veterans Well-being Act, is equal to or greater than 48% are not required to meet the requirement set out in subparagraph (1)(b)(i).

• (1.2) Military service pensioners and former members or reserve force members who are entitled to a disability award or entitled to pain and suffering compensation are eligible to receive the veterans independence program services referred to in paragraphs 19(a), (b) and (d) or, if it is not reasonably practicable for those services to be provided at their principal residence, the care referred to in paragraph 19(e), to the extent that those services or that care is not available to them as a member or former member of the Canadian Forces nor available as an insured service under a provincial health care system, if

  • (a) they are resident in Canada; and

  • (b) an assessment indicates that

    • (i) their pensioned condition or the disability for which they are entitled to a disability award or entitled to pain and suffering compensation, as the case may be, impairs their ability to remain self-sufficient at their principal residence without those services, and

    • (ii) the provision of those services would assist them to remain self-sufficient at their principal residence or the provision of that care is necessary for health reasons.

• (2) Subject to section 33.1, income-qualified veterans who are 65 years of age or more, income-qualified overseas service civilians who are 65 years of age or more and Canada service veterans are eligible to receive the veterans independence program services referred to in paragraphs 19(a) to (d) or, where it is not reasonably practicable for those services to be provided at their principal residence, the care referred to in paragraph 19(e), to the extent that those services or that care is not available to them as an insured service under a provincial health care system, if

  • (a) they are resident in Canada; and

  • (b) an assessment indicates that the provision of those services would assist them to remain self-sufficient at their principal residence or the provision of that care is necessary for health reasons.

• (3) Subject to section 33.1, prisoners of war who are entitled to basic compensation under subsection 71.2(1) of the Pension Act and former members and reserve force members who have received a detention benefit under Part 3 of the Veterans Well-being Act are eligible to receive the veterans independence program services referred to in paragraphs 19(a), (b) and (d) or, if it is not reasonably practicable for those services to be provided at their principal residence, the care referred to in paragraph 19(e), to the extent that those services or that care is not available as an insured service under a provincial health care system, if

  • (a) they are totally disabled, whether by reason of military service or not;

  • (b) they are resident in Canada; and

  • (c) an assessment indicates that the provision of those services would assist them to remain in their principal residence or that the provision of that care is necessary for health reasons.

• (4) Subject to section 33.1, overseas service veterans eligible for intermediate care or chronic care in a contract bed under subsection 21(1) are also eligible to receive the veterans independence program services referred to in paragraphs 19(a), (b) and (d), to the extent that those services are not available to them as an insured service under a provincial health care system, if

  • (a) they have applied to the Minister for admission to a contract bed, and are not admitted because there is no vacancy in a contract bed within a reasonable distance of the community in which they normally reside;

  • (b) they are resident in Canada; and

  • (c) an assessment indicates that the provision of those services would assist them to remain self-sufficient at their principal residence.