2022 Annual Report2022 Annual Report

Your Donation in Action

The support of War Amps donors funds our many programs for amputees and provides financial assistance towards artificial limbs. We do not receive government grants.

Advocating for All Amputees

The War Amps advocates for the rights and interests of all Canadian amputees and works on behalf of individual amputees who have encountered discrimination or red tape in accessing care, important financial benefits and legal rights.

Securing a landmark win against insurance denial

This year, we assisted 11 amputee members who had received unjustified insurance claim denials for their artificial limbs. While we advocate for all Canadian amputees, our efforts through our Advocacy Program focus on specific cases that will act as landmark decisions and have rippling positive effects for many other amputees across the country.

One case of note this year involved an adult above-knee amputee, who learned that their insurer would only cover $8,932 of a $108,932 artificial leg with a microprocessor knee and microprocessor ankle-foot system, despite having 100 per cent coverage. Their insurance provider told them that they would not pay the full amount because it falls within their “myoelectric exclusion” policy.

The War Amps became involved on behalf of this amputee, writing a submission to their insurer in June to appeal the denial. We addressed the medical necessity and benefit of this limb to our member’s physical and mental health, and flagged that the insurer had wrongly classified microprocessor components as myoelectric. In fact, this is a common misunderstanding on the part of many provincial and private insurers. The microprocessor components are part of a conventional artificial leg and have nothing to do with myoelectric limbs, which are used by arm amputees only.

After a back-and-forth discussion, this amputee’s insurer agreed to cover 100 per cent of the cost of the $108,932 artificial leg, as per their coverage policy. We received a note of thanks from the amputee’s prosthetist, as well as a message from the member, who said, “I am shocked and speechless. I had lost hope when I received the last letter from my insurer, so thank you for advocating for me. Words really cannot describe the appreciation I’m feeling; this is truly going to be life-changing for me. I hope you know the difference you are making in people’s lives.”

Working toward improvements to Alberta’s prosthetic coverage

Over the past five years, The War Amps has been involved with advocating for changes to the Alberta Aids to Daily Living (AADL) prosthetic coverage, which is administered through the provincial health-care system. In 2018, we were invited to sit on an advisory committee with AADL, but after the end of the meetings, AADL declined to connect again.

In December 2022, AADL reached out to us again to meet about proposed changes to the approved product list for artificial limbs and components, which is a list of what the government will cover. We were optimistic about this opportunity to add our input and advocate for amputees and were pleased to see positive proposed changes, such as increased coverage for previously underfunded items and the use of more generic terminology to reduce restrictions on coverage and, therefore, allow for more appropriate clinical care.

However, we believe the Alberta government still has strides to make in other areas that negatively impact the province’s amputees, including inadequate funding of microprocessor-controlled knees, which help prevent dangerous falls for above-knee amputees. We also wrote to AADL to encourage them to revisit Policy GN-16, which states that Albertans with private insurance that covers 100 per cent of their artificial limbs are not eligible for the same benefit under provincial funding, and only if private insurance is exhausted does the possibility for AADL to pay the remainder arise.

Unfortunately, this policy misses the mark as it is The War Amps firm position that government funding must be accessed first, with private insurance meant to offset any additional costs.

This issue has appeared recently in the case of a 52-year-old partial hand amputee from Alberta, whose prosthetist contacted our Advocacy Program in February 2022. Their prosthetist shared that their patient’s private insurance, which should have covered 100 per cent of their partial hand prosthesis (totalling $5,926), would only pay $2,500. Due to the province’s policy, AADL would not pay the remainder for this amputee, as their private insurance coverage stated the full cost would be funded.

The War Amps advocated for our member to their private insurance, and because of our involvement, the insurer agreed to cover 100 per cent of the cost. While this is an excellent outcome for our member, it highlights the issues with Alberta’s prosthetic coverage policies and is likely one of many cases where provincial and private insurance policies are at odds, and the technicalities of each create complications and funding denials for amputees.

Going forward, we will continue to communicate with AADL to address this issue and ensure that the provincial health-care system is prioritizing the needs of amputees.

Filling the gaps in unsuccessful advocacy cases

While our advocacy work often leads to positive results for not only individual amputees, but all Canadian amputees, there are times where government and insurers do not recognize their funding models as outdated. Even with our efforts, in some cases we reach a standstill that leaves a significant balance remaining in order for the amputee to receive their prescribed prosthetic care.

In certain cases, if we aren’t successful in getting a positive insurance outcome for the member we’re advocating for, we step in to fill the gap to make sure that our members can receive their medically necessary care. This is in addition to our standard contribution given to all adult amputees.

In 2022, we flagged four insurance cases in serious need of our assistance that met the following criteria: they have been waiting for over two years, experienced a change in urgency regarding their need for an artificial limb, received at least two denials from their insurer, and could not pay for the outstanding balance out of pocket. It’s important to note that these cases are rare and are the exception, not the rule.

We stepped in to cover the remaining balance of these four amputees’ artificial limbs, allowing our members to get back on the road to independence and to put a challenging chapter of their lives behind them. It also highlights just how important it is that government and insurers pay what they have promised for amputees receiving medically prescribed care.

Offering support to vulnerable members

With living expenses rising, amputees are doubly affected by having to also face the high cost of artificial limbs and the insufficient funding from provincial and private insurers. As part of our Advocacy Program, we monitor cases where our members are experiencing extreme financial hardship and offer our assistance for the most critical cases when specific criteria are met. This year, we supported 140 adult amputees above and beyond our standard funding for their prosthetic and daily living needs.

One case we assisted with is a 51-year-old British Columbia resident with a below-knee amputation. They submitted a claim through the BC health-care system for a new water leg, which would allow them to bathe safely while standing. The government incorrectly deemed this a “recreational” limb and would not fund it. Likewise, their private insurance denied their claim as well. This member approached The War Amps, and we were able to fund $7,929 towards their water leg. Afterwards, they told us it meant the world to them by helping them regain independence, while also helping their spouse, who had taken on a physically stressful role as caregiver.

The support we provide through our extreme financial hardship funding isn’t solely for artificial limbs; we also contribute towards vitally needed daily living aids. A 62-year-old amputee missing both their legs below the knee needed a hospital bed to be able to safely transfer in and out of bed to their powered wheelchair and wheeled toilet, due to the bed being the same height as their mobility aids. Unfortunately, this amputee could not afford the specialized bed and cannot wear artificial limbs for medical reasons, so they must rely on mobility aids only. Advocacy funded $646 towards a hospital bed for this member to help them transfer from bed to wheelchair safely, greatly increasing their independence.

The Key Tag Service

The Key Tag Service began in 1946 after the Second World War, launching a key return service that would prove to be a valuable aid to Canadians. War Amps members from the First and Second World Wars started the service to create jobs for amputee veterans and to generate revenue for the Association, which in turn funded our programs and raised awareness of The War Amps efforts.

Today, Canadians continue to benefit from this public service, with more than 1.5 million sets of lost keys returned to their owners, including expensive-to-replace car fobs. In 2022, The War Amps Key Tag Service returned 6,403 sets of lost keys to their owners by courier – for free! To this day, the Key Tag Service sheltered workshop in Scarborough, Ontario, continues to employ amputees and people with disabilities.

Our Work for Veterans

The War Amps continues to be the leader in advocating for veterans’ rights and legislation, as well as the driving force behind the National Council of Veteran Associations in Canada (NCVA). With more than 100 years of experience in this area, we are represented on four of the six ministerial advisory groups of Veterans Affairs Canada (VAC), co-chairing two of these advisory committees.

In 2022, we continued our ongoing fight for veterans dealing with lengthy wait times when applying for disability pensions and health-care benefits, as well as other areas in which we have been outspoken advocates for many years, such as a “one veteran, one standard” approach for pensions, family and caregiver benefits, and having the issue of marriage after 60 adequately addressed.

Funding ground-breaking research into veterans’ health

In November, we announced an exciting collaboration with the renowned Canadian Institute for Military and Veteran Health Research (CIMVHR) to fund much-needed research on the health-care needs of seriously disabled veterans, for which The War Amps agreed to provide $500,000 in funding.

By providing these grants, our goal is to address the noticeable lack of research funding for health-related issues that war amputees and seriously disabled veterans face, ensuring that they receive access to the highest level of care and expertise.

We collaborated with CIMVHR and their network of world-class academic researchers to make this a reality. Some of these vital health-care research projects include exploring cutting-edge advances in artificial limb technology and investigating how innovations in surgical procedures like osseointegration have the potential to transform the mobility of military leg amputees.

The War Amps is looking forward to the important research that will come out of these projects in the near future and seeing the positive impact it will have on Canada’s seriously disabled veterans.

Addressing the VAC disability wait-time crisis

There is no doubt that the overriding concern in the veterans’ community today remains the intolerable backlog and wait times confronting veterans making applications for disability pensions and health-care benefits, which can take over a year. Throughout the pandemic, which caused further delays, we have fought for “systemic” change to resolve this issue. We have made numerous submissions to the Minister of Veterans Affairs and senior VAC officials, as well as communicated with the media, to bring attention to this crisis affecting our country’s disabled veterans.

It remains our contention in relation to this ongoing administrative crisis that the department should adopt the position that veterans’ claims be considered at face value and be based on the reasonable evidence provided by the veteran and their family, with the proviso that individual files could be monitored over time and “spot audits” carried out to address any potential abuses. The clear reality that the medical reports usually required by VAC to support these applications continue to be difficult to obtain at this time must be recognized when considering this issue.

While the Standing Committee on Veterans Affairs released a report in late 2020 accepting the majority of The War Amps and the NCVA’s recommendations to relieve this crisis, in the years since, it is clear that meaningful progress has not been made, and VAC’s measures to increase staffing and digital resources will not be sufficient on their own.

We are not alone in thinking this; this sentiment was underlined by not only the recent Auditor General’s report of May 2022 but also by the Parliamentary Budget Officer’s report of September 2020.

The Auditor General, Karen Hogan, tabled a report in Parliament on May 31, 2022, concluding that Canada’s disabled veterans continue to face intolerably long wait times and an unacceptable backlog in earning entitlement for deserved financial assistance and benefits from VAC.

Hogan stated in her press conference that she was unimpressed with the efforts made by the department over the last number of years and called for the prioritization of a “realistic plan” to finally ensure that disabled veterans are not forced to wait months or even years for the financial support and compensation they need.

We urge VAC to fully recognize the substantive findings and criticisms of the Auditor General’s report and implement with the highest priority the statutory, regulatory and policy changes proposed in the report to create a more immediate resolution for veterans and their families, who are often facing severe financial insecurity.

A step forward for veterans’ mental health

As of April 1, 2022, veterans who are in need of mental health support while waiting for their benefits applications to be adjudicated can now seek care without delay. While this amendment to the Veterans Health Care Regulations does not entirely adopt our stance on automatic entitlement, it does provide a significant step forward in recognizing the need for urgency in granting immediate treatment benefits for mental health conditions.

We will continue to advocate in this regard, with this positive development acting as a potential springboard to expanding this principle so that veterans with any form of serious disability are not left waiting for health-care and treatment benefits.

Calling for “one veteran, one standard” for military pensions

The War Amps and the NCVA continue to advocate for improvements to existing veterans legislation, particularly so with respect to the Pension for Life (PFL) provisions originally announced in December 2017 and formally implemented on April 1, 2019. It is clear that these new benefits under PFL have limited applicability for the majority of seriously disabled veterans – indeed, some are actually worse off.

As stated in our many submissions to VAC and Parliament, the Government has not met veterans’ expectations with regard to the commitment to “re-establish lifelong pensions” to ensure that a comparable level of financial security is provided to all disabled veterans throughout their life, regardless of where or when they were injured.

We believe it is totally unacceptable that there continues to be legislation in Canada that provides a significantly higher level of compensation to a veteran who was injured prior to 2006 (those covered under the Pension Act) when compared to a veteran who is injured post-2006 (those covered under the New Veterans Charter/Veterans Well-being Act [NVC/VWA]). If applied to the Afghanistan conflict, this discrimination results in veterans of the same war having drastically different pension benefits.

We urge VAC, working together with relevant ministerial advisory groups and other veteran stakeholders, to create a comprehensive pension/wellness program model that would essentially treat all veterans with parallel disabilities in the same manner, regardless of when or where they were injured. It has been our longstanding recommendation that the department should use a combination of the best parts of both Acts to provide a better compensation/wellness model for all disabled veterans in Canada.

Support for families and caregivers of veterans

Since the enactment of the NVC/VWA in 2006, The War Amps and the NCVA have taken the strong position that the federal government has not addressed the plight of families of veterans, particularly in cases where a member of the family, often a spouse, is required to act in the role of caregiver to a disabled veteran.

Currently, the Caregiver Recognition Benefit provides only $13,000 of non-taxable support per year to a caregiver. This program is clearly inadequate, as it fails to provide appropriate support for caregivers who often have to leave their employment to care for their veteran family member. In 2021, we made a formal submission to the Standing Committee on Veterans Affairs with important recommendations that were adopted by the committee to ensure caregivers are properly compensated for their work. We strongly believe VAC should adopt our longstanding recommendations, including incorporating the eligibility standards of the Attendance Allowance (AA) and the amount of allowance in the Department of National Defence’s Attendant Care Benefit into the NVC/VWA, which has been supported by the committee. We also recommend creating distinct grade levels of compensation for this newly created AA, as well as fine-tuning the concept of allowance given to informal caregivers to recognize their effort and economic loss.

We remain adamant that the Government should follow a “one veteran, one standard” approach by adopting a comprehensive program model for all veterans and their caregivers, thereby resulting in the elimination of artificial cut‑off dates that arbitrarily distinguish veterans and their caregivers based on whether the veteran was injured before or after 2006.

Advocating against the “marriage after 60” clause

For more than 25 years, The War Amps and the NCVA have made submissions to the Government in relation to our concerns about the infamous “marriage after 60” clause affecting Canadian Armed Forces retirees. Currently, retirees contribute to the Canadian Forces Superannuation account throughout their career and one of the important benefits is a 50 per cent Survivor’s Benefit, except when the retiree marries after age 60. To provide their new spouses a Survivor’s Benefit, veterans over 60 must reduce their own account commensurately.

The resulting financial impact on veterans over the age of 60 and their new spouses is often quite distressing. Over the last 20 years, various governments have made unfulfilled promises to the veterans’ community to eliminate this clause, including in a 2019 federal budget provision. Unfortunately, the clause still stands.

We believe that it is long overdue for the Government to implement the excellent recommendations brought forward by the Standing Committee on Veterans Affairs, which call for the elimination of this clause and the immediate implementation of the Veterans Survivors Fund. We will continue this longstanding fight for veterans; after so many years of tortuous advocacy, they deserve nothing less.

Governance