Backgrounder Article from  National Defence and the Canadian Armed Forces

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All Canadian Armed Forces (CAF) members, regardless of where they serve, have access to a standard of health service comparable to that of other Canadians. This medical care is provided by the Canadian Forces Health Services Group, rather than the provincial or territorial health authority as is the case for other Canadians. The majority of CAF members are healthy adults, free from major medical concerns. For those members who become more seriously ill or injured, the CAF has developed a comprehensive approach to providing tailored and focused care to them.

Care and support in these cases is integrated throughout a member’s recovery, rehabilitation, and reintegration, calling upon all systems to work together to serve a common objective: caring for our members. Facilitated by health care and support services as well as the member’s chain of command, care and support is tailored to each member’s needs, as recovery from an injury or illness follows no defined schedule.

The CAF’s Spectrum of Care defines what medical support can be provided to CAF members and provides direction to health care providers, the chain of command and personnel. It authorizes the use of public funds to ensure that CAF personnel have access to a standard of health services that is comparableto that received by Canadians under provincial health care plans.

Access to Care

All CAF personnel, which includes Regular Force members and Reserve Force members working under any terms of service (Class A, Class B, Class C) and who become injured or ill during service, may be assessed at any CAF medical clinic.

Regular Force members

All Regular Force members who become injured or ill can access programs and services offered within the CAF Spectrum of Care.

Reserve Force members

A Reserve Force member’s terms of service will define whether a member who becomes injured or ill can access programs and services offered within the CAF Spectrum of Care or within appropriate provincial health care services.

  • Full-Time Reservists - Class B (full-time 180 days or more) & Class C (operational) service:  Reservists on these terms of service, who become injured or ill, can access programs and services offered within the CAF Spectrum of Care. Reservists on these terms of service will be cared for by the CAF’s health service until such a time as the member no longer requires that care, or until the member’s care has been successfully transferred to a provincial health care system should that be the most appropriate care option.
  • Part-Time Reservists - Class A (part-time) & Class B (full-time less than 180 days) service:  Reservists on these terms of service, who become injured or ill during service, may be assessed at any CAF medical clinic. Depending on the circumstances, the member may be cared for by the CAF’s health service or referred to the appropriate civilian care facility. Whereby an injury or illness is not service-related, the member may be assessed at any CAF medical clinic and will be directed to the appropriate civilian care facility.

The CAF’s primary goal is always to return personnel to duty in their military occupation as soon as medically possible. Achieving that goal depends on a number of factors, including the nature and severity of the illness or injury, the speed and intensity of the intervention, patient morale and commitment, the quality of case management and the efficacy of available treatments.In some individual cases, the road to recovery, rehabilitation and reintegration is measured in months. For those with serious injuries, however, the road to recovery can be measured in years—from the point of injury or illness to when our members no longer require CAF care and support.

Recovery

Recovery is the period of treatment and convalescence during which patients transition from initial onset of illness or injury to the point where they are stable and ready to receive longer-term medical care, and ready to optimize their functional capacity in many aspects of their life whether it be vocationally, socially, or in their mobility.

CAF personnel can become ill or suffer an injury at any time, in any place, and the Canadian Forces Health Services Group has the ability to provide location-dependant care through a variety of means:  primary care clinics, field ambulances (mobile medical units), as well as its field hospitals. There is a primary care clinic on every base.

For patients with complex injuries or illness, a casualty management team helps each patient navigate through their recovery by overseeing and coordinating medical, psychosocial, and spiritual care. After recovering, a patient then moves into rehabilitation.

Rehabilitation

Rehabilitation is an active process designed to improve functionality following injury or illness, which means having a patient regain maximum self-sufficiency. This can take various forms including physical, mental, vocational, and social rehabilitation.

The CAF rehabilitation program delivers intense, challenging, goal-centred physiotherapy and mental health treatments, sometimes making use of leading-edge technology to do so. The Computer Assisted Rehabilitation Environment (CAREN) System is a great example of computer-generated graphics and technology combined in one impressive machine that allows for enhanced rehabilitation services. Strategically located in health facilities in Edmonton and Ottawa, this system is a safe, controlled, and therapeutic environment for CAF members to challenge their abilities and allow them to progress in their physical rehabilitation, and to potentially undergo exposure therapy as part of treatment for mental health conditions.

There are also seven Operational Trauma Stress Support Centres located across Canada. These Centres, recognized as centres of excellence in the area of mental health, have four mandates—assessment, treatment, outreach and education, and research—and are staffed by an interdisciplinary team of psychiatrists, psychologists, social workers, mental health nurses, addictions counsellors, and health services chaplains.   

For information on the mental health services programs available in the CAF, please visit the Mental Health Services and Support backgrounder.

After an ill or injured CAF member has completed rehabilitation, they will then begin reintegration.

Reintegration

The CAF provides a consistent and integrated process for members recovering from illness or injury, to help them progressively return to work, or to prepare them for a civilian career and life. The reintegration phase is a shared responsibility between the member, the medical staff, and the chain of command.  The purpose of reintegration is to re-instill a rehabilitated member’s confidence, self-esteem, and a sense of pride; all key ingredients on their road to recovery.

As soon as a medical officer determines that the ill or injured person can begin to re-integrate, a return to work plan is developed by a designated return to work coordinator in conjunction with the individual and their commanding officer. The intensity and complexity of their assigned work tasks increase as the member's condition improves. The ultimate aim is to return the person to full-time military duties within their original unit or part-time with another military unit. This step is vital as the individual gains therapeutic, psychological and social benefits from returning to work, which can assist them recover more quickly as a result. 

In some cases, reintegration may entail a member going back to school, engaging in work with the Royal Canadian Legion, local private sector employers, or with another government department. Working outside the CAF can sometimes be more conducive to a member’s recovery if reminders of the military contribute to the illness or injury. Often members find a new niche and actively pursue a new beginning outside the military.

Noting that the CAF’s primary goal is always to return personnel to duty if possible, for those members who will transition to civilian life, the CAF works with the member to develop a tailored and flexible plan that features comprehensive health care, and social and career transition support. In most cases, medically releasing members will begin a six-month transition period as part of their plan. However, those medically releasing members who are determined to have complex transition needs because of the seriousness of their illnesses or injuries will have a transition period of up to three years. A transition plan is not developed until the member’s medical condition is stable, which can take anywhere from several months to a few years. For more information on the transition plan and medical releases, please see the CAF Backgrounder on Medical Releases.

The Joint Personnel Support Unit

A key element in coordinating care and support to CAF members from recovery to rehabilitation is the Joint Personnel Support Unit which includes 24 Integrated Personnel Support Centres located across Canada. The Joint Personnel Support Unit provides focused, individual assistance and expedites access to CAF and Veterans Affairs Canada programs, family support expertise, and peer support. It provides one-stop access to services and benefits, simplifying the process for members seeking assistance. The Joint Personnel Support Unit performs the following core functions:

  • return to duty program coordination;
  • outreach to deliver information on casualty support programs and services;
  • casualty follow-up and monitoring;
  • casualty administrative and advocacy services;
  • military leadership, supervision, and administrative support to personnel who are posted to the Joint Personnel Support Unit; and
  • liaison with military family resource centers, local base support representatives and local unit commanding officers.

Integrated Personnel Support Centres include representation from the Department of National Defence (DND), the CAF, and Veterans Affairs Canada. Family liaison officers, military chaplains, and peer support coordinators, among others, work together to coordinate the provision of family, spiritual, social, and financial support services. This collaboration has greatly facilitated the comprehensive care for our members and their families. Staff members are extremely dedicated and compassionate and do everything possible to enhance recovery for a return to duty, or when necessary, to ensure a smooth transition for those moving into civilian life.

The Joint Personnel Support Unit also provides information and support to members with less complex requirements who are not posted to the unit. The unit also responds to queries from family members regarding support services and programs for ill and injured personnel, and provides referrals as appropriate.

For more information on where Integrated Personnel Support Centres are located and how to contact them, please visit the Casualty Support – Contact Us page.

The Joint Personnel Support Unit plays a central role in the transition process for CAF personnel recovering from serious illness or injury, and either progressing towards a return to duty or preparing for a civilian career. For more information on support to those releasing for medical reasons, please visit the CAF Backgrounder on Medical Releases.

Transition

For those members that do transition to civilian life, the CAF offers extensive programs and services to help them through the process. For example, CAF Transition Services can prepare members for a second career, is connected with potential employers and industry, and educates these stakeholders on the benefits of hiring former military members. CAF Transition Services also connects releasing military members with continuing education, vocational training, entrepreneurial opportunities, and other opportunities. More information on this program is available in the CAF Transition Services backgrounder.

Further Support Services

There are also additional support programs and compensation and benefit packages in place to assist ill or injured members:

  • As trained religious and spiritual caregivers, CAF chaplains contribute significantly to the spiritual and mental health care of CAF members and their families. They make themselves available to support members in need 24/7 and provide support and advice to the chain of command and care providers.
  • The Member Assistance Program (1-800-268-7708) provides 24/7 external, short-term counselling to Regular and Reserve Force personnel and their families who are seeking assistance.
  • Former CAF personnel and their families have access to the Veterans Affairs Canada Assistance Service, a voluntary and confidential counselling service delivered through a nation-wide team of professional counsellors and accessed initially through a toll-free line at 1-800-268-7708.
  • The Operational Stress Injury Social Support program provides peer support to military personnel, veterans and their families affected by operational stress injuries, which includes post-traumatic stress disorder.
  • The Injured Soldier Network enhances the functional readiness of ill or injured CAF personnel by focusing on peer support strategies through which they can meet the requirements of Universality of Service and develop an independent and autonomous lifestyle.

For more information on the disability benefits and compensation provided by DND, Veterans Affairs Canada and third-party non-public support programs, please visit the Fact Sheet on Compensation and Benefits Available to Ill and Injured CAF Members or visit The Guide to Benefits, Programs, and Services for Serving and Former CAF Members and their Families.

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