Injured veterans promised better rehab are still in pain

“I was very motivated to heal,” he told the Star from his home in Edmonton.

But the publicly-funded program that was supposed to help demoralized him.

The company contracted by the federal government to run the program serving nearly 12,000 veterans assigned Barkwell a “rehabilitation services specialist,” or RSS, in May. The specialist scheduled assessments that would shape Barkwell’s rehabilitation plan.

In June, he was told the specialist left the company. A new one would be assigned “in the next few weeks.” Two months later, nothing.

“Just wanted to make sure I hadn’t fallen through the cracks,” Barkwell messaged the company running the program, Partners in Canadian Veterans Rehabilitation Services (PCVRS), a joint venture between subsidiaries of Loblaw and an Australian firm.

By mid-September, Barkwell, who suffers from anxiety, depression and post-traumatic stress disorder (PTSD), still hadn’t heard from a new RSS. He had run out of mental health treatment benefits.

Distressed, he messaged PCVRS again:

“Could I please request that I get an RSS ASAP reaching out so we can get a rehab plan in place so I don’t lose my progress and degrade back down to just trying not to kill myself?”

In 2021, the federal government said the new rehabilitation program would offer veterans faster access to personalized services. Then-Minister of Veterans Affairs Lawrence MacAulay said PCVRS would ensure that veterans “have the best chance of success as they adapt to life after service.”

These were false promises, 30 veterans and 11 health care professionals told the Star.

They described a bureaucracy rife with delays and redundant assessments. They said PCVRS staff often give veterans inadequate rehabilitation plans that ignore or contradict health care professionals’ advice. Program staff, they said, frequently ask veterans to cut ties with clinicians who do not affiliate with the PCVRS network, disrupting treatments. Veterans said their health worsened as a result.

Fearful of losing the income replacement benefit they rely on after discharge, veterans feel like they have no choice but to comply.

A Nova Scotia psychiatrist with a large caseload of veterans said that PCVRS’s insistence on reassessing patients resurfaces trauma with no clinical benefit, a view shared among other clinicians. “These patients will get depressed and anxious again,” sometimes for months, the psychiatrist said.

“In medicine and mental health, if you do an unnecessary procedure, that’s unethical.”

An unpublished study obtained by the Star, based on mental health professionals’ reports from across the country, found that the program caused damage.

“Two (veterans) have been to hospital, one has had homicidal ideation and has been arrested,” one clinician reported in the study, which anonymized responses. Another said they have clients “with both increased addiction concerns as well as suicide risk increased” after their interactions with the program.

PCVRS declined to comment for this story, referring all questions to Veterans Affairs Canada (VAC).

Minister of Veterans Affairs Jill McKnight said the Star’s findings “highlight opportunities for improvement,” but that the program is effective for most participants. She said that 74 per cent of surveyed participants reported improved functional capacity or improved overall health and well-being upon completion of the program.

VAC spokesperson Marc Lescoutre said the department “takes concerns raised by Veterans and clinicians seriously,” but declined to address specific cases. He said that existing providers can continue supporting a veteran “when aligned with the Veteran’s needs” and that existing documentation is used where possible “to minimize duplication” of assessments.

In February, the Standing Committee on Veterans Affairs heard a damning assessment of the rehabilitation program from Marc-André Bernard, a Quebec psychologist treating active service members and veterans.

“Bureaucracy to the point of absurdity,” is how he described it under PCVRS. “The program seems to exist for its own sake by piling on administrative requirements that make the process extremely cumbersome and painful for the veteran, irritating and suffocating for the professional.”

The committee’s study of the contract resumes Monday, with executives from PCVRS and senior VAC officials due to appear.

Ottawa announced the $560-million PCVRS contract in 2021. Its value has since grown to $572.8 million through amendments, and the contract could soon be extended for up to six years, likely bringing its cost to taxpayers to well over $1 billion.

PCVRS is a joint venture between WGC International, a subsidiary of an Australian corporation, and Lifemark Health Group, a North York-based network of clinics now owned by Canadian grocery and pharmacy behemoth Loblaw Companies Limited. Neither WCG, Lifemark nor Loblaw answered the Star’s requests for comment.

PCVRS is in charge of co-ordinating medical, psychosocial and vocational evaluations and services for a complex, battered population as they reintegrate into society.

One in six veterans suffers from PTSD, according to the 2022 Canadian Veteran Health Survey, a rate five times greater than the general population. Veterans are also more likely to report back problems, arthritis, anxiety and mood disorders. Nearly half of them live with pain.

Medavie Blue Cross, a not-for-profit insurance organization, previously administered the physical and psychosocial components of the rehabilitation program while WGC ran the vocational rehabilitation in a different partnership. VAC assured that merging services under one provider would improve their delivery and quality.

Bernard, the Quebec psychologist, said the old program sometimes lacked structure and some veterans “were left to their own devices.” But PCVRS overcorrected, he told the Star.

Clinicians, veterans and the Union of Veterans’ Affairs Employees (UVAE), which represents VAC case managers, expressed concerns early on about the new contract and worried it would negatively affect veterans’ care.

In June 2023, the Standing Committee on Veterans Affairs published a report flagging implementation issues and asked VAC to review the contract’s impact on service delivery by November. In that update, VAC said PCVRS had received 70 complaints, “with the majority related to service provision and claims/invoicing.”

PCVRS’s performance has confirmed the union’s initial doubts, said Toufic El-Daher, National President of UVAE. “VAC is overpaying for a system that isn’t working” and veterans are losing access to care, El-Daher told the Star. “This is not improving services — it’s creating new barriers and putting veterans at risk.”

An experienced VAC case manager said that while the previous iteration was based on veterans’ needs, this program “is all geared around feeding the system, feeding the money into PCVRS.” The Star granted the case manager anonymity because they feared retribution from VAC for speaking out.

On its website, PCVRS promises to develop rehabilitation plans that are tailored to veterans’ “unique needs” and support them “with care and compassion.” The program is voluntary, but enrolled veterans must participate or risk losing benefits.

The PCVRS contract was supposed to be evaluated in 2024-2025 “to assess efficiencies gained,” but the review never took place. An evaluation “at this stage would be premature,” Lescoutre said in February.

The contract is up for renewal at the end of this year.

The total number of complaints to PCVRS has grown to 436 as of early February, according to VAC.

Under the rehabilitation program, eligible veterans are assigned a VAC case manager and an RSS working for PCVRS. While case managers are dubbed “Decision Makers” in the contract, PCVRS staff are responsible for developing rehabilitation plans and conducting assessments, including of veterans’ ability to hold a job and eligibility for benefits. Decisions related to benefits are made by VAC, the department said.

Clinicians reported in the unpublished study that PCVRS sets unrealistic goals that do not “appear to be trauma-informed” and are “not in line with the research regarding best practices for trauma-informed care.”

The study was conducted by Alisha Henson, an Ontario psychologist working near CFB Petawawa, and Natalie Gillis, a New Brunswick therapist, who took note of early concerns with the new program and wanted to “provide a snapshot of what clinicians were experiencing and witnessing as a result of PCVRS.”

Based on a 2024 survey of 51 therapists, psychologists and social workers, it found that veterans experienced widespread increases in mental health challenges due to interactions with unqualified PCVRS staff.

Lescoutre, the VAC spokesperson, said PCVRS works with thousands of clinicians across Canada and that “given the limited sample size, scope, and date, conclusions drawn from this study should be interpreted with caution.” He said that PCVRS staff “complete mandatory training, including Veteran-centric approaches, Trauma-Informed Care, and Military Culture Competency.”

Veterans and clinicians interviewed by the Star expressed doubts about the competence of PCVRS staff.

Once he was able to undergo assessments, Barkwell, the Edmonton veteran, said the psychologist assigned by PCVRS told him that he didn’t meet the criteria for PTSD — contradicting a prior diagnosis reached by two other psychologists, a neuropsychologist and a psychiatrist.

Barkwell told her she was the first health care professional to question this diagnosis. “She excused herself for a moment, returned, and informed me she had misread the requirements for PTSD,” Barkwell said.

His rehabilitation plan, which still had not officially started as of February, includes a grading system on his ability to walk for up to 30 minutes — an irrelevant scale. “I can already walk for 30 minutes,” Barkwell said. “At the same time, I require an assistance device to put socks on.”

In one of Mark Bennett’s first calls with PCVRS, an RSS asked him 12 times to fire his care team and take on Lifemark providers. He counted.

“She seemed like a used-car salesman,” Bennett, a 27-year veteran struggling with PTSD, said. “She just would not take no for an answer.”

Bennett, who lives in New Brunswick, was reluctant to switch clinicians and held his ground. Fed up with the PCVRS specialist, he ended the call and reported it to his VAC case manager. “I asked her if she could call PCVRS and explain to them what the meaning of the word ‘no’ means,” he said.

A retired sergeant alleged that a PCVRS staffer repeatedly used her hard-earned benefits as leverage to make her switch providers.

The Star granted anonymity to veterans who feared speaking out could impact the rehabilitation services or benefits they get from VAC or PCVRS, as well as to clinicians who feared losing client referrals in the rehabilitation program.

After four decades of service, the sergeant was medically released in 2024 because of her PTSD, she said. She deployed overseas with an elite counterterrorism unit, saw “some pretty horrific things” and broke 27 bones over the span of her career. But it was sexual assault that left her traumatized.

When she objected to leaving her psychologist, the RSS’s tone then “turned highly aggressive,” she said. “The woman threatened to cut off all benefits I was receiving from veterans affairs unless I agreed to change doctors and follow PCVRS’s treatment plan.”

The upsetting threats went on for weeks, the veteran said, until her psychologist intervened to request that PCVRS only contact her by email.

“I gave over 40 years of my life to my country, and to have some witch … threaten me to cut off my benefits for all that work I did for my country, that just makes my blood boil.”

Carol Heusser, a Brampton, Ont., psychologist who runs a clinic treating dozens of veterans, said it seems PCVRS has a bias against out-of-network providers such as herself.

In one case, Heusser learned of a patient’s psychological rehabilitation plan through the patient himself, without any consultation from PCVRS. “How on earth can they formulate treatment plans without talking to the primary provider?” she asked.

One of PCVRS’s goals is to help veterans go back to work. When they participate in the rehabilitation program, veterans qualify for the income replacement benefit, which covers 90 per cent of their pre-release earnings. If, at the end of the program, they remain too incapacitated to find a job that would pay at least two thirds of what they were making in service, they are deemed to have “diminished earning capacity” (DEC) and can continue receiving benefits.

PCVRS’s contract with the federal government includes outcome targets for 80 per cent of program participants to achieve “improved employability” and “improved labour force capacity.” It stipulates financial incentives if 90 per cent or more of participants “have improved functioning and a decrease in barriers at Plan completion” — along with penalties if 75 per cent or fewer do.

Clinicians cited in the unpublished study said veterans are “being pressured to return to work or school before they have made mental health gains or built a foundation for their civilian lives.” This pressure is “based on the goals of the RSS and not the veteran or their clinician.”

Megan Harding, a 42-year-old Ottawa veteran who toured in Afghanistan and suffers from PTSD and depression, was medically released in the spring of 2023. Last summer, her psychologist found that Harding’s “trauma, depressive, and somatic symptoms” made even part-time work unsuitable at this time. He did not recommend occupational therapy.

PCVRS still required her to start occupational therapy with the goal of returning to work part-time, Harding said.

“I am receiving no benefit from the three sessions I have attended so far and they have only caused things to be worse for me,” she said in February. “I’m beyond mad.”

Many veterans feel betrayed, their injuries aggravated by institutions that were supposed to help them. It’s called “sanctuary trauma.”

Brendan Hynes, a former bomb disposal technician and special forces veteran, has PTSD and brain injuries due to blast exposure that caused loss of balance, chronic stress and fatigue, and severe headaches.

His dealings with PCVRS have left him puzzled and distressed to the point where he disengaged for a year. Hynes said many veterans like him “feel a sense of institutional abandonment.”