‘Nothing Was Ready’: Inside Canada’s Vaccine Injury Support Program – National | Globalnews.ca

A $50-million program the federal government created to help Canadians seriously injured by COVID-19 vaccines is in disarray, current and former staffers say.

The Vaccine Injury Support Program (VISP), created during the pandemic, was designed to compensate people who have been seriously and permanently injured by any Health Canada-authorized vaccine administered in Canada on or after Dec. 8, 2020.

The Public Health Agency of Canada subsequently selected a consulting firm, Oxaro Inc., to administer the program.  The Ottawa-based company vowed it had the “people, processes, and tools” to run the initiative with “industry best practices.”

However, a five-month-long Global News investigation, involving more than 30 interviews with current and former Oxaro employees, injured claimants and their attorneys, has uncovered allegations that the company was unequipped to deliver fully on the program’s mission, questions about why the Public Health Agency of Canada (PHAC) chose this company over others, and internal documents that suggest poor planning from the start.

Global News also heard descriptions of a workplace that lacked the gravitas of a program meant to assist the seriously injured and chronically ill: drinking in the office, ping pong, slushies and Netflix streaming at desks.

The overall result: many claimants feel they have not received the “timely and fair” access to support that the government promised.

When the pandemic struck in 2020, Canada was caught flat-footed.

It was the only G7 country without a vaccine injury support program. Millions of Canadians lined up for the shots, which helped reduce emergency room admissions and curtail the impact of the pandemic.

The government reassured the public that they’d be safe, but it acknowledged that in rare cases, people could experience serious side effects.

There have been 11,702 reports of serious adverse events following a COVID-19 vaccination, according to Health Canada. That’s equal to 0.011 per cent of the 105,015,456 doses administered as of December 2023.

Reactions included Guillain-Barré Syndrome, myocarditis, cardiac arrest and Bell’s Palsy.

For those unfortunate few, then-prime minister Justin Trudeau pledged that VISP would look after them. “We want to make sure that Canadians have fair access to support,” he said in December 2020.

Two months later, PHAC invited companies to submit proposals for administering VISP, saying the agency lacked the staff and expertise to operate the program itself, according to a draft 2023 report on VISP by Health Canada and PHAC.

The government viewed the outsourcing decision as “the best option.” That way, it could avoid a conflict of interest that would arise from serving as both the approver of the vaccines and the one that compensated people for the harms vaccines caused, the documents explained.

Four entities responded to the PHAC request and had roughly three weeks to apply.

Among them was Oxaro (then called Raymond Chabot Grant Thornton Consulting Inc.), a firm that vowed to employ “experienced dedicated case managers to support a claimant throughout the application process.”

It won the contract.

The minister of health pushed Oxaro to launch three months ahead of schedule.

But when the program did, in June 2021, some former staffers say the company wasn’t ready.

Oxaro and the Public Health Agency of Canada declined to be interviewed for this story.

In a statement to Global News, Oxaro wrote, “Our process ensures that all cases are treated fairly and with the same care, respect, and due diligence.”

Seven former workers told Global News that the staff VISP hired to run the day-to-day operations had little, if any, experience in public health, insurance or claims management.

Many employees were straight out of high school or college, or had previous jobs in retail, bartending and data entry, according to former workers and LinkedIn résumés.

There was a revolving door of staff, according to several former employees. A half dozen members of the team that helped prepare the VISP bid were gone within six months, according to three sources familiar with the matter.

Claims managers with more experience were eventually hired, but at least three quit, according to their colleagues.

Among the employee frustrations, there was also no clear roadmap for managing a claim.

Five current and former workers told Global News that policies and procedures were incomplete. Others bemoaned a lack of training.

“They (VISP) had no idea what they were doing,” one former worker said. “Nothing was ready. We were still being designed two years after the contract was awarded.”

“They were building the program as they went,” another said.

The Public Health Agency of Canada did write a policy framework for VISP, but it was up to Oxaro to design and implement it, according to PHAC documents.

It wasn’t properly fleshed out, former workers said.

“I asked for the policy language we would use to decide cases,” one said. “There was none.”

As a result, another worker said they relied on “word of mouth” to figure out how to handle claims.

And to some injured claimants, that lack of guidance was obvious.

Monroe Orleans, a realtor from Hamilton, says his VISP case manager asked him to contact his cardiologist to obtain a letter about his personal tax status.

“Why?!” he exclaimed, mystified, questioning how a heart doctor would know anything about tax filings. VISP eventually approved Orleans’ case for heart damage he suffered after getting the COVID-19 vaccine.  He has a second claim for kidney failure still pending.

Kimberly Macdougall, whose husband died of myopericarditis post-COVID-19 vaccine, was also left dumbfounded.

At the height of her grief, VISP asked her to retrieve physiotherapy records from three years earlier, when her husband broke his hand playing ultimate frisbee.

“What does that have to do with anything?” she said. VISP also approved her case.

Inside VISP’s downtown Ottawa office, the work culture included Friday afternoon drinks, ping pong games (often so loud they affected productivity), slushie machines, streaming videos on phones and “a lot” of chitchat, former workers described.

“I felt like I was there to kind of hang out and socialize,” one said. “It was kind of like school in a way.”

Concerned about appearances, a top Oxaro executive sent an email in advance of an office visit from the Public Health Agency of Canada, instructing workers not to watch videos during the office drop-in.

Though two workers confirmed the existence of the email, Global News was unable to obtain a copy.

In the last year, some workers said, drinking on Fridays has ceased and the company has tried to curb video streaming in the office.

Oxaro would not respond to questions about its workplace culture, nor would it comment on statements by former workers.

Former workers say the casual environment inside VISP contributed to the company missing its targets. Claims piled up.

One worker confessed that the amount of work they completed was “well below” what was expected.  Lost in the rising number of claims were the injured, the worker added.

“I don’t think anyone actually understood the severity or the relevance of the program that was being contracted to the firm,” they said.

“I think they (injured claimants) were merely names on paper and nothing more than that.”

Those injured claimants said the treatment from VISP workers “lacked humanity.”

One injured woman, whose case was eventually approved, said she was brought to tears when her claims manager shouted at her and swore, “You’re just after free money.”

That same VISP case manager allegedly told a second injured person: “You didn’t have to get the vaccine.” He was later fired, according to former workers.

Several workers said that despite the team’s inexperience and limited resources, they still tried their hardest to provide support payments to those in need.

VISP has approved 219 cases. More than 3,000 people have applied.

“I did everything I could for that program. I couldn’t do any more,” one former worker said.

A second former staffer said that in recent months, there were signs of improvement, but that the system was still as slow as “molasses.”

“It’s frustrating,” he said. “I can’t help these (injured) individuals out.”

Global News sent Oxaro a 15-page list of questions, including detailed allegations from former workers and claimants.

Oxaro would not comment on those specifics, stating instead it is working with PHAC and “continues to adapt its approach based on actual number of applications and appeals received.”

Read Oxaro’s response to Global News.

PHAC told Global News it “takes the concerns raised by VISP claimants and beneficiaries seriously” and is “actively reviewing the VISP experience to date,” including an examination of best practices from other countries, to ensure its “future program will effectively meet the needs of Canadians.”

The government’s five-year deal with Oxaro is up for renewal in mid-2026.

Of the $50.6 million the government of Canada has paid to Oxaro, a third of that amount, $16.9 million, has reached the injured.

Oxaro has spent the rest on administrative and program costs, PHAC data shows.

Oxaro said its monthly invoices to the government “reflect actual costs” that are “reviewed and approved by PHAC.”

Health Canada Minister Marjorie Michel, via a spokesperson, sent an unsolicited email to Global News prior to publication, saying: “These allegations are completely unacceptable… I’ve asked PHAC to find a solution that ensures a responsible use of funds and that people receive the support they need. All options are on the table.”

The question many injured claimants and former workers have raised over the course of this investigation: how did an accounting and advisory firm land a contract managing health claims?

In its 155-page submission, Raymond Chabot Grant Thornton Consulting Inc. (now Oxaro) cited two examples of its experience in health claim adjudication.

One was designing and operating the Memorial Grant Program for First Responders, a smaller federal program that pays out a one-time, lump sum to beneficiaries of emergency workers who died as a direct result of their duties.

The other was acting as liquidator of Union of Canada Life Insurance after it became insolvent in 2012, processing outstanding accident, life and medical claims, and transferring policies to other insurers until 2015.

There were three other bidders for the VISP contract, and all had health claims adjudication experience: Green Shield Canada, Crawford & Company (Canada) Inc. and ClaimsPro LP.

Global News obtained a redacted copy of Green Shield’s proposal, which highlighted its track record as Canada’s “fourth-largest health and dental benefits provider,” boasting over 60 years of experience.

“We are ready to begin intaking claims within 45 days,” the GSC bid stated, adding it had a proven track record of timely claim payments, with 99.9 per cent accuracy over each of the last four years.

In March 2021, a six-person committee “unanimously” selected RCGT, PHAC said.

Although the Public Health Agency refused to explain why or how that decision was reached, it did reveal that RCGT (Oxaro) was neither the highest nor lowest bidder.

The unsuccessful bidders would not answer questions from Global News.

As VISP enters its fifth year, roughly 1,700 applicants are still waiting for their cases to be reviewed and decided, according to VISP data.

Part of the reason: the initial forecast for the volume of claims VISP would receive was wildly inaccurate, and the system wasn’t prepared for the influx.

In February 2021, PHAC initially estimated VISP would get 40 claims per year, with the possibility of higher-than-average numbers in the first three years.

That number was bumped up to 400 “valid” claims annually, according to the contract between RCGT and PHAC signed four months later.

It received that amount in the first five months alone, according to VISP data.

VISP has received 3,073 claims to date.

That unforeseen volume hampered the program’s effectiveness almost from the start.

Instead of living up to its bid promise of a call centre that would respond to emails within one hour and contact from an applicant within one day “90% of the time,” applicants have recently received emails stating, “due to an unexpectedly high volume of claims” VISP will “aim to contact claimants quarterly.”

In its written response, Oxaro said, “VISP is a new and demand-based program with an unknown and fluctuating number of applications and appeals.” It continued, “The volume of claims received does have a direct impact on processing timelines,” as does their “nature and complexity.”

PHAC and Oxaro workers have stated the average claim takes 12-18 months to process.

Some applicants who spoke with Global News have been waiting three years for their claim to be decided.

There was a blueprint to follow, however, and it was Canadian-made.

Quebec has had its own vaccine injury program since 1985 – the only jurisdiction in Canada that had one before the pandemic.

When the federal program launched in June 2021, the plan was for it to build “on the model in place in Quebec for 30 years,” according to PHAC documents.

However, Global News discovered that VISP differed from its Quebec counterpart in three key areas, raising questions about efficiency, transparency and fairness.

In Oxaro’s VISP, workers spend thousands of hours redacting all personal information from an applicant’s medical records, causing lengthy slowdowns, sources told Global News.

In Quebec’s program, none of the files are redacted.

Additionally, the federal VISP refuses to reveal the names of the doctors who sit on the medical review boards and decide a claimant’s case, citing “privacy and security reasons.” It will only disclose their respective areas of specialization.

In Quebec, the physician’s identities are shared with an applicant.  Quebec applicants can also select a doctor to sit on the panel as their representative.

Claimants in Quebec can appeal a decision to a provincial tribunal. In VISP, claimants can only appeal within the program to a new panel of three unidentified doctors, not to an independent tribunal.

“We were supposed to be modelled after the Quebec program, but even two years into our (VISP) program, we were still learning things about the Quebec program,” one former worker said.

Some of those who have left their jobs at VISP look back with a feeling that they weren’t able to achieve what the program set out to accomplish: helping the injured access fair and timely financial support.

“I didn’t feel like I was able to properly do my job.”

They left disheartened. Frustrated. Perplexed.

It’s a sentiment shared by those on the other end – the ill and injured waiting for help.

Want to contact us? Email: andrew.mcintosh@corusent or carolyn.jarvis@globalnews.com. You can also reach Andrew at 416-550-4684.