Veterans Health Care Regulations

34.1 (1) Where a person incurs an expenditure to meet a health need, no reimbursement or payment shall be made under these Regulations to or in respect of the person except in accordance with this section.

(2) Subject to subsections (4) to (6), reimbursement or payment shall be made if the person was eligible to receive benefits, services or care under these Regulations for that health need at the time that the expenditure was incurred.

(3) Subject to subsections (4) to (6), reimbursement or payment shall be made if the person, within 90 days after incurring the expenditure, applies for a pension and

• (a) the person is awarded the pension for the condition in respect of which the expenditure was incurred and would have been eligible to receive benefits, services or care in respect of that condition if the person had been entitled to the pension at the time the expenditure was incurred;

• (b) the person is awarded the pension and as a result qualifies as a seriously disabled veteran or seriously disabled civilian; or

• (c) the person is awarded the pension and, as a result, qualifies as a veteran pensioner or civilian pensioner, if the aggregate of all of their disability assessments under the Pension Act and the Canadian Forces Members and Veterans Re-establishment and Compensation Act is equal to or greater than 48%.

(4) A claim for reimbursement or payment must be made by or on behalf of the person within 18 months of the day on which the expenditure was incurred.

(5) Proof of the expenditure must be provided by the person or on the person’s behalf.

(6) Subject to subsection 34(1), no reimbursement or payment shall exceed the maximum amount payable under these Regulations at the time the expenditure was incurred.

(7) This section does not apply to a claim in respect of the services referred to in subparagraph 19(a)(iii) or (v). Payment shall be made for those services only in respect of periods during which a person is eligible to receive those services.