# 2021-113 Pay and Benefits, Allowances

Case summary

F&R Date: 2021-11-22

The grievor paid for infertility services related to in vitro fertilization (IVF) treatment before CANFORGEN 029/19 - Changes to Fertility Services Eligibility in the Canadian Armed Forces was released and the resulting amendments to the Spectrum of Care (SoC). The grievor contended that, despite not being entitled to reimbursement before the CANFORGEN was released, she should be entitled to reimbursement of IVF costs as the policy does not indicate that fees must be incurred after the CANFORGEN's release date. She noted that she meets all eligibility criteria in the policy and requested reimbursement of IVF costs.

The Director Medical Policy (D Med Pol) explained that reimbursement of IVF before the CANFORGEN was released required a diagnosis of bilateral fallopian tube obstruction, which did not apply to the grievor, and this was the reason for the denial of funding. There was no Initial Authority (IA) decision in the grievance since the IA was not able to complete the decision within the four-month timeline.

The Committee reviewed the Spectrum of Care (SoC) in effect at the time the grievor paid for and received IVF fertility services. The policy required that the infertility be the result of bilateral fallopian tube obstruction in order to be eligible for funding. Since the grievor did not suffer from this condition, as confirmed by D Med Pol, the Committee found that the grievor was treated in accordance with the SoC in effect at that time. The Committee also found that the CANFORGEN, and the amended SoC, do not permit reimbursement retroactively, as there was no existing authority to reimburse IVF expenses for the grievor's situation.

FA decision summary

The Chief of the Defence Staff agreed with the Committee's findings and recommendation not to afford the grievor redress.