# 2024-086 Pay and Benefits, Spectrum of Care

Case summary

F&R Date: 2025-05-23

The grievor disputed the decision not to fully reimburse the cost of his glasses. He contested the funding limits, stating that they are insufficient to purchase prism lenses that he believed he had found for a reasonable price at a physical store, which he stated was his only purchasing option. As redress, he requested full reimbursement of his glasses.  

The Surgeon General, acting as the Initial Authority (IA), denied redress stating that the grievor's circumstances did not warrant an increase to the maximum reimbursable amount for glasses and lenses. The IA stated that the grievor could have purchased prism lenses within the funding limit using alternative suppliers, such as online providers, as provided in paragraph 32 of the Canadian Forces Health Services Group Instructions 4020-05. The IA also found that the grievor's situation did not meet the criteria to justify an increase to the maximum reimbursable amount provided for in the Canadian Armed Forces (CAF) Spectrum of Care (SoC).  

The Committee found that the grievor had been treated in accordance with SoC entitlements for Vision Care. The Committee noted that Visual Care policies do not distinguish between “regular” and more complex lens prescriptions, thus the maximum reimbursable amounts apply to all prescription eyewear as one general category. Further, the Committee found that there are no “exceptional circumstance” criteria to be met because no such policy provision exists. The Committee remarked that since the CAF already provides health coverage for its members that may exceed that of public or employer healthcare plans, the CAF may wish to review its Vision Care policies to include adequate coverage for members whose main duties require long periods of reading.