QR&Os: Volume I - Chapter 34 Medical Services

Official Format

Effective 1 August 2015, the official version of the QR&O is that published in PDF format on this website. In the event of any inconsistency between this consolidation and any printed or electronic copy, this consolidation prevails to the extent of the inconsistency. The HTML version on this website is provided solely for the convenience of readers. Any discrepancies between the HTML and the official PDF version should be reported to the DSCS, Corporate Secretary.

Amendment List:

  • 1 June 2014 – amended article: 34.15

History:

Section 1 - General

34.01 - DEFINITIONS

In this chapter:

"civilian" (civil)
means a person who is not a member of the Canadian Forces, a public servant, a dependant, a school teacher, a member of a force or civilian component of a North Atlantic Treaty Organization State or a dependant of a member of that force or that civilian component;
"civilian component" (élément civil)
has the same meaning as defined in Article I of the Agreement between the Parties to the North Atlantic Treaty Regarding the Status of their Forces (QR&O Vol IV, Appendix 2.4);
"dependant" (personne à charge)
means:

a. the spouse or common-law partner, child, housekeeper or other person in respect of whom a member of the Canadian Forces or a public servant may obtain hospital or surgical-medical insurance under a plan sponsored by the Government of Canada or in respect of whom a school teacher may obtain such insurance if that person were a member of the Canadian Forces or a public servant; or

 

b. a spouse or common-law partner of a member of a force of a North Atlantic Treaty Organization State or a civilian
component of that force or a child depending on the member for support;

(1 September 2001)
"force of a North Atlantic Treaty Organization State" (force d'un État Partie au Traité de l'Atlantique Nord)
has the same meaning as "force" in Article I of the Agreement between the Parties to the North Atlantic Treaty Regarding the Status of their Forces (QR&O Volume IV, Appendix 2.4);
"in-patient care" (soins hospitaliers)
means that portion of medical care, exclusive of professional care, that is provided to a patient who is admitted to a hospital;
"isolated unit" (unité isolée)
means a unit so designated by the Minister;
"medical care" (soins de santé)
means medical and surgical treatment including necessary drugs and dressing, diagnostic and investigational procedures, hospitalization, preventive medicine procedures, transportation as a patient and the supply and maintenance of prosthetic appliances;
"out-patient care" (soins ambulatoires)
means that portion of medical care that is provided to a patient who is not admitted to hospital;
"overseas area" (secteur outre-mer)
means the area outside the United Kingdom and the continental limits of North America;
"professional care" (soins professionnels)
means that portion of medical care provided to an individual by a licensed medical practitioner, including a service medical officer;
"public servant" (fonctionnaire)
means an employee of the Government of Canada who is eligible for participation in the Public Service Health Care Plan;
"school teacher" (instituteur)
means a member of the supervisory, administrative or teaching staff of a school of the Department;
"semi-isolated unit" (unité semi-isolée)
means a unit so designated by the Minister.

(G) [P.C. 2001-1508 effective 1 September 2001]

34.011 - RESPONSIBILITIES OF MEDICAL OFFICERS

The senior medical officer at all levels of command is the responsible adviser to the senior officer exercising the function of command or executive authority on all matters pertaining to the health and physical efficiency of all personnel under his jurisdiction.

(C)

34.012 - MEDICAL LIABILITY - GOOD SAMARITAN ASSISTANCE

(1) Except where a medical officer derives remuneration or other benefit from such assistance, medical care may be provided, in addition to those situations prescribed in this chapter, by a medical officer to any person, whether on or off a defence establishment, in any emergency situation when such action may be life saving, reduce the degree of injury or relieve emotional pain and suffering.

(2) Medical care provided under paragraph (1) shall be provided free of charge.

(G)

[34.02 to 34.04 inclusive: not allocated]

34.05 - CHARGES FOR MEDICAL CARE

(1) Any charge that in this chapter is required to be made for medical care provided by a Canadian Forces medical facility shall, subject to paragraph (5), be levied against an individual or agency, or both, at the rates prescribed in this article.

(2) Charges for medical care provided by a Canadian Forces medical facility in Canada shall be:

  1. for any of the care provided that is included in "insured services" under the hospital insurance plan of the province or territory in which the medical facility is located,
    1. at the rates agreed upon between the federal government and the government of the province or territory in respect of that facility, where the facility is designated as a treatment hospital under that plan, or
    2. at the rates prescribed by the Minister, where the facility is not designated as a treatment hospital under that plan;
  2. for any professional care provided that is not charged for under subparagraph (a),
    1. where the province or territory in which the facility is located has a medical care plan, at the rates agreed upon between the federal government and the provincial or territorial government for any of the care provided that is included in "insured services" under that plan, or
    2. where the province or territory in which the facility is located does not have a medical care plan, at the rates prescribed in the schedule of fees for that province or territory for any of the care provided that is listed in that schedule; or
  3. at the rates prescribed by the Minister, for any other medical care provided.

(3) Charges for medical care provided by a Canadian Forces medical facility outside Canada or by a medical facility of the forces of another country that cares for members of the Canadian Forces outside Canada under arrangements for admission made by Canadian Forces authorities shall be:

  1. for any care provided to a patient insured under the Hospital Insurance (Outside Canada) Plan that is included as "insured services" under the plan, at the rates payable under that plan;
  2. for professional care not included in "insured services" described in subparagraph (a) but which is described in the Schedule of Operations for the Surgical Expense Benefit of the Public Service Health Care Plan, at the rates equal to the maximum amounts prescribed in that schedule for that care;
  3. for any medical care, other than that described in subparagraphs (a) and (b), for which charges would normally be accepted as eligible expenses under the Major Medical Expense Benefit of the Public Service Health Care Plan, at the rates determined by the Minister that are consistent with amounts accepted for payment as reasonable and customary charges under that Benefit; or
  4. for any other medical care, at the rates prescribed by the Minister.

(4) Notwithstanding paragraphs (2) and (3), where a patient who is not insured under a provincial or territorial hospital insurance or medical care plan is referred for treatment to a Canadian Forces medical facility by another department of the federal government, charges for the medical care provided shall be levied in the manner and at rates agreed upon between the Ministers concerned.

(5) The Minister may waive any charge that by this chapter is required to be made for medical care where, in his opinion, the imposition of that charge would constitute an undue hardship on the person responsible for payment.

(G)

[34.06: not allocated]


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Section 2 - Medical Care of Officers and Non-commissioned Members

34.07 - ENTITLEMENT TO MEDICAL CARE

(1) In Canada, medical care authorized in this article shall be provided:

  1. in a medical facility operated by the Canadian Forces or, where authorized by the commanding officer of an officer or non-commissioned member on the advice of the appropriate senior medical officer, in a medical facility operated by another department of the federal government or a civilian medical facility; and
  2. by a medical officer of the Canadian Forces or, where authorized by the commanding officer of an officer or non-commissioned member on the advice of the appropriate senior medical officer, by a medical doctor employed by another department of the federal government, a civilian medical doctor or such other health care personnel as may be authorized by the Chief of the Defence Staff.

(2) Where emergency medical care is required and the Canadian Forces medical facilities or medical personnel described in paragraph (1) have been determined to be unavailable or where the urgency of the situation precludes such a determination, medical care may be obtained from other sources and the receipt of that care shall be reported to the parent unit by the member concerned as soon as possible.

(3) Outside Canada, medical care shall be provided in accordance with article 34.10 (Medical Care in Foreign Countries).

(4) Subject to paragraphs (5) to (8), medical care shall be provided at public expense to a member of:

  1. the Regular Force;
  2. the Special Force;
  3. the Reserve Force;
  4. a force of a North, Atlantic Treaty Organization State in Canada in connection with his official duties, where reciprocal agreements for the provision of free medical care are provided for by that State; or
  5. any other military force, as directed by the Minister.

(5) Unless the Minister otherwise directs, a member of the Canadian Forces or of a force of a North Atlantic Treaty Organization State or other military force is not entitled to medical care at public expense:

  1. beyond the 21st day of a period of absence without authority;
  2. beyond the date of his release, except as may be provided under the Veterans Treatment Regulations to a former member of the Canadian Forces; or
  3. where he has failed to comply with regulations governing the provision of medical care, except that the charges for medical care obtained may be paid from public funds if subsequent action is taken to recover the cost from the member.

(6) Subject to paragraph (5), a member of the Reserve Force whose need for medical care is attributable to the performance of duty is entitled:

  1. for the remaining period of duty to medical care at public expense; and
  2. after termination of the period of duty to such medical care at public expense as the attending physician may consider necessary and as authorized by the officer commanding the command.

(7) Subject to paragraph (5), a member of the Reserve Force whose need for medical care is not attributable to the performance of his duty and is not a result of his misconduct or imprudence is entitled:

  1. where the requirement arises while he is on active service or on Class "C" Reserve Service, to medical care in accordance with paragraph (6);
  2. where the requirement arises while he is on Class "A" or "B" Reserve Service, to receive at public expense medical care in whole or in part which is not provided for under his provincial health care plan until the date upon which the period of duty terminates or the date upon which he is returned to his home, whichever is the earlier, unless otherwise authorized by the Minister; or
  3. where the requirement arises while he is on any duty not mentioned in subparagraphs (a) and (b) and unless the Minister otherwise directs, to medical care in accordance with paragraph (6).

(8) A member of the Reserve Force who is not on active service, Class "B" Reserve Service or Class "C" Reserve Service and who, in the opinion of the officer commanding the command, unreasonably refuses to accept the medical care prescribed shall not be granted any further medical care for that specific condition, effective the date of refusal.

(9) A person subject to the Code of Service Discipline under paragraphs 60(1)(d), (e), (f), (g), (h), (i) or, (j) of the National Defence Act who is held in service custody shall, where the person requires medical care during confinement, be given medical care at public expense until the person is discharged from service custody or from hospital, whichever is the later.

(M)

[34.08 and 34.09 inclusive: not allocated]

34.10 - MEDICAL CARE IN FOREIGN COUNTRIES

(1) An officer or non-commissioned member who is entitled to and requires medical care while in a foreign country other than the United States shall report to any unit of the Canadian Forces or, where such a unit is not available, shall report in the order shown to:

  1. any available unit of another of Her Majesty's forces;
  2. the nearest diplomatic or consular authority representing Canada, or the United Kingdom;
  3. the nearest unit of a foreign armed force; or
  4. a civilian medical practitioner or hospital.

(2) Where an officer or non-commissioned member reports to a facility referred to in subparagraph (1)(c) or (d), the member shall ensure that the nearest diplomatic or consular authority representing Canada or the United Kingdom is informed of the circumstances immediately.

(3) An officer or non-commissioned member who requires medical care while within the continental limits of the United States shall report for treatment in accordance with orders issued by the Chief of the Defence Staff.

(M)

34.11 - MEDICAL CARE WHILE ON LEAVE IN CANADA

(1) A member of the Canadian Forces or of a force of a North Atlantic Treaty Organization State while on leave in Canada who is entitled to medical care shall report to the nearest base or unit that is readily accessible when the member:

  1. requires medical care; or
  2. has been in contact with an infectious disease.

(2) Where a base or unit is not readily accessible, a member of the Canadian Forces or of a force of a North Atlantic Treaty Organization State shall:

  1. report to the Department of Veterans Affairs where it is practical to do so or a civilian medical practitioner or hospital when it is not; and
  2. personally ensure that the commanding officer of the nearest base or unit is informed.

(3) The commanding officer of a base or unit to which a member of the Canadian Forces or of a North Atlantic Treaty Organization State has reported under paragraph (1), or who has received information under subparagraph (2)(b) shall:

  1. immediately inform the member's commanding officer; and
  2. after medical care is completed or suspended, obtain and forward a descriptive case history to the member's commanding officer.

(4) Accounts rendered by civilian medical practitioners or hospitals for medical care obtained in accordance with paragraph (2) shall be forwarded in quadruplicate to the member's base or unit for payment by the Department.

(G)

[34.12: not allocated]

34.13 - CONTROL OF MEDICAL CARE

(1) An officer or non-commissioned member shall produce his identification card and, if applicable, leave form when applying for medical care under article 34.10 (Medical Care in Foreign Countries) or 34.11 (Medical Care While on Leave in Canada).

(2) An officer or non-commissioned member who has received medical care while absent from his base or unit shall report to the medical officer immediately on return.

(C)

[34.14: not allocated]

34.15 - MEDICAL BOARDS

(1) A medical board shall be assembled to examine the medical condition of a member:

  1. of the Regular Force or the Special Force
    1. before he is released or is transferred to the Reserve Force,
    2. before his medical category is permanently altered,
    3. before he proceeds on leave without pay and after his return from that leave,
    4. when the total of sick leave recommended exceeds 30 days,
    5. on repatriation to Canada for medical reasons, and
    6. at any other time prescribed in orders issued by the Chief of the Defence Staff; and
  2. of the Reserve Force when prescribed in orders issued by the Chief of the Defence Staff.

(2) A medical board shall consist of two medical officers when available or one medical officer when two medical officers are not available.

(3) A civilian medical practitioner employed under article 34.17 (Employment of Additional Medical Doctors and Other Health Care Personnel) may be appointed to a medical board in addition to a medical officer mentioned in paragraph (2) where it is considered desirable.

(M)

34.16 - MEDICAL EXAMINATION

An officer or non-commissioned member is required to undergo medical examinations and chest X-rays on the occasions prescribed in orders issued by the Chief of the Defence Staff.

(C)

34.165 - MEDICAL EXAMINATION BEFORE COMMITTAL

(1) A person shall, prior to committal to undergo a punishment of imprisonment or detention, be medically examined by a medical officer who shall certify on the Committal Order (see article 114.04 - Authority for Committal and Custody Pending Committal) that the person is fit, fit subject to limitations or unfit to undergo the punishment.

(2) A certificate made under paragraph (1) shall be in the following form:

Certificate of Medical Fitness

I certify that _____ [service number / rank / surname / given names]

is (fit)

(fit subject to _____ [specify limitations] )

(unfit by reason of _____ [specify reasons] )

to undergo (imprisonment)

(detention)

_____ [date] _____ [medical officer]

(C) [1 September 1999 – (1)]

34.17 - EMPLOYMENT OF ADDITIONAL MEDICAL DOCTORS AND OTHER HEALTH CARE PERSONNEL

(1) For the purposes of this article, "other health care personnel" means persons, other than medical doctors, who are certified or qualified to provide medical or health care of a kind prescribed in orders issued by the Chief of the Defence Staff.

(2) Where an officer designated for that purpose in orders issued by the Chief of the Defence Staff certifies that necessary medical care cannot be provided by a medical facility operated by the Canadian Forces or another department of the federal government, the officer may, subject to any limitations prescribed in orders issued by the Chief of the Defence Staff, authorize the employment of:

  1. medical officers of the Reserve Force; and
  2. civilian medical doctors and other health care personnel.

(3) The employment and subsequent reimbursement of fees and expenses for the services of persons described in subparagraphs (2)(a) and (b) shall be in accordance with articles 210.50 (Employment of Medical Officers - Reserve Force) and 210.61 (Employment of Civilian Medical Doctors and Other Civilian Health Care Personnel - Fees and Expenses), respectively.

(G)

[34.18 to 34.20 inclusive: not allocated]


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Section 3 - Medical Care of Dependants

34.21 - AVAILABILITY OF FACILITIES

Where considering the provision of medical care under this section, the medical officer concerned shall exercise his discretion to ensure that the care will not interfere with the proper medical care of service personnel under his charge.

(G)

34.22 - MEDICAL EXAMINATION - DEPENDANTS

(1) The dependants of an officer or non-commissioned member shall be medically examined before they are moved at public expense to a unit or location designated by the Chief of the Defence Staff.

(2) An examination required under paragraph (1) shall be carried out by the medical services of the Canadian Forces or a civilian medical practitioner employed under article 34.17 (Employment of Additional Medical Doctors and Other Health Care Personnel).

(G)

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34.23 - PROVISION OF MEDICAL CARE GENERALLY - DEPENDANTS

(1) A dependant of a member of the Regular Force, of the Reserve Force on Class "C" Reserve Service or of a force of a North Atlantic Treaty Organization State may be provided with medical care by the medical services of the Canadian Forces:

  1. in an emergency;
  2. where, in the opinion of the Surgeon General, no adequate civilian medical facilities exist;
  3. at the request of an appropriate civilian medical authority, where it is necessary to supplement civilian medical services; or
  4. in any other circumstances prescribed by the Minister.

(2) Subject to any conditions prescribed by the Minister, a dependant of a member of the Regular Force, of the Reserve Force on Class "C" Reserve Service or of a force of a North Atlantic Treaty Organization State may be provided with the following medical care by the medical services of the Canadian Forces free of charge:

  1. inoculations and vaccinations that are not readily available from civilian sources;
  2. drugs and dressings;
  3. treatment, including necessary ambulance service and treatment in hospital, of an infectious disease,
    1. where the dependant is residing in public quarters, service-controlled trailer parks or similar accommodation located on or associated with a defence establishment, and
    2. where the infectious disease, in the opinion of the senior medical officer concerned, constitutes a menace to the health of other persons within the defence establishment;
  4. health examinations in schools of the Department; and
  5. medical examinations required under article 34.22 (Medical Examination - Dependants).

(3) Subject to paragraph (2), medical care provided under paragraph (1) shall be charged for in accordance with article 34.05 (Charges for Medical Care).

(G)

34.24 - PROVISION OF MEDICAL CARE AT SEMI-ISOLATED UNITS

(1) Subject to any limitations prescribed by the Minister, a dependant who accompanies a member of the Regular Force or of the Reserve Force on Class "C" Reserve Service serving at a semi-isolated unit may, in addition to the medical care provided under article 34.23 (Provision of Medical Care Generally - Dependants), be provided with the following medical care by Canadian military medical facilities in the area:

  1. well-baby, pre-natal and post-natal clinics, free of charge; and
  2. out-patient care at rates in accordance with article 34.05 (Charges for Medical Care), except care provided under article 34.23 free of charge.

(2) Where the condition of the patient warrants, out-patient care may include house calls for examination and treatment.

(3) Where the senior medical officer considers it advisable in the interest of the patient to move him to another medical facility, the commanding officer may authorize the use of military transportation to convey the patient to and from the nearest appropriate medical facility.

(4) Where medical or other conditions preclude authorization under paragraph (3) of evacuation of a patient, any medical care provided shall be charged for in accordance with article 34.05.

(G)

34.25 - PROVISION OF MEDICAL CARE AT ISOLATED UNITS

(1) Subject to any limitations prescribed by the Minister, a dependant who accompanies a member of the Regular Force or of the Reserve Force on Class "C" Reserve Service serving at an isolated unit may, in addition to the medical care mentioned in article 34.23 (Provision of Medical Care Generally - Dependants), be provided with the following medical care to the extent available by Canadian military medical facilities in the area:

  1. well-baby, pre-natal and post-natal clinics, free of charge; and
  2. in-patient and out-patient care at rates in accordance with article 34.05 (Charges for Medical Care), except care provided under article 34.23 free of charge.

(2) Where the condition of the patient warrants, out-patient care may include house calls for examination and treatment.

(3) When the senior medical officer considers it advisable in the interest of a patient to move the patient to another medical facility, the officer commanding the command or formation concerned may authorize the benefits established in CBI 209.992 (Transportation of Dependants - Medical Care and Dental Treatment) for the journey to and from the nearest appropriate medical facility.

(G) [P.C. 2001-1508 effective 1 September 2001 – (3)]

34.26 - PROVISION OF MEDICAL CARE - OVERSEAS AREAS

A dependant who accompanies a member of the Regular Force or of the Reserve Force on class "C" Reserve Service serving in an overseas area may be provided with the medical care mentioned in article 34.23 (Provision of Medical Care Generally - Dependants) and with the additional medical care mentioned in article 34.25 (Provision of Medical Care at Isolated Units) in accordance with those articles, in a Canadian military medical facility or, where the care required is not available from a Canadian military medical facility, in a medical facility of the armed forces of another country that cares for members of the Canadian Forces in an overseas area under arrangements for admission made by Canadian military authorities at the rates prescribed in article 34.05 (Charges for Medical Care).

(G)

[34.27 to 34.29 inclusive: not allocated]


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Section 4 - Medical Care of Civilians, Public Servants, School Teachers and their Dependants

34.30 - PROVISION OF MEDICAL CARE TO CIVILIANS

(1) When considering the provision of medical care under this section, a medical officer shall exercise discretion to ensure that such care will not interfere with the proper medical care of service personnel under the medical officer's charge.

(2) Subject to paragraph (1), medical care may be extended to a civilian by the medical services of the Canadian Forces:

  1. in an emergency at the discretion of the senior medical officer present, examination and treatment in order to alleviate pain and suffering and to preserve life to the extent required to evacuate the patient to a civilian medical facility;
  2. where no civilian medical facilities exist;
  3. at the request of an appropriate civilian medical authority, where it is necessary to supplement civilian medical services; or
  4. under any other circumstances prescribed by the Minister.

(3) Where the senior medical officer considers it advisable in the interests of the patient to move him to another medical facility, the commanding officer may authorize the use of service transportation to convey the patient to and from the nearest appropriate medical facility.

(4) All medical care provided to a civilian under this article shall be charged for in accordance with article 34.05 (Charges for Medical Care).

(G)

34.31 - PROVISION OF MEDICAL CARE TO PUBLIC SERVANTS, SCHOOL TEACHERS, PERSONNEL OF VISITING FORCES AND THEIR DEPENDANTS

(1) The medical care authorized for dependants of service personnel under articles 34.23 (Provision of Medical Care Generally - Dependants), 34.24 (Provision of Medical Care at Semi-isolated Units), 34.25 (Provision of Medical Care at Isolated Units) and 34.26 (Provision of Medical Care - Overseas Areas) may be provided to public servants, school teachers and their dependants and members of a civilian component of a North Atlantic Treaty Organization State and their dependants.

(2) Subject to paragraph (3), medical care provided under paragraph (1) shall be charged for in accordance with article 34.05 (Charges for Medical Care).

(3) The medical care described in subparagraphs (2)(a), (c) and (d) of article 34.23 or in subparagraph (1)(a) of articles 34.24 and 34.25 may be provided free of charge under paragraph (1).

(G)

[34.32 to 34.99 inclusive: not allocated]