Four years after a number of changes regarding the medical care of reservists were recommended, the ombudsman for the Canadian Forces says civilian soldiers are still not treated equally.

Pierre Daigle says only four of the 12 recommendations made in a landmark 2008 report on the care of Canadian reservists have been implemented by the Conservative government.

In his follow-up report released Wednesday, Daigle said it was disappointing that so few of the recommendations have been applied.

“The reservists themselves don’t know what they’re entitled to so they don’t look for the care,” Daigle told reporters.

He added that reservists have been turned away from military medical clinics because those working in them are not aware civilian soldiers are entitled to a certain level of care.

The ombudsman began his investigation in 2006 and tabled the report in 2008. It took into account input from almost 400 individuals, the majority of whom were reservists.

Six of the recommendations have been partially implemented, while two others have not been addressed at all.

"The true value of a vital report of this nature is the degree to which accepted recommendations are followed-up on and implemented," said Daigle. "It's my job as ombudsman to flag items of concern to the Minister of National Defence which impact members of the National Defence and Canadian Forces community."

Specifically, the report notes that a wide gap still exists between the compensation doled out in cases of accidental dismemberment to reservists and that given to their full-time counterparts, which was described as a “grave unfairness.” Under the existing plan, a reserve member receives only 40 per cent of what full-time soldier gets for the same dismemberment.

If a reservist and a regular force member were involved in the same accident and each lost one hand, the regular force member would be compensated for $125,000 compared to the reservist at $50,000, the report notes.

"I was expecting a better average in the implementation," Daigle told The Canadian Press. “Everything there was not that difficult to implement. There still seems to be two classes of soldiers in the Canadian Forces, and this is disappointing."

Daigle also found reservists do not undergo regular health assessments and immunizations, and inconsistent medical screenings risk the well-being of reservists -- potentially leading to the deployment of medically unfit soldiers in domestic operations, such as floods or ice storms.

One area of improvement highlighted was the implementation of electronic medical records for all reservists.

A spokesperson for Defence Minister Peter MacKay told The Canadian Press that the latest ombudsman report presents an uneven picture of what the government has attempted to implement over the last four years.

"Minister MacKay has consistently stated that the care of ill and injured personnel is his central priority," said Jay Paxton. "Not reflected in the ombudsman's report are the monies Minister MacKay reallocated from within his budget, a total of $11.4 million, to augment mental-health care and preventive programs for regular and reserve force members.”

The 2008 report was the first comprehensive investigation involving Canada’s reserve forces undertaken by the ombudsman’s office and it revealed a number of problems for reservists who injured themselves on duty.

“While reservists are being called on more and more to fill the same roles as members of the regular force, when reservists need medical attention, they often find that they are not treated the same way as regular force members,” reads the 2008 report.

At the time, about 20 per cent of the Canadian troops in Afghanistan were reservists.

With files from The Canadian Press