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Submission For The Record of Mr. Joseph A. Violante, Disabled American Veterans, National Legislative Director

 

Mr. Chairman and Members of the Committee:

The Disabled American Veterans (DAV), a national veterans service organization, was founded in 1920 and chartered by Congress in 1932 to represent this Nation’s war-disabled veterans.  DAV is dedicated to a single purpose: building better lives for our nation’s disabled veterans and their families.  While representing the interests of all service-disabled veterans, DAV counts among its membership 1.3 million war veterans who were injured in service to the Nation.  On behalf of DAV, I appreciate the opportunity to submit testimony to the Committee on the matter before you today. 

The President's Commission on Care for America’s Returning Wounded Warriors (hereinafter, “Dole-Shalala”) was ordered by President Bush following the public outcry earlier this year on discovery of substandard living conditions and confusing bureaucracy affecting hundreds of wounded soldiers at Walter Reed Army Medical Center. All of us were justifiably outraged that our Nation’s newest wounded and disabled military service members were being forced to live in deplorable conditions and experienced frustrating delays to get their disabilities adjudicated by the military service departments.  But even today, Mr. Chairman, injured and ill veterans continue to be denied benefits to which they are rightfully entitled, and I will explain our stance on this issue further in this testimony.

In general the report issued July 25, 2007 by Dole-Shalala strikes a positive chord in advocating improved support to the immediate families of the wounded; calling for better coordination between the Department of Veterans Affairs (VA) and the Department of Defense (DoD) across a number of separate, but overlapping responsibilities; and, establishing within both VA and DoD better guidance and more informed assistance for wounded service members, veterans and their families.  These are very good ideas and should be implemented rapidly.  We support them and commend the Commission for making these recommendations.  In fact DAV, in our Stand Up For Veterans initiative (www.standup4vets.org), is developing our own legislative recommendations, for consideration by Congress, covering areas very similar to the Dole-Shalala recommendations of better supporting family caregivers and improving coordination of care.  We hope to have our recommendations from that initiative, formulated by consultants now working with DAV after completing significant careers in the VA health care system, in legislative form to you by the end of this session of Congress, and for further consideration by the Committee early next year. 

Over the years DAV and other veterans service organizations have testified before this Committee and others on numerous occasions to identify many existing gaps in health and benefits systems, and to urge they be filled by actions within either VA or DoD, or both, or by Congress.  Congress has responded to many of these initiatives, and we appreciate that assistance.  Nevertheless, we believe a few of the Dole-Shalala recommendations that seek the same goals are in fact misguided or fail to recognize a degree of effectiveness that we at DAV understand and appreciate from decades of direct experience working in this very field, helping veterans obtain their rightful government benefits.

Recalling the explosion of media reports earlier this year to document the Walter Reed Army Medical Center scandal, it is ironic that the recommendations from a well-conceived, two-year study by the President's Task Force to Improve Health Care Delivery for Our Nation’s Veterans issued in 2003, with broad support from the entire veterans community, have gone nowhere. Yet the Dole-Shalala recommendations—some of which could do harm to the very system now in place and intended to help veterans, are apparently being put on a fast track to implementation.  DAV was invited with others to a White House briefing only a few days ago to be informed that the Administration is in the final stages of developing proposed legislation to carry out the Dole-Shalala recommendations, less than two months following the report of the Commission.  We at DAV hope this Committee—one that will have the major responsibility to consider the Administration’s proposal, will very carefully evaluate the potential consequences of this bill.  Its untoward affects in some areas that seem to help one group of disabled veterans may well damage the best interests of another group.  DAV’s policy is to protect the interests of all service-disabled veterans, not one group to the detriment of another.

In respect to protecting the interests of all disabled veterans, a major strategic goal of DAV, we appreciate the Committee’s interest in scheduling a hearing next month on the need for reform of funding of VA’s health care system – a key issue ignored by the Dole-Shalala Commission’s report.  The Senate Committee on Veterans’ Affairs held such a hearing on July 25, 2007, the same date that the Dole-Shalala Commission issued its report.  The President’s earlier Task Force in 2003 specifically pointed out the obvious mismatch between funding made available through the discretionary appropriations process now in use, versus meeting the true financial needs of VA health care.  This President’s Task Force hypothesis was validated in 2005 and 2006 by very public and embarrassing developments in VA health care when, during both periods, the VA Secretary reluctantly admitted to Congress that VA needed major emergency supplemental funding to keep the system financially solvent.  Congress eventually provided that needed extra funding, but we continue to believe that significant reform is necessary.  DAV strongly supports conversion of VA health care funding to a mandatory status as our top legislative goal, and we look forward to further discussions of this issue at your upcoming hearing.

Mr. Chairman, most of the six Dole-Shalala recommendations are already being addressed in the Department of Veterans Affairs. For example, early on in these wars VA established poly-trauma rehabilitation centers to treat traumatic brain injuries and other poly-trauma cases from the wars in Iraq and Afghanistan, and VA has been the pioneering force and recognized expert in the treatment and research on post-traumatic stress disorder (PTSD).  So, in many ways, VA is far and away ahead of the Dole-Shalala recommendations.

The VA has an established nationwide health care system that is a recognized leader in specialized treatment (including long term medical and vocational rehabilitation) of the kinds of injuries and psychological wounds occurring in the wars in Iraq and Afghanistan. Yet, initially Dole-Shalala has recommended that DoD take the lead role in coordinating long-term care for men and women with traumatic brain injury and post-traumatic stress disorder after they’ve been released from the military medical system.  The report recommends these individuals, as veterans, retain lifetime access to DoD health care through its TRICARE program, rather than make a smooth transition to VA care as the primary locus of their long-term rehabilitation.  While we do not object on its face to continued TRICARE eligibility for this newest generation of veterans, no former injured veteran group has ever been given this government benefit (even following the Persian Gulf War, when casualties were light).  This proposal, if approved by Congress, would set a precedent to continue for veterans of any future U.S. conflict.  After several decades of growing reliance on DoD, rather than VA, by service-disabled veterans, we question whether the VA health care system we know today would be able to retain its viability if wounded war veterans were still attached on a long term basis primarily to military medicine.  The military’s top mission in health care is the maintenance of readiness.  Giving the military a new mission to provide lifelong care to severely disabled veteran will sap resources and challenge the military services’ ability to sustain a strong readiness posture.

Mr. Chairman we are most troubled by an ill-advised Dole-Shalala recommendation for a seemingly wholesale and radical overhaul of the disability evaluation and compensation systems in use today in DoD and VA. Dole-Shalala would establish a complicated and different system of compensation payments for our newest injured military members while failing to address the accuracy and timeliness problems that have plagued both the VA and DoD for many years.  Dole-Shalala would have the government adjudicate disability for new and future injuries based on two primary factors—loss of earnings and diminished quality of life—instead of retaining and fixing the highly structured disability compensation system now in use that collectively considers both factors.  Even more troubling is the Dole-Shalala recommendation to drastically reduce the level of government disability compensation when a veteran stops working or gains eligibility for receipt of Social Security benefits. 

Based on DAV’s eight decades of contact with, and work in, the VA and DoD disability adjudication systems, DAV testified before the Dole-Shalala Commission and called for adequate staffing, structured training programs, and strict accountability for claims processing in VA.  Unfortunately, the Commission ignored our recommendations.  Our testimony to the Commission is attached to this testimony to provide the Committee an opportunity to fully consider our views as provided previously to the Dole-Shalala Commission.  Dole-Shalala had the opportunity to push the VA to take the first genuine steps toward effectively reducing to a minimum the present massive claims backlog.  Sadly, it chose not to do so by failing to address the staffing, accuracy and timeliness problems that have plagued both VA and DoD and instead proposed a program exclusively attuned to new combat-wounded veterans. Without that important and vital mandate as suggested by DAV, the VA may never be fully responsive to the needs of disabled veterans already in its claims adjudication queue. We question where this leaves the 600,000 veterans of earlier military service now awaiting resolution of their VA claims.  Implementing this Dole-Shalala recommendation would set a dual standard for disabled veterans—one that DAV could not support.

Mr. Chairman, it may be good to remind the Committee that this is not our first, nor probably our last, war.  Currently, like many other veterans organizations, members of DAV are largely drawn from the Vietnam War generation.  We at DAV are wartime veterans and have suffered many of the same kinds of injuries that are being suffered now in Baghdad or Kabul in our latest wars.  Had it not been for the existence of a caring, attentive VA system almost 40 years ago, including its health and compensation programs that sustained us and our families through the long-term rehabilitation process, and the VA’s Vocational Rehabilitation Program (under title 38, United States Code Chapter 31), that enabled us to embark on many rewarding careers, as disabled veterans we simply could not know where our lives might have taken us.  The VA health care system has been an intimate part of our lives for decades since those traumatic “Alive Day” events in the early lives of DAV members.  The quality of care and dedication to purpose and commitment of VA employees would be difficult to match elsewhere, in public or private systems.

We believe VA has a system that has worked well for years, is time tested and proven, but is now under fire because of the process, as opposed to the fundamentals.  We believe the fundamentals are sound at VA and should be preserved.  To provide VA what it needs in financial resources to employ and train sufficient staff, and to hold them accountable for the work they are supposed to do, would go a long way to keeping the system solvent well into the future to meet the needs of older veterans, the newest generation of wounded combat veterans, and future generations to come.  Said another way, we at DAV do not see the need for wholesale changes and the development of an entirely new compensation and benefit system at VA to replace, for new veterans what has worked successfully to assist veterans over many decades.

In 2004, in section 1501 of Public Law 108-136, the National Defense Authorization Act for FY 2004, Congress authorized a Veterans Disability Benefits Commission to examine VA’s disability compensation system, and to make a report with recommendations for any needed reforms.  The report of that Commission is due for release next month.  We hope this Committee will examine that report at least as closely as you examine this one from Dole-Shalala, to determine a proper and equitable disability compensation policy for war-wounded veterans, whether new or old.

Mr. Chairman, in summary DAV is concerned about the Dole-Shalala Commission report, especially in the areas indicated.  When the Administration’s legislative proposal is released to implement the intent of the Commission’s recommendations, we are hopeful DAV will have an opportunity to review it and provide the Committee further commentary before you act on that proposal.

Mr. Chairman this concludes DAV’s statement.  Again, on behalf of DAV, thank you for the opportunity to provide this testimony.