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Witness Testimony of Ms. Debra J. Gipson, Individual Servicemember

I would like to thank Chairman Runyon for holding this important hearing on the Integrated Disability Evaluation System (IDES).  I am honored to have been asked to participate.

History

            In 2011, while training to deploy to Afghanistan, I sustained a severe back injury. By the time my Reserve detachment reached the Active Duty training site, Fort Bliss, Texas, I was confined to a wheel chair earning me the nickname, “The Wheel Chair Soldier.” Days later, I was prescribed a cocktail of drugs which allowed me to walk but not without excruciating pain. Placed in the Warrior Transition Program efforts to rehabilitate my injury were unsuccessful and required surgical intervention.

Before my back surgery could be performed, I required a surgical procedure to treat uterine fibroids; tumors on my uterus. I did not receive a follow-up gynecological appointment. Placed in IDES, I was determined medically unfit to serve, received a 20% disability rating, medically separated and received separation pay. Within days of signing paperwork agreeing to the rating, it was determined that I urgently needed a hysterectomy. I want to be clear that had I received a follow-up to the original gynecological procedure the hysterectomy would have been performed earlier and my disability rating would have been 70%.

Instead of being medically retired, I was medically separated from the United States Army on January 11, 2014. 

Introduction

In my opinion, a strong democracy requires two professions: the Legislator and the Servicemember; each the weapon of the other. Healthy Servicemembers are the weapons of the Legislator while the Legislator is the weapon of wounded, injured and ill Servicemembers. We’ve served as your weapon. On behalf of disabled and medically separated Veterans, we respectfully request that you harness your arsenal’s full potential to fix this system and maintain the strength of our democracy.

I present the following long and short term recommendations:

Long-Term Recommendations

1.         Establish a Consolidated Disability Evaluation System.

The Integrated Disability Evaluation System (IDES), the disability ratings process by which Servicemembers are evaluated and declared eligible for compensation is timely, burdensome and inefficient.The VA and DoD must consolidate the Departments’ disability systems with the shared goal to promulgate policy and prescribe uniform guidelines, procedures and standards to eliminate redundancy inherent in adjudicating claims using dual disability rating systems.  

2.         Create a Sole Source Disability Rating.

The military rates only “fitting” conditions while the VA rates all service connected injuries resulting in two different ratings for qualifying Servicemembers. The DoD and VA will need to reach a consensus on the definition of qualifying conditions and events and the rate at which those conditions and events are to be compensated. Understandably, a bias in favor of the current, more generous VA system will result in a corresponding rise in retirement and medical costs.  

3.         Information Sharing.

            Plans to roll-out shared use technology by 2017 will enhance and improve agency accessibility to health care records. The plan is both necessary and ambitious. However, the current lack of available technology is only part of a much larger problem. Government agencies, among them the DoD and the VA, must generate Memoranda of Agreement allowing agencies to openly share information. This will likely require a change in agency culture from one of independence to interdependence on sharing information and resources.

Interim Recommendations

1.         Fiscal Set Aside.

            Veterans in the Servicemembers Transition Process frequently complain about the receipt of timely payments once his or her claim has been adjudicated. To date, the receipt of benefit payments can take from 90 days to a year or more to process. While uncertain of the legal or tax implications, I recommend that once a Servicemember enters Federal service (Active Duty, Reserve or Guard) a percentage of the Servicemember’s salary be escrowed until the IDES or (retirement) process is complete. The funds set aside could then be automatically reimbursed to the Veteran as a lump sum payment used to bridge the gap between the date of retirement (or separation) and receipt of any long-term or separation benefits.    

2.         Emergency Surgery Rating Reconsideration.          

            Servicemembers who require emergency surgeries within sixty (60) to ninety (90) days of being rated should receive automatic disability rating reconsideration.

3.         Complete a Comprehensive Staffing Needs Assessment.

            The Office of Personnel Management must undertake a comprehensive staffing needs assessment to: a) properly assess the cost/benefit of properly staffing the IDES system, and b) research areas where backlogged claims exist to determine whether problems of redundancy and inefficiency are functions of process or staffing related to organizational behavior, poor training, and/or a lack of incentives.

Staffing at the appropriate level will go a long way towards: a) eliminating the current claims backlog and, b) reducing the amount of time it takes to assess individual claims. Increasing staff means a short-term increase in personnel costs offset by a reduction in both the amount of time it takes to process claims and the number of Servicemembers anxiously awaiting claims adjudication.

4.         Manage Fraud, Waste and Abuse.

            The system is replete with opportunities for fraud, waste and abuse. The underlying premise of the adjudication process is to provide compensation and benefits for long-term injuries and illnesses. Any system which compensates Servicemembers for injuries and illnesses must also incentivize healing and recovery. It isn’t a politically popular notion. However, necessary if ballooning costs are to be reduced and full recovery a goal.      

A comprehensive assessment of where opportunities for fraud, waste and abuse exist must be conducted and measures put in place to mitigate such opportunities. Examples include: encouraging physician second opinions, eliminating redundancy in paperwork, and information sharing not just between agencies but within.            

5.         Organizational Change.

            We have got to change the organizational culture which punishes Servicemembers (directly or indirectly) for sustaining wounds, injuries or illnesses. In the current climate, Servicemembers deemed unfit to fight or conduct acts of physical fitness are cast aside and labeled; often unfairly, as lazy or cowardly. I do not advocate group hugs on the battlefield. However, leadership training must encourage compassion, dignity and respect. Likewise, service providers, whether military or civilian, must receive similar training.

Toxic leaders (military and civilian) and service providers must be either retrained or moved out of leadership or positions of authority to mitigate damage to wounded and/or recovering Servicemembers.

Conclusion

The recommended suggestions to improve IDES will each require a cost-benefit analysis to determine feasibility. Such analysis is beyond the scope of this presenter. What is certain is that each cost and benefit must be assessed using both quantitative and qualitative analysis. It is my belief that undertaking such analysis, however painstaking, will improve IDES to the benefit of retiring Servicemembers.