Richard C. Daley, Associate National Legislation Director, Paralyzed Veterans of America
Chairman Stutzman, Ranking Member Braley, and members of the Subcommittee, Paralyzed Veterans of America (PVA) would like to thank you for the opportunity to testify concerning the issue of the Department of Veterans’ Affairs (VA) Vocational Rehabilitation and Employment Program (VR&E). The Global War on Terror has produced a large number of men and women that have honorably served the country and have returned to civilian life with one or more physical and or psychological wounds that create barriers to entry, or reentry into the civilian workforce. PVA would like to thank Congress and this Subcommittee for all the support they have provided disabled veterans and all veterans to make this transition successfully.
The purpose of the VR&E program, as authorized under Chapter 31 of title 38 USC, is to provide comprehensive services to address the employment barriers of service-connected disabled veterans in an effort to achieve maximum independence in daily living, and to obtain and maintain gainful employment. Ultimately, a goal of the VR&E program is to provide services to severely disabled veterans that will help them achieve the highest quality of life possible.
Currently, to be eligible for VR&E, a veteran must have been discharged under circumstances other than dishonorable; have a disability rating or 20 percent or more that was incurred in, or aggravated by their service; and be in need of vocational rehabilitation in an effort to overcome employment barriers caused by such service-connected disability. VR&E provides for 48 months of entitlement to use the program and, unfortunately veterans only have twelve years from the date of the initial VA disability rating notification to utilize the program, with an exception for those with a serious employment disability.
PVA and the other co-authors of the The Independent Budget, Disabled American Veterans, AMVETS, and Veterans of Foreign Wars strongly believe that this 12 year eligibility period should be eliminated and all veterans with employment impediments should qualify for VR&E services. Many veterans are not aware of the VA’s VR&E program and how it can be used to improve veterans’ lives. Often veterans learn of the VR&E services while talking to a VSO service officer or a service organization years after their discharge and they have little time remaining to utilize the program.
After severe injuries such as Traumatic Brain Injury (TBI) or Spinal Cord Injury (SCI) a veteran requires years to complete rehabilitation and make the adjustment to basic activities of daily living. During this time he or she is focused on recovery and the activity of returning to work is not a top priority for the veteran. Nevertheless, the veteran’s eligibility is elapsing.
Additionally, as many disabled veterans age, the service connected disability may impose further restrictions on a veteran preventing him or her from continuing their civilian work activities. The veteran may still have the economic need and the desire to work for another ten or twenty years. With the 12 year limitation, many service connected disabled veterans are disqualified and not able to utilize the VR&E services they have earned through the VA.
During the process of testing, evaluating, and preparing rehabilitation plans for qualifying veterans, the VR&E program often uses contracted suppliers. The VA claims that this is the only possible option available to address the needs of veterans in remote geographic areas and provide some of the support functions such as administrating testing procedures. PVA questions the use of contractors to perform the individual “one-on-one” work with veterans. We are concerned that this “one-on-one” work with the veteran is being contracted out in order for the trained VA counselor to have time to complete required VA paper work. If this in fact is true, then this is certainly not the best use of the experienced VA counselors’ expertise.
Another issue of concern for PVA is uniformity of the VR&E program regulations. PVA has received reports that different VA offices interpret the regulations pertaining to the VR&E program differently. This fosters inconsistent case management and a lack of accountability. In a previous hearing, PVA explained the story of one of our members with a recent spinal cord injury that was participating in the VR&E program. The program required the veteran to attend regular scheduled sessions and the veteran had problems with punctual attendance for the prescribed program at a VA facility. This was due to a physical and medical condition directly related to his injury. The veteran was expelled from the program, against the veteran’s wishes, because of his late arrivals. PVA believes this was a strict interpretation of the regulation for participation in the program. The veteran was seriously disabled and still has the ambition and desire to work. The VA should work with the veteran, not against the veteran.
Lastly, another issue brought to our attention by our service officers is the inability to quickly provide some basic services to those veterans that have been diagnosed with amyotrophic lateral sclerosis (ALS), which is a terminal condition. In recent years the VA has required the rating system to expedite these claims since an ALS diagnosed veteran has limited time (two to five years) to live. This has resulted in the ALS veteran receiving his or her usual compensation check as quickly as possible. In advanced stages of ALS, the veteran will rely on a wheelchair for mobility and most likely choose to spend the remaining months at home with family, rather than in a nursing facility or VA hospital. The procedure to modify the bathroom door for the wheelchair and other minor modifications now requires a veteran to submit the application for a Specially Adaptive Housing (SAH) grant, wait for approval of the application and submit the technical drawing for the construction modifications. The VA will then approve the plan or make recommendations for the modification. If recommendations are needed, the veteran resubmits the plan, and waits for the VA to approve the plan again. The VA also goes to the home to inspect the proposed site modification and at that time they may require additional plans for more modifications such as the addition of a second accessible rear entrance for emergency exit. This requires another application and another set of drawings and another approval procedure. The entire process could require six to twelve months.
The veteran’s only request was to modify the bathroom door by enlarging it two inches to accommodate the wheelchair. Any other mobility inconveniences would be tolerated in order to allow the veteran to remain in the home during the last months of life. Unfortunately as the veteran waits for the system to complete the requirements of the VA procedures, it is not unusual for the veteran to die before the home is modified to the VA standards.
For years the VA VR&E program has used funds from the Independent Living (IL) program to accommodate the ALS diagnosed veteran. The veteran and IL Counselor would select a previously approved contractor who follows the VA guidelines for bathroom modifications. The work is completed in weeks and the contractor is paid with IL funds.
In the last year the VA has changed this procedure and will not allow the IL program to pay for modifications and requires the Specially Adapted Housing (SAH) grant through the VA prosthetics program to accommodate the necessary modifications. This in fact, may be the new method to administer and account for these funds, but it is not working for the dying ALS veteran. PVA strongly encourages Congress and the VA to change its current policy involving veterans with ALS so that these claims are expedited to ensure veterans receive all necessary support during these last months of life.
VR&E should be more flexible with providing programs for veterans. The goal should be employment whenever possible, not just completing a prescribed course. This should include educational programs and non-degree employment training programs. Moreover, the VA should ensure that the training options offered through VR&E are compatible with the current 21st Century workplace.
The VA’s VR&E program provides invaluable services to America’s veterans. From technical and professional training to self-esteem and a sense of financial independence. It is for this reason the VR&E services should fully meet the needs of veterans who have made the ultimate sacrifice and incurred a service-connected disability.
PVA would like to thank this Subcommittee again for their constructive input on the programs of the Department of Veterans Affairs that help improve the lives of veterans. That concludes my testimony, I would be happy to answer questions you may have.