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LTG James Terry Scott USA (Ret.), Chairman

LTG James Terry Scott USA (Ret.), Chairman, Advisory Committee on Disability Compensation

Mr. Chairman and Members of the Subcommittee:  It is my pleasure to appear before you today representing the Advisory Committee on Disability Compensation and the Veterans Disability Benefits Commission that met from 2005 to 2007 and reported out to you in October of that year. 

The Advisory Committee is chartered by the Secretary of Veterans Affairs under the provisions of 38 U.S.C. in compliance with P.L. 110-389 to advise the Secretary with respect to the maintenance and periodic readjustment of the VA Schedule for Rating Disabilities.  Our charter is to “(A)ssemble and review relevant information relating to the needs of veterans with disabilities; provide information relating to the character of disabilities arising from service in the Armed Forces; provide an on-going assessment of the effectiveness of the VA’s Schedule for Rating Disabilities; and provide on-going advice on the most appropriate means of responding to the needs of veterans relating to disability compensation in the future”.

Your letter asked me to testify on the Advisory Committee’s views on the transition from service member to Veteran, with a particular focus on the implementation of the Integrated Disability Evaluation System (IDES). 

First, a bit of background.  At the time the Veterans Disability Benefits Commission was created by the National Defense Appropriations Act of 2004 it was already apparent that the peacetime system for transitioning sick and injured service members to Veteran status was overwhelmed.  From the outset, and well before the reprehensible situations at the Walter Reed Barracks and other locations were recognized, the Commission recognized the need for a seamless and rapid transition process that protected the service member while he or she progressed to Veteran status.  Transition became one of the major issues studied by the Commission.  Interim recommendations addressing transition issues were offered  as deliberations progressed.

The Veterans Disability Benefits Commission (VDBC)

examined the policies and processes within the Departments of Defense, Veterans Affairs, Labor, Health and Human Services, and the Social Security Administration that affected military separation or retirement.  Each of these entities plays a significant role in the transition of Veterans and their families.

Of the 113 recommendations the Commission made, many of them pertained to improving the transition process.  I am providing for the record a list of the key transition recommendations and the status of their implementation as I understand it.

4.4 and 4.5: VA should develop a process for updating disability examination work sheets and mandate the use of approved templates.  (This is currently being addressed by the adoption of Disability Benefit Questionaires for the use of VA and non-VA medical examiners.)

4.10: VA and the DoD should conduct a comprehensive multidisciplinary medical, psychological, and vocational evaluation of each Veteran applying for disability compensation at the time of service separation.  (This is partially addressed by the IDES system for sick or injured service members and by the expanded TAP briefings.  Complete physical exams for all separating service members are still not required.)

4.23: VA should immediately begin to update the current rating schedule beginning with those body systems addressing the evaluation and rating of PTSD and other mental disorders and of traumatic brain injury and then proceed through the other body systems until the Rating Schedule has been comprehensively revised. (This is currently being addressed by VA with a projected completion in 2016.)

5.7: DoD should require a mandatory benefits briefing to all separating military personnel, including Reserve and National Guard members prior to discharge from active service.  (This is being partially addressed by the services and VA through expanded TAP briefings.)

5.28: VA should develop and implement new criteria specific to posttraumatic stress disorder in the VA Schedule for Rating Disabilities.  (This has been done and is awaiting approval.)

6.9: Access to vocational rehabilitation should be expanded to all medically separated service members.  (Programs have been expanded but universal access has not been achieved.)

6.10: All service disabled veterans should have access to vocational rehabilitation and employment services.  (These programs have been expanded, but are still not available to all service disabled veterans.)

7.11: VA and DoD should adopt a consistent and uniform policy for rating disabilities, using the VA Schedule for Rating Disabilities (VASRD).  (This has largely been accomplished by DoD accepting the VASRD.  It is an integral part of the IDES.)

7.13: VA and DoD should realign the disability evaluation process so that the services determine fitness for duty and service members who are found unfit are referred to VA for disability rating.  All conditions that are identified as part of a single, comprehensive medical examination should be rated and compensated.  (The IDES system has adopted this procedure.)

10.1: VA and DoD should enhance the Joint Executive Council’s strategic plan by including specific milestones and designating an official to be responsible for ensuring that the milestones are reached.  (This has been fully implemented by VA and DoD.)

10.3: DOL and SSA should be included in the Joint Executive Council to improve the transition process.  (DOL participation in transition and in follow up has greatly increased.)

10.4: To facilitate seamless transition, Congress should adequately fund and mandate the Transition Assistance Program (TAP) DoD-wide to ensure that all service members are knowledgeable about benefits before leaving the service.  (Expansion of TAP is a major ongoing effort in VA today).

10.5: Benefits Delivery and Discharge (BDD) should be available to all disabled exiting service members (to include National Guard, Reserve, and medical hold patients). (Progress unknown).

10.6: DoD should mandate that separation examinations be performed on all service members. (While progress has been made, this is still not a requirement in all services for all separating members.  While requiring resources, this policy will pay great dividends in future years by providing a clear picture of physical and mental condition at separation which can be used in determining service connection for disability.

10.8: DoD should expand existing programs that translate military occupational skills, experience, and certification to civilian employment.  (Progress unknown.)

10.11: VA and DoD should expedite development and implementation of compatible information systems including a detailed project management plan that includes specific milestones and lead agency assignment.  (This complex issue is under development.)

Of the recommendations pertaining to transition that both the Veterans Disability Benefits Commission and the Advisory Committee on Disability Compensation have offered, the one with the most potential to reduce the time to process claims and improve accuracy and consistency is the ongoing plan to revise the VASRD.  This complex, multi-year revision will incorporate current medical knowledge and technology as well as streamline the diagnosis, evaluation, and adjudication processes.

Another key recommendation with potential long term positive effect is the movement to an electronic claims record.  This is another extremely complex challenge that the VA has accepted and is working. When fully implemented it will simplify and expedite the claims process.

The Current IDES program incorporates many of the recommendations from the Veterans Disability Benefits Commission and the Advisory Committee on Disability Compensation.  It represents a tremendous effort on the part of  VA and DoD to focus on the transition of service members who are sick or injured to Veteran status.  All parties, including the Congress are frustrated by the average time still required to complete the transition.  However, from the perspective of someone who has had the opportunity to contribute to this effort over the last eight years, I believe the progress is significant and, more importantly, that the progress will continue.

On behalf of the Advisory Committee, thank you for the opportunity to testify on this important matter.