STATEMENT OF
JOHN MEDVE
EXECUTIVE DIRECTOR OF VA/DOD COLLABORATION SERVICE
OFFICE OF POLICY AND PLANNING
U.S. DEPARTMENT OF VETERANS AFFAIRS
BEFORE THE
SENATE VETERANS’ AFFAIRS COMMITTEE

NOVEMBER 18, 2010

Good morning, Chairman Akaka and Members of the Committee.  My name is John Medve, and I am the Executive Director of the Department of Veterans Affairs (VA)/Department of Defense (DoD) Collaboration Service for VA’s Office of Policy and Planning.  I am pleased to join my colleague Deputy Under Secretary Campbell from the DoD and provide the Committee with an overview of VA’s and DoD’s plans for the way forward with the Integrated Disability Evaluation System (IDES). 

First, I want to acknowledge and thank you, Mr. Chairman, and the other members of this Committee for the leadership role you have taken on the issues of seamless transition for our wounded, ill, and injured warriors and Veterans.

The IDES is central to Secretary Shinseki’s efforts to transform the Department into a high performing 21st century organization focused on our Nation’s Veterans as its clients.  IDES, along with our work on the Virtual Lifetime Electronic Record (VLER), will improve the seamless transition of our Servicemembers from active duty to Veteran status.  The end goal is for Veterans to be able to easily enter the VA health and benefits system and receive the care and services they have earned.

Before going into our plans for the way forward, I think it would be helpful to start with how we got to where we are today. 

Through the leadership of Congress, in collaboration with VA and DoD, in early 2007, the Departments realized that changes were needed to the existing process in DoD’s disability evaluation system (DES).  The VA/DoD DES Pilot was launched in November 2007 and was intended to simplify and increase the transparency of the DES process for the Servicemember while reducing the processing time and improving the consistency of ratings for those who are ultimately being medically separated.  The National Defense Authorization Act (NDAA) 2008 further energized our efforts when it was signed into law and authorized the creation of a pilot program to make changes and improve DoD’s DES. Through these changes, the Departments hoped to provide a more effective transition of Servicemembers from DoD to VA care and a smoother transition to Veteran status.  We believe that the resulting DES Pilot, currently operational at 27 sites nationwide, has largely achieved those goals.  I acknowledge that there have been bumps in the road and many lessons learned, but I look forward to sharing with you how VA has worked with its DoD partners to create a more transparent, consistent and expeditious disability evaluation process for Servicemembers who are being medically retired or separated.  While we recognize that challenges remain, overall this is a good news story for Servicemembers and Veterans.

From the outset, we recognized that the DES Pilot Model was preceded by a maligned legacy process that was in some cases cumbersome and redundant.  The Pilot Model originally was launched as a joint VA/DoD process at three operational sites in the National Capital Region and was recognized as a significant improvement over the legacy process.  As a result of the desire by both Departments to expand the benefits of the Pilot to more Servicemembers, VA and DoD expanded the Pilot, starting in the fall of 2008 and ending in March 2010, from the original 3 to the current 27 Pilot sites covering 47 percent of the DES population. 

In contrast to the DES legacy process, the Pilot Model provides a single disability examination and a single-source disability rating that are used by both Departments in executing their respective responsibilities.  This results in more consistent evaluations, faster decisions, and timely benefit delivery for those retired or separated, while empowering Servicemembers with essential information to better enable them to transition to civilian life.  I would like to highlight the improvements we have made to compensation delivery.  VA prepares a proposed rating decision for use by DoD in determining fitness for duty for Servicemembers enrolled in the DES.  As a result, VA benefits are delivered within the shortest period allowed by law following discharge, and we have eliminated the “pay gap” that previously existed under the legacy process, i.e., the lag time between a servicemember separating from DoD due to disability and receiving his or her first VA disability payment.

Concrete examples of how our integrated approach has eliminated much of the sequential and duplicative processes found in the legacy system include reduction of the overall processing time for the delivery of DoD disability benefits from 540 days to 291 days while shortening the period until delivery of VA disability benefits after separation from an average of 166 days to near 30 days.

Based on these successes and after carefully addressing your IDES expansion concerns, the co-chairs of the Senior Oversight Committee agreed in July 2010 to expand the pilot and rename it IDES.  Senior leadership of VA, the Armed Services, and the Joint Staff strongly supported this plan and the need for all Servicemembers to receive the benefits of this improved pilot model.  We are now working together to launch IDES enterprise-wide.  While we are very proud of the successes of this model, we are also aware of remaining challenges.  We recognize that despite the overall reduction in combined processing time, VA can do better by improving exam timeliness.  We also recognize that as we expanded outside of the National Capital Region, we had not yet developed robust business processes to certify each site’s preparedness before it became operational.  This was a lesson learned at Ft. Carson, where the Departments have aggressively worked to remediate the issues of an unanticipated demand for disability exams.  We also recognize that there have been successes, such as Ft. Riley, Kansas, where VA and Army leadership took steps to avoid such problems as those experienced at Ft. Carson.  Through these efforts, and our analysis of lessons learned, we have developed Initial Operating Capability (IOC) readiness criteria that stress quality over expedience to ensure that future sites are operationally ready for IDES.  For a site to be deemed ready it must:  (1) be able to provide exam coverage through either the Veterans Health Administration, DoD, or contracted services; (2) have sufficient space and equipment for DoD and VA personnel; (3) meet VA information technology requirements; and (4) have local staff who have completed IDES training.  If any of these criteria is not met, then IDES cannot operate at that proposed site. 

In developing the plan for expansion, we will launch new sites in four stages over the course of fiscal year 2011.  This will be done in quarterly increments between October 2010 and October 2011.  Stage I of this expansion includes 28 locations on the West Coast and in the Southeast United States.  Of the 28 locations, 16 will initially use contracted exam providers, and the remainder will provide exams in conjunction with a VA medical facility.  Let me assure you that as we transition from the DES Pilot to IDES, we are jointly addressing the challenges I have highlighted and have taken active, concrete steps to ensure that we have the best, most effective program possible. 

On September 27-30, 2010, VA and DoD hosted a joint Training/Planning conference that set the stage for the roll-out of the next 28 sites.  The conference resulted in improved communications between VA and DoD at each site, individual site assessment analyses and evaluations, and development of joint local plans to meet IOC requirements.  This conference will be followed by similar events over the next few months as we prepare for the remaining stages of IDES implementation.  In fact, VA and DoD began a conference on November 16, 2010, which is wrapping up its work today.
As we move forward, we are mindful of the concerns and recommendations of the Government Accountability Office (GAO) in its recent draft report currently entitled “Military and Veterans Disability System: Pilot has Achieved Some Goals but Further Planning and Monitoring Needed.”  VA is currently drafting responses to the GAO recommendations. 

VA and DoD have jointly worked on improving and expanding the DES pilot so that Servicemembers can benefit from a uniform and integrated program.  Secretary Shinseki and Secretary Gates continue to provide leadership, commitment, and support to ensure a successful transition from the legacy DES process to the IDES without compromising quality for expediency.  In fact, on a recent visit to Ft. Drum, Secretary Shinseki held a roundtable with Servicemembers and received feedback on IDES.  We are incorporating his findings into IDES.

While we are pleased with the joint efforts and progress made, there is much more to do.  VA and DoD are committed to providing more support for our Nation’s wounded, ill, and injured warriors and Veterans through an improved IDES.  As such, we believe that continued partnership with DoD is critical and no less than our Servicemembers and Veterans deserve.
 
Thank you again for your support to our wounded, ill, and injured Servicemembers, Veterans, and their families.  Mr. Chairman, this concludes my testimony.  I will be happy to respond to any questions that you or other Members may have.