STATEMENT BY

MAJOR GENERAL BENJAMIN R. MIXON
COMMANDING GENERAL
25TH INFANTRY DIVISION (LIGHT)
UNITED STATES ARMY

SENATE COMMITTEE ON VETERANS' AFFAIRS
UNITED STATES SENATE

109TH CONGRESS

CARING FOR RETURNING SERVICE MEMBERS

13 JANUARY 2006

NOT FOR PUBLICATION
          UNTIL RELEASED BY THE
          SENATE COMMITTEE ON VETERANS' AFFAIRS

Statement By:
Major General Benjamin R. Mixon
Commanding General
25th Infantry Division, Schofield Barracks, Hawaii

Mr. Chairman and distinguished members of the Committee:

Thank you for inviting me to testify.  We at the 25th Infantry Division appreciate the opportunity to discuss the transition of our Soldiers from Active, Reserve, and National Guard duty to veterans' status, an issue that is very important to us.

The 25th Infantry Division has had over 1700 Soldiers leave the military honorably over the past 6 months.  We have found that these departed Soldiers have had various degrees of interaction with Veterans Affairs (VA), with most of the interaction being extremely helpful to both the Soldier and the family members of the veterans.  The most influential programs we've seen working are for Soldiers who return early from deployment due to injury or illness, and Soldiers who are medically discharged from the Army.  There are programs such as the Deployment Cycle Support process where the Soldiers returning from deployment with their unit receive information about VA, and programs to inform separating soldiers and retirees within 180 days of discharge of their VA benefits and disability claim abilities through the Army Career and Alumni Program (ACAP), and the VA Benefits Delivery at Discharge (BDD) program.  The ACAP and BDD programs inform all separating/ retiring soldiers of their VA benefits due to their honorable service, including medical disability claims.

The VA Pacific Islands has a very thorough system in place for Army veterans who separate or retire from the 25th.  Separating soldiers participate in the ACAP and BDD processes, where they are briefed by a representative from the VA on all VA programs available to them.  Following the briefing, every separating/ retiring solder is linked up with both a VA disability and healthcare representative, who sit down with the Soldier and his or her medical records to discuss all the available options.  The VA representative goes page by page through the service member's records to inform the Soldier of any possible benefits that he/she can apply for from the VA.  Service members can file their claims while still on active duty, as long as they are within 180 days of separating or retiring.  If they are not able to file a claim within that window, they can file their claim after they retire at the VA Regional Office closest to their residence.  The VA immediately processes claims of servicemen and women who are still on active duty through the BDD program, so the VA encourages Soldiers to file their claims as close as possible to within 180 days of discharge, with the goal to complete their claim prior to discharge

Service members are finding a majority of the portions of the VA BDD process efficient while other segments, such as final electronic cycle input of VA disabilities following a decision with award of compensation benefits, are slowing the process of receiving a disability check in conjunction with a retirement check.  One upcoming retiree said initiating his claim was very efficient; someone called him within a week of putting in his paperwork.  This is considerably faster than it would have been had he not submitted his claim for benefits until after he had been discharged.  It then took a month for him to see a VA doctor to assess his injuries which he received while still on active duty.  He presently is still on active duty and waiting for VA to certify his claim so he can receive disability after retirement. 

The overwhelming significance of the 25th Infantry Division working with the VA to assist in the transition of the Soldiers and their families into civilian life, and VA care and benefits is twofold:  First, the claims are processed much faster while the Soldier is on active duty, with decisions of benefits made in almost two thirds less time than it takes for claims processed after departure from service.  Second, the upfront knowledge of available VA programs and benefits can be a key decision maker for the Soldier and his/her family of how to use these benefits immediately following discharge, and how to program their transition into a new life style, based on available VA benefits.

25th ID Soldiers who return early from deployment due to illness or injury receive assistance from the Tripler Managed Care Division and the recently formed Patient Family Assistance Team (PFAT).  These services provide the service member with everything from medical care to financial services.  The Patient Family Assistance Team was organized in 2004 by Tripler Army Medical Center and has been very successful thus far in aiding our troops.  The team has social workers, a physician, a VA benefits representative, liaisons with other military care facilities across the world, and a presiding officer who is the Chief of Patient Administration (PAD).  The team also helps coordinate travel for dependents, personal and specialized care, housing, and financial services for each Soldier.  The VA benefits representative became a great liaison between the VA Vet Center and Department of Army (DA) helping facilitate direct counseling referrals for dependents of those killed and servicemen and women suffering with symptoms of Post Traumatic Stress Disorder (PTSD).  This VA team member also plays a crucial role in facilitating a seamless transition of care between the military behavioral health staff and the VHA Mental Health professionals who are helping provide care to the numerous Soldiers suffering from emotional trauma caused by combat.  The VA Social Work staff has trained military personnel, and at times provided direct care for Soldiers dealing with drug and alcohol abuse.  The Tripler Managed Care Division provides a Case Manager to each Soldier. 

The Case Manager is an activated National Guard Registered Nurse (RN) who has successfully completed the Case Manager course and is on orders to Tripler Army Medical Center for this purpose.  There are about 250 medical cases the Managed Care Division handles, with a ratio of approximately 1 Case Manager for 50 active duty Soldiers.  The ratio is approximately 1 to 35 for Hawaii National Guard and Reservists who return to the island due to the fact that their care will most likely be longer term on the island as opposed to active component Soldiers moving back to the mainland for various reasons.  The Case Managers have daily interaction with Soldiers and meet twice a month with the Patient Family Assistance Team to discuss any changes to or new benefits for Soldiers and to pass along information.  The Case Managers direct the Soldiers to the VA office in the hospital to make sure they get registered.  They explain to the Soldiers individually, based on their specific circumstances, the programs and benefits that apply to them and for which they are eligible.  One of the most important actions Case Managers take is ensuring no Soldier leaves the hospital without the proper Line of Duty paperwork that is critical for future care and disability payments for which they may want to apply.   The Managed Care Division also has a contracted social worker who is accustomed to working with Soldiers who do not want to seek mental health or post traumatic health treatment from military physicians.         
 
Soldiers returning from deployment on schedule with their unit all must go through a reverse Soldier Readiness Process in which they complete paperwork documenting their return from deployment, undergo a mental health screening, financial and housing processing, and other readiness items.  One of the booths they must stop at has a Health Benefits Advisor who gives them informational pamphlets on Veteran's Assistance and TRICARE.  In order for Soldiers to complete their reverse Soldier Readiness Process, they must have the Health Benefits Advisor's signature on their paperwork signifying they received the information.  We have realized that many Soldiers do not take the time to read this valuable information; their focus is solely on completing all redeployment tasks and enjoying being home.  To better inform Soldiers of their VA benefits, they attend various briefings and appointments on the third day of this process, after their 72 hour pass, to help them adjust to being back in Hawaii and in a garrison environment, and to help them get appointments for housing, finance, and vehicle pick-up.  On this day of briefings, one of them is given by a VA representative.  The briefing is extremely informative and gives the Soldiers all the information and points of contact necessary to use the VA.

Soldiers who may be medically discharged undergo a different process.  They will first receive a permanent profile, documenting their permanent injury and/or illness.  As soon as they receive this profile, they are required to attend a Division and medical briefing to begin the medical board process, which ultimately will determine fitness for duty.  At the medical brief, they are informed about the VA programs and benefits they are entitled to and are referred to VA employees for benefit counseling and to complete benefit applications.  This is especially significant for those who are eligible and need disability compensation.  Some Soldiers are referred to the VA's Vocational Rehabilitation Division where they receive contact vocational educational counseling.
 
The VA in Hawaii is doing tremendous things for 25th Infantry Division and US Army Hawaii Soldiers.  They provide extremely knowledgeable counselors and case managers to help every individual who returns from war and those who are retiring after a lifetime of service to the Nation.  The Soldiers in the 25th Infantry Division and US Army Hawaii are fortunate to have such a dedicated staff at the Hawaii VA who are continually developing and improving their programs to better support our service members.