GERALD T. MANAR, DEPUTY DIRECTOR
NATIONAL VETERANS SERVICE
VETERANS OF FOREIGN WARS OF THE U.S.
ON BEHALF OF THE MEMBERS OF
THE INDEPENDENT BUDGET
COMMITTEE ON VETERANS AFFAIRS
UNITED STATES SENATE
WASHINGTON, D.C. OCTOBER 17, 2007
Thank you for this opportunity to provide the views of the members of the Independent Budget -- AMVETS, Disabled American Veterans, Paralyzed Veterans of America and the Veterans of Foreign Wars of the United States -- on VA and DOD collaboration, the Report of the President's Commission on Care For America's Returning Wounded Warriors, the Report of the Veterans Disability Benefit Commission and other related reports.
It seems that every few years another study is commissioned to examine some of the problems involving benefits and delivery of benefits available to service disabled veterans. With the Veterans Disability Benefits Commission (VDBC), a pattern has emerged that our nation requires a more comprehensive review every 50 years or so to help us all refocus on the entire system of benefits, note the things that are working well and devise solutions to those that no longer fully address the needs of the men and women who stood ready in both peace and war to defend our nation, even at the possible cost to themselves of disability or death.
Six years after terrorists attacked us on American soil, we remain deeply embroiled in armed conflict in both Iraq and Afghanistan. Over 3,800 men and women have been killed and nearly 28,000 wounded. Another 29,000 were treated for diseases and injuries not arising from combat, disabilities so debilitating that they required air transport from the region in order to receive appropriate medical treatment. There is no accounting for the thousands of other service men and women who were treated and returned to duty in that troubled region of the world.
Thousands of soldiers, Marines, sailors and airmen have returned home with catastrophic injuries. It was their difficulty in obtaining treatment, proper housing, adequate benefits and services, as well as basic help in the transition from military service to civilian life that caught our attention earlier this year. What was most disturbing was that the problems coming to light in 2007, while perhaps exacerbated by the current conflict, have existed to some extent for decades. The Presidents Commission on Care for America's Returning Wounded Warriors (PCCWW), created in March 2007 and reporting four months later, examined how the armed services treat those with serious injuries and help them through discharge from service and transfer to the Department of Veterans Affairs.
While this testimony will focus primarily on the recommendations of the PCCWW and VDBC on transition issues, we will also address the recommendations of both commissions on benefits provided by the Department of Veterans Affairs for disabilities arising while performing military service.
You have before you enough ideas, suggestions and recommendations to create another title in the US Code and keep regulation writers at both the Department of Defense and the Department of Veterans Affairs busy for the next 10 years. It is little wonder that you have asked those of us at this table to help you parse the cornucopia of proposals and make coherent the competing voices.
There are many good things presented in these reports: some are simple, others complex beyond imagination. Some will help DoD and VA help service men, women and veterans while others would create more problems. Some are inexpensive while others will place additional burdens on the Treasury.
We offer you our views, not to make your task easier, but rather, to help make the correct path more visible.
They are all veterans equally
One of the Guiding Principals adopted by the VDBC was that benefits should be awarded based on the severity of the service-connected disability and not on the circumstance under which it was acquired. This principle is not new. At one time VA paid higher benefits to veterans with service connected disabilities incurred in combat. However, Congress recognized the inequity of paying veterans with identical disabilities different amounts of compensation solely because one received his injury in combat and the other did not; as a consequence, Congress equalized the rates for all veterans in 1972.
The Veteran Service Organizations we represent today endorse the current government policy and completely reject the notion that injuries acquired in combat are any more disabling, any more worthy of compensation, than those incurred elsewhere in service to our country. We agree with the VDBC that benefits should be based only on the severity of disability.
Care for seriously disabled service members - We support the PCCWW recommendations which would:
We believe that these services should be provided all seriously disabled service members regardless of where their disabilities were acquired. A soldier paralyzed from the neck down from an accident in Germany or Korea is no less deserving of these services than is someone who was paralyzed by an IED in Iraq.
Transfer of patient information across systems - We support the PCCWW recommendations that would:
Strengthen support for families of seriously disabled service members and veterans - We support the PCCWW recommendations that would:
Improve care for service members with post traumatic stress disorder (PTSD) and traumatic brain injury (TBI) - We support the PCCWW recommendations that would:
We believe the better approach would be to vastly increase the numbers of mental health professionals at VA to provide better and timelier service to all veterans with PTSD. While increasing mental health staff, VA should use its fee-basis authority whenever old or young veterans must receive care immediately.
Finally, VA should improve its ability to triage veterans with mental health symptoms to ensure that those who might be a danger to themselves or others are seen immediately and by an appropriate professional.
Again, we believe that every disabled service member should be eligible for every benefit and service required by the severity of the disability they have and not by the place or circumstance under which it was incurred.
Enhance the Joint Executive Council (JEC) - We support the recommendation of the VDBC to:
VA and DoD should develop a joint intensive case management program for severely disabled veterans with an identifiable lead agent - We support the recommendation of the VDBC
Congress should adequately fund and mandate the Transition Assistance program DoD wide - We support the recommendation of the VDBC.
Benefits Delivery at Discharge (BDD) should be available to all disabled service members including Guard, Reserve and medical hold patients - We support the recommendation of the VDBC.
DoD should mandate separation examinations for all service members; the examination should conform with VA protocols and directives - We support the recommendations of the VDBC.
DoD should provide TRICARE free of charge for severely injured service members and their families - We support the recommendation of the VDBC.
We commend the other recommendations from the VDBC dealing with transition issues to you for consideration.
Post Service Transition
Both the PCCWW and the VDBC understand the need to ensure that services and benefits do not stop as disabled service members make the transition to civilian life. Too often, the only "transition" disabled service members received was a Transition Assistance Program briefing or a bit of counseling from the VA or a veteran service officer at a BDD site. The recommendations discussed earlier, if adopted, should make the transition process much better for disabled service members.
However, most veterans are not seriously disabled at discharge and are not processed through the Disability Evaluation System. While they know what their education benefit eligibility might be, they have little knowledge of vocational rehabilitation, home loan guarantees and the like from VA.
Vocational rehabilitation - Both the PCCWW and the VDBC recommended changes in vocational rehabilitation which, in our view, should be seriously considered for implementation.
Transition Payments - As the claims backlogs have increased at the VA, it seems that a growing number of people, including some Members of Congress, have voiced the opinion that these veterans should not be made to wait for VA to decide their claims for benefits. Their greatest concern has been for the recently discharged veteran who often has little income, perhaps some disability and no job. In the last year, some have even suggested that VA should simply pay the veteran whatever it is they claim.
We oppose the use of the disability compensation program to pay what amounts to a transition benefit or bonus. We do, however, support the idea of a transition payment independent of VA compensation. We urge Congress to consider creating such a payment, a form of deferred compensation, independent and separate from VA compensation, to help men and women during the initial few months following their discharge from service.
Reengineering VA disability compensation - revolution or evolution?
In 2004 the Congress enacted legislation creating the Veterans Disability Benefits Commission:
"The purpose of the Veterans' Disability Benefits Commission is to carry out a study of the benefits under the laws of the United States that are provided to compensate and assist veterans and their survivors for disabilities and deaths attributable to military service, and to produce a report on the study."
The first few meetings of the Veterans Disability Benefits Commission (VDBC) (starting in May 2005) were met with skepticism and wariness by some of us in the veteran community. We were well aware of the forces which led to the creation of that commission and were deeply concerned that at least some Commissioners harbored secret agendas which, if adopted, would lead to the dismantling of programs designed to help treat and compensate veterans for the residuals of disabilities incurred or aggravated while in service to our country.
During the 28 public sessions spanning 55 days of public hearings, it became apparent that Commissioners were willing to work hard to learn about compensation benefits: what they are, how the program evolved to where it is today and what problems exist. Further, we were gratified to note that Commissioners were willing to reconsider their opinions as facts were brought to light by the Center for Naval Analyses and the Institute of Medicine. We watched extensive fact gathering and more extensive debates on issues that were critical to the establishment of a foundation for later decisions.
While we have disagreed with some decisions made by the commission we could tell the veterans we represent that the commission was well on the way to producing a thoughtful and constructive report which addressed many problems without harming veterans.
A few weeks ago the VDBC released its final report. Of the commission's 114 recommendations, fully 83 percent deal with compensation benefits or factors related to compensation benefits. Even when the commission drifted a little afield and made recommendations dealing with transition issues, it is clear that most deal with ensuring that VA has the information it needs as soon as possible to process claims from veterans.
The President's Commission on Care for America's Returning Wounded Warriors, on the other hand, was created in March 2007 and delivered its report less than four and a half months later. It produced 24 recommendations; 8 of the 24 recommendations were focused on discarding the current compensation program and substituting a new program requiring a new rating schedule, new rates for disability benefits, new theories of what could be service connected, how long compensation payments would continue and so on.
While there are a few ideas presented by the PCCWW that may have merit, the discussion, below, describes those that are most objectionable.
The Veterans Disability Benefits Commission has exhaustively examined the current compensation program, affirmed its strengths and pushed forward many thoughtful and constructive recommendations for evolving it into a mechanism to better serve America's new generations of veterans. Their approach is to retain the best parts of the disability compensation program and create a process for measured and deliberate reform and improvement. We urge you to carefully consider their recommendations.
We trust that this is the first of several hearings on these reports and other proposals affecting the transition of service members from warrior to respected veteran. We appreciate the opportunity you have afforded us today.
I will be happy to answer any questions you may have for me.
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