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Pilot Program Cuts Disability Evaluation Time, Speeds Veterans' Benefits

By Fred W. Baker III
American Forces Press Service

WASHINGTON, Nov. 30, 2007 – Defense Department and Department of Veterans Affairs officials are piloting a joint program that could effectively dismantle one of the most confusing and frustrating obstacles in wounded warriors' recovery process.

Nine months after Defense Secretary Robert M. Gates said wounded warriors should not return home to battle the bureaucracies of a broken health care system,

a year-long test of a new disability evaluation system started this week. 

The pilot program began at three major medical hospitals treating wounded servicemembers here in the national capital region. Walter Reed Army Medical Center in Washington, D.C., the National Naval Medical Center in Bethesda, Md., and Malcolm Grow Medical Center on Andrews Air Force Base, Md., are taking part in the program.

DoD and VA officials said that partnership is key to the elimination of duplicate processes between the two department’s own evaluation systems.

“This is about as good as it can get within the current statutory framework of the DoD’s role in disability evaluation and the VA’s,” said Michael L. Dominguez, principal deputy undersecretary of defense for personnel and readiness, at a briefing today at the Pentagon.

“I believe as a long-time Washington insider that it is a significant event that two cabinet agencies have found a way to bridge the boundaries in their organizations such that one cabinet agency … agrees to be bound by decisions made by officials in another cabinet agency,” Dominguez said.

Now that the physical process has been streamlined, a single rating system is in place, and the two departments have agreed to abide by the decisions of each other in order to prevent duplicate efforts.

The new system promises to cut in half a process that has taken up to two years and to offer a seamless transition in care and benefits from active-duty to veteran status, officials said.

In the past, each service had its own disability evaluation and rating system and VA had its own. Wounded servicemembers would go through the service board process of receiving a physical examination, a determination of fit or unfit to continue service, and then, if determined unfit, receive a rating.

That rating determined if the servicemember was medically retired or separated with severance pay. The servicemember, once discharged, would enter the VA system, repeat the process, and many times receive a higher disability rating and subsequently a higher level of benefits.

Now, DoD has agreed that VA will conduct a the initial physical examination and, if the servicemember is determined unfit, will assign the disability rating that will be used to determine type of discharge and subsequent VA benefits. The servicemember still has an appeal process if they disagree with the rating.

Also, because VA assigns the rating initially, when the servicemember is discharged they can begin receiving benefits within a few weeks, as opposed to six months or a year later with the previous system.

Changes in the system came after a host of commissions, task forces and review groups have fielded complaints from servicemembers and families. The problems were highlighted at the start of this year when soldier care problems at Walter Reed Army Medical System were publicized in media reports. Calls for revamping the system came from as high as the president.

“It was characterized as unfriendly, redundant and lethargic,” Bill Carr, deputy undersecretary of defense for military personnel policy, said of the old system.

Most of the reports and reviews pointed to the need for “a faster, more compassionate, less adversarial and, by all means, more effective (system). And I think we’ve done those things,” Carr said.

The pilot program will be monitored closely by senior DoD and VA officials during its run and adjusted as needed, Carr said. There is no timeline for implementing the system across the board at other military hospitals.

Initially, eight soldiers at Walter Reed, all who had been through the previous system, tested the new system and reported favorably, said Army Brig. Gen. Mike Tucker, assistant surgeon general for Warrior Care in Transition. Families also reported favorable of the new system.

This pilot comes on the heels of another partnership announced between the two departments last month when they teamed to put in place 10 federal recovery coordinators charged with managing the care of severely injured servicemembers and their families for as long as a lifetime.

Officials said these are the first positions of their kind in the military health care system and were put into place in response to recommendations from servicemembers, families and by the President’s Commission on Care for America’s Returning Wounded Warriors.

VA officials said their department will hire the coordinators and are trying to have them on board by January. They will be assigned to Walter Reed Army Medical Center, the National Naval Medical Center, Brooke Army Medical Center on Fort Sam Houston, Texas and Naval Medical Center San Diego.

The program’s coordinators are charged with managing all the needs of severely injured servicemembers and their families as the troops move through the recovery and rehabilitation process and return to their communities.

The two agencies have also committed to developing a joint inpatient medical record system. The agencies went as far as swapping their heads of information technology for six months to help break down the barriers of data exchange between the two, officials said.

In addition, officials announced today that the two departments have teamed to establish a center of excellence for psychological health and traumatic brain injury. The center started initial operations today in its temporary offices in Rosslyn, Va. The center will serve to advance research on and disseminate information relating to psychological health and traumatic brain injury. The center is led by DoD with VA support and is expected to be fully operational by October 2009.

Contact Author

Bill Carr
Michael L. Dominguez

Related Sites:
Wounded Warrior Care

Related Articles:
Defense, Veterans Affairs Departments to Coordinate on Patient Care

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