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Pentagon/VA Set To Begin New Disability System

Ever since the furor over healthcare at Walter Reed broke into the news, there has been much discussion about the Military and VA healthcare systems and how difficult and frustrating it is to migrate between the two. Because of this controversy, President Bush put together a commission to study the problem and make recommendations on changes. Those recommendations were made and to date, some of those recommendations have been implemented. Last week, President Bush, along with commision co-leaders, former Kansas Senator Bob Dole and former Secretary of Health and Human Services Donna Shalala, urged Congress to quickly pass the bill that President Bush had sent before them, to improve Military and Veteran healthcare.

The Defense Department has announced that they will soon unveil a new and more streamlined disability evaluation process that will work in tandem with the Department of Veterans Affairs and will replace the current system, in which Soldiers transitioning from the Military healthcare system to the VA healthcare system have to undergo two evaulations and two separate disability ratings. The new process, will allow Veterans who are medically retired from the military to apply for and be able to get VA benefits immediately. According to Bill Carr, undersecretary of defense for military personnel policy, the time spent for a service member to from the point of being medically unfit for duty to receiving VA benefits will be cut in about half. That is great news. In the past, it might take months for a medically retired servicemember to be able to begin collecting VA benefits, due to the sometimes duplicated processes in both systems.

This new plan, is the Pentagon’s best efforts in assuring that some of the problems in the system are fixed immediately, without having to wait for Congressional approval. The broader, long-range plans announced by President Bush last week, will require Congressional approval and will take longer to implement. Therefore, by addressing issues that don’t require Congressional approval, the Pentagon and White House will continue to move forward towards implementing the recommendations of the commission.

The new Pentagon plan will be phased in, beginning with a pilot program to be launched in late November at 3 military hospitals. Those hospitals are Walter Reed Army Medical Center in Washington DC, the National Naval Medical Center in Bethesda, Md. and the Malcom Grove Medical Center at Andrews Air Force Base, Md. This plan will be expanded to other military medical facilities as officials have had the opportunity to evaluate its effectiveness, with emphasis being given to the facitlies that great the greatest number of Troops wounded in the wars in Iraq and Afghanistan. The expansion to other military medical facilities will occur as fast as possible, according to Carr.

Defense Secretary Robert Gates has made revamping the Military and VA medical systems one of his top priorities, in answer to the Walter Reed scandal. According to media reports back then, Wounded Warriors were caught in a tangle of red-tape as they transitioned between the systems. The problem was further escaberated by the slow-moving Va benefits process and the fact that there was poor coordination between the military system and the VA system. In the new program, all Troops will be evaluated equally, regardless of how their conditions developed.

Currently, each branch of the military does their own physical exam during the process of determining if the servicemember will be medically separated and their are then given a rating by their military branch for his or her condition. A servicemember who is then medically separated and seeks Va care, has to endure another physical exam and another rating process; a duplication of services which leads to a longer wait for much needed services and benefits. The new system hopes to eliminate this redundancy.

“The most important part of it is that we take duplication and we stamp it out,” Carr said.

With the new system, a single physical exam will be administered to Troops as a part of the standard Medical Evaluation Board, which will determine the servicemembers fittness for duty. Instead of a military doctor, a VA qualified provider, who will have access to the servicemembers medical records, will perform the exam. In addition to evaluating conditions which might make the servicemember unfit for continued military service, the doctor will also give consideration to conditions that the servicemember might have, which have been incurred or aggravated by their military service. If the servicemember doesn’t meet retention standards, they are then referred to a Physical Evaluation Board. The board will then decide if the servicemember will be retained in the military or separate them from service. Under the current system, the board can determine the nature and amount of military benefits. Troops retain the right to appeal the boards finding. If the finding is confirmed during the appeal process, the new system will allow the troops to have any single condition or rating reconsidered by a VA decision review office, while they are still on active duty.

With the current system, a servicemember has to be rated at at least 30 percent disabled by the military to be medically retired. Unless that servicemember has more than 20 years of service, a rating below 30 percent calls for medical separation and in some circumstances, they may recive a lump sum one time payment.

In the new program, the military will no longer issue disability ratings. Instead that will be solely up to the VA to determine the disability ratings. Until the law is changed however, the military will continue to base its disability rating decisions only on conditions that make a servicemember unfit for continued service. That’s why it’s so imperative that Congress act quickly to enact the legislation that President Bush sent before them last week and why he, Dole and Shalala held the joint new conference to implore them to do so.

For example, under the current system, if a servicemember is rated at 20 percent disabled by the military and 10 percent disabled for hypertension, under the current military rating system, for deciding if they will be retained or to release the servicemember, their rating would be 20 percent, because hypertension is considered a treatable condition. Under the current VA system, the servicemember would be given a total rating of 30 percentage when calculating their disability compensation.

If Congress approves the legislation before them on the military and veterans healthcare, that disparity would completely vanish. According to Carr, the plan that was introduced by President Bush, Dole and Shalala, faces competition from separate wounded warrior legislation that has been introduced into the House and Senate, however he feels that the basic premise of the Pentagon plan will likely remain no matter waht happens with follow-on efforts.

“We have done the best that we can under current law,” Carr said. “And we are honoring and mindful of what might come around the corner. Depending on the way they come out, we’ll just reoptimize it again. But I doubt we’re going to change any of the fundamentals of this.”

A Glance At The Disability Program

Current Process:
The Defense and Veterans Affairs departments run separate disability evaluation and ratings systems, each with its own standards for medical exams and separate processes for setting the level of disability, which in turn determines the military disability retirement pay or severance pay from the Defense Department and the amount of VA disability compensation.

Pilot Plan:
An interim program would eliminate the separate military and veterans health exams and separate systems of awarding a disability rating. Injured Troops would undergo a single exam and get a single rating based on VA’s ratings schedule.

The Defense Department would continue paying disability retiredpay and severance pay, while the VA would continue paying disability compensation.

Future Plan:
If Congress approves a White House plan, the Defense Department’s role in disability decisions would be reduced to ruling on whether a person is fit to continue military service.

Those found unfit would get a pension based on their rank and years of service. VA would then determine the level of disability.

Based on that rating, an individual would receive enhanced disabilty compensation featuring several components - the basic disability payment, plus a transition payment equal to a minimum of three months basic pay, plus a payment based on an assessment of how the disability has diminised the veteran’s quality of life and the potential loss of future income.

Exact levels of pay would be determined by a proposed seven-month stud.

This is an issue that I will continue to watch with great interest. On a daily basis, I come in contact with servicemembers who are transitioning out of the military for medical reasons and have heard of the differences between the military rating system and the VA rating system. I feel it will be much less confusing and provide our Warriors with the best of both systems by consolidating and streamlining the process. As things develop on this issue, I’ll report more here at A Soldier’s Mind.

Army Times

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