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Panel Approves VA Care for All Vets
Senate Grabs Reform Lead on VA Access, Disability Pay
If there are silver linings behind the grinding sacrifice and heartbreak that the invasion of Iraq has brought to the U.S. military, one of them is likely to be comprehensive reform to the way disabled military members and their families are helped by the government before and after leaving service.
The Senate armed services and veterans’ affairs committees this month sprinted ahead of House colleagues, and ahead too of various commissions and task forces, in the race to do whatever seems right and affordable for America’s veterans, particularly wounded warriors.
The veterans’ affairs committee, chaired by Sen. Daniel Akaka (D-Hawaii), approved legislation Wednesday that would re-open the Department of Veterans Affairs health system to 1.7 million veterans in Priority Group 8, those who have adequate incomes and no service-connected ailments.
The Group 8 provision is in the Traumatic Brain Injury and Other Health Programs Enhancement Act (S 1233). Other provisions would:
-- Require the VA to develop individualized plans for rehabilitation and reintegration of veterans who suffer traumatic brain injury (TBI), a signature injury of current wars where the enemy relies on roadside bombs.
-- Extend eligibility for VA healthcare for all combat veterans from two years up to five years after release or discharge. This would provide more time to identify and treat TBI and post-traumatic stress disorder (PTSD).
-- Directs that VA enter into agreements with non-VA care facilities to provide TBI care and rehabilitation when VA care is not available at a reasonable distance from the veterans’ home.
-- Directs that VA conduct a five-year pilot program to assess the effectiveness of providing assisted living services to veterans with TBI to enhance rehabilitation and quality of life.
The committee grabbed its Group 8 language from a separate bill introduced by Sen. Patty Murray (D-Wash.). It would order VA to rescind a four-year-old regulation that bans new Group 8 enrollments. VA Secretary Jim Nicholson would retain authority to impose the ban again. However, he would have to reaffirm that the ban is still necessary.
Sen. Larry Craig (R-Idaho), former committee chairman, supports most of S 1233 but he tried to dissuade colleagues from re-opening Group 8 enrollment, arguing it could tighten access to care for war wounded veterans.
The Democrats’ answer to long lines for VA health care, he said, “is simply to get more people standing in line.”
But Akaka said all provisions of S. 1223 “complement” the Dignified Treatment of Wounded Warriors Act of 2007 (S. 1606) approved a week earlier by the Senate Armed Services Committee. S. 1606, in turn, goes far beyond help for disabled veterans approved by the House in the spring.
For starters, the Senate armed services committee, chaired by Sen. Carl Levin (D-Mich.), endorses a special review of disability ratings for all veterans who, since Sept. 11, 2001, have separated from service with disability severance pay rather then disability retirement. It’s part of the committee’s goal to enforce consistency in disability awards across the services and, to the extent possible, with the VA.
The House-passed packet of wounded warrior initiatives focused on improving support services for injured members and families. The Senate bill is more ambitious, inspired by testimony last April from retired Army Lt. Gen. James Terry Scott, chairman of the Veterans' Disability Benefits Commission.
The Army in particular, according to data presented by Scott, appears to be stingy in awarding ratings of 30 percent or higher, the threshold to be a disabled “retiree” with a lifetime annuity, TRICARE coverage and base shopping. Members separated for with ratings below 30 percent get only a lump sum severance.
S. 1606 would require the services to use VA standards for rating disabilities and to rate every disability that impacts fitness for duty, not just a single disqualifying condition as some of the services routinely do now.
Other provisions strive for seamless transition to VA care, to raise severance pay and to close gaps in care for TBI and post-traumatic stress.
The bill would require the services to use the same statutory presumptions that VA uses in determining whether a disability is service connected. The military now presumes some conditions are service-connected only if the member has been in at least eight years. The Senate bill would lower that threshold to six months’ active duty, unless there is compelling evidence that the condition existed before entering service.
The bill also would raise minimum severance payments to a year’s basic pay for disabilities incurred in a combat zone and to a six months’ basic pay minimum for others. Current severance, which is tied to time in service, can be as little as three months’ basic pay for a young recruit injured in war.
The bill would mandate two pilot programs to test the viability of having the VA assess disability levels before members leave service.
It would enhance health coverage in a couple of ways. To address the complaint that medically-retired TBI veterans miss out on some cutting edge care only available on active duty, the committee voted to give disabled retirees active duty health coverage for three years after they leave service. That could be extended to five years in special cases.
Also, family members of severely wounded members who lose their own health coverage and need medical care while attending to loved ones at service hospitals could receive care there on a space-available basis. This would be family at a member’s bedside on invitational travel orders.
Meanwhile, VA is implementing recommendations of an interagency task force on returning war heroes; the services are acting on recommendations of an independent review group on outpatient care; Congress awaits recommendations in July of the president's commission on wounded warriors; and in October lawmakers will get a final report and recommendations from the Veterans’ Disability Benefits Commission.
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