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VA-DoD Disability Reforms
Commission: Remove DoD From 'Disability Business'
After months of top-level negotiations, the departments of Defense and Veterans Affairs are only weeks away from testing a plan to streamline and partially merge their separate disability rating processes.
But as first steps are taken toward what a senior Defense official said will be “remarkable changes” to the method of setting disability separations and retirements, a blue ribbon panel has said: Go farther, much farther.
The President’s Commission on Care for America’s Returning Wounded Warriors, in releasing its final report Wednesday, recommended getting “DoD completely out of the disability business” by giving VA sole responsibility for setting disability ratings and awarding compensation. Disabled service members would see the current “confusing, parallel systems of ratings and compensation” replaced by a single, simple and more generous system.
Other commission recommendations call for: a patient-centered recovery plan for each severely-injured member; aggressive prevention and treatment of post-traumatic stress disorder and traumatic brain injury; strengthened support services for families of wounded members; faster transfer of patient information between DoD and VA; and shoring up staff at the Walter Reed Army Medical Center until its closing in 2011.
Former senator Robert Dole, a disabled veteran of World War II, and Donna Shalala, secretary of the Department of Health and Human Services during the Clinton administration, chaired the nine-member panel. Its recommendation to “completely restructure the disability determination and compensation system” would shrink the military’s role down to determining if members remain fit for duty. Those found to be unfit during a “single, comprehensive, standardized medical examination” administered by DoD would be separated with a lifetime annuity tied to rank and years of service.
VA then would determine disability ratings and level of disability payment which would be paid in addition to their military annuity. This approach, in effect, would secure full “concurrent receipt” of military retirement and VA disability compensation, a goal that disabled retirees have fought for, with only partial success, for decades.
The Dole-Shalala report says VA disability payments should have three components: transition money to help with the expense of returning to civilian life; earning-loss pay to make up for reduced future earnings; quality-of-life pay “to compensate for permanent losses of various kinds.”
Disabled vets would continue to qualify for VA healthcare. But any service member found unfit for duty from combat-related injuries also would be eligible for lifetime TRICARE coverage. Put simply, the commission said, DoD should focus on keeping a fit force and “acknowledge” years of service while the VA should rate and compensate service-connected disabilities.
The day the commission released its report, the Senate passed the Dignified Treatment of Wounded Warriors Act with has more modest provisions to streamline the VA and DoD disability process, with special focus on ending rating disparities between services and between DoD and VA.
It would require the services to use VA standards for rating disabilities and to rate every disability impacting fitness for duty, not just a single disqualifying condition as is routine for some service branches. Any disability ratings awarded since 9/11 that resulted in payment of lump sum severance rather than a disability retirement would be reviewed again.
The Senate bill also would require that services use the same statutory presumptions VA uses in determining if a disability is service connected. A service no longer could presume that some conditions are not service-connected if the member hasn’t been in at least eight years. This threshold would be lowered to six months’ active duty, barring compelling evidence that the disabling condition existed before the member entered service.
The Senate also would raise minimum severance payments to a year’s worth of basic pay for disabilities incurred in a combat zone or from combat operations, and to six months’ basic pay for other disabilities. Currently, a young recruit wounded in war can get as little as three months’ basic pay.
Finally, the bill would mandate pilot programs to test the viability of having the VA assess disability levels before members leave service. Anticipating these changes, senior Defense and service leaders have been preparing with VA counterparts to a test a partial merger of their disability setting processes.
William Carr, deputy under secretary of defense for military personnel policy, said that under the pilot program, planned for D.C. area military hospitals, VA alone will conduct a single, comprehensive physical of injured or ailing service members while they are still on active duty. VA then will rate all physical and mental conditions found.
The services will determine what conditions, if any, make the member unfit for duty and award disability severance pay or disability retirement based on all “unfitting” conditions. A combined rating of 30 percent for such conditions will continue to be the service threshold for awarding disability retirement, which comes with lifetime eligibility for TRICARE and other retiree privileges. VA still will set its level of disability and compensation based on all service-connected conditions found.
Carr said these changes to the disability process will make the systems more simple and transparent. The test will begin as a paper exercise in August to find problems and set “protocols,” he said. Before November, the new ratings process could be operating on a test basis in the D.C. area.
This plan won’t get DoD out of the “disability business” entirely, as recommended by Dole-Shalala, Carr said. But DoD soon could be out of the “disability rating” business and using VA to end any unfair disparities.
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