Transcripts For CSPAN2 Key Capitol Hill Hearings 20140602

In cspans sundays at eight. Now available at your favorite bookseller. Cspan, created by americas Cable Companies 35 years ago and brought to you as a Public Service by your local cable or satellite provider. At noon on cspan, the only russian lawmaker to vote against russias annex sakes of crimea will be speaking at the Heritage Foundation in washington, d. C. About russia politics, the russia very you Russia Ukraine conflict and u. S. russian relations. You can watch that at 12 p. M. Eastern on cspan. The House Veterans Affairs subcommittee held a hearing addressing the benefits claims backlog and veterans making the transition to civilian life. This is about two hours and 20 minutes. Good afternoon and welcome, everyone. The oversight hearing of the subcommittee on disabilities and Memorial Affairs will now come to order. Todays hearing will focus upon vas role in the transition from Service Member to veteran with a particular focus on the integrated Disability Evaluation System commonly known as ides. As well as the benefits delivery discharge and quick Start Programs, we will seek information on va resources and production as well as timeless quality of vas components in the process. Further, i would like to, i would like to hear today about the quality of communication both within transitioning Service Members as well as between the department of defense and the department of Veterans Affairs in this process. First to address ides, while i understand that timelines are improving, we want to start off by making it clear that why this is, why this continuing while this continuing improvement matters, i frequently am contacted by Service Members who are frustrated with the process. They do not know how long its going the take, then when they will get answers, and they dont know when they can make plans for their future. I understand that dod reports quite High Satisfaction from Service Members undergoing ides, but it does not reflect the stories recently shared with me. Ive also gotten the sense that the ides process may not be a top priority to va because va has chosen to place what it seems to be fairly exclusive service on eliminating the backlog of claim toss the detriment of these transitioning Service Members. So lets begin understanding that if this belief exists at va, it is not okay. These transitioning Service Members have served in recent years during a decadeplus of wars in iraq and afghanistan with many, with multiple deployments and many with serviceconnected injuries that prevent their continued military service. Here i have correspondence from the past couple of months received from soldiers who are awaiting the start of their postmilitary lives, one soldier frustrated with his inability to pay for the future. To plan for the future. He wrote and i quote it has been four years since i have shared a christmas with my family. It would mean the world if i could finally spend christmas with them this year. I have gone through the board processes and am currently awaiting ratings. End quote. Another reads, quote i have been awaiting my rating for a long time now. Ive also been trying to contact my va reps, and the only way i can talk to them is if i go down to their office. I call and call and leave messages and emails but never get anything back unless im in their office. This entire waiting game has been putting me on, putting a very big strain on my family, and ive been trying to convince my family that it is going to come any day now. Well, it hasnt, and now my life now my wife wants to get a divorce. I dont know what i would do without my two daughters and my wife. If there is anything you can do to help me out or get me some information, that would be great, end quote. And another infantryman wrote, quote im losing my mind trying to find out why it is taking my rating so long to come back from the va. I honestly wouldnt reach out if it werent very important, but ive been under so much stress lately that my Blood Pressure has shot through the roof, my whole med board process has been putting me through hell. More so than my trip to afghanistan in 2009. If there is anything you could do to assist me in figuring out what it takes, what has taken the va so long to rate me and possibly expedite the process, i would forever be grateful, end quote. These pleas are for assistance and disgusting, and we must do better. Todays hearing is entitled defineed expectations evaluating the vas performance in Service Member transition process, and if nothing else, i want that to be the takeaway, defined expectations. These men and women have served honorably during a very difficult time in the military. At the very least, they deserve an open line of communication and deserve reasonable, defined expectations as their timelines, their futures, their transition to the civilian world. More must be done to define expectations. In addition to the ides updates at the forefront of todays hearing, we will also seek information on the process including the uses of brokering as well as timelines and accuracy of the benefits delivery discharge and quick Start Programs. We will hear about the vas anticipated new predischarge program which may consolidate the existing bdd and quick Start Programs. I look forward to hearing from todays witnesses, and with that, i will begin introductions. Seated at the witness table we have all members from the first panel. From the d. Of defense, we have ms. Nancy weaver, Deputy Assistant secretary of defense, warrior care policy who is accompanied by mr. Dave bowen, director of Health Information technology, Defense Health agency. And from the department of Veterans Affairs, we have mrs. Diana reubens, deputy undersecretary for Field Operations with the benefits administration who is accompanied by mr. Thomas murphy, director of compensation services. Upon conclusion of the first panel, we will seat two subsequent panels which include for panel two ms. Linda holiday, the assistant Inspector General for audits and evaluations for the office of the Inspector Generals u. S. Department of Veterans Affairs accompanied by ms. Nora stokes, director of the benefits and inspections division. And mr. Roman d around moan figuera, project manager with the inspections division. Panel three will consist of mr. Eric jenkins who is here in representation of the american ped ration of Government Federation of Government Employees and Afge National va council. Ms. Deborah gipson is here today and she will be introduced shortly by our congressman orourke. Mr. Gerardo avila, national medpeb representative with the American Legion, and mr. Paul v. A. Lair row, the assistant National Legislative director with disabled american veterans, and mr. Brendon gehrke, senior veteran associate with veterans of foreign wars of the United States. One final point, all of the named witnesses are present. I must advise pursuant to title 18 United States code section 1001, known as the false statement act, this is a crime to knowingly give false statements in federal jurisdiction including a congressional hearing. With that acknowledgment, i thank you all for being with us today. I now yield to Ranking Member, ms. Titus, for her Opening Statement. Thank you, mr. Chairman. Thank you for holding this hearing today. Thank all of you for coming to provide us with some needed information. As you heard the chairman describe, today were going to look into the performance of programs that va and dod utilize for determining fit for duty status for ill or injured Service Members as well as programs that are designed to expedite the adjudication of claims admitted by exiting Service Members. Particularly, were going to focus on the integrated Disability Evaluation System, the discharge program, bdd, and the quick Start Program. All of these programs have been up and running for a number of years. Ides was initiated in 2007 as a follow up to the poor conditions that were exposed at Walter Reed Army hospital. Bdd was launched back in 1995 as a Pilot Program and then became full hi operational in 1998 fully operational in 1998. The intent was to assist disabled Service Members in making a seamless and Successful Transition to civilian life by allowing them to get their claim completed as early as possible while they have all their medical information readily available. Quick start was launched in 2008, and its similar in nature to bdd, and it was established to provide a expedited disabilities benefit process to Service Members who are going to be discharged within 59 days. Now, despite having long been established and having enough time to get over growing pains and any other problems in the early stages, all of these programs continue to face challenges and are performing far below expectations. The one similarity that they seem to have is that they suffer from a continued poor performance in the adjudication of the claims in each of the three programs. Of particular interest to me is a number of claims under bdd and quick start that has dropped off. There are many fewer claims now than there used to be, and im concerned that the reason for that is because Service Members are choosing to bypass these programs that are designed to provide an expedited system over concerns that participation actually delays the process of receiving benefits. In fact, quick start has been known to be called quick start and slow finish as a result of that. Weve had highlighted for us by the vas oig about eliminating benefits backlog has kind of shifted priorities and come at the expense of other benefits and claims such as ides and quick start which have been moved to the back burner, and thats unfortunate. You heard the chairman read some of the emails that weve been receiving. They all generally have the same ask. Im in the army, im waiting waiting for a decision. My family and i need to get on with our lives. Our staff has witnessed firsthand the poor culture thats often present at these ides stations and Wounded Warrior battalions. I want to thank ms. Gipson who is an army veteran who recently went through the process and came to be with us today to talk about some of the negative culture thats in these programs and how we might address it. Its just a concern that these programs that are supposed to be so helpful really end up being harmful because they hold our Service Members lives in bureaucratic limbo. An Army Reservist who enters ides today wont complete the program until august 17, 2015, 181 days of this 443day period will be spent waiting for a va rater to pick up the claim and provide him or her with a rating. To get a rating just to get a rating, it takes that long. So as our Service Members wait for a rating decision, theyre forced to delay critical aspects of their transition. They and their spouses hesitate to relocate, to to buy a home, to enter a school program, to find a new job because they just dont know whats going to happen to em. Now, we know that Service Members face obstacles when theyre transitioning out of the armed services. Thats already difficult enough. The va should be an asset, not a hindrance to that process. So i think we need to take a hard look at the resources that we are dedicating to these programs and figure out how we can meet their goals today and not tomorrow. So we need to take a fresh look at these programs. We recently, i was with the staff who recently looked at this and found that 95 of Service Members who somewhere the ides program are found not to be fit to serve because of an illness or an injury, so they are they know theyre going to be discharged. 95 . If we know that many are not going to go back into the service that are going to be discharged, shouldnt we be taking a different approach, offering them some flexibility, some options while they are making that transition . So i hope that those are the kind of things that well look at today in this hearing and see if we cant reprioritize and shift some of our emphasis on being flexible and making this work as opposed to just having families sit around waiting for the rating. Thank you, and i yield back. Thank the gentlelady. With that, ill recognize the chairman of the full committee, mr. Miller, for a statement. Thank you very much, mr. Chairman. I appreciate the indulgence. I want to make a few remarks on the Service Member transition problem, process particularly in regards to ides. Currently, the timeline of ides induction to receipt of benefits is targeted not to exceed 295 days, but recent dod and va reports place the average timeline at over 350 days. Thats an average, but that average means that there are many Service Members that take much longer to complete. And in an effort to address ides inefficiencies, i recently introduced an amendment to the fy15 National Defense authorization act that would do the following first, it would require the use of a standardized form set which would be approved by both the secretaries of kod and va as dod and va as was envisioned by the dole commissioners recommendations. Second, it would colocate certain personnel to allow for greater or interdepartment collaboration and to reduce delays in transfers of information. Third, it would compel the usage of a bridging Software Solution between dods my ides and vas ebenefits dashboards to allow Service Members Greater Transparency as to where they are in the process at the current time. Finally, the amendment would establish a working group comprised of various personnel at dod and va as well as private Industry Leaders to reevaluate the program itself. Now, the working group would then make recommendations on how to better serve those who are going through this process as well as how to better utilize the resources that are allocated. I do want to take a moment to emphasize that the goals of my ides amendment are twofold. First, increase transparency to the Service Member and increased accountability for the respective departments. As i think everybody in this room is already aware, the issues of transparency and accountability are of utmost importance particularly as we continue to investigate the ongoing delays in accessing care at Va Health Care facilities across this great nation. Since the transition process whether through ides, bdd, quick start or the traditional claims process is a Service Members first exposure to the va system, we want to insure that it is a positive experience for all who use it and those that it was designed to serve. Those very people that have served our country. Mr. Chairman and to members of the committee, thank you for your indulgence, and i yield back my time. Thank the gentleman. And now i want to recognize mr. Orourke for, i believe, he has a statement, Opening Statement. Mr. Chairman, i just wanted to actually introduce someone whos going to be on one of the later panels, deborah gipson. Im sad to say, mr. Chairman, a former constituent of mine. She just moved out of el paso in march of this year. Were going to miss her. Prior to that, she was stationed at fort bliss, a former captain in the u. S. Army, and during her time as a commissioned officer she served as the executive officer for the warrior transition unit, Bravo Company at fort bliss, texas. She was medically separated from service through the integrated Disability Evaluation System or ides, and shes here today, again in a later panel, to deliver a statement about her experience with ides and offer recommendations to improve the system. Mr. Chairman, i just wanted to be here to welcome her and introduce her to the rest of this committee. With that, i yield back. Thank you. I dont believe any other members have a statement, so at this time i welcome our first panel. And your complete and written statements will be entered into the hearing record, and ms. Weaver, you are now recognized for five minutes. Thank you. Finish chairman runyon, Ranking Member titus and distinguished members of the subcommittee, thank you for the opportunity to appear before you today to discuss the integrated Disability Evaluation System, also known as ides. Since 2007 the departments of defense and Veterans Affairs have collaborated to create an integrated and transparent Disability Evaluation System for Service Members who have illnesses or injuries that may impede their ability to perform their military duties. Today ides accounts for about 97 of all dod disability evaluation cases. In ides Service Members receive a set of disability examinations conducted according to va protocols and disability ratings prepared by va. Departments military departments determine fitness for duty and only compensate Service Members for conditions that compromise their ability to perform their military duties. V ark compensates va compensates for all positions incurred or aggravated during military it is service. The advantages of ides compared to legacy systems include the elimination of duly candidate medical duplicate medical exams, consistency between dod and va disability ratings and reduced wait times for va disability benefits since rating determinations are completed prior to Service Members separation. These advantages have contributeed to improved Service Member within the ides process. Were continuing to implement process enhancements such as improvemented policy, increased saf thing increased Staffing Levels and new training requirements for caseworkers. These and other improvements have enabled us to achieve and remain below our ides Core Processing goal of 105 days for the past several months. Information technology can also help us gain more efficiency within the ides process. Thats why were working to develop a system that will support endtoend Case Management, tracking, reporting and bidirection aleck tronic case transfer. Well continue to work with va to insure requirements are identified early. The department of defense is working diligently to support an integrated disability system that insures Service Members receive timely and transparent compensation for injuries or illnesses incurred by line of duty today, tomorrow and in the future. Thank you, and we look forward to your questions. Thank you, ms. Weaver. And now next we will hear from ms. Rubins. You are now recognized for five minutes. Good afternoon, chairman runyon, Ranking Member titus, members of the subcommittee. My testimony today will focus on the status of the integrated Disability Evaluation System or ides, benefits delivery at discharge, bdd, and the quick Start Programs. With respect to ides, joint everetts over the past six years have resulted in changes and improvements in our evaluation system. Together the departments have created an integrated process for Service Members who are being medically retired or separated. This joint process was designed to eliminate the due licktive, timeconsuming elements of the separating disability determination processes within va and dod. The goals of our integration were to provide a seamless transition of benefits and health care for separating Service Members through ides. As a result of our collaborative efforts, we have worked to achieve these goals. Currently, there are approximately 29,000 Service Members for the four combined core steps va average processing time in 2014 was 183 days, the lowest since april of 2013. Our target for those combined core steps is 100 days of that 295combined va dod target. In an effort to continue to improve, we created a plan that loved a phased involved a phased approach. The first phase was to meet timeliness standards by march of 2014 which we have done. This portion of the ides process is focused on insuring Service Members who are transitioning into the civilian world as veterans receive timely benefits to which they are entitled. The second phase of the plan is to meet the timeliness standards for the proposed ratings by october of 2014. We are on track to heat that goal and will do so. Our continued partnership with dod is critical. Va and dod are committed to supporting our nations wounded, ill and injured Service Members through the ides process. The bdd and quick Start Programs are important elements to provide transitional assistance to separating or retiring Service Members and engage those Service Members in the disability claims process prior to discharge. Vbas goal is to insure that each Service Member separating from active duty who wishes to file a claim for serviceconnected disability benefits will receive assistance to do so. Participation in the wdd program is available to Service Members who are then 601 is 80 days of being released from active duty and are able to report for a va exam prior to discharge. Quick start made predischarge claim processing available to 100 of transitioning Service Members including those who are within 59 days of separation. Like many of our regular nonpredischarge claims work, vba has made tremendous progress, but we recognize we have work left to do. The average days pending for our quick start claims is 98. 3 days, an improvement of 1 37 days since may of 2012. The average days for our bdd claims is 13 be 6 136 days, an improvement since april of 2013. Claims accuracy is a key element of vbas transformation plan, and we continue to improve this that arena as well, but it is not measured specifically for our process at the three rating activity sites. Instead, its measured for each Regional Office as a whole including the bdd and quick start claims we are processing. Our three Regional Offices have three months to issue base quality between 9698 . Vba is now working to redefine the predischarge claim process by building on lessons through the execution of our bdd and quick Start Programs. The new predischarge program will consolidate and replace the existing bdd and quick Start Programs. Well be leveraging functionality now available in our ebenefits system to add convenience to both the application process and efficiency throughout the claims process. Vba is committed to supporting our nays Service Members our nations Service Members. We believe that the continued enhancements are critical to program success. Nothing less than our Service Members and future veterans deserve. That concludes my at the same s. Im happy to answer any questions you may have. Thank you, ms. Reubens, and ill begin a round of questioning alternating between members as their arrival times. My first question is for both the va and the dod. Ms. Weaver, you indicated throughout the process that dod and va caseworkers keep Service Members informed of progress in their cases. While this streamlined communication may exist in ice lated cases isolated cases, we know from speaking to large groups and several examples in my Opening Statement that Service Members at numerous installations this communication is simply not occurring as a matter of routine. How is this communication going to prove, and i would like both perspectives from both the dod, ms. Weave, and, ms. Rubens, at the va. Thank you, sir. Weve recently increased our manpower, and we find that we also improved the training. We have minimum training standards and required training for each of the peblows, providing them more information. As far as keeping the individual aware at the beginning of the process, each member who is enrolled or referred to ides is given a caseworker or a peblow. That individual sewer acts with the service interacts with the Service Member throughout all phases. At the beginning of the process, the member is told approximately how long the process would take and is updated as they move from phase to phase and keeps them aware of what they need to do, and they are encouraged to keep their family members updated or bring them in so that they are aware of whats going on through the process also. Ms. Rubens . Military Services Coordinators are located at the intake sites along with the dod dod peblows this an effort to insure conditions, but any claimed conditions that that veteran wants to claim. Our military Services Coordinators are there to help walk them through that application process and understand the process. Theyre also there, frankly, to serve, if you will, as a touch point or a reach back to our rating activity sites so if that veteran has questions, were capable of also getting back to that rating activity site to share information with that Service Member and or their family. I want to go back to ms. Weaver. You said the interactions happen typically as they move from phase to phase. Are there huge gaps in timing of different phases . Are they pretty standard as they would find in a timeline . Say theres three phases in the process. Does one take threequarters of the year and the next one take a month . Or when the informal peb is going to be completed and moved to the next one, next phase. I have one last question and im going to go over a little bit. Its actually for mr. Murphy. Accuracy is overarching matter of importance, id like to ask you question about the quality component. Vba Start Program has several classifications of their such as benefit entitlement decision documentation slashed notification and administrative. However, the National Rating agencies is based solely on benefit and entitlement area to understand is that start does not count errors for instance, with potential to affect Veterans Benefits such as when a claims folder lacked required evidence including a medical examination or opinionated to make an accurate decision. Can you comment on any of that . I would say that that is not an accurate statement. That is the absence of an examination when one was needed would be called as a benefit entitlement so we do have the classifications of errors you just describe which is a benefit entitlement air but part of that is that if there is something that should been gained, evidence that shouldve been included in the file or reviewed that wouldve affected the outcome, that would require a benefit and dog hair to be called. Okay. I would benefit error here. Thank you, mr. Chair the. I would just ask as rubin if you have an explanation for why the number of people going into these programs has dropped off . Is only a third of the transitioning Service Members elect to use these programs, and also if you think that the va made the same kind of investment that the department of defense made in personnel, and some of the changes described by ms. Weaver, if that would help with the backlog . Certainly. I would tell you that ive heard particularly some of the concerns about the quick start not getting as many referrals as we anticipated. I would tell you that we know we have some challenges with timeliness. We made some dramatic changes to the resources that we provide to both the beauty and quick start processing in july of 2012 in an effort to ensure that we close on those performance, particularly on timeliness numbers that we were seeing them. I reflected in my statement the improvements weve made and we continue to look for those to be not only sustained but grown upon as we work to merge vbd and quick start from the standpoint of the expectation that that servicemember transitioning whether they have won the 59 days and perhaps not able to get to ap exam prior to discharge or whether the 60one or 80 day mark and, in fact, complete the exam process to ensure timely processing of those claims as the transition into civilian life. The deadlines that you have for meeting the goals keep getting pushed back, dont they . Now have been pushed back to october for meeting some of those timelines that were supposed to be met in august . The timelines that youre referring to of late are for the ides program and would you look at those somewhat differently because of the nature of that servicemember and the ides program being boarded out for disease or injury. From that standpoint, in august for the proposed ratings we will close the inventory capacity that we need to. By october we will hit our deadline for providing that proposed rating. And we are already for the final notification to that servicemember, we are now meeting the 30 days for that time period. Okay. With the average of 48 days i think, all right. Id like to ask you about the fact that 95 of the people are going to be discharged to go into this program. Is there not some way to address that . Weve heard a lot about segmented lanes and express lanes for other kinds of benefits. Is that not some way to look as a more flexibility there, if we know 95 are not going to go back into active duty . Can we figure out someway to prioritize those cases and move them out faster . You know, i think that particularly around the ides program it has been a joint process with dod. We want to ensure that we are meeting the spirit and intent which is to move that along as quickly as possible come and i will turn to ms. Weaver to correct me to 100 but also think that theres the obligation of ensuring weve gotten them to the point where theyre ready to be discharged and want to ensure that we work with dod and the requirements that theyve established for ensuring that servicemember is ready for transition. I dont know if you would add to that. We are working with va to look at other opportunities and concepts to expedite the process. We do have an expedited process for catastrophically injured or ill personnel. To date, after breaching each member who was qualified, we have had no one who has opted to take that process, but were looking to see if we can broaden that concept to those that arent catastrophically but too seriously come and see if we can expedite it. These are in concert stages and were working with the va on that. Okay. Thank you, mr. Chairman. Thank the Ranking Member. Without the chair recognizes mr. Cook. Thank you, mr. Chair. A couple of comments and probably the same ones i had when i was chair of the Veterans Committee in the house in california. I look at it from the perspective of the veterans and the people that you were dealing with. You know, just going through this paper right now, were looking at bgg, ides, peblo, mdb bbq ccd, i know that one, thats assistant division commander, and i knew mdb, Marine Expeditionary brigade. Abbe lowell the flagship those captured by the north koreans. I thought it was bva Battle Damage assessment. I could go on and on and on. And if i was a person being discharged, you know, i think i know more about klingon and that vocabulary than these acronyms which just keep multiplying over and over. You use them all the time. The average person, i think i know most of it. I try to forget most of them, you know, after 20 sixers in the marine corps and then i got into education and to learn all kinds of things. The point im making is that trying to communicate with the people that you serve by using this foreign language, at least from my perspective, is very difficult. A lot of people dont get it, particularly the seniors. They have a series of problems. This type is talked about that 95 . When i see 95 , ma i think thats something that we can make it to streamline the process. We can do that. Airlines notify people when the plane is going to be late or what have you. The technology now. Im probabl progress want to tat technology because im horrible at it. Thank god im married, either wife who is very bright, and ive grandkids to fix my computer. But a lot of people are just braindead when it comes to technology. But you have to have a respect for some of these things that can streamline that and make the system more efficient. Now, it just upsets me that it takes so long, and i look at it, and this is a statement more than a question, that when world war ii started, you know, where people had to enlist, does through the physicals and get trained and be on the front line almost, you know, so that we wouldnt lose the war, they did it. In getting people in, the same thing with korea and other times where you get people in and you can expedite the process. And now we have a system on the backend where people, i spent 26 years, a lot of people spent a lot of years. Its a very, very cumbersome process that and i think part of it is that its very complex, at least pashtun and i dont think im the dumbest person in this group, may guide them, but trying to understand all this stuff when you are going through it, i think weve got to at least make it more userfriendly so that you can have that feedback easily. And right now the process starting with the language is very, very cumbersome. Everybody that works in it, they have their comfort set of acronyms and will category. The average person is too nice to see what does that mean, or whats the impact on it . Im dumb so i have to ask what the acronym is. And give me an explanation. But the average veteran that comes in there, a lot of them you are used to taking orders and what have you. They are relying on the gunnery sergeant, that staff sergeant, that Master Sergeant who, they are vital. And then you combine that come out of that, and were talking about a bureaucratic nightmare. So understand what youre going to do, and i applaud it. I just want to throw my 2 cents into, hey, lets get it down to where only somebody like me could understand it and other veterans. I think he would have much more cooperation they could understand whats going on. Thank you. I yield back. Thank the gentleman. With that the chair recognizes the gentleman from texas, mr. Orourke. Thank you, mr. Chairman. Mr. Cook, giving me feel a lot more comfortable with my ignorance. Eq can admit it, then i feel a lot more comfortable in admitting my own. But mr. Chair, earlier i had the privilege of introducing ms. Gipson who because defined in a later panel. I first met her in el paso when she was at the wtu. Should organize a tour of the facility for me, and in getting to to the facility and meeting some of the Service Members who were there, we first learned that we had soldiers at the wtu could literally been languishing there for months and years because of delays within this ides system. And ms. Rivlin come with last a chance to speak about this in february, ms. Rubens, i talked about the va rating goal being 15 days and 40 fort bliss soldier of the wtu it was actually 143 days. The benefits goal being 30 days at that time. It was 87 days in reality. That was my focus and is still my focus today because what i think i have heard you all say is that we are now meeting our benefits goal as of april of this year. But when i look at the latest data, which is 18 may of this year, it shows that for the army we are at 48 days instead of the goal of 30. The fort bliss soldier is at 49 days. When i look at what youre committing to doing by augustoctober and the rating getting to 15 days, we are currently at 132 days army wide, and we are at 131, for the soldiers at the wtu at fort bliss. So explain to me the inconsistencies on the benefits goal that you say youve already achieved and the numbers that im seeing here for me and the now you can possibly achieve the goal for october given the wide variance between where youre supposed to be and where you are today. Yes, sir. And i would tell you that i think we are talking about the work we are completing in the current month versus the numbers youre reflecting our for the entire year, the average of everything that we have completed. What we know about the work we are completing today as we look if you will behind in the system, that work thats coming down the path is much younger. As we are now achieving for the benefits of notification phase, we are now in a timely position. The capacity that we have will continue to maintain that timely output for those clients that are coming to us in that component of the face. As we continue to work for the proposed ratings, similar issues, the capacity with which we are tackling the volume of work, come august will now marry up with the work flowing to those folks, and going out the door with will put us into a timely at that 15 day for proposed rating decision, timeframe as well. Allowing us for the october number to catch up, if you will, on the average for the entire year. The ec if if i can understand this because this is a difficult concept for me to get, and its similar to the way that you explained to us the backlog numbers when it comes to disability claims for veterans. And how we should imagine that backlog. So if someone interest the system today, which issues fort bliss as an example at the wtu, at the benefits they could wait no longer than 30 days, is that correct . At the end of the process the final notification, when we get that final package back from dod, the time it will take a spin to finally promulgate that benefit of notification on average for the army is at 30 days. I wanted to go look and see if fort bliss is outside of that but i believe were now looking at a timely situation across the benefits phase. I have limited time but the reason then that im showing 48 days on the white versus for days which is what youre saying is you still have those older cases in the system, and as soon as they without you will be at that 30 days . You are looking at information and thats why he to go perhaps it was when it are staffers to look at. Are you looking at the average processing time across the entire course of the year, as we were the older ones out, that means the days to complete have gone higher and as we look at the work coming in it is not timely. Okay. This is something my time has elapsed. This is something that im going to ask my staff through this hearing to memorialize in a letter to you and get a written response back from you so i fully understand, it can go back to the wtu at the fort bliss and explained in my own words, which im not yet able to do given your answer. I think youre saying what i want you to say and what they want to hear but a want to make sure that were absolutely clear on what the expectation is and what we are deluding. Appreciate that in advance for getting back to us. Happy to do that and orson with anybody you would want us to sit with and look at the statistics. Thank you, mr. Chair. With that of record as the gentleman from florida spent appreciate you letting this hearing as well. I think mr. Cook is right on, but hes been saying it now for months, years really, lets sit down and work in this because its so very important to the veteran. Im 51 and to tell you the truth, i have to read these things twice to understand what they are. I mean, just for the good of the veterans, we owe them that so that they can look at it and not have to have the computer training, what have you, not have to go my kids six my computer, too. I mean, lets get serious about this. I have a couple of questions. Ms. Weaver, you noted that by the summer of 2014 the military department will be able to work for a much improved setup policy guidance. When exactly this policy documents be issued . They are in the final processing, and they will start being published hopefully next month through the end of august. Okay. Would you be able to quantify their impacts on both quality and consistency of the decisions . And how will that occur . We are implementing a Quality Assurance program, and thats one of the new policies that we have that will help the department measure accuracy and consistency, particularly in how policy is applied across the services. Services perform to evaluation, osv performs one. We analyze the results and then we can see if policy has been applied, or if policy needs to be revised. Thank you. Ms. Weaver, you noted that 83 of Service Members are satisfied with the ides experience. Could you tell us more about that . Elaborate, please. Each quarter we do a Customer Satisfaction survey. The survey is done at a sampling of nine of the major locations where ides is, where the members are enrolled, and the consensus of the remaining 131. The survey is done after a medical Evaluation Board, and again after the physical Evaluation Board. Its a volunteer survey, july through december. We did have 8000 individuals who participated in the survey, and from the 30 questions, for related to Customer Satisfaction, 83 indicated they were satisfied with the process. 8000 of how many artistic faded in the process . So what percentage with it because you said 8000 or dissipate. How many are in the process . 8000 rate in the survey. What would you say the percentage is . I dont have that number but i could certainly get it for you. Please, or would you like to estimate approximately . I dont have any number of how many can you please give that to me and maybe chairman and the rest of the panel might want that information of a. Absolutely spent thank you. Ms. Weaver, you highlighted the electronic case file transfer system that was piloted in 2012, but you note that until va develops its end of the technology it will not yield benefits and its not going to be timely, in other words. Please elaborate on this, and what has dod developed and what does va need to do . We have used a the electric transfer, and it was see what i mean . It was a successfully piloted, that we made the transfer in december of 2013. But what we are working on is a joint system, Case Management system called joint Disability Evaluation System that will allow us to track cases, monitor exactly where theyre at so we can go from facetoface and exactly where the case is and do a transfer to and from internal within the service from the nep or medical Evaluation Board to the physical Evaluation Board, and from dod to va. We are in the concept phase, identifying the requirements, and we think this is going to gain major deficiencies for modern and efficient system spent thank you very much. I yield back. Spent with that advocate is the other member from florida. No, questions, mr. Chairman. Thank you. Thank the gentleman. Im going to ask one followup. I to let a couple but mr. Bilirakis got to the mall. So thank you your got to the mall. This is the kind of question in the mold of colonel koch over here. We hear everything is going right. I want to hear from ms. Weaver and ms. Rubens what isnt going right . What do we need to fix that would make huge difference in the process . I mean, what can we really tackle . What are we going to get out of this hearing, i mean, as colonel koch over here identified his flaws in front of everyone, thats what we want to know from you. What is the one thing that could change the trajectory of this whole process . I think what dod is hearing from the hearing is that we need to go back and look at our survey. We have a significant number of people who are participants, participating in the survey, and were getting results that say as of december, 83 were satisfied with the process. As of the end of march, 4000 more surveys, 84 were satisfied with the process, and were trying to make changes from information that we get to the survey. We may need to look and see whether or not how we can reach out and touch the individuals who are expressing concern with either the time or the counseling that they are getting. Ms. Rubens . I would tackle some of the sentiments, and, obviously, it sounds as if our ability to communicate with the Service Members, send the veteran, could be improved. Vba has worked in the last year to pick up if you will another component of that transitioning Service Member who as he or she begins to think about what next by placing our vacation rehabilitation and employment counselors at many ides sites as well in an effort to continue to build about system around that transitioning Service Member. And i would tell you that obviously we want to continue to Work Together in that electronic interface to ensure that as dod a cause for services builds that integrated Case Management system, it marries up if you will into our new Veterans Benefits management system, our paperless environment to ease the process by which we share information, not only internally but with that transitioning service there as well as if they have selected a Veterans Service officer as we roll out our new stakeholder enterprise portal functionality in july of this year. So that they will have the ability to also support that Service Member and that communication standpoint. I think this goes back to mr. Bilirakis question. What does the va need to do on your end of the electronic case transfer, file transfer, to make it optimal . I would tell you that as far as making it optimal there are some things we need to do from the nsc, the military Services Coordinator at the intake side and their ability to work within that environment as those from an electronic standpoint, the functionality of incorporating into that come interface with it to ensure thats occurring but it is on our roadmap to accomplish that. And has dod continues to build their new Case Management system we want to make sure we are there to incorporate that as well into vbms. What part of what fiscal year is that happening . I will have to take that would for the record. Im not sure where it is on the roadmap. There are a number of things that were trying to import, if you will, or built into the functionality for vbms. And one last question for ms. Weaver. You said you had an 83 satisfaction rating. What was that 17 on the other side, what was the kind of overall disappointment in the system . Well, it arranged. A lot of the comments were that they did not get the information they needed. It was varying with the medical Evaluation Board and the fiscal evaluation, including the unsatisfactory rating that they got. They would like a different rating, and move from there. Any other questions . Mr. Orourke . Thank you, mr. Chair. Id like to followup with ms. Rubens on the line of questioning i was pursuing earlier about ides, and i think i may have some questions that can hopefully clarify this issue. On the benefits backlog portion of the dras process, you said that in march you eliminated the backlog and april youre hitting your target of 30 days, is that correct . Yes, sir. We close the capacity gap with what we had to work and wont have the capacity to do in march, and april the work we can begin to see flowthrough was meeting that time limit target. And the number i referred to earlier, i show that army wide we are at 48 days, ma not 30. Thats the last three months so that might explain the difference. So my question to you is, if we take this same measure three months from today come it will show 30 or under . Yes, sir. We have built this in a projection and our capacity and are modeling to ensure that as we move forward we maintain achievement of the target. I want to ask the same set of questions as it pertains to the va rating part of this, which is that the goal is 15 days. Today, the last three month average shows army wide 132 days. Are you saying that by august you will relieve the backlog, and by october you will meet that 15 day go . Yes, sir. Been three much am october when you look at the roy through much average we will see 15 . And 15 for the proposed, 30 for the final notification. Wonderful. And would you mind if again were able to get a commitment from you in writing . Not at all. I really appreciate that. Thank you. Thats all, mr. Chair mimic thank the gentleman. No other members having any further questions, i ask that any of the questions that you all were taking for the record, please submit them in writing. Thank you very much. Thank you all again. I think its particularly helpful to have both the va and dod at the table when discussing ides pick your now excuse in the witness table and well see our second panel from va oig. [inaudible conversations] [inaudible conversations] welcome the members of the das office of Inspector General. We appreciate your attendance stake him to complete a written statement will be entered in the hearing record. Ms. Halliday come to recognize for five minutes to begin your testimony. Thank you, chairman runyan and members of the subcommittee, thank you for the opportunity to discuss the oig review of vbas predischarge program. Our testimony offers an independent assessment of pdas quicquick Start Program, one can moment of vbas predischarge program. With me today is the director and our atlanta audit office into managers from oigs benefits Inspection Division and bay pines florida. Ms. Stokes, the director and mr. Varela of correctly have over like to have over 40 years of the work expense, notably they have experience working in key positions such as veteran service representatives, rating specialist, decision review officer, certification, test writer, star quality reviewer as well as veteran Service Center manager. The quick Start Program is designed to provide a seamless transition from dod and vas health care and benefit system. Service members can submit claims up to 180 days prior to discharge under the program. Further, the Program Makes it possible for veterans to receive disability benefits soon after leaving military service. To assess the programs performance, we reviewed quick start claims completed in 2011, and then again in 2013. We found improvement in claims processing timelessness time in his. During the period vba reduce the average days to complete quick start claims from 291 to 249 days. However, while timeliness improved, digital improvement is needed if the va is to achieve the va secretaries fy 2015 target of processing disability claims in 125 days. The delays in processing start claims resulted from Inadequate Program controls, and the redirection of resources to process other claims processing priorities. Adequate resources and the proper allocation of resources are paramount for va to realize the benefits of its transformational initiatives. Delays also occurred due to a lack of training to ensure staff properly identified quick start claims, which is the first step to initiate timely processing action. Our review results support that the quick start claims were at risk of processing errors, such as erroneous disability evaluations or improper grants, or denial of benefits. We projected vba staff actually processed 62 of the quick start claims in 2011, love accuracy rate for 2013 improved to 69 . These rates are still well below the secretaries 98 accuracy goal for fy 2015. Delays and errors impact veterans receive disability benefit payments in two ways. First, the processing delays in 2011 resulted in a number of veterans waiting an additional 196 days to receive about 88 million in benefits payments. By 2013, the same type of processing delays were reduced, but still cause of veterans to wait about 99 days to receive approximately 20 million benefits payments. Unfortunately, processing delays also impact other endowment decisions such as veterans preferences, delayed care at va medical centers, and participation in vocational rehabilitation efforts. Secondly, the claims processing errors have a direct Financial Impact on the amount of benefits a veteran receives a monthly recurring entitlement payments. We projected a claims processing errors resulted in veterans being underpaid about 2. 8 million dollars. Projected overpayments were valued at approximate 453,000 for the same period. Additionally, claims processing errors that do not affect current monthly benefits have the potential to affect future benefits if left uncorrected. While vba is making incremental progress in areas specifically targeted through this initiative, much more work needs to be done. We will continue to look for ways to promote improvements in benefits delivery operations during our future National Audits and our inspections. Mr. Chairman, that concludes my statement and we will be happy to answer any questions you or the committee has. Thank you, ms. Halliday. We will begin a round of questions. First question, as you know while vba is reporting that time in this and equal if not greater concern is the accuracy of the outcome for each veteran. Vba is looking at hundreds of thousands of claims and the veteran is looking at one and only one. Ms. Halliday, accuracy as highlighted in your testament as a serious area of concern. Id like to also ask you the question about the das quality components star. United vba star program has several classification errors, such as benefit entitlement, decision documentation notification and administered. Mr. Murphy responded to an inquiry as to stars of failure to count their incidents with potential, with potential to affect Veterans Benefits such as when a claims folder lacked required evidence including medical examination or opinionated to make an accurate decision. Can you comment on the . Yes, i would appreciate that. The oig uses a broader definition of what constitutes an error. We report errors that affect Veterans Benefits as well as those that have the potential to affect Veterans Benefits in the future, if left uncorrected. We think this is important. Its a veteran centric approach. We do not feel that the star program counts all of its errors. There is a discriminate between what oig considers and their and how vba calculates its accuracy rating. I have a couple of examples here that we think might help you understand. Vba does not consider an incorrect disability evaluation to be a benefit entitlement error unless the air impact of the veterans overall combined disability evaluation. However, oig what identify this case as an error because it has the potential to affect the future benefits, if left uncorrected. And that also has a corresponding effect to com, it could affect other programs, too. As the ratings change. Also, cases where the bsf simply do not request or symmetrically delay requesting the mandatory routine future examination to determine whether the temporary 100 disability determination should continue. We clearly call in air. We see a significant Financial Impact and her associate with not managing those claims are probably. Spent thank you. Next question, is the working with the oig to make improvements identified in the audit process . This past year there has been significant challenges to us to address the oversight needed that we are expected and charged with the look and the benefits inspections and to perform National Audits. I finally raised this issue to the undersecretary, allison hickey. She has agreed to try to ensure that we do not have these obstacles or have this resistance and that we work toward a facilitated process so that oig can help vba get it right. This is important to spend so much time dealing with a nuance of a technically how you Say Something versus trying to fix the big picture, is not the way to go. I think you need to look at what are we saying, why are we saying it, how does it affect veterans . And then go make changes you need in these programs. Last question. In your view, given the challenges the va faces addressing the longstanding backlog of claims, do you feel the va has control over its remaining workload . At this time we see vba spending backlog in compensation claims is dropping. However, i have significant concerns that they do not have a good handle on some of the workload in other areas. For example, in the area of dependency issues, as of may 15, 2004, their own report, the vets net operations report, shows almost 253,000 disability claims that will impact of benefits on average, the claims are pending over 315 days. For eligibility determinations, the same report shows approximately 110,000 education decisions relating to benefits that have been pending on average 361 days. And in predetermined notices, we see approximately just over 81,000 predetermined notices affecting benefits that have been pending for 177 days. There are definitely problems in managing the workload. The priorities we hear time and time again, the priority is to bring down the pending backlog in compensation at the expense of not addressing some of the other issues. The quick Start Program is a perfect example within our audit where resources were redirected away from that program, and you can see in the audit there is a table that the workload, the time limit, spiked in 2012, and then the vba is working hard now and has the resources back into program. But you have to keep resources dedicated to significant transformational initiatives if you want to achieve success. Thank you for the answer. I had that precise discussion with chairman miller this morning, so thank you. With that ill recognize the Ranking Member, ms. Titus. Thank you, mr. Chairman. I was going to ask that question, to come if you do think that these programs are being hurt either focus on just reducing the backlog, no matter what. And the people who are in, the veterans were in these programs dont count as part of those figures that are used to show the backlog, even though they are waiting this long periods of time, is that accurate . That is why understand, yes. Another thing that doesnt seem to count, and you mentioned that the va doesnt count the processing time that occurs prior to leaving the service, when theyre talking about the amount of time it takes to process one of these claims. Would you expand on why that would be an important aspect of this whole backlog . In the simplest of terms, if i am a veteran and i file a claim, i start counting from that day. Now, i understand that vba is very concerned that they have up front processing at a point where the active Service Member has not become entitled to the benefit. But when youre looking at a process, you must look at the process throughout the entire processing cycle so that you can understand where you have dedicated your resources and to what extent you are getting the appropriate outcomes from that resource. So in fashion it might feel if you go with the veteran centric approach you would count that time. You would not start the payments for entitlement until they were released from active duty and came into va care. That would help you to understand the whole process and procedure and make needed adjustments . Absolutely. I think that, in the many discussions i have had with ms. Rubens and mr. Murphy, i know that resources are needed. You have to make good decisions on where those resources are. So i think its very important to measure all of your resources and track those. Its obviously an area where the undersecretary had not concurred with us in our report, and we are going to stand pat with what we say. Thank you. In going back to the first point about these programs failing because so much, or doing less well than expected, so much emphasis put on the backlog. Its a matter of robbing peter to pay paul, isnt . I said that a number of times. Great minds think alike. Thank you, mr. Chairman. The chair recognizes mr. Co mr. Cook. Thank you very much. And i wont say too much more about acronyms, maybe. Your report, very sensitive because i used to be an ig, and i looked at your recommendatio recommendations. And by the way, ig, thats a thankless job. How to lose friends and not influence people i used to say. But its one that you have to have been an organization, and your job is not to make friends. You already know that. Its bothered me a little bit, and maybe if you could help me out, where in two cases it had the vba, which is help me here, thats the Veterans Benefits administration . Yes. They disagreed with your opinion, and then you had, the other one where was actually the undersecretary, is about the same individual for all intensive purposes . I would consider it the same. Intents and purposes. I was looking at it, particularly one where the undersecretary nonconcurred the base of went along with it anyway. Did this go all the way up to the secretary, or is this something, is that a command decision that undersecretary were getting into some dicey stuff in the last few days on this. And im trying to figure out whos going to make these command decision. These are pretty important. Maybe its just my sensitivity with ig reports, but 26 years in the marine corps, what have you, everybody kind of gets a little nervous about ig reports and they Pay Attention to them. At least i used to. Maybe because i used to write them. But any comment on that . I dont mean to put you on the spot. You know what im saying i think. It is the responsibility of the undersecretary for benefits to provide the official signed comments to an ig report. I believe that the secretary does get copies, its copied at the point when we issued the draft report for review and to obtain those comments and then get copies of the final reports to if a report is significant, we certainly brief. I think with all traditional audit processes that has an exit briefing where we have a discussion with the vba officials that are charged with the governance of the specific program. Ive had many briefings with the team, and they feed up to their usb. This is an important point, at least to me. In the military you used to have two things. One was you would have, by direction authority. In other words, Commanding Officer but somebody in the command could sign their signature by direction. That means that, you know, by signing by direction, that the command approves this. The other was releasing authority. Releasing Authority Means you can go out with a message that you are the commanding general, second marine division. You dont give those, that authority a way, and thats why i brought up that point that whoever signs that basically the secretary, the way i understand it is concurring with all those decisions that are made. Its on his or her watch. Correct me if im wrong,. If its a sign for general hickey by one of her staff, yes, this is the official comment. Okay. All right. In terms of your role, and i think its very, very important to go back to how would you even be more proactive in light of some of the things . Do you have any recommendations in regards to that . Im not asking you to do more work but yeah, i am asking you to do more work. I think we planned the odd as appropriate based on the risk in the program. I think if you were to ask me about a more proactive i think it needs to be more discussion at the senior levels as work is completed to really how are you going to fix the problem. And as i alluded to before, worrying about the little tactical nuances and getting everything just letter perfect really doesnt get you there. You really have to address the overall problem and how veterans are affected with the processing and whats happening, and whatever objective of the audit youre dealing with. Thank you. I yield back. Chair recognizes the gentleman from texas, mr. Orourke. Thank you, chairman. The benefits delivery discharge claims and the quick start claims i think you debate are under 25,000. So were measuring those in thousand i may tens of thousands and then all other claims moving to the vba were measuring and hundreds of thousands or millions. So when you were responding to ms. Titus question earlier about robbing peter to pay paul, and you also mentioned that we need to make better decisions about how resources are allocated, do you have some recommendations for the vba or for the committees of oversight in terms of how we should be spending that money in a smarter fashion . I would like to see that you ask vba to do a good static analysis for its initiative staffing analysis, and its work in us. There are too many areas that are being under addressed at this point, are what i would consider under managed. I think at some point if you were to put the right resources on some of these things, such as temporary 100 disability evaluations not being managed effectively, and the associated Financial Impact that we report in our reports, that would start to reduce and would have a better operation, not only from the fact that veterans would be served quicker with whatever decisions and reviews that were needed to make sure their claims were accurate, and then we would be saying that you have a stronger, you are making a stronger position as far as the financial stewardship that you are charged with the vba to ensure the entitlement decisions are accurate and timely. Thank you for that. The chairman brought up a good question about why the vas a score for accuracy is better than your score, and you said one difference is methodology. You look at potential adverse impacts the benefits down the road. Perhaps the vba does not. Is there any other difference in how you assess and the vba assesses accuracy . Yes, i believe there are. Id like to ask ms. Stokes to talk to the tactile aspects of that. As you mentioned, there are some definite differences as far as the potential to affect benefits, and we do call oftentimes enters that relate to that big and that is particularly when things are missing from the file, and as rooster murphy indicated in his response, i believe the specific question had to do with whether or not a the examination if it were missing, would that constitute an error. What we find during our in its inspections are that the examinations may be not necessary missing, some are missing, some are inadequate but they are used to evaluate cases with anyway. Our position is according to vba policy, those examinations should be returned. If an examiner notes something during a physical examination and another disability questionnaire is required and its not completed, then we consider that an error as well because you cannot come to the point where you can make a decision on a disability evaluation if you do not have medical evidence to go one way or the other. So those are some stark differences in the methods that we would determine an error versus vba. Ms. Halliday, i would hate for you to ask for vba and a certain want to follow up with ms. Rubens and her team, but whats their response to that distinction and the assertion that those exams should be returned or should be counted differently than they are right now . We agreed to disagree. Gotcha. Thats what its documented in this audit. Audit. Okay. My last question i dont know if you heard the exchange over ides and where we are against backlog and golfer benefits of backlog and goal for rating. Did you have any concerns or questions or did you agree with the assessmenassessmen t provided by vba about where were at and where were likely to be by october. I cant comment to that. I dont have any ongoing work addressing that. Thank you. Thank you, mr. Chair. Mr. Jolly spent 50 that i want to follow up just a bit of what we discussed, and i stand that disagreed on time in his issues seems somewhat jurisdictional and a couple other matters. But on accuracy, your report that the agassi rate is about 69 . One of the areas of nonconcurrence is something that seems pretty benign, which is insufficient oversight and training. Can you elaborate a little bit on that . I mean, ill put my cards on the table. In many ways you are providing a little bit of oversight into reasons for the inaccuracy. It appears one of the reasons you identified was insufficient and internal training and oversight. Or engaged in the same issue right now at the department obviously on health care delivery. Can you elaborate to the extent you are permitted to on the disagreement on the interpretation of out the departments ability to provide the oversight and training in this specific area . Id like to ask cant who led the audit, but i do believe as you look at the training issue, it spoke specifically to have you identified a quick start claim. And unlike him to the department actually agreed with the training recommendation on the identification of the quick start claims. Where they disagreed was on the clarification of policy concerning nexus between Service Members, the disability incurred during service and the claim disability. And actually our agassi experts here are ms. Stokes and mr. Figaro. So ill turn over to ms. Stokes. One of theirs that we agreed with the oversight was lacking have to do with just the local quality review. So at the local level we did find that the agassi reviews that most Regional Offices would conduct on a monthly basis for individual performance was lacking. While they did have some we did find it to be inadequate. When we discussed this with a staff in the cbs site that process quick start claims, they told us that they were busy, they had other responsibilities, and that they did not have the time to conduct a comprehensive review. At the National Level we found there was a lack of oversight in that the method that star uses to select their samples was lacking and that it did not sufficient identify enough cases that you could ask to get a feel for what the accuracy rate was for quick start claims. When they did conduct their quay reviews, they also did not track and trend those types of errors so that they could use those training deficiencies by tailoring training to particular areas. I see. One of the reasons given was busy. I mean, i guess the part that concerns me is, specifically, the use of the word training. Because of what that means for the abilities of an employee to perform. Oversight in one way is a little less concerning if thats where its deficient, but if training is where its deficient, you know, that just breeds more systemic problem as caseloads go up and the number of, the number of cases go up, failure and training just continues to build upon itself and create a larger problem. I appreciate your answering the question. Thank you, mr. Chairman. Thank the gentleman. Any members have any further questions . With that, thank you all again, and you are now excused from the witness table, and we ask the third panel to come forward. [inaudible conversations] [inaudible conversations] good afternoon, everyone. As i noted in prior panels, all of your complete and written statements will be entered into the hearing record. I know i did this earlier, but i want to recognize mr. Orourke if he would like to make his introduction again. Thank you, mr. Chair. The person i want to introduce deserves a second introduction. Ms. Gipson is a retired captain from the army, was the executive officer at the warrior transition unit in el paso at fort bliss, a former constituent of mine recently until march. She was instrumental in insuring that i understood some of the issues at the wtu by arranging a tour there, and i think will speak very eloquently to some of her personal challenges that can be extrapolated against the challenges that many transitioning Service Members face. And so were very glad and grateful for her presence here today. Thank you, mr. Chair. Thank the gentleman. With that, were going to start with mr. Jenkins. Mr. Jenkins, you are now recognized for five minutes for your testimony. Chairman runyon, Ranking Member titus and distinguished members of the subcommittee, thank you for the opportunity to testify before the subcommittee on the Critical Issues surrounding the bdd, quick start and ides program. I appreciate the opportunity to share views on behalf of our members processing these claims daily. Im a 15year combat veteran who served in both Operation Enduring freedom and iraqi freedom. I am proud to serve veterans every day, and im also a disabled veteran. As an rsr, i work both bdd and quick start claims, and i would like to begin my testimony by stating my dedication to all these programs. These programs are critical for providing recentlydischarged veterans the benefits as soon as possible, and it is essential that these programs are functioning at their highest capacity. My Regional Office has a history of brokering claims to other Regional Offices in an effort to reduce the backlog. In doing so, it has created a lack of sufficient cases that are ready for decision. We have broken out approximately 20,000 cases in the last three years and now claims processers are struggling to received a adequate amounts of work to meet their production standards. Supervisors have been left scrambling to find work for the quick start employees. Due to brokering, were relegated to completing tasks traditionally done by vsrs. Due to the lack of work, management recently instructed employees in bdd to begin a practice called prereg consisting of rating a case that is not, in fact, ready for decision because we are awaiting exams or additional evidence. Management instructed raters to rate these claims as if the medical evidence a had already been received, yet told employees to not finalize the rating. This raises certain questions of the processing of the claim. Employees potentially receive quality errors if medical evidence arrives and does not coincide with employees prerating decision. Veterans should be concerned about this method used by vba management and its effect on their rating decision. Afg urges congress to hold vbas Senior Management accountable for their brokering methods and potential effects it has on veterans and their dependents. As with bdd and quick start, employees in the ides process report the same dedication to the process. However, they did outline several issues that consistently appear. Ides claim processers expressed their frustrations with the lack of communication and training issues with mscs or military Service Coordinators as they are called. Mscs are scattered at military bases all around the world, and when the claims processer is attempting to locate Additional Information about the claim, it is often difficult to locate the original msc. The claim is supposed to be ready for decision, however, our reports say often times this is not the case. This slows down the process for the vpa employee, but most importantly, increases waiting times for the veteran. Afg believes that more detailed training will significantly reduce this issue. Ides processers also expressed issues with the National Guard and reserve claims. The issue being not having complete military records. And as they come to the original office not ready for decision as well, at times when attempting to receive medical records the rater cannot locate the records or the unit the veterans currently assigned to. All of these issues translate to Major Concerns with ides production levels. Claims processers are also told not to defer cases even though a decision cannot be made due to a lack of necessary evidence. There is constant pressure from the vas office of Field Operations and the production cold as established by ofo are arbitrary and unfair. Afg also heard issues regarding processing claims. Claim levels have skyrocketed while Regional Offices have seen minimal growth this staffing. Afg urges vba to hire additional claims processers and provide more indepth and relevant training for current employees. Afge also urges vpa management to conduct a motion study to determine how long each task takes to complete while working on a claim. With the recent transfer, this study is more applicable and necessary than ever. Once again, id like to thank the committee for providing afge an opportunity to share our views, and id with be happy to share any questions. Thank you, mr. Jenkins. With that, ms. Gipson, you are now recognized for five minutes for your testimony. Thank you, chairman runyan. Id also like to thank congressman orourke for inviting me to speak today. In 2011 while training to deploy to afghanistan, i received a severe back injury. By the time my reserve detachment reached the active duty training site, fort bliss, texas, i was combined to a wheelchair, earning me the nickname, the wheelchair soldier, days later i was prescribed a cocktail of drugs which allowed me to walk but not without excruciating pain. Placed in the warrior transition program, efforts to rehabilitate my injury were unsuccessful requiring surgical intervention. Before my back surgery could be performed, i required a surgical procedure to treat uterine fibers, tumors on my uterus. I did not receive a followup gynecological appointment. Placed in ides, i was determined to be medically unfit to serve, received a 20 disability rating, medically separated, i received separation pay. Within days of signing paperwork agreeing to the rating, it was determined that i urgently needed a hysterectomy. I want to be clear that had i received the followup to the original gynecological procedure, my hysterectomy would have been performed at least a year earlier, and my disability rating would have been 70 . Instead of being medically retired, i was medically separated from the United States army on january 11, 2014. In my opinion, a strong democracy requires two professions; the legislator and the Service Member. Each the weapon of the other. Healthy Service Members are the weapons of the legislator while the legislator is the weapon of wounded, injured and ill Service Members. We served as your weapon. On behalf of disabled and medically separated veterans, we respectfully request that you harness your arsenals full potential to fix the ides system and maintain the strength of our democracy. I would like to present to you both short and longterm recommendations. Please note that i participated in ides as an end user, and please forgive me for any policy recommendations which overlap those of previous presenters. The first, establish a consolidated Disability Evaluation System. The ides system is tiresome, timely, burdensome and inefficient. The va and dod must consolidate the departments disability systems with the shared goal to promulgate policy and prescribe uniform guidelines, procedures and standards to eliminate redeny dancy redundancy inherent in adjudicating claims. Second, create a sole source rating system. The va rates all serviceconnected injuries, resulting in two different Rating Systems for Service Members. But dod and va will need to reach a consensus on the definition of qualifying conditions. And events and the rate at which those conditions and events are to be compensated. Understandably, a bias in the favor of the more generous va system will result in a corresponding rise in retirement and medical costs. Information sharing. Plans to roll out shared use technology will enhance and improve Agency Accessibility to health care records. The plan is both necessary and ambitious. However, the current lack of available technology, i believe, is only part of a much larger problem. Government agencies among them dod and va must generate memorandum of agreement allowing agencies to openly share information. This will likely create a change in agency cultures from one of independence to interdependence on sharing information and resources. My interim recommendations are as follows. First, i recommend a fiscal set aside. Veterans in the Service Member transition process frequently complain about the receipt of timely payments once his or her claim has been adjudicated. To date, the rate of benefit payments can take 90 days to a year or more to process. While uncertain of the legal or the tax implications. I recommend that once a Service Member enters federal service, active duty, guard or reserve, a percentage of the Service Members salary be escrowed until the ides or retirement process is completed. The funds set aside could then be automatically reimbursed to the veteran as a lump sum payment used to bridge the gap between the date of retirement or separation and receipt of any long or shortterm benefit. An emergency rating reconsideration. Service members who require emergency surgeries within 60 to 90 days of being rated should receive an automatic disability rating reconsideration. Thirdly, complete a comprehensive staffing Needs Assessment which i believe has been covered by other members of the panel. Fourth, reduce waste, fraud and abuse. The system is replete with opportunities for fraud, waste and abuse. The underlying premise of the adjudication process is to provide compensation and benefits for longterm injury and illnesses. Any system which compensates Service Members for injuries and illnesses must also incentivize healing and recovery. It isnt a politically correct notion, a politically popular notion. However, if ballooning costs are to be reduced and full recovery is to be achieved, this must also be a corresponding goal. [inaudible] must be performed about where opportunities exist to eliminate fraud, and abuse. And finally, organizational change. We have got to change the Organizational Culture which punishes Service Members either directly or indirectly for wounds, injuries or illnesses. In the current climate, Service Members deemed unpit to fight or unfit to fight or conduct acts of physical fitness are cast aside and labeled, often unfairly, as lazy or cowardly. I do not advocate battlefield group hugs. However, leadership training must encourage compassion, dignity and respect. Likewise, Service Providers whether military or civilian must receive similar training. Toxic leaders, both military and civilian, must be either retrained or moved out of leadership positions or positions of authority to mitigate damage to woundedu ykyn and or recovering Service Members. In conclusion, the recommended suggestions to improve ides will each require a cost benefit analysis to determine feasibility. Such analysis is beyond the scope of this presenter. What is certain is that each cost benefit must be assessed using both qualitative and quantitative analysis. It is my belief that undertaking such analysis, however painstaking, would improve of ides to the benefit of retiring Service Members. Thank you. Thank you. And with that, ill recognize mr. Avila for his testimony. Good afternoon, chairman, representative titus and members of the committee. On behalf of Dan Dellinger and the 2. 4 members of the American Legion, i want to thank you for bringing attention to americas transitioning Service Members. I think its especially important that youre paying close attention to the rof7m4j4 of the Veterans Service organizations. Veterans Service Organizations such as American Legion bring experience to the claims process and our critical stakeholders who can help the government meet the obligation to the veteran. The va has recognized this on the civilian side of the dividing line of service, and through the programs like the fully developed claims initiative capitalized on the partnership to improve the claims process and help veterans get the disability benefits they earned through their sacrifice in a more timely fashion. In my current position as medical board and fiscal board representative, i have the privilege of assisting Service Members who might not be able to continue their military career due to a medical condition. These individuals represent some of the most at risk transitioning Service Members due to the current medical needs. While the current improvised disability system known as ides, the joint program by dod and va, is an improvement over the reeves system of doing medical evaluations, we can always make it better. American legion maintains a National Staff at the benefits delivery discharge location at winstonsalem, north carolina, and salt lake city, utah, as well as our processing site at joint base lewismcchord in Washington State and the washington, d. C. Capital region. We found specific members could benefit from better information, this is perhaps better illustrated by members of the reserve and National Guard who might be going through the process by themselves back at their home state. They do not have the access to the same information and resources as their active duty counterparts. The veterans that are going to transition are making decisions that will impact their entire civilian lives, and they are being asked to do so with little understanding of what that impact would be. As officers, we can bring insight into what bin fits they are entitled or not entitled to. We can also help them understand the importance of the medical exams. Helping Service Members manage expectations and understanding the timelines is critical. Helping them understand what job training and resources are available, what short distance what short discharge or retirement options are best suited to them, the kind of guidance thats still hit or miss without good counseling. The American Legion helps over 500 Service Members a quarter with their bdd and quick start claims, but thousands of veterans still go unrepresented. It is often difficult for Service Organizations to communicate directly with Service Members on post. When you consider a report issued on may 20th by the ig, vas making errors on these claims only around 69 of an accuracy rate. Veterans need advocacy of every stage of the process. The American Legion hopes to continue working with department of defense and the department of Veterans Affairs to insure that all veterans have advocacy throughout their transition process. The system exists to serve those who wear the uniform of the United States of america, but the American Legion exists to be a veteran serving veterans organization, and we can beth do that when we bridge the gap between our veterans and Service Members and the Services Provided by dod and the va. Thank you for inclusion of the stakeholders. Were happy to answer any questions. Thank you. And well recognize mr. Varella for his testimony from dav. Thank you, chairman runyan. Good afternoon, Ranking Member titus, members of the subcommittee. Dav appreciates the opportunity to testify at this hearing, Service Members who are participate anything the wdd or the quick Start Programs. My own remarks will address three issues we find particularly important. First, time frames and benchmarks established within the ides program. The ides program was constructed with the cantation of Service Members reaching finality within 295 days, and we will highlight several critical point along this transition path. Proposed rating decisions are required to be issued within 15 days of receiving notification that a Service Member has been deemed unfit for duty. Dav Service Officers in the field do report delays in the proposed rating process in some areas ranging anywhere from three to six months. Once separated from service and now considered a veteran, their disability compensation payments are expected to begin within 30 days of discharge. Dav Service Officers have reported delays in the processing of finalized ides claims in providence, rhode island, and previous delays in seattle, washington. Improvements have been noted due mostly to consolidation and reorganization of resources. Delays also reported in rhode island not only affecting final rating board determinations, but also the proposed rating board determinations. Dav finds most reports delayed are personnel related, specifically a lack thereof. A situation would demand has outpaced resources. A thorough evaluation is needed to determine exact resource and Personnel Requirements and whether proper casetostaff ratio model exists. Of critical importance is when an active duty Service Member crosses the threshold and becomes a veteran. A delay could have serious consequences as Compensation Benefits hay, in fact, be their sole source of income. Second is access and support. Davs Transition Service officers have earned a renowned reputation within the veteran community. Despite their proven track record, the launch of the new tab gps program has adversely affected the level of service to be provided. Dav was heavily engaged in the preset process, provided briefings to class participants many times at the insistence of military installations. They screened personnel medical records and performed oneonone counseling to provide information and answer any questions posed by the participants. Unfortunately, our role continues to diminish and has met with some resistance at some military installations. In some cases, there have been attempts to remove the vso presence and functions entirely. What is presently occurring seems counterintuitive. In some instances assistance is promoted whether through the ides process itself, but most certainly while engage with the the va during the claim and appeal process. Vsos represent roughly 60 of claimants and 70 of appellants before the va. Collaborative efforts between vsos and Program Affiliates would serve as a benefit to separating Service Members. Third, vocational services. Service members proceeding with ratings of 20 or greater have direct access to voc rehab counselors. Bear in mind this ides Mission Parameter is staffed with voc rehab counselors that are drawn away from daily Regional Office operations. Dav has testified on many occasions regarding the benefits of the program. We can provide opportunities for immediate transition to employment upon separation, career counseling and Supportive Services and plans if employment is not aligned prior to separation. The army benefits may not be realized by preset personnel as their focus could be on the use of post9 11 g. I. Bill benefits. However, we have recommended that Congress Remove the 12year period to use this earned benefit to insure its available when needed, regardless of when that need arises. With the wide range of benefits, its imperative that Service Members have as complete an understanding as possible. It could prove critical at some point in the future if circumstances in their lives change. In conclusion, resource needs must be comprehensively identified, procured and utilized. Programmatic goals and parameters must be aligned to or exceed this mission. Vso involvement is vital and should receive greater support by all program partners. Eligible apartments must continue to be identified, availing new services during the active duty phase that gives our wounded, ill and injured Service Members and their families the best advantage by leveraging all available tools and resources needed to successfully transition out of the military. Again, chairman runyan, Ranking Member titus and members of the subcommittee, we thank you for the opportunity to present this testimony today. Thank you. And with that, ill recognize mr. Gehrke for the vfw testimony. Mr. Chairman and members of the subcommittee, on behalf of the men and women of the veterans of foreign wars, i would like to thank you for the opportunity to testify at todays hearing on vas performance in the Service Members transition process. This past memorial day Many Americans displayed feelings of pride in veterans who fought in americas wars. Surveys show 91 of americans say that they are proud of military Service Members. Unfortunately, the pride america has for its Service Members still is not fully matched by the Government Agencies charged with supporting their transition back to civilian life. The 2007 walter reed scandal was a wakeup call to americans that the government was not properly caring for our Wounded Warriors. The public was outraged that marines and soldiers were living in disparaging conditions, forced to deal with inattentive management. Equally concerning was that veterans were being shortchanged on their disability and Retirement Benefits they have earned. As a result, congress and the president conducted fierce oversight over the military and Veterans Health care and disability benefits system. Congress concluded that the care coordination and reintegration Services Provided by the agencies were fragmented, leaving the public, Service Members and their families to question the governments commitment to those who carry the burden of battle. In 2008 congress forced dod and va to create policies to insure that the Disability Evaluation Systems which termed their military and Veterans Benefits were streamlined and fair. As a result, dod and va collaborated to create the integrated Disability Evaluation System which simplified the process by eliminating duplicative disability examinations, ratings and placing va counselors in military transition facilities. The vas also responded by expanding the benefits delivery of discharge and quick Start Programs to allow Service Members to make claims before their discharge tate. The vfk believes these promising programs vfw believes these promising rams are a step in the right direction. Service members still suffer from the defense departments disjointed policies and leadership which government wounded governed Wounded Warrior care, inadequate staffing dedicated to the benefits evaluation process, no integrated Electronic Health care system and poor communication. The result of dods and vas shortcomings is that Service Members are waiting too long in wounded transition units as va processes their disability claims. To reduce claims processing time, we recommend that, the od collaborate with va to reduce red tape and that va expedite the adjudication of bdd and quick start claims. To insure that dod creates policies that insures Service Members are not shortchanged, we recommend Congress Give the undersecretary of personnel and readiness the Sole Authority to develop policy to improve the care and Services Provided through ides. To say the transition process is seamless or that dod and va have an integrated disability evaluation process would be inaccurate. It is ill possible to have an integrated disability process without an integrated electronic records system. Therefore, it is imperative that congress use their complete authority to insure dod collaborates with va to create a fully integrated electronic records health care system. Also communication between dods and va senior officials must increase, and the departments must conductwn bettr outreach to Service Members, family caregivers and vsos. In conclusion, we acknowledge that both the departments of defense and veteran affairs are delivering qualityb care to Service Members and veterans when accessible. We give them credit for addressing the Disability Evaluation System and setting ambitious timeliness goals for delivering benefits so long as those goals are achievable. Timeliness has drastically um proofed from the estimated improved from the estimated 540 days it took to complete a claim, and va and dod continue to shorten the amount of time it takes to process disability claims. However, va and dod do not have the policies, procedures and resources to address the influx of Service Members who will be transitioning to civilian life as forces draw down. It is imperative that congress not only boost its aggressive oversight over the agencies to insure that they properly plan for the future, but they also must provide the fiscal resources to improve the access to care and benefits that our Service Members have earned. Mr. Chairman, this concludes my testimony, and i look forward to answering any of the questions the committee may have. Thank you. And with that, well begin our round of questioning. And my first question is going to be for mr. Avila. You note in your testimony that in recent audit by the va oig on the quick Start Program, va responded that lack of timeliness was due to an increase in agent orange claims. Unfortunately, this seems to be a pattern from the va. This that they do not adequately project their future workload and divert attention there problems focusing on the unrepresented issues unrelated issues. Can you please elaborate and how it negatively impacts a substantive focus on the improvement of predischarge claims . Mr. Chairman, the work on the issue in ides, i myself went through the predischarge claim. I retired two years ago, and i used the predischarge claim. I used the bdd. Because i filed when i had over, i think i did it at 180 days. And that was a program that was currently being pushed by the va that said if you file this way, your claim will be processed, and youll receive benefits as soon as you exit the military. Maybe some of the issue is that these claims go to certain Regional Offices, and a lot of members started filing the claims in either winstonsalem or utah started seeing the claims, and what we started seeing the claims was that the bdd and quick start claims became a backlog because every Service Member that was trysting was advised this would be the