October 29, 2007
By William H. McMichael
The Defense Department will soon unveil a new, streamlined disability evaluation system that, in tandem with the Department of Veterans Affairs, will replace the current cumbersome process with a single exam and single disability rating.
According to a copy of the plan obtained by Military Times and confirmed by Pentagon officials, veterans medically retired from service will be able to apply for, and get, VA benefits immediately.
Overall, the time spent in the system, from the point a service member is found unfit for duty until he begins receiving VA disability payments, will be cut “by about half,” said to Bill Carr, undersecretary of defense for military personnel policy.
The plan is the Pentagon’s best effort to make some fixes to the system immediately, without having to seek congressional approval. A broader, longer-range plan unveiled by the White House on Oct. 16, based on recent recommendations from a blue-ribbon commission, will require congressional approval and will take longer to implement.
The Pentagon’s interim plan will be phased in with a pilot program to be launched in late November at three military hospitals: Walter Reed Army Medical Center in Washington, D.C.; National Naval Medical Center in Bethesda, Md.; and Malcolm Grove Medical Center at Andrews Air Force Base, Md.
The plan will expand to other facilities as officials evaluate its effectiveness, with the emphasis on facilities that treat greater numbers of troops wounded in the wars. Carr said expansion will take place “as fast as it can.”
The plan, a top priority of Defense Secretary Robert Gates, is the Pentagon’s answer to the Walter Reed scandal earlier this year. Media reports described wounded troops caught in tangle of red tape during their treatment and subsequent medical evaluations.
The problems were complicated by the slow-moving VA benefits process and poor coordination between VA and the Pentagon — and exacerbated by the wars in Iraq and Afghanistan, in which more than 28,000 troops have been wounded, more than 13,600 of them seriously.
The new program will evaluate all service members equally, regardless of how their condition developed.
Each service now does its own physical exam during the process leading to possible separation, and each service member is rated for his condition. A member medically separated or retired who then seeks VA care faces another physical exam and yet another rating.
The plan eliminates such redundancy. “The most important part of it is that we take duplication and we stamp it out,” Carr said.
The single exam will be administered to troops as part of the standard Medical Evaluation Board, which determines a member’s fitness for duty. But instead of a military doctor, a VA-qualified provider with access to the member’s medical records will perform the exam. In addition to evaluating conditions that could make the member unfit for service, the doctor will also consider problems the member may say have been incurred in or aggravated by military service.
If the MEB, which also considers a commanding officer’s input, decides the member does not meet retention standards, the case is referred to a Physical Evaluation Board. This board decides whether to retain, separate or return the member to duty and, under the current system, can determine the nature and amount of military disability benefits.
Troops will retain the right to appeal this decision to a formal Physical Evaluation Board. But if the original finding is confirmed, the new system will allow troops to have any single condition or rating reconsidered by a VA decision review officer while still on active duty.
As it now stands, if a member is rated by the military as at least 30 percent disabled, he is medically retired. Unless the member served more than 20 years, a rating below 30 percent calls for medical separation and, under some conditions, a lump-sum, one-time payment.
In the new plan, the military no longer will issue ratings; that will be solely the VA’s job.
But until the law is changed, the military will continue to base its disability ratings decisions only on those conditions that make a member unfit for continued service.
For example, if a member is rated as 20 percent disabled for a knee injury and 10 percent disabled for hypertension, the military’s rating for the purpose of deciding whether to keep or release the member would be 20 percent, since hypertension is treatable, Carr said. In contrast, VA would use the total rating of 30 percent to calculate disability compensation for that member, using its own formula.
That disparity would vanish if Congress adopts the plan announced Oct. 16 by President Bush, Carr said. But while that plan faces competition from separate “wounded warrior” legislation introduced in the House and Senate, Carr said the essence of the new Pentagon plan likely will stand no matter what happens with follow-on efforts.
“We have done the best that we can under current law,” Carr said. “And we are honoring ... what might come around the corner. Depending on the way they come out, we’ll just re-optimize it again. But I doubt we’re going to change any of the fundamentals of this.”
Carr agreed that the shock of the Walter Reed scandal and Gates’ subsequent push to fix the problems sped the process along. But he said three congressionally mandated Pentagon executive groups had been looking at such changes for the past two years. Disability proposal at a glance Current plan --
The Defense and Veterans Affairs departments run separate disability evaluation and ratings systems, each with its own standards for medical exams and separate processes for setting the level of disability, which in turn determines the military disability retirement pay or severance pay from the Defense Department and the amount of VA disability compensation. Pilot plan --
An interim program would eliminate the separate military and veterans health exams and separate systems of awarding a disability rating. Injured troops would undergo a single exam and get a single rating based on VA’s ratings schedule.
The Defense Department would continue paying disability retired pay and severance pay, while the VA would continue paying disability compensation. Future plan --
If Congress approves a White House plan, the Defense Department’s role in disability decisions would be reduced to ruling on whether a person is fit to continue military service.
Those found unfit would get a pension based on their rank and years of service. VA would then determine the level of disability.
Based on that rating, an individual would receive enhanced disability compensation featuring several components — the basic disability payment, plus a transition payment equal to a minimum of three months of basic pay, plus a payment based on an assessment of how the disability has diminished the veteran’s quality of life and the potential loss of future income.
The exact levels of pay would be determined by a proposed seven-month study.