Defense, VA Team Proposes Disability Process Changes

By Jim Garamone
American Forces Press Service

Oct. 23, 2007 - Defense Secretary Robert M. Gates gave an interagency task force studying the disability rating system for wounded warriors its marching orders: "Aside from the war itself, we have no higher priority." The task force came back with a proposal that should cut the time wounded or sick servicemembers wait for a disability rating in half, said Bill Carr, the deputy undersecretary of defense for military personnel policy and a member of the interagency team.

The streamlined disability evaluation system seeks to fix problems wounded personnel faced in the different evaluation processes that the Defense Department and the Department of Veterans Affairs used. Servicemembers often were in limbo for a year as the process continued.

The interagency group studied the Defense and VA processes with an eye to combining the processes within existing law. "We're going to eliminate the redundancy which takes the form of both of us doing a physical exam and then both of us rating what the physical exam told us about how severe the injury is," Carr said during a recent interview. "Because we consolidate, we cut the time about in half."

The changes all are within current law, Carr said. "We had to make improvements and do it fast, which means we couldn't assume that we had legislation enacted," he said.

In the past, a wounded or ill servicemember would have a military physical and then there would be a military decision about retention and a Defense Department disability rating. The servicemember would then go through the same process for the VA rating.
Now the defense and VA physicals are combined. The physical will be in a defense facility, "but a VA physician will administer it and document it to VA standards, which DoD will accept," Carr said. "But it comes back to DoD to make a decision on what that means in terms of retention."

If the service makes the decision that the servicemember cannot continue to serve, the packet goes to VA and "they tell us what the rating is for each condition listed."

"VA makes the disability rating call, tells us, and then we apply the law," Carr said.

"There's a lot of strong interest by the services – not VA, not anyone else, but the services – to determine if you are fit (to continue in the military)," Carr said. "But once they reach that determination, then we can simplify things quite a bit in the physical exam and the rating process."

The Defense Department and VA will launch a pilot of the program next month at Washington-area military hospitals -- Walter Reed Army Medical Center in Washington, Bethesda National Naval Medical Center in Maryland, and the Air Force's Malcolm Grow Medical Center at Andrews Air Force Base, Md. "We will expand as quickly as we can," Carr said. "If this proves as successful as we think it might be, then we'll begin expanding as soon as we can train people in other military hospitals to do what Walter Reed and Bethesda will be doing."

The defense disability system handles about 20,000 cases each year of various degrees of disability, Carr said. Of those found unfit, the vast majority – nearly 90 percent – are less than 30 percent disabled and leave with a severance payment. The others are judged 30 percent or more disabled and are medically retired.

More changes in the system will come about as a result of the recommendations of a blue-ribbon panel headed by former Kansas Sen. Robert Dole and former Health and Human Services Secretary Donna Shalala.

Also the Senate has a bill, the House has a bill and the president proposed a bill on Oct. 16. "No matter how that shakes out, the changes that we've made in this process are fundamentally sound and probably continue," Carr said.

"The big and almost revolutionary changes are accomplished with this interagency sharing and division of labor," he said. "The stuff that will come out in legislation will work in this framework very well."