Veterans' Disability Benefits
Opportunities Remain for Improving Accountability for and Access to Benefits Delivery at Discharge Program Gao ID: GAO-10-450T February 24, 2010Through the Benefits Delivery at Discharge (BDD) program, the Department of Veterans Affairs (VA) collaborates with the Department of Defense (DOD) to streamline access to veterans' disability benefits by allowing some servicemembers to file a claim and undergo a single collaborative exam process prior to discharge. BDD is designed for servicemembers with conditions that, while disabling, do not generally prevent them from performing their military duties. This program can shorten the time it takes for veterans to receive benefits by several months. GAO was asked to discuss issues surrounding VA's and DOD's BDD program and related Quick Start program, and identify ways VA and DOD could improve these programs for transitioning servicemembers. This statement is based on GAO's September 2008 report (GAO-08-901) that examined (1) VA efforts to manage the BDD program and (2) how VA and DOD are addressing challenges servicemembers face in accessing the BDD program. GAO updated some information to reflect the current status of claims processing and improvement initiatives in the BDD program.
Although VA awards disability benefits more quickly under BDD than through its traditional disability claims process, gaps in program management and accountability remain. For example, VA does not separately measure the total time its personnel spend developing BDD claims. As a result, VA has limited information on potential problems and improvement opportunities regarding BDD claims. GAO continues to believe that VA should measure BDD development time; however, VA told GAO it has no plans to capture this information. GAO also found that VA implemented two initiatives to improve the BDD program--i.e., consolidating BDD processing in two offices and instituting paperless processing of BDD claims to increase efficiencies and improve security of information--but did not evaluate whether or the extent to which desired improvements resulted. Finally, GAO found that VA was not completely or consistently monitoring BDD operations at all locations. VA has since taken steps to review BDD operations at more sites and has revised its protocols to ensure more consistent reviews of BDD operations. VA and DOD have taken steps to improve servicemembers' access to the BDD program; however, opportunities remain for further improvement. For servicemembers such as National Guard and Reservists who are generally unable to complete the BDD claims process within the required time frame, VA established an alternative predischarge program called Quick Start. Under this program, servicemembers may still initiate a disability application prior to discharge, but can complete the claims process, including medical exams, at another location after discharge. In response to GAO's recommendation, VA has taken steps to collect additional data to determine the extent to which the Quick Start program is helping those with limited or no access to the BDD program. However, as with BDD claims, VA told GAO it has no plans to measure time spent developing these particular claims, and GAO continues to believe it should. VA and DOD have coordinated to increase BDD program awareness through VA benefits briefings for servicemembers, and DOD established a goal that 85 percent of servicemembers attend these non-mandatory briefings. GAO continues to believe that DOD should establish a plan with a specific time frame for meeting this goal, but DOD has not developed such a plan. Finally, GAO found that some bases faced difficulties maintaining local agreements intended to prevent redundancy and inconvenience for servicemembers in obtaining required medical exams. In response to GAO's recommendation, DOD reported that it is working with VA to identify best practices to address local challenges to implementing their cooperative exam process.
GAO-10-450T, Veterans' Disability Benefits: Opportunities Remain for Improving Accountability for and Access to Benefits Delivery at Discharge Program
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Testimony:
Before the Subcommittee on Disability Assistance and Memorial Affairs,
Committee on Veterans' Affairs, House of Representatives:
United States Government Accountability Office: GAO:
For Release on Delivery:
Expected at 2:00 p.m. EST:
Wednesday, February 24, 2010:
Veterans' Disability Benefits:
Opportunities Remain for Improving Accountability for and Access to
Benefits Delivery at Discharge Program:
Statement of Daniel Bertoni, Director: Education, Workforce, and
Income Security Issues:
GAO-10-450T:
GAO Highlights:
Highlights of GAO-10-450T, a testimony before the Subcommittee on
Disability Assistance and Memorial Affairs, Committee on Veterans‘
Affairs, House of Representatives.
Why GAO Did This Study:
Through the Benefits Delivery at Discharge (BDD) program, the
Department of Veterans Affairs (VA) collaborates with the Department
of Defense (DOD) to streamline access to veterans‘ disability benefits
by allowing some servicemembers to file a claim and undergo a single
collaborative exam process prior to discharge. BDD is designed for
servicemembers with conditions that, while disabling, do not generally
prevent them from performing their military duties. This program can
shorten the time it takes for veterans to receive benefits by several
months.
GAO was asked to discuss issues surrounding VA‘s and DOD‘s BDD program
and related Quick Start program, and identify ways VA and DOD could
improve these programs for transitioning servicemembers. This
statement is based on GAO‘s September 2008 report (GAO-08-901) that
examined (1) VA efforts to manage the BDD program and (2) how VA and
DOD are addressing challenges servicemembers face in accessing the BDD
program. GAO updated some information to reflect the current status of
claims processing and improvement initiatives in the BDD program.
What GAO Found:
Although VA awards disability benefits more quickly under BDD than
through its traditional disability claims process, gaps in program
management and accountability remain. For example, VA does not
separately measure the total time its personnel spend developing BDD
claims. As a result, VA has limited information on potential problems
and improvement opportunities regarding BDD claims. GAO continues to
believe that VA should measure BDD development time; however, VA told
GAO it has no plans to capture this information. GAO also found that
VA implemented two initiatives to improve the BDD program”i.e.,
consolidating BDD processing in two offices and instituting paperless
processing of BDD claims to increase efficiencies and improve security
of information”but did not evaluate whether or the extent to which
desired improvements resulted. Finally, GAO found that VA was not
completely or consistently monitoring BDD operations at all locations.
VA has since taken steps to review BDD operations at more sites and
has revised its protocols to ensure more consistent reviews of BDD
operations.
VA and DOD have taken steps to improve servicemembers‘ access to the
BDD program; however, opportunities remain for further improvement.
For servicemembers such as National Guard and Reservists who are
generally unable to complete the BDD claims process within the
required time frame, VA established an alternative predischarge
program called Quick Start. Under this program, servicemembers may
still initiate a disability application prior to discharge, but can
complete the claims process, including medical exams, at another
location after discharge. In response to GAO‘s recommendation, VA has
taken steps to collect additional data to determine the extent to
which the Quick Start program is helping those with limited or no
access to the BDD program. However, as with BDD claims, VA told GAO it
has no plans to measure time spent developing these particular claims,
and GAO continues to believe it should. VA and DOD have coordinated to
increase BDD program awareness through VA benefits briefings for
servicemembers, and DOD established a goal that 85 percent of
servicemembers attend these non-mandatory briefings. GAO continues to
believe that DOD should establish a plan with a specific time frame
for meeting this goal, but DOD has not developed such a plan. Finally,
GAO found that some bases faced difficulties maintaining local
agreements intended to prevent redundancy and inconvenience for
servicemembers in obtaining required medical exams. In response to GAO‘
s recommendation, DOD reported that it is working with VA to identify
best practices to address local challenges to implementing their
cooperative exam process.
View [hyperlink, http://www.gao.gov/products/GAO-10-450T] or key
components. For more information, contact Daniel Bertoni at (202) 512-
7215 or bertonid@gao.gov.
[End of section]
Mr. Chairman and Members of the Subcommittee:
I am pleased to have the opportunity to comment on the Benefits
Delivery at Discharge (BDD) program and related Quick Start program,
which are administered by the Department of Veterans Affairs (VA) in
collaboration with the Department of Defense (DOD). Both programs are
intended to help servicemembers transition from military service to
life as civilians and veterans by allowing them to initiate their VA
disability benefits applications while they are still in the military.
The BDD program further allows servicemembers to go through one
collaborative examination process that satisfies DOD's requirement to
determine their general health and VA's requirement to assess any
claimed disabilities, instead of separate exam processes for both DOD
and VA. Under BDD and Quick Start, veterans should begin receiving
benefits sooner than the 6 to 7 months it would typically take if they
had applied after discharge under the traditional disability claims
process. Both programs are designed for servicemembers with conditions
that, while disabling, do not generally prevent them from performing
their military duties.[Footnote 1]
You asked us to discuss issues surrounding VA's and DOD's BDD program
and related Quick Start program, and identify ways VA and DOD could
improve these programs for transitioning servicemembers. My statement
draws on our prior work, which examined (1) VA efforts to manage the
BDD program and (2) how VA and DOD are addressing challenges that
servicemembers face accessing the BDD program,[Footnote 2] and was
conducted in accordance with generally accepted government auditing
standards. We have updated some information to reflect the current
status of VA claims processing and improvement initiatives in the BDD
program.
In summary, we found that although VA awards compensation more quickly
under BDD than through its traditional disability claims process,
there are gaps in program management, accountability, and access. For
example, VA does not track time spent developing a BDD claim prior to
the servicemember's discharge and therefore lacks information on how
efficiently its personnel are developing BDD claims. In addition,
although VA and DOD have made efforts to improve all servicemembers'
access to the BDD program, we identified additional opportunities to
help improve access. For example, VA established the Quick Start
program whereby servicemembers unable to complete exams within BDD's
required time frames--such as National Guard and Reserves--may at
least initiate a disability application prior to discharge.[Footnote
3] However, VA lacked sufficient data to determine whether the Quick
Start program was helping those with no or limited access to the BDD
program. In response to our recommendation, VA has updated its data
system to track participation by National Guard/Reserves. We also
found that efforts to raise awareness about the BDD program may not
reach all those who are eligible. DOD has set a goal that 85 percent
of servicemembers attend Transition Assistance Program (TAP) sessions,
but it has not implemented our recommendation to establish a plan with
a specific time frame to meet this goal, and we continue to believe
that it should.
Background:
Through its disability compensation program, VA pays monthly benefits
to veterans with service-connected disabilities.[Footnote 4] Under
VA's BDD program, any member of the armed forces who has seen active
duty--including those in the National Guard or Reserves--may apply for
VA disability benefits prior to discharge. The program allows veterans
to file for and potentially receive benefits earlier and faster than
under the traditional claim process because medical records are more
readily accessible and key forms needed to process the claim can be
signed immediately. Establishing that the claim is related to the
member's military service may also be easier under the BDD program
because the member is still on active duty status. In 2008, VA and DOD
offered the program at 142 bases,[Footnote 5] providing access to over
70 percent of servicemembers who were discharged in fiscal year
2007.[Footnote 6] In July 2008, VA issued policy guidance allowing
servicemembers being discharged from any military base to initiate BDD
claims at other locations where VA personnel were located, such as at
all of its 57 regional offices. VA also established an alternative
predischarge program, now called Quick Start, to provide members who
cannot participate in the BDD program an opportunity to initiate
claims before discharge. Last year, over 51,000 claims were filed
through the BDD and Quick Start programs.
To participate in the BDD program, servicemembers generally must meet
six requirements: (1) be in the process of being honorably discharged
from military service, (2) initiate their application for VA
disability benefits between 60 and 180 days prior to their discharge
date, (3) sign a Veterans Claims Assistance Act (VCAA) form,[Footnote
7] (4) obtain and provide copies of their service medical records to
local VA personnel, (5) complete a VA medical exam, and (6) remain
near the base until the exam process is done. The 60-to 180-day time
frame is intended to provide sufficient time prior to discharge for
local VA personnel at BDD intake sites to assist members with their
disability applications, including scheduling exams.
While VA has examination requirements for those applying for
disability compensation, DOD also has examination requirements for
those leaving military service. For all servicemembers leaving the
military, the military services generally require health assessments
that consist of a questionnaire about the member's general health and
medical history, among other topics. In some cases, members who are
separating from the military may receive a physical exam to obtain
evidence for a particular medical problem or problems that might
exist. The purpose of the exam is to obtain information on the
individual's medical history, and includes diagnostic and clinical
tests, depending on the types of disabilities being claimed. VA's exam
for disability compensation is more comprehensive and detailed than
the military services' separation exams, which are intended to
document continued fitness for duty, whereas the purpose of the VA
exam is to document disability or loss of function.[Footnote 8]
Under the BDD program, DOD and VA coordinate efforts to perform exams
for servicemembers being discharged that satisfy requirements of both
the military and VA. Because of variation in the availability of local
resources, such as physicians trained to use VA's exam protocols, DOD
and VA agreed that local military bases should have flexibility to
determine whether VA or military physicians or some combination of
both will conduct the exam. In 2004, the agencies signed a memorandum
of agreement (MOA) delineating their roles and responsibilities. The
national agreement delegates authority to VA regional offices and
individual military bases to create memorandums of understanding (MOU)
that detail how the exam process will be implemented at the local
level.
VA's Veterans Benefits Administration (VBA) is responsible for
administering and monitoring the BDD program.[Footnote 9] VBA
personnel assemble claims-related information and send the claims to
be processed at one of two regional offices.[Footnote 10] VBA is also
responsible for the paperless BDD claims process, an initiative
intended to improve efficiency by converting claims-related
information stored in paper folders into electronic format, as part of
VA's effort to have all claims processed electronically by the end of
2012.
VA has established a performance goal to increase the percentage of
first-time disability claims filed through the BDD program.
Servicemembers generally learn of the BDD program through VA-sponsored
benefits briefings conducted at military bases as part of TAP
sessions. Led primarily by the Department of Labor, TAP consists of
about 3 to 4 days of briefings on a variety of topics related to
benefits and services available to servicemembers as they are
discharged and begin life as veterans. Generally, servicemembers are
required to attend a short introductory briefing, while all other
sessions--including the VA benefits segment in which members learn
about BDD--are optional.
In addition to its participation goal for the BDD program, VA has
three general goals for the timeliness and accuracy of all disability
claims: average days pending (i.e., waiting for a final decision),
average days to complete all work to reach a final decision, and
average accuracy rate (percentage of claims with no processing
errors).[Footnote 11] In 2009, VA reached its performance goal for one
measure, i.e., average days to complete claims was 161 days compared
with a goal of 168 days. However VA fell short of two goals last year:
Average days pending was 117 days compared with a goal of 116 days,
and national accuracy rates were 83 percent compared with a goal of 90
percent.[Footnote 12]
VA's Management of the BDD Program Provides Limited Accountability for
Results, although Recent Improvements Have Been Made:
VA Has a Performance Measure for BDD Participation, but Lacks Adequate
Measures for Timeliness of BDD Claims:
VA has established one performance measure for the BDD program that
tracks participation in the program. Since fiscal year 2005, VA has
tracked the percentage of all disability claims filed through the BDD
program within 1 year of discharge. VA's most recent data for fiscal
year 2008 indicate that 59 percent of claims filed within 1 year of
discharge were filed through the BDD program--9 percentage points
higher than its fiscal year 2008 goal of 50 percent. VA recently
revised this measure so that it accounts only for claims filed by
members who are discharging from bases covered by the BDD program.
[Footnote 13]
Although VA fine-tuned its measure for BDD program participation, VA
does not adequately measure timeliness of BDD claims. VA tracks the
days it takes to process traditional claims starting with the date a
veteran first files a claim, whereas it tracks days to process BDD
claims starting with the date a servicemember is discharged.[Footnote
14] This approach highlights a key advantage of the BDD program--that
it takes less time for the veteran to receive benefits after
discharge. However, the time VA spends developing a claim before a
servicemember's discharge--at least 60 days according to VA--is not
included in its measures of timeliness for processing BDD claims, even
though claims development is included in VA's timeliness measures for
traditional disability claims.[Footnote 15]
VA officials told us the agency does not measure the timeliness of BDD
claims development for three reasons: (1) VA lacks legal authority to
provide compensation until a servicemember is discharged and becomes a
veteran; (2) VA officials perceive most development activities, such
as obtaining the separation exam and medical records, to be outside of
their control; and (3) VA officials said that a primary objective of
the program was to shorten the time from which the member was entitled
to benefits--by definition, after discharge--to the time he or she
actually received them.
While it is useful to know how soon after discharge servicemembers
begin receiving benefits, excluding the time VA personnel spend on
developing BDD claims limits VA's information on challenges in this
stage of the process and may inhibit VA from taking action to address
them. Personnel in 12 of the 14 BDD intake bases we reviewed indicated
significant challenges with claims development activities, such as
scheduling and completing sometimes multiple exams for servicemembers
who leave an area. Challenges such as these may delay the development
of servicemembers' claims, putting them at risk of having to drop out
of the BDD program. The fact that the servicemember is not yet a
veteran does not absolve VA from tracking the time and resources spent
developing BDD claims, which could ultimately help VA identify and
mitigate program challenges. As for lack of control over the claims
development process, VA also faces similar limitations with
traditional disability claims, because VA must rely on veterans to
submit their applications and on other agencies or medical providers
for records associated with the claim. Nevertheless, VA tracks time
spent developing these claims and could also do this for BDD claims.
VA Has Not Fully Evaluated Initiatives to Improve the BDD Program:
VA implemented two initiatives to improve the BDD program but did not
fully evaluate either. In 2006, VA finished consolidating claims
processing activities for BDD into two regional offices--Salt Lake
City, Utah, and Winston-Salem, North Carolina--to improve the
consistency and timeliness of BDD ratings.[Footnote 16] In fiscal year
2007, each office completed about 11,000 BDD claims. Although VA
reported to us that it monitors claims workloads between these offices
and, in one case, sent claims from one office to the other so that
claims could be processed more quickly, VA had not conducted an
evaluation to determine whether consistency improved compared with
prior practices.
VA also has not evaluated a second BDD initiative, known as the
paperless claims processing initiative, which is intended to increase
the timeliness of claims processing and security of BDD claims
information. Since our report, VA told us that all BDD claims have
been processed in the paperless environment since August 2008, and
that it continues to monitor the BDD paperless initiative by hosting
monthly teleconference calls with all 57 regional offices, intake
sites, and area offices to provide ongoing guidance and training, as
well as address any issues or problems the field may be experiencing.
However, VA has not evaluated the extent to which this initiative
improved overall timeliness or security.
VA's Review of BDD Operations Has Been Inconsistent, although VA Has
Recently Taken Steps to Improve Monitoring:
We identified gaps related to VA's monitoring of the BDD program, but
VA has since taken some steps to address those gaps. For example, we
found that between September 2002 and May 2008, VA conducted reviews
of BDD operations in only 16 of the 40 offices it visited. Further, in
10 of the offices that were reviewed, VA personnel did not document
the extent to which BDD claims were fully developed before being
passed on to the processing office, pursuant to VA policy.[Footnote
17] We also found that the review protocol did not prompt reviewers to
verify the extent to which claims were being fully developed before
being sent to the processing office. In addition, for 14 offices,
reviewers did not address whether agreements related to processing BDD
claims existed between the processing office and relevant regional
office, even though VA's BDD operations review protocol specifically
prompts reviewers to check for such agreements. In response to our
recommendations, VA officials reported that they have increased the
number of BDD oversight visits, including visits to sites that had not
been reviewed in several years, such as Honolulu, Hawaii, and
Louisville, Kentucky. Furthermore, VA revised its protocol to require
a review of BDD operations as part of its site visits to monitor
regional offices.
VA and DOD Took Steps to Increase Access to the BDD Program, but Some
Servicemembers May Still Face Barriers to Participation:
Some Servicemembers Have Limited Access to the BDD Program, but May
Participate in the Alternative Quick Start Program:
Although the BDD program is designed to provide most servicemembers
with access, some members may be unable to initiate a claim 60 to 180
days prior to discharge or remain within the vicinity of the base long
enough to complete their exams. According to VA officials, this is a
challenge particularly for demobilizing servicemembers of the National
Guard and Reserves, who typically remain at a base for only 2 to 5
days before returning home, and are generally unable in this brief
time to complete requisite exams or obtain required copies of their
service medical records. Servicemembers located in remote locations
until just a few days prior to discharge may also be unable to
participate. Finally, we were told that servicemembers going through
the DOD Medical Board process are ineligible for the BDD program
because they typically are not given a firm discharge date in advance
of the 60-to 180-day discharge window, and a firm date is required to
avoid servicemembers returning to active duty after completing the
claims process.[Footnote 18]
In April 2007, VA established an alternative predischarge program, now
known as Quick Start, to provide members who cannot participate in the
BDD program an opportunity to initiate disability claims before they
are discharged. Under this program, local VA personnel typically
develop servicemembers' claims as much as possible prior to discharge
and then send the claims to the San Diego or Winston-Salem regional
offices, which were designated as consolidated processing sites for
Quick Start claims in August 2009.[Footnote 19] In addition, in 2009,
VA also created a predischarge Web site, which allows servicemembers
to initiate either a BDD or Quick Start claim electronically, although
exams must still be completed in person.
We found VA lacked data to assess the extent to which servicemembers
benefit from the alternative predischarge program. Specifically, we
found that VA was unable to assess participation in the Quick Start
program by National Guard and Reserve servicemembers because they
could not be distinguished from other servicemembers.[Footnote 20] In
response to our recommendation, the agency reported that it has
updated its data system to distinguish between National Guard/Reserves
and full-time active duty servicemembers who file such claims.
We also found that, like BDD claims, timeliness measures for Quick
Start claims do not include days spent developing the claim prior to
discharge. According to VA officials, the timeliness of Quick Start
claims may vary substantially from both BDD and traditional claims.
For example, servicemembers who are on base only a few days prior to
discharge, such as members of the National Guard and Reserves, may
have enough time only to fill out the application before returning
home and may need to schedule the VA exam necessary to fully develop
their claim after discharge. Overall, this will most likely result in
less timely receipt of VA disability compensation than through the BDD
program, but more timely than traditional claims. On the other hand,
servicemembers with more time before discharge may be able to complete
more or all of the claim development process, including the VA exam.
Because VA does not adequately track timeliness of Quick Start, it may
be unable to identify trends and potential challenges associated with
developing and processing these claims. However, as with BDD claims,
VA told us it has no plans to measure time spent developing these
particular claims, and we continue to believe it should.
VA and DOD Have Coordinated to Provide Briefings with Information
about BDD, but Military Duties and Other Factors May Hinder Attendance:
VA and DOD have coordinated to provide servicemembers with information
about the BDD program through VA benefits briefings and other
initiatives, but attending these briefings is optional for most
servicemembers. According to DOD and VA personnel, most servicemembers
learn about the program through VA benefits briefings conducted as
part of TAP sessions, although some may also learn about BDD through
base television spots, papers, and word of mouth.[Footnote 21]
However, the Marine Corps is the only service branch to require
servicemembers to attend VA benefits briefings. For the other service
branches, participation requirements may vary by base and command.
We found that commanders' and supervisors' support for transition
services, such as VA-sponsored benefits briefings, can vary by base.
[Footnote 22] Even though DOD policy requires commanders to allow
servicemembers to attend TAP sessions upon the member's request, we
were told at one base that servicemembers have on occasion not been
released from their duties to attend the briefings, resulting in VA
personnel going up the chain of command to obtain permission for the
members to attend. At two bases, VA officials considered outreach to
be difficult--because of conflicting missions between VA and DOD and
lack of support from some base commanders--resulting often in
servicemembers being called away from the briefings.
Although some military officials recommended that servicemembers be
required to attend TAP sessions, rather than mandate attendance, DOD
decided in August 2007 to establish a goal that 85 percent of
separating servicemembers and demobilizing National Guard and Reserve
members participate in TAP sessions, including VA benefits briefings.
We recommended that DOD establish a plan with a specific time frame
for meeting this goal, but DOD has not developed such a plan. We
continue to believe that DOD should establish a plan for meeting its
goal. In the course of our review, we also learned that TAP
participation data may be inaccurate or overstated because unique
identifiers were not used to document servicemembers' attendance and
servicemembers who attend more than one briefing could be double-
counted. Currently, the Department of Labor (DOL), VA, and DOD track
participation in their respective TAP sessions separately. We
recommended that DOD establish an accurate measure of servicemembers'
participation in TAP, including VA benefits briefings. DOD recently
reported it is working in collaboration with DOL and VA to determine
what improvements can be made in measuring servicemembers'
participation in all components of TAP.
Most BDD Sites Have Local Memorandums of Understanding to Provide a
Cooperative Exam Process, but Maintaining Them Has Been a Challenge
for Some Bases:
Most BDD sites employ local MOUs to establish a cooperative exam
process, and implementation of the exam process varies significantly.
[Footnote 23] According to data provided by VA during our review, more
than 60 percent of bases offering the BDD program had local MOUs that
called for the exclusive use of VA physicians, 30 percent used VA
contractors to conduct exams, and 7 percent used a sequential process
involving resources and exams from both VA and DOD.[Footnote 24] At
bases offering the BDD program overseas, VA exams were conducted by
physicians under contract with DOD because VA does not have physicians
at these bases.
At several bases we visited, we identified resource constraints and
communication challenges that have affected servicemenbers' access to
the program. Resource challenges we identified at five bases included
no designated VA exam provider for more than 7 months, difficulties
hiring physicians, and displaced staff because of construction. At
seven bases, we identified communication challenges or a lack of
awareness of the local cooperative exam MOU caused by uncertainties
generally resulting from deployment of a key DOD local official or
changes in command leadership. In one case, communication between DOD
and VA personnel was conducted on an inconsistent basis, if at all.
Such constraints and challenges have caused delays in servicemembers'
exams or otherwise made it difficult to meet time frames required by
the BDD program.
At the time of our review, DOD and VA had provided some guidance on
implementing and maintaining local MOUs; however, personnel in some
sites we visited were interested in learning about promising practices
at other bases. We recommended that VA and DOD identify and
disseminate information on promising practices that address challenges
local officials commonly face in ensuring servicemembers have full
access to a cooperative exam. DOD officials recently reported
collaborating with VA on a September 2009 conference focusing on
seamless transition. DOD officials planned to work with conference
sponsors to identify best practices for dealing with the cooperative
exam process as it relates to the challenges local personnel commonly
face.
Conclusion:
The BDD program appears to be an effective means for thousands of
separating servicemembers to receive their disability benefits faster
than if they had filed a claim under VA's traditional process. Despite
BDD's inherent advantages, VA has not followed through on
opportunities to ensure accountability and to optimize results.
Similarly, although DOD and VA have made significant progress in
increasing servicemembers' access to the BDD and Quick Start programs,
opportunities to further ensure or improve access remain. At a time
when so many servicemembers are being discharged with injuries, it is
more important than ever to process benefits as efficiently and
effectively as possible. BDD and Quick Start programs have great
potential to achieve these goals, as long as VA maintains a sharp
focus on accountability, and both DOD and VA follow through on
recommended actions.
Mr. Chairman, this concludes my prepared statement. I would be pleased
to answer any questions that you or other Members of the Subcommittee
may have.
[End of section]
Related Products:
Veterans' Disability Benefits: Further Evaluation of Ongoing
Initiatives Could Help Identify Effective Approaches for Improving
Claims Processing. [hyperlink,
http://www.gao.gov/products/GAO-10-213]. Washington, D.C.: January 29,
2010.
Veterans' Disability Benefits: Preliminary Findings on Claims
Processing Trends and Improvement Efforts. [hyperlink,
http://www.gao.gov/products/GAO-09-910T]. Washington, D.C.: July 29,
2009.
Military Disability System: Increased Supports for Servicemembers and
Better Pilot Planning Could Improve the Disability Evaluation Process.
[hyperlink, http://www.gao.gov/products/GAO-08-1137]. Washington,
D.C.: September 24, 2008.
Veterans' Benefits: Increased Focus on Evaluation and Accountability
Would Enhance Training and Performance Management for Claims
Processors. [hyperlink, http://www.gao.gov/products/GAO-08-561].
Washington, D.C.: May 27, 2008.
Federal Disability Programs: More Strategic Coordination Could Help
Overcome Challenges to Needed Transformation. [hyperlink,
http://www.gao.gov/products/GAO-08-635]. Washington, D.C.: May 20,
2008.
VA and DOD Health Care: Progress Made on Implementation of 2003
President's Task Force Recommendations on Collaboration and
Coordination, but More Remains to Be Done. [hyperlink,
http://www.gao.gov/products/GAO-08-495R]. Washington, D.C.: April 30,
2008.
VA Health Care: Additional Efforts to Better Assess Joint Ventures
Needed. [hyperlink, http://www.gao.gov/products/GAO-08-399].
Washington, D.C.: March 28, 2008.
DOD and VA: Preliminary Observations on Efforts to Improve Care
Management and Disability Evaluations for Servicemembers. [hyperlink,
http://www.gao.gov/products/GAO-08-514T]. Washington, D.C.: February
27, 2008.
Information Technology: VA and DOD Continue to Expand Sharing of
Medical Information, but Still Lack Comprehensive Electronic Medical
Records. [hyperlink, http://www.gao.gov/products/GAO-08-207T].
Washington, D.C.: October 24, 2007.
DOD and VA: Preliminary Observations on Efforts to Improve Health Care
and Disability Evaluations for Returning Servicemembers. [hyperlink,
http://www.gao.gov/products/GAO-07-1256T]. Washington, D.C.: September
26, 2007.
GAO Findings and Recommendations Regarding DOD and VA Disability
Systems. [hyperlink, http://www.gao.gov/products/GAO-07-906R].
Washington, D.C.: May 25, 2007.
Information Technology: VA and DOD Are Making Progress in Sharing
Medical Information, but Are Far from Comprehensive Electronic Medical
Records. [hyperlink, http://www.gao.gov/products/GAO-07-852T].
Washington, D.C.: May 8, 2007.
Veterans' Disability Benefits: Processing of Claims Continues to
Present Challenges. [hyperlink,
http://www.gao.gov/products/GAO-07-562T]. Washington, D.C.: March 13,
2007.
Veterans' Disability Benefits: Long-Standing Claims Processing
Challenges Persist. [hyperlink,
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2007.
High Risk Series: An Update. [hyperlink,
http://www.gao.gov/products/GAO-07-310]. Washington, D.C.: January 31,
2007.
Veterans' Disability Benefits: VA Can Improve Its Procedures for
Obtaining Military Service Records. [hyperlink,
http://www.gao.gov/products/GAO-07-98]. Washington, D.C.: December 12,
2006.
Military Disability Evaluation: Ensuring Consistent and Timely
Outcomes for Reserve and Active Duty Service Members. [hyperlink,
http://www.gao.gov/products/GAO-06-561T]. Washington, D.C.: April 6,
2006.
Military Disability System: Improved Oversight Needed to Ensure
Consistent and Timely Outcomes for Reserve and Active Duty Service
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Washington, D.C.: March 31, 2006.
VA and DOD Health Care: Opportunities to Maximize Resource Sharing
Remain. [hyperlink, http://www.gao.gov/products/GAO-06-315].
Washington, D.C.: March 20, 2006.
Veterans' Benefits: Further Changes in VBA's Field Office Structure
Could Help Improve Disability Claims Processing. [hyperlink,
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2005.
Veterans' Disability Benefits: Claims Processing Challenges and
Opportunities for Improvements. [hyperlink,
http://www.gao.gov/products/GAO-06-283T]. Washington, D.C.: December
7, 2005.
Veterans' Disability Benefits: Claims Processing Problems Persist and
Major Performance Improvements May Be Difficult. [hyperlink,
http://www.gao.gov/products/GAO-05-749T]. Washington, D.C.: May 26,
2005.
Military and Veterans' Benefits: Enhanced Services Could Improve
Transition Assistance for Reserves and National Guard. [hyperlink,
http://www.gao.gov/products/GAO-05-544]. Washington, D.C.: May 20,
2005.
VA and DOD Health Care: Efforts to Coordinate a Single Physical Exam
Process for Servicemembers Leaving the Military. [hyperlink,
http://www.gao.gov/products/GAO-05-64]. Washington, D.C.: November 12,
2004.
Veterans' Benefits: Improvements Needed in the Reporting and Use of
Data on the Accuracy of Disability Claims Decisions. [hyperlink,
http://www.gao.gov/products/GAO-03-1045]. Washington, D.C.: September
30, 2003.
[End of section]
Footnotes:
[1] The military has a separate disability evaluation process for
servicemembers who are being discharged because they can no longer
perform their duties because of a disabling condition.
[2] GAO, Veterans' Disability Benefits: Better Accountability and
Access Would Improve the Benefits Delivery at Discharge Program,
[hyperlink, http://www.gao.gov/products/GAO-08-901]. (Washington,
D.C.: Sept. 9, 2008).
[3] At the time of our review, VA referred to this program as its new,
alternative predischarge program. Today, this program is referred to
as the Quick Start program.
[4] The amount of disability compensation depends largely on the
severity of the disability, which VA measures in 10 percent increments
on a scale of 0 percent to 100 percent. In 2010, basic monthly
payments for veterans with no dependents have ranged from $123 for 10
percent disability to $2,673 for 100 percent disability.
[5] BDD is also present at an additional 11 Coast Guard bases, which
are administered by the Department of Homeland Security.
[6] This percentage does not include members of the National Guard or
Reserve forces.
[7] The Veterans Claims Assistance Act of 2000 (VCAA) (Pub. L. No.
106- 475) assigns VA the duty to assist veterans in obtaining any
records relevant to their claims, provided the veterans adequately
identify such records so that VA is able to request them.
[8] See GAO, VA and DOD Health Care: Efforts to Coordinate a Single
Physical Exam Process for Servicemembers Leaving the Military,
[hyperlink, http://www.gao.gov/products/GAO-05-64] (Washington, D.C.:
Nov. 12, 2004).
[9] While VA administers the BDD program, VA and DOD's Joint Executive
Council (JEC) oversees joint efforts to eliminate barriers that
servicemembers may face as they leave the military. Under the JEC, the
Benefits Executive Council is focused on improving information sharing
between the agencies and the transition process for servicemembers.
[10] In 2006 VA completed its consolidation of BDD processing
activities into two regional offices--Salt Lake City, Utah, and
Winston-Salem, North Carolina--to increase the consistency of BDD
claims.
[11] VA has several other measures for claims overall, including
measures of satisfaction and how well VA keeps veterans informed of
benefits.
[12] National accuracy rate data are through July 2009.
[13] Previously, VA had included in the denominator claims from
members who were discharged from non-BDD locations. Using those data,
in fiscal year 2007, only 43 percent of first-year claims were filed
through BDD, significantly short of VA's goal. VA will come closer to
its goal by excluding servicemembers who, being from non-BDD
locations, will generally be unable to meet BDD program requirements.
[14] While VA lacks a separate performance measure on BDD timeliness,
VA officials reported the agency does track the average days BDD
claims are pending a decision and the average days it takes VA to
complete work on BDD claims separately from traditional claims.
However, VA includes only the time after servicemember discharge when
tracking BDD timeliness.
[15] By not including the time it takes to develop BDD claims, VA
underestimates its overall processing time. However the impact is not
large because predischarge (BDD and Quick Start) claims represent a
small portion of all claims processed--about 5 percent in 2009.
[16] These two regional offices complete development, rating, award
actions, and notification actions for BDD claims.
[17] VA policy directs the processing offices to have agreements with
all of the regional offices in their jurisdiction to define roles and
responsibilities for processing BDD claims.
[18] DOD and VA are piloting a program whereby the assessment used to
determine a wounded soldier's fitness for duty can be used to
determine VA disability benefits for those ultimately deemed unfit.
[19] These designated processing sites complete development, rating,
award actions, and notification actions for Quick Start claims.
[20] At the time of our review, VA also expressed concern that early
Quick Start program data might not be accurate because of to the
newness of the program.
[21] In addition, the Benefits Executive Council's BDD Working Group
has also developed a BDD and Quick Start pamphlet to be distributed at
all VA intake sites, and VA's recently developed predischarge Web site
also includes links to the TAP Web site and information.
[22] GAO, Military and Veterans' Benefits: Enhanced Services Could
Improve Transition Assistance for Reserves and National Guard,
[hyperlink, http://www.gao.gov/products/GAO-05-544] (Washington, D.C.:
May 20, 2005).
[23] At the time of our review, 130 of the 142 DOD bases that offered
the BDD program had a local MOU in place; the remaining 12 bases were
newer and had not yet established local MOUs. VA noted that its policy
guidance (Fast Letter 08-20), signed July 2, 2008, eliminated the
requirement for a local MOU to be in place in order for VA to accept a
BDD claim. In this guidance, VA expanded the definition of a BDD
claim, removing the criterion that BDD claims may be accepted only at
military bases where local MOUs are in place.
[24] For example, at 2 bases, DOD officials started the exam process
by conducting diagnostic testing, such as hearing and vision tests; a
VA physician or contractor conducted the remainder of the exam, which
was then incorporated to meet both VA and DOD separation requirements.
[End of section]
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