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DoD, VA launch new disability evaluation test

The Defense Department has begun its test of what it promises will be a new, streamlined disability evaluation system, more closely aligned with the Department of Veterans Affairs, that represents the first steps in replacing the cumbersome process that separating troops have had to endure with a single exam and single disability rating.

At a Pentagon news conference Friday, officials said the pilot disability plan, being launched at three Washington-area military hospitals, will allow veterans medically retired from service to apply for and begin drawing VA benefits almost immediately. Overall, the time spent in the system, from the point a member is found unfit for duty until he or she begins receiving VA disability payments, will improve dramatically, according to Bill Carr, under secretary of defense for military personnel policy.

The new program, which officially began Nov. 26, takes a system Carr described as “unfriendly, redundant and lethargic” and, by way of the pilot program, begins to reshape it into one that is “faster, more compassionate, less adversarial and, by all means, more effective.”

“I think we’ve done those things,” Carr said.

Officials say they will probably fine-tune the system during the course of the pilot program, but that the basic tenets are essentially set. “This is about as good as it can get within the current statutory framework” of the Defense Department and VA roles in disability evaluation, said Michael Dominguez, principal deputy under secretary of defense for personnel and readiness.

The three military hospitals involved in the pilot are Walter Reed Army Medical Center in Washington, National Naval Medical Center in Bethesda, Md., and Malcolm Grove Medical Center at Andrews Air Force Base, Md.

The Defense Department also announced Friday the launch of the Defense Center for Psychological Health and Traumatic Brain Injury, a Pentagon-VA collaboration that will “advance and disseminate” knowledge of the two areas of study, “enhance clinical and management approaches” and ease the administration of related services for such problems and injuries, which are on the rise due to the wars in Iraq and Afghanistan.

S. Ward Casscells, assistant secretary of defense for health affairs, said the new mental health center will “integrate quality programs and advanced medical technology to give us unprecedented expertise” in dealing with mental health issues and TBI.

Two other initiatives, the Defense and Veterans Brain Injury Center (DVBIC) and the DoD Center for Deployment Psychology, are now a part of the new defense center.

TBI has been called the “signature wound” of the Iraq and Afghanistan wars. VA officials believe that close to 6 percent of all veterans of the two wars will be diagnosed with the condition. A study by the DVBIC found that 14 percent to 20 percent of veterans in previous wars suffered traumatic brain injuries, and officials there believe the percentage from the current wars will be higher because of the prevalence of roadside bomb attacks and greater survivability rates due to improved body armor.

The pilot disability evaluation program, a top priority of Defense Secretary Robert Gates, is the Pentagon’s answer to last winter’s Walter Reed controversy. News reports described outpatient troops undergoing treatment for war wounds who faced a disturbing morass of red tape and subsequent medical evaluations. The slow-moving VA benefits process and poor coordination between the two agencies further complicated matters.

Currently, each service performs its own physical exam during the process leading to possible separation from the service, and the member is rated for that condition. A member medically separated or retired who seeks VA care then faces another physical exam, another rating and more time and paperwork.

The new plan will eliminate such redundancy, officials said. Troops sent for a standard Medical Evaluation Board, which determines a service member’s fitness for duty, will receive a single exam by a VA-certified provider — with access to the troop’s medical records — and be rated according to VA standards.

If a service member is separated and goes to VA to apply for benefits and continued treatment, Carr said, the benefits will start quickly because VA will already have the records and the rating.

Such an agreement between two government agencies is remarkable, Dominguez and Carr said. Carr admitted that in the past, the two agencies have given some service members markedly different ratings for the same condition, with the VA usually giving the higher rating. But he said the Defense Department will abide by VA’s ratings under the new streamlined system.

“They are systematically higher,” Carr said of the VA rating system. “We accept that. Who knows which is right? If you’re earnestly applying what you’re seeing in that body system against the [VA] rating manual ... we don’t question it.”