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55–231 2010

EXAMINATION OF THE U.S. DEPARTMENT OF 

VETERANS AFFAIRS BENEFITS DELIVERY AT 

DISCHARGE AND QUICK START PROGRAMS 

HEARING 

BEFORE THE

SUBCOMMITTEE ON DISABILITY ASSISTANCE 

AND MEMORIAL AFFAIRS 

OF THE

COMMITTEE ON VETERANS’ AFFAIRS 

U.S. HOUSE OF REPRESENTATIVES 

ONE HUNDRED ELEVENTH CONGRESS 

SECOND SESSION 

FEBRUARY 24, 2010

Serial No. 111–63 

Printed for the use of the Committee on Veterans’ Affairs 

( 


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COMMITTEE ON VETERANS’ AFFAIRS 

BOB FILNER, California, Chairman 

CORRINE BROWN, Florida 

VIC SNYDER, Arkansas 

MICHAEL H. MICHAUD, Maine 

STEPHANIE HERSETH SANDLIN, South 

Dakota 

HARRY E. MITCHELL, Arizona 

JOHN J. HALL, New York 

DEBORAH L. HALVORSON, Illinois 

THOMAS S.P. PERRIELLO, Virginia 

HARRY TEAGUE, New Mexico 

CIRO D. RODRIGUEZ, Texas 

JOE DONNELLY, Indiana 

JERRY MCNERNEY, California 

ZACHARY T. SPACE, Ohio 

TIMOTHY J. WALZ, Minnesota 

JOHN H. ADLER, New Jersey 

ANN KIRKPATRICK, Arizona 

GLENN C. NYE, Virginia 

STEVE BUYER, Indiana, Ranking 

CLIFF STEARNS, Florida 

JERRY MORAN, Kansas 

HENRY E. BROWN, JR., South Carolina 

JEFF MILLER, Florida 

JOHN BOOZMAN, Arkansas 

BRIAN P. BILBRAY, California 

DOUG LAMBORN, Colorado 

GUS M. BILIRAKIS, Florida 

VERN BUCHANAN, Florida 

DAVID P. ROE, Tennessee 

MALCOM A. SHORTER, Staff Director 

SUBCOMMITTEE ON DISABILITY ASSISTANCE AND MEMORIAL AFFAIRS 

JOHN J. HALL, New York, Chairman 

DEBORAH L. HALVORSON, Illinois 

JOE DONNELLY, Indiana 

CIRO D. RODRIGUEZ, Texas 

ANN KIRKPATRICK, Arizona 

DOUG LAMBORN, Colorado, Ranking 

JEFF MILLER, Florida 

BRIAN P. BILBRAY, California 

Pursuant to clause 2(e)(4) of Rule XI of the Rules of the House, public hearing records 

of the Committee on Veterans’ Affairs are also published in electronic form. The printed 

hearing record remains the official version. Because electronic submissions are used to 

prepare both printed and electronic versions of the hearing record, the process of converting 

between various electronic formats may introduce unintentional errors or omissions. Such occurrences are inherent in the current publication process and should diminish as the process 

is further refined. 


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C O N T E N T S 

February 24, 2010 

Page 

Examination of the U.S. Department of Veterans Affairs Benefits Delivery 

at Discharge and Quick Start Programs ............................................................ 1 

OPENING STATEMENTS 

Chairman John J. Hall ............................................................................................ 2 

Prepared statement of Chairman Hall ........................................................... 27 

Hon. Doug Lamborn, Ranking Republican Member ............................................. 1 

Prepared statement of Congressman Lamborn .............................................. 28 

WITNESSES 

U.S. Government Accountability Office, Daniel Bertoni, Director, Education, 

Workforce, and Income Security Issues ............................................................. 4 

Prepared statement of Mr. Bertoni ................................................................. 28 

U.S. Department of Defense, Hon. Noel C. Koch, Deputy Under Secretary 

of Defense (Wounded Warrior Care and Transition Policy) ............................. 10 

Prepared statement of Mr. Koch ..................................................................... 36 

U.S. Department of Veterans Affairs, Diana Rubens, Associate Deputy Under 

Secretary for Field Operations, Veterans Benefits Administration ................. 23 

Prepared statement of Ms. Rubens ................................................................. 47 

American Veterans (AMVETS), Raymond C. Kelley, National Legislative Director ..................................................................................................................... 19 

Prepared statement of Mr. Kelley ................................................................... 42 

Disabled American Veterans, John L. Wilson, Assistant National Legislative 

Director ................................................................................................................. 20 

Prepared statement of Mr. Wilson .................................................................. 43 

Iraq and Afghanistan Veterans of America, Thomas Tarantino, Legislative 

Associate ............................................................................................................... 15 

Prepared statement of Mr. Tarantino ............................................................. 38 

Veterans of Foreign Wars of the United States, Gerald T. Manar, Deputy 

Director, National Veterans Service ................................................................... 17 

Prepared statement of Mr. Manar .................................................................. 40 

SUBMISSION FOR THE RECORD 

American Federation of Government Employees, AFL–CIO, and AFGE National Veterans Affairs Counsel, statement ....................................................... 49 

MATERIAL SUBMITTED FOR THE RECORD 

Post-Hearing Questions and Responses for the Record: 

Hon. John J. Hall, Chairman, Subcommittee on Disability Assistance 

and Memorial Affairs, Committee on Veterans’ Affairs, to Daniel 

Bertoni, Director, Education, Workforce, and Income Security Issues, 

U.S. Government Accountability Office, letter dated March 25, 2010, 

and response letter and attachment, dated April 16, 2010 ....................... 52 

Hon. John J. Hall, Chairman, Subcommittee on Disability Assistance 

and Memorial Affairs, Committee on Veterans’ Affairs, to Hon. Noel 

Koch, Deputy Under Secretary of Defense, Office of Wounded Warrior 

Care and Transition Policy, U.S. Department of Defense, letter dated 

March 25, 2010, and DoD responses ........................................................... 55 


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iv 

Post-Hearing Questions and Responses for the Record—Continued 

Hon. John J. Hall, Chairman, Subcommittee on Disability Assistance 

and Memorial Affairs, Committee on Veterans’ Affairs, to Thomas 

Tarantino, Legislative Associate, Iraq and Afghanistan Veterans of 

America, letter dated March 25, 2010, and IAVA responses .................... 58 

Hon. John J. Hall, Chairman, Subcommittee on Disability Assistance 

and Memorial Affairs, Committee on Veterans’ Affairs, to Gerald T. 

Manar, Deputy Director, National Veterans Service, Veterans of Foreign Wars of the United States, letter dated March 25, 2010, and 

VFW responses .............................................................................................. 60 

Hon. John J. Hall, Chairman, Subcommittee on Disability Assistance 

and Memorial Affairs, Committee on Veterans’ Affairs, to Raymond 

C. Kelley, National Legislative Director, AMVETS, letter dated March 

25, 2010, and AMVETS responses ............................................................... 64 

Hon. John J. Hall, Chairman, Subcommittee on Disability Assistance 

and Memorial Affairs, Committee on Veterans’ Affairs, to John L. Wilson, Assistant National Legislative Director, Disabled American Veterans, letter dated March 25, 2010, and DAV responses .......................... 65 

Hon. John J. Hall, Chairman, Subcommittee on Disability Assistance 

and Memorial Affairs, Committee on Veterans’ Affairs, to Diana 

Rubens, Associate Deputy Under Secretary for Field Operations, Veterans Benefits Administration, U.S. Department of Veterans Affairs, 

letter dated March 25, 2010, and VA responses ........................................ 68 


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EXAMINATION OF THE U.S. DEPARTMENT OF 

VETERANS AFFAIRS BENEFITS DELIVERY AT 

DISCHARGE AND QUICK START PROGRAMS 

THURSDAY, FEBRUARY 24, 2010 

U.S. HOUSE OF REPRESENTATIVES, 

COMMITTEE ON VETERANS’ AFFAIRS, 

SUBCOMMITTEE ON DISABILITY ASSISTANCE AND

MEMORIAL AFFAIRS, 

Washington, DC. 

The Subcommittee met, pursuant to notice, at 2:03 p.m., in Room 

334, Cannon House Office Building, Hon. John J. Hall [Chairman 

of the Subcommittee] presiding. 

Present: Representatives Hall, Rodriguez, and Lamborn. 

Mr. HALL. Welcome to the Subcommittee on Disability Assistance 

and Memorial Affairs Subcommittee hearing on Examination of the 

U.S. Department of Veterans Affairs (VA) Benefits Delivery at Discharge (BDD) and Quick Start Programs. 

Could I ask everyone, please, to rise for the Pledge of Allegiance? 

[Pledge of Allegiance.] 

Mr. HALL. Thank you, all. Ladies and gentlemen, we are here 

today to examine the Benefits Delivery at Discharge or BDD and 

Quick Start programs, two components of the pre-discharge program, which were established by the U.S. Departments of Defense 

(DoD) and Veterans Affairs to streamline servicemembers’ transition from active duty to veteran status. 

And because of the scheduling problems that we have here in the 

House with multiple Committee meetings, I am going to recognize 

Ranking Member Lamborn for his opening statement, first. 

Mr. Lamborn. 

OPENING STATEMENT OF HON. DOUG LAMBORN 

Mr. LAMBORN. Well, thank you, Mr. Chairman. I appreciate your 

flexibility in doing this. Normally, I am very happy to go second 

here. But I do have to be at another Subcommittee where I am also 

the Ranking Member, so it is one of those times when I wish I 

could be in two places at once. 

I also welcome everyone today to this hearing on the Benefits Delivery at Discharge and Quick Start Programs. These programs are 

focused on the concept of providing a seamless transition from military service to civilian life. 

I, along with Chairman Hall, my fellow Subcommittee Members, 

and many of you here are long-time advocates for creating a seamless transition. Therefore, I am sure we can all recognize the inherVerDate Nov 24 2008 23:55 Jul 26, 2010 Jkt 055231 PO 00000 Frm 00005 Fmt 6633 Sfmt 6633 I:\WAYS\OUT\55231.XXX GPO1 PsN: 55231

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ent value of beginning the VA claims process while service medical 

records are readily available and proof of service-connection is easily established. 

Allowing veterans to file VA compensation claims prior to separation from active duty is simply a logical approach. BDD is more efficient than the traditional VA claims process and it eliminates 

many problems that are created by the time gap that often exists 

between discharge and application for benefits. 

Among the requirements to establish eligibility for VA compensation, veterans must be able to show that a condition was incurred 

during service and that there is a continuity of treatment between 

that incurrence and the current condition for which they are filing. 

Obviously with BDD there is no time gap, so it alleviates the 

need to show continuity of treatment. This saves both the veteran 

and the VA a lot of time and effort obtaining private treatment 

records. One can imagine that such efforts can become quite extensive for claims filed several years subsequent to service. 

In 2008, full Committee Ranking Member Steve Buyer requested 

a U.S. Government Accountability Office (GAO) assessment of the 

BDD program. GAO’s findings confirmed that allowing claims to be 

filed prior to discharge is more efficient than the traditional VA 

claims process. 

While I am optimistic about the overall assessment of the program, I encourage VA to make every effort to improve the program 

and increase access to BDD sites. I believe that processing as many 

claims as possible in this manner will have a positive impact 

throughout the entire system. 

Thank you and I yield back. And once again, thank you, 

Mr. Chairman. 

[The prepared statement of Congressman Lamborn appears on 

p. 28.] 

OPENING STATEMENT OF CHAIRMAN HALL 

Mr. HALL. Thank you, Mr. Lamborn. 

By way of background, any member of the Armed Forces who has 

seen active duty, including those in the Guard and Reserve, are eligible to apply for VA disability benefits prior to leaving military 

service through the BDD or Quick Start pre-discharge programs. 

During the application process, servicemembers can get help in 

completing forms and preparing other required documentation from 

VA personnel located at their bases. 

Additionally, this pre-discharge program combines, both, the 

health exam required by DoD upon exiting the military and the VA 

disabilities assessment exam into one single exam. Once a BDD or 

Quick Start claim is approved, veterans may begin receiving benefits within 2 or 3 months, instead of the 6 to 7 months it would 

typically take if they had applied after discharge under the traditional disability claims process. 

Participation in the BDD program is open to servicemembers 

who are within 60 to 180 days of being released from active duty 

and who are able to complete their scheduled VA medical examinations prior to leaving their points of separation. The Quick Start 

program is available to servicemembers within 1 to 59 days of separation from service or servicemembers who do not meet the BDD 


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criteria requiring availability for all examinations prior to discharge. 

The BDD program started as a pilot program in 1995 at three 

Army bases and three VA regional offices (ROs). In 1998, VA and 

DoD fully rolled out the BDD program. 

Last Congress, my friend Congressman Peter Welch of Vermont 

introduced H.R. 2259, legislation to expand the BDD program to 

members of the National Guard and Reserves, which was incorporated in the National Defense Authorization Act for 2008, Public 

Law 110–181. This statute ensures that Guardsmen as well as Reservists can participate in the VA/DoD pre-discharge program. 

In the last 15 years, over 170,000 servicemembers have availed 

themselves of the BDD and Quick Start process. The programs 

have expanded from 3 military bases to more than 153 locations in 

the United States, Germany, and South Korea. 

According to VA, the majority of pre-discharge claims, 46,856 

claims to be exact, were processed in 2009 in a paperless environment, with an average processing time of 95.5 days. It is VA’s stated goal to process all compensation and pension claims in a 

paperless environment eventually, and the Subcommittee is committed to helping VA achieve this. 

I, along with Congressman Rodriquez, and other Members of this 

Committee and Congress, requested that GAO prepare a report to 

assess the effectiveness of these programs, Quick Start and BDD, 

and I look forward to hearing from the GAO about its report, about 

its recommendations, how they have been implemented, and what, 

if any, impact they have had upon the pre-discharge program. 

We also look forward to feedback from veteran service organizations as well as the VA and DoD on what, if any, resources are 

needed that we in Congress can provide to fully realize the full potential of these two programs. 

The examination of VA and DoD’s pre-discharge program follows 

up our last hearing concerning the implementation of the Veterans’ 

Benefits Improvement Act of 2008, which was codified in Public 

Law 110–389. That law paved the way for a number of initiatives 

also targeting the VA claims backlog, which is an issue that concerns us all. It is my hope that the BDD and Quick Start programs 

that we are considering today, coupled with the electronic claims 

system and other business process transformation efforts in Public 

Law 110–389, which are currently underway at VA, will together 

significantly transform the VA claims processing system so that 

someday, someday soon we may play Taps for the VA compensation 

and pension (C&P) backlog. 

I would like to remind our panelists that the complete written 

statements you have submitted are being made a part of the hearing record. Please limit your remarks to 5 minutes so that we can 

have sufficient time for questions and avoid the dreaded buzzer for 

the votes that will be called at some unknown time. 

Our first panel consists of David Bertoni, Director of Education, 

Workforce, and Income Security Issues with the Government Accountability Office. 

Mr. Bertoni, welcome. You are now recognized for 5 minutes. 

[The prepared statement of Chairman Hall appears on p. 27.] 


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STATEMENT OF DANIEL BERTONI, DIRECTOR, EDUCATION 

WORKFORCE, AND INCOME SECURITY ISSUES, U.S. GOVERNMENT ACCOUNTABILITY OFFICE 

Mr. BERTONI. Thank you very much. Good afternoon, Mr. Chairman. I am pleased to be here to discuss the Benefits, Delivery at 

Discharge and Quick Start programs which represent a collaborative effort by the Departments of Veterans Affairs and Defense 

to expedite the disability claims process for servicemembers. These 

programs streamline access to VA disability benefits by allowing 

many servicemembers to file and initiate claims development prior 

to discharge, thus shortening the time it takes to receive benefits. 

Last year over 51,000 claims were filed through both programs. 

My statement today draws on our prior work and focuses on two 

areas, an assessment of VA’s overall management of the BDD program and steps VA and DoD have taken to expand access to both 

BDD and Quick Start. 

In summary, although VA awards benefits more quickly under 

BDD than through the traditional claims process, gaps in program 

management and accountability remain. We found that VA’s BDD 

timeliness measure excludes time spent and claims development 

prior to a servicemember’s discharge. Thus, VA has limited information on a frequently problematic phase of the process. 

Conversely, claims development activities are included in VA’s 

timeliness measure for traditional claims. Personnel, 12 of the 14 

intake sites we reviewed, noted significant claims development 

challenges, including difficulty in scheduling and completing exams 

and gathering additional medical evidence. We continue to believe 

that tracking the time and resources spent on claims development 

could help VA mitigate any barriers to program efficiency and servicemember participation. 

We also found that VA implemented two key initiatives, consolidation of BDD claims processing activities in two locations and 

paperless claims processing, without fully evaluating their effectiveness over prior practices. 

While we support VA’s efforts to achieve greater efficiencies, we 

continue to believe ongoing evaluation is necessary to optimize results for these initiatives. And finally, we identified gaps of VA’s 

monitoring activities for this program. At the time of our review, 

VA reviewed BDD operations in only 16 of 40 Regional Offices and 

reviewers rarely examined these cases to ensure they were properly 

developed and they lacked protocols to do so. Per our recommendation, VA has since taken steps to increase the scope and quality of 

site visits. 

In regard to improving servicemember access to expedited services, VA and DoD have taken a number of actions, most notably establishing the Quick Start Program for servicemembers, such as 

National Guard and Reservists who are generally unable to complete the BDD application and medical exams prior to discharge. 

We have recommended and VA has begun to collect additional 

data to assess whether Quick Start is meeting servicemember 

needs. However, as with BDD, VA has no plans to track the time 

spent developing these claims. 

VA and DoD have also coordinated to increase program awareness of BDD and Quick Start through VA benefit briefings and 


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DoD has established an 85 percent participation goal for those 

briefings. However, our work shows that DoD needs better metrics 

for capturing servicemember participation, as well as a service delivery plan for meeting its targeted goal. 

Despite these efforts, during our site visits, we identified numerous implementation challenges associated with local DoD and VA 

agreements intended to prevent redundancies and servicemember 

inconvenience in obtaining required medical exams. These challenges were often due to turnover on base command, communication breakdowns and resource constraints, sometimes resulting in 

multiple unnecessary medical exams and delayed claims development. 

However, in response to our findings and recommendation, VA 

and DoD have begun to explore local office best practices to address 

challenges to the cooperative exam process. 

And in closing, I want to strongly emphasize that at a time when 

so many servicemembers are being discharged with injuries and 

the current conflicts in Iraq and Afghanistan, opportunities exist to 

improve, both, the BDD and Quick Start programs as long as both 

VA and DoD maintain a sharp focus on accountability and follow 

through on recommended actions. 

Mr. Chairman, this concludes my remarks. I am happy to answer 

any questions you may have. I am within my time. 

[The prepared statement of Mr. Bertoni appears on p. 28.] 

Mr. HALL. Good job setting an example for all witnesses to come. 

Mr. BERTONI. I’ve set a high bar. 

Mr. HALL. And maybe for the Chairman himself. 

Thank you, Mr. Bertoni. You point out that VA has established 

only one performance measure for BDD and Quick Start programs, 

which is tracking participation in the programs. VA does not track 

for these claims, as it does for general compensation claims, how 

much time a veteran has to wait for a final decision, the average 

days that it takes to complete all work to reach a final decision or 

the percentage of claims with no processing errors. 

How do you think additional performance measurements, such as 

those mentioned, could assist VA in fully implementing these programs? 

Mr. BERTONI. I think the rationale is that they had the STARreview process, which is a systematic technical accuracy review 

where they sample a number of cases. Our concern is that this review is not capturing enough of these type of specialized cases to 

give them a good enough reading on what is going on. 

So in general, you need good management information data to 

improve your program. You need to know how accurate your cases 

are, how consistent you are rating cases, how much time they are 

being taken to be processed, how long they sit in a particular 

phase. 

Right now, there are three entry points for getting VA benefits, 

the traditional method, the DES—the DoD VA Disability Evaluation System pilot, which down the road might go worldwide, and 

there is BDD and Quick Start. For the other two programs, I can 

look at the metrics and I can track from time of entry, from time 

of application to the time those benefits are delivered and get a 


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good sense of what is going on at all phases. That is not the case 

with BDD and Quick Start. 

Mr. HALL. Your testimony also notes that VA tracks days it 

takes to process traditional claims starting with the date that a 

veteran first files a claim. Whereas, it tracks days to process BDD 

claims starting with the date of discharge of that servicemember. 

This approach does not count the time that VA spends developing 

the claim while the servicemember is still in active duty or still 

under the DoD’s purview. 

The VA claims it does not measure the full claim processing time 

because it lacks legal authority to provide compensation until a 

servicemember is discharged and becomes a veteran. Do you have 

any suggestions that might allow VA to track the time to process 

the entire disability claim, including that time before discharge and 

how might this improve the BDD and Quick Start programs? 

Mr. BERTONI. Absolutely. I agree they don’t have the legal authority to pay the claim but they have the legal authority to develop the case, and if a person applies for benefits while a servicemember, the clock ticks, the VA representatives develop that case, 

it gets to a point where it is rating ready and you stop the clock. 

So if that is 1, 2 or 3 months, that is the development phase. 

Six months down the road, once that person discharges, the clock 

starts again. That is the rating phase, whatever that takes, the 76 

days. We put those two pieces together. That is development. That 

is the entire time for the case to be developed. So it is not a matter 

of not having legal authority to pay. They can develop a case before 

they are able to pay. It is a matter of doing it. 

And again, it is happening with the DES pilot right now between 

DoD and VA. They are tracking from date of referral to date of payment and it is possible and we believe it is reasonable for them to 

be doing, to make this process more transparent, and it is certainly 

to give them the metrics and the data that they can make adjustments down the road. 

One thing they have not been able to do is to reach their 60-day 

optimal goal at the back end. Perhaps that is due to problems at 

the front end with development, but they are not tracking it, they 

are not looking at it. If they were, they might be able to make the 

adjustments to reach that 60-day goal at the front end. 

Mr. HALL. Right. Well, thank you, sir. We have a few examples 

that have come before the Committee and the Subcommittee where 

VA and DoD have maybe not been as cooperative or may not have 

allowed the overlap of work to happen that would enable a seamless transition in several different areas, and since we have representatives from both DoD and VA here, maybe we will get a 

chance to talk about that. 

But you note in your testimony that most VA and DoD Memorandums of Understanding (MOUs) require a VA physician to administer the joint physical exam required by BDD and Quick Start. 

You also mentioned that only 7 percent of those MOUs surveyed 

permit disability exams to be administered by either a VA or DoD 

physician. Do you suggest that MOUs need to be expanded to permit DoD physicians or contracted physicians to conduct these 

exams as well as VA docs? How does the effectiveness of this program suffer as a result of this limitation? 


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Mr. BERTONI. I think, again, I will just hearken back to the pilot, 

the DES pilot, though that is right now basically, it is primarily 

the exams are coming from VA staff. Even in this program, I think 

90 percent of the exams are being conducted by either VA staff or 

contracted with VA. I think the thinking is they have the broader 

expertise to assist in making the fit/unfit decision for the military, 

but also to assess and compile all the other potential injuries that 

that person might claim down the road for VA benefits. 

At the same time, there is leeway in those agreements for DoD 

physicians, DoD contractors or some type of hybrid approach between VA and DoD to do, sort of, share those duties. 

I think that what it comes down to in a lot of respects is resources. And right now VA has stepped up and I am not sure if 

they have asked or what the dialogue is between VA and DoD as 

to expanding the role on DoD’s end. 

Mr. HALL. Well, the dialogue between Secretary Shinseki and 

Secretary Gates has certainly been, I think, at a deeper level and 

a more cooperative level than what I have noticed in previous cases 

of Secretaries of both Departments. Hopefully that cooperative relationship will translate down through both Departments. 

You also noted in your testimony that VA has implemented two 

initiatives to improve BDD and Quick Start, but that they did not 

fully evaluate either. These include VA’s consolidating claims, processing activities into two regional offices and creating a paperless 

claims processing system. Do you know why VA has not evaluated 

these measures and what the implications might be of not doing 

that? 

Mr. BERTONI. I think the position was that they—I think in one 

of the meetings, as far as the electronic processing goes, it was a 

proof of concept. It appeared to work. We decided to rule it out. 

And now that is ruled out, it didn’t make any sense to go back, 

cease and desist and evaluate it. We gave them that. At the end 

of the day we said that is fine, but we still think that you need to 

go back in and develop an evaluation plan for both of these efforts: 

What level of performance are you shooting for; what metrics are 

you going to measure against in terms of how you are trending; 

and, ultimately, how are you evaluating this? 

This is basic principles of pilot planning, basic principles of business reengineering processes. We didn’t see it. We would hope that 

they agree to look at this and monitor it. I don’t know what they 

are doing right now, but I believe they have gone back and are 

looking at some of the aspects of both of those programs. Our recommendations are open. Down the road we will look further into 

it and see if we can close them out. 

Mr. HALL. Thank you. 

Mr. Rodriguez, would you like to ask a question? 

Mr. RODRIGUEZ. Yes. Thank you. Let me first apologize for being 

late. 

Let me ask you—I know you have addressed this issue many 

times in the past from the GAO perspective and made recommendations and we have had a lot of difficulty in the transition 

between DoD and VA. We have pumped in a lot of money trying 

to get the DoD and the VA to come together and I think somebody 

explained that DoD has another great system; however, and the VA 


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has a great system, they just don’t talk to each other. I was wondering if you had any thoughts about what we need to do next after 

my 12 years on the Committee, this dialogue occurred even before 

I arrived here. What do we need to do to or what kind of studies 

do we need to do to get us to the next level? 

At one point we had talked about getting a private entity to come 

in from the outside and try to do the same first and now, as you 

have done, the GAO reports indicate a number of areas where a 

variety of programs could be tracing data more effectively. What 

other GAO studies could be utilized that would give us a better 

handle as to how to do this? From your perspective, what other 

GAO studies or reports could be helpful for us coming to grips with 

this and now moving forward with the VA and trying to get it to 

the next level? 

Mr. BERTONI. Okay. Let me just say, we have been at the ground 

floor at both the DES the pilot, as well as looking at the BDD program for quite some time. So I would say, in terms of two large 

bureaucracies coming together and trying to merge or meld two 

processes that, I think, both think they do very well, I think there 

are just external forces—Walter Reed, the current wars, oversight 

on your part, GAO—basically involved here are sort of, I don’t want 

to say forcing, but helping them to work together. And I could say 

in, both, the BDD program as well as the DES pilot, there is a lot 

of cooperation between the two entities, not always consistent in 

terms of how they view every aspect, but I would say, very productive in terms of their cooperation. 

In terms of information, we have received and the cooperation we 

have received in both those efforts, it has been exceptional, so I 

just want you to know that. 

I think, as far as further improvement, these two programs, the 

BDD and the DES pilot, they are very close, so I am sorry—I know 

it is BDD, but I want to bring that in also. 

They just need to keep working to sort of, to refine the machine, 

and I think this report that we issued, we essentially said BDD 

and Quick Start is a good program. It has many positive attributes. 

It just needs to be refined and tweaked. And if you do some of 

these things, it will be a better program in terms of service delivery. 

In terms of other reports, we have a body of work. I would much 

rather think about that and perhaps submit something to you at 

a later time. 

Mr. RODRIGUEZ. I would like to see those ideas because a lot of 

times you react to what we come out with but you might have a 

better feel as to what might be helpful to improve services as we 

provide more resources. And at some point we felt, and we should 

have for good reason that we weren’t providing them with the necessary resources. 

But as we move forward with resources, we expect them to be 

held accountable. Can you provide me or the Chairman, with some 

ideas as to how we can go about additional studies that could be 

done to allow for more recommendations and how best to do this? 

Because as elected officials, our biggest problem is not only the 

bureaucracy out there, but I am sure that this is the same case for 

the Secretary. 


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Mr. BERTONI. Sure and, just, I am in the process now of drafting 

a report for this Committee, looking at training for VSRs and 

RVSRs. That is going to be very important in terms of the fact that 

they have hired 4,200 staff over the last several years. These folks 

are the folks that are being placed in these rating centers, in these 

processing centers. They are the ones that are going to have to 

move this work, are crucial to accuracy, consistency and timeliness 

of the work. 

So I think that is an important piece we are doing it. We will 

be out shortly. We also have some work. We just issued and under 

way, looking at how they can expedite the backlog problem, so I 

will have my staff get in contact with you. 

Mr. RODRIGUEZ. With the understanding that, we have only dealt 

with about 8 million veterans from 23 million in the country, we 

have to continue to push forth on the outreach to our veterans. 

Okay. Thank you. 

Mr. BERTONI. And the BDD program is a good tool for the outreach and education to sort of bring that service into play earlier 

in the servicemember’s life. 

Mr. HALL. Thank you, Mr. Rodriguez. I would just say that I 

think we all are in agreement that these are good programs that 

are positive steps for our veterans and we are trying to figure out 

how to make them better. 

As part of that quest, and noting that VA has created a pre-discharge Web site so that servicemembers can initiate Quick Start or 

BDD claim electronically, I wanted to ask you in closing whether 

you think this paperless system should be expanded to permit all 

claims to be processed or initiated electronically. How much effect 

do you think that would have upon the stubborn claims backlog? 

Mr. BERTONI. In terms of having accessibility via the Web site, 

I think that is—all modern business is heading in that direction. 

You know, commerce and transactions, that is how it is happening 

today. We have servicemembers coming back, these young individuals who have, you know, they are very familiar with that kind of 

public service delivery. So any time you can do that, open up another portal for quick service, we would support that. 

We have not got in and looked at the actual functioning of that 

system, so the jury’s out there. 

What was the other part of your question? 

Mr. HALL. That was it. Thank you. 

Thank you, Mr. Bertoni. I appreciate very much your testimony 

and look forward to your next progress report, and you are now excused with our gratitude. 

Mr. BERTONI. We will follow up on recommendations and keep 

you apprised. 

Mr. HALL. We will absolutely try to do our best. 

Because of scheduling and travel plans, we are going to ask the 

Honorable Noel Koch, Deputy Under Secretary of Defense, from the 

third panel, to come up and be our next panel all by himself. He 

is the Under Secretary for Wounded Warrior Care and Transition 

Policy at the U.S. Department of Defense, and we will just take 

you, Mr. Under Secretary, out of order so you can make your plane. 

As usual, your statement is a part of the written record of this 

hearing, so feel free to improvise as you wish for 5 minutes. 


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You are now recognized, sir. 

STATEMENT OF HON. NOEL C. KOCH, DEPUTY UNDER SECRETARY OF DEFENSE (WOUNDED WARRIOR CARE AND 

TRANSITION POLICY), U.S. DEPARTMENT OF DEFENSE 

Mr. KOCH. Thank you, Mr. Chairman, and thank you very much 

for your consideration and realigning the witnesses. It is a great 

pleasure, as always, to be before this Committee, and as you already have my testimony, this is, of course, this is an area in which 

we are, we are a junior partner and, in fact, with the Veterans Administration and happy to be. 

So our job and our responsibility is, for the most part, to make 

sure that our veterans—or not veterans but pre-veterans, people 

who are prior to separation, who will be separating, are fully informed on the programs and the benefits that are available to 

them. 

And so as Mr. Bertoni has indicated, this is very much a work 

in progress. The programs, themselves, are unexceptionable, I 

think. There is always room for improvement, but I think that the 

programs themselves are excellent. The question is, are we—how 

is it working on the execution side? 

So in the interest of improvement, one of the things that we did, 

as you know, I think, Mr. Chairman and Members, our responsibility is to focus on wounded warriors and their care and their 

transition either back to active duty or to veteran status. And of 

course, many of them do go back on active duty. 

And so that, it would appear that our charter is somewhat limited to those people and, of course, the programs that we are talking about are much broader and encompass all the servicemembers 

that we have. 

So, but, from the perspective, from the place that we stand in 

this process, we do touch, I think, morally wounded warriors, but 

everybody across the board. 

As you are familiar with the Transition Assistance Program 

(TAP), this was started during the Gulf War. It is 20 years old, or 

more than 20 years old now. And it was very much outdated and 

so last November we went away for a week, took this thing apart 

completely, along with our colleagues in this endeavor, and put it 

back together and updated it so that it accommodates people who 

are not very much, very well accommodated previously, our National Guardsmen and our Reservists who are very much engaged 

in the fight today. 

And so in other areas of communication, again, this seems to be 

the entire issue is how do we make our people aware of what is 

available to them. And I have now visited many, many hospitals 

and warrior transition units and met with hundreds and hundreds, 

literally of, just our clients and people we are responsible for, constituents, and it is a constant source of partly amazement and partly disappointment at how little aware they are. And so before we 

get to the challenging questions, I think we can stipulate that we 

are not doing as well in this communications effort. The numbers 

don’t show it and the anecdotal revenues doesn’t show it, and so 

we are working very hard to correct that and to find a way to communicate. 


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And, Mr. Chairman and Members, you will appreciate this. This 

is partly a generational issue. They don’t communicate the way 

people my age communicate. They don’t refer to these thick manuals that we put out, that they are just chock full of information, 

which nobody reads. 

Even Web sites are becoming somewhat antiquated in the eyes 

of some of our younger servicemembers and so we have, and I have 

indicated in my testimony, we are moving into social media, such 

as Facebook. 

It is very successful. We have two Marines on the space station 

who are friends of ours on Facebook, and we have other people like 

this, and we are working with Twitter, and we are finding some 

success here. 

Now, how successful are we? These programs are too embryonic 

at this point for us to make a judgment to say, okay, we know this 

is working, the baseline still remains to be established and I am 

about to run out of 5 minutes, and so I will be happy to take your 

questions. Thank you. 

[The prepared statement of Mr. Koch appears on p. 36.] 

Mr. HALL. Thank you, sir. I appreciate your work and your testimony and your brevity and also your written submission, during 

which, you point out that servicemembers learn of BDD and Quick 

Start programs during the TAP briefings. 

However, GAO states that only the Marines have made these 

briefings mandatory. We have learned that while DoD policy requires commanders to allow servicemembers to attend TAP sessions upon the Member’s request, in some cases servicemembers 

have not been released from their other duties in order to attend 

TAP briefings. 

So given this, why are the TAP briefings not made mandatory for 

all of the service branches? And further, why not make BDD and 

Quick Start available for all servicemembers as a part of the normal discharge process? 

Mr. KOCH. Let me answer the first part of your question, Mr. 

Chairman, first. This—you have touched on a very sore point here, 

and it is a sore one with me particularly because we would like to 

make just about everything that constitutes a benefit or a prospective benefit for the servicemembers mandatory, for them to be 

aware of these things. 

And in some cases we have been successful in making that happen. In other cases we have not. There are contravening priorities 

here. In some cases, you know, we have limited manpower and 

where some of these things can be done in theater, they are also 

fighting a war in theater, and so it becomes difficult to persuade 

the higher authorities to make certain programs mandatory because the commanders object to that, and so to some extent it becomes almost a local option. 

We want it to be mandatory for the servicemember to have, to 

be able to be told about it, and then if they want to avail themselves of the additional information to be briefed or counseled, 

whatever arrangements are provided for them, then their commanders, it should be mandatory for the commanders to release 

them so that they can avail themselves of this benefit. We have 


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not, in every case, been able to do that, and I think we will just 

continually chip away at it. 

I am sorry. The second question, I believe, was why are the benefits delivery in Quick Start not available to all of them. Quick 

Start, as you know, essentially focused more on the benefit accrues 

to the Reservists and that National Guardsmen, more usefully than 

to our active components. And the reason for it is, of course, they 

don’t know. There is a shorter fuse on this, a shorter timeline for 

them to get into the system and the reason is because they don’t 

necessarily know when they are going to be up for rotation. 

As far as the BDD is concerned, this is available to everybody. 

It is just that not everybody needs to have these benefits. They are 

not necessarily all hurt in any way that would give them access, 

and in other cases they just don’t want to bother with it. And the 

third case, as I indicated in my oral testimony, in some cases I am 

sure there are people that simply don’t know about it because we 

have failed to reach them. 

Mr. HALL. Well, I appreciate that. I think we all share the goal 

that you just stated of having the knowledge of these programs 

made available and passed on to every servicemember, be they active duty, Guard or Reserve. 

I am still curious as to why the Marines have made the Transition Assistance Program briefings mandatory and the other services have not. I don’t know. Maybe we need to get that answer from 

somebody else. But it is two schools of thought obviously. 

The Quick Start program was created to ensure that our soldiers 

serving in active duty who come from Guard and Reserve units can 

also take advantage of the benefits of the pre-discharge program. 

Are we offering Quick Start at Guard bases? In particular, I am curious whether my own constituents serving, for instance, in the National Guard at Camp Smith and New York and the Hudson Valley, can get a Quick Start exam when they return and demobilize 

there? 

Mr. KOCH. Mr. Chairman, I think I am going to have to get back 

to you on that question because I think it is a split issue. In some 

places it is available and other places it is not available. 

[The DoD subsequently provided the following information:] 

The Department of Veterans Affairs provides information on the Quick Start program at military installations where demobilization/deactivation of National 

Guard and Reserves takes place and there is a VA presence. National Guard and 

Reservists can file their Quick Start claim while still on Active Duty; however, 

the examination to meet the requirements of Quick Start cannot be accomplished 

in the limited time during demobilization/deactivation. 

Once the servicemember has completed and submitted the Quick Start application 

a VA representative can schedule the member for the Quick Start examination 

prior to their release from Active Duty. The actual examination occurs after the 

servicemember has returned to home station. 

Mr. HALL. Maybe when you get back to us because other Members, I am sure, would like to know for their districts, how that decision is made and what, you know, what percentage of bases and 

where they are and, you know, how is it decided that, you know, 

which base will have a Quick Start examination available. 

And lastly, I want to ask you, the Subcommittee has taken a particular interest in servicemembers suffering from post-traumatic 

stress disorder (PTSD), traumatic brain injury (TBI) and military 


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sexual trauma (MST) to make sure that they receive the benefits 

to which they are entitled. The full VA Committee on the House 

side has examined how some servicemembers suffering from these 

disabilities take their own lives before they get help, or in spite of 

getting help, or tragically, we have a record number of veterans 

and soldiers who are still in uniform committing suicide or attempting suicide. 

With this in mind, could you offer some thoughts about the steps 

we are taking during the pre-discharge process to screen for PTSD, 

TBI, MST and possible depression or other psychological states 

that might lead to suicidal tendencies? 

Mr. KOCH. Yes, sir. Let me try to provide a blanket answer to 

that if I may. We try to screen for these disabilities before the servicemember moves on to—for example, when they come back from 

theater, they are tested to see if they are exhibiting symptoms of 

post-traumatic stress or other psychological and mental health 

issues that might be debilitating. And we just don’t have our arms 

around it. I am sorry. Again, I could probably give you a very eloquent long answer that wouldn’t make a whole lot of sense and by 

the time you distilled it, it would come down to the fact that we 

are still just not very good at this. 

One of the problems is, I can tell you in my generation coming 

back from Vietnam, there are a lot of things that people look for 

in terms of symptoms, maybe symptoms of post-traumatic stress, 

but they also may be symptoms of the fact that you are just coming 

home hot, you don’t want to be here in many cases. You know, you 

want to be back down range, you want to be with your unit, you 

want to be with your friends, you don’t want to face the complexity 

of the life that you are going back to. 

There are a lot of reasons why people come home in ways and 

upset and exhibit symptoms that may be construed as post-traumatic stress or other—you know, TBI is the result of, you know, 

that is different. We know what that is. But diagnosing post-traumatic stress is a very—is a problem of a different magnitude and 

while the symptoms that you are looking at really are not symptoms, but are being misread, that does not preclude that individual 

from suffering from post-traumatic stress 15 or 20 years later and 

you are not going to catch it at the front end. 

And so where we have very good as it—dealing with traumatic 

amputations, providing the necessary prosthesis, the counseling 

and everything that helps people get back on their feet after they 

have lost their legs. We can do that. And even traumatic brain injury is something that we know we can work with this to some degree of feeling like we are making progress. In the area of posttraumatic stress, I don’t know that anybody is going to come up 

there and say, they are pretty happy, I think we have finally got 

our arms around it. If they tell you that, you know, you ought to 

have them under oath. 

Mr. HALL. I appreciate your candor and honesty, sir. And it is 

nice to hear anybody from government or business or anywhere 

say, honestly, we don’t have our arms around it. This is something 

that we all are trying to improve as much as possible, but nobody 

at this point, I don’t think, expects that we will have a foolproof 

way of identifying those people in that kind of trouble. 


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But before you leave, I just wanted to ask if you have any suggestions or approaches that you are trying or that you suggest that 

we might, on the Congressional side, be able to do to help make 

that identification? 

Mr. KOCH. Well, your funding is—at least we are happy with our 

fundings. That may be something, if you are people tell you, that 

we are satisfied with what we have, we are satisfied with your support, we are grateful for your questions and for your—because it 

stimulates our thinking. 

There is one thing that, I guess, you and all of our colleagues 

could help us with and, you may notice when you hear Admiral 

Mullen or other senior military leadership talk about the problem 

that we just finished discussing, they don’t refer to disorder and I 

would like to see if we could, first, if we could get this out of the 

Diagnostic and Statistical Manual of Mental Disorders manual. 

When we talk about post-traumatic stress disorder, we are automatically creating a problem for that individual, because it is a 

term that connotes dysfunctionality, it connotes something that is 

weird, if you like, in that person, and that is a great disservice to 

the individual because when you begin with the notion that it is 

a disorder, which I think it should not be called that, then you get 

quickly to this issue of stigma, which is just a kinder word for prejudice and it is a short jump from prejudice to discrimination in a 

job market and these people shouldn’t—— 

Mr. HALL. Thank you, sir. You are echoing the statement of a father of a young veteran who took his own life who testified before 

this Subcommittee and suggested that it be called post-traumatic 

stress injury or post-traumatic stress syndrome which it use to be. 

Anything but disorder because of the fact that it attaches a stigma 

to it. 

Mr. KOCH. Thank you. 

Mr. HALL. To what is actually a human response to an inhuman 

experience or living through conditions and events that most 

human beings don’t have to deal with. 

So I appreciate your testimony and your suggestions and I hope 

you have a safe travel, sir. Thank you very much for your testimony. 

Mr. KOCH. Thank you, Mr. Chairman. 

Mr. HALL. Mr. Under Secretary, you are now excused. 

Mr. KOCH. Thank you, Counsel. 

Mr. HALL. I will go back to our scheduled program and ask Panel 

2 to join us now, please, including Thomas Tarantino, Legislative 

Associate, Iraq and Afghanistan Veterans of America (IAVA); Gerald T. Manar, Deputy Director of the National Veterans Service, 

Veterans of Foreign Wars of the United States (VFW); Raymond C. 

Kelley, the National Legislative Director of AMVETS; and Mr. 

John L. Wilson, Assistant National Legislative Director for Disabled American Veterans (DAV). 

Gentlemen, thank you for your patience. Your written statements 

are in the record, and Mr. Tarantino, you are now recognized for 

5 minutes. 


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STATEMENTS OF THOMAS TARANTINO, LEGISLATIVE ASSOCIATE, IRAQ AND AFGHANISTAN VETERANS OF AMERICA; 

GERALD T. MANAR, DEPUTY DIRECTOR, NATIONAL VETERANS SERVICE, VETERANS OF FOREIGN WARS OF THE 

UNITED STATES; RAYMOND C. KELLEY, NATIONAL LEGISLATIVE DIRECTOR, AMERICAN VETERANS (AMVETS); AND 

JOHN L. WILSON, ASSISTANT NATIONAL LEGISLATIVE DIRECTOR, DISABLED AMERICAN VETERANS 

STATEMENT OF THOMAS TARANTINO 

Mr. TARANTINO. Mr. Chairman, thank you very much and on behalf of Iraq and Afghanistan Veterans of America’s 180,000 members and supporters, I would personally like to thank you for the 

opportunity to speak before you today and express our views of our 

membership on some very important issues. 

As an Operation Iraqi Freedom veteran with 10 years of service 

in the Army, I have seen firsthand the difficulties many face when 

transitioning from being a servicemember to a veteran. For the 

wounded warrior torn from service due to their extraordinary sacrifice, or the young veteran who spent most of their formative years 

in uniform, the transition can be very difficult. And all too often, 

we leave behind the structured, accessible care and benefits of the 

military when seeking benefits to the Department of Veterans Affairs, where we are left largely on our own devices. 

In response to the need for a more seamless transition from servicemember to veteran, the VA and the Department of Defense have 

embarked on several initiatives that allow servicemembers to walk 

off post with their benefits in hand. However, the potential of these 

programs has yet to be fully realized. And their full impact will not 

be felt until the VA begins aggressive outreach to servicemembers 

and the DoD makes transition programs uniform and mandatory. 

When I left the Army in 2007, I had absolutely no idea of the 

scope and availability of the benefits that I was entitled to as a veteran. In fact, it never even occurred to me to seek benefits and 

health care from the Department of Veterans Affairs just for the 

general wear and tear of a decade of military service. If it weren’t 

for an old Sergeant Major that was attending the Army Civilian 

Alumni Program with me, I would have never even applied. 

And we cannot rely on word of mouth to spread this information. 

The DoD and the VA must integrate their outreach and ensure a 

smooth transition of services before a servicemember is ready to 

leave the uniform behind. Otherwise, more men and women are 

going to fall through the cracks. 

Now, as you mentioned, the Marine Corps mandates TAPS programs, I believe, within 90 days of separation, and the Army conducts their Civilian Alumni Program within 30 days of separation. 

Both of these programs are useful for what they are, but they really begin far too late to utilize the Benefits Delivery at Discharge 

Program. And neither program has comprehensive or mandatory 

briefings about the availability of VA services. 

The VA must begin to see itself as a military alumni program. 

Many of us remember that guy in the cheap suit from our college 

alumni society who greets us on freshman year and continues to 

pester us throughout college and for years afterward. It may have 


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been kind of annoying, but the message was communicated clearly 

and it was consistent. The VA needs to be communicating at least 

that effectively with our veterans. There should be absolutely no 

excuse for any veteran not knowing what services are available to 

them when they separate. And only when the VA integrates its 

outreach and education efforts with the DoD will benefits programs 

reach their full potential. 

Now, early outreach also requires VA boots on the ground. To effectively utilize Quick Start services the VA must have a presence, 

physically, at all military installations in order to provide access 

and information to the benefits and services that servicemembers 

have earned. Additionally, the VA should offer training to AGR 

members of the National Guard and Reserve so that there can be 

benefits counselors and educate servicemembers who do not have 

the same interaction with the military services as do their active 

duty counterparts. 

Just as the VA must rethink the way it conducts outreach, the 

DoD must understand that it has an inherent responsibility to its 

servicemembers to set them up for success whether they retire 

from service or they choose to leave before retirement. The military 

is a lifestyle. It is not a job. And those who choose this life must 

be afforded every opportunity to excel both while in uniform and 

when they put the uniform away. The DoD must mandate comprehensive and structured Transitional Assistance Programs that 

integrates the VA benefits and services. 

Now, in addition to integrating outreach and training, we also 

need to address the expedience and accuracy of the benefits process. The Benefits Delivery at Discharge Program generally provides 

more accurate and timely benefits to separating servicemembers 

than the standard benefits approval process. However, this is largely due to the co-location of the servicemember with their respective 

records and the DoD medical facility. 

Many of the processing issues that plague the standard system 

still do exist, but they are mitigated by the fact that the servicemember is still in uniform, has full access to DoD care and services 

while waiting for their rating, thus reducing the time it takes to 

develop their claim during these programs. 

I think we all know that receiving a disability rating at the VA 

can be a long and confusing process for a veteran. And often, veterans must wait for a rating that does not accurately reflect what 

they are entitled to. The VA currently uses a disability evaluation 

process that was outdated long before many Iraq and Afghanistan 

veterans were even born. And this has lead to a situation where 

hundreds of thousands of veterans must navigate an antiquated 

system that focuses on quantity over quality of processed claims. 

And consequently, 17 percent of cases do not accurately compensate veterans for their earned benefits. And as we all know, 

this leads to months, if not years, of delayed payments. 

And IAVA applauds some of the innovative initiatives that the 

VA and the DoD have undertaken to solve this problem, such as 

the pilot that integrates the Virtual VA into the Benefits Delivery 

at Discharge process and the Six Sigma pilot at the Little Rock Regional Office for the traditional claims process. 


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But now it is time to take it to the next level. You know, the Virtual VA is a step in the right direction, but it has to integrate with 

the Veterans Health Administration as well as the Board of Appeals process if it is ever to be actually effective. And informational 

Web sites, VA.gov and within the DoD are great, but today’s veteran expects services through their Web sites in addition to information. 

Mr. HALL. Mr. Tarantino if you would summarize with these bullet points and—— 

Mr. TARANTINO. I mean basically—— 

Mr. HALL. I appreciate it. Thank you. 

Mr. TARANTINO. Basically, IAVA, along with the other veterans 

organizations, are pushing to reform the disability process as a 

whole. We want to change the work culture at the VA to emphasize 

quality over quantity, we want a modern information technology 

(IT) system, and we want a more transparent application process 

where that emphasizes customer service and removes unnecessary 

steps. 

Thank you very much for the opportunity. 

[The prepared statement of Mr. Tarantino appears on p. 38.] 

Mr. HALL. Thank you, Mr. Tarantino. I am sorry to interrupt 

you, but we have votes coming up and I am hoping to get all of 

our panelists’ testimony before that happens. 

Mr. Manar, you are now recognized. 

STATEMENT OF GERALD T. MANAR 

Mr. MANAR. Mr. Chairman, thank you for this opportunity to 

speak before the Subcommittee. On behalf of the 2.1 million men 

and women of the Veterans of Foreign Wars of the United States 

and our auxiliaries, we appreciate the opportunity to present our 

views and concerns regarding the VA Benefits Delivery at Discharge and Quick Start Programs. 

In the past 20 years, DoD and VA have made significant strides 

to ensure that our newest veterans are better prepared for life after 

discharge than any generation of veterans that preceded them. Unfortunately, we believe that VA fails to reach tens of thousands of 

those leaving active duty and most members of the Reserve and 

National Guard. Further, the quality of the ratings given those 

warriors is often poor. 

The VFW began placing National Service Officers on select military installations in 2001. Today, we have nine Pre-Discharge 

Claims Representatives serving servicemembers at 16 military installations. We also have National Service Officers in San Juan and 

Las Vegas who work at nearby military bases and help 

servicemembers who qualify for the BDD and Quick Start Programs. Last year our service officers briefed over 14,400 

servicemembers and helped over 8,400 file disability claims. They 

received over $9 million in benefits shortly after discharge. 

VA reports that it received 51,000 claims from the BDD and 

Quick Start programs in 2008, up from 47,000 the year before. Further, it reports that nearly 60 percent of those it briefed filed 

claims. 

If 51,000 claimants represent 60 percent of those briefed, then 

VA is briefing only about 85,000 servicemembers. However, with 


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over a hundred thousand personnel leaving active duty and another hundred thousand released from the Reserves and National 

Guard each year, it is clear that a large number of those who serve 

our Nation are not receiving critical information through VA’s outreach effort. 

The most interesting observation to be made from this data is 

that it appears VA is a victim of its own success. While 51,000 

claims submitted under the BDD and Quick Start program may 

constitute only a small part of VA’s annual claims receipt, VA devotes a significant portion of its workforce to educating 

servicemembers, as well as developing and rating those claims, 

thereby reducing its ability to deal with the rest of the workload. 

We do not suggest that VA or DoD lessen their efforts in helping 

servicemembers prepare for life after the military. It is absolutely 

the right thing to do. However, it is important to recognize that 

doing so comes at a cost. We applaud Congress for encouraging 

these programs, and we support VA and DoD in their efforts to ensure that every servicemember has an opportunity to adequately 

prepare for their lives after discharge. 

As we see it, VA has several challenges to resolve if it hopes to 

increase the number of servicemembers it reaches and the quality 

of the service it provides them. 

There are too many servicemembers who are not adequately 

briefed about their benefits prior to discharge. Further, VA has 

been slow to expand the BDD program to additional installations. 

Since 2004, VA has expanded its presence at military bases from 

139 to only 153 bases. VA must move more quickly to expand to 

other military installations. 

Veteran service organizations are critical partners in the BDD 

program. VA personnel often do little more than help 

servicemembers fill out a claim form. VFW service officers usually 

spend an hour with each servicemember, they go through the service treatment records page by page, identifying chronic problems 

which may be granted service connection and ensure that those 

conditions are documented on the application. Finally, they provide 

answers about what to expect in dealing with VA. 

As helpful as veteran service officers are, you would think that 

DoD would welcome us with open arms. Gaining the permission of 

DoD to work on base requires careful and extended negotiations 

with both base commanders and the VA. That’s because VA does 

not anticipate that service organizations may be able to provide 

service officers to help. As a consequence, space, always at a premium, is often difficult to find. 

As VA and DoD expand the BDD program to other installations, 

we urge them to reach out to veteran service organizations to determine whether we’re able to provide service officers to help them 

help servicemembers. 

Finally, in our experience, quality of disability ratings is no better in BDD and Quick Start cases than it is for other veterans. In 

November 2009, Winston-Salem, San Diego, and Salt Lake City, 

the offices where these claims are processed, had substantive error 

rates ranging from 17 to 22 percent. By VA’s own admission, and 

we view these numbers with a great deal of suspicion based on our 

own experience, one out of every five decisions it makes are wrong. 


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There are 29 Members in the House Veterans’ Affairs Committee. If you all submitted claims for benefits from the VA, nearly 

six of you would have ratings which were in error. 

We encourage Secretary Shinseki and his management team to 

focus this year on changing the culture in the Veterans Benefits 

Administration (VBA) so that quality is the rule not the exception. 

I thank you for this opportunity to testify on these important 

programs, and I look forward to answering any questions you may 

have. 

[The prepared statement of Mr. Manar appears on p. 40.] 

Mr. HALL. Thank you, Mr. Manar. 

Mr. Kelley, you are now recognized. 

STATEMENT OF RAYMOND C. KELLEY 

Mr. KELLEY. Thank you, Mr. Chairman. Due to time constraints, 

I’m going to limit my discussion to the BDD program only. 

Despite the fact that tens of thousands of servicemembers have 

used the BDD program at more than 150 locations, there are issues 

that must be addressed to improve the program, not only for the 

veterans who utilize it, but also for DoD and VA. If there continues 

to be impediments and inconsistencies in the departments that facilitate the program, it’s value will be lost. 

The concept of a single separation physical seems simple enough; 

however, physicals can be facilitated by either DoD, VA, a contractor, or a combination of the three. The national agreement between VA and DoD sets guidelines for local MOUs that will determine who will be responsible for the physical. However, there have 

been some challenges at the local level in communicating and following the content of the local MOU. 

A 2008 GAO report found that more than half of all BDD intake 

sites visited had challenges in administering a single comprehensive exam. Often it was the lack of communication that failed to 

reach DoD personnel at the lowest level, therefore, duplicate exams 

continued to take place. Often local leadership and commands did 

not understand the program, and, therefore, ignored the MOU and 

continued to administer two exams. 

Resources were also identified as a challenge for local BDD facilities. In some locations, DoD physicians were not qualified to conduct exams that would meet both DoD and VA requirements. In 

other locations when DoD is required by the local MOU to conduct 

the exam, no provisions were put in place to accommodate the increase in time and resources it would take to conduct the exam. 

These and other issues make it difficult for bases offering BDD 

to meet time frames set by the program. These MOUs must be disseminated and understood by all personnel who are effected by the 

MOU to insure proper implementation. Also, if there are implementation issues, the MOU must be revised to better meet the needs 

of the BDD sites. 

Because VA does not control or enforce the local BDD sites, 

AMVETS believes VA cannot expect—cannot be expected to account BDD development time in their timeliness of claims process. 

However, AMVETS believes it is important to track the BDD process from intake so efficiencies can be identified and best practices 

can be developed. A plan should be put in place that will allow VA 


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to track the development process of BDD claims and conduct periodic reviews so efficiencies can be determined. 

Enforcing—informing servicemembers of this program continues 

to be difficult. Again, local commands’ understanding and support 

for the program greatly affect participation. If the military command does not see the value in the program, they will not be as 

likely to disseminate the information to the troops. VA and DoD 

must make a concerted effort to educate base command structures 

so there will be a buy-in to the program. 

The Transition Assistance Program should be an excellent way 

to communicate the BDD program to transitioning servicemembers, 

as well. However, only the Marine Corps mandates that TAP participates—participants attend the VA presentation. Since this portion isn’t mandatory, servicemembers have the perception it isn’t 

important, leading to low participation. The VA benefits portion of 

TAP should be mandatory. 

AMVETS also believes each regional office should have the authority to rate BDD claims. We understand that as a pilot program, 

it was practical to have only two offices rate these claims. But now 

with more than 150 intake locations, allowing ROs to rate claims 

should increase the timeliness of adjudication. 

AMVETS is also concerned that BDD enrollees must fill out different forms—BDD enrollees must fill out a different form than 

veterans who file a traditional claim. These are stark differences 

in the two forms—there are stark differences in the two forms, 

most notably the length of the form and the depth of the questions 

asked. The BDD form is shorter and lacks instructions. Also the respondent’s burden of time for filling out the BDD form is half of 

that of the traditional form. This is due, in part, to the degree of 

explanation that is required. For example, each form asks the veteran to state what disabilities they are claiming. The BDD form 

provides a small block with only four notebook-style lines for the 

veteran to state their claim. But in the traditional form, the veteran is provided with an entire page asking for specific details. A 

study must be conducted to determine if providing servicemembers 

with a reduced form has any adverse effects on the development 

and the final rating of these claims. 

Mr. Chairman, this concludes my testimony. And I will be happy 

to answer any questions that you have. 

[The prepared statement of Mr. Kelley appears on p. 42.] 

Mr. HALL. Thank you, Mr. Kelley. 

Mr. Wilson, you are recognized for 5 minutes. 

STATEMENT OF JOHN L. WILSON 

Mr. WILSON. Thank you, sir. Mr. Chairman and Members of the 

Committee, I am glad to be here today on behalf of the Disabled 

American Veterans to address the Department of Veterans Affairs 

Benefits Delivery Discharge and Quick Start programs. 

VA and DoD collaboration to establish single separation exam 

programs has generally been successful. According to a GAO report 

entitled, ‘‘Better Accountability and Access Would Improve the 

Benefits Delivery at Discharge Program,’’ of September 2008, and 

the February 2010 GAO report on the same subject, veterans may 

begin receiving benefits within 2 to 3 months instead of the typical 


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6 or 7 months if they had applied after discharge under the traditional disability claims process. 

While the programs can generally be viewed as successful, there 

are concerns with performance measures and program management. For example, VA’s FY 2009 Performance and Accountability 

Report, or PAR, has only one supporting measure for BDD and 

Quick Start. It does not separate BDD and Quick Start data despite their specific eligibility differences and population focus. VA 

also does not include BDD claim development time, as a rule, as 

was discussed earlier. 

While the timeliness of receipt of benefits after discharge is useful, excluding the time spent on development of claims makes it 

difficult to correct negative trends and adopt positive ones. This 

most recent GAO report draws the same conclusion as Disabled 

American Veterans. 

An important next step for a seamless transition of all military 

personnel would be implementation of a mandatory single comprehensive medical examination in order to complete military separation. It seems logical. 

The DoD and VA have made positive strides in transitioning our 

Nation’s military to civilian lives and jobs at their work with the 

Department of Labor’s Transition Assistance Program and Disabled 

Transition Assistance Program. These TAP and DTAP programs 

have improved but challenges remain. The prospect of a servicemember after multiple deployments returning stateside to be 

placed on medical or administrative hold has dissuaded some from 

going to these briefings and from filing disability claims. Also, 

while receiving information has improved, quick processing time 

may allow some individuals to fall through the cracks. This is of 

particular concern for DTAP participants where those with severe 

disabilities may already be getting health care from a VA spinal 

cord injury center despite still being on active duty. Since they are 

no longer located near a military installation, they are often forgotten in the transition systems process. DTAP has not had the same 

level of success as TAP, and closer coordination from the DoD, VA, 

and VETS is critical to improving this disparity. 

In conclusion, the BDD and Quick Start programs are a generally effective tool. Their effectiveness could be even greater 

should the DoD and VA incorporate our suggestions. 

It has been a pleasure to appear before you this afternoon. I will 

be happy to answer any questions you may have. 

[The prepared statement of Mr. Wilson appears on p. 43.] 

Mr. HALL. Thank you very much, Mr. Wilson. And I will ask 

each of you to answer this, if you would. Both BDD and Quick 

Start are generally considered to be successful programs and good 

ideas. That being said, if there was one thing you would change in 

these programs, what would it be? Mr. Tarantino. 

Mr. TARANTINO. Mr. Chairman, I think you are correct. They are 

excellent programs, and they are great ideas. The fact that it took 

12 years just to get to the not-quite full implementation is a little 

bit insane. 

I think if I would change that, I would roll it out completely, and 

I would make sure that every single servicemember knows that 

these programs exist and are able to easily apply for them, that it 


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is command supported, and it’s part of transition assistance, not 

just 60 or 90 days out, but 6 months to a year out when they are 

actually looking at that decision, thinking about their retention options. 

Mr. HALL. Thank you. Mr. Manar. 

Mr. MANAR. Well, I could say, ‘‘Ditto,’’ but let me expand on a 

couple of other things, and that is quality. As I spoke earlier, quality is really poor in the VA rating program. And I think if we could 

change one thing, it would be that the quality of rating decisions 

be improved substantially. 

No one in this room would even think about buying a car, for instance, where 20 percent of its parts were defective or where you 

had a chance that one out of every five cars would stop working 

as soon as you left the dealership. 

So I think the VA—the one thing we need here is vastly improved quality of rating decisions. 

Mr. HALL. Mr. Kelley. 

Mr. KELLEY. I think that, to continue to add, having MOUs at 

the local level that work and insuring that those MOUs work. So 

if the DoD is tasked with providing these physicals, that, okay, 

that’s what the MOU says, but do they have all the resources that 

they need on that base to facilitate that in a timely manner and 

with the resources that they need? And I think that’s the biggest 

thing, and perhaps educating DoD leadership on the importance of 

this BDD program. 

Mr. HALL. Mr. Wilson. 

Mr. WILSON. Building on that, I would say mandatory physical 

exams. For active duty personnel, it’s not a problem. For the Guard 

and Reserve, demobilization makes this difficult. But nonetheless, 

the resources should be made available to keep every Guardsman 

or Reservist on active duty—on active duty orders until they are 

able to get their separation physicals. At that time, and only then, 

should their paperwork be certified and they are eligible to then 

separate from the service. 

Mr. HALL. Okay. Thank you so much for your testimony. You 

have been most helpful. We will submit more questions to you in 

writing, if you don’t mind. And I think we can move on with the 

information you have given us, and go to our final witness before 

these votes are called. 

So Mr. Tarantino, Mr. Manar, Mr. Kelley, and Mr. Wilson, you 

are all excused. Thank you, again, very much, for your service to 

our veterans. 

Our third panel now consists of Diana Rubens, Associate Deputy 

Under Secretary for Field Operations, Veterans Benefits Administration, U.S. Department of Veterans Affairs, accompanied by Mr. 

Bradley Mayes, Director of Compensation and Pension Service at 

the VBA, U.S. Department of Veterans Affairs. Thank you both for 

your patience and thank you to all of our previous witnesses for 

their concise testimony. 

Ms. Rubens, welcome and you are now recognized. 


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STATEMENT OF DIANA RUBENS, ASSOCIATE DEPUTY UNDER 

SECRETARY FOR FIELD OPERATIONS, VETERANS BENEFITS 

ADMINISTRATION, U.S. DEPARTMENT OF VETERANS AFFAIRS; ACCOMPANIED BY BRADLEY G. MAYES, DIRECTOR, 

COMPENSATION AND PENSION SERVICE, VETERANS BENEFITS ADMINISTRATION, U.S. DEPARTMENT OF VETERANS AFFAIRS 

Mr. RUBENS. Thank you, Mr. Chairman. Thank you for your support on the issues for veterans benefits. 

It is my pleasure today to discuss our ongoing nationwide Benefits Delivery at Discharge and Quick Start pre-discharge programs. 

As you mentioned, Mr. Mayes has joined me here today. 

These two programs are really just elements of our strategy to 

provide that transition assistance to separating or retiring 

servicemembers and to engage those servicemembers in the claims 

process prior to discharge. A pre-discharge claim is any claim received from a servicemember prior to release from active duty. 

VBA’s goal is to ensure that each and every servicemember separating or retiring from active duty who wishes to file a claim with 

VA for a service-connected disability benefit will receive assistance 

in doing just that. 

We have talked a lot about the fact that the BDD program is 

open to servicemembers who are within 60 to 180 days of being released, as well as the Quick Start being available to those 

servicemembers with 59 days or less prior to separation. 

One of the things that I think is interesting is that during the 

fiscal year 2009, our BDD and Quick Start claims may have represented just 20 percent of all our original compensation claims received nationwide. But during the same period, approximately 65 

percent of separating servicemembers who filed their claims within 

1 year of separation came through the BDD and Quick Start programs. So we think that our profile using these programs has been 

high. We know that we’d like to improve it, but we think we’re 

doing pretty well at this point. 

The timeliness for our processing for both BDD and Quick Start 

claims is much better than our general workload, and we believe 

that that is because we are getting that head start on the claim 

before that servicemember gets out of the Service. 

As mentioned previously, one of the things that we have worked 

to do is streamline the process by incorporating an imaging technology for the paperless processing of the BDD claims. Our BDD 

paperless processing began initially as a pilot in the WinstonSalem Rating Activity Site in March of 2006, and was expanded to 

the Salt Lake Rating Activity Site in March of 2007. The goal was 

to paperlessly process our BDD claims through the entire life cycle 

from initial submission through adjudication and, if applicable, 

through the appeals resolution. The advantage to processing BDD 

claims in a paperless environment included reduction of time and 

cost associated with shipment of folders. In August of 2008, we 

began ensuring that all BDD claims were being sent to our scanning vendor so that they could be incorporated into the paperless 

environment. 

Talking about the environment that we are using today, what we 

recognize is that our existing Virtual VA architecture and configuVerDate Nov 24 2008 23:55 Jul 26, 2010 Jkt 055231 PO 00000 Frm 00027 Fmt 6633 Sfmt 6633 I:\WAYS\OUT\55231.XXX GPO1 PsN: 55231

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ration are not scalable for all C&P processing. Currently we are developing the Veterans Benefits Management System as an initiative to establish our large-scale effort so that we have an IT solution that will allow us to do all processing within that paperless 

environment. 

We have talked quite a bit about the outreach efforts and the 

things that we are doing jointly with DoD to ensure that 

servicemembers prior to release are getting information. In addition to having those brochures, the Web sites, and the folks out at 

the TAP and the DTAP sessions, I want to touch on the fact that 

we are continuing to expand the number of servicemembers we are 

reaching. In fiscal year 2008, there were roughly 300,000 

servicemembers that, through the myriad or programs we have, received information on benefits prior to discharge. In fiscal year 

2009, that number exceeded 360,000. So we are looking to continue 

to increase that exposure to ensure all servicemembers released 

from active duty are aware of the benefits that they have so richly 

earned. 

I am going to conclude with renewing our commitment to providing efficient and timely service to our Nation’s veterans. We continue to evaluate the BDD and Quick Start programs to look for 

those improvements that we can accomplish with current technology, as well as new technology to further enhance benefits delivery under these important programs and to improve the veteran’s 

experience. 

This concludes my testimony. I would be pleased to answer any 

questions you might have. 

[The prepared statement of Ms. Rubens appears on p. 47.] 

Mr. HALL. Thank you, Ms. Rubens. You are onto something, you 

and Mr. Mayes. And I think we are all impressed with the potential and also with what has been realized already with these programs. 

Your testimony points out that 65 percent of separating 

servicemembers who filed their claims within 1 year did so through 

BDD and Quick Start. My first question is would there be a benefit 

to keeping statistics of BDD and Quick Start utilization separately? 

Mr. MAYES.. Mr. Chairman, we are tracking the utilization, in 

other words, service personnel that are separating and filing their 

claims through the BDD program or the Quick Start program as 

a ratio of all of those servicemembers that are filing claims within 

a year. That is one of the things that we have worked with the Department of Defense to come up with a utilization rate measure. So 

we are doing that. 

And we have seen it increase through the years, as Ms. Ruben 

pointed out in her testimony, which we believe is a measure of the 

success. To me that says that we are getting the word out. The 

commands are making the servicemembers available. As you mentioned, and I think Under Secretary Koch mentioned, for the Marine Corps it is mandatory. We are continuing to push that through 

our collaboration with DoD through the Benefits Executive Council 

and the Joint Executive Council. 

So those are the kinds of things that we are doing, as you mentioned, in improving utilization. 


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Mr. HALL. Right. Excuse me. There’s 12 minutes left on the vote, 

and I just want to ask you a couple more questions, and then we 

will submit further questions in writing. But what do you think accounts for the other 35 percent who do not participate in the program? 

Mr. RUBENS. I would tell you that I think that there are some 

servicemembers who, as they get out, feel as though they are 

healthy, that their period of service hasn’t brought them to the 

point where they need to submit a claim. 

Mr. HALL. Okay. And thank you. Sounds like a reasonable assumption for many of them. We understand that there are 142 

BDD sites. Are there qualified physicians available to do BDD 

exams at all those sites? 

Mr. MAYES. There are actually 131 sites that are covered by a 

formal Memorandum of Understanding, 95 total MOA. We are 

doing the single separation exam at 153 sites. So there is capacity 

to do those single separation exams at all of those sites. As we 

mentioned, and I think you mentioned in your opening statement, 

servicemembers can still file claims through the Quick Start program even if they can’t get the single separation exam at that site. 

Mr. HALL. What help can we in Congress give you to expand 

BDD and Quick Start? 

Mr. MAYES. Mr. Chairman, I think that Congress help us get the 

word out. We delivered pamphlets. You clearly have a good grasp 

of the program. I think that is helpful. When your staff and your 

local offices understand this program, they have an opportunity to 

interact with veterans, Guard, and Reserve units, helping us to 

continue to do that. 

And as Under Secretary Koch said, us presenting here before you 

and answering these questions forces us to take a look at what we 

are doing. We are going to continue to collaborate with the Department of Defense to push so that we have access to active duty and 

Guard and Reserve members service personnel before they get out. 

We would love to see mandatory TAP so that we have that opportunity to educate people that are leaving the service. 

Mr. HALL. Thank you, Mr. Mayes. And I have one last question 

is regarding the GAO report, which noted a failure to effectively 

track the accuracy of claims that are processed through these specific programs. Does the VA view this as a significant concern and 

are there any potential complications involved in tracking these 

programs separately? 

Mr. MAYES. We do look at a valid sample of decisions requiring 

a rating determination for each regional office around the country. 

It is a valid sample, 256 cases per regional office per year. That 

would include the Rating Activity Sites at Winston-Salem, Salt 

Lake, and the site in San Diego. 

So within that sampling are cases that are worked through the 

BDD program. All of the sites where there is consolidated processing actually had higher quality on average than the nationwide 

average. So we felt that through that National Quality Assurance 

Program that we were capturing how well they make an entitlement determination. In the end, the entitlement determination for 

a BDD or a Quick Start claim is grounded in the same requireVerDate Nov 24 2008 23:55 Jul 26, 2010 Jkt 055231 PO 00000 Frm 00029 Fmt 6633 Sfmt 6633 I:\WAYS\OUT\55231.XXX GPO1 PsN: 55231

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ments, the same regulations, the same rules as any other claim. So 

we felt we were properly evaluating the quality for those sites. 

Mr. HALL. Well, thank you, Ms. Rubens and Mr. Mayes, for your 

work for our veterans and servicemembers and for your testimony 

today. The Subcommittee may have further questions that we will 

submit in writing to you. Those Members who were unable to be 

here today may have questions, but I want to note that there are 

5 legislative days for other Members to make remarks or submit 

questions for the record. And thank you to all of our witnesses 

today. 

This hearing is now adjourned. 

[Whereupon, at 3:27 p.m., the Subcommittee was adjourned.] 


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A P P E N D I X 

Prepared Statement of Hon. John J. Hall, Chairman, 

Subcommittee on Disability Assistance and Memorial Affairs 

Good afternoon. 

Would everyone please rise for the Pledge of Allegiance? Flags are located at the 

front and back of the room. 

Ladies and gentlemen, we are here today to examine the Benefits Delivery at Discharge (BDD) and Quick Start programs, two components of the pre-discharge program established by the Departments of Defense (DoD) and Veterans Affairs (VA) 

to streamline servicemembers’ transition from active duty to veterans’ status. 

By way of background, any member of the Armed Forces who has seen active 

duty—including those in the National Guard or Reserves—is eligible to apply for VA 

disability benefits prior to leaving military service through the BDD program or 

Quick Start pre-discharge program. During the application process, servicemembers 

can get help in completing forms and preparing other required documentation from 

VA personnel located at their bases. Additionally, this pre-discharge program combines the health exam required by the DoD upon exiting the military and the VA 

disabilities assessment exam into a single exam. 

Once a BDD or Quick Start claim is approved, veterans may begin receiving benefits within 2 to 3 months, instead of the 6 to 7 months it would typically take if 

they had applied after discharge under the traditional disability claims process. 

Participation in the BDD program is open to servicemembers who are within 60 

to 180 days of being released from active duty and who are able to complete their 

scheduled VA medical examinations prior to leaving their points of separation. The 

Quick Start program is available to servicemembers within 1 to 59 days of separation from service or servicemembers who do not meet the BDD criteria requiring 

availability for all examinations prior to discharge. 

The BDD program started as a pilot program in 1995 at three Army bases and 

three VA regional offices. In 1998, VA and DoD fully rolled out the BDD program. 

Last Congress, my friend Rep. Peter Welch (D–VT) introduced H.R. 2259, legislation to expand the BDD program to members of the National Guard and Reserves 

which was incorporated in the National Defense Authorization Act for 2008 (P.L. 

110–181). This statute ensures that Guardsmen as well as Reservists can participate in the VA/DoD pre-discharge program. 

In the past 15 years, over 170,000 servicemembers have availed themselves to 

BDD and QuickStart processing. The programs have expanded from 3 military bases 

to more than 153 locations in the United States, Germany, and South Korea. 

According to VA, the majority of pre-discharge claims, 46,856 processed in 2009, 

were processed in a paperless environment, with an average processing time of 95.5 

days. It is VA’s stated goal to be processing all compensation and pension claims 

in a ‘‘paperless’’ environment. The Subcommittee is committed to helping VA 

achieve this goal. 

I, along with Congressman Rodriquez, and other Members of this Committee and 

Congress, requested that GAO prepare a report to assess the effectiveness of the 

BDD and Quick Start initiatives. I look forward to hearing from the GAO about its 

report, how its recommendations have been implemented, and what, if any impact 

they have had on the pre-discharge program. 

We also look forward to feedback from veteran service organizations as well as 

from VA and DoD on what if any resources are needed to fully realize the potential 

of these two tools. 

The examination of VA and DoD’s pre-discharge program follows up our last hearing concerning the implementation of the Veterans’ Benefits Improvement Act of 

2008, which was codified in P.L. 110–389. P.L. 110–389 paved the way for a number 

of initiatives also targeting the VA claims backlog issue. It is my hope that the BDD 

and Quick Start programs we examine today, coupled with the electronic claims system and other business reformation efforts in P.L. 110–389 currently underway at 


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VA will together help significantly transform today’s VA claims processing system 

so that we may soon play ‘‘Taps’’ for the VA comp & pen backlog. 

I now recognize Ranking Member Lamborn for his opening statement. 

f 

Prepared Statement of Hon. Doug Lamborn, Ranking Republican 

Member, Subcommittee on Disability Assistance 

Thank you Mr. Chairman, 

And welcome everyone, to this hearing on the Benefits Delivery at Discharge and 

Quick Start programs. 

These programs are modeled on the concept of providing a seamless transition 

from military service to civilian life. 

I, along with Chairman Hall, my fellow Subcommittee Members, and many of you 

here, are long-time advocates for creating a seamless transition. 

Therefore I’m sure we can all recognize the inherent value of beginning the VA 

claims process while service medical records are readily available and proof of service connection is easily established. 

Allowing veterans to file VA compensation claims prior to separation from active 

duty, is simply a logical approach. 

BDD is more efficient than the traditional VA claims process and it eliminates 

many problems that are created by the time gap that often exists between discharge 

and application for benefits. 

Among the requirements to establish eligibility for VA compensation, veterans 

must be able to show that a condition was incurred during service, and that there 

is continuity of treatment between that incurrence and the current condition for 

which they are filing. 

Obviously, with BDD there is no time gap, so it alleviates the need to show continuity of treatment. 

This saves both the veteran and VA a lot of time and effort obtaining private 

treatment records. 

One can imagine that such efforts can become quite extensive for claims filed several years subsequent to service. 

In 2008, full Committee Ranking Member Steve Buyer requested a U.S. Government Accountability Office assessment of the BDD program. 

GAO’s findings confirmed that allowing claims to befiled prior to discharge is 

more efficient than the traditional VA claims process. 

While I am optimistic about the overall assessment of the program, I encourage 

VA to make every effort to improve the program and increase access to BDD sites. 

I believe that processing as many claims as possible in this manner will have a 

positive impact throughout the entire system—Thank you, I yield back. 

f 

Prepared Statement of Daniel Bertoni, Director, Education, Workforce, and 

Income Security Issues, U.S. Government Accountability Office 

VETERANS’ DISABILITY BENEFITS 

Opportunities Remain for Improving Accountability for and Access to 

Benefits Delivery at Discharge Program 

GAO Highlights 

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 


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1The 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. 

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. 

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.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 

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2GAO, Veterans’ Disability Benefits: Better Accountability and Access Would Improve the 

Benefits Delivery at Discharge Program, 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. 4The 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. 6This percentage does not include members of the National Guard or Reserve forces. 

7The 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. 

gram,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.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.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,5 providing access to over 

70 percent of servicemembers who were discharged in fiscal year 2007.6 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,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. 

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8See GAO, VA and DoD Health Care: Efforts to Coordinate a Single Physical Exam Process 

for Servicemembers Leaving the Military, GAO–05–64 (Washington, D.C.: Nov. 12, 2004). 9While 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. 

ice. 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.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.9 VBA personnel assemble claims-related information 

and send the claims to be processed at one of two regional offices.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).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.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. 


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13Previously, 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. 14While 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. 16These two regional offices complete development, rating, award actions, and notification actions for BDD claims. 

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.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.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.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.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 


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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. 18DoD 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. 19These designated processing sites complete development, rating, award actions, and notification actions for Quick Start claims. 

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.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.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 2009.19 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 


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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. 22GAO, Military and Veterans’ Benefits: Enhanced Services Could Improve Transition Assistance for Reserves and National Guard, GAO–05–544 (Washington, D.C.: May 20, 2005). 

servicemembers.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.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.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 doublecounted. 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. 


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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. 24For 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. 

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.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.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 servicemembers’ 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. 

Related Products 

Veterans’ Disability Benefits: Further Evaluation of Ongoing Initiatives Could 

Help Identify Effective Approaches for Improving Claims Processing. GAO–10–213. 

Washington, D.C.: January 29, 2010. 

Veterans’ Disability Benefits: Preliminary Findings on Claims Processing Trends 

and Improvement Efforts. 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. GAO–08–1137. 

Washington, D.C.: September 24, 2008. 


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Veterans’ Benefits: Increased Focus on Evaluation and Accountability Would Enhance Training and Performance Management for Claims Processors. GAO–08–561. 

Washington, D.C.: May 27, 2008. 

Federal Disability Programs: More Strategic Coordination Could Help Overcome 

Challenges to Needed Transformation. 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. GAO–08–495R. Washington, D.C.: April 30, 2008. 

VA Health Care: Additional Efforts to Better Assess Joint Ventures Needed. 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. 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. 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. GAO–07–1256T. Washington, 

D.C.: September 26, 2007. 

GAO Findings and Recommendations Regarding DoD and VA Disability Systems. 

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. GAO–07– 

852T. Washington, D.C.: May 8, 2007. 

Veterans’ Disability Benefits: Processing of Claims Continues to Present Challenges. GAO–07–562T. Washington, D.C.: March 13, 2007. 

Veterans’ Disability Benefits: Long-Standing Claims Processing Challenges Persist. 

GAO–07–512T. Washington, D.C.: March 7, 2007. 

High Risk Series: An Update. GAO–07–310. Washington, D.C.: January 31, 2007. 

Veterans’ Disability Benefits: VA Can Improve Its Procedures for Obtaining Military Service Records. GAO–07–98. Washington, D.C.: December 12, 2006. 

Military Disability Evaluation: Ensuring Consistent and Timely Outcomes for Reserve and Active Duty Service Members. 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 Members. GAO–06–362. Washington, D.C.: March 31, 2006. 

VA and DoD Health Care: Opportunities to Maximize Resource Sharing Remain. 

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. GAO–06–149. Washington, D.C.: December 9, 

2005. 

Veterans’ Disability Benefits: Claims Processing Challenges and Opportunities for 

Improvements. GAO–06–283T. Washington, D.C.: December 7, 2005. 

Veterans’ Disability Benefits: Claims Processing Problems Persist and Major Performance Improvements May Be Difficult. GAO–05–749T. Washington, D.C.: May 

26, 2005. 

Military and Veterans’ Benefits: Enhanced Services Could Improve Transition Assistance for Reserves and National Guard. 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. 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. GAO–03–1045. Washington, D.C.: September 30, 2003. 

f 

Prepared Statement of Hon. Noel C. Koch, Deputy Under 

Secretary of Defense (Wounded Warrior Care and Transition 

Policy), U.S. Department Secretary of Defense 

Mr. Chairman, thank you for inviting me to join you today to discuss how the Department of Defense (DoD) in collaboration with the Department of Veterans Affairs 

(VA) is working to increase transitioning servicemember’s participation in the Benefits Delivery at Discharge (BDD) and Quick Start Programs. The Departments conVerDate Nov 24 2008 23:55 Jul 26, 2010 Jkt 055231 PO 00000 Frm 00040 Fmt 6604 Sfmt 6621 I:\WAYS\OUT\55231.XXX GPO1 PsN: 55231

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tinue to work together to address these issues through the auspices of the DoD/VA 

Benefits Executive Council and the Joint Executive Council. 

The Office of Wounded Warrior Care and Transition Policy’s (WWCTP) mission 

is to ensure Wounded, Ill, Injured & transitioning Warriors receive the highest quality care and seamless transition support. Some of our Wounded, Ill or Injured 

servicemembers may be able to return to active duty following their recovery, and 

may choose to do so, while others may leave military service. But while in the care 

of DoD, it is my office’s job to develop policy and provide oversight of several parts 

of a servicemember’s care, recovery and transition. 

As you are aware, one of the most important efforts we made was in response 

to the recommendations sent forth by the President’s Commission on Care for America’s Returning Wounded Warriors and required by the National Defense Authorization Act for Fiscal Year 2008 (NDAA 2008) to provide a single point of contact for 

recovering servicemembers and their families. In response to the NDAA requirement, we launched the Department of Defense Recovery Coordination Program 

(RCP). 

The RCP places Recovery Care Coordinators (RCC) in each Military Department’s 

Wounded Warrior Program. The RCCs support eligible Wounded, Ill and Injured 

servicemembers, including members of the Reserve Component, and their families, 

by ensuring their non-medical needs are met along the road to recovery. 

My office also has oversight for training the Recovery Care Coordinators. To improve outreach to those supported by an RCC, I had my staff expand the training 

curriculum for the DoD Transition Assistance Program (TAP) and its TurboTAP 

Web site. RCCs are told how to connect wounded, ill and injured servicemembers 

with the BDD and Quick Start Programs through their supporting TAP office. BDD 

or Quick Start can now be added to the members’ comprehensive plan, if applicable. 

Servicemembers leaving the military are informed about BDD and Quick Start 

during the Pre-separation Counseling phase of the transition process. There are five 

components of TAP, namely: 

• Pre-separation Counseling—sponsored by DoD and the Military Services • VA Benefits Briefings—sponsored by VA • Disabled Transition Assistance Program (DTAP)—sponsored by VA • Department of Labor (DOL) TAP Employment Workshops—sponsored by 

DOL • One-on-one coaching which occurs following the previously mentioned four 

components. 

Information on BDD and Quick Start is first provided during the pre-separation 

portion of the transition process. These programs are addressed again, in greater 

depth, by VA during the VA sponsored VA Benefits Briefing, and a third time during the VA sponsored DTAP. Servicemembers meeting the eligibility criteria are 

given a minimum of three opportunities to learn about these vital programs. 

Other actions the Department has taken in conjunction with our partners at VA 

to educate and inform servicemembers about the BDD and Quick Start Programs 

include: 

• Launched the VA Pre-Discharge Web site in June 2009 and linked it to our 

DoD TurboTAP Web site. 

• Developed a BDD and Quick Start pamphlet. 

• Promoted BDD and Quick Start on servicemember’s Leave and Earnings 

Statements (September 2009). 

• Convened the Joint Interagency Strategic Working Group for the Transition 

Assistance Program to assess and update the program. 

• One outcome was a recommendation that DoD update its DoD Instruction 

on Pre-separation Counseling by requiring counselors to cover the BDD 

and Quick Start Programs. This policy modification will help us close any 

gaps that may exist. 

• Another outcome was to update the Pre-separation Counseling Checklist 

for Active Component and Transitioning Counseling Checklist for Demobilizing/Deactivating Reserve Component Services members by adding 

BDD and Quick Start. Although our emphasis is on counseling and coaching servicemembers, it is equally important that we document that counseling was conducted. The forms are the tools which allow us to do that. 

• Within two weeks following the Joint Interagency Strategic Working 

Group meeting, DoD TAP joined the social network community by 

launching the DoD TAP Facebook. We are taking advantage of the popularity of social media as another communications resource to promote 

transition services and benefits to military personnel and families. One 


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of the first links and resources on our Facebook homepage is to the PreDischarge Web site. 

So where are we today? What other steps are we taking that will continue to foster our commitment and support to our deserving warriors? 

The Department will soon issue a Memorandum to the Military Departments asking senior leaders and commanders at all levels to strengthen their emphasis on the 

importance of BDD and Quick Start. We view this Memorandum as a ‘‘call to action’’ 

to our commanders to become more engaged with ensuring eligible servicemembers 

submit their claim for disability compensation through BDD or Quick Start before 

separating from the military. 

As the Co-Chairs of the Benefits Executive Council (BEC), my distinguished colleague, the former Under Secretary for Benefits, and I wanted to institutionalize 

and strengthen responsibilities of our Pre-Discharge Working Group, which falls 

under our purview. To accomplish this we directed this group to develop a ‘‘Pre-Discharge Working Group Charter’’ for our approval. I am delighted to report, Mr. 

Chairman that I recently signed the Charter as the DoD BEC co-chair and sent it 

to my VA Co-chair counter-part, the Acting Under Secretary for Benefits for his signature. 

But these programs and actions notwithstanding, much remains to be done. Both 

DoD and VA are aware that we can improve how we care for our servicemembers 

and Veterans, be it through further research, continuing to ease access to benefits 

for those who earned them, and finding more efficient and effective service-delivery 

systems that will provide better support for our warriors and their families. 

Mr. Chairman, we are reminded daily of our obligation to our servicemembers and 

their families, and particularly to the Wounded, Ill and Injured, and those who bear 

the greatest burden of caring for them. We are committed to providing the support 

they need to help ensure a successful transition through recovery and rehabilitation 

and back to active duty or reintegration into their communities. 

We appreciate the opportunity to come before you today to discuss a subject which 

the Secretary of Defense has said repeatedly is a Departmental priority second only 

to the wars in which we are engaged. I will be happy to answer your questions. 

Thank you. 

f 

Prepared Statement of Thomas Tarantino, Legislative 

Associate, Iraq and Afghanistan Veterans of America 

Mister Chairman, Ranking Member, and Members of the Subcommittee, on behalf 

of Iraq and Afghanistan Veterans of America’s (IAVA) 180,000 members and supporters, I would like to thank you for the opportunity to speak before you today to 

express the concerns of our membership on some very important issues facing veterans of Iraq and Afghanistan and their families. 

As an OIF veteran with 10 years of service in the Army, I have seen firsthand 

the difficulties that many face when transitioning from being a servicemember to 

being a veteran. For the wounded warrior, torn from service due to their extraordinary sacrifice, and the young veteran, who spent most of their formative years in 

uniform, the transition can be difficult. All too often, we leave behind structured and 

accessible care and benefits of the military when seeking care and benefits at the 

Department of Veterans Affairs (VA), where we’re left to our own devices. 

In response to the need for a more seamless transition from servicemember to veteran, the VA and Department of Defense (DoD) have embarked on several initiatives that allow servicemembers to walk off post with their benefits in hand. However, the potential of these programs has yet to be fully realized. And their full impact will not be felt until the VA begins aggressive outreach to servicemembers and 

the DoD makes transition programs uniform and mandatory. 

When I left the Army in 2007, I had no idea of the scope and availability of the 

benefits I was entitled to as a veteran. In fact, it never occurred to me to seek benefits and health care from the VA for the general wear and tear of a decade of military service. If it weren’t for the advice of a Sergeant Major attending the Army 

Civilian Alumni Program with me I would never have applied. 

But we cannot rely on word of mouth to spread this information. The DoD and 

the VA must integrate their outreach and ensure a smooth transition of services before a servicemember is ready to leave the uniform behind. Otherwise, more men 

and women will fall through the cracks. The Marine Corps mandates TAPS programs within 90 days of separation, while the Army conducts their Civilian Alumni 

Program within 30 days. Both of these programs are useful, but begin far too late 

to effectively utilize the Benefits Delivery at Discharge Program. Additionally, neiVerDate Nov 24 2008 23:55 Jul 26, 2010 Jkt 055231 PO 00000 Frm 00042 Fmt 6604 Sfmt 6621 I:\WAYS\OUT\55231.XXX GPO1 PsN: 55231

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ther program has comprehensive and mandatory briefings about the availability of 

VA services. 

The VA must begin to see itself as a military alumni program. Many of us remember the guy from our college’s alumni society who greeted us freshman year and continued to pester us throughout college and for years afterward. It may have been 

annoying at times, but the message was communicated clearly and consistently. The 

VA needs to be communicating at least that effectively with our veterans. There 

should be no excuse for a veteran not knowing what services are available to them 

when they separate. Only when the VA integrates its outreach and education efforts 

with the DoD will benefits programs reach their full potential. 

Early outreach also requires VA boots on the ground. To effectively utilize quick 

start services the VA must have a presence at all military installations in order to 

provide access and information to the benefits and services that the servicemembers 

have earned. Additionally, the VA should offer training to AGR members of the National Guard and reserve in order to educate servicemembers who do not have the 

same interaction with the military services as their active duty counterparts. 

Just as the VA must rethink the way it conducts outreach, the DoD must understand that it has a responsibility to its servicemembers to set them up for success 

whether they retire from service or choose to leave. The military is a lifestyle, not 

a job. Those that choose this life must be afforded every opportunity to excel both 

while in uniform, and when they put the uniform away. The DoD must mandate 

a comprehensive and structured Transitional Assistance Program that integrates 

VA benefits and services. 

In addition to integrating outreach and training we need to address the expedience and accuracy of the benefits process. The Benefits Delivery at Discharge Program generally provides more accurate and timely benefits to separating 

servicemembers than the standard benefits approval process. However, this is largely due to the co-location of the servicemember with their respective records and DoD 

medical facility. Many of the processing issues that plague the standard system still 

exist. They are mitigated by the fact that the servicemember is still in uniform and 

has full access to DoD care and services, while waiting for their rating, thus reducing the time it takes to develop a claim. 

Receiving a disability rating at the VA can be a long and confusing process for 

a veteran. Often, a veteran must wait for a rating that does not accurately reflect 

what they are entitled to. The VA currently uses a disability evaluation process that 

was outdated long before many Iraq and Afghanistan veterans were born. This has 

lead to a situation where hundreds of thousands of veterans must navigate an antiquated system that focuses on the quantity over quality of the processed claims. 

Consequently, 17 percent of cases do not accurately compensate veterans for their 

earned benefits. And as we all know, that leads to months, if not years, of delayed 

payments. 

IAVA applauds some of the innovative initiatives that the VA has undertaken to 

mitigate this problem. Two such programs are the pilot that integrates the Virtual 

VA into the Benefits Delivery at Discharge process, establishing online information 

for quick start programs, and the Six Sigma pilot at the Little Rock Regional Office. 

Now it is time to take it to the next level. The Virtual VA is a step in the right 

direction, but it must integrate with VHA records if it is to be effective. Informational Web sites are good, but today’s veterans expect a Web site to offer services 

as well as information. 

This year IAVA, along with many of our fellow Veterans Service Organizations, 

have selected reform of the disability benefits approval process as our number one 

legislative issue. We believe that our veterans and survivors deserve a top quality 

disability claims system and we commit to supporting and passing disability claims 

reform legislation that: 

• Develops a work culture at VA that emphasizes quality at all steps by creating a management culture that measures and rewards quality of results, 

not just quantity, and provides sufficient training of VA’s management and 

workforce in order to achieve this outcome. 

• Modernizes the IT infrastructure and optimizes business processes by creating a secure and accessible paperless IT system which rapidly moves and 

organizes the information necessary for VA to approve claims for benefits, 

while optimizing workflow and business processes. 

• Develops a simpler and more transparent application and approval process by 

creating a universal and simple application process that provides veterans 

with regular updates on the progress of their claims and allows them to access their records and the status of their claims. 


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Thank you again for the chance to communicate our analysis and suggestions on 

this most important issues facing veterans of Iraq and Afghanistan. We look forward to continuing to work with the committee and I appreciate your time and attention. 

f 

Prepared Statement of Gerald T. Manar, Deputy Director, National 

Veterans Service, Veterans of Foreign Wars of the United States 

MR. CHAIRMAN AND MEMBERS OF THE COMMITTEE: On behalf of the 2.1 

million men and women of the Veterans of Foreign Wars of the U.S. (VFW) and our 

Auxiliaries, we appreciate the opportunity to present our views and concerns regarding the VA Benefits Delivery at Discharge (BDD) and Quick Start Programs. 

In 1973, I spent the last two weeks of active duty in the Navy at Treasure Island 

in San Francisco Bay. During that entire period I did not hear a single word about 

VA disability compensation, VA health care or the GI Bill. My experience was, I believe, not at all out of the ordinary. Other than education benefits, I knew virtually 

nothing about the services VA provided to veterans until I was hired by VA in 1974 

as a benefits counselor to work on college campuses in the Detroit area. 

The world has changed tremendously in the decades since my discharge from the 

Navy. DoD and VA have made significant strides to ensure that our newest veterans are better prepared for life after discharge than any generation of veterans 

that preceded them. Unfortunately, VA fails to reach tens of thousands of those 

leaving active duty and most Reserve and National Guard members. Further, the 

quality of the ratings given these warriors is, in a word, awful. 

Background 

The Transition Assistance Program (TAP) and the Disability Transition Assistance Program (DTAP) was created in the 1980’s to better inform servicemembers 

about benefits and opportunities following service. Those programs have expanded 

significantly so that today, classes and briefings start months before release from 

active duty. The TAP and DTAP don’t just cover VA benefits. Information on resume 

writing, employment counseling, small business information, personal finance, and 

much more is provided to soon to be released servicemen and women. 

From 2005–2007, VA briefed over 1 million servicemen and women and interviewed over 318,000. 

The BDD initiative is an outgrowth of the TAP and DTAP programs. It began in 

1995 as a joint project by VA and DoD at only three Army bases. It has expanded 

to over 150 installations covering all branches of service. This program allows 

servicemembers within 60 to 180 days of discharge to file a claim for compensation 

benefits, receive necessary medical examinations, and obtain a rating soon after release from active duty. 

Veterans of Foreign Wars 

Veteran service organizations have worked hand in hand with the VA and DoD 

to ensure that our nation’s newest veterans receive every benefit to which they are 

entitled under the law. 

The VFW began placing national service officers on select military installations 

in 2001. Today, we have 9 Pre-Discharge Claims Representatives serving troops at 

16 military installations. We also have national service officers in San Juan and Las 

Vegas who perform TAP briefings several times a month at nearby military bases 

and help servicemembers who qualify for the BDD and Quick Start programs. Last 

year our service officers briefed over 14,400 servicemembers and helped over 8,400 

soldiers, sailors, airmen and marines file disability claims with VA. 

The VFW also has two full time specialists reviewing BDD ratings at the VA regional offices in Winston-Salem and Salt Lake City Rating Activity Sites RAS. All 

told in 2009, our small cadre of national service officers helped BDD and Quick 

Start participants receive over $9 million in benefits at or shortly after discharge. 

Challenges 

VA reports that it received 51,000 claims from the BDD and Quick Start claims 

programs in 2008, up from 47,000 the year before. Further, it reports that nearly 

60 percent of those it briefed filed claims. 

These numbers are fascinating for several reasons. First, that at least 60 percent 

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cant. While I do not have the exact numbers, our experience is that nearly all will 

receive service connection for at least one disability and most will receive compensation at some level. 

Second, if 51,000 claimants represent 60 percent of those briefed, then VA is briefing only about 85,000 servicemembers. However, it is our understanding that each 

year over 100,000 personnel leave active duty and another 100,000 are released 

from the Reserves and National Guard. While some Reserve and National Guard 

personnel use the BDD and Quick Start programs as they depart active duty it is 

clear that a large portion of those serving on active duty and in the reserves are 

not receiving critical information through VA’s outreach efforts. 

The most interesting observation is that VA is a victim of its own success. It may 

be merely a coincidence but in the mid-1990s at about the time VA expanded its 

TAP and DTAP programs, VA’s workload began to increase. While 51,000 claims 

submitted under the BDD and Quick Start programs may constitute only 5 percent 

of VA’s annual claim receipts, VA devotes a significant portion of its workforce to 

educating servicemembers and encouraging them to file claims. Further, many highly skilled personnel at the Winston-Salem, Salt Lake City and San Diego Regional 

Offices have been tasked to work BDD and Quick Start claims exclusively. 

We do not suggest that VA or DoD lessen their efforts in helping servicemembers 

prepare for life after the military. It is absolutely the right thing; it may not always 

be the easiest or cheapest thing. We applaud Congress for encouraging these programs and we support VA and DoD in their efforts to ensure that every servicemember has an opportunity to adequately prepare for their post-discharge life. 

As We See It 

VA has several challenges to resolve if it hopes to improve the number of 

servicemembers it reaches and the quality of the service it provides them: 

There are too many servicemembers who are not adequately briefed about their 

benefits prior to discharge. While DoD may require pre-discharge education far 

too many servicemembers are either not provided, or find some way to avoid 

these programs. Further, VA has been slow to expand the BDD program to additional installations. In 2004, VA was at 139 military bases; in 2008 the number stood at only 150. VA must move more quickly to expand to other military 

installations. 

Veteran Service Organizations are a critical partner in the BDD program. VA 

personnel have neither the time nor, often, the expertise to help 

servicemembers fill out more than a claim. VFW service officers usually spend 

an hour with each servicemember, talking with them about their problems and 

concerns; they go through the service treatment records page by page, identifying chronic problems which originate or are aggravated by military service 

and ensure that those conditions are both listed and documented on the application. They accomplish Veterans Claims Assistance Act (VCAA) notification 

which helps shorten the development process. Finally, they provide answers 

about what to expect in dealing with VA. 

As helpful as veteran service officers are you would think that DoD would welcome us with open arms. Gaining the permission of DoD to work on base requires careful and extended negotiations with both DoD and VA. That’s because 

VA does not anticipate that service organizations may be able to provide service 

officers to help. As a consequence, space, always at a premium, is often difficult 

to find. 

As VA and DoD expand the BDD program to other installations, we urge them 

reach out to Veteran Service Organizations to determine whether we are able to provide service officers to help them help servicemembers. 

Finally, in our experience quality of disability ratings is no better in BDD and 

Quick Start cases than it is for other veterans. The VA STAR report for November, 

2009, shows that 17 percent of all ratings nationally contained at least one substantive error. Winston-Salem met the national error rate, while San Diego, where 

Quick Start claims are rated had a 19 percent error rate. Salt Lake City trailed 

with a 22 percent error rate. Essentially, one out of every 5 decisions made by VA 

are wrong. 

There are 29 members on the House Veterans Affairs Committee. If you all submitted claims for benefits from the VA nearly 6 of you would have ratings which 

were wrong. 

We encourage Secretary Shinseki and his management team to focus this year on 

changing the culture in VBA so that quality is the rule, not the exception. 


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Aristotle once said: ‘‘We are what we repeatedly do. Excellence then is not an act, 

but a habit.’’ 

VA needs to create a culture where excellence is a habit. 

f 

Prepared Statement of Raymond C. Kelley, National 

Legislative Director, American Veterans (AMVETS) 

Chairman Hall, Ranking Member Lamborn, and members of the subcommittee, 

thank you for the opportunity to appear before you today to provide AMVETS’ views 

regarding the Benefits Delivery at Discharge and Quick Start Programs. 

The Benefits Delivery at Discharge (BDD) program was established to allow 

servicemembers to begin their disability claims process prior to discharge. Another 

benefit to this program is the servicemembers will receive a single physical that will 

satisfy both the requirements for DoD separation as well as VA disability claims assessment. By doing this, servicemembers who are less than 180 days but more than 

60 days away from separating from active military service can initiate a VA disability claim. This will allow for a more seamless transition for the servicemember 

who may begin receiving disability compensation within one to three months after 

discharge as apposed to six to seven months if they file their claim in the tradition 

manner. 

Despite the fact that tens of thousands of servicemembers have used the BDD 

program at more than 150 locations, there are issues that must be addressed to improve the program not only for the veterans who utilize it, but also for DoD and 

VA. If there continue to be impediments and inconsistencies for the departments 

that facilitate the program, the real value of the program will be lost. 

The concept of a single separation physical seems simple enough. However, the 

physicals can be facilitated by either DoD, VA, a contractor, or a combination of the 

three. The national agreement between VA and DoD set guidelines for local Memorandums of Understanding (MOU) that will determine who will be responsible for 

the physical. However, there have been some challenges at the local level in communicating and following the content of the local MOU. The ‘‘Veterans’ Disability Benefits’’ GAO report (GAO–08–901) found that more than half of all BDD intake sites 

visited had challenges in administering a single, comprehensive exam. Often it was 

a lack of communication that failed to reach DoD personnel at the lowest level, 

therefore, duplicate exams continued to take place. Often, local leadership of commands did not understand the program and therefore they ignored the MOU and 

continued to administer two physicals. 

Resource changes were also identified as a challenge for local BDD facilities. In 

some locations DoD is responsible for conducting the exam, but current physicians 

were not qualified to conduct exams that would meet both DoD and VA requirements. At other locations, when DoD is required by the local MOU to conduct the 

exam, no provisions were put in place to accommodate the increase in time and resources it would take to conduct the exams. These and other issues make it difficult 

for bases offering BDD to meet time frames set by the program. These MOUs must 

be disseminated to and understood by all personnel who are affected by the MOU 

to ensure proper implementation. Also, if there are implementation issues the MOU 

must be revised to better meet the needs of BDD sites 

Because VA does not control or enforce the local BDD sites, AMVETS believes VA 

cannot be expected to account BDD development time in their timeliness of claims 

processing. However, AMVETS believes it is important to track the BDD process 

from intake so efficiencies can be indentified and best practices can be developed. 

A plan should be put into place that will allow VA to track the development process 

of BDD claims and conduct periodic reviews so efficiency can be determined. 

Informing servicemembers of this program continues to be difficult. Again, local 

commands’ understanding and support for the program greatly affects participation. 

If the military command does not see the value in the program, they will not be 

as likely to disseminate the information to the troops. VA and DoD must make a 

concerted effort to educate base command structures so there will be buy-in of the 

program. This is the first step to delivering the information to troops. 

The Transition Assistance Program (TAP) should be an excellent way to communicate the BDD program to transitioning servicemembers as well. However, only the 

Marine Corps mandates that TAP participants attend the VA presentation. Since 

this portion is mandatory, servicemembers have the perception that it is unimportant, leading to low participation. The VA benefits portion of TAP should be mandatory. 


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AMVETS also believes each Regional Office (RO) should have the authority to 

rate BDD claims. We understand that as a pilot program, it was practical to have 

only two offices rate these claims, but now with more than 150 intake locations allowing the ROs to rate claims should increase the timeliness of adjudication. 

AMVETS is also concerned that BDD enrollees must fill out VA Form 21–526c, 

the Pre-Discharge Compensation Claim, while veterans who file a traditional claim 

must fill out VA Form 21–526. There are stark differences in the two forms. The 

two most notable differences are the length of the form and the depth of the questions asked. The BDD forms are four pages shorter and lack the instructions that 

are present in the traditional VA compensation and pension form. Also, the respondent’s burden of time for filling out the BDD forms is half that of the traditional 

form. This is due in part to the degree of explanation that is required. For example, 

each form asks the veteran to state what disabilities they are claiming. The BBD 

form provides a small block with four ‘‘notebook’’ style lines for the veteran to state 

their claim, but in the traditional form the veteran is provided with an entire page 

asking for specific details pertaining to each of the veterans’ claims. A study must 

be conducted to determine if providing servicemembers with a reduced form has any 

adverse affects on the development and the final rating of these claims. 

Mr. Chairman, thank you again for providing AMVETS the opportunity to present 

our views on BDD and Quick Start. This concludes my testimony and I will be 

happy to answer any questions you may have. 

f 

Prepared Statement of John L. Wilson, Assistant 

National Legislative Director, Disabled American Veterans 

Mr. Chairman and Members of the Committee: 

I am pleased to have this opportunity to appear before you on behalf of the Disabled American Veterans (DAV) to address the Department of Veteran Affairs (VA) 

Benefits Delivery at Discharge and Quick Start Programs. 

The Benefits Delivery at Discharge (BDD) and Quick Start programs provide 

servicemembers the opportunity to apply for disability compensation benefits from 

the VA prior to retirement or separation from military service. Servicemembers who 

leave the military and file disability claims with the VA may be subject to duplicative physical exams in order to meet requirements of both the Department of Defense’s (DoD’s) military services and VA. To streamline the process, the military 

services and VA moved to coordinate their physical exam requirements by developing a single separation exam program. This program found its beginnings in 1995 

when VA began accepting disability compensation claims from servicemembers in 

the BDD program at three VA regional offices and three Army installations. However, differences in the availability of physicians trained to use VA’s exam protocols, 

resulted in DoD and VA agreeing that local military bases be given flexibility in implementing the exams by allowing either VA or military physicians to conduct the 

exam. 

In 1998, VA and DoD signed a memorandum of understanding (MOU) instructing 

local units to establish single separation exam programs. In 2002, the agencies created a Joint Executive Council to oversee joint efforts to eliminate barriers 

servicemembers face as they leave the military. The Joint Executive Council’s Benefits Executive Council, is focused on improving information sharing between the 

agencies and improving the transition process for servicemembers. The agencies 

signed another memorandum of agreement in 2004, laying out roles and responsibilities for each agency in establishing a cooperative separation exam process. The 

signing of the National Defense Authorization Act for Fiscal Year 2008 mandated 

BDD services were to also be provided to National Guard and Reserve personnel at 

non-traditional BDD sites such as armories, military family support center to the 

maximum extent possible. 

Participation in the BDD program is offered to servicemembers who are within 

60 to 180 days of release from active duty and who remain in the area in order to 

complete the medical examinations. To participate in BDD, servicemembers generally must meet six requirements: (1) be in the process of being honorably discharged, (2) initiate their VA disability benefits application between 60 and 180 

days prior to discharge, (3) sign a Veterans Claims Assistance Act (VCAA) form, (4) 

provide the VA copies of service medical records, (5) complete a VA medical exam, 

and (6) remain near the base until all exams are completed. The BDD claims are 

then processed at VA Regional Offices at Salt lake City, Utah or Winston-Salem, 

North Carolina. 


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Quick Start is offered to all servicemembers with less than 60 days remaining on 

active duty or demobilization. It is well suited for National Guard and Reserve 

members as they can file a claim while attending demobilization briefings and continue the claims process after returning home. This may make it possible for them 

to receive VA compensation benefits faster after separation or retirement. 

Servicemembers with 1–59 days remaining on active duty or full-time Reserve or National Guard (Title 10 or Title 32) or servicemembers who do not meet the BDD 

criteria requiring availability for all examinations prior to discharge may apply 

through Quick Start. There are three ways to apply for Quick Start: (1) Download 

VA Form 21–526, Veteran’s Application for Compensation and/or Pension, from the 

VA Web site and submit it to the nearest VA Regional Office or any location where 

VA accepts claims; (2) Submit an online application at www.va.gov using ‘‘Apply Online’’, then click ‘‘Compensation & Pension’’ on the drop-down menu; (3) Request a 

claim form be mailed by calling the VA toll-free number. The servicemember must 

submit a paper copy of their service treatment records with each of the three options. 

Current BDD program participants include 40 regional offices and 153 military 

installations (142 DoD sites and 11 Homeland Security Coast Guard sites). This 

number includes 5 locations overseas (3 in Korea and 2 in Germany). VA also issued 

policy guidance that allows servicemembers being discharged from any base to file 

BDD claims at all 57 VA Regional Offices and other locations where VA personnel 

are located. 

The Veterans Benefits Administration (VBA) has also established a Web site of 

http://www.vba.va.gov/predischarge/index.htm to provide information on the four 

components of the Pre-Discharge Program: 

• BDD • Quick Start • Disability Evaluation System (Pilot program) • Seriously Injured/Very Seriously Injured (SI/VSI) 

The collaboration between the VA and the military services to establish single 

separation exam programs has generally been a successful endeavor. According to 

a Government Accountability Office (GAO) Report titled ‘‘Better Accountability and 

Access Would Improve the Benefits Delivery at Discharge Program,’’ GAO–08–901, 

September 9, 2008, once a BDD application is approved, veterans may begin receiving benefits within 2 to 3 months, instead of the 6 to 7 months it typically takes 

if they had applied after discharge under the traditional disability claims process. 

In the past 5 years, about 140,000 servicemembers have used the BDD program. 

More than 70 percent of servicemembers leaving the military in fiscal year (FY) 

2007 were discharged at military bases offering the BDD program. 

A primary advantage of this program is that service treatment records are more 

readily accessible to the servicemember and the VA so filing a VA disability claim 

through the BDD program can be faster than filing a claim as a veteran under the 

traditional claim process. Establishing service connection for a claimed condition 

may be easier, since the member is still on active duty status. Key forms needed 

to process the claim can also be signed immediately. 

While the programs can generally be viewed as successful, there are concerns 

with performance measures and program management. For example, VA’s FY 2009 

Performance and Accountability Report (PAR) has only one supporting measure for 

BDD and Quick Start. The PAR supporting measure is ‘‘out of all original claims 

filed within the first year of release from active duty, the percentage filed at a BDD 

site prior to a servicemember’s discharge.’’ The strategic goal is 65 percent. Results 

for each of the fiscal years is as follows: FY 2006 result of 46 percent with a target 

of 53 percent; FY 2007 result of 53 percent with a target of 48 percent; FY 2008 

result of 59 percent with a target of 50 percent; FY 2009 result is unknown with 

a target of 60 percent. While increasing participation seems evident, the measure 

references BDD and Quick Start together, despite their very specific differences. 

Since both programs are measured in a combined fashion, it is difficult to determine 

the utilization rates of the two programs. Also, there is no breakout by Service component making it difficult to determine the number of National Guard and Reservists who are using these programs. 

While program participation is measured, VA does not adequately measure timeliness and accuracy rates separately from claims that go through the traditional process. The current bookkeeping rules stipulate that BDD claims be tracked from the 

date of discharge whereas traditional claims are tracked beginning from the date 

a veteran files a claim. So, while VA and DoD state a key advantage of the BDD 

program is that it takes less time for the veteran to receive benefits after discharge, 

the accuracy of such a statement remains unclear. While a case can be made that 


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the clock should not start ticking until the servicemember transitions from the service and attains veteran status with the necessary DD–214 form in hand, the actual 

work done by VA employees to complete the rating decision and place the disability 

compensation benefit in the new veterans account is not accurately measured. At 

least 60 days is spent by VA staff developing a claim before a servicemember’s discharge but this 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. According to the aforementioned GAO Report, VA data 

shows that it is not processing claims (including BDD claims) as quickly as expected. By the end of FY 2007, it was taking an average of 76 days to complete BDD 

claims, even though VA has an informal goal of completing work on BDD claims 

no later than 60 days after discharge. In contrast, VA was taking an average of 183 

days to complete all claims, compared to a goal of 125 days. 

While information detailing the timeliness of receipt of benefits after discharge is 

useful, excluding the time spent on development of claims makes it difficult to identify and understand any challenges in this stage of the process. This, in turn, impacts VA’s ability to identify problems in a timely fashion and develop viable solutions to address them. The GAO Report GAO–08–901 noted, 

Personnel in 12 of the 14 BDD intake bases we reviewed indicated significant 

challenges with various claims development activities. For example, personnel 

on several bases told us they had a hard time scheduling exams, because 

servicemembers were leaving the area so they could complete their service at 

home, among other reasons. Also, servicemembers at several bases may have 

to obtain more than one exam and therefore take more time to complete their 

BDD claim. Challenges such as these may delay the development of 

servicemembers’ claims, putting them at risk of having to drop out of the BDD 

program. Unless VA tracks performance related to claims development prior to 

discharge, it cannot easily identify problems and compare performance across 

BDD locations. 

The report also noted, ‘‘VA calculates a national accuracy rate, based on the percentage of claims that were processed without any errors. However, VA’s accuracy 

reviews to date have focused on claims overall, and have not targeted specific types 

of claims, such as BDD. VA officials stated that the current sample approach and 

size are sufficient for estimating a national accuracy rate, but are not sufficient for 

obtaining precise results for specific types of claims. Consequently, VA is unaware 

of the extent to which BDD claims are more or less accurately processed relative 

to other claims and has incomplete information to help identify problems or challenges that BDD locations may face related to accurately developing claims.’’ 

As mentioned earlier, the servicemember applying for VA benefits through BDD 

or Quick Start must provide either the original or a copy of their paper service 

treatment records. This burden will be overcome for them and every other servicemember applying under other programs once the Veterans Lifetime Electronic 

Record is established. 

Another important step would be the implementation of a single comprehensive 

medical examination as a prerequisite to completing the military separation process. 

If and when a single separation physical becomes the standard, VA should have this 

responsibility because it has the expertise to conduct a comprehensive examination 

as part of its compensation and pension process. 

The problem with separation physicals identified for active duty servicemembers 

is compounded when mobilized Reserve and Guard forces enter the mix. A mandatory separation physical is not required for demobilizing Reserve and Guard members. Unfortunately, there have been some cases when they were not made aware 

of this option, which later negatively impacted their ability to obtain a favorable 

service connection. While separation physical examinations of demobilizing personnel have greatly improved, there are still a number of servicemembers who ‘‘opt 

out’’ of the physicals, even when encouraged by medical personnel to have them. 

While the expense and manpower needed to facilitate these physical exams might 

be significant, the separation physical is critical to the future care of demobilizing 

servicemembers. Mandatory separation physical examinations would also enhance 

collaboration by the DoD and VA to identify, collect, and maintain the specific data 

needed by each to recognize, treat, and prevent illnesses and injuries resulting from 

military service. 

The DoD and VA have made positive strides in transitioning our nation’s military 

to civilian lives and jobs. The Department of Labor’s (DOL) Transition Assistance 

Program (TAP) and Disabled Transition Assistance Program (DTAP), which are 

handled by the Veterans Employment and Training Service (VETS) are typically the 

first point of contact with the VA and DOL for a separating servicemember. Thanks 


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to the insistence of the DoD, local commanders are allowing more of their soldiers, 

sailors, airmen, marines, and coastguardsmen to attend these courses well enough 

in advance to take advantage of the information they receive. 

The TAP and DTAP programs have continued to improve, but challenges remain 

at some local military installations, overseas locations and with services and information for those with injuries. The prospect of a servicemember after having been 

on multiple deployments to return stateside and then be placed on medical or administrative hold has persuaded some from filing a claim for VA compensation or 

other ancillary benefits. Also, though individuals are receiving the information, the 

haphazard nature and quick processing time may allow some individuals to fall 

through the cracks. This is of particular concern in the DTAP program where those 

with severe disabilities may already be getting health care and rehabilitation from 

a VA spinal cord injury center despite still being on active duty. Because these individuals are no longer located on or near a military installation, they are often forgotten in the transition assistance process. DTAP has not had the same level of success as TAP, and it is critical that coordination be closer between the DoD, VA, and 

VETS to improve this disparity. 

Many veterans with significant disabilities are turning to state vocational rehabilitation and workforce development systems because of these and other impediments to accessing VA’s vocational rehabilitation and employment benefits. Almost 

all state vocational rehabilitation agencies have entered into memoranda of understanding with VA to serve veterans. Disabled Veterans Outreach Program and Local 

Veterans’ Employment Representative Program personnel are often housed in state 

One-Stop Career Centers and these positions are often praised as a model that 

should be emulated by the broader workforce system. However, all of these vocational programs are under considerable resource distress and their ability to serve 

veterans who are unserved by the Vocational Rehabilitation and Employment Service is hindered by their own personnel and budgetary limitations. 

Although the achievements of the DoD and VA have been good with departing active duty servicemembers, there is a much greater concern with the large numbers 

of Reserve and National Guard servicemembers moving through the discharge system. Both the DoD and VA seem ill-prepared to handle the large numbers and prolonged activation of reserve forces for the global war on terrorism. The greatest 

challenge with these servicemembers is their rapid transition from active duty to 

civilian life. If servicemembers are uninjured, they may clear the demobilization station in a few days, and little of this time is dedicated to informing them about veterans benefits and services. Additionally, DoD personnel at these sites are most focused on processing soldiers through the site. Lack of space and facilities often restricts contact between demobilizing soldiers and VA representatives. 

The DoD and VA have made progress in the transition process. Unfortunately, 

limited funding and a focus on current military operations interfere with providing 

for servicemembers who have chosen to leave military service. If we are to ensure 

that the mistakes of the first Gulf War are not repeated during this extended global 

war on terrorism, it is imperative that a truly seamless transition be created. With 

this, it is imperative that proper funding levels be provided to VA and the other 

agencies providing services for the vast increase in new veterans from the National 

Guard and Reserves. Servicemembers exiting military service should be afforded 

easy access to health care and other benefits that they have earned. This can only 

be accomplished by ensuring that the DoD and VA improve their coordination and 

information sharing to provide a seamless transition. 

A review of the VA/DoD Joint Executive Council’s Strategic Plan for FY 2009 to 

2011 addresses the issue of seamless transition in Goal 3, Seamless Coordination 

of Benefits. Their goal is to ‘‘enhance collaboration efforts to streamline benefits application processes, eliminate duplicative requirements, and correct other business 

practices that complicate the transition from active duty to veterans status.’’ Their 

objective is ‘‘to improve participation in the BDD program nationwide and ensure 

servicemembers are afforded the single cooperative examinations where available.’’ 

To achieve this goal, the Benefits Executive Council’s Benefits Delivery at Discharge 

Working Group is to align BDD with concurrent efforts dedicated to streamlining 

delivery of VA benefits for eligible personnel; calculate and analyze BDD participation rates at MOU sites; and instill ownership of BDD with operational commanders. While strategic goals and objectives are important, they achieve the best 

results when there are measureable outcomes with clear due dates. A review of this 

objective finds neither. So, this successful program may lack the clarity of data from 

the DoD as well, which may delay even greater utilization of this important and effective program. 

It is the recommendation of the DAV that: 


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1. DoD and VA ensure that servicemembers have a seamless transition from 

military to civilian life. 

2. DoD and VA continue to develop electronic medical records that are interoperable and bidirectional, allowing for a two-way electronic exchange of 

health information and occupational and environmental exposure data. 

These electronic medical records should also include an easily transferable 

electronic DD–214. 

3. In accordance with the recommendation of the FY 2008 National Defense 

Authorization Act and the recommendation of the President’s Commission, 

the DoD and VA implement a single comprehensive medical examination as 

a prerequisite of promptly completing the military separation process. VA 

should be responsible for handling this duty. 

4. DoD and VA encourage active duty servicemembers to seek veterans service 

organization representation during outprocessing and discharge examinations. 

5. Congress and the Administration provide adequate funding to support TAP 

and DTAP which are managed by the DOL Veterans Employment and 

Training Service to ensure that active duty, as well as National Guard and 

Reserve, servicemembers do not fall through the cracks while transitioning. 

6. VA track and account for the time needed for claims development activities 

that occur prior to discharge in the agency’s timeliness calculation for BDD 

and pre-discharge claims; 

7. VA separately estimate the accuracy of BDD and predischarge claims; 

8. VA collect data for all claims filed by Service component and analyze the 

extent to which different components are filing claims and receiving timely 

benefits under BDD, Quick Start, predischarge and traditional claims processes; 

9. VA include program reviews of BDD operations as part of oversight visits 

to regional offices with BDD operations and ensure such reviews are consistently conducted and reported; 

10. DoD establish an accurate measure of servicemembers’ participation in TAP 

including VA benefit briefings; and 

11. DoD establish a plan with specific time frames for meeting its goal of 85 

percent participation rate in TAP. 

Mr. Chairman, this concludes my testimony. I will be pleased to answer any questions you or the Committee may have. 

f 

Prepared Statement of Diana Rubens, Associate Deputy Under Secretary 

for Field Operations, Veterans Benefits Administration, U.S. Department 

of Veterans Affairs 

Mr. Chairman and Members of the Subcommittee, it is my pleasure to be here 

today to discuss our ongoing nationwide Benefits Delivery at Discharge (BDD) and 

Quick Start pre-discharge programs. Joining me today is Bradley Mayes, Director 

of the Department of Veterans Affairs (VA) Compensation & Pension (C&P) Service. 

The BDD and Quick Start programs are two elements of the Veterans Benefits 

Administration’s (VBA) strategy to provide transitional assistance to separating or 

retiring servicemembers and engage servicemembers in the claims process prior to 

discharge. A pre-discharge claim is any claim received from a servicemember prior 

to release from active duty. VBA’s goal is to ensure that each and every servicemember separating or retiring from active duty who wishes to file a claim with VA for 

service-connected disability benefits will receive assistance in doing so. 

Participation in the BDD program is open to servicemembers who are within 60 

to 180 days of being released from active duty and who are able to report for a VA 

examination prior to discharge. However, for those servicemembers with 59 days or 

less before separation, VA introduced the ‘‘Quick Start’’ pre-discharge claims process 

in July 2008. This provides servicemembers within 59 days of separation, or 

servicemembers within 60–180 days of separation who are unable to complete all 

required examinations prior to leaving the point of separation, to be assisted in filing their disability claim. 

The BDD and Quick Start pre-discharge programs offer advantages to Veterans. 

Minimal development is required because service records are readily available and 

examinations are requested prior to discharge. Once service treatment records are 

obtained, the servicemember acknowledges that notification required by the Veterans Claims Assistance Act of 2000 has been provided and is offered the opportunity to acknowledge that no additional medical evidence needs to be submitted. 


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After the VA examination is conducted, the claim can be rated in a timely manner. 

This process has generated a very high participation rate among servicemembers because disability benefits are received shortly after separation from service. During 

fiscal year (FY) 2009, BDD and Quick Start claims represented just over 20 percent 

of all original compensation claims received nationwide. However, during this same 

period, approximately 65 percent of separating servicemembers who filed their 

claims within one year of their discharge did so through the BDD and Quick Start 

programs. 

The average processing time, or average days to complete (ADC), for BDD and 

Quick Start claims continues to show gradual improvement. At the end of FY 2009, 

ADC for BDD claims was 70.8 days. At the end of FY 2009, ADC for Quick Start 

claims was 105.9. ADC for both programs remains significantly lower than the nationwide ADC (160.7 days at the end of FY 2009) for all disability rating claims received. 

Background 

VBA established the BDD program at three VA regional offices and three Army 

installations in 1995, and nationwide expansion began in 1998. Expansion promoted 

the development of claims and the conduct of physical examinations sufficient for 

VA rating purposes prior to separation with a disability rating to be completed as 

closely proximate as possible to separation from active duty. 

As the program gained momentum, the Department of Defense (DoD) and VA 

signed a national memorandum of agreement in 2004 to establish the specific responsibilities of each department. At the same time, a team of VBA leaders from 

central office, area offices, and regional offices (ROs) developed a proposal in November 2004 for consolidation of BDD claims processing. This provided an opportunity 

to improve consistency in the way BDD claims are received and processed. It also 

allowed VBA to reach a greater number of servicemembers as well as improve the 

quality and accuracy of rating decisions. The Winston-Salem and Salt Lake City 

ROs were selected as consolidated processing locations. BDD claims from the Eastern and Southern Areas were consolidated to Winston-Salem, while the BDD claims 

from the Central and Western Areas were transferred to Salt Lake City. This consolidation was completed in April 2007. 

BDD claims processing was further streamlined by incorporating imaging technology to enable paperless processing of these claims. Paperless BDD claims processing began as a pilot at the Winston-Salem Rating Activity Site (RAS) in March 

2006 and was expanded to the Salt Lake City RAS in March 2007. The goal was 

to paperlessly process BDD claims through their entire life cycle, from initial submission through adjudication and if applicable, appeal resolution. The advantages 

to processing BDD claims in a paperless environment included the reduction of time 

and costs associated with shipment of claims folders. In August 2008, all BDD 

claims were sent to our scanning vendor for paperless claims processing at the two 

RAS, and the expansion of BDD paperless claims processing was complete. 

Consolidation of pre-discharge claims continued with the consolidation of Quick 

Start claims to the San Diego RO and Winston-Salem RO in 2009. The San Diego 

RO handles claims filed within VA’s central and western areas and also those filed 

from military installations in Korea. The Winston-Salem RO handles claims filed 

within VA’s eastern and southern areas and also those filed from military installations in Germany. 

Current Technology Environment 

Currently, all BDD claims are sent to VBA’s scanning vendor, Hands On Ventures 

Services. All information located within a BDD claims folder is scanned and 

uploaded into Virtual VA. Virtual VA is the current image repository and provides 

image capture, storage, and retrieval. The existing Virtual VA architecture and configuration are not a scalable solution for all C&P processing or VBA. The Veterans 

Benefits Management System (VBMS) initiative is a large-scale effort to develop an 

IT solution that is built on a scalable, agile architecture. Coupled with VBA’s business transformation strategy, the VBMS initiative will enable our organization to 

reach its goal of a benefits delivery model that provides world-class service to our 

nation’s Veterans. 

Staffing 

VBA currently has 143 employees dedicated to processing BDD claims at the Winston-Salem and Salt Lake City RAS, and 129 employees at Winston-Salem and San 

Diego dedicated to processing Quick Start claims. Additional management and adVerDate Nov 24 2008 23:55 Jul 26, 2010 Jkt 055231 PO 00000 Frm 00052 Fmt 6604 Sfmt 6621 I:\WAYS\OUT\55231.XXX GPO1 PsN: 55231

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ministrative staff are assigned to support BDD and Quick Start claims processing. 

These employees are dedicated and provide excellent service to participants in both 

programs. 

Outreach Efforts 

To ensure that servicemembers are aware of both the BDD and Quick Start programs, VA developed several outreach initiatives. Brochures describing the BDD 

and Quick Start processes are distributed to servicemembers approaching separation. They are provided to all military installations involved with the programs and 

are handed out to servicemembers during pre-discharge workshops describing VA 

benefits. In addition, a Web page on VA’s Internet site describes the pre-discharge 

programs and explains all requirements. To simplify the actual claims process, BDD 

and Quick Start claimants can now apply online. These outreach initiatives increase 

servicemembers’ access to VA benefits and improve claims processing timeliness. 

In addition to the BDD and Quick Start programs, VA continues to collaborate 

with DoD in the seamless transition initiative, promoting a smooth and efficient 

transition for individuals separating from the military. This includes National 

Guard and Reserve members who are demobilizing from overseas deployment and 

returning to their home units. VBA and the Veterans Health Administration conduct joint briefing sessions at military bases designed to provide information on the 

entire range of VA benefits and health care services. 

One formal pre-discharge outreach program conducted by VA and the Departments of Defense and Labor is the Transition Assistance Program (TAP). During 

TAP briefings, VBA personnel explain the disability compensation process and provide assistance to servicemembers interested in filing a claim. The Disabled Transition Assistance Program (DTAP) is specifically designed to assist servicemembers 

facing separation because of disability incurred during service. In addition to TAP 

and DTAP briefings, VA conducts informational sessions for demobilized National 

Guard and Reserve members at the unit’s community location. 

Another major seamless transition project resulting from DoD and VA collaboration is the Disability Evaluation System (DES) for the 27,000 servicemembers who 

enter the medical evaluation board process on an annual basis. The goals are to improve consistency of outcomes, establish an increased sense of equity by DES participants, increase transparency, reduce the time servicemembers are in the process, 

and ease their transition to civilian life. This joint effort reduced the time from separation to receipt of initial VA disability payment to an average of 25 days. By end 

of March 2010, the pilot will be at 27 installations, accounting for 46 percent of all 

DES participants. Plans are underway for full deployment of the pilot process, pending authorization of the VA/DoD Senior Oversight Committee. 

Conclusion 

VBA is committed to providing efficient and timely service to our nation’s Veterans. We will continue to evaluate the BDD and Quick Start programs to identify 

improvements that can be accomplished with the current technology platform and 

to capture requirements for new technology capabilities to further enhance benefits 

delivery under these important programs and improve Veterans’ experience. This 

concludes my testimony. I would be pleased to address any questions you may have. 

f 

Statement of American Federation of Government Employees, 

AFL–CIO and AFGE National Veterans Affairs Council 

Thank you for the opportunity to present the views of members of the American 

Federation of Government Employees (AFGE) and the AFGE National Veterans Affairs Council (AFGE NVAC) who process claims under the Benefits Delivery at Discharge (BDD) and Quick Start Programs. 

Recommendation: Eliminate Redundancy 

One of the most significant problems plaguing the BDD and Quick Start Program 

is the redundancy created by two separate programs that essentially perform the 

same task. The only real difference between the two programs is application deadlines, i.e. between 60 and 180 days prior to separation for BDD, and 60 days or less 

for Quick Start. 

The operation of two similar program results in the unnecessary duplication of resources, including supervisory and support personnel. This arrangement also creates 


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inequities: Since the Quick Start team works exclusively on claims filed within 60 

days prior to separation; they are necessarily completing more recent claims than 

those being processed in BDD. 

It would be more efficient and equitable to place both programs under the BDD 

umbrella and eliminate the arbitrary restriction that BDD claims cannot be filed 

within 60 days prior to separation. In addition, all claims processed from active military service under the pre-discharge processes should be processed via a Paperless 

Claims Processing System. As the VA is transitioning into the paperless environment, to continue processing claims outside of the paperless system, as Quick Start 

does, will only result in further delays in the transition. 

Recommendation: Improve Training 

Our VBA members express great frustration at the lack of adequate training generally, and specifically for these programs. Current training requirements for VBA 

employees processing BDD and Quick Start claims is minimal, consisting exclusively 

of emails that list references to review. Employees are denied the opportunity for 

interaction or discussion about many of the complicated tasks required to process 

these pre-discharge claims. 

Recommendation: Stop consolidation of paperless pre-discharge claims 

With regard to claims handled through Supplemental Paperless Claims Processing, AFGE and AFGE NVAC recommend that all claims be maintained in the 

VARO of jurisdiction. Consolidation of paperless pre-discharge claims to centralized 

locations is a disservice to veterans, especially since the paperless claims processing 

system is now available for use by all offices. Consolidation results in unnecessary 

delays in processing when the need for additional development or examinations 

arises, and the claim is no longer located in the state where the veteran resides. 

The current practice of isolating paperless claims (following the initial rating action) at the VARO Winston Salem and VARO Salt Lake also results in unnecessary 

delays in filing supplemental claims. Veterans who participate in the Quick Start 

program have their claims forwarded to the VARO of jurisdiction. Veterans should 

not be treated differently due to the time in which they filed their claim during separation. 

Recommendation: Increase the quality and consistency of C&P Exams 

The poor quality of many C&P exams, and thus, the need for re-examination, results in further processing delays. These exam deficiencies particularly impact predischarge claims. 

Recommendation: Improve tracking of pre-discharge claims 

Currently, BDD and Quick Start claims are only tracked after discharge, when 

most of the development is already complete. AFGE and AFGE NVAC concur with 

GAO’s recommendation to track BDD and Quick Start claims during the development process. Tracking during claims development would enable VBA to identify 

areas of deficiencies. 

For example, a common problem with pre-discharge cases is the difficulty of obtaining service treatment records (STRs). The current practice of requesting a copy 

of the veteran’s STR at his or her DTAP briefing works well for those who are part 

of the regular armed forces. However, some of these veterans have prior periods of 

service; before the case can be rated, VBA must obtain the STRs for all periods of 

service. This results in additional delay because VBA must then request STRs from 

the National Personnel Records Center or Records Management Center. 

Tracking during the development process would enable VBA to spot deficiencies, 

such as how many veterans have prior periods of service and the timeliness delays 

that are caused by not requesting all STRs up front. 

Another problem concerning STRs involves veterans from the National Guard or 

Reserve. They are not required to submit STRs with their application and the obligation falls on VBA to obtain the STRs from the state adjutant general or from the 

reserve unit. This often causes delays in the claims process because the employee 

frequently has to send multiple requests to get these records. Often times records 

for these veterans are never received. 


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Therefore, VBA should be tracking how many cases are submitted by National 

Guard and Reservists and the amount of time required to obtain their STRs, as well 

as how often the STR is unavailable. Tracking would also enable VBA to identify 

improper denials resulting from missing STRs. 

Thank you. 


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MATERIAL SUBMITTED FOR THE RECORD 

Committee on Veterans’ Affairs 

Subcommittee on Disability Assistance and Memorial Affairs 

Washington, DC. 

March 25, 2010 

Daniel Bertoni 

Director, Education, Workforce, and Income Security Issues 

U.S. Government Accountability Office 

441 G Street, NW 

Washington, DC 20548 

Dear Mr. Bertoni: 

Thank you for testifying at the House Committee on Veterans’ Affairs’ Subcommittee on Disability Assistance and Memorial Affairs’ oversight hearing on the 

‘‘Examination of the Benefits Delivery at Discharge and Quick Start Programs,’’ 

held on February 24, 2010. I would greatly appreciate if you would provide answers 

to the enclosed follow-up hearing questions by Monday, April 26, 2010. 

In an effort to reduce printing costs, the Committee on Veterans’ Affairs, in cooperation with the Joint Committee on Printing, is implementing some formatting 

changes for material for all full Committee and subcommittee hearings. Therefore, 

it would be appreciated if you could provide your answers consecutively on letter 

size paper, single-spaced. In addition, please restate the question in its entirety before the answer. 

Due to the delay in receiving mail, please provide your responses to Ms. Megan 

Williams by fax at (202) 225–2034. If you have any questions, please call (202) 225– 

3608. 

Sincerely, 

John J. Hall 

Chairman 

U.S. Government Accountability 

Washington, DC. 

April 16, 2010 

The Honorable John J. Hall 

Chairman 

Subcommittee on Disability and Memorial Affairs 

Committee on Veterans’ Affairs 

House of Representatives 

Subject: Responses to Questions for the Record—Hearing Entitled Examination of 

the Benefits Delivery at Discharge and Quick Start Programs 

Dear Mr. Chairman: 

This letter responds to your March 25, 2010 request that we address questions 

for the record related to the Subcommittee’s February 24, 2010 hearing examining 

the Benefits Delivery at Discharge and Quick Start Programs. Our responses to the 

questions, which are in the enclosure, are based on our previous work and knowledge of the subjects raised by the questions. 

If you have any questions about the letter or need additional information, please 

contact me at (202) 512–7215 or bertonid@gao.gov. 

Sincerely yours, 

Daniel Bertoni 

Director, Education, Workforce, and Income Security Issues 

Enclosure 


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1GAO, Veterans’ Disability Benefits: Better Accountability and Access Would Improve the Benefits Delivery at Discharge Program, GAO–08–901 (Washington, D.C.: Sept. 9, 2008). 2GAO, Military and Veterans’ Benefits: Enhanced Services Could Improve Transition Assistance for Reserves and National Guard, GAO–05–544 (Washington, D.C.: May 20, 2005). 

Response to Questions from the House Committee on Veterans’ Affairs 

Subcommittee on Disability Assistance and Memorial Affairs 

Oversight Hearing the ‘‘Examination of Benefits Delivery at Discharge and 

Quick Start Programs’’ 

February 24, 2010 

1. In your testimony, you recommended that DoD expand mandatory 

Transition Assistance Program (TAP) briefings beyond the Marine 

Corps to all military service branches. 

In our 2008 report, we recommended that to ensure that potentially eligible participants are aware of the BDD program, DoD should establish a plan with specific 

time frames for meeting its goal of 85 percent participation in TAP. Increased participation in the VA benefits session in TAP may allow more members to self-identify their eligibility for these programs. Although DoD reported to us in September 

2009 that it is preparing to develop a plan and specific time frames in the coming 

months, the longer the agencies lack a plan or a way to accurately measure progress 

toward meeting the TAP participation goal, the less information they will have on 

the extent to which VA benefits briefings are reaching all transitioning 

servicemembers may benefit from VA’s pre-discharge programs. 

In your opinion, what are the pros and cons of this proposed expansion 

of TAP? 

In our 2008 report 1, we note that according to DoD and VA personnel, 

servicemembers most commonly learn about the program through VA benefits briefings conducted as part of TAP sessions. We found that without such briefings, some 

members may not recognize they are entitled to receive VA benefits, and may file 

claims through BDD or Quick Start programs. However, because briefings are not 

mandatory for all service branches, whether commanders and supervisors encourage 

servicemembers to attend briefings varies by base. Moreover, some DoD officials told 

us that servicemembers may not recognize the importance of the VA benefits briefings if participation is not required, because members have a host of discharge requirements and limited time to complete them. 

While VA and DoD have explored the expansion of TAP, they have not made participation in TAP sessions mandatory for servicemembers. We reported in a 2005 

report 2 that command supervisors may feel that mission needs are too pressing to 

allow some servicemembers to participate in TAP. In addition, DoD officials have 

indicated that because TAP sessions involve components from three federal agencies—DoD, VA, and DOL—the coordination of a mandated program could be challenging. 

Could VA’s disability claims process be improved by establishing the 

BDD or Quick Start programs as automatic components of the discharge 

process for all servicemembers, whether they are claiming a service connected disability or not? 

Filing a VA disability claim through the BDD program can be faster than filing 

a claim as a veteran under the traditional claim process, because medical records 

are more readily accessible and key forms needed to process the claim can be signed 

immediately. Moreover, establishing that the claim is related to the member’s military service may be easier, since the member is still on active duty status. On the 

other hand, expanding the number of claims processed through the BDD and Quick 

Start programs to include all servicemembers who are discharged regardless of 

whether they have a service connected disability will likely result in processing ineligible claims, which in turn may negate some of the programs’ efficiencies. Any 

decrease in the overall speed of claims processing may result in less timely receipt 

of VA disability compensation for all servicemembers participating in the programs. 

This is especially true since, over the last several years, VA has experienced an increase in disability compensation claims, which in turn has contributed to a growing 

number of pending claims. 

2. A Veteran Service Organization (VSO) representative testified that 

the BDD and Quick Start programs could be improved by allowing 

servicemembers to start the pre-discharge process earlier, perhaps 


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as early as six months before discharge. What impact would such a 

move have on further improving the BDD and Quick Start programs? Do you think that an earlier start date for the pre-discharge 

process might permit disabled veterans to begin receiving benefit 

compensation within a month after discharge rather than 180 days 

after discharge, on average, as is the case now? 

Under the BDD program’s current structure, servicemembers may initiate a claim 

as early as 180 days (6 months) prior to discharge or as late as 60 days (2 months) 

prior to discharge. According to VA, these times frames allow for sufficient time 

prior to discharge for local VA personnel at BDD intake sites located on or near the 

base to assist members with their disability applications, including scheduling their 

exam(s). While a claim may be developed prior to discharge, VA cannot authorize 

the award until the member is discharged. To the extent that 180 days provides sufficient time to process BDD claims and VA is legislatively restricted regarding when 

it can authorize and award payments until discharge, it is unclear how allowing a 

member to file a claim earlier than the 180 days currently allowed would improve 

the BDD program or expedite receipt of benefits. 

Quick Start claims are available for servicemembers—such as National Guard 

and Reservists—who are not able to meet BDD program requirements, such as remaining on base long enough to complete exams within the 60–180 day time window. Unlike BDD claims, Quick Start claims generally require additional development after discharge, which can delay award decisions and receipt of payment. Our 

prior work did not explore the feasibility or efficacy of initiating the process earlier 

for servicemembers—such as National Guard and Reservists—who, because they are 

deactivated quickly after returning to their home base, generally have difficulty 

meeting BDD program requirements. 

3. In your testimony, you note that most VA and DoD Memos of Understanding (MOU) require a VA physician to administer the joint physical exam required by the BDD and Quick Start programs. As a result, you observe that many servicemembers stationed on bases with 

no access to VA physicians cannot secure the joint exam needed for 

the BDD program. How should this problem be fixed, and what can 

Congress do to assist the resolution of this issue? 

Most VA and DoD BDD MOUs require a VA physician to administer the joint 

physical exam offered under the BDD program. However, a physical exam prior to 

discharge is not a requirement for participation in the Quick Start program. In our 

2008 report, we recommended that to ensure that servicemembers have full access 

to a cooperative exam process that is convenient, efficient, and consistent for 

servicemembers, the Chairs of the Joint Executive Council should direct the Benefits Executive Council to identify and disseminate information on promising practices that address challenges local officials commonly face. VA and DoD have taken 

some steps to implement this recommendation, including collaborating to identify 

best practices for dealing with the cooperative exam process as it relates to the challenges local personnel commonly face. 

In addition, DoD and VA are piloting a joint disability evaluation process involving a single physical exam for servicemembers who may need to be discharged due 

to a disabling condition. The pilot is currently taking place at 27 military facilities, 

many of which are also BDD facilities, and DoD and VA are considering whether 

to expand the pilot DoD-wide. The pilot may present an additional opportunity to 

improve collaboration and communication between DoD and VA. However, it could 

also present challenges, for example, by increasing local VA offices’ exam caseloads. 

GAO has a review underway of the disability evaluation system pilot. 

4. Your testimony noted that VA consolidated the claims processing operations for the BDD program into two VA Regional Offices (ROs), 

in Winston-Salem, NC and Salt Lake City, UT. Quick Start claims are 

also processed in two locations, the Winston-Salem RO and the San 

Diego RO. One VSO representative recommended that the processing 

of these claims could be expedited by permitting all ROs to process 

BDD and Quick Start claims. Do you agree with this recommendation, or do you recommend another approach? 

In our 2008 report, we noted that in 2006 VA completed its effort to consolidate 

rating activities for BDD claims in two regional offices—Salt Lake City, Utah, and 

Winston-Salem, North Carolina—in order to improve the consistency and timeliness 

of BDD ratings. We noted that VA had not evaluated whether consistency or timeliness had improved compared to prior practices, although VA officials told us they 


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3 In our 2008 report, we recommended that VA conduct an evaluation of the paperless claims 

processing initiative to determine which adjustments, if any, are needed to improve implementation of the program. 

monitored claims workloads between the rating offices and in one case sent claims 

from one office to the other so claims could be processed more quickly. Since our 

report, in August 2009, VA consolidated the processing of Quick Start claims to two 

locations, Winston-Salem, North Carolina and San Diego, California. Consistent 

with our prior recommendation related to another initiative 3, before VA considers 

making changes to its Quick Start processes, such as adding additional rating sites, 

it would be prudent for VA to evaluate the impact of consolidation on timeliness as 

well as on consistency of Quick Start claims processing. 

5. In 2009, a reported 65 percent of separating servicemembers who 

filed a claim within one year of their discharge did so through one 

of these programs. Is this an acceptable level of participation? If not, 

what should be the proper target? 

For several years, VA has had a strategic target that 65 percent of separating 

servicemembers who filed a claim within one year of discharge would file through 

the BDD program. According to VA, while the agency has yet to reach that goal, 

it is striving to do so by 2011. VA recently modified the measurement of BDD participation by including only those members who discharge from BDD locations (in 

the past, it had included members discharging from any location, including those 

that did not accept BDD claims). This change reduces the number of 

servicemembers counted in the denominator without changing the numerator, and 

therefore makes VA’s target of 65 percent easier to reach. 

Beyond this change, VA may also have begun to include claims filed under the 

Quick Start program in the BDD participation rate numerator. In its 2009 Performance and Accountability Report, VA reported that the BDD participation rate now 

includes those whose ‘‘date of claim’’ is before discharge, which presumably would 

include servicemembers who use the Quick Start program. Because Quick Start 

claims can be filed from any location, this adjustment could result in some 

servicemembers being counted in the numerator (for filing Quick Start Claims) and 

not in the denominator (for filing from non-BDD locations). Further, if the BDD participation rate does include Quick Start claims, then it may make sense to have a 

target that is higher than 65 percent participation, since the current target was set 

before Quick Start existed. 

In our prior work, we were unable to obtain data from DoD on the number of 

servicemembers discharged from BDD versus non-BDD locations and therefore did 

not assess the appropriateness of the adjusted 65 percent target. Regardless of the 

target rate, we continue to believe that—because servicemembers generally learn 

about BDD through TAP—it is important that VA and DoD make progress toward 

developing a plan and an accurate measure for achieving their TAP participation 

goal. 

f 

Committee on Veterans’ Affairs 

Subcommittee on Disability Assistance and Memorial Affairs 

Washington, DC. 

March 25, 2010 

The Honorable Noel Koch 

Deputy Under Secretary of Defense 

Office of Wounded Warrior Care and Transition Policy 

U.S. Department of Defense 

1400 Defense Pentagon 

Washington, DC 20301 

Dear Mr. Koch: 

Thank you for testifying at the House Committee on Veterans’ Affairs’ Subcommittee on Disability Assistance and Memorial Affairs’ oversight hearing on the 

‘‘Examination of the Benefits Delivery at Discharge and Quick Start Programs,’’ 

held on February 24, 2010. I would greatly appreciate if you would provide answers 

to the enclosed follow-up hearing questions by Monday, April 26, 2010. 

In an effort to reduce printing costs, the Committee on Veterans’ Affairs, in cooperation with the Joint Committee on Printing, is implementing some formatting 

changes for material for all full Committee and subcommittee hearings. Therefore, 

it would be appreciated if you could provide your answers consecutively on letter 


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56 

size paper, single-spaced. In addition, please restate the question in its entirety before the answer. 

Due to the delay in receiving mail, please provide your responses to Ms. Megan 

Williams by fax at (202) 225–2034. If you have any questions, please call (202) 225– 

3608. 

Sincerely, 

John J. Hall 

Chairman 

Questions From the House Committee on Veterans’ Affairs 

Subcommittee on Disability Assistance and Memorial Affairs 

Oversight Hearing the ‘‘Examination of the Benefits Delivery at Discharge 

and Quick Start Programs’’ 

February 24, 2010 

Question 1: Your testimony pointed out that servicemembers learn of the BDD 

and Quick Start programs during Transition Assistance Program (TAP) briefings. 

However, a 2008 report issued by the U.S. Government Accountability Office (GAO) 

entitled Veterans’ Disability Benefits: Better Accountability and Access Would Improve the Benefits Delivery at Discharge Program, revealed that only the Marines 

have made these briefings mandatory. The Subcommittee has learned that while 

Department of Defense (DoD) policy requires commanders to allow servicemembers 

to attend TAP sessions upon the member’s request, in some cases servicemembers 

have not been released from their duties to attend the briefings. Why aren’t TAP 

briefings mandatory for all branches, and what additional resources, if any, does 

DoD need to make TAP briefings mandatory for all of the service branches? 

Answer: The Department would have to defer to the Departments of Labor and 

Veterans Affairs regarding modifying mandatory servicemember participation in 

TAP. DoD does not have the authority to make those sessions mandatory. 

The Joint Executive Committee (JEC) requested the TAP Steering Committee, an 

inter-agency body (representatives from Departments of Defense, Labor, Veterans 

Affairs, Homeland Security, the Military Departments, and the Office of Personnel 

Management) responsible for monitoring all aspects of TAP, to develop a plan for 

mandatory TAP briefings. This plan will be presented at the June JEC meeting. 

Question 2: At what point does the pre-discharge process begin once a servicemember approaches the date of their discharge? Are servicemembers transferred out 

of theatre to have their physicals, get TAP briefings, and complete other decommissioning procedures? 

Answer: Servicemembers can file a BDD claim no more than 180-days but not 

less than 60 days prior to separation, retirement, or in the case of a National 

Guardsman/Reservist, release from active duty. It is VA policy that the Servicemember filing under BDD must: (1) have a known separation date; (2) complete a single 

joint examination; (3) turn in a complete copy of their medical record at the time 

they submit their BDD claim. 

Quick Start program claims can be filed no more than 59-days before but not less 

than 1 day prior to separation, retirement, or in the case of a National Guardsman/ 

Reservist, release from active duty. The same requirements for BDD are applicable 

to Quick Start claims. 

In regard to location, no, DoD does not transfer servicemembers out of theater to 

complete physical exams, get TAP briefings, or complete other decommissioning requirements. 

These pre-discharge program requirements were established by the Department 

of Veterans Affairs. 

Question 3: A veteran service organization (VSO) representative testified that 

the BDD and Quick Start programs could be improved by allowing servicemembers 

to start the pre-discharge process earlier, perhaps as early as 6 months before discharge. What are the pros and cons of starting the pre-discharge process earlier in 

DoD’s opinion? 

Answer: The following pros and cons reflect the opinions, not DoD policy. 

Pros of starting the pre-discharge process earlier: 


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1. Servicemembers would have more time to assimilate the enormous volume 

of information on the benefits, services, and resources they may be entitled 

to receive. 

2. A higher percentage of servicemembers re-enlist the earlier they start the 

transition process compared to those starting the transition process much 

later (findings from an Informal Navy survey conducted in the 1990s). 

3. Allows servicemembers to submit applications for VA compensation claims in 

a timely manner before separating or retiring. 

4. Servicemembers would have more time to compare and weigh their options 

for staying in the military vs. actually separating or retiring. 

5. Stressors normally associated with the entire transition process and experience may be reduced if servicemembers start the process earlier. 

6. More spouses may become actively involved in the transition process if the 

servicemember began the pre-discharge process earlier. 

7. Professional staffs should be able to manage clients better, devote more time 

to those who need the most attention, and provide more individualized assistance in counseling and coaching servicemembers. 

Cons of starting the pre-discharge process earlier: 

1. Will require the Services to increase resources. Servicemembers who begin 

the process earlier tend to go back multiple times for individualized counseling/coaching, compared to the number of repeat visitors to transition offices when servicemembers have little time remaining on Active Duty. (This 

may be problematic for operations) 

2. Demobilizing National Guard and Reservists would begin the process in theatre. This would require additional facilities, equipment, personnel, etc. to be 

permanently placed in theatre to assist in the early transition process. 

3. Conducting pre-discharge counseling in theater may not be conducive for 

Servicemembers receiving and assimilating the information and assistance. 

4. For National Guard and Reservists, providing the transition process earlier 

at home station would mean increasing the number of non-training days a 

member would be called on Active Duty to receive the necessary counseling 

and coaching. This could also be a problem for employers. 

5. For deployed National Guard/Reservists, they would not be able to complete 

the joint DoD/VA physical examination while in theater to take advantage 

of an earlier submission date. For that reason, DoD would have to defer to 

the Department of Veterans Affairs (VA) regarding changes in policy that 

would allow earlier acceptance of pre-discharge claims and earlier administration of the joint DoD/VA physical examination under VA’s program. 

Question 4: In your opinion, are there other ways for improving the pre-discharge process to facilitate increased usage of the BDD and Quick Start program 

for transitioning disabled servicemembers? 

Answer: Yes, there are other ways to improve the pre-discharge process. The Department is undertaking several initiatives to improve usage of BDD and Quick 

Start, for example Recovery Care Coordinators will be trained to inform 

transitioning disabled Servicemembers who they need to contact for assistance in 

applying for BDD/Quick Start. Also, we are modifying the pre-separation counseling 

checklist for Active Duty and the transitioning checklist for the Reserve Components so BDD/Quick Start items will be addressed by transitioning counselors. Lastly, we have added the pre-discharge link to the official DoD TurboTAP Web site and 

are doing strategic messaging on our social networking sites (i.e., Facebook and 

Twitter) to encourage early participation where services are available. 

Question 5: GAO noted in its testimony, that most VA and DoD Memos of Understanding (MOU) require a VA physician to administer the joint physical exam 

required by the BDD and Quick Start programs. GAO thus observed that many 

servicemembers stationed on bases with no access to VA physicians cannot secure 

the joint exam needed for the BDD program. How should this problem be fixed, and 

what can Congress do to assist the resolution of this issue? 

Answer: If the military installation is not located near a Department of Veterans 

Affairs (VA) hospital, VA can contract out the joint DoD/VA examination to meet 

the required examination protocol. At those military locations where the necessary 

resources are available (sufficient medical personnel/type of specialty equipment), 

DoD providers can also be trained to conduct the joint DoD/VA examination. The 

Department is closely monitoring these situations, and making the adjustments 

when needed. 


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The Department appreciates Congressional support, and we will continue to work 

with Congress to provide legislative requests through the formal legislative request 

channels. 

Question 6: How many military bases are there, and what percentage of these 

bases enables servicemembers to access joint DoD/VA exams? 

Answer: The joint DoD/VA exam is provided at 131 military installations, which 

is 16 percent of the 820 U.S. military installations. 

Question 7: The Quick Start program was created to ensure that our soldiers 

serving in active duty from Guard and Reserve units can also take advantage of the 

benefits of the pre-discharge program. Are we offering Quick Start examinations at 

Guard bases, such as the NY National Guard’s Camp Smith? If so, how many Guard 

bases have the resources to perform these Quick Start exams? What resources do 

you need to ensure that Quick Start exams can be offered at all bases that Guard 

Members and Reservists return after their active duty service? 

Answer: Yes, the Department offers examinations at 53 military installations 

where demobilization/deactivation of National Guard and Reserves takes place and 

there is a VA presence. NY National Guard Camp Smith is not currently one of 

those installations. 

The Department defers to VA on additional resources required for expanding the 

Quick Start program as VA is the administrator of the program. 

Question 8: How much time is needed, on average, to administer a joint DoD/ 

VA exam? 

Answer: The Department of Veterans Affairs reports from October 1, 2009 

through March 31, 2010, took an average of 33.2 days to administer the joint DoD/ 

VA exam. 

Committee on Veterans’ Affairs 

Subcommittee on Disability Assistance and Memorial Affairs 

Washington, DC. 

March 25, 2010 

Thomas Tarantino 

Legislative Associate 

Iraq and Afghanistan Veterans of America 

292 Madison Avenue, 10th Floor 

New York, NY 10017 

Dear Mr. Tarantino: 

Thank you for testifying at the House Committee on Veterans’ Affairs’ Subcommittee on Disability Assistance and Memorial Affairs’ oversight hearing on the 

‘‘Examination of the Benefits Delivery at Discharge and Quick Start Programs,’’ 

held on February 24, 2010. I would greatly appreciate if you would provide answers 

to the enclosed follow-up hearing questions by Monday, April 26, 2010. 

In an effort to reduce printing costs, the Committee on Veterans’ Affairs, in cooperation with the Joint Committee on Printing, is implementing some formatting 

changes for material for all full Committee and subcommittee hearings. Therefore, 

it would be appreciated if you could provide your answers consecutively on letter 

size paper, single-spaced. In addition, please restate the question in its entirety before the answer. 

Due to the delay in receiving mail, please provide your responses to Ms. Megan 

Williams by fax at (202) 225–2034. If you have any questions, please call (202) 225– 

3608. 

Sincerely, 

John J. Hall 

Chairman 


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TO: House Veterans Affairs Committee (DAMA) 

RE: Follow-Up Questions from IAVA’s Testimony on February 24, 

2010 

PREPARED BY: Tom Tarantino, Legislative Associate 

1. How would it help VA if the Transition Assistance Program (TAP) 

briefings and BDD or Quick Start exams were mandatory for all decommissioning servicemembers? Do you believe VA has the resources needed for this expansion? 

Over the past year, VA has engaged in an ever-increasing effort to reach out to 

veterans in hopes of enrolling them into the VA Heath Care system. Mandatory 

TAP briefings would provide a captive audience to reach out to new veterans and 

explain how the VA can be used as a resource. Most servicemembers do not have 

a clear idea as to what the VA does, or what services it provides. Mandatory briefings at or near the point of discharge should be a key component to achieving a 

seamless transition from DoD to VA Care. These briefings should be uniform across 

all services and within a time frame that use of BDD and Quick Start programs 

are feasible. 

The VA has regional offices all over the Nation that cover every military base 

where out-processing is conducted, yet, there is no established procedure for having 

VA representatives liaising with DoD out-processing services. The VA should have 

a team in every VISN whose sole function is to be a new veterans first contact with 

the VA while processing out of the military. They should be experts in VA services 

and have the ability to either enroll them into VA health care, or direct them to 

a service officer for assistance with VBA claims. A new veteran shouldn’t have to 

search to find the benefits that they have earned. 

2. What can Congress do to assist VA and DoD in expanding TAP briefings and BDD or Quick Start exams to all discharging 

servicemembers? 

Congress needs to enact legislation that requires TAP briefings for all exiting 

servicemembers. While each service will have service specific components to the 

briefing, the timeline and the VA benefits portion should be uniform and explicit 

in statute. These briefings should be conducted by a VA expert and mandated in 

such a time frame where utilization of BDD and Quick Start programs are both convenient and realistic. 

3. The Memo of Understanding (MOU) between VA and DoD largely 

permits only VA physicians to conduct single exams. Is this a problem and if so, should more training be provided to DoD physicians 

so that they can conduct these exams more often? 

While it would be ideal for expedience and convenience to have both DoD and VA 

physicians conduct the exit physical evaluations, it isn’t realistic. VA physicians are 

the only ones consistently qualified to conduct Compensation and Pension examinations and apply the VA schedule of rating. As the ultimate disability rating is under 

VA regulations, the examination should remain a VA function. 

4. You testified that even when comprehensive physical exams are administered, there is not enough time or resources to complete them 

effectively. What might Congress do to resolve this issue? 

As mentioned in my answer to question 2, TAP briefings must be mandatory with 

uniform benefits briefings. These briefings should be conducted within a time frame 

where utilization of BDD is realistic and covenant. In these briefings 

servicemembers should be able to begin the BDD or quick start process. This way, 

all parties have sufficient time to conduct the exams and evaluate the results. 

5. GAO reported that VA has established only one measure for gauging 

the effectiveness of the BDD and Quick Start programs. However, it 

seams that VA has several means for measuring general disability 

claims. Do you agree additional quality measurements could assist 

VA in fully implementing BDD? 

Yes. However, the VA does not have a particularly good method for measuring 

quality in any of its disability claims. With a 17 percent error rate in the regular 


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claims process, it’s clear that this is an area that the VA must improve on as a 

whole. The STAR program is largely a quality assurance method, which is procedural in nature and does very little to ensure that the decisions themselves were 

correct. The VA needs to reassess its entire quality control program before extending the current broken evaluation system to BDD and Quick Start. 

6. Some Veteran Service Organizations (VSOs) express frustration by 

VA’s lack of efforts in collaborating with them in increasing utilization of BDD and Quick Start programs. Please expand upon the challenges faces by your organization in this regard? What can Congress 

do to increase the cooperation between VA and VSOs with respect 

to the BDD and Quick Start Programs? 

IAVA helps veterans by raising awareness, advocating for reforms and assisting 

veterans and their families to find the best services available. However, we do not 

provide traditional services and do not employ service officers. As such, we have not 

seen too many organizational challenges in this regard. We do believe that VSO 

Service Officers are invaluable resources for veterans navigating the VA system. 

Service officers should be a component to TAP programs and be included in local 

BDD and Quick Start Programs. Local service offices can act as a knowledgeable 

interface between the veteran, the DoD and the VA during the process. 

7. Are you aware of any unique challenges by members of the National 

Guard and Reservists in gaining information about the Quick Start 

program and filing claims through this program? 

Members of the National Guard and Reserve components are being mobilized at 

unprecedented rates. As a result, more members of the Select Reserve are eligible 

for a wider range of VA benefits than ever before. Yet, members of the Select Reserve do not have the same access to information and benefits, as do their Active 

Duty peers. To help bridge this gap IAVA recommends that VA offer training to selected AGR members of the National Guard and Reserve so that each unit has a 

benefits and resources councilor organic to the unit. 

f 

Committee on Veterans’ Affairs 

Subcommittee on Disability Assistance and Memorial Affairs 

Washington, DC. 

March 25, 2010 

Gerald T. Manar 

Deputy Director of National Veterans Service 

Veterans of Foreign Wars of the United States 

200 Maryland Avenue, SE 

Washington, DC 20002 

Dear Mr. Manar: 

Thank you for testifying at the House Committee on Veterans’ Affairs’ Subcommittee on Disability Assistance and Memorial Affairs’ oversight hearing on the 

‘‘Examination of the Benefits Delivery at Discharge and Quick Start Programs,’’ 

held on February 24, 2010. I would greatly appreciate if you would provide answers 

to the enclosed follow-up hearing questions by Monday, April 26, 2010. 

In an effort to reduce printing costs, the Committee on Veterans’ Affairs, in cooperation with the Joint Committee on Printing, is implementing some formatting 

changes for material for all full committee and subcommittee hearings. Therefore, 

it would be appreciated if you could provide your answers consecutively on letter 

size paper, single-spaced. In addition, please restate the question in its entirety before the answer. 

Due to the delay in receiving mail, please provide your responses to Ms. Megan 

Williams by fax at (202) 225–2034. If you have any questions, please call (202) 225– 

3608. 

Sincerely, 

John J. Hall 

Chairman 


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1Presentation by Acting Under Secretary for Benefits to the Advisory Committee on Disability 

Compensation, April 20, 2010. 

Questions from the House Committee on Veterans’ Affairs 

Subcommittee on Disability Assistance and Memorial Affairs 

Oversight Hearing the ‘‘Examination of the Benefits Delivery at Discharge 

and Quick Start Programs’’ 

February 24, 2010 

This is in response to the questions submitted by the House Committee on Veteran’s Affairs in conjunction with the oversight hearing on the ‘‘Examination of the 

Benefits Delivery at Discharge and Quick Start Programs’’ held on February 24, 

2010. 

1. How would it help VA if the Transition Assistance Program (TAP) briefings 

and BDD or Quick Start exams were mandatory for all decommissioning 

servicemembers? Do you believe VA has the resources needed for this expansion? 

Response: ‘‘How would it help VA’’ is not, in our view, the appropriate question. 

Rather, we believe that the question to ask is ‘‘how would it help discharging 

servicemembers if the TAP briefings were mandatory and BDD and Quick Start examinations required?’’ 

Clearly, making TAP briefings mandatory for all discharging servicemembers, including deactivating National Guard and Reserve personnel would impose an additional and substantial burden on VA. Although VBA has received substantial increases in FTE over the past few years, the focus has been on training them to develop, process and finalize pending claims. Outreach, while very important, only attracts more claims; it doesn’t resolve any. Should Congress decide to make TAP 

briefings mandatory, additional FTE would be required for both the outreach efforts 

AND claims processing. 

We do not believe that VBA currently has the resources to increase outreach nor 

the staff to process the additional claims generated from outreach efforts. FTE provided by Congress in the last few years has been allocated to processing claims. 

Claims receipts increased by 14 percent in FY 2009 and, reportedly, by another 10 

percent FYTD. Clearly, they need to focus on the current work at this time. 

However, VBA estimates that pending inventories will peak in FY 2012 and begin 

to fall in the years that follow. Rather than decrease FTE as anticipated in FY 2014 

and beyond, VBA could reallocate staff to improving outreach to departing 

servicemembers. While this is not the ideal approach, it is, in our view, the most 

practical.1

2. What can Congress do to assist VA and DoD in expanding TAP briefings and 

BDD or Quick Start exams to all discharging servicemembers. 

Response: There are several issues here: 

• What can Congress do to expand TAP briefings? The simplest thing is to pass 

legislation requiring every discharging servicemember, including Guard and 

reserve personnel, to participate in mandatory TAP briefings. These briefings 

are designed to provide discharging servicemembers essential information on 

a wide variety of subjects which help ease transition from active duty to civilian life. 

Since VA does not, in our opinion, currently have the resources to provide 

staff to conduct additional TAP briefings, it would be necessary to either plusup the Veterans Benefits Administration (VBA) FTE or utilize alternative 

methods, such as computerized training modules or videoconferencing, to provide this information. 

• Should Congress require a discharge physical examination for all discharging 

servicemembers? At one time discharging servicemembers were required to 

undergo a complete physical examination at discharge. This examination provided a coda to military service by providing a snapshot at the point of discharge of the servicemembers physical and mental condition. It also complimented the entrance examination and provided VA with information that 

documented changes, whether acute or chronic, new or old, at discharge. We 

believe it is an extremely useful tool which should be required of all. 

• A literal reading of the question suggests the possibility of requiring BDD and 

Quick Start claims from all servicemembers at discharge. We believe this to 

be overly broad and, frankly, unnecessary. Discharging members must be 


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thoroughly briefed on the various programs that may be available to them as 

they transition from active duty. However, not everyone leaves service with 

a chronic condition potentially entitling them to benefits. Such a requirement 

would be overly burdensome on VA and its associates and wasteful of scarce 

government resources. We would not endorse such a proposal. 

3. The Memo of Understanding (MOU) between VA and DoD largely permits 

only VA physicians to conduct the single exams. Is this a problem and if so, 

should more training be provided to DoD physicians so that they can conduct 

these exams more often? 

Response: We have insufficient information to respond substantively to this 

question. We do know that VA uses some QTC contracted physicians to conduct 

BDD and Quick Start exams. 

4. You testified that even when comprehensive physical exams are administered, there is not enough time or resources to complete them effectively. 

What might Congress do to resolve this issue? 

Response: We regularly receive reports from veterans that the examinations provided them were quick and, in the veterans lay opinion, not thorough. These reports 

come from both discharging servicemembers undergoing BDD/Quick Start exams 

and veterans undergoing exams at VA facilities. Of particular concern are psychiatric examinations which, by their very nature, rely heavily on a review of medical records, extensive interviews and testing, all of which take time. Examinations 

which experts in the field indicate should normally take 60–90 minutes are completed in 15–20 minutes. Unfortunately, simply reviewing examination reports does 

not provide any indication of the amount of time afforded servicemembers or veterans since the report invariably appears to be complete. 

We believe that a study of scheduling practices at military installations where 

BDD/Quick Start examinations are given would quickly indicate what the average 

examination time allotted is, together with outliers, by body system. We urge a 

study of scheduling of psychiatric examinations for compensation purposes, both 

original and claims for increase. Further, the study could include post examination 

surveys of those examined to better understand what went on during the examination. This should provide objective data so as to better inform VA and this Committee. 

5. GAO reported that VA has established only one measure for gauging the effectiveness of the BDD and Quick Start programs. However, it seems that 

VA has several means for measuring general disability claims. Do you agree 

additional quality measurements could assist VA in fully implementing the 

BDD and Quick Start programs. 

Response: Yes. 

6. Some Veteran Service Organizations express frustration by VA’s lack of efforts in collaborating with them in increasing utilization of BDD and Quick 

Start programs. Please expand upon the challenges faced by your organization in this regard? What can Congress do to increase the cooperation between VA and VSO’s with respect to the BDD and Quick Start programs? 

Response: Our testimony reflected our experiences with VA and DoD with regards to the BDD and Quick Start programs. The rank and file workers, even many 

VA supervisors on military bases, recognize that VSO’s can provide valuable assistance in educating and assisting discharging servicemembers. Once we are on a military base, VA staff and base officials quickly see the positive impact we have on 

the claims intake portion of the BDD/Quick Start programs. 

Where we have difficulty is getting on a military base in the first place. VA must 

negotiate for space and access with local DoD officials, individuals who are often distracted by the realities of housing and training servicemembers who are either preparing for deployment or returning from overseas. Their focus is on the war and the 

warriors who fight for our nation. It is our opinion that many within DoD do not 

adequately recognize that ensuring a quality transition from military service to civilian life is just as essential as recruiting, training and leading men and women 

in the defense of our nation. As a consequence, they look on VA, and by extension, 

VSO’s, with suspicion, thinking that our very presence will somehow distract them 

and their troops from their primary mission. 

As a consequence, VA often finds it difficult to obtain adequate space on a military base for its own workers. Since VA fails to include service organizations in its 

BDD/Quick Start expansion plans, it is no surprise that space for service officers 


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is not usually included in their planning. Once a VSO offers to place a service officer 

on a base to help, it must negotiate with both base officials and the VA. 

Please allow me to offer the following as an example of the problems we experience with military personnel when seeking entry to a base to help servicemembers. 

Several years ago we became concerned that Army personnel going through the 

DES program at Walter Reed were not adequately represented and, as a result, 

were receiving decisions which significantly under evaluated the chronic problems 

for which they had to leave service. We decided to place a highly qualified service 

officer at Walter Reed to assist interested Army personnel. We met with a dozen 

civilian and military officials at the base seeking a minimum amount of space in 

which to work. We were rebuffed at every turn. Even a meeting between high level 

VA officials, senior VSO executives representing the major VSO’s and DoD personnel at Walter Reed failed to produce positive results. As a consequence, soldiers 

at Walter Reed do not have the opportunity to consult a VFW service officer during 

the DES process. 

Interestingly, when we decided to shift our efforts to the Bethesda Naval Hospital, 

we were able to gain access and office space with minimal effort. As a consequence, 

our service officer has started helping Navy and Marine personnel with BDD and 

Quick Start claims. 

What we would like to see is DoD and VA actively include at least the major 

VSO’s in planning when BDD/Quick Start expansion is considered. VA should ask 

us if we are able to provide service officers at those military bases to which they 

are expanding. While we may not be able to place a service officer at every base 

where VA has a presence because of budget reasons, we would certainly appreciate 

the opportunity to participate. 

7. Are you aware of any unique challenges encountered by members of the National Guard and Reservists in gaining information about the Quick Start 

program and filing claims through this program? 

Response: We know that National Guard and Reservists returning from deployment are quickly returned to their communities and released from active duty. 

Therefore they are often unable to participate in TAP briefings and do not have the 

opportunity to participate in the BDD program because of the short time remaining 

on active duty. 

Much of VA’s outreach to servicemembers is focused on over 100 military installations. With Guard units scattered across the United States and Puerto Rico, it is 

a challenge for VA to find the resources to provide TAP style briefings and claims 

assistance to them. 

Many VSO’s conduct outreach to Guard and Reserve centers. Some of these visits 

are coordinated with VA. At other times we visit at the request of the Guard or Reserves. However, we are not aware of any program by VA to ensure that all returning Guard and Reserve personnel receive a timely TAP briefing along with assistance in completing claims. 

There is no doubt that this is problematic for VA. Outreach is performed by VA 

regional office staff, sometimes hundreds of miles distant from a Guard or Reserve 

center. Further, the service to be provided is two-fold: first, brief them on what benefits and services are available to them; then assist individuals with completing 

compensation claims. The first can be done in a matter of hours. Helping individuals 

file claims, if done right, will take much longer. 

At BDD sites, VFW service officers usually spend about an hour with each servicemember, helping them fill out the claim, pouring over service treatment records 

and ensuring that all chronic conditions related to service are claimed. It is much 

more difficult to provide this service to Guard and Reserve personnel because of the 

number of personnel filing all at once and their distance from VA and VSO personnel. 

We believe that VA could construct a plan for conducting systematic outreach and 

claims assistance to Guard and Reserve personnel who have been recently deactivated. VA should work with the VSO’s who work in their regional offices in order 

to coordinate activities. In this way it would be possible for a number of VA and 

VSO personnel to appear at a Guard or Reserve center and provide information and 

services to appropriate personnel. Once such a plan is developed, it could be tested 

in a number of states in order to determine the efficacy of the plan. Data could be 

gathered and a report provided your Committee. 

f 


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Committee on Veterans’ Affairs 

Subcommittee on Disability Assistance and Memorial Affairs 

Washington, DC. 

March 25, 2010 

Raymond C. Kelley 

National Legislative Director 

AMVETS 

4647 Forbes Boulevard 

Lanham MD, 20706 

Dear Mr. Kelley: 

Thank you for testifying at the House Committee on Veterans’ Affairs’ Subcommittee on Disability Assistance and Memorial Affairs’ oversight hearing on the 

‘‘Examination of the Benefits Delivery at Discharge and Quick Start Programs,’’ 

held on February 24, 2010. I would greatly appreciate if you would provide answers 

to the enclosed follow-up hearing questions by Monday, April 26, 2010. 

In an effort to reduce printing costs, the Committee on Veterans’ Affairs, in cooperation with the Joint Committee on Printing, is implementing some formatting 

changes for material for all full committee and subcommittee hearings. Therefore, 

it would be appreciated if you could provide your answers consecutively on letter 

size paper, single-spaced. In addition, please restate the question in its entirety before the answer. 

Due to the delay in receiving mail, please provide your responses to Ms. Megan 

Williams by fax at (202) 225–2034. If you have any questions, please call (202) 225– 

3608. 

Sincerely, 

John J. Hall 

Chairman 

Questions from the House Committee on Veteran’s Affairs 

Subcommittee on Disability Assistance and Memorial Affairs 

Oversight Hearing on ‘‘Examination of the Benefits Delivery at Discharge 

and Quick Start Programs’’ 

February 24, 2010 

1. How would it help VA if the Transition Assistance Program (TAP) 

briefings and BDD or Quick Start exams were mandatory for all decommissioning servicemembers? Do you believe VA has the resources needed for this expansion? 

It would help transitioning servicemembers if VA TAP briefings were mandatory. 

AMVETS doesn’t believe this will cause a resource issue, because VA is present at 

most TAP briefings but servicemembers don’t participate. Not all transitioning 

servicemembers leave service with a disability; therefore, AMVETS does not believe 

that BDD or Quick Start exams need to be mandatory. However, we would like to 

see the Disability Evaluation System (DES) program expand and become mandatory 

for all transitioning servicemembers. 

2. What can Congress do to assist VA and DoD in expanding TAP briefings and BDD or Quick Start exams to all discharged 

servicemembers? 

Congress should mandate that all transitioning servicemembers must attend VA 

TAP briefings. 

3. The Memorandum of Understanding (MOU) between VA and DoD 

largely permits only VA physicians to conduct the single exam. Is 

this a problem and if so, should more training be provided to DoD 

physicians so they can conduct these exams more often. 

The MOU between DoD and VA is a general agreement that allows local DoD facilities to enter into MOUs with local VA facilities. These local MOUs dictate who 

is responsible for what aspects of the single exams. The issues that arise are often 

ones of logistics. For instance: the MOU states VA will conduct the physicals and 

DoD will provide examination rooms. This seams benign enough; however, DoD may 

not understand what equipment will be needed for VA to conduct a thorough exam. 

A clearer explanation of what needs and expectations are for each location so there 


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is not a lack of resources. In cases where DoD will be conducting the exams, it is 

important that they provide a medical evaluation that is complete and in a format 

that is usable by VA. AMVETS suggests that VA design medical condition templates 

for DoD and civilian doctors to use to ensure all pertinent information is included 

so VA will not have to conduct a second exam because critical information is not 

included. 

4. You testified that even when comprehensive physical exams are administrated, there is not enough time or resources to complete them 

effectively. What might Congress do to resolve this issue? 

Again, AMVETS attributes this to vague MOUs between local DoD and VA facilities. AMVETS believes this is a problem that can be easily solved by the two agencies. If upon their recommendations it is believed that more funding for these programs is needed then Congress should appropriate sufficient funding. 

5. GAO reported that VA has established only one measure for measure 

for gauging the effectiveness of the BDD and Quick Start programs. 

However, it seems that VA has several means for measuring general 

disability claims. Do you agree additional quality measurements 

could assist VA in fully implementing the BDD and Quick Start programs? 

Yes, there needs to be a more emphasis on quality. AMVETS is working with 

other VSOs to construct a metric to more evenly evaluate effectiveness. 

6. Some Veterans Service Organizations (VSOs) express frustration by 

VA’s lack of efforts in collaborating with them in increasing utilization of BDD and Quick Start programs. Please expand upon the challenges faced by your organization in this regard? What can Congress 

do to increase the cooperation between VA and VSOs with respect 

to the BDD and Quick Start programs? 

This is more of a problem between DoD and the VSOs. For our service officers 

to assist servicemembers with a Quick Start of BDD claim they need access to them 

on military installations. This requires cooperation between the Commanders on 

each of the bases and the VSOs. 

7. Are you aware of any unique challenges encountered by members of 

the National Guard and reservists in gaining information about the 

Quick Start program and filing claims through this program? 

Time is the largest factor in all Guard and reserve transition issues. Most demobilizations take less than one week. It is impossible to conduct a complete physical 

for hundreds to thousands of returning servicemembers. The simple solution is to 

provide a VA briefing prior to Guard and reserve member’s exit exam. This will provide them with the knowledge to tell the medical professional conduction the evaluation every condition that started or got worse while on active duty. As long as the 

information is in their medical records and the veteran files for disability within one 

year they will have a very quick claims process. 

f 

Committee on Veterans’ Affairs 

Subcommittee on Disability Assistance and Memorial Affairs 

Washington, DC. 

March 25, 2010 

John L. Wilson 

Assistant National Legislative Director 

Disabled American Veteran 

807 Maine Avenue, NW 

Washington, DC 20024 

Dear Mr. Wilson: 

Thank you for testifying at the House Committee on Veterans’ Affairs’ Subcommittee on Disability Assistance and Memorial Affairs’ oversight hearing on the 

‘‘Examination of the Benefits Delivery at Discharge and Quick Start Programs,’’ 

held on February 24, 2010. I would greatly appreciate if you would provide answers 

to the enclosed follow-up hearing questions by Monday, April 26, 2010. 

In an effort to reduce printing costs, the Committee on Veterans’ Affairs, in cooperation with the Joint Committee on Printing, is implementing some formatting 

changes for material for all full committee and subcommittee hearings. Therefore, 

it would be appreciated if you could provide your answers consecutively on letter 


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size paper, single-spaced. In addition, please restate the question in its entirety before the answer. 

Due to the delay in receiving mail, please provide your responses to Ms. Megan 

Williams by fax at (202) 225–2034. If you have any questions, please call (202) 225– 

3608. 

Sincerely, 

John J. Hall 

Chairman 

Post-Hearing Questions For John Wilson, Assistant National 

Legislative Director of the Disabled American Veterans 

Following the February 24, 2010 Hearing of the United States House of 

Representatives, House Veterans’ Affairs, Subcommittee on Disability 

Assistance and Memorial Affairs 

1. How would it help VA if the Transition Assistance Program (TAP) briefings 

and BDD or Quick Start exams were mandatory for all decommissioning 

servicemembers? Do you believe VA has the resources needed for this expansion? 

Response: Mandatory TAP, Disability Transition Assistance Programs (DTAP) 

briefings and Benefits Delivery at Discharge (BDD) and Quick Start medical examinations would ensure all separating military personnel would be better informed as 

to the variety of benefits for which they qualify. Additionally, all medical evidence 

necessary to determine service connection for claimed disabilities would be readily 

available, which would expedite the claims adjudication process and facilitate placing any disability compensation that is due in the ‘‘hands’’ of the member shortly 

after transitioning into veterans status. 

Regarding the question of resources, if all decommissioning servicemembers were 

required to complete TAP/DTAP and BDD/Quick Start programs, the Department 

of Veterans Affairs (VA) would likely need additional resources to ensure the timely 

delivery of these services. 

2. What can Congress do to assist VA and Department of Defense (DoD) in expanding TAP briefings and BDD or Quick Start exams to all discharging 

servicemembers? 

Response: We recommend Congress provide sufficient funding, staffing and oversight for TAP/DTAP to ensure these services are available to support all routine discharges per year from each branch of service. 

We further recommend Congress provide sufficient funding to ensure that members of the National Guard and Reserve forces who are activated for 12 months or 

longer be afforded a period of active duty of five days, within 90 days of separation, 

in order to attend TAP and DTAP workshops. Additionally, Congress should require 

completion of a separation physical exam and attending TAP/DTAP as mandatory 

conditions for all separating military personnel to receive the DD Form 214, Certificate of Release or Discharge from Active Duty. 

3. The Memo of Understanding (MOU) between VA and DoD largely permits 

only VA physicians to conduct the single exams. Is this a problem and if so, 

should more training be provided to DoD physicians so they can conduct the 

exams more often? 

Response: The DoD’s role in providing separation physical exams was modified 

because of previous instances where DoD improperly applied disability standards 

specified in the VA Schedule for Rating Disabilities and also because transitioning 

personnel who file disability claims with the VA were subject to duplicative physical 

exams in order to meet requirements of both the DoD and VA. A study in 1994 of 

the Navy and Marine Corps’ mandated separation exams found that while they met 

the services’ needs for a separation physical, 75 percent of the exams’ findings were 

insufficient for the purpose of disability ratings. Often the diagnosis or findings 

were not in line with the requirements of the VA rating schedule. 

Maximizing the use of available physician resources whether from DoD, VA or 

others provides the greatest flexibility to ensure that transitioning personnel obtain 

this critical medical exam. To maximize their use, duplicative exams can be eliminated by DoD and VA establishing the use of medical examination templates, as is 

currently being done in certain VA pilots, to ensure that all examinations are adeVerDate Nov 24 2008 23:55 Jul 26, 2010 Jkt 055231 PO 00000 Frm 00070 Fmt 6621 Sfmt 6621 I:\WAYS\OUT\55231.XXX GPO1 PsN: 55231

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quate for rating purposes regardless of source. It seems prudent to further clarify 

MOU procedures accordingly. 

4. You testified that even when comprehensive physical exams are administered, there is not enough time or resources to complete them effectively. 

What might Congress do to resolve this issue? 

Response: DAV recommends Congress provide the DoD and VA the necessary resources to ensure all transitioning military personnel applying for disability compensation receive separation physicals, whether active duty, mobilized Reserve or 

Guard forces. We further recommend Congress provide sufficient funding to ensure 

that members of the National Guard and Reserve forces who are activated for 12 

months or longer be afforded a period of active duty of five days, within 90 days 

of separation, in order to attend TAP and DTAP workshops. 

5. GAO reported that VA has established only one measure for gauging the effectiveness of the BDD and Quick Start programs. However, it seems that 

VA has several means for measuring general disability claims. Do you agree 

additional quality measurements could assist VA in fully implementing the 

BDD and Quick Start programs? 

Response: The inclusion of additional quality measures could provide the VA 

with information that would further enhance the effectiveness of this important program. For example, monitoring all actions taken from the date VA receives a claim, 

as opposed to the current practice of monitoring all actions taken from the date of 

receipt of the DD Form 214, may provide both DoD and VA with important information that resolves other process problems that are not presently apparent. 

The VA/DoD Joint Executive Council has only a general focus on this area. Its 

objective as found in its Strategic Plan for FY 2009 to 2011 is ‘‘to improve participation in the BDD program nationwide and ensure servicemembers are afforded the 

single cooperative examinations where available.’’ The plan to streamline benefits 

application processes, eliminate duplicative requirements and correct various business practices that complicate the process will prove more useful however when 

there are measureable outcomes. Congressional oversight of the success of this strategic plan is also recommended. 

6. Some Veteran Service Organizations (VSOs) express frustration by VA’s lack 

of efforts in collaborating with them in increasing utilization of BDD and 

Quick Start programs. Please expand upon the challenges faced by your organization in this regard. What can Congress do to increase the cooperation 

between VA and VSOs with respect to the BDD and Quick Start programs? 

Response: VSOs at a number of military installations were given access to provide free assistance to military personnel in various stages of preparation for separation from military services. In 1998, for example, VSOs at the national, state and 

county level were acknowledged as playing an important role with VAROs in VBA 

predischarge claims development, examinations and rating decisions (VA Circular 

20–98–2, Change 1 dated January 25, 1999). VSOs were encouraged to participate 

with VAROs and to be made an integral part of the planning and execution of these 

programs. VSOs were authorized to conduct TAP and DTAP briefings, consult with 

personnel on VA benefits, and conduct reviews of service treatment records in order 

to advise claimants and to assist them in preparing benefit applications. In Appendix A, section 10 of this same circular VSOs were identified as partners and ‘‘full 

integration of the veterans’ service organizations is important for the support of the 

pre-discharge examination and claims adjudication process.’’ 

Today, VSOs’ access to military installations varies, with some simply not allowing VSOs access. Congressional action directing VSOs’ access to conduct TAP and 

DTAP briefings, consult with personnel on VA benefits, and conduct reviews of service treatment records in order to advise claimants and to assist them in preparing 

benefit applications is critical. If VSOs are incorporated as full partners in this area, 

we could provide transitioning military personnel a critical adjunct to existing programs and could offer constructive comments to DoD and VA on delivery of services 

to ensure best practices are adopted and less constructive initiatives discarded. 

7. Are you aware of any unique challenges encountered by members of the National Guard and Reservists in gaining information about the Quick Start 

program and filing claims through this program? 

Response: A unique challenge that National Guard and Reserve personnel often 

face is their rapid demobilization from active duty status which may preclude their 

being fully informed about benefits potentially available to them. Additionally, since 


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separation physical exams are not mandatory, this may later impact their eligibility 

for disability compensation for service-connected conditions. 

f 

Committee on Veterans’ Affairs 

Subcommittee on Disability Assistance and Memorial Affairs 

Washington, DC. 

March 25, 2010 

Diana Rubens 

Associate Deputy Under Secretary for Field Operations 

Veterans Benefits Administration 

U.S. Department of Veterans Affairs 

810 Vermont Ave., NW 

Washington, DC 20420 

Dear Ms. Rubens: 

Thank you for testifying at the House Committee on Veterans’ Affairs’ Subcommittee on Disability Assistance and Memorial Affairs’ oversight hearing on the 

‘‘Examination of the Benefits Delivery at Discharge and Quick Start Programs,’’ 

held on February 24, 2010. I would greatly appreciate if you would provide answers 

to the enclosed follow-up hearing questions by Monday, April 26, 2010. 

In an effort to reduce printing costs, the Committee on Veterans’ Affairs, in cooperation with the Joint Committee on Printing, is implementing some formatting 

changes for material for all full committee and subcommittee hearings. Therefore, 

it would be appreciated if you could provide your answers consecutively on letter 

size paper, single-spaced. In addition, please restate the question in its entirety before the answer. 

Due to the delay in receiving mail, please provide your responses to Ms. Megan 

Williams by fax at (202) 225–2034. If you have any questions, please call (202) 225– 

3608. 

Sincerely, 

John J. Hall 

Chairman 

Questions for the Record 

House Committee on Veterans’ Affairs 

Subcommittee on Disability Assistance and Memorial Affairs 

Hearing on Examination of the U.S. Department of Veterans Affairs 

Benefits Delivery at Discharge and Quick Start Programs 

February 24, 2010 

Question 1: What percentage of VA’s current inventory of disability claims includes first-time claims from Servicemembers returning from Iraq and Afghanistan? 

Response: As of March 31, 2010, the 15,932 initial claims submitted by 

Servicemembers returning from Iraq and Afghanistan represent 3.2 percent of VA’s 

inventory of 493,732 disability compensation claims. 

Question 2: Would it help VA if the Transition Assistance Program (TAP) briefings and BDD or Quick Start exams were mandatory for all decommissioning 

servicemembers, and if so, how? If VA favors this expansion, does VA have the resources needed to achieve this objective? What can Congress do to assist you in expanding TAP briefings and BDD or Quick Start exams to all discharging 

servicemembers? 

Response: Mandatory TAP briefings would significantly help support VA’s mission. TAP briefings provide VA the opportunity to promote the BDD and Quick 

Start programs and provide information about Veterans’ benefits and services. If all 

separating Servicemembers were required to attend TAP briefings, VA would need 

additional resources to reach all Servicemembers, particularly those separating from 

remote locations. VA is working to develop innovative ways of delivering TAP briefings for Servicemembers in situations and locations where briefings are difficult to 

conduct, including those separating from naval vessels while on deployment, remote 

locations, Guard and Reserve units returning from theater, and Servicemembers 

serving in small detachments such as embassy guard personnel and recruiters. 


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VA supports mandatory separation physicals for all separating, deactivating reserve component personnel and all retirees. Examinations adequate for use in the 

claims process are conducted to VA standards for Veterans who participate in BDD, 

Quick Start, the Joint DoD/VA Disability Evaluation System Pilot, and for those 

Veterans who file a claim within a year of separation from service. This represents 

approximately one half of all initial claims VA receives. The remainder of the claims 

are received from Veterans many years post service. Mandatory separation 

physicals need not be as extensive as an examination for a compensation claim, but 

they would serve critical needs that are currently not being met. Those needs include the following: 1. The examination results, if automated, would aid in predicting future claim activity and would materially aid in VA’s efforts to project future requirements in a manner similar to Social Security; and 2. The examination 

results would provide a critical baseline of the state of a Servicemember’s health at 

time of separation that could document his/her state of hearing and vision, and determine whether isolated reports of treatment for routine medical events, such as 

strains, have resolved or continue to have residuals that justify an award of service 

connection. 

Question 3: Despite the Memo of Understanding (MOU) between the VA and 

DoD, many units are still failing to execute a single physical exam that will meet 

both the VA and DoD’s standards. How can we help local units to get a single examination process established? Can this problem be solved simply through education 

and training, or should the policy be fundamentally changed? 

Response: The existing MOUs regarding single examinations do not mandate 

separation physicals for all separating Servicemembers. Rather, they are an agreement as to the standard to which examinations will be conducted (and by whom) 

when they are needed for a specific purpose such as a disability claim or a retirement physical. The policy should be fundamentally changed. Mandatory separation 

physicals for all Servicemembers leaving a period of active duty should be instituted 

for those individuals who do not file a claim for disability benefits prior to separation. It must be recognized that this core baseline reading is a foundational piece 

to any future disability decision rendered on a Veteran who chooses to file a disability claim many years after service. 

Question 4: How does the effectiveness of these programs suffer through having 

MOUs with DoD that largely permit only VA physicians to conduct the single 

exams? If this is a problem, should more training be provided to DoD physicians 

so that they can conduct these exams more often? 

Response: The memorandum of agreement between VA and DoD does not specify 

that the examination must be conducted by a VA physician, only that the examination be conducted in accordance with VA examination protocols. In this period of 

conflict, it is not surprising that DoD, with its own clinical staffing challenges, believes that its primary focus must be on forward-deployed health and health maintenance of the force. Locally, individual VA regional offices, VA medical centers and 

military treatment facilities (MTFs) will sign a memorandum of understanding, defining each agency’s responsibilities. Responsibility for completing the exam (or aspects of the exam) is based largely on the availability of each agency’s resources at 

or near the location. 

If DoD physicians are available at MTFs, training in many cases is provided 

through VHA’s examiner testing protocol to enable DoD clinicians to conduct examinations in accordance with VA’s examination protocols. 

Question 5: The Government Accountability Office (GAO) testified that VA has 

established only one measure for gauging the effectiveness of the BDD and Quick 

Start programs. However, it seems that VA has several means for measuring general disability claims including: (a) how much time a veteran has to wait for a final 

decision, (b) average days to complete all work to reach a final decision, and (c) percentage of claims with no processing errors. I understand that if VA performed 

these surveys, such as tracking total time to develop a claim, the results may suggest that VA has more work to do to achieve its goals. However, can’t these additional performance measurements assist VA in fully implementing the BDD and 

Quick Start programs? 

Response: The effectiveness of the BDD and Quick Start programs is generally 

gauged utilizing the same measurements applied to all other disability claims. 

These measurements include ‘‘average days to complete’’ (average days to complete 

all work) and ‘‘average days pending’’ (average age of the currently pending workload). VA conducts the same quality assurance reviews for the sites that process 

BDD and Quick Start claims as are used for other regional offices. 


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BDD claims present unique issues with regard to measuring ‘‘average days to 

process’’ and ‘‘average days pending’’ in that there are significant differences when 

compared to normal Veterans claims processing. If VA were to measure from the 

date the Servicemember filed his/her claim, both of these measures would be meaningless since they would be controlled by: (a) when the Servicemember filed his/her 

claim in relation to his/her expected separation date; and (b) the fact that VA cannot 

influence this time since VA has no legal authority to finalize the decision and make 

payment until the member separates. Thus, we believe that the true measure of the 

success and effectiveness of the pre-discharge programs is the time delay between 

separation and notification of entitlement. 

Question 6: Veterans Service Organizations (VSOs) suggest they can play a critical role in improving the implementation of BBD and Quick Start programs. What 

can we do to increase your cooperation with VSO’s in this regard? What challenges 

might you face in forging this cooperation? 

Response: At the Transition Assistance Program briefings, VA advises 

Servicemembers about the opportunity to be represented by a VSO. There is no inherent legal or VA-imposed process limitation in the ability of service organizations 

to represent Servicemembers in the VA claims process while they are still on active 

duty. In fact, partnerships exist with various organizations, including state Departments of Veterans’ Affairs, at some BDD sites. We are aware, however, that service 

organizations sometimes have difficulty obtaining office space on military installations due to the widespread space scarcity on most installations following consolidation of facilities through the BRAC activities. 

Question 7: What unique challenges does VA encounter with educating members 

of the National Guard and Reservists about the BDD and Quick Start programs, 

and processing the Quick Start claims? How many Quick Start claims do you process each year? How many do you complete annually? 

Response: Normally, deployed members of the reserve components cannot participate in the BDD program because of the extremely brief period of time that they 

have on active duty following return from theater. VA often receives limited notice 

of the demobilization events and has limited time to interact with the 

Servicemembers. 

When VA reaches Servicemembers at the demobilization events, there is insufficient time to conduct medical examinations and gather evidence while on active 

duty. VA accepts Quick Start claims at demobilization events, but locating and obtaining service treatment records from individual units can be time consuming. Frequently there is a delay, sometimes significant, in associating in-theater treatment 

records with their medical jacket. VA completed 16,162 Quick Start claims during 

FY08, and 22,021 Quick Start claims during FY09. This fiscal year 11,712 Quick 

Start claims have been completed through the end of March. We do not have a report that identifies which of those claims was from reserve component 

Servicemembers. 

Question 8: What can this Committee do to assist VA in addressing any technical 

or training issues related to the BDD and Quick Start programs? Will the 4,000 additional disability raters requested in the Administration’s FY11 budget make any 

impact in the ability to expand the BDD and Quick Start programs? 

Response: VA requests the House Committee on Veterans’ Affairs maintain its 

current level of support to ensure the continuing success of the BDD and Quick 

Start programs. The additional staffing in VA’s 2011 budget submission are primarily focused on addressing the increasing demand for services as represented by 

the unprecedented claim rate, including claims received through the BDD and Quick 

Start programs. VA continues to seek opportunities to reach out and assist separating Servicemembers while they are on active duty and is committed to supporting 

the smooth transition from military to civilian life. 

Æ 


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