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DEFINED EXPECTATIONS: EVALUATING VA’S PERFORMANCE IN THE SERVICEMEMBER TRANSITION PROCESS 

HEARING 

BEFORE THE

SUBCOMMITTEE ON DISABILITY 

ASSISTANCE AND MEMORIAL AFFAIRS 

OF THE

COMMITTEE ON VETERANS’ AFFAIRS 

U.S. HOUSE OF REPRESENTATIVES 

ONE HUNDRED THIRTEENTH CONGRESS 

SECOND SESSION 

THURSDAY, MAY 29, 2014 

Serial No. 113–71 

Printed for the use of the Committee on Veterans’ Affairs 

( 

Available via the World Wide Web: http://www.fdsys.gov 


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COMMITTEE ON VETERANS’ AFFAIRS 

JEFF MILLER, Florida, Chairman 

DOUG LAMBORN, Colorado 

GUS M. BILIRAKIS, Florida, Vice-Chairman 

DAVID P. ROE, Tennessee 

BILL FLORES, Texas 

JEFF DENHAM, California 

JON RUNYAN, New Jersey 

DAN BENISHEK, Michigan 

TIM HUELSKAMP, Kansas 

MIKE COFFMAN, Colorado 

BRAD R. WENSTRUP, Ohio 

PAUL COOK, California 

JACKIE WALORSKI, Indiana 

DAVID JOLLY, Florida 

MICHAEL H. MICHAUD, Maine, Ranking 

Minority Member 

CORRINE BROWN, Florida 

MARK TAKANO, California 

JULIA BROWNLEY, California 

DINA TITUS, Nevada 

ANN KIRKPATRICK, Arizona 

RAUL RUIZ, California 

GLORIA NEGRETE MCLEOD, California 

ANN M. KUSTER, New Hampshire 

BETO O’ROURKE, Texas 

TIMOTHY J. WALZ, Minnesota 

JON TOWERS, Staff Director 

NANCY DOLAN, Democratic Staff Director 

SUBCOMMITTEE ON DISABILITY ASSISTANCE AND MEMORIAL 

AFFAIRS 

JON RUNYAN, New Jersey, Chairman 

DOUG LAMBORN, Colorado 

GUS BILIRAKIS, Florida 

MARK AMODEI, Nevada 

PAUL COOK, California 

DAVID JOLLY, Florida 

DINA TITUS, Nevada, Ranking Member 

BETO O’ROURKE, Texas 

RAUL RUIZ, California 

GLORIA NEGRETE MCLEOD, 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 

Thursday, May 29, 2014 

Page 

Defined Expectations: Evaluating VA’s Performance in the Servicemember 

Transition Process ................................................................................................ 1 

OPENING STATEMENTS 

Hon. Jon Runyan, Chairman .................................................................................. 1 

Hon. Dina Titus, Ranking Member ........................................................................ 3 

Prepared Statement ......................................................................................... 41 

Hon. Jeff Miller, Chairman of the Full Committee .............................................. 5 

WITNESSES 

Ms. Nancy E. Weaver, Deputy Assistant Secretary of Defense, Warrior Care 

Policy DoD ............................................................................................................ 7 

Prepared Statement ......................................................................................... 42 

Accompanied by: 

Mr. Dave Bowen, Director of Health Information Technology, Defense 

Health Agency DoD 

Ms. Diana Rubens, Deputy Under Secretary for Field Operations, Veterans 

Benefits Administration, U.S. Department of Veterans’ Affairs ...................... 8 

Prepared Statement ......................................................................................... 47 

Accompanied by: 

Thomas Murphy, Director of Compensation Service, VBA, U.S. Department of Veterans’ Affairs 

Ms. Linda A. Halliday, Assistant Inspector General for Audits and Evaluations, Office of Inspector General, U.S. Department of Veterans Affairs ........ 19 

Prepared Statement ......................................................................................... 50 

Accompanied by: 

Ms. Nora Stokes, Director, Bay Pines Benefits Inspection Division, 

OIG, U.S. Department of Veterans’ Affairs 

And 

Mr. Ramon Figueroa, Project Manager, Bay Pines Benefits Inspection 

Division, Office of Inspector General, U.S. Department of Veterans’ Affairs 

Mr. Eric Jenkins, Rating Veterans Service Representative, Winston Salem 

Regional Office, American Federation of Government Employees, AFL-CIO 

and the AFGE National VA Council .................................................................. 27 

Prepared Statement ......................................................................................... 61 

Ms. Debra J. Gipson, Individual Servicemember .................................................. 29 

Prepared Statement ......................................................................................... 66 

Mr. Gerardo Avila, National MEB/PEB Representative, The American Legion 31 

Prepared Statement ......................................................................................... 68 

Mr. Paul Raymond Varela, Assistant National Legislative Director, DAV ........ 32 

Prepared Statement ......................................................................................... 73 

Mr. Brendon Gehrke, Senior Legislative Associate, Veterans of Foreign Wars 

of the United States ............................................................................................. 34 

Prepared Statement ......................................................................................... 83 


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DEFINED EXPECTATIONS: EVALUATING VA’S 

PERFORMANCE IN THE SERVICEMEMBER 

TRANSITION PROCESS 

Thursday, May 29, 2014 

U.S. HOUSE OF REPRESENTATIVES

COMMITTEE ON VETERANS’ AFFAIRS

SUBCOMMITTEE ON DISABILITY ASSISTANCE AND MEMORIAL

AFFAIRS

Washington, D.C. 

The subcommittee met, pursuant to notice, at 2:35 p.m., in Room 

334, Cannon House Office Building, Hon. Jon Runyan [chairman of 

the subcommittee] presiding. 

Present: Representatives Runyan, Bilirakis, Cook, Jolly Titus, 

and O’Rourke. 

Also Present: Representative Miller. 

OPENING STATEMENT OF CHAIRMAN JON RUNYAN 

Mr. RUNYAN. Good afternoon and welcome, everyone. The oversight hearing of the Subcommittee on Disability Assistance and 

Memorial Affairs will now come to order. 

Today’s hearing will focus upon VA’s role in the transition from 

servicemember to veteran with a particular focus on the Integrated 

Disability Evaluation System commonly known as IDES, as well as 

the Benefits Delivery at Discharge and Quick Start programs. 

We will seek information on VA resources and production as well 

as timeliness and quality of VA’s components in the process. 

Further, I would like to hear today about the quality of communication both within transitioning members as well as between the 

Department of Defense and the Department of Veterans Affairs in 

this process. 

First to address IDES, while I understand that time lines are improving, we want to start off by making it clear that while this continuing improvement matters, I am frequently contacted by 

servicemembers who are frustrated with the process. They do not 

know how long it is going to take, when they will get answers, and 

they do not know when they can make plans for their future. 

I understand that the DoD reports quite high satisfaction from 

servicemembers undergoing IDES, but it does not reflect the stories 

that have recently been shared with me. 

I have also gotten the sense that the IDES process may not be 

a top priority to VA because VA has chosen to place what seems 

to be a fairly exclusive focus on eliminating the backlog of claims 

to the detriment of these transitioning servicemembers. 


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So let’s begin the understanding that if this belief exists at VA, 

it is not okay. These transitioning servicemembers have served in 

recent years during a decade plus of wars in Iraq and Afghanistan 

and with multiple deployments and many with service-connected 

injuries that prevent their continued military service. 

Here I have correspondence from the past couple of months received from soldiers who are awaiting the start of their post military lives. 

One soldier frustrated with his inability to plan for the future 

wrote, and I quote, ‘‘It has been four years since I have shared a 

Christmas with my family. It would mean the world if I could finally spend Christmas with them this year. I have gone through 

the MEB board processes and am currently awaiting ratings,’’ end 

quote. 

Another reads, quote, ‘‘I have been awaiting my rating for a long 

time now. I have also been trying to contact my VA reps and the 

only way I can talk to them is if I go down to their office. I call 

and call and leave messages and emails but never get anything 

back unless I am in their office. This entire waiting game has been 

putting a very big strain on my family and I have been trying to 

convince my family that it is going to come any day now. Well, it 

hasn’t and now my wife wants to get a divorce. I do not know what 

I would do without my two daughters and my wife. If there is anything you can do to help me out or get me some information, that 

would be great,’’ end quote. 

And another infantryman wrote, quote, ‘‘I am losing my mind 

trying to find out why it is taking my rating so long to come back 

from the VA. I honestly wouldn’t reach out if it weren’t very important, but I have been under so much stress lately that my blood 

pressure has shot through the roof. My whole MEB board process 

has been putting me through hell more so than my trip to Afghanistan in 2009. If there is anything you could do to assist me in figuring out what is taking the VA so long to rate me and possibly 

expedite the process, I would forever be grateful,’’ end quote. 

These pleas are for assistance and disgusting, and we must do 

better. 

Today’s hearing is entitled Defined Expectations: Evaluating the 

VA’s Performance in Servicemember Transition Process. And if 

nothing else, I want that to be the takeaway, defined expectations. 

These men and women have served honorably during a very difficult time in the military. At the very least, they deserve an open 

line of communication and deserve reasonable, defined expectations 

as their time lines, their futures, their transition to the civilian 

world, more must be done to define expectations. 

In addition to the IDES updates at the forefront of today’s hearing, we will also seek information on the process including the uses 

of brokering as well as time lines and accuracy of the Benefits to 

Delivery at Discharge and Quick Start programs. We will hear 

about the VA’s anticipated new pre-discharge program which may 

consolidate the existing BDD and Quick Start programs. 

I look forward to hearing from today’s witnesses. And with that, 

I will begin introductions. 

Seated at the witness table, we have all members from the first 

panel. From the Department of Defense, we have Ms. Nancy 


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Weaver, deputy assistant secretary of Defense, Warrior Care Policy, who is accompanied by Mr. Dave Bowen, Director of Health Information Technology, Defense Health Agency. 

And from the Department of Veterans Affairs, we have Ms. 

Diana Rubens, deputy under secretary for Field Operations with 

the Veterans Benefits Administration, who is accompanied by Mr. 

Thomas Murphy, Director of Compensation Services. 

Upon conclusion of the first panel, we will see two subsequent 

panels which include for panel two Ms. Linda Halliday, the assistant inspector general for Audits and Evaluations for the Office of 

Inspector General, U.S. Department of Veterans Affairs, accompanied by Ms. Nora Stokes, director of the Bay Pines Benefits Inspection Division, and Mr. Ramon Figueroa, project manager with 

the Bay Pines Benefits Inspection Division. 

Panel three will consist of Mr. Eric Jenkins who is here in representation of the American Federation of Government Employees, 

AFL–CIO, and the AFGE National VA Council. 

Ms. Debra Gipson is here today and is an individual member and 

she will be introduced shortly by Congressman O’Rourke. 

Mr. Gerardo Avila, national MEB/PEB representative with The 

American Legion; and Mr. Paul Varela, assistant national legislative director with Disabled American Veterans; and Mr. Brendon 

Gehrke, senior legislative associate with the Veterans of Foreign 

Wars of the United States. 

One final point, all of the named witnesses are present. I must 

advise that pursuant to Title 18, United States Code Section 1001 

known as the False Statement Act, this is a crime to knowingly 

give false statements in federal jurisdiction including a congressional hearing. 

With that acknowledgment, I thank you all for being with us 

today. 

I now yield to the ranking member, Ms. Titus, for her opening 

statement. 

OPENING STATEMENT OF DINA TITUS, RANKING MINORITY 

MEMBER 

Ms. TITUS. Thank you, Mr. Chairman. Thank you for holding this 

hearing today. 

Thank all of you for coming to provide us with some needed information. 

As you heard the chairman describe today, we are going to look 

into the performance of programs that VA and DoD utilize for determining fit for duty status for ill or injured servicemembers, as 

well as programs that are designed to expedite the adjudication of 

claims submitted by separating servicemembers. 

Particularly we are going to focus on the Integrated Disability 

Evaluation System, IDES, the Benefits Delivery at Discharge program, BDD, and the Quick Start program. All of these programs 

have now been up and running for a number of years. 

IDES was initiated in 2007 as a follow-up to the poor conditions 

and fragmented care that were exposed at Walter Reed Army Hospital. 

BDD was launched back in 1995 as a pilot program and then became fully operational in 1998. The intent of BDD was to assist 


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disabled servicemembers in making a seamless and successful transition to civilian life by allowing them to get their claims completed 

as early as possible while they have all their medical information 

readily available. 

Quick Start was launched in 2008 and it is similar in nature to 

BDD. And it was established to provide an expedited disabilities 

benefit process to servicemembers who are going to be discharged 

within 59 days. 

Now, despite having long been established and having enough 

time to get over growing pains and any other problems in the early 

stages, all of these programs continue to face challenges, are performing far below expectations. 

The one similarity that they seem to have is that they suffer 

from a continued poor performance in the adjudication of the 

claims in each of the three programs. 

Of particular interest to me is the number of claims under the 

BDD and Quick Start that has dropped off. There are many fewer 

claims now than there used to be and I am concerned that the reason for that is that servicemembers are choosing to bypass these 

programs that are designed to provide an expedited system over 

concerns that participation actually delays the process of receiving 

benefits. 

In fact, Quick Start has been known to be called Quick Start and 

slow finish as a result of that. 

So we have had highlighted for us by the VA’s OIG about eliminating the benefits backlog has kind of shifted priorities and come 

at the expense of other benefits and claims such as IDES and 

Quick Start which have been moved to the back burner, and that 

is unfortunate. 

You heard the chairman read some of the emails that we have 

been receiving. They all generally have the same ask. I am in the 

army. I am waiting for a decision. My family and I need to get on 

with our lives. 

Our staff has witnessed firsthand the poor culture that is often 

present at these IDES stations and wounded warrior battalions. 

I want to thank Ms. Gipson, who is an army veteran, who recently went through the process and came to be with us today to 

talk about some of the negative culture that is in these program 

and how we might address it. 

It is just a concern that these programs that are supposed to be 

so helpful really end up being harmful because they hold our 

servicemembers’ lives in bureaucratic limbo. 

An army reservist who enters IDES today won’t complete the 

program until August 17th, 2015. A hundred and eighty-one days 

of this 443 day period will be spent waiting for a VA rater to pick 

up the claim and provide him or her with a rating. Just to get a 

rating it takes that long. 

So as our servicemembers wait for a rating decision, they are 

forced to delay critical aspects of their transition. They and their 

spouses are hesitant to relocate, to buy a home, to enter a school 

program, to find a new job because they just don’t know what is 

going to happen to them. 

Now, we know that servicemembers face obstacles when they are 

transitioning out of the Armed Services. That is already difficult 


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enough. The VA should be an asset, not a hindrance to that process. 

So I think we need to take a hard look at the resources that we 

are dedicating to these programs and figure out how we can meet 

their goals today and not tomorrow. So we need to take a fresh look 

at these programs. 

We with the staff recently looked at this and found that 95 percent of servicemembers who enter the IDES program are found not 

to be fit to serve because of an illness or an injury, so they know 

they are going to be discharged, 95 percent. 

If we know that many are not going to go back into the service 

but are going to be discharged, shouldn’t we be taking a different 

approach offering them some flexibility, some options while they 

are making that transition? 

So I hope that those are the kind of things that we will look at 

today in this hearing and see if we can’t re-prioritize and shift 

some of our emphasis on being flexible and making this work as 

opposed to just having families sit around waiting for the rating. 

Thank you. I yield back. 

[THE PREPARED STATEMENT OF HON. DINA TITUS APPEARS IN THE

APPENDIX] 

Mr. RUNYAN. Thank the gentle lady. 

With that, I will recognize the chairman of the full committee, 

Mr. Miller, for a statement. 

OPENING STATEMENT OF HON. JEFF MILLER 

Mr. MILLER. Thank you very much, Mr. Chairman. I appreciate 

the indulgence. I want to make a few remarks on the 

servicemember transition process, particularly in regards to IDES. 

Currently the time line of IDES induction to receipt of benefits 

is targeted not to exceed 295 days, but recent DoD and VA reports 

place the average time line at over 350 days. That is an average, 

but that average means that there are many servicemembers that 

take much longer to complete. 

In an effort to address IDES inefficiencies, I recently introduced 

an amendment to the fiscal year 2015 National Defense Authorization Act that would do the following: 

First, it would require the use of a standardized form set which 

would be approved by both the secretaries of DoD and VA as was 

envisioned by the Dole-Shalala commissioners’ recommendations. 

Second, it would collocate certain DoD and VA personnel to allow 

for great interdepartmental collaboration and to reduce delays in 

transfers of information. 

Third, it would compel the usage of a bridging software solution 

between DoD’s MY IDES and VA’s ebenefits dashboards to allow 

servicemembers greater transparency as to where they are in the 

process at the current time. 

Finally, the amendment would establish a working group comprised of various personnel of DoD and VA as well as private industry leaders to reevaluate the program itself. 

The working group would then make recommendations on how to 

better serve those who are going through this process as well as 

how to better utilize the resources that are allocated. 


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I do want to take a moment to emphasize that the goals of my 

IDES amendment are twofold. First, increased transparency to the 

servicemembers and increased accountability for the respective departments. 

So I think everybody in this room is already aware the issues of 

transparency and accountability are of utmost importance, particularly as we continue to investigate the ongoing delays in accessing 

care at the VA healthcare facilities across this great Nation. 

Since the transition process, whether through IDES, BDD, Quick 

Start, or the traditional claims process, is a servicemember’s first 

exposure to the VA system, and we want to ensure that it is a positive experience for all who use it and those that it was designed 

to serve, those very people that have served our country. 

Mr. Chairman and to Members of the committee, thank you for 

your indulgence and I yield back my time. 

Mr. RUNYAN. Thank the gentleman. 

And now I want to recognize Mr. O’Rourke. I believe he has a 

statement, opening statement. 

Mr. O’ROURKE. Thank you, Mr. Chairman. 

I just wanted to actually introduce someone who is going to be 

on one of the later panels, Debra Gipson. I am sad to say, Mr. 

Chairman, a former constituent of mine, she just moved out of El 

Paso in March of this year. We are going to miss her. But prior to 

that, she was stationed at Fort Bliss, a former captain in the U.S. 

Army. 

And during her time as a commissioned officer, she served as the 

executive officer for the Warrior Transition Unit, Bravo Company 

at Fort Bliss, Texas. She was medically separated from service 

through the Integrated Disability Evaluation System or IDES. 

And she is here today again in a later panel to deliver a statement about her experience with IDES and offer recommendations 

to improve the system. 

And so, Mr. Chairman, I just wanted to be here to welcome her 

and introduce her to the rest of this committee. 

With that, I yield back. 

Mr. RUNYAN. Thank you. 

And I don’t believe any other Members have a statement. So at 

this time, I welcome our first panel. And your complete and written 

statements will be entered into the hearing record. 

And, Ms. Weaver, you are now recognized for five minutes. 


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STATEMENTS OF NANCY E. WEAVER, DEPUTY ASSISTANT SECRETARY OF DEFENSE, WARRIOR CARE POLICY, DEPARTMENT OF DEFENSE, ACCOMPANIED BY DAVE BOWEN, DIRECTOR OF HEALTH INFORMATION TECHNOLOGY, DEFENSE 

HEALTH AGENCY, DEPARTMENT OF DEFENSE; DIANA 

RUBENS, DEPUTY UNDER SECRETARY FOR FIELD OPERATIONS, VETERANS BENEFITS ADMINISTRATION, U.S. DEPARTMENT OF VETERANS AFFAIRS, ACCOMPANIED BY 

THOMAS MURPHY, DIRECTOR OF COMPENSATION SERVICE, 

VETERANS BENEFITS ADMINISTRATION, U.S. DEPARTMENT 

OF VETERANS AFFAIRS 

STATEMENT OF NANCY E. WEAVER 

Ms. WEAVER. Thank you. 

Chairman Runyan, Ranking Member Titus, and distinguished 

Members of the subcommittee, thank you for the opportunity to appear before you today to discuss the Integrated Disability Evaluation System, also known as IDES. 

Since 2007, the Departments of Defense and Veterans Affairs 

have collaborated to create an integrated and transparent disability evaluation system for servicemembers who have illnesses or 

injuries that may impede their ability to perform their military duties. 

Today IDES accounts for about 97 percent of all DoD disability 

evaluation cases. In IDES, servicemembers receive a set of disability examinations conducted according to VA protocols and disability ratings prepared by VA. 

Military departments determine fitness for duty and only compensate servicemembers for conditions that compromise their ability to perform their military duties. VA compensates for all conditions incurred or aggravated during military service. 

The advantages of IDES compared to Legacy systems include the 

elimination of duplicate medical exams, consistency between DoD 

and VA disability ratings, and reduce wait times for VA disability 

benefits since rating determinations are completed prior to 

servicemembers’ separation. These advantages have contributed to 

improved servicemember satisfaction within the IDES process. 

We are continuing to implement process enhancements such as 

improved policy, increased staffing levels, and new training requirements for caseworkers. These and other improvements have 

enabled us to achieve and remain below our IDES core processing 

goal of 105 days for the past several months. 

Information technology can also help us gain more efficiency 

within the IDES process. That is why we are working to develop 

a system that will support end-to-end case management, tracking, 

reporting, and a bidirectional electronic case file transfer. 

We will continue to work with VA to ensure system interface requirements are identified early. The Department of Defense is 

working diligently to support an integrated disability system that 

ensures servicemembers receive timely and transparent compensation for injuries or illnesses incurred by the line of duty today, tomorrow, and in the future. 

Thank you, and we look forward to your questions. 


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[The prepared statement of Nancy E. Weaver appears in the Appendix] 

Mr. RUNYAN. Thank you, Ms. Weaver. 

And now next we will hear from Ms. Rubens. Ms. Rubens, you 

are now recognized for five minutes. 

STATEMENT OF DIANA RUBENS 

Ms. RUBENS. Good afternoon, Chairman Runyan, Ranking Member Titus, Members of the subcommittee. 

My testimony today will focus on the status of the Integrated 

Disability Evaluation System or IDES, Benefits Delivery at Discharge, BDD, and the Quick Start programs. 

With respect to IDES, VA and DoD’s joint efforts over the past 

six years have resulted in changes and improvements in our disability evaluation system. Together the departments have created 

an integrated process for servicemembers who are being medically 

retired or separated. 

This joint process was designed to eliminate the duplicative, 

time-consuming elements of the separating disability determination 

processes within VA and DoD. 

The goals of our integration were to provide a seamless transition of benefits and healthcare for separating servicemembers 

through IDES. As a result of our collaborative efforts, we have 

worked to achieve these goals. 

Currently there are approximately 29,000 servicemembers. For 

the four combined core steps, VA average processing time in April 

2014 was 183 days, the lowest core time since April of 2013. Our 

target for those combined core steps is 100 days of that 295 day 

combined VA/DoD target. 

In an effort to continue to improve, we created a plan to improve 

IDES timeliness that involved a phased approach. The first phase 

of that plan was to meet benefit notification timeliness standards 

by March of 2014 which we have done. 

This portion of the IDES process is focused on ensuring 

servicemembers who are transitioning into the civilian world as 

veterans receive timely benefits to which they are entitled. 

The second phase of the plan is to meet the timeliness standards 

for the proposed ratings by October of 2014. We are on track to 

meet that goal and will do. 

Our continued partnership with DoD is critical. VA and DoD are 

committed to supporting our Nation’s wounded, ill, and injured 

servicemembers through the IDES process. 

The BDD and Quick Start programs are important elements of 

VBA’s strategy to provide transitional assistance to separating or 

retiring servicemembers and engage those servicemembers in the 

disability claims process prior to discharge. 

VBA’s goal is to ensure that each servicemember separating from 

active duty who wishes to file a claim with VA for service-connected disability benefits will receive assistance to do so. 

Participation in the BDD program is available to servicemembers 

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

are able to report for a VA exam prior to discharge. 


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Quick Start made pre-discharge claim processing available to 100 

percent of transitioning servicemembers including those who are 

within 59 days of separation. 

Like many of our regular non-pre-discharge claims work, VBA 

has made tremendous progress in the past 12 to 15 months, but 

we recognize we have work left to do. 

As of April of 2014, the average days pending for our Quick Start 

claims is 98.3 days, an improvement of 137 days since May of 2012. 

As of April of 2014, the average days pending for our BDD claims 

is 136 days, an improvement of 55 days since April of 2013. 

Claims accuracy is a key element of VBA’s transformation plan 

overall, and we continue to improve in that arena as well, but currently it is not measured specifically for our BDD or Quick Start 

claims process at the three rating activity sites. 

Instead, the accuracy is measured for each regional office as a 

whole including the BDD and Quick Start claims that we are processing. 

As of April of 2014, our three regional offices processing BDD 

and Quick Start claims and their rating activities have threemonth, issued-based quality between 96 and 98 percent. 

VBA is now working to redesign the pre-discharge claim process 

by building on lessons through the execution of our BDD and Quick 

Start programs. The new pre-discharge program will consolidate 

and replace the existing BDD and Quick Start programs. 

We will be leveraging functionality now available in our Veterans 

Benefits Management System and in our ebenefits system to add 

convenience to both the application process and efficiency throughout the claims process. 

VBA is committed to supporting our Nation’s servicemembers 

through improvements in our pre-discharge programs. We believe 

that the continued enhancements are critical to program success, 

nothing less than our servicemembers and future veterans deserve. 

That concludes my statement. I am happy to answer any questions you might have. 

[THE PREPARED STATEMENT OF DIANA RUBENS APPEARS IN THE

APPENDIX] 

Mr. RUNYAN. Thank you, Ms. Rubens. 

And I will begin a round of questioning alternating between 

Members at their arrival times. My first is for both the VA and the 

DoD. 

Ms. Weaver, you indicated throughout the process that DoD and 

VA caseworkers keep servicemembers informed of progress in their 

cases. While this streamlined communication may exist in isolated 

cases, we know from speaking to large groups and several examples in my opening statement that for servicemembers at numerous 

installations, this communication is simply not occurring as a matter of routine. 

How is this communication going to prove, and I would like both 

perspectives from both you at the DoD, Ms. Weaver, and Ms. 

Rubens at the VA? 

Ms. WEAVER. Thank you, sir. 

We have recently increased our manpower in the PEBLOs, and 

we find that we have also improved the training. We have minimal 


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training standards and required training for each of the PEBLOs, 

providing them more information. 

As far as keeping the individual aware at the beginning of the 

process, each member who is enrolled or referred to IDES is given 

a caseworker or a PEBLO. That individual interacts with the 

servicemember throughout all phases. 

At the beginning of the process, the member is told approximately how long the process would take and is updated as they 

move from phase to phase and keeps them aware of what they 

need to do. And they are encouraged to keep their family members 

updated or bring them in so that they are aware of what is going 

on through the process also. 

Mr. RUNYAN. Ms. Rubens. 

Ms. RUBENS. Our military services coordinators are located at 

the intake sites along with the DoD PEBLOs in an effort to ensure 

not only referred conditions that DoD is referring to the MEB/PEB 

process, but any claimed conditions that veteran wants to claim, 

our military services coordinators are there to help walk them 

through that application process and understand the process. 

They are also there, frankly, to serve, if you will, as a touch point 

or a reach back to our rating activity sites so that as that veteran 

has questions, we are capable of also getting back to that rating 

activity site to share information with that servicemember and/or 

their family. 

Mr. RUNYAN. I want to go back to Ms. Weaver. You said the 

interactions happen typically as they move from phase to phase. 

Are there huge gaps in timing of different phases, or are they 

pretty standard as they fall in a time line? Say there are three 

phases in the process. Does one take three-quarters of the year; the 

next one take a month typically? 

Ms. WEAVER. Each phase that they go through has a goal in the 

process. 

Mr. RUNYAN. Are the servicemembers made aware of the time 

line in the phase or just the overall process? 

Ms. WEAVER. They are told of the overall as well as each phase. 

And as they go through each phase, they can tell them where the 

next phase should be. 

However, we don’t have a case tracking system that will tell 

them where in the phase they are, if their claim is being adjudicated, and how long it is going to take before that is done or 

when the informal PEB is going to be completed and moved to the 

next one, next phase. 

Mr. RUNYAN. I have one last question, and I am going to go over 

a little bit. It is actually for Mr. Murphy. 

As accuracy is an overarching matter of importance, I would like 

to ask you a question about VBA’s quality component STAR. 

VBA’s STAR program has several classifications of error such as 

benefit entitlement decision documentation/notification and administrative. However, VBA’s national rating agency is based solely on 

benefit and entitlement error. 

My understanding is that STAR does not count errors, for instance, with potential to affect veterans’ benefits such as when a 

claims folder lacked required evidence including a medical examination or opinion needed to make an accurate decision. 


VACREP180 with DISTILLER
11 

Can you comment on any of that? 

Mr. MURPHY. I would say that that is not an accurate statement, 

that the absence of an examination when one was needed would be 

called a benefit entitlement error for us. So we do have the classifications of error that you just described, which is a benefit entitlement error. 

Part of that is that if there is something that should have been 

gained, evidence that should have been included in the file or reviewed that would have affected the outcome, that would require 

a benefit entitlement error to be called. 

Mr. RUNYAN. Okay. With that, I recognize Ms. Titus for her 

questions. 

Ms. TITUS. Thank you, Mr. Chairman. 

I would just ask Ms. Rubens if you have an explanation for why 

the number of people going into these programs has dropped off. 

Only a third of the transitioning servicemembers elect to use these 

programs do you think that if the VA made the same kind of investment that the Department of Defense made in personnel and 

also some of the made changes described by Ms. Weaver, would 

that help with the backlog? 

Ms. RUBENS. Certainly. I would tell you that I have heard particularly some of the concerns about the Quick Start not getting as 

many referrals as we anticipated. I would tell you that we know 

we had some challenges with timeliness. 

We made some dramatic changes to the resources that we provided to both the BDD and Quick Start processing in July of 2012 

in an effort to ensure that we closed on those performance, particularly around timeliness, numbers that we were seeing then. 

I reflected in my statement the improvements we have made, 

and we continue to look for those to be not only sustained but 

grown upon as we work to merge BDD and Quick Start from the 

standpoint of the expectation that servicemember transitioning, 

whether they have one to 59 days and perhaps not able to get to 

a VA exam prior to discharge or whether the 60–180–day mark and 

can, in fact, complete the exam process to ensure timely processing 

of those claims as they transition to civilian life. 

Ms. TITUS. The deadlines that you have, though, for meeting the 

goals keep getting pushed back, don’t they? Hadn’t one now been 

pushed back to October for meeting some of those time lines that 

were supposed to be met in August? 

Ms. RUBENS. Ma’am, the time lines that you are referring to, I 

believe, are for the IDES program versus the BDD and Quick 

Start. And we do look at those somewhat differently because of the 

nature of that servicemember and the IDES program being boarded 

out for disease or injury. 

From that standpoint, in August for the proposed ratings, we will 

close the inventory capacity that we need to. By October, we will 

hit our deadline for providing the proposed ratings. And we are all 

ready for the final notification to that servicemember. We are now 

meeting 30 days for that time period. 

Ms. TITUS. Okay. With an average of 48 days, I think, but—all 

right. I would like to ask you about the fact that 95 percent of the 

people in this program are going to be discharged. 


VACREP180 with DISTILLER
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Is there not some way to address that? We have heard a lot 

about segmented lanes and express lanes for other kinds of benefits. Is there not some way to look at some more flexibility there? 

If we know 95 percent are not going to go back into active duty, 

can’t we figure out some way to prioritize those cases and move 

them out faster? 

Ms. RUBENS. You know, ma’am, I think that particularly around 

the IDES program, it has been a joint process with DoD. We want 

to ensure that we are meeting the spirit and the intent, which is 

to move that along as quickly as possible. 

And I will turn to Ms. Weaver to correct me to a hundred percent, but I also think that there is the obligation of ensuring we 

have gotten them to the point where they are ready to be discharged and want to ensure that we work with DoD and the requirements that they have established for ensuring that 

servicemember is ready for transition. 

Ms. Weaver, I don’t know if you would add to that. 

Ms. WEAVER. We are working with VA to look at other opportunities and concepts to expedite the process. We do have an expedited 

process for catastrophically injured or ill personnel. 

To date, after briefing each member who was qualified, we have 

had no one who has opted to take that process, but we are looking 

to see if we can broaden that concept to those that aren’t catastrophically, but too seriously, and see if we can expedite it. These 

are in concept stages, and we are working with the VA on that. 

Ms. TITUS. Okay. Thank you, Mr. Chairman. 

Mr. RUNYAN. Thank the ranking member. 

With that, the chair recognizes Mr. Cook. 

Mr. COOK. Thank you, Mr. Chair. 

Just a couple of comments and probably the same ones I had 

when I was chair of the Veterans Committee and I was in California. And I look at it from the perspective of the veterans and 

the people that you are dealing with. 

You know, just going through this paper right now, we are looking at BDD, IDES, PEBLO, MSC, MEB, DBQs, CAVC, ADC. I 

know that one. That is assistant division commander. And I knew 

MEB. That’s marine expeditionary brigade. The PEBLO was the 

spy ship that was captured by the North Koreans. I thought it was 

BDA, which is battle damage assessment. NARSUM, DBQ, I could 

go on and on and on. 

You know, I think I know more about Klingon and that vocabulary than these acronyms, which just keep multiplying over and 

over. You use them all the time. I think I know most of them. I 

tried to forget most of them, you know, after 26 years in the marine corps, and then I got an education, and you learn all kinds of 

things. 

The point I am making is that trying to communicate with the 

people that you serve by using this foreign language, at least from 

my perspective, is very, very difficult. And a lot of people don’t get 

it, particularly the seniors. They have serious problems. 

Ms. Titus talked about that 95 percent. When I see 95 percent, 

I think that is something that we can make to streamline the process. We can do that. You know, airlines notify people when their 

plane is going to be late or what have you. 


VACREP180 with DISTILLER
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The technology now, and I tell you, I am probably the worst one 

to talk about technology because I am horrible at it. You know, 

thank God I am married. I have a wife who is very bright and I 

have grand kids who fix my computer. 

But a lot of people are just brain dead when it comes to technology, but you have to have a respect for some of these things that 

can streamline that and make the system more efficient. 

Now, it just upsets me that it takes so long. And I look at it, and 

this is a statement more than a question, that when World War II 

started, you know, where people had to enlist, go through the 

physicals, get trained, be on the front line almost, you know, so 

that we wouldn’t lose the war, they did it. And getting people in 

there, same thing with Korea and other times where you get people 

in and you can expedite the process. 

And now we have the system on the back end where people—I 

spent 26 years, lot of people spent a lot of years. It is a very, very 

cumbersome process that—and I think part of it is that it is very 

complex, at least, and I don’t think I am the dumbest person. In 

this group, maybe I am. 

But trying to understand all this stuff when you are going 

through it, I think we have got to at least make it more user 

friendly so that you can have that feedback easily and right now 

the process starting with the language is very, very cumbersome. 

Everybody that works, they have their comfort set of acronyms 

and vocabulary. The average person is too nice to say what does 

that mean or what is the impact on it. I am dumb, so I have to 

ask what the acronym is and give me an explanation. 

But the average veteran that comes in there that are used to— 

a lot of them are used to taking orders and what have you, they 

are relying on that gunnery sergeant, that staff sergeant, that master sergeant who they are vital. And then you come out of that and 

we are talking about a bureaucratic nightmare. 

So I understand what you are trying to do and I applaud it. I 

just want to throw my two cents into, hey, let’s get it down to 

where at least somebody like me could understand it and other veterans. I think you would have much more cooperation and they 

could understand what is going on. 

Thank you. I yield back. 

Mr. RUNYAN. Thank the gentleman. 

With that, the chair recognizes the gentleman from Texas, Mr. 

O’Rourke. 

Mr. O’ROURKE. Thank you, Mr. Chair. 

And, Mr. Cook, you made me feel a lot more comfortable with my 

ignorance. And so if you can admit it, then I feel a lot more comfortable in admitting my own. 

But, Mr. Chair, earlier I had the privilege of introducing Ms. 

Gipson who will be testifying in a later panel. I first met her in 

El Paso when she was at the WTU. She had organized a tour of 

that facility for me. 

And in getting to tour that facility and meeting some of the 

servicemembers who were there, we first learned that we had soldiers at Fort Bliss at the WTU who had literally been languishing 

there for months and years because of delays within this IDES system and specifically the DRAS in Seattle. 


VACREP180 with DISTILLER
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And, Ms. Rubens, when we last had a chance to speak about this 

in February of this year, I talked about the VA rating goal being 

15 days and for the Fort Bliss soldier at the WTU, it was actually 

143 days. The benefits goal being 30 days at that time. It was 87 

days in reality. 

That was my focus then. It is still my focus today because what 

I think I have heard you all say is that we are now meeting our 

benefits goal as of April of this year. 

But when I look at the latest data which is 18th May of this 

year, it shows that for the army, we are at 48 days instead of the 

goal of 30. And the Fort Bliss soldier is at 49 days. 

When I look at what you are committing to doing by August 

slash October in the rating getting to 15 days, we are currently at 

132 days army-wide and we are at 131 for the soldiers at the WTU 

at Fort Bliss. 

So explain to me the inconsistencies on the benefits goal that you 

say that you have already achieved and the numbers that I am seeing here for May and then how you can possibly achieve the goal 

for October given the wide variance between where you are supposed to be and where you are today. 

Ms. RUBENS. Yes, sir. And I would tell you that I think that we 

are talking about the work that we are completing in the current 

month versus the numbers you are reflecting are for the entire 

year, the average of everything that we have completed. 

What we know about the work we are completing today as we 

look, if you will, behind it in the system, that work that is coming 

down the path is much younger. And so as we are now achieving 

for the benefits notification phase, we are now in a timely position. 

The capacity that we have will continue to maintain that timely 

output for those claims that are coming to us in that component 

of the phase. 

As we continue to work for the proposed ratings, similar issue, 

the capacity with which we are tackling the volume of work come 

August, we will now marry up the work flowing to those folks and 

going out the door will put us into a timely, 15 day for a proposed 

rating decision time frame as well allowing us for the October number to catch up, if you will, on the average for the entire year. 

Mr. O’ROURKE. Let me see if I can understand this because this 

is a difficult concept for me to get and it is similar to the way that 

you explained to us the backlog numbers when it comes to disability claims for veterans and how we should be measuring that 

backlog. 

So if someone enters the system today, we will just use Fort Bliss 

as an example, at the WTU there, at the benefit stage, they will 

wait no longer than 30 days; is that correct? 

Ms. RUBENS. At the end of the process, the final notification 

when we get that final package back from DoD, the time it will 

take us then to finally promulgate that benefits notification on average for the army is at 30 days. 

I will need to go and look to see if Fort Bliss is outside of that, 

but I believe we are now looking at a timely situation across the 

benefits phase. 

Mr. O’ROURKE. Okay. And I have got limited time, but the reason then that I am showing 48 days army-wide versus 30 days 


VACREP180 with DISTILLER
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which is what you are saying is that you still have those older 

cases in the system and as soon as they move out, you will be at 

that 30 day? 

Ms. RUBENS. And/or you are looking at information, and that is 

why I need to go perhaps to sit with one of your staffers to look 

at. Are you looking at the average processing time across the entire 

course of the year which as we work the older ones out meant that 

days to complete had gone higher and as we look at the work coming in, it is now timely. 

Mr. O’ROURKE. Okay. My time has elapsed. This is something 

that I am going to ask my staff through this hearing to memorialize in a letter to you and get a written response back from you 

so I fully understand it can go back to the WTU at Fort Bliss and 

explain it in my own words which I am not yet able to do given 

your answer. I think you are saying what I want you to say and 

what they want to hear, but I want to make sure that we are absolutely clear on what the expectation is and what we are delivering. 

So appreciate that in advance for getting back to us. 

Ms. RUBENS. Happy to do that and/or sit with anybody you might 

to have us sit with to look at the Bliss statistics. 

Mr. O’ROURKE. Thank you. 

Thank you, Mr. Chair. 

Mr. RUNYAN. Thank the gentleman. 

With that, I recognize the gentleman from Florida, Mr. Bilirakis. 

Mr. BILIRAKIS. Thank you, Mr. Chairman. I appreciate you holding this hearing as well. 

And I think Mr. Cook is right on with his acronyms, but, you 

know, he has been saying it now for months, years really, and let’s 

sit down and work on this because it is so very important to the 

veteran. 

And I am 51 and to tell you the truth, I have to read these things 

twice to understand what they are. So, I mean, just for the good 

of the veterans, so we owe them that, so that they can look at it 

and not have to have the computer training, what have you, and 

not have to go to—it is nice for them to spend time with their 

grandchildren, but my kids fix my computer, too. So, I mean, let’s 

get serious about this. 

And I have a couple questions here. Ms. Weaver, you noted that 

by the summer of 2014, the military departments will be able to 

work from a much improved set of policy documents that will provide better guidance. 

When exactly will these policy documents be issued? 

Ms. WEAVER. They are in the final processing and they will start 

being published hopefully next month through the end of August. 

Mr. BILIRAKIS. Okay. Will you be able to quantify their impacts 

on both quality and consistency of the decisions and how will that 

occur? 

Ms. WEAVER. We are implementing a quality assurance program 

and that is one of the new policies that we have that will help the 

department measure accuracy and consistency, particularly in how 

policy is applied across the services. Services performed to evaluations, OSD performs one. We analyze the results and then we can 

see if policy has been applied or if policy needs to be revised. 

Mr. BILIRAKIS. Thank you. 


VACREP180 with DISTILLER
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Ms. Weaver, you noted that 83 percent of servicemembers are 

satisfied with the IDES, here we go with the IDES, experience. 

Could you tell us more about that? Elaborate, please. 

Ms. WEAVER. Each quarter, we do a customer satisfaction survey. 

The survey is done at a sampling of nine of the major locations 

where IDES is—where the members are enrolled and consensus at 

the remaining 131 MTFs. The survey is done after the medical 

evaluation board and again after the physical evaluation board. 

It is a volunteer survey. July through December, we did have 

8,000 individuals who participated in the survey. And from the 30 

questions, four related to customer satisfaction, 83 percent indicated they were satisfied with the process. 

Mr. BILIRAKIS. Okay. Now 8,000 of how many participated in the 

process? So what percentage would that be? You said 8,000 participated. How many are in the process? Eight thousand participated 

in the survey, but what would you say percentage is? 

Ms. WEAVER. I don’t have that number, sir, but I can certainly 

get it for you. 

Mr. BILIRAKIS. Please, or would you like to estimate approximately? 

Ms. WEAVER. I don’t have any number of how many. 

Mr. BILIRAKIS. Okay. Can you please get that to me and maybe, 

you know, the chairman? 

Ms. WEAVER. Absolutely. 

Mr. BILIRAKIS. The rest of the panel might want that information 

as well. Thank you. 

Ms. Weaver, you highlighted the Electronic Case File Transfer 

System that DoD piloted in 2012, but you know that until VA develops its end of the technology, it will not yield benefits and it is 

not going to be timely, in other words. 

Please elaborate on this and what has DoD developed and what 

does VA need to do? 

Ms. WEAVER. We have used the electric transfer and it was—— 

Mr. BILIRAKIS. See what I mean? 

Ms. WEAVER. Yeah. And it was successfully that we made the 

transfer in December of 2013. But what we are working on is a 

joint system, case management system called Joint Disability Evaluation System that will allow us to track cases, monitor exactly 

where they are at so that we can go from phase to phase and know 

exactly where the case is and do a transfer to and from internal 

within the service from the MEB or medical evaluation board to 

the physical evaluation board and from DoD to VA. 

We are in the concept phase identifying the requirements and we 

think it is going to gain major efficiencies for a modern and efficient system. 

Mr. BILIRAKIS. All right. Thank you very much. 

I yield back, Mr. Chairman. Appreciate it. 

Mr. RUNYAN. Thank the gentleman. 

With that, I recognize the other member from Florida, Mr. Jolly. 

Mr. JOLLY. No questions, Mr. Chairman. Thank you. 

Mr. RUNYAN. Thank the gentleman. 

I am going to ask one follow-up. I actually had a couple, but Mr. 

Bilirakis got to them all. So thank you. 


VACREP180 with DISTILLER
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This is the kind of question in the mold of Colonel Cook over 

here. We hear everything that is going right. I want to hear from 

Ms. Weaver and Ms. Rubens what isn’t going right. 

What do we really need to fix that would make a huge difference 

in the process? I mean, what can really tackle? What are we going 

to get out of this hearing? I mean, as Colonel Cook over here identified his flaws in front of everyone. That is what we want to know 

from you. So what is the one thing that could change the trajectory 

of this whole process? 

Ms. WEAVER. I think what DoD is hearing from the hearing is 

that we need to go back and look at our survey. We have a significant number of people who are participating in the survey and we 

are getting results that say as of December, 83 percent were satisfied with the process. As of the end of March, 4,000 more surveys, 

84 percent were satisfied with the process. 

And we are trying to make changes from the information that we 

get to the survey. We may need to look and see whether or not 

we—how we can reach out and touch the individuals who are expressing concern with either the time or the counseling that they 

are getting. 

Mr. RUNYAN. Ms. Rubens. 

Ms. RUBENS. I would echo some of those sentiments and obviously it sounds as if our ability to communicate with the 

servicemember, soon to be veteran could be improved. 

VBA has worked in the last year to pick up, if you will, another 

component of that transitioning servicemember who as he or she 

begins to think about what next by placing our vocational rehabilitation and employment counselors at many IDES sites as well in 

an effort to continue to build that, if you will, system around that 

transitional servicemember. 

And I would tell you that obviously we want to continue to work 

together in that electronic interface to ensure that as DoD across 

the services builds that integrated case management system, it 

marries up, if you will, sir, into our new Veterans Benefits Management System, our paperless environment to ease the process by 

which we share information not only internally but with that 

transitioning servicemember as well as if they have selected a veteran service officer as we roll out our new stakeholder enterprise 

portal functionality in July of this year so that they will have the 

ability to also support that servicemember and that communication 

standpoint. 

Mr. RUNYAN. I think you touched on a little bit there, it goes 

back, Ms. Rubens, to Mr. Bilirakis’s question. What does the VA 

need to do on your end of the electronic case transfer, file transfer 

to make it optimal? 

Ms. RUBENS. I would tell you that as far as making ECFT optimal, there are some things that we need to do from a—the MSC, 

the military services coordinator, at that intake site and their ability to work within that environment as well as from an electronic 

standpoint, the functionality of incorporating ECFT into that, if 

you will, interface with VBMS to ensure that is occurring. 

And it is our roadmap to accomplish that. And as DoD continues 

to build their new case management system, we want to make sure 

that we are there to incorporate that as well into VBMS. 


VACREP180 with DISTILLER
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Mr. RUNYAN. And what part of what fiscal year is that happening? 

Ms. RUBENS. Sir, I will have to take that one for the record. I 

am not sure where it is on the roadmap. There are a number of 

things that we are trying to import, if you will, or build into the 

functionality for VBMS. 

Mr. RUNYAN. And one last question for Ms. Weaver. You said 

that an 83 percent satisfaction rating. What was the 17 percent on 

the other side, what was the kind of overall disappointment in the 

system? 

Ms. WEAVER. It ranged. A lot of the comments were that they did 

not get the information they needed. It was varying with the medical evaluation board and the physical evaluation including the unsatisfactory rating that they got. They would like a different rating 

and move from there. 

Mr. RUNYAN. Any other Member? Mr. O’Rourke. 

Mr. O’ROURKE. Thank you, Mr. Chair. 

I would like to follow-up with Ms. Rubens on the line of questioning that I was pursuing earlier about IDES. And I think I may 

have some questions that can hopefully clarify this issue. 

On the benefits backlog portion of the DRAS process, you said 

that in March, you eliminated the backlog and by April, you were 

hitting your target of 30 days; is that correct? 

Ms. RUBENS. Yes, sir. We closed the capacity gap between what 

we had to work and what we had the capacity to do in March. And 

in April, the work that we then began to see flow through was 

meeting that timeliness target. 

Mr. O’ROURKE. And the number I referred to earlier or I showed 

that army-wide, we are at 48 days, not 30, that is the last three 

months. So that might explain the difference. 

So my question to you is, if we take this same measure three 

months from today, it will show 30 or under? 

Ms. RUBENS. Yes, sir. 

Mr. O’ROURKE. Okay. Great. 

Ms. RUBENS. We have built this in our projection, in our capacity, in our modeling to ensure that as we move forward, we maintain achievement of the target. 

Mr. O’ROURKE. So I want to ask the same set of questions as it 

pertains to the VA rating part of this which is that the goal is 15 

days. Today the last three month average shows army-wide 132 

days. 

Are you saying that by August, you will relieve the backlog and 

by October, you will meet that 15 day goal? 

Ms. RUBENS. Yes, sir. 

Mr. O’ROURKE. Okay. And then three months from October when 

we look at the rolling three month average, we will see 15? 

Ms. RUBENS. And 15 for the proposed and 30 for the final notification, yes, sir. 

Mr. O’ROURKE. Wonderful. And would you mind if, again, we 

were able to get that commitment from you in writing? 

Ms. RUBENS. Not at all, sir. 

Mr. O’ROURKE. Okay. I really appreciate that. Thank you. 

That is all, Mr. Chair. 

Mr. RUNYAN. Thank the gentleman. 


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And no other Members have any further questions. 

I ask that any of the questions that you all were taking for the 

record, please submit them in writing. Thank you very much. 

Thank you all again. I think it is particularly helpful to have both 

the VA and the DoD at the table when discussing IDES. 

You are now excused from the witness table, and we seat our second panel from VAOIG. 

Welcome the members of the VA’s Office of Inspector General. 

We appreciate your attendance today. Your complete and written 

statements will be entered into the hearing record. 

Ms. Halliday, you are now recognized for five minutes to begin 

your testimony. 

STATEMENT OF MS. LINDA A. HALLIDAY, ASSISTANT INSPECTOR GENERAL FOR AUDITS AND EVALUATIONS, OFFICE OF 

INSPECTOR GENERAL, U.S. DEPARTMENT OF VETERANS AFFAIRS; ACCOMPANIED BY MS. NORA STOKES, DIRECTOR, 

BAY PINES BENEFITS INSPECTION DIVISION, OFFICE OF INSPECTOR GENERAL, U.S. DEPARTMENT OF VETERANS AFFAIRS; ACCOMPANIED BY MR. RAMON FIGUEROA, PROJECT 

MANAGER, BAY PINES BENEFITS INSPECTION DIVISION, OFFICE OF INSPECTOR GENERAL, U.S. DEPARTMENT OF VETERANS AFFAIRS 

STATEMENT OF LINDA HALLIDAY 

Ms. HALLIDAY. Thank you. Chairman Runyan and members of 

the subcommittee, thank you for the opportunity to discuss the 

OIG’s review of VBA’s pre-discharge program. Our testimony offers 

an independent assessment of VBA’s Quick Start Program, one 

component of VBA’s pre-discharge program. With me today is Mr. 

Kent Wrathall, the Director in our Atlanta Audit Office; and two 

managers from OIG’s Benefits Inspection Division in Bay Pines, 

Florida, Ms. Nora Stokes, the Director, and Ramon Figueroa, who 

collectively have over 40 years of VBA work experience. Notably 

they have experience working in key positions such as Veterans 

Service Representative, Ratings Specialist, Decision Review Officer, 

certification test writer, STAR quality reviewer, as well as a Veterans Service Center manager. 

The Quick Start Program was designed to provide a seamless 

transition from DoD to VA’s Healthcare and Benefits System. 

Servicemembers can submit claims up to 180 days prior to discharge under the program. Further, the program makes it possible 

for veterans to receive VA disability benefits soon after leaving 

military service. To assess the program’s performance we reviewed 

Quick Start claims completed in 2011 and then again in 2013, and 

we found improvement in claims processing timeliness. During the 

period VBA reduced the average days to complete Quick Start 

claims from 291 to 249 days. However, while timeliness improved 

additional improvement is needed if VBA is to achieve the VA Secretary’s fiscal year 2015 target of processing disability claims in 

125 days. 

Delays in processing Quick Start claims resulted from inadequate program controls and the redirection of resources to process 

other claims processing priorities. Adequate resources and the 


VACREP180 with DISTILLER
20 

proper allocation of resources are paramount for VA to realize the 

benefits of its transformational initiatives. Delays also occurred due 

to a lack of training to ensure staff properly identified Quick Start 

claims, which is the first step to initiate timely processing actions. 

Our review results support that the Quick Start claims were at 

risk of processing errors, such as erroneous disability evaluations 

or improper grants or denial of benefits. We projected VBA staff accurately processed 62 percent of the Quick Start claims in 2011, 

while the accuracy rate for 2013 improved to 69 percent. These 

rates are still well below the Secretary’s 98 percent accuracy goal 

for fiscal year 2015. 

Delays and errors impact veterans’ receipt of disability benefit 

payments in two ways. First, the processing delays in 2011 resulted in a number of veterans waiting an additional 196 days to 

receive about $88 million in benefits payments. By 2013 the same 

type of processing delays were reduced but still caused veterans to 

wait about 99 days to receive approximately $20 million in benefits 

payments. Unfortunately processing delays also impact other entitlement decisions, such as veterans preferences, delayed care at VA 

medical centers, and participation in vocational rehabilitation efforts. 

Secondly, the claims processing errors have a direct financial impact on the amount of benefits a veteran receives in monthly recurring entitlement payments. We projected claims processing errors 

resulted in veterans being underpaid about $2.8 million. Projected 

overpayments were valued at approximately $463,000 for the same 

period. Additionally, claims processing errors that do not affect current monthly benefits have the potential to affect future benefits if 

left uncorrected. 

While VBA is making incremental progress in areas specifically 

targeted through this initiative, much more work needs to be done. 

We will continue to look for ways to promote improvements in benefits delivery operations during our future national audits and our 

VARO inspections. Mr. Chairman, that concludes my statement 

and we would be happy to answer any questions you or the committee has. 

[THE PREPARED STATEMENT OF LINDA A. HALLIDAY APPEARS IN

THE APPENDIX] 

Mr. RUNYAN. Thank you, Ms. Halliday. And we will begin a 

round of questions. First question, as you know while VBA is reporting timeliness an equal if not greater concern is the accuracy 

of the outcome for each veteran. VBA is looking at hundreds of 

thousands of claims and the veteran is looking at one and only one. 

Ms. Halliday, as accuracy as highlighted in your testimony is a serious area of concern, I would like to also ask you the question 

about VBA’s quality component, STAR. You noted that VBA’s 

STAR program has several classification errors such as benefit entitlement, decision documentation/notification, and administrative. 

Mr. Murphy responded to an inquiry as to STAR’s failure to count 

error for incidents with potential to affect veterans’ benefits, such 

as when a claims folder lacked required evidence including medical 

examination or opinion needed to make an accurate decision. Can 

you comment on that? 


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21 

Ms. HALLIDAY. Yes, I would appreciate that. The OIG uses a 

broader definition of what constitutes an error. We report errors 

that affect veterans benefits as well as those that have the potential to affect veterans benefits in the future if left uncorrected. We 

think this is important. It is a veteran-centric approach. We do not 

feel that the STAR program counts all of its errors. There is a disagreement between what OIG considers an error and how VBA calculates its accuracy rate. 

I have a couple of examples here that we think might help you 

understand. VBA does not consider an incorrect disability evaluation to be a benefit entitlement error unless the error impacted the 

veteran’s overall combined disability evaluation. However, OIG 

would identify this case as an error because it has the potential to 

affect the future benefits if left uncorrected and that it also has a 

corresponding potential to affect other programs as the ratings 

change. 

Also, cases where VBA staff simply do not request or significantly delay requesting the mandatory routine future examination 

to determine whether the temporary 100 percent disability determination should continue we clearly call an error. We see a significant financial impact associated with not managing those claims 

appropriately. 

Mr. RUNYAN. Thank you. Next question, is VA working with the 

OIG to make the improvements identified in the audit process? 

Ms. HALLIDAY. This past year there have been significant challenges to us to address the oversight that we are expected and 

charged with to look in the benefits inspections and to perform national audits. I finally raised this issue to the Under Secretary Allison Hickey. She has agreed to try to ensure that we do not have 

these obstacles or have this resistance and that we work toward a 

facilitated process so that OIG can help VBA get it right. 

This is important. To spend so much time dealing with a nuance 

of a technical issue technically how you say something versus trying to fix the big picture is not the way to go. I think you need to 

look at what are we saying. Why are we saying it? How does it affect veterans? And then go make the changes you need in these 

programs. 

Mr. RUNYAN. Last question. In your view, given the challenges 

VA faces addressing the longstanding backlog of claims, do you feel 

the VA has control over its remaining workload? 

Ms. HALLIDAY. At this time we see that VBA’s pending backlog 

in compensation claims is dropping. However, I have significant 

concerns that they do not have a good handle on some of the workload in their other areas. For example, in the area of dependency 

issues. As of May 15, 2014 their own VOR report, which is the 

VETSNET Operations Report, shows almost 253,000 disability 

claims that will impact benefits. On average the claims are pending 

over 315 days. For eligibility determinations, the same report 

shows approximately 110,000 adjudication decisions relating to 

benefits that have been pending on average 361 days. And in predetermination notices we see approximately just over 81,000 predetermination notices affecting benefits that have been pending for 

177 days. 


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There are definitely problems in managing the workload. The 

priorities, we hear time and time again the priority is to bring 

down the pending backlog in compensation at the expense of not 

addressing some of the other issues. The Quick Start program is 

a perfect example within our audit where resources were redirected 

away from that program. And you can see in the audit there is a 

table that the workload, the timeliness spiked in 2012. And I know 

VBA is working hard now and has put resources back in the program, but you have to keep resources dedicated to significant 

transformational initiatives if you want to achieve success. 

Mr. RUNYAN. Thank you for that answer. And I had that precise 

discussion with Chairman Miller this morning. So, thank you. With 

that, I will recognize the Ranking Member Ms. Titus. 

Ms. TITUS. Thank you, Mr. Chairman. I was going to ask that 

question, too. Do you think that these programs are being hurt by 

the focus on just reducing the backlog no matter what? And the 

veterans who are in these programs do not count as part of those 

figures that are used to show the backlog, even though they are 

waiting those long periods of time. Is that accurate? 

Ms. HALLIDAY. That is my understanding, yes. 

Ms. TITUS. Another thing that does not seem to count, and you 

mentioned that the VA does not count the processing time that occurs prior to leaving the service when they are talking about the 

amount of time it takes to process one of these claims. Would you 

expand on why that would be an important aspect of this whole 

backlog? 

Ms. HALLIDAY. In the simplest of terms, if I am a veteran and 

I file a claim, I start counting from that day. 

Ms. TITUS. Yes. 

Ms. HALLIDAY. Now I understand that VBA is very concerned 

that they have upfront processing at a point where the active 

servicemember has not become entitled to the benefit. But when 

you are looking at a process you must look at the process throughout the entire processing cycle so that you can understand where 

you have dedicated your resources and to what extent you are getting the appropriate outcomes from that resource. So, and I feel 

that if you go with a veteran-centric approach you would count that 

time. You would not start the payments for entitlement until they 

were released from active duty and came into VA care. 

Ms. TITUS. And would that help you to understand the whole 

process and the procedure? 

Ms. HALLIDAY. Right. 

Ms. TITUS. And make needed adjustments? 

Ms. HALLIDAY. Absolutely. I think that in the many discussions 

I have had with Ms. Rubens and Mr. Murphy, I know that resources are needed and you have to make good decisions on where 

those resources are. So I think it is very important to measure all 

of your resources and track those. It is obviously an area where the 

Under Secretary had not concurred with us in our report, and we 

are going to stand pat with what we have said. 

Ms. TITUS. Okay. Well, thank you. And going back to the first 

point about these programs failing because so many are doing less 

well than expected, because so much emphasis is put on the backlog, isn’t it really kind of a matter of robbing Peter to pay Paul? 


VACREP180 with DISTILLER
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Ms. HALLIDAY. I have said that a number of times. 

Ms. TITUS. Okay. Well great minds think alike. Thank you, Mr. 

Chairman. 

Mr. RUNYAN. The chair recognizes Mr. Cook. 

Mr. COOK. Thank you very much. And I will not say too much 

more about acronyms, maybe. The, your report, very sensitive, because I used to be an IG. And I looked at your recommendations. 

And by the way, IG, that is a thankless job. How to lose friends 

and not influence people, I used to say. But it is one that you have 

to have in an organization. And your job is not to make friends. 

You already know that. 

It bothered me a little bit, and maybe if you could help me out, 

where the, in two cases it had the VBA, which is, help me here? 

That is the Veterans Benefits Administration? 

Ms. HALLIDAY. Yes. 

Mr. COOK. They disagreed with your opinion. And then you had 

the other one where it was actually the Under Secretary, is that 

the same individual for all intents and purposes? 

Ms. HALLIDAY. I would consider it the same. 

Mr. COOK. You know these are, I was looking at them, you know, 

particularly one where the Under Secretary non-concurred but basically went along with it anyway. Did this go all the way up to 

the Secretary? Or is this something, is that a command decision 

that an Under Secretary would, because we are getting into some 

dicey stuff in the last few days on this. And I am trying to figure 

out on who is going to make these command decisions. These are 

pretty important. And maybe it is just my sensitivity with IG reports but 26 years in the Marine Corps, or what have you, everybody kind of gets a little nervous about IG reports and they pay 

attention to them, at least I used to. Maybe because I used to write 

them. But any comment on that at all? I do not mean to put you 

on the spot. But you know what I am saying, I think. 

Ms. HALLIDAY. It is the responsibility of the Under Secretary for 

Benefits to provide the official signed comments to an IG report. I 

believe that the Secretary does get copies. He gets copies at the 

point of when we issue the draft report for review and to obtain 

those comments, and then gets copies of the final reports. If a report is significant we certainly brief, I would think we follow traditional audit processes that has an exit briefing, where we have a 

discussion with the VBA officials that are charged with the governance of the specific program. I have had many briefings with that 

team. And they feed up to their USB. 

Mr. COOK. Well this is an important point, at least to me. In the 

military you used to have two things. One was you would have by 

direction authority, in other words it is a commanding officer but 

somebody in the command could sign their signature by direction. 

That means that, you know, by signing by direction that the commander approves this. The other was releasing authority. Releasing authority means you can go out with a message that you are 

the Commanding General 2nd Marine Division. Very, you do not 

give those, that authority away. And that is why I brought up that 

point that whoever signs that basically the Secretary, the way I understand it, is concurring with all those decisions that are made. 

It is on his or her watch. Correct me if I am wrong. 


VACREP180 with DISTILLER
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Ms. HALLIDAY. If it is signed for General Hickey by one of her 

staff, yes. This is the official comments. 

Mr. COOK. Okay. All right. The, in terms of your role, and I think 

it is very, very important to go back to, how would you even be 

more proactive in light of some of the things? Do you have any recommendations in regards to that? I am not asking you to do more 

work but, yes, I am asking you to do more work. 

Ms. HALLIDAY. I think that we plan the audits appropriately 

based on the risks in the programs. I think if you were to ask me 

about being more proactive I think there needs to be more discussion at the senior levels as work is completed to really how are you 

going to fix the problem? And as I alluded to before, worrying 

about the little technical nuances in getting everything just letter 

perfect really does not get you there. You really have to address the 

overall problem and how veterans are affected with the process and 

what is happening in whatever objective of the audit you are dealing with. 

Mr. COOK. Thank you. I yield back. 

Mr. RUNYAN. The chair recognizes the gentleman from Texas, 

Mr. O’Rourke. 

Mr. O’ROURKE. Thank you, Chairman. The BDD, the Benefits 

Delivery Discharge claims and the Quick Start claims I think year 

to date are under 25,000. So if we are measuring that in the thousands or maybe tens of thousands, and then all other claims moving through the VBA we are measuring in the hundreds of thousands or millions. So when you were responding to Ms. Titus’ question earlier about robbing Peter to pay Paul, and you also mentioned that we need to make better decisions about how resources 

are allocated, do you have some recommendations for the VBA or 

for the committees of oversight in terms of how we should be 

spending that money in a smarter fashion? 

Ms. HALLIDAY. I would like to see that you ask VBA to do a good 

staffing analysis for its initiatives and for its current work in 

house. There are too many areas that are being underaddressed at 

this point, or what I would consider undermanaged. I think at 

some point if you were to put the right resources on some of these 

things, such as temporary 100 percent disability evaluations not 

being managed effectively and the association financial impact that 

we report in our reports, that would start to reduce and you would 

have a better operation. Not only from the fact that veterans would 

be served quicker with whatever decisions and reviews that were 

needed to make sure their claims were accurate. And then we 

would be saying that you have a stronger, you are making a 

stronger position as far as the financial stewardship that you are 

charged with VBA to ensure the entitlement decisions are accurate 

and timely. 

Mr. O’ROURKE. And the, thank you for that, the chairman 

brought up a good question about why the VA’s score for accuracy 

is better than your score. And you said one difference in the methodology is you look at potential adverse impacts to benefits down 

the road and perhaps the VBA does not. Is there any other difference in how you assess and the VBA assesses accuracy? 

Ms. HALLIDAY. Yes, I believe there are. I would like to ask Nora 

Stokes to talk to the technical aspects of that. 


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Ms. STOKES. As you mentioned there are some definite differences as far as the potential to affect benefits. And we do call 

oftentimes errors that relate to that. And that is particularly when 

things are missing from the file. And as Mr. Murphy had indicated 

in his response, I believe the specific question had to do with 

whether or not a VA examination if it were missing would that constitute an error. What we find in our benefits inspections are the 

VA examinations may be not necessarily missing, some are missing, some are inadequate, but they are used to evaluate cases with 

anyway. Our position is according to VBA policy those examinations should be returned. If an examiner notes something during 

a physical examination and another disability questionnaire is required and it is not completed and we consider that an error as 

well because you cannot come to the point where you can make a 

decision on a disability evaluation if you do not have medical evidence to go one way or the other. So those are some stark differences in the methods that we would determine an error versus 

VBA. 

Mr. O’ROURKE. And Ms. Halliday, I hate to ask you to speak for 

the VBA, and I certainly want to follow up with Ms. Rubens and 

her team, but what is their response to that distinction and the assertion that those exams should be returned or should be counted 

differently than they are right now? 

Ms. HALLIDAY. We have agreed to disagree—— 

Mr. O’ROURKE. Got you. 

Ms. HALLIDAY [continuing]. At that point. That is why it is documented in this audit. 

Mr. O’ROURKE. Okay. And then my last question, I do not know 

if you heard the exchange over IDES and where we are against 

backlog and goal for benefits and backlog and goal for rating. Did 

you have any concerns or questions? Or do you agree with the assessment provided by VBA about where we are at and where we 

are likely to be by October? 

Ms. HALLIDAY. I cannot comment to that, sir. I do not have any 

ongoing work addressing that. 

Mr. O’ROURKE. Thank you. Thank you, Mr. Chair. 

Mr. RUNYAN. Mr. Jolly. 

Mr. JOLLY. Thank you. I want to follow up just on a little bit of 

what we have discussed. And I understand the disagreement on 

timeliness issues seems somewhat jurisdictional and a couple of 

other matters. But on accuracy, you report that the accuracy rate 

is about 69 percent and one of the areas of non-concurrence is 

something that seems pretty benign, which was insufficient oversight and training. Can you elaborate a little bit on that? And, I 

mean, I will put my cards on the table. In many ways you are providing a little bit of oversight into reasons for the inaccuracy it appears. One of the reasons you identified was insufficient internal 

training and oversight. We are engaged in the same issue right 

now with the department obviously on healthcare deliver. Can you 

elaborate to the extent you are permitted to on the disagreement 

on the interpretation about the department’s ability to provide the 

oversight and training in this specific area? 

Ms. HALLIDAY. Yes. I would like to ask Kent Wrathall, who led 

the audit. But I do believe as you looked at the training issue it 


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spoke specifically to how you identify a Quick Start claim. And I 

would like him to—— 

Mr. WRATHALL. The department actually agreed with the training recommendation on the identification of the Quick Start claims. 

Where they disagreed was on the clarification of policy concerning 

the nexus between servicemembers, the disability incurred during 

service and the claimed disability. And actually our accuracy experts here are Ms. Stokes and Mr. Figueroa, so I will turn it over 

to Ms. Stokes. 

Ms. STOKES. Yes. One of the areas that we where the oversight 

was lacking had to do with just the local quality reviews. So at the 

local level we did find that the accuracy reviews that most regional 

offices would conduct on a monthly basis for individual performance was lacking. While they did have some we did find it to be 

inadequate. When we discussed with the staff in the CPS sites that 

process Quick Start claims they told us that they were busy, they 

had other responsibilities, and that they did not have the time to 

conduct the comprehensive review. 

At the national level we found there was a lack of oversight in 

that the method that STAR uses to select their samples was lacking in that it did not sufficiently identify enough cases that you 

could actually get a feel for what the accuracy rate was for Quick 

Start claims. Or they co-mingled the results of the Quick Start 

cases with the results of the regional office. As an example, the 

Winston-Salem office had I believe for the year of fiscal year 2011 

they had 255 reviews but only six of those claims that were reviewed were related to Quick Start. So we found that the method 

they are using was not sufficient to observe any sort of training deficiencies. And the other part of that is not only at the local and 

the national level were they not able to have a valid sample that 

might point to some of these training deficiencies, at the local level 

when they did conduct their quality reviews they also did not track 

and trend those types of errors so that they could address those 

training deficiencies by tailoring training to those particular areas. 

Mr. JOLLY. I see. One of the reasons given was busy. I mean, I 

guess the part that concerns me is specifically the use of the word 

training because of what that means for the ability of an employee 

to perform. Oversight in one way is a little less concerning if that 

is where it is deficient. But if training is where it is deficient, you 

know, that just breeds a more systemic problem as case loads go 

up and the number of cases go up, failure in training just continues 

to build upon itself and create a larger problem. I appreciate your 

answer to the question. Thank you. Thank you, Mr. Chairman. 

Mr. RUNYAN. I thank the gentleman. Do any members have any 

further questions? With that, thank you all again and you are now 

excused from the witness table and we ask the third panel to come 

forward. 

Good afternoon, everyone. As I noted in prior panels all of your 

complete and written statements will be entered into the hearing 

record. I know I did this earlier, but I want to recognize Mr. 

O’Rourke if he would like to make his introduction again. 

Mr. O’ROURKE. Thank you, Mr. Chair. The person I want to introduce deserves a second introduction. Ms. Gipson is a Retired 

Captain from the U.S. Army, was the Executive Officer at the 


VACREP180 with DISTILLER
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Warrior Transition Unit in El Paso at Fort Bliss, a former constituent of mine recently until March. She was instrumental in ensuring that I understood some of the issues at the WTU by arranging a tour there and I think will speak very eloquently to some of 

her personal challenges that can be extrapolated against the challenges that many transitioning servicemembers face. And so we are 

very glad and grate for her presence here today. Thank you, Mr. 

Chair. 

Mr. RUNYAN. I thank the gentleman. With that, we are going to 

start with Mr. Jenkins. Mr. Jenkins, you are now recognized for 

five minutes for your testimony. 

STATEMENTS OF MR. ERIC JENKINS, RATING VETERANS 

SERVICE REPRESENTATIVE, WINSTON–SALEM REGIONAL 

OFFICE, AMERICAN FEDERATION OF GOVERNMENT EMPLOYEES, AFL–CIO AND THE AFGE NATIONAL VA COUNCIL; 

MS. DEBRA J. GIPSON, INDIVIDUAL SERVICEMEMBER; MR. 

GERARDO AVILA, NATIONAL MEB/PEB REPRESENTATIVE, 

THE AMERICAN LEGION; MR. PAUL RAYMOND VARELA, ASSISTANT NATIONAL LEGISLATIVE DIRECTOR DISABLED 

AMERICAN VETERANS; AND MR. BRENDON GEHRKE, SENIOR 

LEGISLATIVE ASSOCIATE, VETERANS OF FOREIGN WARS OF 

THE UNITED STATES 

STATEMENT OF ERIC JENKINS 

Mr. JENKINS. Chairman Runyan, Ranking Member Titus, and 

distinguished members of the subcommittee, thank you for the opportunity to testify before the subcommittee on the critical issues 

surrounding the BDD, Quick Start, and IDES programs. 

I am a 15-year veteran of the United States Marine Corps who 

served in both Operation Enduring Freedom and Iraqi Freedom. I 

am an RVSR in the Winston-Salem regional office where I have 

worked for the past nine years. I am proud to serve veterans every 

day and I am also a disabled veteran. 

As an RVSR I work both BDD and Quick Start claims and I 

would like to begin my testimony by stating my dedication as well 

as AFGE’s dedication to all of these programs. These programs are 

critical for providing recently discharged veterans their benefits as 

soon as possible and it is essential that these programs are functioning at their highest capacity. 

My regional office has a history of brokering claims to other regional offices in an effort to reduce the backlog. In doing so it has 

created a lack of sufficient cases that are ready for decision. We 

have brokered out approximately 20,000 cases in the last three 

years and now claims processors are struggling to receive adequate 

amounts of work to meet their production standards. Supervisors 

have been left scrambling to find work for the Quick Start employees. Due to brokering RSVRs are relegated to completing tasks traditionally done by VSRs. 

Due to the lack of work, management recently instructed employees in BDD to begin a practice called pre-rating. Pre-rating consists 

of rating a case that is not in fact ready for decision because we 

are awaiting VA exams or additional evidence. Management instructed the raters to rate these claims as if the medical evidence 


VACREP180 with DISTILLER
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had already been received yet told the employees to not finalize the 

rating. This raises serious questions for both the veteran and VBA 

employees processing the claim. Employees could potentially receive quality errors if medical evidence arrives and does not coincide with the employee’s pre-rating decision which also could lead 

to PIPS. Veterans should be concerned about this method used by 

VBA management and its effect on their rating decision. AFGE 

urges Congress to hold VBA senior management accountable for 

their brokering methods and potential effects it has on veterans 

and their dependents. 

As with BDD and Quick Start, employees in the IDES programs 

report the same dedication to IDES process. However, they did outline several issues that consistently appear. IDES claim processors 

expressed their frustrations with the lack of communication and 

training issues with MSCs, or military service coordinators as they 

are called. MSCs are scattered at military bases all around the 

world and when a claims processor at a VBA office is attempting 

to locate additional information about a claim it is often difficult 

to locate the original MSC. When the claim is sent to the regional 

office it is supposed to be ready for decision. However, our reports 

say that oftentimes this is not the case. This slows down the process for the VBA employee but most importantly increases wait 

times for the veteran. AFGE believes that more detailed training 

for MSCs will significantly reduce this issue. 

IDES processors also expressed issues with the National Guard 

and Reserve claims, the issue being not having complete military 

records and as they come to the regional office not ready for decision as well. At times when attempting to receive medical records 

the rater cannot locate the records or the unit the veteran is currently assigned to. All of these issues translate to major concerns 

with IDES production levels. Claims processors are also told not to 

defer cases, even though a decision cannot be made due to a lack 

of necessary evidence. There is constant pressure from the VA’s Office of Field Operations and the production quotas established by 

OFO are arbitrary and unfair. 

AFGE also heard issues regarding resources for processing BDD, 

Quick Start, and IDES claims. Claims levels have skyrocketed 

while regional offices have seen minimal growth in staffing. AFGE 

urges VBA to hire additional claims processors and provide more 

in depth and relevant training for current employees. 

AFGE also urges VBA management to conduct a time motion 

study to determine how long each task takes to complete while 

working a claim. With the recent transfer to VBMS this time motion study is more applicable and necessary than ever. 

Once again, I would like to thank the committee for providing 

AFGE the opportunity to share our views and I would be happy to 

answer any questions. 

[THE PREPARED STATEMENT OF ERIC JENKINS APPEARS IN THE APPENDIX] 

Mr. RUNYAN. Thank you, Mr. Jenkins. With that, Ms. Gipson, 

you are now recognized for five minutes for your testimony. 


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STATEMENT OF DEBRA J. GIPSON 

Ms. GIPSON. Thank you, Chairman Runyan. I would also like to 

thank Congressman O’Rourke for inviting me to speak today. 

In 2011 while training to deploy to Afghanistan I received a severe back injury. By the time my Reserve detachment reached the 

active duty training site, Fort Bliss, Texas, I was confined to a 

wheelchair, earning me the nickname, ‘‘The Wheelchair Soldier.’’ 

Days later I was prescribed a cocktail of drugs which allowed me 

to walk but not without excruciating pain. Placed in the warrior 

transition program, efforts to rehabilitate my injury were unsuccessful requiring surgical intervention. 

Before my back surgery could be performed I required a surgical 

procedure to treat uterine fibroids, tumors on my uterus. I did not 

receive a follow up gynecological appointment. 

Placed in IDES, I was determined to be medically unfit to serve, 

received a 20 percent disability rating, medically separated, and received separation pay. Within days of signing paperwork agreeing 

to the rating, it was determined that I urgently needed a 

hysterectomy. I want to be clear that had I received a follow up to 

the original gynecological procedure, my hysterectomy would have 

been performed at least a year earlier and my disability rating 

would have been 70 percent. Instead of being medically retired, I 

was medically separated from the United States Army on January 

11, 2014. 

In my opinion a strong democracy requires two professions, the 

legislator and the servicemember, each the weapon of the other. 

Healthy servicemembers are the weapons of the legislator while 

the legislator is the weapon of wounded, injured, and ill 

servicemembers. We have served as your weapon. On behalf of disabled and medically separated veterans we respectfully request 

that you harness your arsenal’s full potential to fix the IDES system and maintain the strength of our democracy. 

I would like to present to you both short and long term 

recommendations. Please note that I participated in IDES as an 

end user, and please forgive me for any policy recommendations 

which overlap those of previous presenters. 

The first, establish a consolidated disability evaluation system. 

The IDES system is tiresome, timely, burdensome, and inefficient. 

The VA and DoD must consolidate the departments’ disability systems with the shared goal to promulgate policy and prescribe uniform guidelines, procedures, and standards to eliminate redundancy inherent in adjudicating claims. 

Second, create a sole source disability rating. The military rates 

only fitting conditions while the VA rates all service connected injuries resulting in two different rating systems for servicemembers. 

The DoD and VA will need to reach a consensus on the definition 

of qualifying conditions and the rate at which those conditions and 

events are to be compensated. Understandably a bias in the favor 

of the more generous VA system will result in a corresponding rise 

in both retirement and medical costs. 

Information sharing. Plans to roll out shared use technology will 

enhance and improve agency accessibility to healthcare records. 

The plan is both necessary and ambitious. However, the current 

lack of available technology I believe is only part of a much larger 


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problem. Government agencies, among them DoD and VA, must 

generate memoranda of agreement allowing agencies to openly 

share information. This will likely create a change in agency cultures from one of independence to interdependence when sharing 

information and resources. 

My interim recommendations are as follows. First, I recommend 

a fiscal set aside. Veterans in the servicemember transition process 

frequently complain about the receipt of timely payments once his 

or her claim has been adjudicated. To date, the receipt of benefit 

payments can take from 90 days to a year or more to process. 

While uncertain of the legal or the tax implications, I recommend 

that once a servicemember enters federal service, active duty, 

Guard or Reserve, a percentage of the servicemember’s salary be 

escrowed until the IDES or retirement process is completed. The 

funds set aside could then be automatically reimbursed to the veteran as a lump sum payment used to bridge the gap between the 

date of retirement or separation and receipt of any long or short 

term benefits. 

An emergency rating reconsideration. Servicemembers who require emergency surgeries within 60 to 90 days of being rated 

should receive an automatic disability rating reconsideration. 

Thirdly, complete a comprehensive staffing needs assessment, 

which I believe has been covered by other members of the panel. 

Fourth, reduce waste, fraud, and abuse. The system is replete 

with opportunities for fraud, waste and abuse. The underlying 

premise of the adjudication process is to provide compensation and 

benefits for long term injury and illnesses. Any system which compensates servicemembers for injuries and illnesses must also 

incentivize healing and recovery. It is not a politically popular notion, however if the looming costs are to be reduced and full recovery is to be achieved this must also be a corresponding goal. A comprehensive assessment then must be performed about where opportunities exist to eliminate fraud, waste, and abuse. 

And finally, organizational change. We have got to change the organizational culture which punishes servicemembers either directly 

or indirectly for wounds, injuries, or illnesses. In the current climate servicemembers deemed unfit to fight or conduct acts of physical fitness are cast aside and labeled, often unfairly, as lazy or 

cowardly. I do not advocate battlefield group hugs. However, leadership training must encourage compassion, dignity, and respect. 

Likewise service providers, whether military or civilian, must receive similar training. Toxic leaders, both military and civilian, 

must be either retrained or moved out of leadership positions or positions of authority to mitigate damage to wounded and/or recovering servicemembers. 

In conclusion the recommended suggestions to improve IDES will 

each require a cross benefit analysis to determine feasibility. Such 

analysis is beyond the scope of this presenter. What is certain is 

that each cost and benefit must be assessed using both qualitative 

and quantitative analysis. It is my belief that undertaking such 

analysis, however painstaking, would improve IDES to the benefit 

of retiring servicemembers. Thank you. 

[THE PREPARED STATEMENT OF DEBRA GIPSON APPEARS IN THE

APPENDIX] 


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Mr. RUNYAN. Thank you. And with that, I recognize Mr. Avila for 

his testimony. 

STATEMENT OF GERARDO AVILA 

Mr. AVILA. Good afternoon, Chairman Runyan, Ranking Member 

Titus, and members of the committee. On behalf of our National 

Commander Dan Dellinger and the 2.4 million members of the 

American Legion, I want to thank you for bringing to the attention 

of America the transition of these servicemembers. I think it is especially important that you are paying close attention to the words 

of the veterans service organizations. Veterans service organizations such as the American Legion bring experience to the claims 

process and are critical stakeholders who can help the government 

meet its obligation to the veteran. The VA has recognized this on 

the civilian side of the dividing line of service and through their 

programs like the Fully Developed Claims Initiative capitalized on 

the partnership to improve the claims process and help veterans 

get the disability benefits they earned through their sacrifice in a 

more timely fashion. 

In my current position as Medical Board and Fiscal Board Representative, I have the privilege of assisting servicemembers who 

might not be able to continue their military career due to a medical 

condition. These individuals represent some of the most at risk 

transitioning servicemembers due to their current medical needs. 

While the current Improvised Disability Evaluation System, 

known as IDES, a joint program by DoD and VA, is an improvement over the previous system of doing medical evaluations, we 

can always make it better. The American Legion maintains a national staff at the Benefits Delivery Discharge location at WinstonSalem, North Carolina and Salt Lake City, Utah, as well as out 

processing sites at Joint Base Lewis-McChord in Washington State, 

and the Washington, D.C. Capital Region. What we found is that 

servicemembers could benefit from better information. This is perhaps better illustrated by members of the Reserve and National 

Guard who might be going through the process by themselves back 

at their home state. They do not have the access to the same information and resources as their active duty counterparts. 

These veterans going through transition are making decisions 

that will impact their entire civilian lives and often they are being 

asked to do so with little understanding of what that impact will 

be. As American Legion service officers we can bring insight to 

what benefits they are entitled or not entitled to. We can also help 

them understand the importance of their medical exams. Helping 

servicemembers manage expectations and understanding the 

timelines is critical. Helping them understand what job training 

and resources are available, what short discharge or retirement options are best suited to them. The kind of guidance is still hit or 

miss without good counseling. 

The American Legion helps over 500 servicemembers a quarter 

with their BDD and Quick Start claims but thousands of veterans 

still go unrepresented. It is often difficult for service organizations 

to communicate directly with servicemembers on post. When you 

consider a report issue on May 20th by the IG, VA is making errors 

on these claims with only around a 69 percent accuracy rate. 


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Veterans need advocacy at every stage of the process. The American Legion hopes to continue working with the Department of Defense and the Department of Veterans Affairs to ensure that all 

veterans have advocacy throughout their transition process. The 

system exists to serve those who wear the uniform of the United 

States of America. But the American Legion exists to be a veteran 

serving veterans organization. And we can best do that when we 

bridge the gap between our veterans and servicemembers and the 

services provided by DoD and the VA. 

Thank you for inclusion of the stakeholders. We are happy to answer any questions. 

[THE PREPARED STATEMENT OF GERARDO AVILA APPEARS IN THE

APPENDIX] 

Mr. RUNYAN. Thank you. And we will recognize Mr. Varela for 

his testimony from DAV. 

STATEMENT OF PAUL RAYMOND VARELA 

Mr. VARELA. Thank you, Chairman Runyan. Good afternoon, 

Ranking Member Titus, and members of the subcommittee. DAV 

appreciates the opportunity to testify today at this hearing to examine more closely the IDES program and other aspects affecting 

active duty servicemembers participating in the BDD or Quick 

Start programs, commonly referred to as the pre-separation process. My oral remarks will address three issues we find particularly 

important. 

First, time frames and benchmarks established within the IDES 

program. The IDES program was constructed with the expectation 

of servicemember reaching finality within 295 days and we will 

highlight several critical points along this transition path. Proposed 

rating decisions by D–RAS locations are required to be issued within 15 days of receiving notification that a servicemember has been 

deemed unfit for duty. DAV service officers in the field do report 

delays in the proposed rating process, in some areas ranging anywhere from three to six months. Once separated from service and 

now considered a veteran their disability compensation payments 

are expected to begin within 30 days of discharge. DAV service officers have reported delays in the processing of finalized IDES 

claims in Providence, Rhode Island and previous delays in Seattle, 

Washington. At Seattle, Washington D–RAS sites improvements 

have been noted within the past few months due mostly to consolidation and reorganization of resources. Delays are also reported out 

of D–RAS sites in Rhode Island, not only affecting final rating 

board determinations but also the proposed rating board determination. 

DAV finds most reports of delays are personnel related, specifically a lack thereof, a situation where demand has outpaced resources. A thorough evaluation is needed to determine exact resource and personnel requirements and whether a proper case to 

staff ration model exists. Of critical importance is when an active 

duty servicemember crosses the threshold and becomes a veteran. 

A delay here could have serious consequences as compensation benefits may in fact be their sole source of income. 

Second is VSO access and support. DAV’s transition service officers have earned a renowned reputation for their services within 


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the active duty and veteran community. Despite their reputable attributes and proven track records the launch of the new TAP/GPS 

program, whether deliberate or not, has adversely affected the level 

of service DAV TSOs have been able to provide during the pre-sep 

process. Prior to TAP/GPS DAV was heavily engaged in the pre-sep 

process. TSOs routinely provided briefings to class participants, 

many times at the insistence of military installations. They 

screened personnel medical records and performed one on one 

counseling to provide information and answer any questions posed 

by the participants. 

Unfortunately our role continues to diminish and is met with 

some resistance at some military installations. In some cases there 

have even been attempts to remove the VSO presence and functions entirely. What is presently occurring seems counterintuitive. 

In some instances VSOs’ assistance is promoted, whether through 

the IDES process itself during the physical evaluation board proceedings, but most certainly while engaged with the VA during the 

claim and appeal process. VSOs represent roughly 60 percent of 

claimants and 70 percent of appellants before the VA. Collaborative 

efforts between VSOs and program affiliates would serve as a benefit to our separating servicemembers. 

Third, vocational rehabilitation and employment services. 

Servicemembers proceeding through IDES with ratings of 20 percent or greater have direct access to voc rehab counselors stationed 

at military installations where IDES is performed. Bear in mind 

this IDES mission parameter is staffed with voc rehab counselors 

that are drawn away from daily regional office VR&E operations. 

DAV has testified on many occasions regarding the benefits of the 

VR&E program. VR&E can provide opportunities for immediate 

transition to employment upon separation, career counseling, and 

supportive services and plans if employment is not aligned prior to 

separation. VR&E benefits may not be realized by pre-sep personnel as their focus could be on the use of Post-9/11 G.I. Bill benefits. However, DAV and our independent budget partners have recommended that Congress remove the 12-year delimiting period to 

use this earned benefit to ensure it is available when needed, regardless of when that need arises. With the wide range of benefits 

offered through the voc rehab program it is imperative that 

servicemembers have as complete an understanding of this benefit 

as possible. It could prove critical at some point in the future if circumstances in their lives change. 

In conclusion resource needs must be comprehensively identified, 

procured, and utilized. Programmatic goals and parameters must 

be aligned to meet or exceed this servicemember and veteran-centric mission. VSO involvement during the pre-sep process is vital 

and should receive greater support by all program partners. VR&E 

eligible participants must continue to be identified. Availing these 

services during the active duty phase assures program understanding and gives our wounded, ill, and injured servicemembers 

and their families the best advantage by leveraging all available 

tools and resources needed to successfully transition out of the 

military. 


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Again, Chairman Runyan, Ranking Member Titus, and members 

of the subcommittee, we thank you for the opportunity to present 

this testimony today. 

[THE PREPARED STATEMENT OF PAUL RAYMOND VARELA APPEARS

IN THE APPENDIX] 

Mr. RUNYAN. Thank you. And with that I would recognize Mr. 

Gehrke for the VFW testimony. 

STATEMENT OF BRENDON GEHRKE 

Mr. GEHRKE. Mr. Chairman and members of the subcommittee, 

on behalf of the men and women of the Veterans of Foreign Wars, 

I would like to thank you for the opportunity to testify at today’s 

hearing on VA’s performance in the servicemembers transition 

process. This past Memorial Day many Americans displayed pride 

in the veterans who fought in America’s wars. Surveys show 91 

percent of Americans say that they are proud of military 

servicemembers. Unfortunately the pride America has for its 

servicemembers still is not fully matched by the government agencies charged with supporting their transition back to civilian life. 

The 2007 Walter Reed scandal was a wake-up call to Americans 

that the government was not properly caring for our wounded warriors. The public was outraged that Marines and soldiers were living in disparaging conditions, forced to deal with inattentive management and woefully inadequate care delivery. Equally concerning 

was that veterans were being shortchanged on the disability and 

retirements they have earned. 

As a result Congress and the President conducted fierce oversight over the military’s and veterans healthcare and disability 

benefits system. Congress concluded that the care, coordination, 

and reintegration services provided by the agencies were fragmented, leaving the public, servicemembers, and their families to 

question the government’s commitment to those who carry the burden of battle. In 2008, Congress forced DoD and VA to create policies to ensure that the disability evaluation systems which determined their military and veterans benefits were streamlined and 

fair. As a result, DoD and VA collaborated to create the Integrated 

Disability Evaluation System, which simplified the disability evaluation process by eliminating duplicative disability examinations, 

ratings, and placing VA counselors in military transition facilities. 

The VA has also responded by expanding the Benefits Delivery at 

Discharge and Quick Start Programs to allow servicemembers to 

submit claims before their discharge date. 

The VFW believes these promising programs are a step in the 

right direction. However, we recognize that these programs are far 

from perfect. Servicemembers still suffer from the Defense Department’s disjointed policies and leadership, which govern wounded 

warrior care; inadequate VA and DoD staffing dedicated to the benefits evaluation process; no integrated electronic healthcare system; 

and poor communication. The result of DoD’s and VA’s shortcomings is that servicemembers are waiting too long in wounded 

transition units as VA processes their disability claims. 

To reduce claims processing times we recommend that DoD collaborate with VA to reduce red tape and that VA expedite the adjudication of BDD and Quick Start claims. To ensure DoD creates 


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and enforces the policies that ensure servicemembers are not shortchanged on benefits and that all policies are equitable, we recommend that Congress give the Under Secretary of Personnel and 

Readiness the sole authority to develop policy to improve the care 

and services provided through IDES. 

To say the transition process is seamless for servicemembers or 

that DoD and VA have an integrated disability evaluation process 

would be inaccurate. It is impossible to have an integrated disability evaluation process without an integrated electronic 

healthcare record system. Therefore it is imperative that Congress 

use their complete authority to ensure DoD collaborates with VA 

to create a fully integrated electronic healthcare record system. 

Also communication between DoD and VA senior officials must increase and the departments must conduct better outreach to 

servicemembers, family caregivers, and VSOs. 

In conclusion we acknowledge that both the Departments of Defense and Veterans Affairs are delivering quality care to 

servicemembers and veterans when accessible. We give them credit 

for addressing the disability evaluation system and setting ambitious timeliness goals for delivery and benefits so long as those 

goals are achievable. Timeliness is drastically improved from the 

estimated 540 days it took to complete a claim with the legacy system and VA and DoD continue to shorten the amount of time it 

takes to process disability claims. However, VA and DoD do not 

have the policies, procedures, and resources to address the influx 

of servicemembers who will be transitioning to civilian life as forces 

draw down. It is imperative that Congress not only boost its aggressive oversight over the agencies to ensure that they properly 

plan for the future, but they also must provide the fiscal resources 

to improve the access to care and benefits that our servicemembers 

have earned. 

Mr. Chairman, this concludes my testimony and I look forward 

to answering any questions the committee may have. 

[THE PREPARED STATEMENT OF BRENDON GEHRKE APPEARS IN THE

APPENDIX] 

Mr. RUNYAN. Thank you. And with that we will begin a round 

of questioning. And my first question is going to be for Mr. Avila. 

You note in your testimony that in a recent audit by the VAOIG 

on the Quick Start program VA responded that a lack of timeliness 

was due to an increase in Agent Orange claims. Unfortunately this 

seems to be a pattern from the VA in that they do not adequately 

project their future workload and divert attention from problems 

focusing on the unrelated issues. Can you please elaborate on this 

statement and how it negatively impacts a substantive focus on the 

improvement of pre-discharge claims? 

Mr. AVILA. Mr. Chairman, when I work as an MEB/PEB issue 

in the IDES, I myself went through the pre-discharge claim. I retired two years ago and I used the pre-discharge claim. I used the 

BDD because I filed when I had over, I think I did it at 180 days. 

And that was a program that was currently being pushed by the 

VA. They said if you file this way your claim will be processed and 

you will receive benefits as soon as you exit the military. 

Maybe some of the issue is that these claims go to certain regional offices and a lot of members started filing the claims and eiVerDate Aug 31 2005 09:13 Oct 01, 2015 Jkt 000000 PO 00000 Frm 00039 Fmt 6633 Sfmt 6633 Y:\88-982.TXT PAT

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ther Winston-Salem or Utah would start receiving the claims. And 

what we started seeing is that the BDD and the Quick Start claims 

became a backlog because every servicemember that was 

transitioning was advised that this would be the most advantageous way. And by everybody filing we created a backlog. 

I believe now that BDD and the Quick Start claims have come 

down a bit. I mentioned the Benefits Deliver at Discharge, which 

was another initiative that started. Basically you are submitting a 

claim along with all your medical documentation and asking the 

VA to adjudicate the claim because they have all the information 

available. And I believe right now these claims are being adjudicated, depending on the regional office, between 130 and 135 

days. And like I said, I deal with the IDES and maybe some of the 

issues with IDES too is all Army cases go to the Seattle Regional 

Office, all the other services go to Providence, Rhode Island. And 

I know right now the issue on that is the Seattle Regional Office, 

the Army, if you look at the number, they have the majority of the 

IDES cases. So maybe this is, I do not know, do they switch them 

off to another office? Or maybe there is another, we have got to 

look at another system to get these members their ratings a little 

bit quicker so we can definitely process them out. 

Mr. RUNYAN. Thank you. And my next question is for Mr. Jenkins. You note in your written testimony that pre-discharge employees experienced difficulties with communication with MSCs. 

Two-part question, what suggestions do you have to improving 

communication between MSCs and VSRs? And do you believe that 

greater VSO involvement in pre-discharge claims would help alleviate some of the concerns? 

Mr. JENKINS. Well to answer your question, chairman, any time 

we can have a VSO involved that is going to assist, they have direct contact with the veteran, they are interacting on a regular 

basis, and sometimes they can even speak for the veteran when it 

comes to a claim so they can speed the process along. As far as 

communication between MSCs and VSRs, training has a lot to do 

with it. Some of the MSCs that have been hired do not have previous development training. So they have a lack of understanding 

of the process. It all has to do with staffing, training. Those are the 

bottom lines to it all. They have to be trained properly and they 

have to understand the process between, how it works between the 

regional office and the IDES locations as well. 

Mr. RUNYAN. Thank you. And with that, I yield to the Ranking 

Member Ms. Titus. 

Ms. TITUS. Thank you, Mr. Chairman. I would just say first, Ms. 

Gipson, my colleague Mr. Beto O’Rourke was certainly right. Yours 

is a power and eloquent voice for change and I thank you very 

much for being here. I would just ask you if at any point during 

the process were you asked by anybody, or did you take a survey, 

about how it was working? What could have been done better, if 

you were satisfied? Did you get, did you feel like anybody was asking for your feedback? 

Ms. GIPSON. Yes, ma’am. I do. The issue with the survey is, you, 

I have some familiarity with surveys. And when you survey people 

makes a difference in what their response will be. 

Ms. TITUS. Yes. 


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Ms. GIPSON. So for example if you survey a servicemember who 

has recently entered the IDES process and they are within the first 

30-day window, their comment about the VA, or about the IDES 

system, is not going to be negative at all because they have only 

participated in the process for 30 days. If however you survey that 

same servicemember, say for example within six months of them 

exiting the service, when they have had an opportunity to sort of 

reflect back upon when or what happened to them, I think that the 

numbers may look very different. 

Ms. TITUS. Yes. 

Ms. GIPSON. And so to answer your question more specifically, 

yes, we were surveyed. But at the time, for example, that I took 

the survey, I was about six months into the process and that did 

not seem very daunting to me. Had I been surveyed again at 

month 15 my answers very likely would have changed. 

Ms. TITUS. So you think the results are skewed based on when 

people take the survey—— 

Ms. GIPSON. Yes, ma’am. 

Ms. TITUS [continuing]. And what has happened to them? 

Ms. GIPSON. Yes, ma’am. 

Ms. TITUS. I suspect that is true. It is pretty easy to manipulate 

numbers like that. 

Ms. GIPSON. Yes, ma’am. Yes, ma’am. 

Ms. TITUS. I would also ask the VSOs, starting with Mr. Avila, 

if you have ever heard that term Quick Start, Slow Finish, or 

Quick Start, No Finish? And have you, have you ever discouraged 

any soldiers from going through any of these programs, as we have 

heard of anecdotally? And then finally, I think Mr. Varela mentioned this, what specifically can we do to enhance your role to help 

soldiers before they are discharged like you help them after they 

become veterans that might facilitate this process? 

Mr. AVILA. I have heard of the term, the Fast Start. What I currently do, I deal mainly with the MEB/PEB. I do assist 

servicemembers. And I know the other VSOs have representatives 

at installations. What I am currently advising somebody that is 

getting out is do not do BDD. I ask them to do an FDC. Right now 

that is what is getting results a little bit quicker. So they wait 

until they retire, they go through their transition course and gather all of the information and then once you are retired, or you can 

do it before, fill out all your paperwork, and then on your first day 

of retirement you go and submit it to the VA and use the FDC 

method. It depends on the regional office as well. 

What can we do? I think TAPS, there was focus on TAPS several 

years ago, to put different resources out there for veterans that are 

transitioning. So for my point on the IDES, I think we need to do 

the same part. Because yes. So these soldiers, as you know, they 

have legal rights. Once they get the MEB results they have so 

many days to seek legal counsel. They can use the JAG offices on 

the installation. They can use the DSOs. The issue is that not a 

lot of DSOs are doing specific IDES cases. They are doing your 

transitional VA claim. So I think maybe speaking with DoD, and 

I did have a meeting with DoD, Bret Stevens who is the Director 

of the IDES, and trying to see what the American Legion can do. 

We have service officers. Can we assist? What can we do to get the 


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word out to these members so they can make the best decisions as 

they go through the process? 

Mr. VARELA. Thank you, Congresswoman. Yes, we have heard of 

that term before, Quick Start, Slow Finish. We have discouraged 

some servicemembers from going through BDD or Quick Start, depending on their individual circumstances. What can we do? VSOs 

used to have broader access. And then all of a sudden with the implementation of TAP/GPS, we just became more and more 

marginalized. It is a collaborative effort. I mean, we are all in it 

together. We understand the active duty component, and we understand the veteran component. And we have transition service officers. I like to call them translation service officers, because we can 

translate a lot of what is happening in terms that they can understand. 

Mr. GEHRKE. Thank you, ranking member, for the question. I 

think the numbers on the Quick Start speak for itself. It is 249 

days on average, I think. Members receive their benefits eight 

months after they discharge. So that is definitely not delivery on 

discharge. In regards to Quick Start, we will recommend to some 

servicemembers, veterans, that they not submit a Quick Start 

claim. It depends on where they are going home to. So if they are 

going home to St. Paul or Columbia, which regional office operates 

faster than the others, then we will say, no, wait until you get 

home and we will send a fully developed claim in. If they are going 

to, say, Waco or Houston, which is not well at all, we will say, no, 

let us do a Quick Start now and start the process because once you 

go home it is going to be horrendous. 

One thing that we recommended in the testimony is to treat 

Quick Start claims like you would a fully developed claim. The only 

thing different from a fully developed claim and a BDD or a Quick 

Start—well, I would say a BDD claim, is a DD–214. So theoretically they get to the rating officer fully developed and you theoretically should be able to rate that day. However, they are kind of 

pushed to the side and kind of waited on as they work their other 

cases. So if you treated them as the same process you would an 

FDC claim, you would likely see a fall in the processing times. But 

it is also important to recognize that if you shift the resources 

there you are essentially taking resources from elsewhere. But we 

believe these servicemembers are in need of the benefits the most. 

They are transitioning, they are wounded, they are still maybe 

looking for a job. So they are going through a lot of transition 

process and they really need that income to help them through that 

process. So I think it is appropriate to prioritize those claims. 

Ms. TITUS. Well, thank you for your help. Thank you, Mr. Chairman, for the time. 

Mr. RUNYAN. I thank the gentlelady, and recognize the gentleman from Texas, Mr. O’Rourke. 

Mr. O’ROURKE. Thank you, Mr. Chairman. I would like to begin 

by just noting for the record that Ms. Rubens from the VBA is still 

here and was here to listen to the OIG and to the testimony from 

veterans and VSOs and those who are working within the system 

to serve veterans, and also note that Ms. Halliday and her team 

from the OIG are here to listen. So I really appreciate their attenVerDate Aug 31 2005 09:13 Oct 01, 2015 Jkt 000000 PO 00000 Frm 00042 Fmt 6633 Sfmt 6633 Y:\88-982.TXT PAT

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tion and respect to the members who are here giving their testimony. 

Ms. Gipson, you came up with a number of really good recommendations for us and VBA and DoD to follow. One of them was 

to change a culture that can seem as though it is punishing 

servicemembers. And I have heard this directly from 

servicemembers at the WTU at Fort Bliss in El Paso. We have read 

of some really egregious cases where it seems that the punishment 

is punitive, overly punitive if not downright humiliating. And I 

hope those are the exceptions and not the norm. And it is part of 

the pressure I feel to get that wait time down, which back in February was 185 additional days over the goal down to what Ms. 

Rubens has committed to in terms of what the VBA can control. 

Can you talk about from your own experiences what you have seen 

or witnessed within that culture, and how we might go about 

changing it? And I will have one additional question. So if you 

could answer that within the span of about a minute or two that 

would be great. 

Ms. GIPSON. Yes, sir. It has been my experience that soldiers are 

often treated with if not open hostility then at a minimum a sort 

of dismissive attitude. It is not, I think that you have to start with 

the premise that soldiers deserve this, the wounded warrior programs and they deserve to have their illnesses and injuries treated. 

I think if you start there then that is a great springboard to build, 

around which to build policies and procedures that will advocate on 

behalf of the soldier. 

What I think happens is that there is a sort of consensus that 

these programs are there simply for soldiers to take advantage of 

and to get as many benefits as they possibly can before they exit 

the system. And there is a resentment that builds up. And I think 

if there can be policies that can abate that mentality, I think you 

can go a long way in changing the culture. 

Mr. O’ROURKE. And I should also say that I have had a chance 

to speak with some of the commanders at the WTU, and you know 

from their perspective they have this obligation and responsibility 

to maintain discipline and readiness and there is this understandable tension between people who are on the verge of transitioning 

out and their commanders who may have them for, you know, in 

the case of El Paso a period approaching 200 days longer than they 

should have. So it gives us added impetus to try to reform this system and as you say reform the culture within it. 

Mr. Gehrke, I wanted to follow up on some of the comments that 

you made and ask you a question that I asked the OIG about 

where we might better commit resources and staffing. We heard 

from Mr. Jenkins that one potential byproduct of brokering is that 

we have some regional offices looking for work or creating new or 

different kinds of work that may not be as effective or as efficient. 

You have heard my concerns about the wait times in the IDES 

process. What are your views on how we could improve staffing levels, resourcing? What are we missing and where are we missing 

that? 

Mr. GEHRKE. Thank you for the question. I think Ms. Gipson was 

right on in saying that there needs to be some sort of staffing reassessment. I mean, we hear in all of these VAOIG reports or GAO 


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reports that, one, there has been mismanagement. But two, it is always coupled with that there is a lack of staff. And so I would like 

to personally know what the formula is for deciding staffing levels, 

whether they have such a formula and what it consists of, and then 

how often they do those staff assessments. And not just for VBA, 

for VHA as well, and DoD as well. Because we always hear that 

they are missing physicians, they are missing rating officers, 

PEBLOs, across the board. And so there is a lack of resources. But 

it is hard to decide where to put the money and where to allocate 

those resources if there is not a proper formula for deciding what 

those staffing levels should be, and where it is missing, and where 

maybe it might be too much. 

Mr. O’ROURKE. You know, from my perspective as long as VBA 

is able to meet their stated goals for timeliness and accuracy, I am 

very happy for them to decide where those resources are placed. 

When they are unable to then it seems as though they may need 

some help from either oversight bodies or VSOs that work directly 

with them. I would just welcome you and the other VSOs who are 

here to continue to stay in touch with us, where you might see deficiencies, where we are not meeting our goals when it comes to accuracy and timeliness, and where we might recommend additional 

resources being placed. So I appreciate your perspective on this. 

And it looks like I am out of time, but I would like to follow up 

with you if you have additional comments. And with that, Mr. 

Chair, I will yield back. 

Mr. RUNYAN. Do you want another minute or two? 

Mr. O’ROURKE. Well, Mr. Gehrke, it looked like you were about 

to say something else. And so with the chair’s indulgence I would 

love to get your answer on that. 

Mr. GEHRKE. I was just going to say I think in the VAOIG report 

on Quick Start they pointed out that I believe it was San Diego or 

Salt Lake City that they had requested additional staff and VA 

provided those staff, and then that facility went and used the staff 

for other purposes. So we see that quite often. Where they say that 

we are going to use all this hundred people for Quick Start and 

they cut them in half and use them for Nehmer cases or some sort 

of other cases. Which shows that they may need even more staff 

than they are asking for or that is being allocated to them. 

Mr. O’ROURKE. Thank you, Mr. Chair. 

Mr. RUNYAN. I thank the gentleman, and I thank everyone for 

being with us today, and the panel is excused. I appreciate the 

time and attention you spent preparing your remarks. 

It is obvious that there is still much to be done in IDES as well 

as the transitioning disability benefits programs. I do not want 

anyone here to lose sight of these transitioning servicemembers, 

our newest veterans, with any false argument that the VA has 

more important priorities until 2015. VA has always had to maintain multiple priorities and now through 2015 is no different. 

I ask unanimous consent that all members have five legislative 

days to revise and extend their remarks and include any extraneous material. Hearing no objection, so ordered. I thank the members for their attendance today and the hearing is now adjourned. 

[Whereupon, at 4:52 p.m., the subcommittee was adjourned.] 


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f 

APPENDIX 

PREPARED STATEMENT OF RANKING MEMBER, DINA TITUS

Thank you, Mr. Chairman for holding this hearing today on behalf of our nation’s 

veterans. 

Today, we will look into the performance of programs that VA and DoD utilizes 

to determine ill or injured servicemembers fit for duty status, as well as programs 

designed to expedite the adjudication of separating servicemembers claims. Particularly we will focus on the Integrated Disability Evaluation System (IDES), the Benefits Delivery at Discharge program (BDD) and the Quick Start Program. 

All of these programs have now been up and running for a number of years. IDES 

was initiated in 2007 in follow-up to poor conditions and fragmented care that our 

Servicemembers were receiving at Walter Reed Army Hospital. 

BDD was launched in 1995 as a pilot, and fully launched in 1998. The intent of 

BDD is to assist disabled servicemembers in making a seamless and successful transition to civilian life by allowing them to get their claim completed as early as possible while they have their medical information readily available and it is clear that 

there is a nexus between their disability and military service. 

Quick Start was launched in 2008, is similar in nature to BDD, and was established to provide an expedited disability benefits process to servicemembers that will 

be discharged within 59 days. 

Despite having been long established, and the intent and need to assist our 

servicemembers transition into civilians, all three of these programs continue to be 

fraught with challenges and are performing far below expectations. 

The one similarity that all of these programs have is that they all suffer from continued poor timeliness on behalf of VBA in adjudicating these claims. BDD and 

Quick Start have particularly seen a drop off in the number of claims filed under 

the program. In our Committee oversight travel, we have heard VA employees and 

VSO’s alike suggest that participating in these programs will actually increase the 

time it takes for a veteran to receive an outcome on their case versus their intent 

to reduce it. The programs have also started to draw their own mantras amongst 

employees and veteran advocates such as ‘‘Quick Start, Slow Finish.’’ 

In meeting with the VAOIG they have highlighted that eliminating the backlog 

has started to come at the price of other benefits and claims such as IDES, Quick 

Start and BDD, being moved to the back burner. The IG also highlights concerning 

disparities between VA’s internal determinations of accuracy via STAR reviews and 

the accuracy levels that they have found in their reviews. I believe the timeliness 

metrics in combination with the VAOIG’s findings speak for themselves, BDD, 

IDES, and Quick Start are simply not a VA priority. 

With regards to IDES, our committee continues to receive constant emails from 

servicemembers. They all generally have the same ask, ‘‘I am in the Army, and I 

am waiting for a rating decision from the DRAS (D–RAZ) in Seattle, Washington, 

I need my VA rating so that I can get out of the military so that my family and 

I can move on with our lives.’’ Many of them have emphasized a negative impact 

that the IDES process has had on them and their relationships with their families. 

Our staff has witnessed firsthand the poor culture that is often prevalent at IDES 

stations and Wounded Warrior Battalions. I want to thank Ms. Gipson, an Army 

veteran who recently went through the process, and is with us here today, for highlighting the negative culture in IDES, amongst other issues, in her testimony. 

I want to be clear about something with regards to the IDES process. There is 

no other process whereby VBA is holding individuals’ lives, our Nation’s injured 

servicemen and women, in bureaucratic limbo based on their need to reach a decision. An Army Reservist that enters the VA Rating stage of the IDES process today 

will not get her decision back from the Seattle DRAS (D–RAZ) until November 26th. 

She likely joined the IDES process around February 17th, 2014 and will not complete the process until June 23rd, 2015. 

As our servicemembers wait for a VA rating decision, they are often disconnected 

from their families who may be at the place they call home, which is often not the 

same location as the IDES processing facility. 

As our servicemembers wait for a VA Rating decision, they and their spouses are 

often hesitant to take college courses or technical training as they do not know 

when or how the IDES process will end. 

As our servicemembers wait for a VA rating decision, they and their spouses are 

often unable to accept or seek employment as they do not know when they will be 

discharged and when they will get back to the place they call home. 


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For all of these reasons, and most all because it is the right thing to do, VA needs 

to take a hard look at their resources pointed at IDES and say how do we get to 

our goals today and not tomorrow. 

VA’s timeliness issues aside, I would also like to start the dialogue on looking at 

the IDES process from a new perspective. An angle that emphasizes the 

servicemembers, their families, and their transition, over the current process that 

emphasizes DoD’s need to determine if the servicemember is found ‘‘physically and 

mentally fit to perform their military duties,’’ or not. 

My staff recently sat down to discuss this idea with DoD and we were surprised 

to learn that 95% of our nation’s servicemembers that enter into IDES are discharged through the program. Knowing that 19 out of 20 Servicemembers are going 

to be discharged how could we offer servicemembers that are selected to go into 

IDES with an alternative option? 

An option that would allow them more geographic flexibility in their transition, 

an option that would give them more flexibility to accept a new employment position 

or pursue an educational degree. Again, with 95% of IDES servicemembers getting 

out, I think we have to ask ourselves are we focused on the right outcomes. 

I think the 378 days that soldiers spend in IDES would be better utilized emphasizing transition through the right mixture of healing, education, and employment 

with fewer DoD requirements and increased access to assistance. A way that allows 

Servicemembers to heal from their injuries while growing their capacity for civilian 

employment. 

In closing, these programs have been around for a long time for the right reasons. 

It is time that we prioritize these programs to do right by those who need it most, 

our ill and injured servicemembers that are transitioning. 

I thank all of our esteemed witnesses for joining us today and look forward to 

hearing their testimony. 

f 

PREPARED STATEMENT OF MS. NANCY E. WEAVER

Summary 

Since 2007, the Department of Defense has collaborated with the Department of 

Veterans Affairs in an integrated and transparent disability evaluation system for 

Servicemembers who have any illnesses or injuries that may compromise their ability to perform military duties. 

In the Integrated Disability Evaluation System (IDES), Servicemembers receive 

a single set of examinations and disability ratings that DoD uses to determine fitness-for-duty and compensation for unfitting conditions and VA uses to compensate 

for all conditions incurred or aggravated during military service. Determinations are 

completed before a Servicemember is separated so both Departments provide disability benefits at the earliest point allowed by law. 

The advantages of IDES, compared to previous legacy systems, include: elimination of separate examinations and disability ratings; consistency between DoD 

and VA disability ratings; and, a reduction of post-separation wait time for VA disability benefits. The IDES reduces the administrative burden on Servicemembers 

who undergo a single exam and complete VA claim paperwork before discharge, and 

has resulted in improved Servicemember satisfaction, disability benefits timeliness, 

and rating transparency. 

DoD has continued to implement process enhancements to include: improved policy; increased staffing levels; and, training standards for counselors. These and 

other improvements have enabled DoD to achieve and remain below its core IDES 

processing goal of 105-days for the past several months. 

DoD is also looking at technology to gain more efficiency. We are working a joint 

system that will leverage existing IT capabilities where appropriate, as well as new 

capabilities, to support end-to-end case management; tracking, reporting; and, a bidirectional electronic IDES case file transfer. We will continue to work with VA to 

ensure system interface requirements are identified and planned for from design 

through deployment. 

In support of VBA’s transition to a fully digital environment for claims processing, 

DoD achieved the goal to implement a secure interface to allow VA to query the 

Health Artifact and Image Management Solution repository for relevant Service 

Treatment Records by January 2014 in accordance with the DoD—VA Joint Strategic Plan. 

We have worked diligently to develop and support a disability evaluation system 

that ensures our Nation’s wounded, ill and injured servicemembers receive timely, 


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transparent, and fair compensation for injuries and illnesses incurred in the line of 

duty. 

Introduction 

Chairman Runyan, Ranking Member Titus, distinguished Members of the Subcommittee, thank you for the opportunity to appear before you today to discuss the 

Integrated Disability Evaluation System, also known as the IDES. 

Over the past several years, the IDES has greatly improved the way the Department of Defense (DoD) and the Department of Veterans Affairs (VA) evaluates our 

seriously wounded, ill, and injured Servicemembers. From 1949 to 2007, medically 

discharged Servicemembers have been processed through separate DoD and VA disability evaluation programs. Each department administered their own disability examinations and ratings and seriously wounded, ill, or injured Servicemembers had 

to wait until after they left military service to apply for VA benefits, even when DoD 

had already examined and rated their disabilities. In 2007, those separate departmental disability processes took about 540 days end to end, including 300 days for 

DoD and 240 days after separation from military service for VA. Separate examinations and ratings by the departments led to inconsistent and confusing results. 

The results of DoD and VA efforts to modernize disability evaluation are that 

since 2007, over 82,000 Servicemembers have benefited from IDES. Our joint processing times have decreased from a total of 540 days under the previous disability 

evaluation system to 353 days total in April 2014, and currently 83 percent of 

Servicemembers in IDES express satisfaction with their IDES experience. 

Although the IDES improves on the previous disability processes, we must continue to enhance this system in order to be flexible in response to the changing demands of the 21st century. DoD is improving the IDES to meet those demands and 

be faster, fairer, and more consistent and transparent than the Departments’ previous processes. The Department of Defense is committed to continuously evaluate 

and implement enhancements that will improve the IDES. 

IDES Benefits 

At its core, IDES remains a fitness for duty evaluation process, with the primary 

objective of determining whether a Servicemember is physically and mentally fit to 

perform their military duties. But, the IDES process also offers a number of improvements and benefits compared to the previous legacy disability evaluation environment. Integrating the previously separate, sequential processes allowed the departments to eliminate duplicate disability examinations and ratings, co-locate 

many process administrators, share full medical records, and capitalize on VA’s disability rating expertise. IDES also provides several direct benefits to 

Servicemembers. IDES introduces disabled Servicemembers to VA’s health care and 

disability benefits system sooner, provides more consistent access to accurate and 

timely information about the process to Servicemembers, their families and caregivers, provides disabled Servicemembers their proposed VA disability rating prior 

to leaving the military, and provides more consistent, understandable outcomes for 

Servicemembers going through the process. And, the Servicemember retains all of 

his or her rights to due process in both Departments. These benefits were achieved 

through successful collaboration between DoD and VA. 

In the past, the two Departments used their own examinations to determine medical conditions incurred or aggravated by military service. They also developed separate ratings for the degree of disability caused by those medical conditions. This 

often led to different results between DoD and VA for disabling conditions, disability 

ratings and compensation levels, fostering confusion and objections over the outcome. Now, DoD provides VA the member’s service treatment record. VA conducts 

the disability examinations, which are then added to create a complete service treatment record. DoD uses the completed service treatment record to determine whether 

each condition makes a Servicemember unfit for continued service. VA uses the Veterans Affairs Schedule for Rating Disabilities (VASRD) to establish a proposed rating for each disability incurred or aggravated by military service. VA shares those 

results with DoD and each Department then uses the results to establish a Veteran’s disability determination. The IDES process ensures consistent disability evaluations and ratings for the set of medical conditions that make a member unfit for 

service. 

Use of a common form and co-located resources also contribute to a faster, fairer, 

and more consistent and transparent process. The Departments share the VA/DoD 

Joint Disability Evaluation Board Claim form, VA Form 21–0819, to refer, track, 

and identify outcomes throughout the IDES process. Another advantage the IDES 

offers is in the area of communication. Wherever practical, DoD and VA case workers are co-located in the same building on DoD installations. This improves information flow and timeliness, and is more convenient for the Servicemember. Throughout 


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the process, DoD and VA case workers keep Servicemembers informed of the 

progress of their case, what events and activities are coming next, and their rights 

and responsibilities. DoD case workers strongly encourage the Servicemember to include family members and caregivers during education and counseling sessions. 

This approach ensures that the Servicemember’s personal support structure is well 

informed as to expectations and requirements. 

Throughout the IDES process, the use of a standardized form, co-located process 

administrators, and the conduct of a single set of examinations to support the disability decisions of each Department help reduce the overall amount of time required for a Servicemember to progress from a disabling wound, illness, or injury 

through the disability evaluation process to the point where they have their DoD 

disability and benefits decisions, as well as their VA disability benefits notification. 

This allows Servicemembers to both better plan for their future as a veteran, as well 

as begin receipt of VA benefits much closer to their date of discharge from military 

service. By integrating the two separate disability evaluation processes, DoD and 

VA are much better positioned to support the Servicemember’s transition to veteran 

status and reintegration back into the civilian community. The measurable improvements have benefitted thousands of seriously wounded, ill, and injured 

Servicemembers. 

IDES Performance 

Over 82,000 Servicemembers have completed IDES since 2007. As of April, 2014, 

there were 29,640 Servicemembers enrolled in the IDES (73 percent Army; 8 percent Marine Corps; 7 percent Navy, 11 percent Air Force). 

As of April 2014, integrating the Departments’ processes had reduced the total 

time from when a DoD physician referrals a seriously wounded, ill or injured 

Servicemember for disability evaluation until receipt of VA disability benefits by 35 

percent (an average of 540 days in the previous disability evaluation system to 353 

days). Working together, the Departments reduced the ‘‘benefits gap’’ (time between 

discharge from the military and receipt of VA benefits) 86 percent from 240 days 

in the previous disability evaluation system to 34 days in April 2014. DoD has demonstrated continuous progress in recent months by reducing the average time to 

complete the DoD’s required core activities by 11 percent from 114 days in November 2013 to 101 days in April 2014. DoD core IDES activities include: physician referral for evaluation and intake counseling; preparation for and execution of a Medical Evaluation Board to assess the member’s illnesses and injuries; preparation for 

and execution of a Physical Evaluation Board to determine whether the member is 

fit to remain in the military or must be separated or retired; and, a transition period 

to out-process and separate or retire those who must leave their Service, against a 

goal of 105 days. DoD has met the 105-day core process timeliness goal for the last 

three consecutive months. Among the Military Departments, the Army has successfully met DoD’s core timeliness goal for the last six consecutive months; the other 

Services are continuing to improve their timeliness. 

However, more work is needed to meet the overall IDES timeliness goals. In April 

2014, a Servicemember’s case file averaged 353 days to complete the integrated DoD 

and VA process against 295-day (Active component) and 305-day (Reserve component) timeliness goals. Days to complete VA core processes improved 25 percent 

from 250 days in November 2013 to 187 days against a goal of 100 days. However, 

DoD and VA cannot achieve the IDES overall 295- and 305-day goals until both Departments reach their respective performance goals. VA has shared their improvement plan to meet its timeliness goal by October 2014. Together, the Departments 

anticipate meeting the overall goal by the end of this year. 

The integrated nature of the IDES means that each Department can gain efficiency in their core processes, but must be attentive of how these efficiencies affect 

both Departments’ processes so they do not inhibit the smooth transition between 

IDES stages. DoD’s improved case processing efficiency resulted in more cases being 

transferred to VA than could be completed, extending the time Servicemembers remained in the IDES process and on active duty. 

Timeliness is important, but DoD is also concerned with whether Servicemembers 

are satisfied with their IDES experience. DoD monitors Servicemember satisfaction 

with IDES through surveys at two key points—after Servicemembers complete their 

Medical Evaluation Board and after they receive the results of their Physical Evaluation Board. Seeking feedback after the Physical Evaluation Board is important to 

DoD because after that board, the Servicemember has been informed of their proposed disability rating and the results of the DoD fitness decision—return to duty, 

separate, temporary disability retirement, or permanent disability retirement. 

Servicemember feedback received between July and December 2013 indicate that 83 


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percent were satisfied with their overall IDES experience. Servicemembers reported 

even higher levels of satisfaction with IDES DoD customer service (88 percent). 

IDES Enhancements 

As IDES matures, DoD has continued to work to refine and enhance the process. 

In 2011, the Warrior Care Policy Office began drafting DoD policy to combine thirteen separate policy documents, disability evaluation issuances, and directive-type 

memoranda. This is the first comprehensive rewrite of IDES policy and procedures 

issuances. By summer 2014, the Military Departments will be able to work from a 

much improved set of policy documents that provides simpler, clearer guidance to 

the individuals administering the program. This should, in turn, lead to more consistent interpretation and implementation of policy and more consistent outcomes. 

DoD appreciates the quality assurance program guidance in the National Defense 

Authorization Act for Fiscal Year 2013 (Public Law 112–239) and is preparing a 

comprehensive disability evaluation quality assurance program to fully implement 

Congress’ guidance in October 2015. Implementing the quality assurance program 

will standardize the way DoD compares and reports the accuracy and consistency 

of DoD disability decisions. Analyses from these reviews will allow DoD to identify 

best practices and areas needing improvement. DoD will institutionalize the quality 

assurance program in policy to ensure long-term improvements to the accuracy and 

consistency of the process. 

DoD increased its IDES staff levels by approximately 700 individuals (127 percent) between 2011 and 2013 to ensure it has sufficient case managers, doctors, lawyers, and adjudication staff to improve timeliness and sustain the performance of 

DoD core functions for Servicemembers in the process. Increased staff helps ensure 

Servicemembers, their families and caregivers receive more frequent and meaningful communication about the IDES and where the member is in the process at any 

given point, which makes the significant life event of transitioning to Veteran status 

somewhat easier. These actions ensure that the IDES is more transparent to participants and their families. 

DoD issued enhanced training requirements for Service Physical Evaluation 

Board Liaison Officers. These new requirements provided minimum standards for 

training program content and performance objectives for Physical Evaluation Board 

Liaison Officers to ensure their consistent performance and that Servicemembers receive the best possible counseling and support while in IDES. 

DoD verifies the Servicemember’s service treatment record includes all available 

information prior to providing the record to VA. This ensures VA has all necessary 

medical information and can complete their medical examination and rating processes faster without searching for additional information. A complete service treatment record also increases the accuracy of medical examinations and helps the 

Servicemember retain an accurate assessment of his or her own health and fitness. 

While this change could result in an increase in time for a minority of cases referred 

into the IDES, it is in the best interest of the Servicemember that DoD provides 

VA all available medical documentation. Having the complete file ensures that all 

medical evidence is available for consideration and can prevent future case rework. 

DoD is continuing to make the necessary improvements to ensure we are using 

the best possible evaluation system. The IDES has been in place since 2007, and 

although we review processes regularly, DoD is conducting a follow-up study to a 

Fiscal Year 2012 National Defense Authorization Act (Public Law 112–239) requirement to provide critical analysis and recommendations for consolidating the organizations that execute the IDES. DoD expects to deliver the results of this analysis 

to Congress this summer. 

In the area of information technology enhancements, over the past year, the Warrior Care Policy Office and the Military Departments have been collaborating to 

identify business needs for a Joint Disability Evaluation System (JDES) IT solution. 

Each Service has varying degrees of IT maturity and none have the functionality 

required to fully meet Service’s needs for disability evaluation. A JDES IT solution 

will provide DoD the capability to manage a flexible and adjustable DES to respond 

to the next contingency operation or war that drives more seriously wounded, ill, 

or injured, and reduce delays in transitioning Servicemembers from active duty to 

Veterans status or reintegration back to their units. It will enable the Department 

to leverage existing IT capabilities where appropriate, and include new capabilities 

to support end-to-end case management: tracking, reporting, and electronic IDES 

case file transfer in a twenty-first century environment. 

The current electronic Case File Transfer (eCFT) system is Phase I of JDES; it 

has been operating as a pilot at two locations since 2012. In December 2013, DoD 

tested an interface between eCFT and the VA Data Access Service (DAS), which allowed the transfer of files electronically to the VA. However, this information techVerDate Aug 31 2005 09:13 Oct 01, 2015 Jkt 000000 PO 00000 Frm 00049 Fmt 6633 Sfmt 6621 Y:\88-982.TXT PAT

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nology solution will only yield benefits in timeliness when VA can successfully establish a bi-directional case file transfer capability. Currently, it takes approximately 14 days of the IDES process to mail records within the Military Departments 

and between VA and DoD. 

DoD also revised the IDES satisfaction surveys in July 2013 to better capture and 

report Servicemembers’ feedback. Additionally, the department recently conducted 

a survey of DoD personnel who administer the IDES process to gauge policy effectiveness, as well as satisfaction with training and resources. 

DoD expects these enhancements to lead to further improvement in IDES performance and the department will continue to monitor current performance and prepare for future challenges. 

Although not part of the IDES, you requested that we provide information as to 

the status of DoD and VA’s agreement to provide electronic Service Treatment 

Records (STR) within 45 days of separation. 

In January 2013, in support of VBA’s transition to a fully digital environment for 

claims processing, DoD committed to accelerate the deployment of the Health Artifact and Image Management Solution (HAIMS) for the purpose of transferring electronic STRs to VA. Specifically, DoD committed to and achieved the goal to develop 

and implement a secure interface to allow VA to query the HAIMS repository for 

relevant STRs effective not later than January 2014 in accordance with the Fiscal 

Year 2013–2015 DoD–VA Joint Strategic Plan. 

As of December 31, 2013, the Services stopped mailing hard copies of STRs to the 

VA and the STR scanning process commenced on January 2, 2014. The process for 

digitizing a Servicemember’s STR and making it retrievable by VBA begins with authorized DoD personnel scanning the paper-based elements of a newly separating 

Servicemember’s STR. The digitized STR, comprised of the scanned information and 

digital content from the Servicemember’s DoD electronic health record, is submitted 

into the HAIMS repository and made available to the VA as a single record. 

The current process entails the MTF conducting a Quality Assurance check on the 

STRs and within 45 days of separation/discharge, sending them to a designated 

scanning location—Central Cells—for each Service. The staffs at the Central Cells 

receive and track all incoming STRs. They also do the document preparation and 

metadata tagging needed for successful upload into HAIMS. Based on the MTF’s QA 

check, the last document scanned into HAIMS is the DD Form 2963 (STR Transfer 

or Certification Form), certifying that all due diligence has be done to ensure the 

STR is complete. 

The Army and Air Force were initially operating at contingency sites and have 

just taken possession of a co-located scanning location in San Antonio, Texas. The 

Navy is using a contract facility in Chantilly, Virginia which is augmented by four 

additional Navy MTFs within CONUS. When a separated Servicemember or Veteran files a claim, a VBA rating specialist establishes a claim in VBMS on behalf 

of that individual. VBMS initiates an automated request for the STR. As of May 

12, 2014, the Services have scanned and uploaded over 44,000 STRs into HAIMS. 

Conclusion 

An efficient disability evaluation system is key to ensuring a fit force and assuring fair compensation for a career cut short because of service-related wound, illness, or injury. Since piloting IDES in 2007, DoD and VA have made significant 

strides improving disability evaluation for our most seriously wounded, ill, and injured Servicemembers. Together DoD and VA have eliminated duplication, reduced 

paperwork and administrative burden, increased transparency and consistency in 

benefits outcomes, and accelerated delivery of disability benefits to eligible 

Servicemembers. As a result, IDES processing times have decreased, system efficiency has increased, and 83 percent of Servicemembers report they are satisfied 

with their IDES experience. Despite these advances, DoD will continue to enhance 

the process to improve timeliness, fairness, consistency, and transparency in the 

IDES. 

Thank you for your support of the brave men and women that serve our nation, 

and your dedication to ensuring DoD has the most efficient systems in place to 

evaluate Servicemembers’ ability to continue military service after a wound, illness, 

or injury and ensure the timely receipt of DoD and VA disability benefits for those 

who are medically discharged. 


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PREPARED STATEMENT OF DIANA RUBENS

Good morning Chairman Runyan, Ranking Member Titus, and Members of the 

Subcommittee. My name is Diana Rubens, Deputy Under Secretary for Field Operations, in the Veterans Benefits Administration (VBA). I am pleased to be joined 

by Thomas Murphy, Director of VBA’s Compensation Service and [TBD], Department of Defense (DoD). My testimony will focus on the status of the Integrated Disability Evaluation System (IDES), Benefits Delivery at Discharge (BDD), and Quick 

Start programs. 

With respect to IDES, VA and DoD’s joint efforts over the past six years have resulted in changes and improvements to DoD’s Disability Evaluation System. These 

changes and improvements began in 2007 in the wake of the issues identified at 

the Walter Reed Army Medical Center. IDES originated as a pilot authorized by the 

National Defense Authorization Act of 2008 and was approved for enterprise-wide 

implementation in 2010, which was completed in October 2011. Since that time, 

IDES has been DoD’s enterprise-wide disability evaluation system. 

Together the Departments have created an integrated disability process for 

Servicemembers who are being medically retired or separated. This joint process 

was designed to eliminate the duplicative, time-consuming, and often confusing elements of the separate and consecutive disability determination processes within VA 

and DoD. The goals of the process were to: (1) Develop a single set of medical exams 

used by VA and DoD for disability rating; (2) eliminate the benefits delivery gap 

from separation to receipt of VA benefits; (3) increase transparency and consistency 

of the disability evaluations for Servicemembers; (4) reduce the combined processing 

time; (5) develop a less complex and non-adversarial process; and (6) provide a 

seamless transition of benefits and health care for separating Servicemembers 

through IDES. As a result of our collaborative efforts, we have met these goals. 

In contrast to the legacy process for disability evaluations, IDES provides a single 

set of disability examinations and a single-source disability rating that are used by 

both Departments in executing their respective responsibilities. IDES has resulted 

in more consistent disability ratings, faster decisions, and more timely delivery of 

benefits for those personnel being medically retired or separated. Following discharge, VA can deliver disability benefits in the shortest period allowed by law, thus 

reducing the ‘‘benefit gap’’ that previously existed under the legacy process. Through 

the integration of VA’s Military Service Coordinators (MSC) into the claims process 

prior to separation, Servicemembers no longer have to navigate the VA disability 

system on their own to apply for VA benefits. The VA and DoD integrated approach 

has eliminated the duplicate medical exam and rating processes found in the legacy 

system. 

VA and DoD continually track and monitor IDES performance. Additionally, VA’s 

IDES Program Office conducts monthly internal video teleconferences with all VA 

senior executives involved in the execution of IDES. VA also conducts bi-weekly teleconferences with DoD and the military Departments to monitor performance, resolve problems, and discuss process improvements. Recently VA participated in the 

first Army IDES training symposium. 

Currently in IDES, there are approximately 29,000 Servicemembers. Within 

IDES, VA is responsible for four core process steps: Claim development, medical examination, proposed rating, and benefit notification. For the combined four core 

steps, VA average processing time in April 2014 was 183 days. This is a 29-day improvement from March 2014 and the lowest VA core time since April 2013. VA’s target for the combined core steps is 100 days of the 295-day combined VA–DoD target. 

VA created a plan to improve IDES timeliness that involved a phased approach. 

The first phase of the plan was to meet benefit notification timeliness standards by 

March 2014. This portion of the IDES process is focused on ensuring 

Servicemembers who transition into the civilian world as veterans timely receive 

benefits to which they are entitled. 

The second phase of the plan is to meet timeliness standards for proposed ratings 

by October 2014. To meet these timeliness standards, VA trained and promoted 36 

raters at the Seattle, Washington, Disability Rating Activity Site (DRAS); brokered 

250 proposed ratings per month from Seattle to Providence, Rhode Island from August 2013 through December 2013; instituted mandatory overtime; and implemented Disability Benefits Questionnaires (DBQ) at all sites. In addition, the Army 

provided 21 soldiers to VA to assist in preparing case files for rating at the Seattle 

DRAS. 

VA achieved its intermediate goal of eliminating excess inventory in the Benefits 

Notification stage in March 2014. In April 2014, VA met the performance goals for 

three of the four core steps: Claims development, medical examinations, and benefit 


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notification. VA is still working on meeting the standard for completing the proposed rating. 

Mandatory overtime for claims processors remains in effect. VA and DoD also remain in close communication, discussing referral rates and production expectations. 

VA is on track to eliminate excess inventory in the proposed rating stage by August 

2014 and meet all timeliness standards by October 2014. VA continues to collaborate with DoD on ways to improve IDES execution, while remaining focused on 

meeting timeliness standards. Our continued partnership with DoD is critical. VA 

and DoD are committed to supporting our Nation’s wounded, ill, and injured 

Servicemembers through the IDES process. 

Benefits Delivery at Discharge (BDD) and Quick Start 

The BDD and Quick Start programs are important elements of VBA’s strategy to 

provide transitional assistance to separating or retiring Servicemembers and engage 

Servicemembers in the disability claims process prior to discharge. VBA’s goal is to 

ensure that each Servicemember separating from active duty who wishes to file a 

claim with VA for service-connected disability benefits will receive assistance in 

doing so. Just as IDES provides Servicemembers facing medical discharges with the 

opportunity to initiate a claim for disability benefits, BDD and Quick Start provide 

this opportunity to Servicemembers who are transitioning via traditional or ‘‘nonmedical’’ separation. 

Participation in the BDD program is available to Servicemembers who are within 

60 to 180 days of being released from active duty and are able to report for a VA 

examination prior to discharge. BDD’s single cooperative examination process meets 

the requirements of a military separation examination and a VA disability rating 

examination. 

VBA established the BDD program in 1995 at three VA regional offices and three 

Army installations. Today, there are 96 BDD memoranda of understandings (MOU) 

covering BDD operations at 131 military installations. The MOUs facilitate the collaboration between local VA regional offices and local military installations by 

streamlining processing of pre-discharge claims. In April 2007, in an effort to promote processing consistency and quality decisions, VBA consolidated BDD rating activity to the VA Regional Offices in Winston-Salem, North Carolina, and Salt Lake 

City, Utah. 

In July 2008, VA introduced the Quick Start pre-discharge claim process. Quick 

Start made pre-discharge claim processing available to 100 percent of transitioning 

Servicemembers, including those who are within 59 days of separation, and those 

who are within 60–180 days of separation but are unable to complete all required 

examinations prior to discharge. In 2010, Quick Start claim processing was consolidated to the VA Regional Offices in San Diego, California, and Winston-Salem, 

North Carolina. 

VA’s and DoD’s marketing efforts, outreach activities with transitioning 

Servicemembers, and the support of Veterans Service Organizations, who promote 

the benefits of these programs, have resulted in high levels of Servicemember participation in the BDD and Quick Start Programs. By 2010, approximately 60,000 of 

the 181,000 transitioning Servicemembers elected to utilize the BDD or Quick Start 

claim processes to submit VA disability claims each year. 

In August 2010, VA published its Final Rule establishing new presumptions of 

service connection for three disabilities associated with Agent Orange exposure: 

Ischemic heart disease, Parkinson’s disease, and hairy cell and other chronic B-cell 

leukemias. From 2010 to 2012, VBA devoted significant resources to readjudicating 

over 90,000 previously denied claims for these three conditions, which was required 

by the order of the U.S. District Court for the Northern District of California in 

Nehmer v. U.S. Department of Veterans Affairs. Additionally, over 50,000 claims received after the decision to establish the new presumptive conditions was announced, but before the effective date of the final regulation implementing the decision, were also subject to Nehmer review. During this effort, VBA’s 13 Day One 

Brokering Centers (D1BC) were dedicated exclusively to this readjudication. During 

this same period, there were significant increases in claim receipts for BDD. 

As the Nehmer mission ended, VBA utilized the D1BCs that were processing 

Nehmer claims to reduce the inventory of BDD and Quick Start claims. This effort 

took place from February 2012 to March 2014 and resulted in significant timeliness 

improvements. As of April 2014, the average days pending for Quick Start claims 

is 98.3 days, an improvement of 137.3 days since May 2012, and the average days 

to complete a Quick Start claim is 158 days fiscal year to date (FYTD), an improvement of 200 days since June 2012. As of April 2014, the average days pending for 

BDD claims is 136.7 days, an improvement of 55.8 days since April 2013, and the 


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average days to complete a BDD claim is 198.2 days, an improvement of 116 days 

since May 2013. 

Beginning in 2012, we began to see new trends in claims received, including a 

significant drop in claims for the Quick Start program, from 32,990 in Fiscal Year 

(FY) 2010 to 21,375 in FY 2013. As of May 2014, a little over 11,000 Quick Start 

claims have been received FYTD, with less than five months remaining. As of April 

2014, there are 6,649 Quick Start claims pending, a decrease of 77 percent from 

January 2012, when there were 29,130 Quick Start claims pending. Receipts for 

BDD have declined steadily from a high of 30,893 in FY 2011, to 30,381 in FY 2012, 

and 27,333 in FY 2013. This FY through mid-May 2014, approximately 13,000 BDD 

claims have been received. 

Claims accuracy is not specifically measured for BDD or Quick Start claims processed at the three Rating Activity Sites. Instead, accuracy is measured for each regional office as a whole. As of April 2014, Winston-Salem’s three-month issue-based 

accuracy is 98.7 percent and claim-level accuracy (12-month) is 89.5 percent; San 

Diego’s three-month issue-based accuracy is 96.1 percent and claim-level accuracy 

(12-month) is 85.2 percent; and Salt Lake City’s three-month issue-based accuracy 

is 98.6 percent and claim-level accuracy (12-month) is 91.7 percent. As part of our 

transformation plan to eliminate the backlog of claims older than 125 days and increase quality to 98 percent, VBA began paperless processing all Quick Start and 

BDD claims in December 2012. In October 2013, VBA began the use of the separation health assessment DBQs to expedite the rating process. 

VBA continually monitors claim accuracy and provides substantial training and 

oversight for claim processing personnel. Benefits Delivery at Discharge and Quick 

Start claims are included in the statistically random sample selected for the regional office’s Systematic Technical Accuracy Review. Compensation Service Quality 

Assurance Program Review Staff also conducts special focused reviews of pre-discharge claims. 

VBA is now working to redesign the pre-discharge claim processes by building on 

lessons learned through the execution of the BDD and Quick Start Programs. The 

new pre-discharge program will consolidate and replace the existing BDD and Quick 

Start programs. VBA is leveraging functionality now available in the Veterans Benefit Managements System and eBenefits, to add convenience to the application process and efficiency throughout the claims process. Servicemembers can currently submit pre-discharge claims electronically through eBenefits; VBA is developing programming that will route these electronic applications directly to dedicated personnel who specialize in pre-discharge claim processing. 

VBA is also working to maximize the use of electronic record-sharing in the predischarge claims process, and eliminate the requirement for pre-discharge claimants 

to gather and submit photocopies of their service treatment records as part of their 

application package. Pre-discharge rating sites will capitalize on DoD’s commitment 

to provide VA with 100 percent of separating Servicemembers’ ‘‘gold standard’’ service treatment records within 45 days of discharge, which will serve to support more 

timely decisions on pre-discharge claims. This is accomplished via the Health Artifact and Image Management Solution (HAIMS) to VBMS interface, which was implemented January 1, 2014. The service treatment record ‘‘gold standard’’ contains 

the complete medical record, complete dental record, and DD Form 2963—Certification Form. All of these need to be available in HAIMS for transmission to VA in 

a complete package within 45 days of separation/retirement from the military. 

VA is committed to supporting our Nation’s Servicemembers through improvements in pre-discharge programs. VA believes its continued enhancements are critical to program success—and are nothing less than our Servicemembers and future 

Veterans deserve. 


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PREPARED STATEMENT OF DEBRA J. GIPSON

I would like to thank Chairman Runyan for holding this important hearing on the 

Integrated Disability Evaluation System (IDES). I am honored to have been asked 

to participate. 

History 

In 2011, while training to deploy to Afghanistan, I sustained a severe back injury. 

By the time my Reserve detachment reached the Active Duty training site, Fort 

Bliss, Texas, I was confined to a wheel chair earning me the nickname, ‘‘The Wheel 

Chair Soldier.’’ Days later, I was prescribed a cocktail of drugs which allowed me 

to walk but not without excruciating pain. Placed in the Warrior Transition Program, efforts to rehabilitate my injury were unsuccessful and required surgical 

intervention. 

Before my back surgery could be performed, I required a surgical procedure to 

treat uterine fibroids; tumors on my uterus. I did not receive a follow-up gynecological appointment. Placed in IDES, I was determined medically unfit to serve, received a 20% disability rating, medically separated and received separation pay. 

Within days of signing paperwork agreeing to the rating, it was determined that I 

urgently needed a hysterectomy. I want to be clear that had I received a follow-up 

to the original gynecological procedure the hysterectomy would have been performed 

earlier and my disability rating would have been 70%. 

Instead of being medically retired, I was medically separated from the United 

States Army on January 11, 2014. 

Introduction 

In my opinion, a strong democracy requires two professions: the Legislator and 

the Servicemember; each the weapon of the other. Healthy Servicemembers are the 

weapons of the Legislator while the Legislator is the weapon of wounded, injured 

and ill Servicemembers. We’ve served as your weapon. On behalf of disabled and 

medically separated Veterans, we respectfully request that you harness your arsenal’s full potential to fix this system and maintain the strength of our democracy. 

I present the following long and short term recommendations: 

Long-Term Recommendations 

1. Establish a Consolidated Disability Evaluation System 

The Integrated Disability Evaluation System (IDES), the disability ratings process 

by which Servicemembers are evaluated and declared eligible for compensation, is 

timely, burdensome and inefficient. The VA and DoD must consolidate the Departments’ disability systems with the shared goal to promulgate policy and prescribe 

uniform guidelines, procedures and standards to eliminate redundancy inherent in 

adjudicating claims using dual disability rating systems. 

2. Create a Sole Source Disability Rating 

The military rates only ‘‘fitting’’ conditions while the VA rates all service connected injuries resulting in two different ratings for qualifying Servicemembers. The 

DoD and VA will need to reach a consensus on the definition of qualifying conditions 

and events and the rate at which those conditions and events are to be compensated. Understandably, a bias in favor of the current, more generous VA system 

will result in a corresponding rise in retirement and medical costs. 

3. Information Sharing 

Plans to roll-out shared use technology by 2017 will enhance and improve agency 

accessibility to health care records. The plan is both necessary and ambitious. However, the current lack of available technology is only part of a much larger problem. 

Government agencies, among them the DoD and the VA, must generate Memoranda 

of Agreement allowing agencies to openly share information. This will likely require 

a change in agency culture from one of independence to interdependence on sharing 

information and resources. 

Interim Recommendations 

1. Fiscal Set Aside 

Veterans in the Servicemembers Transition Process frequently complain about the 

receipt of timely payments once his or her claim has been adjudicated. To date, the 

receipt of benefit payments can take from 90 days to a year or more to process. 

While uncertain of the legal or tax implications, I recommend that once a 

Servicemember enters Federal service (Active Duty, Reserve or Guard) a percentage 

of the Servicemember’s salary be escrowed until the IDES or (retirement) process 

is complete. The funds set aside could then be automatically reimbursed to the Veteran as a lump sum payment used to bridge the gap between the date of retirement 

(or separation) and receipt of any long-term or separation benefits. 


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2. Emergency Surgery Rating Reconsideration 

Servicemembers who require emergency surgeries within sixty (60) to ninety (90) 

days of being rated should receive automatic disability rating reconsideration. 

3. Complete a Comprehensive Staffing Needs Assessment 

The Office of Personnel Management must undertake a comprehensive staffing 

needs assessment to: a) properly assess the cost/benefit of properly staffing the 

IDES system, and b) research areas where backlogged claims exist to determine 

whether problems of redundancy and inefficiency are functions of process or staffing 

related to organizational behavior, poor training, and/or a lack of incentives. 

Staffing at the appropriate level will go a long way towards: a) eliminating the 

current claims backlog and, b) reducing the amount of time it takes to assess individual claims. Increasing staff means a short-term increase in personnel costs offset 

by a reduction in both the amount of time it takes to process claims and the number 

of Servicemembers anxiously awaiting claims adjudication. 

4. Manage Fraud, Waste and Abuse 

The system is replete with opportunities for fraud, waste and abuse. The underlying premise of the adjudication process is to provide compensation and benefits 

for long-term injuries and illnesses. Any system which compensates Servicemembers 

for injuries and illnesses must also incentivize healing and recovery. It isn’t a politically popular notion. However, necessary if ballooning costs are to be reduced and 

full recovery a goal. 

A comprehensive assessment of where opportunities for fraud, waste and abuse 

exist must be conducted and measures put in place to mitigate such opportunities. 

Examples include: encouraging physician second opinions, eliminating redundancy 

in paperwork, and information sharing not just between agencies but within. 

5. Organizational Change. 

We have got to change the organizational culture which punishes Servicemembers 

(directly or indirectly) for sustaining wounds, injuries or illnesses. In the current climate, Servicemembers deemed unfit to fight or conduct acts of physical fitness are 

cast aside and labeled; often unfairly, as lazy or cowardly. I do not advocate group 

hugs on the battlefield. However, leadership training must encourage compassion, 

dignity and respect. Likewise, service providers, whether military or civilian, must 

receive similar training. 

Toxic leaders (military and civilian) and service providers must be either retrained or moved out of leadership or positions of authority to mitigate damage to 

wounded and/or recovering Servicemembers. 

Conclusion 

The recommended suggestions to improve IDES will each require a cost-benefit 

analysis to determine feasibility. Such analysis is beyond the scope of this presenter. 

What is certain is that each cost and benefit must be assessed using both quantitative and qualitative analysis. It is my belief that undertaking such analysis, 

however painstaking, will improve IDES to the benefit of retiring Servicemembers. 


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PREPARED STATEMENT OF BRENDON GEHRKE

Mr. Chairman and Members of the Subcommittee: 

On behalf of the men and women of the Veterans of Foreign Wars of the United 

States (VFW) and our Auxiliaries, I would like to thank you for the opportunity to 

testify on today’s hearing regarding VBA’s role in veterans transition as it relates 

to the Integrated Disability Evaluation System, the Benefits Delivery at Discharge 

and the Quick Start Program. 

In the 2008 National Defense Authorization Act Congress required DoD and VA 

to create policies to ensure that the disability evaluation system, which determines 

military and veterans benefits, is streamlined and fair. As a result, DoD and VA 

collaborated to create the Integrated Disability Evaluation System (IDES) which 

simplified the disability evaluation process by eliminating duplicate disability examinations and ratings, and placing VA counselors in Military Transition Facilities 

(MTF) to ensure a smooth transition to veteran status. The VA and DoD also responded by improving the Benefits Delivery at Discharge (BDD) program and created Quick Start programs to allow servicemembers to submit a disability claim before their discharge date. 

The VFW believes these programs are a step in the right direction to fulfil the 

country’s promise to our wounded warriors, but we recognize that these programs 

are far from perfect. Servicemembers still suffer from the Defense Department’s disjointed policies and leadership which govern wounded warrior care, inadequate VA 

and DoD staffing dedicated to the benefits evaluation process, no Integrated Electronic Healthcare System, and poor communication. We encourage the Committee 

to evaluate and implement the suggestions made by the Government Accountability 

Office (GAO), Recovering Warrior Task Force (RWTF) and Veterans Service Organizations (VSO). 

Processing Times 

Currently, the Veterans Affairs’ Benefits Delivered at Discharge and Quick Start 

programs are not living up to their names. The BDD program rarely delivers benefits within 60 days of discharge, and the Quick Start program may allow 

servicemembers to submit claims earlier, but the adjudication of those claims are 

anything but quick. As indicated in the latest VAOIG report on the Quick Start program, VBA reduced the average days to complete a Quick Start claim from 291 days 

in 2011, to 249 days for the period of April through June 2013. However, VBA needs 

to cut the amount of time to adjudicate a claim in half to achieve the VA Secretary’s 

goal to have no claim pending more than 125 days. Likewise with BDD, the Salt 

Lake City Regional Office, who adjudicates 56 percent of BDD claims, takes an average of 266 days to deliver benefits. This means that a servicemember who applies 

60 days prior to discharge will not receive payment for at least eight months after 

their discharge. 

The amount of time it takes to process a claim through IDES frustrates wounded 

warriors and their commands. As of May 11th, it takes 284 days to process through 

IDES, although that number has grown as high as 376 days in the past year. It 

is important to note that processing times change daily and differ dramatically from 

facility to facility; Fort Knox has taken longer than 423 days to process claims, Fort 

Riley takes upwards of 336 days to process claims, while claims in Fort Gordon may 

process in less than 161 days. The processing time is even higher for reserve component servicemembers. Minnesota’s National Guard Command reports that the average time to complete the IDES process for its soldiers is 581 days. Of Minnesota’s 

active cases, the average soldier has been waiting in processing for 258 days; 43 percent have already exceeded the military’s Medical Command standard of 204 days 

to finish a claim. 

It is clear that the VA backlog is also creating a backlog in IDES cases. The longest phase in the IDES process is the VA disability rating portion, where 59 percent 

of cases pending are awaiting a VA rating decision. VA’s goal is to process IDES 

claims within 100 days, but it takes 230 days on average to process claims. The VA’s 

inability to process IDES claims is adversely affecting wounded warriors recovery 

and their transition process. The backlog creates unnecessary extended separations 

and financial burdens on families causing stress on an already vulnerable family. 

Moreover, it prohibits servicemembers from finding civilian employment and/or 

causes them to miss college enrollment dates. 

Unlike the BDD, Quick Start, or IDES claims, Fully Developed Claims (FDC) are 

close to meeting the Secretary’s goals of adjudicating claims within 125 days. In 

2010, Under Secretary Hickey refined the FDC program and encouraged veterans 

and VSOs to submit claims that do not require development of non-governmental 

evidence. Between the first and second quarter of this year, FDC submission inVerDate Aug 31 2005 09:13 Oct 01, 2015 Jkt 000000 PO 00000 Frm 00087 Fmt 6633 Sfmt 6621 Y:\88-982.TXT PAT

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creased from 12 percent to 18.5 percent, 25 percent of the claims VSOs submit are 

FDC, and the average amount of time to complete an FDC claim was only a 150 

days. Despite the dramatic difference in the number of days it takes to adjudicate 

an FDC claim compared to a pre-discharge or IDES claim, the only document included in an FDC claim that isn’t in a pre-discharge or IDES claim is a DD–214. 

Therefore, we recommend VA allocate resources to work pre-discharge claims as 

they would a FDC claim. 

Inconsistent Management Policies 

It is difficult to evaluate the Department of Veterans Affairs role in the transition 

from servicemember to veteran without mentioning the Department of Defense’s 

role in the transition process. The two agencies are inextricably connected; one 

agency cannot fulfill its responsibilities to the transitioning servicemembers without 

the other. Ultimately, the agencies share equal responsibility to ensure 

servicemembers successfully transition back to civilian life. 

In regards to IDES, DoD is responsible for guiding servicemembers through the 

entire process to ensure they are aware of their options and the many decisions they 

or their families need to make. In regards to the pre-discharge benefits program, 

DoD is responsible for managing all entry point sites and implementing the cooperative exam process—a key aspect of BDD to streamline access to benefits. DoD’s lack 

of leadership, standard policies, and oversight has created large discrepancies in the 

standard of service and treatment servicemembers receive from one site to the next. 

Despite recommendations from VSOs, RWTF and GAO, the Defense Department 

still maintains a disjointed leadership structure for wounded warrior care. The Deputy Under Secretary of Defense for Personnel and Readiness is responsible for establishing health and benefit policies. However, the Deputy Under Secretary can develop the best policy possible to ensure continuum care and transition services but 

without the authority to force the military branches to implement DoD’s guidance, 

as is the current situation, the policies are inept. Our concern is that these inconsistencies in the services’ interpretation and application of the laws governing IDES 

affect servicemembers adversely. 

Therefore, the VFW recommends that Congress give the Under Secretary of Personnel and Readiness the sole authority to develop policy to improve the care and 

services provide through IDES. Only then will the Under Secretary be able to improve management of pre-discharge benefits sites, provide proper oversight, and 

most importantly force services to comply with DoD directives. Empowering senior 

civilian leaders will allow for the long-standing problems plaguing the process to be 

addressed and promote accountability. 

Staffing Resources 

Insufficient staffing and budget allocations on both DoD’s and VA’s part contribute to poor case management and protracted disability determinations. 

servicemembers continue to complain that the military Physical Evaluation Board 

Liaison Officers, who are responsible for guiding the servicemember through the 

IDES process, are often overburdened and poorly trained. The same goes for the VA 

case managers who assist some servicemembers through the VA rating phase. Although VA and DoD officials said they added case managers to its IDES rating sites 

to handle the high demand, we have not seen an improvement in processing times 

or increased attentiveness to servicemembers and their family’s needs. 

However, no matter how many case managers they hire, the long waiting times 

will persist unless VA and DoD ensure adequate physician staffing levels. DoD must 

ensure proper physician staffing levels to identify conditions and write narrative 

summaries that are used to determine the servicemembers’ fitness for duty. Likewise, VA needs an adequate number of physicians to complete the Compensation 

and Pension (C&P) examinations used to determine both DoD and VA disability 

rates. 

Appropriations for VA have not kept pace with the demand created by thousands 

of severely wounded servicemembers returning home, resulting in staff shortage 

across the Veterans Health Administration. Compounding the problem is that sequestration limits DoD’s ability to hire more doctors for the pre-discharge benefit 

sites and the MEB. The Administration (and previous Administrations) has requested insufficient resources to meet the ever-growing need for health care and 

transition services. It is now incumbent upon Congress to provide the staffing, facility resources, and technology software needed to help VA address the claims backlog, including the backlog in BDD, Quick Start and IDES claims. 

Integrated Electronic Health Care Records 

To say the transition process is seamless for servicemembers, or that DoD and VA 

have an integrated disability evaluation process, would be inaccurate, although the 


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agencies have drastically improved collaboration efforts. It is impossible to have an 

integrated disability evaluation process without an Integrated Electronic Healthcare 

Records System. For the past ten years, Presidential Commissions, Congressional 

Task Forces, VSOs and the GAO have described the need for an Integrated Electronic Healthcare Record System; yet veterans are not any closer to having one 

today than they were ten years ago. 

Since VA and DoD providers lack the ability to share health records for 

servicemembers instantaneously, they have to result to more archaic measures of 

sharing information, such as fax or snail mail. For example, one National Guard 

unit reported that they continue to ship hardcopy health records via FedEx to Reserve Components Soldier Medical Support Centers, and they are notified by mail 

when the MTF receives the packet. Furthermore, DoD uses different records keeping systems for inpatient, outpatient, and behavioral health records, making it difficult for servicemembers to ensure all their records are fully compiled and transferred. VA compounds the problem by brokering IDES claims; for example, one 

servicemembers’ records were individually sent to Baltimore, Vermont, Maine, and 

Seattle before it was adjudicated and sent back to the MTF. 

The VA and DoD entered into a Memorandum of Understanding that required 

DoD to provide complete copies of Service Treatment Records (STR) to VA. Although 

the MOU went into effect early this year, a high level VBA official recently stated 

that 81 percent of Gold Standard STR’s are overdue by 45 days. 

In addition, reserve component members face unique difficulties when obtaining 

scattered and often incomplete records because of members’ multiple, nonconsecutive deployments. VA disproportionately denies Reservist and National Guardsmen 

benefits because they cannot establish that their condition is service-connected due 

to the missing Line of Duty (LOD) statements. An LOD determination is an administrative tool for determining a member’s duty status at the time of injury, illness, 

disability, or death, and is the gateway to VA benefits. The VFW encourages Congress to urge the National Guard Bureau to create a uniformed LOD policy and implement a single electronic processing system to ensure all eligible reserve component members have access to earned healthcare and benefits. 

Similar to the lack of an Integrated EHR system, servicemembers need a singular 

transparent system to monitor IDES. Multiple system accesses are still required to 

obtain and track necessary data. The Veterans Tracking Application (VTA) is a joint 

VA/DoD application that tracks the initial arrival of a servicemember into the VA 

health system and monitors benefits applications and administrative details. VTA 

also tracks servicemembers that have been referred to a Medical Evaluation Board 

(MEB). 

We consistently hear from servicemembers, who are frustrated that they do not 

know the status of their IDES case because access is granted to a limited amount 

of staff. As a result, servicemembers cannot plan for the future because they don’t 

know when the next exam will be or their discharge date. We recommend that VA 

work with DoD to broaden VTA access to those supporting wounded warriors to include, MEB attorneys, Community Based Warrior Transition Units and authorized 

veteran advocates. 

Outreach 

The VOW to Hire Heroes Act established a requirement that all servicemembers, 

participate in the Transition Assistance Program by November 2012. Since the universal implementation of TAP, the VFW has gone from having an entire day to brief 

servicemembers on the benefits and resources available to them to five minutes in 

some locations. More so, VA continues to push servicemembers and veterans to the 

e-benefits’ portal, which is not regularly updated, or does it allow veterans to share 

information with service officers. As a result of the TAP changes, we have found 

servicemembers are less aware of the BDD or Quick Start Program and are not 

seeking assistance with claims. In addition, when servicemembers use e-benefits 

they feel as if their claim enters into the abyss. Our fear is that if servicemembers 

do not seek VSO help they will ultimately end up filing appeals as veterans. 

We also understand that the TAP process introduces a variety of information resources, web sites, and call centers to servicemembers so that they can education 

themselves on their benefits. Much of the services provided to servicemembers by 

DoD are redundant, which can overwhelm and confuse servicemembers causing 

them to underutilize the services. An RWTF focus group, ‘‘revealed significantly 

unmet needs for information’’ at various points in the recovery or transition process. 

More so, we receive complaints from family caregivers and surviving spouses that 

DoD does not properly inform them of programs and benefits created by Congress 

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While DoD has developed a means of tracking members’ involvement, it has not 

established an accurate means to measure participation in TAP including VA benefit briefings. We believe that DoD and VA must establish a policy to promote the 

accuracy, timeliness, availability, and relevant information; they must also establish 

the method to gauge servicemembers’ participation and satisfaction with TAP, and 

work to include community partners in the TAP process. 

Conclusion 

The VFW acknowledges that both the Departments of Defense and Veterans Affairs are delivering quality care to servicemembers and veterans. We also give them 

credit for setting ambitious timeliness goals for delivering benefits and addressing 

issues with the disability evaluation system; timeliness has drastically improved 

from the estimated 540 days it took to complete a claim with the legacy system, and 

VA and DoD continue to shorten the amount of times it takes to process all disability claims. 

However, VA and DoD do not have the management, policies, procedures, and resources to address the influx of servicemembers who will be transitioning to civilian 

life once forces withdraw from Afghanistan and DoD cuts its force structure. It is 

imperative that Congress not only continue its aggressive oversight over the agencies to ensure they properly plan for the future, but they must also provide the fiscal 

resources to improve the delivery of care and benefits that our servicemembers have 

earned. 

Æ 


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