Comparison of Selected Recommendations of the President’s Commission on Returning Wounded Warriors (the Dole-Shalala Commission) and the Veterans’ Disability Benefits Commission
Released: 2008-03-10T00:00:00

Overview

This report compares selected recommendations of the President's Commission on Care for America's Returning Wounded Warriors (PCCWW), often called the Dole-Shalala Commission in reference to its co-chairs, and the Veterans' Disability Benefits Commission (VDBC). The recommendations presented are those that relate to the transition of injured servicemembers from military service to civilian life and/or veteran status. This report does not examine certain other recommendations, such as those in the VDBC report regarding benefits for survivors of deceased servicemembers, or regarding evaluation of presumptive disability , i.e., establishing service connection for certain long-term health effects of hazardous exposures.

Congress, the two commissions, and others have determined that certain programs and systems that involve both the Department of Defense (DOD) and the Department of Veterans Affairs (VA) are particularly problematic in providing continuity and quality of care and services to injured servicemembers. In January 2008, Congress passed the National Defense Authorization Act for Fiscal Year 2008 ( P.L. 110-181 ). Titles XVI and XVII of the act address matters related to the care and treatment of servicemembers and former servicemembers (i.e., veterans) who were wounded, or who contracted an illness, while serving on active duty. Among the problems addressed in the act are the efficient maintenance and transfer of servicemembers' health and benefits records between the departments, and the separate evaluations of disability by each department. Efforts to address these and other transition problems were already under way in both departments, partly in response to the recommendations of the PCCWW, the VDBC, and several other commissions or task forces. These legislative and administrative actions constitute the first wave of responses to the recommendations of these bodies. Further congressional and administrative actions are anticipated. As this report is limited to a comparison of the final recommendations of the PCCWW and the VDBC, it will not be updated.

Charges to the Commissions

The commissions were given different charges. The PCCWW was established by Executive Order 13426 in March 2007, and was to focus on the needs of a specific population, namely, seriously injured servicemembers returning from combat theaters in support of Operations Enduring Freedom and Iraqi Freedom (OEF/OIF). The commission was asked to look broadly at services and benefits provided by all relevant Cabinet departments—principally the Departments of Defense (DOD) and Veterans Affairs (VA)—as well as the private sector, and at a broad slate of services and benefits, including health care, disability, traumatic injury, education, employment, and other benefits. The PCCWW was to study individuals' experiences as servicemembers and, for those who were retired or separated from military service, their transition from military to civilian and/or veteran status, problems in providing services and benefits across that transition, and subsequent experiences in civilian life. Though the PCCWW's recommendations were to apply narrowly to seriously injured OEF/OIF servicemembers, it could prove difficult, politically and administratively, to implement the recommendations in this fashion. Doing so could run counter to existing policies, such as compensating service-connected disabilities equally whether or not they are combat related, and prioritizing groups of veterans to receive VA health care.

The VDBC was established in Title XV of the National Defense Authorization Act of 2004 ( P.L. 108-136 ) to study benefits provided to veterans and their survivors to compensate for service-connected disabilities and deaths. The VDBC was to consider these benefits regardless of the time or manner in which a disability or death occurred, and whether it occurred during a conflict or during peace time. While the VDBC examined certain transition issues for injured OEF/OIF servicemembers who were retired or separated from military service, this was not its principal focus. The VDBC examined services and benefits for veterans across their life spans, making a more comprehensive assessment of the full complement of veterans' benefits than did the PCCWW, but a less comprehensive assessment of DOD services, benefits, authorities and policies.

Recommendations of the Commissions

The PCCWW made six broad recommendations, each with several specific action steps directed to the Congress, DOD and/or VA, and published a matrix of the 23 action steps in its main report. The six broad recommendations are as follows:

1. Implement comprehensive recovery plans for returning injured servicemembers.

2. Restructure the military and veterans disability and compensation systems.

3. Improve care for people with post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI).

4. Strengthen support for families.

5. Transfer patient information across the DOD and VA systems.

6. Support Walter Reed Army Medical Center (WRAMC) until its closure.

The VDBC made 113 recommendations , also directed to the Congress, DOD and/or VA, designating 13 of them as priority recommendations. Recommendations were made in the following broad categories:

disability evaluation and compensation; determining eligibility for benefits; appropriateness of the benefits; appropriateness of the level of benefits; survivors and dependents; disability claims administration; transition; and establishing an executive oversight group to implement recommendations.

The attached Table 1 compares selected action steps from the PCCWW and recommendations from the VDBC that relate to the transition of injured servicemembers from military service to civilian life and/or veteran status. Since the PCCWW focused on these individuals, all of its action steps are discussed, and the table is organized according to the PCCWW's six broad recommendations. The table does not include all of the VDBC recommendations, but only those that relate to the transition of injured servicemembers or that are otherwise comparable to recommendations of the PCCWW. Each table entry notes the entity (Congress, DOD and/or VA) to whom the recommendation is directed. Bracketed notations show the relevant numbered recommendation(s) from the PCCWW and VDBC respectively.

Because the commissions had distinct charges and areas of emphasis, head-to-head comparison of their recommendations must be made with care. For example, the commissions largely agreed on the proposed end point for a revised disability compensation system, namely, that DOD would evaluate the fitness of injured servicemembers for continued duty, while VA would evaluate for disability compensation. But the commissions differed in their priorities for implementing this revised system, reflecting their focus on different populations. When comparing PCCWW and VDBC recommendations, it must be borne in mind that unless otherwise stated, PCCWW recommendations would apply, at least initially, only to injured OEF/OIF servicemembers and veterans, while VDBC recommendations would apply to all servicemembers or veterans, including those from previous conflicts, who are otherwise eligible for the service or benefit being discussed.

Additional CRS Reports

The following CRS Reports discuss the variety of DOD and VA programs and benefits that are addressed by the commissions and referred to in this report:

CRS Report RL33991, Disability Evaluation of Military Servicemembers , by [author name scrubbed] et al.; CRS Report RL33537, Military Medical Care: Questions and Answers , by [author name scrubbed]; CRS Report RS22366, Military Support to the Severely Disabled: Overview of Service Programs , by [author name scrubbed]; CRS Report RL33446, Military Pay and Benefits: Key Questions and Answers , by [author name scrubbed]; CRS Report RL33449, Military Retirement, Concurrent Receipt, and Related Major Legislative Issues , by [author name scrubbed]; CRS Report RL33985, Veterans' Benefits: Issues in the 110th Congress , coordinated by [author name scrubbed]; CRS Report RL33993, Veterans' Health Care Issues , by [author name scrubbed]; CRS Report RL33113, Veterans Affairs: Basic Eligibility for Disability Benefit Programs , by [author name scrubbed]; CRS Report RL33323, Veterans Affairs: Benefits for Service-Connected Disabilities , by [author name scrubbed]; CRS Report RS22666, Veterans Benefits: Federal Employment Assistance , by [author name scrubbed]; CRS Report RS22804, Veterans' Benefits: Pension Benefit Programs , by [author name scrubbed] and [author name scrubbed]; CRS Report RL34371, "Wounded Warrior" and Veterans Provisions in the FY2008 National Defense Authorization Act , by [author name scrubbed], [author name scrubbed], and [author name scrubbed]; CRS Report RL34169, The FY2008 National Defense Authorization Act: Selected Military Personnel Policy Issues , by [author name scrubbed] et al.; CRS Report RL31760, The Family and Medical Leave Act: Legislative and Regulatory Activity , by [author name scrubbed]; and CRS Report RL34055, Walter Reed Army Medical Center: Realignment Under BRAC 2005 and Options for Congress , by [author name scrubbed] and [author name scrubbed].