The Defense and Veterans Affairs departments say they are more than halfway through the rollout of a new system that will use one process to evaluate military members’ disabilities. But lawmakers are concerned that even where the new evaluation system’s been put in place, moving wounded warriors through the system still is taking too long.
VA and DoD began the Integrated Disability Evaluation System as a pilot project in 2007. The intent was to eliminate the problem of disabled servicemembers having to go through two separate and lengthy evaluations of their medical status; one by DoD and one by VA. The entire process takes an average of 540 days. The objective under the new system is to reach a decision on an individual member’s case in fewer than 300 days and create a disability rating that both departments will use.
But based on March figures, so far, the system is only reaching that goal in about 15 percent of cases, said Sen. Patty Murray, (D-Wash.), who is the chairwoman of the Veterans Affairs committee.
“At Joint Base Lewis-McChord in my home state of Washington, the average time a soldier waits to get a medical examination today is 84 days,” she said. “That’s well over the target of 45 days. And the ratio of servicemembers to DoD case managers is 130 soldiers to one case manager, well over the goal of 20 to one. And we know that soldier satisfaction is only 54 percent.”
In testimony before the committee Wednesday, VA and DoD leaders said much work remains to be done, but the new integrated system is far better than the collection of evaluation tools the two departments had been using up until now.
“The legacy system really wasn’t a system at all, it was a series of overlapping and inconsistent systems,” said Bill Lynn, deputy Defense secretary. “It had several problems. Processing time was too long, the processes themselves were contradictory. But the biggest problem for an individual member is that it led to a gap in pay and benefits. You would exit the DoD system and it would take six or nine months before you got fully into the VA system and actually got a check. The new system is designed to eliminate that gap. We keep them on the DoD payroll until they actually transition into the VA system. That creates a bill, but it’s a bill well worth paying.”
The integrated approach is now in place in 78 locations across the country. By October, the two departments plan to have all 139 of their sites certified and operating.
But Lynn said even after the new system is technically at the point of full implementation, it still won’t be operating at full speed. He said for now, many wounded servicemembers are simultaneously in the old systems and the new one, and digging through that backlog will take time; perhaps one to two years.
But to Sen. Scott Brown (R-Mass.), even the goals for the new system don’t seem very ambitious.
“Is it streamlining to be at 300 or 400 days? When you’re the servicemember trying to get along with your life, it’s an eternity,” he said.
But Scott Gould, the deputy secretary at VA, said having a somewhat long transition period for a servicemember from the military to veteran status is not necessarily a bad thing, at least not in every case. He said the delayed changeover to veteran status is sometimes intentional.
“We want to provide that servicemember with as much time as they and their families need to make that adjustment,” he said. “If that means a month or two months or three months, and they’re on military pay and they’re getting military healthcare and their family’s on TRICARE, and we know where to find them, that’s a positive in my view.”
Another area of cooperation between DoD and VA is the much talked about joint electronic health record.
The Government Accountability Office released a report in February, finding that two years into the effort, the two departments had not yet articulated how they planned to transition from their current IT architectures to a new, joint system. But Gould told the committee they’ve made major progress.
“GAO has laid out an objective analysis of where we were, and in the last 60 to 90 days, we’ve taken enormous strides forward,” he said.
Gould said DoD and VA have both agreed the health record system will be built with an agile philosophy, with new capabilities delivered frequently. He said it’s the same approach that let VA reduce the percentage of its IT projects that were underperforming from 80 percent to 20 percent.
“We’ve already delivered a prototype of the new interface,” he said. “We will have in place by July of this year the new graphical user interface that will be the front end of the system, so it provides that common interface that both DoD doctors and VA doctors have said would optimize their ability to treat patients. We will have a single sign-on in north Chicago by the end of this year, and we’ll have significant functionality shared between the two agencies by June of 2012. We’re moving down the road quickly on incremental delivery of this new system.”
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