By Leonard J. Selfon, J.D., CAE

The long anticipated report of the Veterans Disability Benefi ts Commission was recently released to Congress and the American people. The report is the culmination of a two-and-ahalf year comprehensive review of Department of Veterans Affairs (VA) programs, processes, regulations, and policies. In its 544-page report, the 13member commission, made up of distinguished retired military officers and veterans advocates, presented 113 recommendations to attempt to cure the most deep- seated flaws in the VA claims adjudication process.

Established by Congress in 2005, the Commission was charged with performing an in-depth analysis of VA benefits and services provided to compensate and assist veterans and their survivors for disabilities and deaths incurred in, or caused by, military service. One of the Commission’s most sweeping recommendations is that VA disability compensation payments should be increased immediately by up to 25%. The Commission found that current payment levels fall short of compensating disabled veterans for their lost quality of life and the ability to engage in the ordinary activities of life, rather than just the impairment of their ability to make a living.

An Antiquated System

Once the VA determines that a veteran’s disability is related to his or her military service,the-veterans-disability-benefits-commission-report-to-congress-sweeping-overhaul-is-required it must then evaluate (or rate) the severity of the disability. The assigned rating determines the appropriate level of compensation. To make this determination, the VA uses what has evolved from a 1945 Schedule for Rating Disabilities, more commonly known as the “rating schedule.” The rating schedule is designed to compensate veterans based on the average impairment of their “earning capacity,” or, in other words, how much the disability prevents the veteran from obtaining and maintaining employment. The rating schedule is a collection of disabilities, grouped by body systems, which sets out different symptoms associated with each disability in an increasing order of severity. Percentages of disability are assigned to each level of symptoms from 0% (non-compensably disabling) to 100% (totally disabling) in ten percent increments.

The rating schedule, however, is antiquated, imprecise, vulnerable to great subjectivity on the part of VA claims adjudicators, and does not take into account the diminution of a disabled veteran’s quality of life. Essentially, the rating schedule is a product of a bygone era. It was formulated at a time when disabled veterans were returning home from World War II. Veterans were universally admired and their disabilities were, for the most part, clear cut. Orthopedic injuries, amputations, and psychiatric disorders were the most common veterans’ disabilities. Since World War II, however, veterans have returned from war with more insidious disorders. Diseases such as those resulting from exposure to chemical, biological and radiological agents, mysterious syndromes, such as Gulf War Illness and the long-term effects of traumatic brain injury were not contemplated by the framers of the original rating schedule.

In the 1940s, the United States was more of an industrial society. Naturally, the emphasis within the VA disability compensation scheme was on the impairment of a veteran’s earning capacity. However, times have changed. Advances in medicine have allowed for more effective treatment, cures, and rehabilitation. Medical knowledge has increased exponentially in the last six decades, diagnostic tools have been refined, and today’s medical professionals are practicing medicine in ways that could not have been envisioned by doctors even two generations ago. Yet, the rating schedule has remained static.

While new disorders have been added from time to time and the symptoms listed in the diagnostic codes have been updated here and there, it is long overdue for a wholesale revision of the rating schedule to bring it in synchronization with the state of modern medicine and American society. The Commission’s critique of the rating schedule is critically important and Congress must carefully consider it.

The Commission’s recommended 25% increase in compensation payments would only be a stopgap measure. “Congress should increase the compensation rates up to 25% as an interim and baseline future benefit for loss of quality of life, pending development and implementation of quality of life measures,” the report stated. “In particular, the measure should take into account the quality of life and other non-work related effects of severe disabilities on veterans and family members.”

Additional Findings

Other Commission findings and recommendations include:

• Veterans with service-connected post-traumatic stress disorder (PTSD) should receive mandatory examinations to evaluate progress, treatment and the appropriateness of existing compensation levels every two to three years.

• The VA should develop specific rating criteria to evaluate PTSD claims, rather than rating PTSD according to diagnostic criteria that is currently used to evaluate claims for all other psychiatric disorders.

• All service-related injuries should be subject to benefi ts, regardless of whether or not the injury was sustained in combat.

• The VA should make better use of technology in the claims adjudication process to reduce both the crushing backlog of pending claims and the frequency of improperly denied benefi ts.

• The goal of disability benefi ts should be rehabilitation and reintegration of veterans into civilian life to the maximum extent possible.

• Benefits should include access to a full range of health care at no cost to service-disabled veterans whatsoever.

• Veterans should be allowed to receive both military retirement pay and VA disability compensation without any offset. Similarly, survivors of veterans who die while on active duty or as the result of a service-connected disability should be entitled to receive both military Survivor Benefit Plan (SBP) benefi ts and VA Dependency and Indemnity Compensation (DIC) survivor benefits without any offset.

• Young, severely disabled veterans who have not worked long enough to otherwise qualify for Social Security Disability Insurance (SSDI) benefi ts should be allowed to receive SSDI.

• The VA’s and the Department of Defense’s (DoD) processes for evaluating disabilities should be realigned according to the same diagnostic and rating criteria to reduce wide variances in interagency disability evaluations. The Commission’s exhaustive study and report represents perhaps the most independent and comprehensive review of VA disability benefits ever undertaken. It would be a national tragedy if Congress and the Administration failed to take full advantage of this once in a lifetime opportunity to properly compensate our disabled veterans and their families who have sacrificed so much for our country and for each of us. The full Commission report can be viewed at www.vetscommission.org/.

Leonard J. Selfon, JD, CAE, is Vice President of VetsFirst.