U.S. Department of Veterans Affairs Budget Request for FY 2011 and FY 2012 House Committee on Veterans’ Affairs | Room 334 Cannon House Office Building Washington, DC | 02/04/2010
Witness Testimony of Paul Sullivan, Veterans for Common Sense, Executive Director Hearing on 02/04/2010: U.S. Department of Veterans Affairs Budget Request for FY 2011 and FY 2012
Oral Statement
Chairman Filner, Ranking Member Buyer, and members of the Committee, thank you for inviting Veterans for Common Sense to testify about the Department of Veterans Affairs’ proposed budget for 2011.
VCS strongly endorses President Obama’s $125 billion VA budget, especially the new $300 million in funding to end homelessness by the end of 2014.
However, we do have some concerns about two cohorts of veterans: first, our Iraq and Afghanistan veterans, and, second, our Gulf War veterans.
VCS urges Congress to require VA to develop more accurate casualty estimates as well as implement a long-range strategic casualty plan.
As of June 2009, VA reported 480,000 veteran patients and 442,000 disability claims from the Iraq and Afghanistan wars. This is far above any worst case scenario for casualties.
VA treats nearly 9,000 new patients per month from the two wars. For VA’s 2012 budget, VA estimated less than 500,000 patients. A more realistic estimate for 2012, based on VA data, is as high as 800,000 new patients and claims from Iraq and Afghanistan veterans.
One factor that may increase healthcare use and claims activity is multiple deployments, as Stanford University researchers estimated 35 percent of new war veterans may return with post traumatic stress disorder – PTSD.
VA’s failure to accurately forecast demand is serious because one-in-four patients wait more than one month to see a doctor. According to the Veterans Benefits Administration, more than one million veterans are now waiting 161 days for an initial answer for a disability claim.
We are alarmed VA’s 2011 budget request shows VBA taking a staggering 190 days to process an initial claim. That’s one more month of waiting for our veterans.
While we support hiring additional VBA staff to process the one-million claim backlog, VBA must also work smarter. VCS urges Congress to fund development of a one-page claim form plus new, simpler regulations VBA staff can learn in six months, not two-to-three years currently required. VCS urges Congress to fund a specific program to implement the proposed lifetime electronic record to end the epidemic of lost and difficult-to-find military service and military medical records.
VCS supports the Veterans’ Benefits Improvement Act of 2008 as a strong move by Congress to improve quality at VBA. We urge Congress to hold accountable those VBA leaders who openly flaunted the law by failing to provide several reports and implement sections of the new law designed to overhaul VBA’s broken claims system.
Specifically, VBA has not created temporary disability rating systems or reports required under Title II, Modernization of VA’s Disability Compensation System, Subtitle A, Benefits Matters, Section 211.
VCS remains deeply concerned that funding for the Board of Veterans Appeals only increased three percent when there is a backlog of 200,000 unprocessed appeals, and where veterans wait four years for a decision.
VCS also urges Congress to fund full-time, permanent VBA claims staff at every military discharge location plus every VHA medical center and clinic.
Here are some VCS budget recommendations for our Gulf War veterans.
First, VCS urges Congress to create and fund a robust Gulf War veteran advocacy committee to provide advice directly to VA Secretary Shinseki on Gulf War illness, treatments, and benefits.
Second, VCS urges Congress to fully fund the Congressionally Directed Medical Research Program, that identifies “off the shelf” treatments.
Third, VCS encourages VA to restore funding for Dr. Robert Haley’s research at the University of Texas Southwestern Medical Center. VA’s IG confirms that VA Central Office employees “impeded the ability of the contracting officers . . . to effectively administer the contract.” In our view, a few VA staff sabotaged Dr. Haley’s research.
Finally, Mr. Chairman, you are correct that VBA’s Veterans Benefits Management System is nothing more than a new name for several existing broken VBA computer systems.
Disney has Pixar studios, and James Cameron has his movie Avatar that thought outside the box. VCS urges Congress to fund a high-priority task force to overhaul VBA immediately, from application to payment and access to healthcare.
Essentially, if the VBA claims process can be described as a bridge, then the current one-lane obsolete wooden structure lacks the capacity to handle the millions of now veterans using it. There are traffic jams trying to cross, and veterans constantly fall over the side or through the cracks and plunge into the icy waters below.
An entirely new concrete and steel high-capacity bridge needs to be built as a replacement. The more time spent adding timber, changing the name, and applying paint to the wooden bridge only means more delays for our veterans seeking healthcare and benefits.
Thank you. I will be glad to answer your questions.
Prepared Statement
Chairman Filner, Ranking Member Buyer, and members of the Committee, thank you for inviting Veterans for Common Sense to testify about the Department of Veterans Affairs’ proposed budget for 2011.
VCS strongly endorses VA’s $125 billion budget. Specifically, we thank the President Barack Obama and VA Secretary Eric Shinseki for increasing funding by nearly $300 million to end homelessness by the end of 2014.
Our testimony today focuses on two cohorts of veterans that require additional funding: first, our new Iraq and Afghanistan veterans, and, second, our Gulf War veterans.
Our 2.2 Iraq and Afghanistan Service Members
More than seven years ago, Veterans for Common Sense voiced concerns regarding the lack of a funding request by VA to care for casualties for the impending invasion of Iraq. The Congressional Budget Office had no cost estimate for healthcare and benefits for veterans. This was an oversight of enormous magnitude – an oversight still haunting this country and veterans today with long delays accessing health care and benefits.
Tragically, the scope of the Iraq and Afghanistan war casualties reached far above any worst case scenario. As of June 2009, VA reported 480,000 veteran patients from the two wars. VA also reported 442,000 disability claims filed. Nearly 300 first-time Iraq and Afghanistan war veterans flood into VA medical facilities every day.
VCS is disappointed that VA does not have an accurate casualty estimate and a long-range strategic casualty plan. Two months ago, VA estimated 419,000 Iraq and Afghanistan War veteran patients treated by VA through the end of September 2010. VA’s estimate was wrong. By June 2009, VA had already treated 480,000 patients.
At the current rate of nearly 9,000 new patients per month, a more realistic VA estimate should have been a cumulative total of 615,000 patients treated as of September 2010. VA’s 200,000 patient underestimation is a colossal failure because VA may lack the mental healthcare providers, disability claims processors, and education benefit processors to meet the need of this increasing cohort of veterans.
One factor that may increase healthcare use and claims activity is multiple deployments, as Stanford University researchers estimated 35 percent of new war veterans may return with post traumatic stress disorder in a study published last year.
VCS is concerned about VA’s continued underestimation of casualties. For 2012, VA estimated less than 500,000 patients from the two wars. However, a more realistic estimate, based on VA data, may be as high as 800,000 by the end of 2012.
As the five years of free healthcare for Iraq and Afghanistan war veterans expires, VBA should expect the number of disability claims to catch up to and then surpass the number of patients. In order to provide a continuity of care, Congress may want to consider extending free VHA healthcare indefinitely to Iraq and Afghanistan war veterans with pending disability claims stalled at VBA.
This issue is serious because, according to three reports issued by VA’s Office of the Inspector General, one-in-four patients wait more than one month to see a doctor. According to the Veterans Benefits Administration, more than one million veterans now wait 161 days for an initial answer for a disability claim.
VCS is highly alarmed that VA’s 2011 budget request shows VBA taking a staggering 190 days to process an initial claim–that’s an unacceptable one month addition to the current delays facing our veterans and families.
VCS remains deeply concerned that funding for the Board of Veterans Affairs only increased three percent. The Board remains a very serious unresolved bottleneck in VA’s broken claims system, with a backlog of 200,000 unprocessed claims. Veterans wait, on average, four to five years for a claim decision from the Board, indicating that staffing, training, policies, procedures, and oversight must be strengthened.
VCS offers a solution for Iraq and Afghanistan war veterans. VA and DoD must develop and implement a transparent strategic casualty plan. This means VA and DoD must improve data collection and forecasting so it is more accurate. VA and DoD must hire more medical professionals, especially mental health professionals.
Furthermore, our government needs to perform pre- and post-deployment medical exams, launch a broad national anti-stigma campaign encouraging veterans to seek medical care, and place full-time, permanent VBA claims staff at every military discharge location and every VHA medical center.
VBA must also streamline the claim process with a one-page form and simpler regulations VBA staff can learn in six months–not the current three years. While VBA has additional funding to hire staff and process an expected surge of Agent Orange claims, VA’s budget does not appear to contain additional funding to hire staff and process post traumatic stress disorder claims under new VA’s new, streamlined regulations expected to be finalized this year.
Our 700,000 Gulf War veterans.
The second cohort of veterans in need of additional funding are our Gulf War veterans. Nearly 20 years after the conflict began, VA and DoD still do not have a comprehensive plan for medical research to better understand and treat the 175,000 ill Gulf War veterans.
VCS urges the Obama Administration and Congress to create and fund a robust Gulf War veteran advocacy committee to provide advice directly to VA Secretary Shinseki on Gulf War illness, treatments, and benefits.
Furthermore, VCS urges Congress to fully fund the Congressionally Directed Medical Research Program, a highly effective approach to identify “off the shelf” treatments for our ailing Gulf War veterans. We urge VA and Congress to work with veterans’ advocates to expand scientific research, especially in the areas of depleted uranium and chemical warfare agents.
VCS encourages VA to fund the research led by Dr. Robert Haley and his excellent team at the University of Texas Southwestern Medical Center in Dallas, Texas.
Finally, VCS urges Congress to ask VA to respond in writing about how they are implementing the recommendations made by the Institute of Medicine regarding veterans’ health. For example, VA and the military should indicate when they will implement IOM’s recommendation to use the best available testing method to determine DU exposure rather than the flawed test they are currently using. Congress should fund the best tests, research, treatment, and benefits for our Gulf War veterans.
Thank you. I will be glad to answer any of your questions.
VA Fact Sheet Consequences of Iraq and Afghanistan Wars
Updated January 27, 2010
U.S. Veteran Patients Treated at VA: 480,324 Veteran Disability Claims Filed Against VA: 442,413
Chart #1, U.S. Troops Deployed to Iraq and Afghanistan War Zones [1]
Deployed to War Zones
Service Members
Still in Military
Percent in Military
Veterans Now Eligible for VA
Percent Veterans
1,946,042
786,405
40{cd9ac3671b356cd86fdb96f1eda7eb3bb1367f54cff58cc36abbd73c33c82e1d}
1,159,637
60{cd9ac3671b356cd86fdb96f1eda7eb3bb1367f54cff58cc36abbd73c33c82e1d}
Chart #2, Iraq and Afghanistan Veteran Patients Treated by VA [2] [3]
Category
Number of Veterans
Percent
Veteran Patients
480,324
41{cd9ac3671b356cd86fdb96f1eda7eb3bb1367f54cff58cc36abbd73c33c82e1d} of Veterans
Mental Health Patients
227,205
47{cd9ac3671b356cd86fdb96f1eda7eb3bb1367f54cff58cc36abbd73c33c82e1d} of Patients
PTSD Patients
134,103
28{cd9ac3671b356cd86fdb96f1eda7eb3bb1367f54cff58cc36abbd73c33c82e1d} of Patients
Chart #3, Iraq and Afghanistan Veterans’ Claims Against VA [4]
Category
Number of Veterans
Percent
Disability Claims Filed
442,413
38{cd9ac3671b356cd86fdb96f1eda7eb3bb1367f54cff58cc36abbd73c33c82e1d} of Veterans
Claims Pending
69,397
16{cd9ac3671b356cd86fdb96f1eda7eb3bb1367f54cff58cc36abbd73c33c82e1d} of Claims Filed
Approved PTSD Claim
67,052
50{cd9ac3671b356cd86fdb96f1eda7eb3bb1367f54cff58cc36abbd73c33c82e1d} of PTSD Patients
Prepared by Veterans for Common Sense using documents obtained through the Freedom of Information Act:
[1] Department of Veterans Affairs (VA), “VA Benefits Activity: Veterans Deployed to the Global War on Terror,” Nov. 18, 2009
[2] VA, “Analysis of VA Health Care Utilization Among US Global War on Terrorism Veterans,” Oct. 2009.
[3] VA, “VA Facility Specific OIF/OEF Veterans Coded with Potential PTSD Through 3rd Qt FY 2009,” Sep. 2009.
[4] VA, “VA Benefits Activity: Veterans Deployed to the Global War on Terror, Nov. 18, 2009.
