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Before the Subcommittee on Disability Assistance and Memorial Affairs, 
Committee on Veterans' Affairs, House of Representatives: 

United States Government Accountability Office: GAO: 

For Release on Delivery: 
Expected at 2:00 p.m. EST:
Wednesday, February 24, 2010: 

Veterans' Disability Benefits: 

Opportunities Remain for Improving Accountability for and Access to 
Benefits Delivery at Discharge Program: 

Statement of Daniel Bertoni, Director: Education, Workforce, and 
Income Security Issues: 


GAO Highlights: 

Highlights of GAO-10-450T, a testimony before the Subcommittee on 
Disability Assistance and Memorial Affairs, Committee on Veterans’ 
Affairs, House of Representatives. 

Why GAO Did This Study: 

Through the Benefits Delivery at Discharge (BDD) program, the 
Department of Veterans Affairs (VA) collaborates with the Department 
of Defense (DOD) to streamline access to veterans’ disability benefits 
by allowing some servicemembers to file a claim and undergo a single 
collaborative exam process prior to discharge. BDD is designed for 
servicemembers with conditions that, while disabling, do not generally 
prevent them from performing their military duties. This program can 
shorten the time it takes for veterans to receive benefits by several 

GAO was asked to discuss issues surrounding VA’s and DOD’s BDD program 
and related Quick Start program, and identify ways VA and DOD could 
improve these programs for transitioning servicemembers. This 
statement is based on GAO’s September 2008 report (GAO-08-901) that 
examined (1) VA efforts to manage the BDD program and (2) how VA and 
DOD are addressing challenges servicemembers face in accessing the BDD 
program. GAO updated some information to reflect the current status of 
claims processing and improvement initiatives in the BDD program. 

What GAO Found: 

Although VA awards disability benefits more quickly under BDD than 
through its traditional disability claims process, gaps in program 
management and accountability remain. For example, VA does not 
separately measure the total time its personnel spend developing BDD 
claims. As a result, VA has limited information on potential problems 
and improvement opportunities regarding BDD claims. GAO continues to 
believe that VA should measure BDD development time; however, VA told 
GAO it has no plans to capture this information. GAO also found that 
VA implemented two initiatives to improve the BDD program—i.e., 
consolidating BDD processing in two offices and instituting paperless 
processing of BDD claims to increase efficiencies and improve security 
of information—but did not evaluate whether or the extent to which 
desired improvements resulted. Finally, GAO found that VA was not 
completely or consistently monitoring BDD operations at all locations. 
VA has since taken steps to review BDD operations at more sites and 
has revised its protocols to ensure more consistent reviews of BDD 

VA and DOD have taken steps to improve servicemembers’ access to the 
BDD program; however, opportunities remain for further improvement. 
For servicemembers such as National Guard and Reservists who are 
generally unable to complete the BDD claims process within the 
required time frame, VA established an alternative predischarge 
program called Quick Start. Under this program, servicemembers may 
still initiate a disability application prior to discharge, but can 
complete the claims process, including medical exams, at another 
location after discharge. In response to GAO’s recommendation, VA has 
taken steps to collect additional data to determine the extent to 
which the Quick Start program is helping those with limited or no 
access to the BDD program. However, as with BDD claims, VA told GAO it 
has no plans to measure time spent developing these particular claims, 
and GAO continues to believe it should. VA and DOD have coordinated to 
increase BDD program awareness through VA benefits briefings for 
servicemembers, and DOD established a goal that 85 percent of 
servicemembers attend these non-mandatory briefings. GAO continues to 
believe that DOD should establish a plan with a specific time frame 
for meeting this goal, but DOD has not developed such a plan. Finally, 
GAO found that some bases faced difficulties maintaining local 
agreements intended to prevent redundancy and inconvenience for 
servicemembers in obtaining required medical exams. In response to GAO’
 s recommendation, DOD reported that it is working with VA to identify 
best practices to address local challenges to implementing their 
cooperative exam process. 

View [hyperlink,] or key 
components. For more information, contact Daniel Bertoni at (202) 512- 
7215 or 

[End of section] 

Mr. Chairman and Members of the Subcommittee: 

I am pleased to have the opportunity to comment on the Benefits 
Delivery at Discharge (BDD) program and related Quick Start program, 
which are administered by the Department of Veterans Affairs (VA) in 
collaboration with the Department of Defense (DOD). Both programs are 
intended to help servicemembers transition from military service to 
life as civilians and veterans by allowing them to initiate their VA 
disability benefits applications while they are still in the military. 
The BDD program further allows servicemembers to go through one 
collaborative examination process that satisfies DOD's requirement to 
determine their general health and VA's requirement to assess any 
claimed disabilities, instead of separate exam processes for both DOD 
and VA. Under BDD and Quick Start, veterans should begin receiving 
benefits sooner than the 6 to 7 months it would typically take if they 
had applied after discharge under the traditional disability claims 
process. Both programs are designed for servicemembers with conditions 
that, while disabling, do not generally prevent them from performing 
their military duties.[Footnote 1] 

You asked us to discuss issues surrounding VA's and DOD's BDD program 
and related Quick Start program, and identify ways VA and DOD could 
improve these programs for transitioning servicemembers. My statement 
draws on our prior work, which examined (1) VA efforts to manage the 
BDD program and (2) how VA and DOD are addressing challenges that 
servicemembers face accessing the BDD program,[Footnote 2] and was 
conducted in accordance with generally accepted government auditing 
standards. We have updated some information to reflect the current 
status of VA claims processing and improvement initiatives in the BDD 

In summary, we found that although VA awards compensation more quickly 
under BDD than through its traditional disability claims process, 
there are gaps in program management, accountability, and access. For 
example, VA does not track time spent developing a BDD claim prior to 
the servicemember's discharge and therefore lacks information on how 
efficiently its personnel are developing BDD claims. In addition, 
although VA and DOD have made efforts to improve all servicemembers' 
access to the BDD program, we identified additional opportunities to 
help improve access. For example, VA established the Quick Start 
program whereby servicemembers unable to complete exams within BDD's 
required time frames--such as National Guard and Reserves--may at 
least initiate a disability application prior to discharge.[Footnote 
3] However, VA lacked sufficient data to determine whether the Quick 
Start program was helping those with no or limited access to the BDD 
program. In response to our recommendation, VA has updated its data 
system to track participation by National Guard/Reserves. We also 
found that efforts to raise awareness about the BDD program may not 
reach all those who are eligible. DOD has set a goal that 85 percent 
of servicemembers attend Transition Assistance Program (TAP) sessions, 
but it has not implemented our recommendation to establish a plan with 
a specific time frame to meet this goal, and we continue to believe 
that it should. 


Through its disability compensation program, VA pays monthly benefits 
to veterans with service-connected disabilities.[Footnote 4] Under 
VA's BDD program, any member of the armed forces who has seen active 
duty--including those in the National Guard or Reserves--may apply for 
VA disability benefits prior to discharge. The program allows veterans 
to file for and potentially receive benefits earlier and faster than 
under the traditional claim process because medical records are more 
readily accessible and key forms needed to process the claim can be 
signed immediately. Establishing that the claim is related to the 
member's military service may also be easier under the BDD program 
because the member is still on active duty status. In 2008, VA and DOD 
offered the program at 142 bases,[Footnote 5] providing access to over 
70 percent of servicemembers who were discharged in fiscal year 
2007.[Footnote 6] In July 2008, VA issued policy guidance allowing 
servicemembers being discharged from any military base to initiate BDD 
claims at other locations where VA personnel were located, such as at 
all of its 57 regional offices. VA also established an alternative 
predischarge program, now called Quick Start, to provide members who 
cannot participate in the BDD program an opportunity to initiate 
claims before discharge. Last year, over 51,000 claims were filed 
through the BDD and Quick Start programs. 

To participate in the BDD program, servicemembers generally must meet 
six requirements: (1) be in the process of being honorably discharged 
from military service, (2) initiate their application for VA 
disability benefits between 60 and 180 days prior to their discharge 
date, (3) sign a Veterans Claims Assistance Act (VCAA) form,[Footnote 
7] (4) obtain and provide copies of their service medical records to 
local VA personnel, (5) complete a VA medical exam, and (6) remain 
near the base until the exam process is done. The 60-to 180-day time 
frame is intended to provide sufficient time prior to discharge for 
local VA personnel at BDD intake sites to assist members with their 
disability applications, including scheduling exams. 

While VA has examination requirements for those applying for 
disability compensation, DOD also has examination requirements for 
those leaving military service. For all servicemembers leaving the 
military, the military services generally require health assessments 
that consist of a questionnaire about the member's general health and 
medical history, among other topics. In some cases, members who are 
separating from the military may receive a physical exam to obtain 
evidence for a particular medical problem or problems that might 
exist. The purpose of the exam is to obtain information on the 
individual's medical history, and includes diagnostic and clinical 
tests, depending on the types of disabilities being claimed. VA's exam 
for disability compensation is more comprehensive and detailed than 
the military services' separation exams, which are intended to 
document continued fitness for duty, whereas the purpose of the VA 
exam is to document disability or loss of function.[Footnote 8] 

Under the BDD program, DOD and VA coordinate efforts to perform exams 
for servicemembers being discharged that satisfy requirements of both 
the military and VA. Because of variation in the availability of local 
resources, such as physicians trained to use VA's exam protocols, DOD 
and VA agreed that local military bases should have flexibility to 
determine whether VA or military physicians or some combination of 
both will conduct the exam. In 2004, the agencies signed a memorandum 
of agreement (MOA) delineating their roles and responsibilities. The 
national agreement delegates authority to VA regional offices and 
individual military bases to create memorandums of understanding (MOU) 
that detail how the exam process will be implemented at the local 

VA's Veterans Benefits Administration (VBA) is responsible for 
administering and monitoring the BDD program.[Footnote 9] VBA 
personnel assemble claims-related information and send the claims to 
be processed at one of two regional offices.[Footnote 10] VBA is also 
responsible for the paperless BDD claims process, an initiative 
intended to improve efficiency by converting claims-related 
information stored in paper folders into electronic format, as part of 
VA's effort to have all claims processed electronically by the end of 

VA has established a performance goal to increase the percentage of 
first-time disability claims filed through the BDD program. 
Servicemembers generally learn of the BDD program through VA-sponsored 
benefits briefings conducted at military bases as part of TAP 
sessions. Led primarily by the Department of Labor, TAP consists of 
about 3 to 4 days of briefings on a variety of topics related to 
benefits and services available to servicemembers as they are 
discharged and begin life as veterans. Generally, servicemembers are 
required to attend a short introductory briefing, while all other 
sessions--including the VA benefits segment in which members learn 
about BDD--are optional. 

In addition to its participation goal for the BDD program, VA has 
three general goals for the timeliness and accuracy of all disability 
claims: average days pending (i.e., waiting for a final decision), 
average days to complete all work to reach a final decision, and 
average accuracy rate (percentage of claims with no processing 
errors).[Footnote 11] In 2009, VA reached its performance goal for one 
measure, i.e., average days to complete claims was 161 days compared 
with a goal of 168 days. However VA fell short of two goals last year: 
Average days pending was 117 days compared with a goal of 116 days, 
and national accuracy rates were 83 percent compared with a goal of 90 
percent.[Footnote 12] 

VA's Management of the BDD Program Provides Limited Accountability for 
Results, although Recent Improvements Have Been Made: 

VA Has a Performance Measure for BDD Participation, but Lacks Adequate 
Measures for Timeliness of BDD Claims: 

VA has established one performance measure for the BDD program that 
tracks participation in the program. Since fiscal year 2005, VA has 
tracked the percentage of all disability claims filed through the BDD 
program within 1 year of discharge. VA's most recent data for fiscal 
year 2008 indicate that 59 percent of claims filed within 1 year of 
discharge were filed through the BDD program--9 percentage points 
higher than its fiscal year 2008 goal of 50 percent. VA recently 
revised this measure so that it accounts only for claims filed by 
members who are discharging from bases covered by the BDD program. 
[Footnote 13] 

Although VA fine-tuned its measure for BDD program participation, VA 
does not adequately measure timeliness of BDD claims. VA tracks the 
days it takes to process traditional claims starting with the date a 
veteran first files a claim, whereas it tracks days to process BDD 
claims starting with the date a servicemember is discharged.[Footnote 
14] This approach highlights a key advantage of the BDD program--that 
it takes less time for the veteran to receive benefits after 
discharge. However, the time VA spends developing a claim before a 
servicemember's discharge--at least 60 days according to VA--is not 
included in its measures of timeliness for processing BDD claims, even 
though claims development is included in VA's timeliness measures for 
traditional disability claims.[Footnote 15] 

VA officials told us the agency does not measure the timeliness of BDD 
claims development for three reasons: (1) VA lacks legal authority to 
provide compensation until a servicemember is discharged and becomes a 
veteran; (2) VA officials perceive most development activities, such 
as obtaining the separation exam and medical records, to be outside of 
their control; and (3) VA officials said that a primary objective of 
the program was to shorten the time from which the member was entitled 
to benefits--by definition, after discharge--to the time he or she 
actually received them. 

While it is useful to know how soon after discharge servicemembers 
begin receiving benefits, excluding the time VA personnel spend on 
developing BDD claims limits VA's information on challenges in this 
stage of the process and may inhibit VA from taking action to address 
them. Personnel in 12 of the 14 BDD intake bases we reviewed indicated 
significant challenges with claims development activities, such as 
scheduling and completing sometimes multiple exams for servicemembers 
who leave an area. Challenges such as these may delay the development 
of servicemembers' claims, putting them at risk of having to drop out 
of the BDD program. The fact that the servicemember is not yet a 
veteran does not absolve VA from tracking the time and resources spent 
developing BDD claims, which could ultimately help VA identify and 
mitigate program challenges. As for lack of control over the claims 
development process, VA also faces similar limitations with 
traditional disability claims, because VA must rely on veterans to 
submit their applications and on other agencies or medical providers 
for records associated with the claim. Nevertheless, VA tracks time 
spent developing these claims and could also do this for BDD claims. 

VA Has Not Fully Evaluated Initiatives to Improve the BDD Program: 

VA implemented two initiatives to improve the BDD program but did not 
fully evaluate either. In 2006, VA finished consolidating claims 
processing activities for BDD into two regional offices--Salt Lake 
City, Utah, and Winston-Salem, North Carolina--to improve the 
consistency and timeliness of BDD ratings.[Footnote 16] In fiscal year 
2007, each office completed about 11,000 BDD claims. Although VA 
reported to us that it monitors claims workloads between these offices 
and, in one case, sent claims from one office to the other so that 
claims could be processed more quickly, VA had not conducted an 
evaluation to determine whether consistency improved compared with 
prior practices. 

VA also has not evaluated a second BDD initiative, known as the 
paperless claims processing initiative, which is intended to increase 
the timeliness of claims processing and security of BDD claims 
information. Since our report, VA told us that all BDD claims have 
been processed in the paperless environment since August 2008, and 
that it continues to monitor the BDD paperless initiative by hosting 
monthly teleconference calls with all 57 regional offices, intake 
sites, and area offices to provide ongoing guidance and training, as 
well as address any issues or problems the field may be experiencing. 
However, VA has not evaluated the extent to which this initiative 
improved overall timeliness or security. 

VA's Review of BDD Operations Has Been Inconsistent, although VA Has 
Recently Taken Steps to Improve Monitoring: 

We identified gaps related to VA's monitoring of the BDD program, but 
VA has since taken some steps to address those gaps. For example, we 
found that between September 2002 and May 2008, VA conducted reviews 
of BDD operations in only 16 of the 40 offices it visited. Further, in 
10 of the offices that were reviewed, VA personnel did not document 
the extent to which BDD claims were fully developed before being 
passed on to the processing office, pursuant to VA policy.[Footnote 
17] We also found that the review protocol did not prompt reviewers to 
verify the extent to which claims were being fully developed before 
being sent to the processing office. In addition, for 14 offices, 
reviewers did not address whether agreements related to processing BDD 
claims existed between the processing office and relevant regional 
office, even though VA's BDD operations review protocol specifically 
prompts reviewers to check for such agreements. In response to our 
recommendations, VA officials reported that they have increased the 
number of BDD oversight visits, including visits to sites that had not 
been reviewed in several years, such as Honolulu, Hawaii, and 
Louisville, Kentucky. Furthermore, VA revised its protocol to require 
a review of BDD operations as part of its site visits to monitor 
regional offices. 

VA and DOD Took Steps to Increase Access to the BDD Program, but Some 
Servicemembers May Still Face Barriers to Participation: 

Some Servicemembers Have Limited Access to the BDD Program, but May 
Participate in the Alternative Quick Start Program: 

Although the BDD program is designed to provide most servicemembers 
with access, some members may be unable to initiate a claim 60 to 180 
days prior to discharge or remain within the vicinity of the base long 
enough to complete their exams. According to VA officials, this is a 
challenge particularly for demobilizing servicemembers of the National 
Guard and Reserves, who typically remain at a base for only 2 to 5 
days before returning home, and are generally unable in this brief 
time to complete requisite exams or obtain required copies of their 
service medical records. Servicemembers located in remote locations 
until just a few days prior to discharge may also be unable to 
participate. Finally, we were told that servicemembers going through 
the DOD Medical Board process are ineligible for the BDD program 
because they typically are not given a firm discharge date in advance 
of the 60-to 180-day discharge window, and a firm date is required to 
avoid servicemembers returning to active duty after completing the 
claims process.[Footnote 18] 

In April 2007, VA established an alternative predischarge program, now 
known as Quick Start, to provide members who cannot participate in the 
BDD program an opportunity to initiate disability claims before they 
are discharged. Under this program, local VA personnel typically 
develop servicemembers' claims as much as possible prior to discharge 
and then send the claims to the San Diego or Winston-Salem regional 
offices, which were designated as consolidated processing sites for 
Quick Start claims in August 2009.[Footnote 19] In addition, in 2009, 
VA also created a predischarge Web site, which allows servicemembers 
to initiate either a BDD or Quick Start claim electronically, although 
exams must still be completed in person. 

We found VA lacked data to assess the extent to which servicemembers 
benefit from the alternative predischarge program. Specifically, we 
found that VA was unable to assess participation in the Quick Start 
program by National Guard and Reserve servicemembers because they 
could not be distinguished from other servicemembers.[Footnote 20] In 
response to our recommendation, the agency reported that it has 
updated its data system to distinguish between National Guard/Reserves 
and full-time active duty servicemembers who file such claims. 

We also found that, like BDD claims, timeliness measures for Quick 
Start claims do not include days spent developing the claim prior to 
discharge. According to VA officials, the timeliness of Quick Start 
claims may vary substantially from both BDD and traditional claims. 
For example, servicemembers who are on base only a few days prior to 
discharge, such as members of the National Guard and Reserves, may 
have enough time only to fill out the application before returning 
home and may need to schedule the VA exam necessary to fully develop 
their claim after discharge. Overall, this will most likely result in 
less timely receipt of VA disability compensation than through the BDD 
program, but more timely than traditional claims. On the other hand, 
servicemembers with more time before discharge may be able to complete 
more or all of the claim development process, including the VA exam. 
Because VA does not adequately track timeliness of Quick Start, it may 
be unable to identify trends and potential challenges associated with 
developing and processing these claims. However, as with BDD claims, 
VA told us it has no plans to measure time spent developing these 
particular claims, and we continue to believe it should. 

VA and DOD Have Coordinated to Provide Briefings with Information 
about BDD, but Military Duties and Other Factors May Hinder Attendance: 

VA and DOD have coordinated to provide servicemembers with information 
about the BDD program through VA benefits briefings and other 
initiatives, but attending these briefings is optional for most 
servicemembers. According to DOD and VA personnel, most servicemembers 
learn about the program through VA benefits briefings conducted as 
part of TAP sessions, although some may also learn about BDD through 
base television spots, papers, and word of mouth.[Footnote 21] 
However, the Marine Corps is the only service branch to require 
servicemembers to attend VA benefits briefings. For the other service 
branches, participation requirements may vary by base and command. 

We found that commanders' and supervisors' support for transition 
services, such as VA-sponsored benefits briefings, can vary by base. 
[Footnote 22] Even though DOD policy requires commanders to allow 
servicemembers to attend TAP sessions upon the member's request, we 
were told at one base that servicemembers have on occasion not been 
released from their duties to attend the briefings, resulting in VA 
personnel going up the chain of command to obtain permission for the 
members to attend. At two bases, VA officials considered outreach to 
be difficult--because of conflicting missions between VA and DOD and 
lack of support from some base commanders--resulting often in 
servicemembers being called away from the briefings. 

Although some military officials recommended that servicemembers be 
required to attend TAP sessions, rather than mandate attendance, DOD 
decided in August 2007 to establish a goal that 85 percent of 
separating servicemembers and demobilizing National Guard and Reserve 
members participate in TAP sessions, including VA benefits briefings. 
We recommended that DOD establish a plan with a specific time frame 
for meeting this goal, but DOD has not developed such a plan. We 
continue to believe that DOD should establish a plan for meeting its 
goal. In the course of our review, we also learned that TAP 
participation data may be inaccurate or overstated because unique 
identifiers were not used to document servicemembers' attendance and 
servicemembers who attend more than one briefing could be double- 
counted. Currently, the Department of Labor (DOL), VA, and DOD track 
participation in their respective TAP sessions separately. We 
recommended that DOD establish an accurate measure of servicemembers' 
participation in TAP, including VA benefits briefings. DOD recently 
reported it is working in collaboration with DOL and VA to determine 
what improvements can be made in measuring servicemembers' 
participation in all components of TAP. 

Most BDD Sites Have Local Memorandums of Understanding to Provide a 
Cooperative Exam Process, but Maintaining Them Has Been a Challenge 
for Some Bases: 

Most BDD sites employ local MOUs to establish a cooperative exam 
process, and implementation of the exam process varies significantly. 
[Footnote 23] According to data provided by VA during our review, more 
than 60 percent of bases offering the BDD program had local MOUs that 
called for the exclusive use of VA physicians, 30 percent used VA 
contractors to conduct exams, and 7 percent used a sequential process 
involving resources and exams from both VA and DOD.[Footnote 24] At 
bases offering the BDD program overseas, VA exams were conducted by 
physicians under contract with DOD because VA does not have physicians 
at these bases. 

At several bases we visited, we identified resource constraints and 
communication challenges that have affected servicemenbers' access to 
the program. Resource challenges we identified at five bases included 
no designated VA exam provider for more than 7 months, difficulties 
hiring physicians, and displaced staff because of construction. At 
seven bases, we identified communication challenges or a lack of 
awareness of the local cooperative exam MOU caused by uncertainties 
generally resulting from deployment of a key DOD local official or 
changes in command leadership. In one case, communication between DOD 
and VA personnel was conducted on an inconsistent basis, if at all. 
Such constraints and challenges have caused delays in servicemembers' 
exams or otherwise made it difficult to meet time frames required by 
the BDD program. 

At the time of our review, DOD and VA had provided some guidance on 
implementing and maintaining local MOUs; however, personnel in some 
sites we visited were interested in learning about promising practices 
at other bases. We recommended that VA and DOD identify and 
disseminate information on promising practices that address challenges 
local officials commonly face in ensuring servicemembers have full 
access to a cooperative exam. DOD officials recently reported 
collaborating with VA on a September 2009 conference focusing on 
seamless transition. DOD officials planned to work with conference 
sponsors to identify best practices for dealing with the cooperative 
exam process as it relates to the challenges local personnel commonly 


The BDD program appears to be an effective means for thousands of 
separating servicemembers to receive their disability benefits faster 
than if they had filed a claim under VA's traditional process. Despite 
BDD's inherent advantages, VA has not followed through on 
opportunities to ensure accountability and to optimize results. 
Similarly, although DOD and VA have made significant progress in 
increasing servicemembers' access to the BDD and Quick Start programs, 
opportunities to further ensure or improve access remain. At a time 
when so many servicemembers are being discharged with injuries, it is 
more important than ever to process benefits as efficiently and 
effectively as possible. BDD and Quick Start programs have great 
potential to achieve these goals, as long as VA maintains a sharp 
focus on accountability, and both DOD and VA follow through on 
recommended actions. 

Mr. Chairman, this concludes my prepared statement. I would be pleased 
to answer any questions that you or other Members of the Subcommittee 
may have. 

[End of section] 

Related Products: 

Veterans' Disability Benefits: Further Evaluation of Ongoing 
Initiatives Could Help Identify Effective Approaches for Improving 
Claims Processing. [hyperlink,]. Washington, D.C.: January 29, 

Veterans' Disability Benefits: Preliminary Findings on Claims 
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Military Disability System: Increased Supports for Servicemembers and 
Better Pilot Planning Could Improve the Disability Evaluation Process. 
[hyperlink,]. Washington, 
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Veterans' Benefits: Increased Focus on Evaluation and Accountability 
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Federal Disability Programs: More Strategic Coordination Could Help 
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VA and DOD Health Care: Progress Made on Implementation of 2003 
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VA Health Care: Additional Efforts to Better Assess Joint Ventures 
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DOD and VA: Preliminary Observations on Efforts to Improve Care 
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Information Technology: VA and DOD Continue to Expand Sharing of 
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GAO Findings and Recommendations Regarding DOD and VA Disability 
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Information Technology: VA and DOD Are Making Progress in Sharing 
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Veterans' Disability Benefits: Processing of Claims Continues to 
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High Risk Series: An Update. [hyperlink,]. Washington, D.C.: January 31, 

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Military Disability Evaluation: Ensuring Consistent and Timely 
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Major Performance Improvements May Be Difficult. [hyperlink,]. Washington, D.C.: May 26, 

Military and Veterans' Benefits: Enhanced Services Could Improve 
Transition Assistance for Reserves and National Guard. [hyperlink,]. Washington, D.C.: May 20, 

VA and DOD Health Care: Efforts to Coordinate a Single Physical Exam 
Process for Servicemembers Leaving the Military. [hyperlink,]. Washington, D.C.: November 12, 

Veterans' Benefits: Improvements Needed in the Reporting and Use of 
Data on the Accuracy of Disability Claims Decisions. [hyperlink,]. Washington, D.C.: September 
30, 2003. 

[End of section] 


[1] The military has a separate disability evaluation process for 
servicemembers who are being discharged because they can no longer 
perform their duties because of a disabling condition. 

[2] GAO, Veterans' Disability Benefits: Better Accountability and 
Access Would Improve the Benefits Delivery at Discharge Program, 
[hyperlink,]. (Washington, 
D.C.: Sept. 9, 2008). 

[3] At the time of our review, VA referred to this program as its new, 
alternative predischarge program. Today, this program is referred to 
as the Quick Start program. 

[4] The amount of disability compensation depends largely on the 
severity of the disability, which VA measures in 10 percent increments 
on a scale of 0 percent to 100 percent. In 2010, basic monthly 
payments for veterans with no dependents have ranged from $123 for 10 
percent disability to $2,673 for 100 percent disability. 

[5] BDD is also present at an additional 11 Coast Guard bases, which 
are administered by the Department of Homeland Security. 

[6] This percentage does not include members of the National Guard or 
Reserve forces. 

[7] The Veterans Claims Assistance Act of 2000 (VCAA) (Pub. L. No. 
106- 475) assigns VA the duty to assist veterans in obtaining any 
records relevant to their claims, provided the veterans adequately 
identify such records so that VA is able to request them. 

[8] See GAO, VA and DOD Health Care: Efforts to Coordinate a Single 
Physical Exam Process for Servicemembers Leaving the Military, 
[hyperlink,] (Washington, D.C.: 
Nov. 12, 2004). 

[9] While VA administers the BDD program, VA and DOD's Joint Executive 
Council (JEC) oversees joint efforts to eliminate barriers that 
servicemembers may face as they leave the military. Under the JEC, the 
Benefits Executive Council is focused on improving information sharing 
between the agencies and the transition process for servicemembers. 

[10] In 2006 VA completed its consolidation of BDD processing 
activities into two regional offices--Salt Lake City, Utah, and 
Winston-Salem, North Carolina--to increase the consistency of BDD 

[11] VA has several other measures for claims overall, including 
measures of satisfaction and how well VA keeps veterans informed of 

[12] National accuracy rate data are through July 2009. 

[13] Previously, VA had included in the denominator claims from 
members who were discharged from non-BDD locations. Using those data, 
in fiscal year 2007, only 43 percent of first-year claims were filed 
through BDD, significantly short of VA's goal. VA will come closer to 
its goal by excluding servicemembers who, being from non-BDD 
locations, will generally be unable to meet BDD program requirements. 

[14] While VA lacks a separate performance measure on BDD timeliness, 
VA officials reported the agency does track the average days BDD 
claims are pending a decision and the average days it takes VA to 
complete work on BDD claims separately from traditional claims. 
However, VA includes only the time after servicemember discharge when 
tracking BDD timeliness. 

[15] By not including the time it takes to develop BDD claims, VA 
underestimates its overall processing time. However the impact is not 
large because predischarge (BDD and Quick Start) claims represent a 
small portion of all claims processed--about 5 percent in 2009. 

[16] These two regional offices complete development, rating, award 
actions, and notification actions for BDD claims. 

[17] VA policy directs the processing offices to have agreements with 
all of the regional offices in their jurisdiction to define roles and 
responsibilities for processing BDD claims. 

[18] DOD and VA are piloting a program whereby the assessment used to 
determine a wounded soldier's fitness for duty can be used to 
determine VA disability benefits for those ultimately deemed unfit. 

[19] These designated processing sites complete development, rating, 
award actions, and notification actions for Quick Start claims. 

[20] At the time of our review, VA also expressed concern that early 
Quick Start program data might not be accurate because of to the 
newness of the program. 

[21] In addition, the Benefits Executive Council's BDD Working Group 
has also developed a BDD and Quick Start pamphlet to be distributed at 
all VA intake sites, and VA's recently developed predischarge Web site 
also includes links to the TAP Web site and information. 

[22] GAO, Military and Veterans' Benefits: Enhanced Services Could 
Improve Transition Assistance for Reserves and National Guard, 
[hyperlink,] (Washington, D.C.: 
May 20, 2005). 

[23] At the time of our review, 130 of the 142 DOD bases that offered 
the BDD program had a local MOU in place; the remaining 12 bases were 
newer and had not yet established local MOUs. VA noted that its policy 
guidance (Fast Letter 08-20), signed July 2, 2008, eliminated the 
requirement for a local MOU to be in place in order for VA to accept a 
BDD claim. In this guidance, VA expanded the definition of a BDD 
claim, removing the criterion that BDD claims may be accepted only at 
military bases where local MOUs are in place. 

[24] For example, at 2 bases, DOD officials started the exam process 
by conducting diagnostic testing, such as hearing and vision tests; a 
VA physician or contractor conducted the remainder of the exam, which 
was then incorporated to meet both VA and DOD separation requirements. 

[End of section] 

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