Military Disability System:

Improved Monitoring Needed to Better Track and Manage Performance

GAO-12-676: Published: Aug 28, 2012. Publicly Released: Sep 19, 2012.

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What GAO Found

Case processing times under the Integrated Disability Evaluation System (IDES) have increased over time, and measures of servicemember satisfaction have shortcomings. Since 2008, annual average processing times for IDES cases have steadily climbed, while the percentage of cases meeting established timeliness goals declined. Average case processing times reached 394 and 420 days for active and reserve component members in fiscal year 2011--compared to goals of 295 and 305 days, respectively, and just 19 percent of active duty and 18 percent of guard or reserve servicemembers completed the process and received benefits within established goals. Of the four phases comprising IDES, the medical evaluation board phase increasingly fell short of timeliness goals, while the physical evaluation board phase, although meeting goals, was taking increasingly more time to complete. With respect to servicemember satisfaction with the IDES process, GAO found shortcomings in how these data are collected and reported, such as unduly limiting who is eligible to receive a survey and computing average satisfaction scores in a manner that may overstate them. Department of Defense (DOD) officials told GAO they are considering alternatives for gauging satisfaction with the process. DOD and Veterans Affairs (VA) are taking steps to improve IDES performance, but progress to date is uneven and it is too early to assess their overall impact. For example, VA increased resources for completing exams and disability ratings while the Army is hiring additional staff for its medical evaluation boards. VA has met exam timeliness goals in the past several months, but other resources have yet to translate into lower processing times. DOD and VA are pursuing system upgrades so that staff and managers at IDES facilities can better track and manage the progress of servicemembers' cases. IDES officials have been working with the military services to correct case data that were inaccurately entered into VA's IDES tracking system, but have not yet identified a permanent solution to improve the accuracy of data input. Finally, DOD, with VA's assistance, is in the early stages of an in-depth review of the entire IDES process and its supporting IT systems. This effort is intended to improve understanding of how each step contributes to overall processing times and identify opportunities to streamline the process and supporting systems. However, timeframes for completing the review or issuing recommendations have yet to be established.

Why GAO Did This Study

Since 2007, DOD and VA have jointly operated IDES--which is intended to expedite benefits for injured servicemembers. IDES replaced the departments' separate processes for evaluating servicemembers for fitness and disability. Initially a pilot at 3 military treatment facilities, IDES is now in place at military treatment facilities worldwide. In previous reports, GAO identified a number of challenges as IDES expanded to more facilities, including staffing shortages and difficultly meeting timeliness goals. In light of IDES' expansion, GAO was asked to examine: (1) the extent to which DOD and VA are meeting IDES timeliness and servicemember satisfaction performance goals, and (2) steps the agencies are taking to improve IDES performance. GAO analyzed IDES timeliness and customer satisfaction data, visited six IDES sites with varying performance, and interviewed DOD and VA officials.

What GAO Recommends

To improve monitoring of IDES timeliness and satisfaction, GAO recommends that DOD and VA work together to (1) develop plans for completing the ongoing business process review and implementing any resulting recommendations and (2) improve the accuracy of case information at the point of data entry; and that (3) DOD consider alternative approaches to measuring satisfaction. DOD and VA concurred with GAO's recommendations.

For more information, contact Daniel Bertoni at (202) 512-7215 or bertonid@gao.gov.

Status Legend:

More Info
  • Review Pending-GAO has not yet assessed implementation status.
  • Open-Actions to satisfy the intent of the recommendation have not been taken or are being planned, or actions that partially satisfy the intent of the recommendation have been taken.
  • Closed-implemented-Actions that satisfy the intent of the recommendation have been taken.
  • Closed-not implemented-While the intent of the recommendation has not been satisfied, time or circumstances have rendered the recommendation invalid.
    • Review Pending
    • Open
    • Closed - implemented
    • Closed - not implemented

    Recommendations for Executive Action

    Recommendation: To ensure that servicemember cases are processed and are awarded benefits in a timely manner, we recommend that the Secretaries of Defense and Veterans Affairs work together to develop timeframes for completing the IDES business process review and implementing any resulting recommendations.

    Agency Affected: Department of Veterans Affairs

    Status: Open

    Comments: VA stated that it provided input on proposed recommendations to improve the IDES that resulted from the DOD-led process review. Once recommendations are finalized and approved by VA and DOD, VA will contribute to the development of timeframes for implementation. GAO will await the completion of this effort, continuing to monitor the implementation of any IDES improvements that result from this effort.

    Recommendation: To ensure that servicemember cases are processed and are awarded benefits in a timely manner, we recommend that the Secretaries of Defense and Veterans Affairs work together to develop timeframes for completing the IDES business process review and implementing any resulting recommendations.

    Agency Affected: Department of Defense

    Status: Open

    Comments: DOD's IDES task force completed its review in October 2012 and is currently exploring options for implementing several policy and procedural changes recommended by the effort. Additionally, DOD is developing a model to simulate the effects of these potential changes on IDES and anticipates completing this model by December 2013. GAO will await the completion of this model and continue to monitor the implementation of any IDES improvements that result from this effort.

    Recommendation: To improve DOD's ability to measure servicemembers' satisfaction with the IDES process, the Secretary of Defense should develop alternative approaches for collecting more meaningful and representative information in a cost effective manner.

    Agency Affected: Department of Defense

    Status: Open

    Comments: DOD revised its approach to surveying IDES customer satisfaction and resumed data collecting in July 2013. DOD states that it revised its survey administration procedures to ensure more IDES participants are able to respond and has begun using probability sampling to reduce the cost of the satisfaction survey. DOD anticipates publishing its first survey results in December 2013 and plans to include analyses of negative and neutral responses to its survey. GAO will continue to monitor DOD's implementation of the customer satisfaction survey.

    Recommendation: To ensure that IDES management decisions continue to be based upon reliable and accurate data, the Secretaries of Defense and Veterans Affairs work together to develop a strategy to continuously monitor and remedy issues with VTA timeliness information. This could include issuing guidance to facilities or developing best practices on preventing and correcting data entry errors; and developing reporting capabilities in VTA to alert facilities to potential issues with their data.

    Agency Affected: Department of Veterans Affairs

    Status: Open

    Comments: VA and DOD identified VTA reporting capabilities needed to assist with workload management and oversight. VA expects these enhancements to be completed by March 2014. Additionally, VA has been conducting training with its employees on VTA data entry procedures and is leading an effort to correct VTA data regarding VA examinations and claims development.

    Recommendation: To ensure that IDES management decisions continue to be based upon reliable and accurate data, the Secretaries of Defense and Veterans Affairs work together to develop a strategy to continuously monitor and remedy issues with VTA timeliness information. This could include issuing guidance to facilities or developing best practices on preventing and correcting data entry errors; and developing reporting capabilities in VTA to alert facilities to potential issues with their data.

    Agency Affected: Department of Defense

    Status: Open

    Comments: A DOD task force collected requirements from the military services for VTA enhancements and delivered them to VA. VA states that VTA enhancements are scheduled to be completed by March 2014. GAO will close this recommendation when this effort is completed.

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