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62 <a href="http://www.mca-marines.org/gazette">www.mca-marines.org/gazette</a> M a r i n e C o r p s G a z e t t e • M a y 2 0 0 9 IDEAS & ISSUES (PERSONAL AFFAIRS) may have been uncomfortable in pass- ing the rigid screening process to enter the Capitol buildings. All hearings were open to the public, and there was an open forum segment scheduled at the end of each day, during which we heard some very interesting, sometimes colorful, and often poignant testimony. In order to get beyond the Washing- ton, DC area we conducted hearings and site visits in cities throughout the country in areas that contained a Veter- ans Medical Center and a major mili- tary base with a military medical center. In order to expand coverage, and to adhere to Federal law, most of these meetings were conducted by “minicommissions” composed of three commissioners and a staff person. Pub- lic “town hall” meetings were held in each city, attracting veterans groups, interested citizens, local politicians, and media representatives. Each visit included Department of Veterans Af- fairs (VA) and military medical centers, where the minicommissions received briefings, conducted tours, and visited with wounded warriors and their fam- ilies. We examined extensive issues lead- ing to 113 recommendations, pub- lished in a 748-paged hardbound book entitled, Honoring the Call to Duty, Vet- erans’ Disability Benefits in the 21st Cen- tury, which focused on the primary issues examined by the VDBC, as fol- lows: • Quality of life (QOL). • The VA schedule for rating disabil- ities (VASRD). • Posttraumatic stress disorder (PTSD). • Individual unemployability (IU). • Presumptions. • Transition (military service to post- military). • Concurrent receipt. • Compatible electronic information systems (between the Department of Defense (DoD) and the VA, as well as between the Services and DoD). • Claims processing (VA and DoD/Services). Within this framework, and after over 21/2 years of work, the recommen- dations address a broad spectrum of veterans’ disability benefits issues to en- sure that Service-disabled veterans and their families are fairly and uniformly compensated. Understandably, and logically, the submission of a hard- bound book of such length and depth is going to be a challenge for Congress and the White House to read, review, and take action. Recognizing this real- ity, the VDBC, still expecting the Con- gress to eventually examine every recommendation, selected 14 “big hit- ters” for Congress to initially consider while moving through the other rec- ommendations for later consideration and action. These 14 major issues, ad- dressed below, were selected not only for their significance and impact, but also for their timeliness, in respect for the severely injured in the current con- flicts as well as those in the older vet- eran population. The following are the major issues that the VDBC selected as requiring early implementation. These were in- cluded in testimony by the Chairman of the Commission to the Senate and House Armed Services Committee and the Senate and House Committees on Veterans’ Affairs, as well as the White House, in December 2007 and Janu- ary 2008. The dialog is still underway as of this writing. • The VA should be compelled to immediately update the current VASRD beginning with those body systems addressing the evaluation and rating of PTSD, other mental disor- ders, and traumatic brain injury, then proceed through the other body sys- tems until the rating schedule has been comprehensively revised/up- dated. • The VA should develop and imple- ment new criteria specific to PTSD in the VASRD and base that criteria on the Diagnostic and Statistical Manual of Mental Disorders and should con- sider a multidimensional framework for characterizing disability due to PTSD. • The VA should establish a holistic approach that couples PTSD treat- ment, compensation, and vocational assessment, with reevaluations occur- ring every 2 to 3 years to gauge treat- ment effectiveness and encourage wellness. • Congress should eliminate the ban on concurrent receipt for all military retirees and for all servicemembers who separated from the military due to Service-connected disabilities. In the future, veterans who retired from the military under Chapter 61 (phys- ically disabled and unable to continue service) with fewer than 20 years of service and a Service-connected dis- ability rating greater than 50 percent, or a disability as a result of combat, should receive disability compensa- tion. • Eligibility for IU should be consis- tently based on the impact of an indi- vidual’s Service-connected disabilities, in combination with education, em- ployment history, and medical effects of an individual’s age or potential em- ployability. The VA should imple- ment a periodic and comprehensive evaluation of IU eligible veterans and authorize a gradual reduction in com- pensation for IU recipients who are able to return to substantially gainful employment rather than abruptly ter- minating disability payments at an ar- bitrary level of earnings. • Recognizing that IU is intended to accommodate individuals with mul- tiple lesser ratings but who remain unable to work, the commission rec- ommended that as the VASRD is re- vised, every effort should be made to accommodate such individuals fairly within the basic rating system, with- out the need for an IU rating. • Congress should increase the com- pensation rates up to 25 percent as an interim baseline for benefits for loss of QOL, pending development and implementation of QOL measures in the rating schedule. In particular, the measure should take into account the QOL and other nonwork-related ef- fects of severe disabilities on veterans and family members. • Congress should consider increas- ing special monthly compensation (SMC), where appropriate, to address
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