Va Needs Sufficient, Timely, And Predictable Funding

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VA NEEDS SUFFICIENT, TIMELY, AND PREDICTABLE FUNDING

As in years past, the fiscal year (FY) 2008 appropriations process was neither seamless nor efficient. Due to political wrangling over the federal budget, and for the 18th time in 21 years, VA did not receive its fiscal year 2008 appropriation until January, despite the bill being completed before the start of the fiscal year on October 1. The process leading up to FY 2009 was equally challenging. Despite excellent funding levels provided over the past two years, the larger appropriations process remains flawed and unpredictable. For only the third time in the past 20 years, VA received its budget prior to the start of the new fiscal year. However, this funding was not completed by Congress in the regular order. The new Administration is still preparing its budget request for FY 2010. Compared to VA's total discretionary budget for FY 2009 of $50.2 billion including medical collections, the Independent Budget (IB) recommends $54.6 billion, an increase of $4.5 billion over last year. Medical Care Budget: The IB recommends $46.6 billion for medical care, an increase of $3.6 billion over FY 2009. Medical and Prosthetic Research: The IB recommends $575 million, $65 million more than VA received in FY 2009, to account for inflation and allow VA to better understand and develop treatments for the unique injuries and diseases of veterans of the wars in Iraq and Afghanistan, as well as for diseases and injuries of older generations of disabled veterans. Benefits Processing: To manage the projected increase in new claims, reduce the out-of-control claims backlog, and improve the quality of processing claims, the IB recommends a total of nearly $2 billion for General Operating Expenses. This is $180 million above the FY 2009 level. Construction Programs: The IB recommends $2.3 billion for FY 2010, $370 million above last year, to address a backlog of current approved maintenance, minor and major construction projects and grant programs. Clearly, the current budget process continues to hamper and threaten VA health care delivery. When VA does not receive its funding in a timely manner, it is forced to ration health care. Much-needed medical staff cannot be hired, medical equipment cannot be procured, waiting times for veterans increase, and the quality of care suffers. The DAV believes a change is warranted and long overdue to sustain a stable and viable health care system. Any reform must include sufficiency, timeliness, and predictability of VA health care funding. For the past decade, the Partnership for Veterans Health Care Budget Reform - a coalition of nine veteran service organizations including DAV, with a combined membership of 8 million veterans - fully endorsed veterans health care budget reform. We fully support the Veterans Health Care Budget Reform and Transparency Act, H.R. 1016 and S. 423. These bills would:

• Authorize Congress to appropriate funding for veterans' medical care one year in advance

• Provide greater transparency to VA's internal budget process, ensuring approval of sufficient funding
  
• Require the Government Accountability Office (GAO) to audit and report to Congress VA's formulation for its health care budget
  

This legislation also is supported by The Military Coalition, comprised of 35 organizations representing the uniformed services and their families and by the American Federation of Government Employees (AFGE). The DAV believes this legislation proposes a reasonable solution to achieve sufficient, timely, and predictable funding. Congress should increase VA discretionary funding by $4.5 billion and pass advanced appropriation legislation, S. 423 and H.R. 1016 to provide a sufficient, timely, and predictable budget for VA health care in future years.

COMPENSATION FOR LOSS OF QUALITY OF LIFE

The DAV believes a realistic increase in VA compensation rates should be made to bring the standard of living of disabled veterans in line with that which they would have enjoyed had they not suffered their service-connected disabilities. The Veterans' Disability Benefits Commission (VDBC) issued its report, Honoring the Call to Duty: Veterans' Disability Benefits in the 21st Century, which identified eight principles as a guide to the development and delivery of future benefits for veterans and their families. One principle is that benefits and services should be provided that collectively compensate for the consequence of service-connected disability on the average impairment of earnings capacity, the ability to engage in usual life activities, and quality of life. The current statutory basis for disability payments based on the VA Schedule for Rating Disabilities is an average impairment of earning capacity. Yet, service-connected disabilities can impede veterans from engaging in usual life activities and can impair their quality of life. Consequently, the VDBC recommended increasing the compensation rates up to 25 percent as an interim and baseline future benefit for loss of quality of life pending development and implementation of a quality of life measure in the VA Rating Schedule. 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. The VDBC consulted with the Institute of Medicine (IOM) and Center for Naval Analyses Corporation (CNAC) on the loss of quality of life for service-connected disabled veterans. A chapter in the IOM Medical Evaluation Committee report, A 21st Century System for Evaluating Veterans for Disability Benefits, is entirely dedicated to addressing impairment, disability and quality of life, and recommended compensating disabled veterans for three consequences of service-connected injuries and disease: work disability, loss of ability to engage in usual life activities other than work, and loss in quality of life. The CNAC analysis of the VA disability compensation system found that the program does provide for reasonable earnings adjustments for most disabling conditions. Additionally, recommendations contained in the report by the President's Commission on the Care for America's Returning Wounded Warriors, includes quality of life payments to compensate for permanent losses of various kinds, as well as compensation for loss of earning capacity. While the DAV disagrees with this Commission's recommendation for a new compensation structure for the newest generation of disabled veterans that would eventually eliminate VA earnings loss payments and shift to Social Security, it is clear that current VA disability compensation does not adequately provide for the full effects of service-connected disabilities. Congress should increase VA disability compensation to include compensation for the loss of quality of life resulting from service-connected disabilities.

STAND UP FOR VETERANS

With ongoing military operations in Afghanistan and Iraq (OEF/OIF), increasing numbers of servicemembers continue to transition to veteran status. Unfortunately, thousands of our military personnel are returning from deployments with physical and mental wounds and permanent disabilities. Already, over 347,000, or 42 percent, of the more than 945,000 discharged veterans from the wars in Iraq and Afghanistan have sought care at VA health care facilities. Returning OEF/OIF veterans are seeking care for a range of health care issues as a result of their wartime military service. Many need specialized treatment for traumatic brain injury, post-deployment mental health readjustment issues, including depression, post traumatic stress disorder and substance-use disorders. Timely access to mental health services is essential to preventing the tragedy of suicide and chronic mental health problems. These wars have produced a number of veterans with catastrophic injuries in need of highly specialized polytrauma care and life-long services and support. Caregivers of the severely wounded also need comprehensive support services to facilitate the veteran's rehabilitation and recovery and maintain their own health and well-being. Likewise, with greater numbers of women serving in the military, including in combat and support roles, there is a new generation of women turning to VA with unique health care needs. Millions more veterans have also been disabled from their military service during prior wars. Veterans have fought to defend our nation and our freedoms; they shouldn't have to fight to get the specialized medical services they need. Our nation must keep faith with these men and women by taking action now to ensure they have access to high quality, timely health care services. Our veterans kept their promise. We must keep ours. We urge the President and Congress to enact legislation to: 1. Reform the federal budget and appropriations process for veterans medical care programs to guarantee that funding is sufficient, timely and predictable in order to sustain VA health care as the "best care anywhere." 2. Mandate that all veterans are properly screened and treated for psychological wounds, including post-traumatic stress disorder, utilizing the most effective treatment and evidence-based therapies. 3. Ensure that all combat veterans, particularly those who may have suffered a traumatic injury, be properly screened using validated assessment tools and, when indicated, be provided timely and convenient access to proven, effective treatments. 4. Provide comprehensive support to family caregivers of severely wounded and disabled veterans, including access for family caregivers to VA mental health care services, financial support, and other support services, in order to promote the full recovery and rehabilitation of these veterans and their families.

ELIMINATING THE OFFSETS

Some service members who are retired from the armed forces on the basis of length of service must forfeit a portion of the retired pay they earned through faithful performance of military service to receive VA compensation for service-connected disabilities. Military retired pay is earned by virtue of a veteran's long service to the nation; disability compensation is for service-incurred disabilities. Most nondisabled retirees pursue second careers after serving in order to supplement their income, thereby justly enjoying a full reward for completion of a military career along with the added reward of full pay in civilian employment. To put service-connected retirees on equal footing with nondisabled retirees, disabled retirees rated 40 percent or lower should receive full military retired pay and compensation to account for diminution of their earning capacities. A disabled veteran should not suffer a financial penalty for choosing military service as a career rather than a civilian career, especially where in all likelihood a civilian career would have involved fewer sacrifices and greater rewards. If a veteran must forfeit a dollar of retired pay for every dollar of VA disability compensation otherwise payable, our government is, in effect, compensating the veteran with nothing for the service-connected disability he or she suffered. Two bills have been introduced in the 111th Congress that would eliminate this longstanding inequity: H.R. 303 and H.R. 333. The DAV supports both of these bills and asks for their immediate consideration. Similarly, Survivor Benefit Plan (SBP) annuities are offset by the amount of any survivor benefits payable under the VA Dependency and Indemnity Compensation (DIC) program. Unlike many retirement plans in the private sector, survivors have no entitlement to any portion of the member's retired pay after his or her death. Under SBP, deductions are made from the member's retired pay to purchase a survivors' annuity. This is not a gratuitous benefit. Upon the veteran's death, the annuity is paid monthly to eligible beneficiaries under the plan. DIC protects the survivors from the losses associated with the veteran's death from service-connected causes or after a period of time when the veteran was unable, because of total disability, to accumulate an estate for inheritance by survivors. If a veteran is retired from the military and enrolled in SBP, the surviving spouse's SBP benefits are reduced by the amount of DIC (currently $1,091 per month). However, if the veteran died of other than service-connected causes or was not totally disabled by service-connected causes for the required time preceding his or her death, beneficiaries receive full SBP payments. There are approximately 61,000 military widows/widowers affected by the DIC offset. Where the monthly DIC rate is equal to, or greater than, the monthly SBP annuity, beneficiaries lose all entitlement to the SBP annuity. The offsets affecting military retirement pay and SBP payments are inequitable because no duplication of benefits is involved. The DAV supports H.R. 775, the "Military Surviving Spouses Equity Act." This legislation would finally end this disparity and would provide surviving spouses with the full spectrum of benefits they have earned and deserve. The DAV strongly supports the repeal of these offsets, which penalize an already financially vulnerable population of survivors, dependents, and retirees. Urge your elected officials to support the removal of these offsets. Pass H.R. 303, H.R. 333, and H.R. 775. http://www.standupforvets.org