▶ 0:15:44Sen. Moran: Good afternoon and welcome. It is good to see kids trick-or-treating. Make me smile. I wish I could give my grandkids on this occasion, but we have important work here and I'm delighted to have the opportunity to bring the committee together and look at disability issues. I think our witnesses for your presence.
▶ 0:16:10Sen. Moran: We have a 5:00 vote and I will try to get us started and that means I should stop the intro and begin the hearing. I want to say a few things first. I appreciate the witnesses that are here. We want your insight and perspective on the issue and we know we will benefit us as legislators and will be helpful to veterans and families that we aim to serve.
▶ 0:16:33Sen. Moran: Our nation owes those who have served in uniform not only gratitude, but a steadfast commitment to provide health care, benefits and support they have earned through their service. It is our duty to make certain we are doing everything possible to make sure veterans lead fulfilling lives after military service. This forms the foundation of this committee's work and the focus of today's hearing.
▶ 0:16:58Sen. Moran: Disability claims process is intended to make certain that those who have a lasting injury, visible or invisible, from their service received care and compensation they deserve. Articles by the washington post have raised concern among the veteran community. I heard from veterans and groups frustrated that these articles left the impression that veterans are engaging in widespread fraud in the disability claims space.
▶ 0:17:29Sen. Moran: Cases of fraud highlighted in the articles don't reflect the reality of who veterans are, the majority of the veteran population or the values veterans a body. They put country before self from their decision to serve to the oath they swore. The attention these stories received provides us an opportunity to have an important discussion about whether the system we have built is serving the needs of veterans today and how we can reform it to better serve those who were designed to
▶ 0:18:03Sen. Moran: Help. . We have an obligation to the men and women with injuries and illnesses conduct did with service in uniform to make sure they have the resources to succeed after the military. Our goal is to examine the facts. Is the system ensuring timely, accurate and fair outcomes? Is it empowering veterans to thrive or creating barriers to their success and opportunities after service? We will hear from the v.a.
▶ 0:18:28Sen. Moran: Inspector general cheryl mason, responsible for rooting out fraud and abuse and who has experience in the disability claims system as former chairwoman of the veteran, the board of veterans appeals. Representatives from three of our largest vector and's service organizations -- veteran service organizations in the claim process.
▶ 0:18:48Sen. Moran: A representative for the government accountability office who published reports and made recommendations on how to prove oversight and management of the disability claims process and daniel gade, a veteran and advocate of changing the disability system to support veterans well-being.
▶ 0:19:08Sen. Moran: This is not the first and will not be the last conversation we have in exploring how to better serve veterans and compensate veterans for service-connected conditions and help them lives strong, successful fulfilling lives.
▶ 0:19:26Sen. Moran: I look forward to this -- the constructive discussion that I'm sure will take place and we will give ranking member blumenthal the opportunity to offer his opening statement as soon as he sits down. You must have heard me call you chairman and you will immediately arrived.
▶ 0:19:52Sen. Blumenthal: Thank you, Mr. chairman and thank you to all of our witnesses. We have more than the usual number. Welcome. We appreciate your public service as veterans and advocate of our veterans.
▶ 0:20:14Sen. Blumenthal: And today's hearing is focused on our nation's obligation for the men and women in uniform, and the system we use to compensate any of them who become ill or injured due to their service.
▶ 0:20:30Sen. Blumenthal: We all know the system inherited by secretary collins was not perfect, but it was providing historic levels of benefits to toxic exposed veterans thanks to the bipartisan act that all of us on this committee I think supported. In a very bipartisan way.
▶ 0:20:54Sen. Blumenthal: The system is being dismantled through a series of reckless policies in my view that are pushing hard working civil servants to process disability claims to the brink of what they can do. The administration's draconian deferred resignation program returned office policy, hiring freeze, arbitrary contract cancellation and other morale crushing initiatives have driven out more than 1800 mission-critical vba employees.
▶ 0:21:27Sen. Blumenthal: The result has been a demoralized vba workforce who is consistently pushed to sacrifice quality for the sake of quantity. There simply are not enough people doing these jobs for the work to be performed capably, at a level that our veterans deserve.
▶ 0:21:53Sen. Blumenthal: It has created more work for claims processors and today we will hear from our bso witnesses on how this abdication in the name of modernization is impacting the veterans you represent. I want to hear your response to those who believe v.a. Disability compensation is too generous. Not my view.
▶ 0:22:17Sen. Blumenthal: That is how the system has been portrayed by some opponents of the system in past years. The articles fail to understand or capture the purpose of the benefit. Instead, they cherry pick anecdotes to wrongfully claim disability benefits is fraught with widespread fraud. There is in fact some wrongdoing and fraud. We need to root it out.
▶ 0:22:50Sen. Blumenthal: Investigate and prosecute it, but not abandoned the system of compensation that is deserved and needed by veterans, our heroes who serve and sacrifice for our country. I want to say finally that the current v.a. Leadership has repeatedly violated the hatch act by blurring the lines between governance and political campaigning.
▶ 0:23:20Sen. Blumenthal: That is unacceptable. There used to be bipartisan pushback to such behavior, and I hope there will be again. Veterans deserve a v.a. That works for them, whether they are democrats or republicans, and avoids pushing hard to send messages. -- partisan messages. I will continue to fight for improvement and expansion of earned v.a. Benefits and I appreciate all of you here who are advocating for that cause.
▶ 0:23:51Sen. Moran: Senator blumenthal, thank you. Testifying is the honorable cheryl mason, v.a. Inspector general. Jeremy bill and wava -- villanueva the associate of paralyzed veterans of america. Mr. jon retzer deputy national legislative director of disabled american veterans. Ryan gallucci executive director of veterans of foreign wars. Retired colonel, Dr.
▶ 0:24:20Sen. Moran: Daniel gade, a retired lieutenant colonel. Ms. elizabeth curda, director of education, workforce, and income of the government accountability office at. Ms. mason, you are recognized for five minutes.
▶ 0:24:41Ms. Mason: Thank you, chairman. Chairman moran, ranking member blumenthal, and members of the committee, I am pleased to be here to discuss, I am sorry, closer to the mic? There we go. Thank you. I'm these to be here today to discuss the important topic. Having been on the job as v.a.
▶ 0:25:03Ms. Mason: Ig for over three months I'm impressed by the dedication and significant oversight my team provides to combat fraud, waste and abuse and improve the effectiveness of v.a. Programs and operations and service to our veterans, families, caregivers and survivors of the veterans who served this country has made sacrifices to do so. Someone in our lives. Others through the challenges of their individual service.
▶ 0:25:29Ms. Mason: Members of the committee have led efforts in passing legislation to expand benefits for veterans over many years, like the pact act. You know how important it is for the government to keep promises to veterans and families. Most deserve and have earned the benefits and services the v.a. Provides them.
▶ 0:25:49Ms. Mason: As the daughter and spouse of veterans and someone who hated her lifelong commitment -- made it her lifelong commitment to champion veterans, I find it represented -- reprehensible -- furthermore using oig evidence collected over several years to make it appear like there is mass fraud by veterans leads the public and the lines veterans. -- maligned veterans.
▶ 0:26:20Ms. Mason: There are bad actors who do commit rod against the v.a. In benefits and health care but they are few in comparison to the 6.9 one million veterans and beneficiaries who receive v.a. Benefits. Oig's investigative metrics indicate 3.7% of our active fraud investigations are veterans suspected of fraud in v.a.'s compensation benefits programs.
▶ 0:26:46Ms. Mason: My special agents investigated portfolios include violent crimes, threats, ethics violations and theft as well as allegations of fraud schemes related to v.a. Programs comprised of education, fiduciary compensation, loan guarantee complex -- contracts and health care. The largest percentage of fraud in these programs is perpetrated against v.a.
▶ 0:27:08Ms. Mason: And veterans and my team investigates these allegations to the full extent of the law and prosecutes them to the full extent of the law with help from doj. V.a. Oig is not one-dimensional. We are not just here to stop rod but to prevent it.
▶ 0:27:25Ms. Mason: One way we do so is through the collaboration of our accomplished staff and disability fraud workgroup sharing information and data across the organization to ensure veterans who have earned their benefits received them and people who defraud v.a. Programs are held accountable. My office of audits and evaluations conducts reviews of v.a. Programs and operations including vba business lines and recommends improvements.
▶ 0:27:55Ms. Mason: These recommendations and endangering claims readers apply laws and policies, the leaders strengthen contracts for better, disability exams, monetary -- establish guard rails and procedures for education programs and test existing automation methods and outcomes. Weaknesses in guidance, application of the law, implementation of policy and lack of roles and oversight increased the probability of fraud against v.a. And veterans.
▶ 0:28:26Ms. Mason: Oig provides fraud alerts about potential fraudulent actions from pension coaching to entities offering fake documentation and promises regarding outcomes and benefits. We provide training and information on how to recognize and report fraud. As the ig I take my duty to be impartial and independent very seriously. Our work is based on the facts and circumstances and evidence of each situation. I can assure you v.a.
▶ 0:28:54Ms. Mason: Oig is committed to recognizing inefficiencies and programs and operations. Over the past three months we used efforts to worker us all directories so our subject matter experts to be -- can share their knowledge to protect benefits and services our veterans have earned. Mr.
▶ 0:29:17Ms. Mason: Chairman, this concludes my statement and I look forward to answering questions and working with you, your staff and this committee to improve oversight of the v.a. And improving lives of veterans. Thank you.
▶ 0:29:29Sen. Moran: Thank you. Mr. villanueva.
▶ 0:29:35Mr. Villanueva: Thank you. Chairman moran, ranking member blumenthal, and members of the committee, I appreciate the opportunity to speak with you today on behalf of paralyzed veterans of america pva about the department of veterans affairs' va disability benefits system to veterans with spinal cord injuries. Due to the nation -- nature of their injuries, paralyzed veterans generally require a range of services and benefits, including health care, specially adapted housing, adaptive equipment for their vehicles, and financial compensation that are tailored to their needs.
▶ 0:30:07Mr. Villanueva: It is disgraceful when disabled veterans are portrayed as fraudsters and chiefs for -- cheats for accessing benefits. Pva acknowledges there are veterans -- these incidences are few and far between. It is a disservice to the sacrifices of the men and women who serve this nation to suggest that large tons of money are being wasted simply because veterans receive earned benefits for service-connected conditions.
▶ 0:30:35Mr. Villanueva: In truth, many veterans find it difficult to file a basic claim for disability. This is why we have service officers to help veterans navigate the disability process. We have gone on record numerous times to discuss ways to make disability compensation less vulnerable to fraud and waste while ensuring veterans are fairly compensated for their conditions.
▶ 0:30:59Mr. Villanueva: I would like to focus on two of those, insurance exams and reviewing db cues for quality insurance. V.a. Must ensure proper cmp exams. What a veteran files for a claim for disability compensation and examination is held to an accurate outcome. The alternative could be years of deals for the veterans to receive their benefits.
▶ 0:31:25Mr. Villanueva: We have heard from officers they see a lack of expertise in specific medical specialties among contracted cmp examiners which delays adjudication of veterans claims. Pva believes medical examinations for complex service related conditions like scid and tbi should be conducted by v.a. Doctors. The v.a.
▶ 0:31:49Mr. Villanueva: Must ensure any contracted examiners are qualified to conduct necessary exams and any legislative proposals supporting contract exams should include such provisions. Equally important are the qualifications of the provider is an accessible barrier free facility to conduct exams. Our members have seen exam rooms that are physically inaccessible and/or lack overhead patient lists, causing members to wonder why the v.a.
▶ 0:32:19Mr. Villanueva: Is sending them to facilities that are ill-equipped to handle them. Another barrier is getting to the contract facility. Several members have been expected to travel over 100 miles to reach the contracted facility, even while the veteran is tickly ill. V.a. And third-party vendor's policies regarding the need to be examined and greater use of telehealth and traveling examiners should be made.
▶ 0:32:51Mr. Villanueva: Second, v.a. Must properly review dbas for quality assurance. The v.a. Can improve the review of db cues to ensure exams are proper and any fraud is caught. V.a. Claims processors have the authority to waive the value of db cues if they believe there might be fraud. V.a. Has analysts who review dbq 's from v.a.
▶ 0:33:19Mr. Villanueva: Contractors but these examiners only review a sample size for contractual compliance. Additionally, they only have access to these dbq's once they are uploaded, so they are reviewing them after a final decision. These examiners should be given greater oversight authority, be allowed to review dbq's submitted and have access prior to uploading them.
▶ 0:33:48Mr. Villanueva: Pva strongly believes the dressing areas for v.a. To be more efficient would benefit veterans and ensure the integrity of the veterans system. Thank you for the opportunity to present our views. We look forward to continuing our work to ensure veterans get timely access to the benefits they deserve.
▶ 0:34:11Sen. Moran: Mr. retzer.
▶ 0:34:17Mr. Retzer: Chairman moran, ranking member blumenthal and thank you for inviting dav to testify today about the department of veterans affairs va disability compensation program, its vital role in supporting veterans, their families and caregivers survivors, as well as the challenges va faces in providing timely and accurate decision. Held more than 560,000 claims and took over the .1 million actions on their behalf at no cost.
▶ 0:34:47Mr. Retzer: These numbers are staggering but they are not just statistics. They represent veterans living with life altering injuries, chronic illnesses, invisible wounds like ptsd, many face barriers with employment, health care and activities of daily living. Behind every claim is a personal sacrifice and a genuine need.
▶ 0:35:13Mr. Retzer: Before I turn to recommendations, I must address the recent article in the washington post that grossly misrepresented disabled veterans in the v.a. Disability compensation system. They claimed veterans are swamping the v.a. With fraudulent or dubious claims. According to the v.a. Office of inspector general, fewer than 200 fraud convictions occur each year.
▶ 0:35:40Mr. Retzer: With 3 million claims processed annually, that is a broad rate of one 100th of 1%. But, chronic pain, hypertension, diabetes, depression and ptsd are claimed to be dubious. These are conditions congress and v.a. Has long recognized as service connectable conditions.
▶ 0:36:05Mr. Retzer: Furthermore the post mischaracterized the pact act, and because of the loophole to abuse. These laws exist to deliver long-overdue justice. The v.a. Disability adjudication process is legally binding. Highly regulated and evidence-based. Service connection generally requires a diagnosed disability and in-service event or exposure and medical linking the two.
▶ 0:36:40Mr. Retzer: Presumptive service connection has an exception that allows v.a. To grant benefits when scientific and historical evidence shows veterans in certain places and locations were exposed. Claims undergo multilayered review by ratings specialists and compensation examiners to ensure accuracy and come liens. Fraud is an exception. It is not systemic. Our recommendations. V.a.
▶ 0:37:06Mr. Retzer: Must have resources to maintain claims accuracy and timeliness area backlogs surged from 150,000 in 2022 to over 400,000 in 2024. Due to the the act and out of reach crisis, increased staffing means numbers are about 135,000. Continued progress depends on sustaining vba funding, strategic use of overtime and close monitoring of staffing needs.
▶ 0:37:36Mr. Retzer: Second, we must simplify the claims process. Veterans should be able to file a claim by telephone. V.a. Claims process is recognized as nonadversarial and processors should claims to maximize benefits. V.a. Requirements specify veterans should specify a single benefit on an intent to file form can delay and reduce payments unfairly.
▶ 0:38:02Mr. Retzer: If a veteran checks one box but qualifies for another benefit they lose retroactive entitlement. This rule should be removed. Vba must optimize technology. Artificial intelligence, document digitization and data mining can transform claims processes but accuracy, oversight and staff support are essential. Vba and its contractors must develop I.t.
▶ 0:38:29Mr. Retzer: Systems that integrate accredited service organizations were filing claims and appeals. But accredited representative order was developed without consulting major accredited veterans service organizations.
▶ 0:38:46Mr. Retzer: It is advisable that vba and contractors seek input and collaboration with dav and other major accredited veterans service organizations on future enhancements and new system builds to ensure usable, accuracy, and alignment with veterans needs.
▶ 0:39:06Mr. Retzer: Improve the presumptive making process for toxic exposed veterans, expanding research, creating review processes and establishing stakeholder oversight will help in decades long wait for toxic exposed veterans. These rules deliver justice and allow vba to adjudicate large cohorts efficiently, reducing delays and hills. Mr.
▶ 0:39:34Mr. Retzer: Chairman, the veterans we represent are counting on this committee to ensure the system works for them, not against them. Every veteran, so every veteran has an opportunity to have success after the service. Thank you and I'm happy to answer any questions.
▶ 0:39:51Sen. Moran: Mr. gallucci.
▶ 0:39:55Mr. Gallucci: Chairman moran, ranking member blumenthal, members of the committee, on the half of the vfw thank you for the opportunity. When americans raise their right hand and swear an oath, they agree to surrender their personal freedoms, obey all lawful orders, risk life and limb, and if ordered, march into combat. In return, that contract says it is enshrined in dd form four.
▶ 0:40:24Mr. Gallucci: Every veteran who served honorably has kept their end of the contract. Lately, headlines question whether our veterans deserve it. The washington post, the economist and others say benefits are absurdly generous and fraud is rampant or suggest a disability industrial complex of profits off the system. We heard it before.
▶ 0:40:46Mr. Gallucci: In the 1930's when the economy act/benefits come at the recommendation of archibald roosevelt, and in the 19 50's when bradley chaired a commission that tried to strip benefits from less disabled and questioned toxic exposure. We buried those bad ideas then and it is our duty to bury them today. Fraud exists in large systems. Medicare, social dirty, and v.a.. But it is rare and prosecuted when it is found.
▶ 0:41:14Mr. Gallucci: What is not rare are invisible war area ptsd, tbi, cancer is caused by toxic exposure. To claim these are embellished or fake is ignorant or cruel. Invisible doesn't mean imaginary. Reporting like the post misrepresents key facts. They tell readers half a million veterans are service-connected we minor skin conditions, failing to note 76% of these veterans are rated at 0%.
▶ 0:41:42Mr. Gallucci: If you add 10% ratings which often don't affect compensation, the number jumps to nearly 94%. The dataset does not support rampant exaggeration of fraud. The post conveniently ignores the unique occupational hazards of military service and why skin on foot conditions are common. There is a reason it is called trench foot. It is easier to claim benefits now but this is a feature, not a flop.
▶ 0:42:08Mr. Gallucci: The pact act leveled the playing field. We fought deliberately to improve access because past generations suffered in silence. Ptsd claims have risen but it is naïve to think ptsd is new. Past conflicts label that shell shock and it was a condition we tried to hide.
▶ 0:42:29Mr. Gallucci: Today veterans talk about dental health because it is ok to have ptsd and lane benefits because we talk about it, veterans are fighting stigma for all americans. This is the sobering true cost of two wars many households could afford to overlook. Disability compensation is the settlement of a debt for the social and occupational losses associated with the real and persistent hazards of military service. A paycheck does not a race a missing limb and a steady job doesn't cure a damaged long.
▶ 0:43:01Mr. Gallucci: The all volunteer force understands military service is dangerous. We choose to serve because service is authentic and necessary and in our contracts the U.S. committed to make us whole when we were ordered to combat or other hazardous situations. Perverse incentives exist like concurrent receipt kicking in at 50% disability or family care kicking in at 100%. Bad policy can drive bad behavior but congress should not blame the veteran.
▶ 0:43:29Mr. Gallucci: On fraud, let's talk about claim sharks who promised benefit increases by submitting questionable evidence for hefty and illegal cuts of the action. The vfw led the fight against this not a prophet but support veterans and protect the benefit process. The vfw testified before congress 15 times over the last three years raising this along.
▶ 0:43:52Mr. Gallucci: We had countless conversations with the committee seeking to stop the fleecing of veterans and taxpayers but the calls have gone unheeded then we are no targets of the washington post accusing bso's of embellishing. Our representatives are bound by ethics regulations. We tell veterans what they need to know, not what they want to hear and we invited the v.a. General counsel to audit our training in 2021 and offer that still stands four years later.
▶ 0:44:19Mr. Gallucci: It costs vfw and partners tens of millions of dollars each year to provide this because every veterans deserve an advocate. However veterans did not ask what was in the air they breathe over the water they drink. They can't walk away if they don't want to do it anymore. We serve in accordance with the contract we signed and many live with the illnesses that steel sleep, breath and ability to work, suggesting they embellished their suffering for money is insulting.
▶ 0:44:48Mr. Gallucci: Simpler forms, improved access to route -- two exams and reliable technology. Veterans and bso's are not the problem. We appear before congress every year asking for reforms that sometimes come to fruition, other times don't. As we speak the government shutdown disrupts our work as deadlines approach. Veterans cannot afford to wait. We must avoid unnecessary pain and hardship. Veterans of the committee, the volunteer force carried the nation through a quarter century of war.
▶ 0:45:19Mr. Gallucci: The nation must keep its word. It is time for all of us to honor the contract. I look forward to answering questions. >> Dr. gade.
▶ 0:45:31Mr. Gade: Thank you for the opportunity to testify on the va disability compensation system. My testimony will differ from most you've heard. I am a member of no veterans service organization and have no motive other than to help restore the lives and dignity of millions of veterans. For too long, you've been told that the best way to care for veterans is to shovel billions of taxpayer dollars into their pockets. This approach has resulted in a that class that is sicker, more marginally employed, and more suicidal than ever.
▶ 0:45:56Mr. Gade: By paying veterans to be sick, we create more sick veterans separated from meaningful lives of purpose and we deepen our suicide crisis. I developed this perspective through hard experience and long study. I was wounded in combat twice, losing my right leg and spending a year at walter reed. After recovery, I earned a master's degree and joined the white house domestic policy council, where my previously acquired "user level" experience was bolstered by my work alongside both the dole shalala commission and the scott commission.
▶ 0:46:20Mr. Gade: I later completed a phd in public policy, focused on the va claims process, and while teaching at west point co-led the independence project, a randomized control trial demonstrating the powerful link between employment and health. In 2021, I published "wounding
▶ 0:46:32Warriors: How bad policy is making veterans sicker and poorer," and recently served two years as virginia's commissioner of veterans services. The surge in disability claims is not due to combat injuries but to a culture that rewards illness. Last year alone, over 450,000 new compensation recipients entered the system, while total combat-wounded from the global war on terror number around 50,000. Last year, more than 270,000 veterans began receiving compensation for tinnitus, which is 100 times the number of combat amputees.
▶ 0:47:06Warriors: Over a 20 year period. Blessedly high survival rates from combat wounds are not the cause of the growth. This lie allows advocates to tuck every veteran disability claim under the cloak of combat wounds. Under the cloak of virtue. Instead, the avalanche of claims is driven by non-profits and pay to play claims companies that encourage veterans to selectively exaggerate or falsify symptoms to "grab all they can".
▶ 0:47:25Warriors: Aging, genetic, and lifestyle conditions are increasingly labeled "service connected", resulting in tens or hundreds of thousands of veterans rated as "100% disabled" who have no true incapacity, or whose incapacity would have eventuated regardless of service status. I propose two two principles of reform.
▶ 0:47:45Warriors: Number one, meaningful employment is powerful medicine a 2020 paper called employment a "critical mental health intervention." unfortunately, veteran participation in the labor market, especially among men in prime working years, is markedly lower than their civilian counterparts, and has been steadily declining over the past 20 years. Disability compensation discourages work by rewarding inactivity, some programs create a direct barrier to work.
▶ 0:48:07Warriors: Any separation from the labor force causes isolation, malaise, and reduced income coupled with a demand for ever-higher "disability" payments. We should shift dollars from paying veterans to be sick toward meaningful incentives for gaining and maintaining productive employment. Early positive incentives can have a long-lasting positive effect, as demonstrated by the independence project. Number disability compensation two, is a destructive goal "disability" is a negative word.
▶ 0:48:37Warriors: In latin, "dis" means "not", "opposite of" or "apart". The disability compensation system pulls veterans into a destructive identity as "disabled veteran" rather than helping create a positive, forward-looking life and career. This system is anti-thriving, anti-productivity, and ultimately anti-veteran. Further, it discourages future generations serving by painting veterans as a troubled, problem class.
▶ 0:49:01Warriors: The compensation system traps veterans in a disability identity, teaching them to chase a 100% rating as proof of honor or source of validation. 9 of the top 10 conditions for newly rated veterans are easily exaggerated or totally unverifiable. We need a system that affirms veterans' capacity to thrive, not their presumed fragility. Here are several reforms that would protect the integrity of the system. Number treat but do not one.
▶ 0:49:27Warriors: Compensate for non-disabling conditions, and eliminate conditions caused by genetics, aging, or lifestyle from the compensation rolls. Sleep apnea is one obvious example. There are hundreds of others. Require active treatment for compensated mental health conditions. If compensation is warranted, so is care. Extend va medical eligibility three. For all service-related conditions without tying it to disability ratings, removing incentives for false claims.
▶ 0:49:54Warriors: The current disability system robs veterans of purpose and dignity, trapping them in idleness and despair. Further, the isolation brought on by separation from the labor market can and does send many veterans into a morass of tragic consequences. Reform will be difficult. Entrenched interests protect the status quo. But it is essential. A close look at past changes shows that what survives the legislative and rule-making process are usually additions to existing programs or the creation of new programs. The va budget grows inexorably despite the system causing immense ongoing harm.
▶ 0:50:23Warriors: Deep structural reform will save lives and restore what veterans truly need, meaning, work, and hope. The senator tuberville I say, war eagle.
▶ 0:50:38Sen. Moran: Ms. curda.
▶ 0:50:44Ms. Curda: Good afternoon chairman moran, ranking member , blumenthal, and members of the committee. I am pleased to be here today to discuss our work on the managing of the compensation program. Ba has taken steps to improve the room but ba is a large, decentralized organization where efforts to bring about positive change can face strong headwinds.
▶ 0:51:07Ms. Curda: As a result of the situation we put v.a.'s disability compensation from on our high risk list, a list of programs considered to be high-risk because there is waste, mismanagement or a need for broad-based transformation. In the case of disability compensation, v.a. Has been trying to update and modernize the program for years with limited success. Underpinning many of these albums are v.a. Leaders and managers not fully leveraging practices to manage the program.
▶ 0:51:41Ms. Curda: These are practices like setting goals, developing plans to achieve the goals, collecting data and assessing results. These practices set up organizations for success. Here, that means providing accurate and equitable decisions on claims for veterans.
▶ 0:51:59Ms. Curda: Talk of management practices may seem dry and technical, but effective management of the disability compensation room can help a meet veterans needs by providing timely and accurate decisions. It can save taxpayer dollars by reducing the stakes and costly rework. My testimony discusses first, v.a.'s long-standing challenges with managing changes to the disability compensation program.
▶ 0:52:25Ms. Curda: Second, challenges to ensuring the quality of disability compensation decisions, and third, policy approach is disability commissions have raised for modernizing v.a.'s disability structure. For the first area on managing changes to the program, one the example of a long-standing challenges v.a.'s effort to update its ratings schedule. V.a.
▶ 0:52:49Ms. Curda: Continues to rely on outdated medical and earnings loss information in the schedule to determine whether veterans qualify for disability benefits. V.a.'s updates of the medical information in the schedule have been slow. Dna is 10 years behind its goal. V.a. Officials have updated many systems but several systems remain outdated. Moreover, the ratings schedule hasn't been comprehensively adjusted since its creation in 1985.
▶ 0:53:20Ms. Curda: Past studies found given all the changes in the labor market, veterans were not being equitably competent sated under this 1940's model. In ensuring the quality of decisions, our firework identified challenges to be a providing hike all in the for veterans and training claims processors. These exams and training are key for accurately processing veterans claims and rework.
▶ 0:53:51Ms. Curda: We made five recommendations to strengthen v.a.'s oversight of contracted medical exam validity. Our recommendations generally focused on three areas, identifying and correcting the most frequent or complex problems with contracted exams, incorrect financial incentive payments to contractors, and third, a gap in feedback from those who perform disability medical exams. V.a. General he agreed with the recommendations. Today, none of the five have been fully implemented.
▶ 0:54:23Ms. Curda: In addition, our 2021 report highlighted shortfalls in ba management of trainings for new and experienced claims processors. To address this we made 10 recommendations. Today, four remain open including ones to enhance v.a.'s planning and evaluation of training programs.
▶ 0:54:45Ms. Curda: On program modernization, prior work identified policy options proposed by others for rethinking v.a.'s existing disability benefit structure. For example, our 2012 report examined opportunities and challenges of several policy options. These included things like integrating vocational services with cash assistance rather than focusing on compensation.
▶ 0:55:09Ms. Curda: Addressing the long-standing challenges we identified requires sustained leadership over management practices and this would help ensure veterans receive accurate and timely decisions on the disability company vision lens while also safeguarding taxpayer dollars. This concludes my statement harriet I'm happy to address your questions.
▶ 0:55:30Sen. Tuberville: Thank you for your passion. This is a great panel and thank you for doing this. We spend a lot of time doing things to help veterans. I come from a military family and I have been very passionate. Benefits for the right veterans, that is our title today. I would like for anybody to answer this. I don't know who to ask.
▶ 0:55:59Sen. Tuberville: But many will remember the veterans access choice and accountability act of 2014 come a commission was established to develop recommendations to improve the vha. The call came after a scandal at the vha. Don't each of you think it is time for a commission established to develop recommendations to improve the vba and don't our veterans deserve a system like this with a commission? If anybody wants to answer this.
▶ 0:56:29Sen. Tuberville: Pusher button and have at it. -- push your button and have at it.
▶ 0:56:34Sen. Moran: I guess I will --
▶ 0:56:37Ms. Mason: I guess I will jump in. A commission would be very well-placed. I think it is needed to look at the vba process like it is supposed to do and vha.
▶ 0:56:52Sen. Tuberville: Anyone else? Go ahead. >> thank you, senator. I get nervous about the prospect of a commission, and there is a reason.
▶ 0:57:02Sen. Thune: All do.
▶ 0:57:03Mr. Gallucci: With air commission as an organization we were champions of that and it couldn't make it past the first marker. We are seeing the repercussions. We are talking about the benefits administration and the veterans health administration and it is obvious the infrastructure is in the wrong place. It resulted in higher costs for care. I would argue that a form like this is a good start to have these discussions. I know Dr.
▶ 0:57:33Mr. Gallucci: Gade and I don't agree on everything but there were things he said that I think we would agree on as far as incentivizing the right behavior by veterans who are only seeking the benefits they have earned their service contract.
▶ 0:57:53Sen. Tuberville: With fast track information and the pact act it has strained disability claims processes. How can we simplify that and make sure they both work? A lot of money has been put into this. Anybody? >> I would like to briefly point out that there are several things in the packed act that are problematic from and overloading the system point of view and also problematic from a moral point of view.
▶ 0:58:25Sen. Tuberville: The pact act mix hypertension presumptive condition for all vietnam veterans exposed to agent orange. What is not mentioned in the pact act or any discussion around that is that when you norm for age, sex and race, non-veterans of those age groups have the same exact hypertension rate as veterans and those age groups.
▶ 0:58:52Sen. Tuberville: Compensating for something that is, forgive the expression but, old fat people get hypertension. That will help -- happen to all of us at some point. The pact act allowed people to shift the responsibility for those lifestyle conditions from themselves to the government and blame the government for problems that are not the fault of the government and therefore taxpayers are taking a bath on that.
▶ 0:59:20Sen. Tuberville: Thank you. Anybody, what simple changes do we need to make to make sure disability claims go to the right people? >> I would say we need to speed up the science.
▶ 0:59:36Sen. Tuberville: The issue we see with uzbekistan, there is a stark difference between what service members who develop rare cancers and health-care conditions while still on active duty, gaining benefits and those who, the uniform came up at the condition didn't develop until 15 months after they came off active duty and they have been struggling ever since, one of the greatest detriments we have is the time it takes to identify when toxic
▶ 1:00:06Sen. Tuberville: Exposure has happened and make the veteran hole. I think because of the framework, there needs to be urgency for people like those who served on k2.
▶ 1:00:17Sen. Tuberville: Urgency doesn't work in the federal government. We wish it did. Thank you, my time is up.
▶ 1:00:23Sen. Moran: Senator blumenthal.
▶ 1:00:26Sen. Blumenthal: Thank you, Mr. chairman. And thank you all for being here and for your testimony. Let me ask you, Ms. curda, as you know, substantial numbers of v.a. Employees have been cut. And as many as 30,000 will be cut.
▶ 1:00:52Sen. Blumenthal: The original number was 83,000, the uproar and reaction to secretary collins announcement caused it to be reduced. But doesn't that kind of cut in workforce have an impact on the quality of work in processing disability claims?
▶ 1:01:11Ms. Curda: Well, one of the issues on our high risk list is the ability of v.a. To process disability claims and manage the workloads as we have been discussing. There have been many changes to what is eligible and that increased claims substantially. And over time, the v.a. Has had an extensive backlog they have not been able to keep up with.
▶ 1:01:37Ms. Curda: So they have been in kind of a pattern of, recently, hiring more staff to be able to process claims and they have most recently been somewhat successful in bringing the backlogs down, and improving timeliness. I don't know how many of those people that you mentioned were actually processing disability claims. I would expect v.a.
▶ 1:02:01Ms. Curda: To conduct analysis, workforce planning analysis to see what with the cuts to staff in the disability claims processing urea, what effect would that have on productivity and the backlogs because they were making progress and I don't know that these cuts are affecting that are not.
▶ 1:02:20Sen. Blumenthal: But if you cut the number of people doing the work and the work increases, it will take longer and possibly be more error-prone?
▶ 1:02:29Ms. Curda: That is a logical conclusion.
▶ 1:02:32Sen. Blumenthal: Mr. gallucci, I was struck by your comment that if there are problems in the programs, we should fix the programs, not blame the veterans. The veterans are not the problem.
▶ 1:02:51Sen. Blumenthal: And I'm struck by statements from the administration, including the top levels of the office of management and budget, russell vought, that means testing is maybe a reform that should be adopted.
▶ 1:03:16Sen. Blumenthal: He suggested that the administration should, quote, target significant cost savings from revising disability rating awards. I haven't heard the secretary criticize or refute that potential course of action. What do you think of it?
▶ 1:03:36Mr. Gallucci: Senator, the idea to restrict benefit payments to service disabled veterans at a lower percentage, that dates back to the bradley commission in the 1950's. It was a recommendation that came out of there at the time and there was nothing really to substantiate that at the time. One of the things that we often talk about, we talk about social and occupational impairment and lost average earnings potential.
▶ 1:04:06Mr. Gallucci: It really should be a dead conversation on means testing for a service-connected disability. That is very different. There is mean testing for pension. But we are talking about a surface of compared disability. -- service impaired disability. That is different grade we have nothing that will allow for that, I change from congress that we would vocally oppose.
▶ 1:04:34Mr. Gallucci: There is a philosophy there that when you sign the contract, and it is the clause in the contract that says we will send you, you will be ordered to deploy to combat or other hazardous situations and I worry sometimes we lose the focus on that other hazardous situations point.
▶ 1:04:54Mr. Gallucci: The washington boys -- post did that in the article, talking about what they presumed to be nonservice related conditions, and that could be a whole other hearing to break down how those are service related because of the unique nature of military service.
▶ 1:05:17Mr. Gallucci: When you talk about lower percentages, the occupational impairment that comes with that, time for medical appointments, underemployment, those are issues for veterans who face chronic health conditions that require consistent care.
▶ 1:05:26Sen. Blumenthal: We don't need a commission to tell us we ought to sustain disability benefits for injured veterans, do we?
▶ 1:05:34Mr. Gallucci: I think it is an obligation of our country to honor the enlistment contract that we all signed to provide care and benefits we have earned.
▶ 1:05:44Sen. Blumenthal: Exactly. One last question for Mr. retzer. You said bso's have been excluded from the space that they have at regional offices. Would you tell the committee about that?
▶ 1:06:09Mr. Retzer: Thank you for the question. Unfortunately, our national service officers around the country who have been co-located within the regional offices are not allowed to conduct normal business to be able to assist veterans, although the regional offices are closed. We were only allowed 30 minutes.
▶ 1:06:32Mr. Retzer: One example is north carolina, we went there one morning and we had over 180 pieces of mail and when you look at that, those are time sensitive issues. The effective dates to file initial lands and evidence to support pending claims and so on, it makes it difficult for us.
▶ 1:06:48Mr. Retzer: Our team is ready to provide services,, doing telework, we have been ready in the pandemic preparedness but we are seeing service offices having to deal with the pii, taking information out of the regional office and doing that work and being responsible. And they are, but it really drives a wedge in the process because within the v.a. Regional office we have the capacity of technology and the resources to secure work. We are very disappointed. We hope the v.a.
▶ 1:07:18Mr. Retzer: Will open back up for all organizations credited there because this is the first time in and he shut we are actually not allowed to stay -- in any shutdown that we are not allowed to stay.
▶ 1:07:29Sen. Blumenthal: I have spoken to others about it. I don't know if that is the experience of other bso's as well. Thank you. Is that true at the vfw?
▶ 1:07:42Mr. Gallucci: It is. It is the common experience for those of us who utilize federal facilities. We were notified this morning by general counsel, the processing of accreditations is not considered an accepted activity.
▶ 1:07:57Sen. Blumenthal: I might ask, I mentioned it to the inspector general mason and perhaps she can look into it. Thank you all.
▶ 1:08:09Sen. Moran: Senator hirono.
▶ 1:08:14Sen. Hirono: Thank you. I think when you read the washington post article, the recent article, it really gives the impression that the whole system of ratings and disability payments and all of that is fraught with peril. And fraud. A system as large as that, there will be fraud.
▶ 1:08:40Sen. Hirono: What I would like to ask the inspector general is, a system like this, a program like this will have fraud. My concern is, do we have the capacity within the v.a. To investigate fraud? I'm not sure prosecute fraud, whether the v.a. Has lawyers that do that or whether that has to go to the attorney general's office but really, I would like to know what kind of capacity is in the v.a.
▶ 1:09:07Sen. Hirono: To investigate fraud. Meaning, that has the entity that I guess would be your office, that would investigate fraud. Have you seen reductions in the number of people in your office?
▶ 1:09:27Ms. Mason: Senator, let me answer that question. It is our office that is charged with the duty to investigate and work with doj, primarily the assistant U.S. attorneys as well as local law enforcement, to go after the fraud. And we do that. To go after fraud there has to be a threshold of intent.
▶ 1:09:56Ms. Mason: There has to be corroborating evidence and facts. Our office does that. As far as the number of people we have, we have that currently in the shutdown. . My investigators are working.
▶ 1:10:06Sen. Hirono: I would like to ask a create -- a question relating to pre-shutdown. The last ig had over 1000 staff. Is that what you have?
▶ 1:10:21Ms. Mason: Currently we have approximately 1000 staff prior to shut down. Opm authorized me through exemptions to hire 35 additional staff across the oig which included two investigators and we were proceeding to do that, but the shutdown got in the way.
▶ 1:10:43Sen. Hirono: We could end the shutdown of a certain party decides to restore health care for the american people but we don't -- won't get into that right now. You have the same number of people that your predecessor had and you have the authority to hire 35 more. Do consider that enough of a staff, enough capacity to deal with the millions and millions of veterans that you are dealing with?
▶ 1:11:09Sen. Hirono: And I don't know how many hundreds of thousands of claims that you are being asked to review?
▶ 1:11:13Ms. Mason: Let me clarify that, senator. Prior, at the beginning of 2025 we had 11--- 1175 people. We lost some people. We are at about 1000 right now. My budget as presumed we think will allow me to hire additional 70 people. Opm gives me credit for 35. We don't go after the claims.
▶ 1:11:43Ms. Mason: We don't adjudicate the claims, we investigate fraud and we do oversight of the department who does all of those claims. But we have the people to do that.
▶ 1:11:52Sen. Hirono: There is another office in the v.a. That has oversight over the claimants and you have all of these people who have to determine ratings and --
▶ 1:12:01Ms. Mason: That is the veterans --
▶ 1:12:04Sen. Hirono: And disability that leads to certain amounts being paid. Do you think you have enough capacity to investigate all of the fraud that you think is out there?
▶ 1:12:19Ms. Mason: We do. The majority of our work is in education and health care and fiduciary fraud as well as some compensation, but as I testified earlier --
▶ 1:12:33Sen. Hirono: I'm running out of time. You would take issue with the washington post article that indicates massive fraud?
▶ 1:12:39Ms. Mason: I take issue, yes. There is no massive fraud.
▶ 1:12:44Sen. Hirono: I want to thank the people who testified because you are right there on the ground dealing with the veterans and I know from the veterans I hear from, that there are delays getting their ratings. There are any number of ways the system can be improved and we heard from Ms.
▶ 1:13:04Sen. Hirono: Curda, about a number of recommendations that could improve the system. The indications seem to be the v.a. Has not made the kind of changes that were recommended. Would those of you who represent the v.a., would you that these recommendations have not been complied with or met?
▶ 1:13:34Sen. Hirono: Anyone want to weigh in briefly because my time is already up? >> I would agree that oversight and quality controls need to be there. When talking about fraud or questionable claims, I point to one of the examples in the washington post story talking about a veteran receiving benefits for an accident related to a dui. I believe that is a quality control thing. There are things that are supposed to be considered willful misconduct that do not qualify for benefits.
▶ 1:14:06Sen. Hirono: When something like that is found, v.a. Has the quality controls in place to make sure that they are not awarding benefits in a situation that they should not.
▶ 1:14:15Sen. Hirono: Do you think they have those controls in place?
▶ 1:14:19Mr. Gallucci: I think they need to improve on those quality controls.
▶ 1:14:22Chair Moran: Senator blackburn.
▶ 1:14:25Sen. Blackburn: Thank you Mr. chairman. I got a couple questions but before I start I want to correct the record. Republicans are not denying health care to anyone. There is a discussion over the biden bonus credits that were given differing -- given during covid and our ally -- our friends across the aisle could end the shutdown today by voting for a clean cr --
▶ 1:14:54Sen. Hirono: I was trying not to get into it with my colleague.
▶ 1:14:58Sen. Blackburn: And then also I would note that the claims backlog that was referenced happened during the last administration and we discussed this at length in hearing after hearing, with the fact that workers were working remotely and of course miss mason I want to come to you on this.
▶ 1:15:25Sen. Blackburn: The pact act implementation caused a lot of confusion. There was the warning of a $3 billion shortfall and it was going to require emergency spending, and then of course we found out later that this was just a budgeting boondoggle and the implementation of the pact act, the v.a. Systems couldn't handle it and there was no shortfall.
▶ 1:15:57Sen. Blackburn: But this frightened a lot of veterans and their families and the good news is we've got some leadership at the v.a. Now that is straightening this out and we are grateful for that. What I would like to hear from you is your sense of how well the v.a.
▶ 1:16:13Sen. Blackburn: Leadership is following through on your recommendations to titan oversight -- tighten oversight and prevent that misstep from happening gay guy -- happening in -- happening again.
▶ 1:16:29Ms. Mason: -- the lack of controls and oversight within vba around pact act, especially with the fact that they have scattered guidance all over the place and the manual is not in compliance with the law. Right now they tell us they have a plan. We have not seen anything. They are partially shut down, they are being -- they are doing claims.
▶ 1:16:56Ms. Mason: We are following up and we have further evaluations to look at and audits to do once we get back.
▶ 1:17:02Sen. Blackburn: Mr. gade, thank you for your testimony. I noted that you made a strong case that the disability system sometimes will trap veterans. What is the first couple of things that you think congress could change that would help clean the system up?
▶ 1:17:27Dr. Gade: Thank you. The first thing I think ought to be changed is how we talk about the word disability. Only in the v.a. System are flat feet or tinnitus a disability. But we have is an overbroad definition of the word.
▶ 1:17:45Dr. Gade: If we went to acs, or any other publicly available definition like the social security disability definition, what we would have is the ability to put more money to things that matter, things like employment, rehabilitation, medical care, and less money in transfer payments that we know are causing people to be sicker and trapped in this cycle of malaise.
▶ 1:18:13Sen. Blackburn: Ms. curda, would you agree with that? You have weighed in on this.
▶ 1:18:19Ms. Curda: In my testimony, we did work some years ago where we looked at all of the commissions that have looked at reform options for the disability system, and summarized those positions, the advantages, the disadvantages. I don't know that there is one right answer. It is a policy call and there are no changes that don't come without some kind of a cost, one way or another.
▶ 1:18:49Ms. Curda: There will be winners and losers and there will be a cost to administer more complex systems.
▶ 1:18:57Sen. Blackburn: But you had referenced the high risk areas for mismanagement and not being one of them.
▶ 1:19:02Ms. Curda: For sure they have not updated the schedule for how they decide those compensation levels within existing law.
▶ 1:19:12Sen. Blackburn: Thank you Mr. chairman.
▶ 1:19:15Chair Moran: Senator boozman.
▶ 1:19:18Sen. Boozman: Thank you for bringing a who's who of experts on this issue. We appreciate you all being here on such an important topic. While we have recently seen progress in ensuring veterans are receiving claims decisions in a timely manner, providing adequate business -- there is still more work to do.
▶ 1:19:47Sen. Boozman: There is evidence of veterans in my state waiting years and years, some perishing before getting a final ruling. I'm confident in the v.a. Disability system but that confidence does not come without the desire to continue pushing forward to best serve our nation's heroes. Mr. gade, I'm interested in the principle of meaningful employment.
▶ 1:20:12Sen. Boozman: Like you I believe that active participation in the workforce and larger society serves as a powerful remedy to some of the issues our veterans face. What ideas do you have for this committee and how weak it -- on how we can support that principle through compensation without creating fear or hesitation among veterans about losing benefits?
▶ 1:20:33Dr. Gade: In my written testimony I submitted, there is a report of something called the independence project. The independence project was a randomized controlled trial where we took two groups of veterans and gave one certain benefits and did not give anything to the other, we just monitored them.
▶ 1:20:55Dr. Gade: The veterans given incentives upfront to thrive were able to do so, and those gains in employment, not only in the percent of them who were employed but also in their salaries, and their gains in physical and mental health sustained far after the incentive payments ended.
▶ 1:21:13Dr. Gade: So what you have is the ability right there, a scientific basis exists to put incentives in place to get the kind of positive outcomes we want and to not get the negative income -- negative outcomes.
▶ 1:21:27Sen. Boozman: Ms. curda, gla is laid out -- when it undertakes reforms of the disability compensation program. Would you elaborate on any doubts?
▶ 1:21:45Ms. Curda: Thank you for that question. When we set out to look at how they manage reforms at v.a., the first question we asked was how many initiatives do we have ongoing, and they could not tell us. We had to assemble that list and these were significant initiatives, 23 of them over three years that we looked at.
▶ 1:22:07Ms. Curda: We pulled a sample of five of those randomly and compared them to how they are being managed for success, and found lots of issues. We made a lot of recommendations to improve those initiatives because they want to goals, they want involving stakeholders or monitoring progress -- they weren't involving stakeholders or monitoring progress.
▶ 1:22:32Ms. Curda: We were looking at creating specialized teams to monitor military sexual assault claims. Across the board they did not have clear goals with measurable outcomes, did not have clear leadership oversight, they work -- there were recommendations from the ig that did not get implemented.
▶ 1:22:54Ms. Curda: It was never clear -- they were making changes to how things got done but it was never clear that anything was improved as a result. That is the kind of thing. It is important to have goals, to know where you are headed before you start and that ability to then tell congress and people this investment had a payoff.
▶ 1:23:20Sen. Boozman: Is that a cultural thing or poor leadership? With it being so broad in the group that you studied.
▶ 1:23:29Ms. Curda: I think perhaps there is a culture, there are lots of fires to put out at the v.a.. The culture is to put together a tiger team and fix this right away and really hurry and I think sometimes they don't have a good system in place to ensure that when they get started that they have a good plan.
▶ 1:23:50Ms. Curda: That was one of our high-priority recommendations for the secretary, put in place a polity -- policy that if you start a major reform initiative, that they have these elements in place at the start so you know where you are headed.
▶ 1:24:03Sen. Boozman: Thank you Mr. chairman.
▶ 1:24:05Chair Moran: Senator shaheen -- senator sheehy.
▶ 1:24:11Sen. Sheehy: I take these issues very seriously. I want to echo some comments from our vfw partners about some poisonous rhetoric from the washington post that accused our veteran community and broader veteran service community of fraud, taking advantage of the american people. When this group of people raised their hand to swear an oath to defend this country, the system is not perfect. There is no question.
▶ 1:24:43Sen. Sheehy: The v.a. Is not perfect, veterans are not perfect and there is new -- and there is fraud, no doubt. The byline of that rhetoric should not be attacking veterans, it should be an internal organ -- examination of how to do better things in this government and how to make v.a. Focused on veteran outcomes and not process. We've been lost in the bureaucracy for too long.
▶ 1:25:12Sen. Sheehy: Veterans, not victims is my favorite saying. We are not victims, we don't come back sorry asking for handouts, we come back wanting a new mission in life and to continue to serve our country. We want our veterans to come home and be empowered, not treated like victims. But sometimes they need help to do so and I welcome your thoughts specifically. Dr.
▶ 1:25:37Sen. Sheehy: Gade, related to how does our incentive system within disability claims, how is it in the transition process? Are we incentivizing veterans to succeed at the end of that process or are we driving them into a cul-de-sac of dependence? Ultimately we want to help them as a bridge to another successful chapter in life.
▶ 1:26:03Sen. Sheehy: We want them to be done and be proud of their service and then open a new chapter for a life to succeed.
▶ 1:26:08Dr. Gade: Thank you for that question. When I went through the transition assistance program leaving the military, we spent about half a day on employment stuff and about a day and a half on how to file disability claims. The proverbial lady in tennis shoes said claim everything you can, it is free money.
▶ 1:26:31Dr. Gade: If you have these conditions you get this but if you look at it carefully, and she stomped on the floor and said if you look at it carefully, you can see that if you have these conditions, you can get to 70% and if you have these conditions you can get to 100%. It is right there in front of people that all you have to do is exaggerate and get paid more. That is not my main problem. My main problem is what happens then.
▶ 1:26:57Dr. Gade: If a veteran is separated from the labor market, they don't work anymore, sitting at home, on the couch, the children going to school and what happens when those people come back home is the veteran is still sitting there. That is a life of disempowerment. Men get so much identity from their work that we ought to be pulling all of our effort into positive meaningful gainful employment and get away from saying to everybody, get everything you can from the government, just fill out this little form.
▶ 1:27:29Sen. Sheehy: That's exactly right. Disability is too often confused that if you are able to work, you don't deserve that but disability, you will carry that injury for the rest of your life are what you did for this country. What do you think about alternatives to how the system is currently structured? This is open to anyone.
▶ 1:27:54Sen. Sheehy: How can we better structure this so that after our veterans leave, take the uniform off, we are incentivizing them to find new careers in succeed in those careers.
▶ 1:28:06Dr. Gade: If I a really quick. The way we talk about disability is different than any other program. The bar is much lower and the conditions are much broader. I'm not making this proposal necessarily but if we were to take the people 60% and below from the annual benefits report and say those are conditions we are going to treat for but we are not going to compensate because they are not a disability by any other definition of the word.
▶ 1:28:35Dr. Gade: You would save $20 billion a year that then you can put towards meaningful job programs, internships and externships and education and even higher benefits for the triple amputee and the person with a traumatic brain injury. There is a way to do this that is smart and incentivizes the right things and that is what I am begging folks to focus on.
▶ 1:28:57Sen. Sheehy: Did you want to wrap up?
▶ 1:29:02Mr. Retzer: We know about the injuries and illnesses but we have questions about the rehabilitation and reintegration and then there is compensation. We need to understand it is couple metairie and we need to understand we need to ensure that when we look at the v.a. Ability, health, vocational programs and education, that is the struggle we are having. V.a.
▶ 1:29:27Mr. Retzer: Needs to continue to expand programs like a veterans readiness employment system while they ensure that veterans getting the compensation as you said, that they have earned these benefits. We want to make sure they strengthen the partnerships out there to employees and workforces to ensure they are hiring and recruiting veterans, and really emphasize there is a difference between the integration back into employment versus compensation.
▶ 1:29:53Sen. Sheehy: We are at the end of our nation's longest war and may see another war soon so the work you are doing is critical. Veterans not victims, outcomes over process, patients over bureaucracy.
▶ 1:30:07Chair Moran: Mr. sheehy, thank you. Senator duckworth.
▶ 1:30:14Sen. Duckworth: Thank you Mr. chairman. I must express disappointment in the decision to convene a legislative hearing that amplifies the washington post misleading and flawed attack against the v.a.
▶ 1:30:27Sen. Duckworth: Disability benefits system, especially by inviting a witness who supports those sentiments and adding insult to injury, falsely depicting our nation's disabled veterans as dishonest fraudsters and cheaters originating from a paper owned by a multibillionaire who has -- whose net worth exceeds the total amount the united states government spends on disability compensation to over 6 million disabled veterans in any year.
▶ 1:30:55Sen. Duckworth: Nobody is denying the unfortunate reality that a small number of veterans exist who dishonor their own service and that of their fellow veterans by defrauding the v.a. These individuals can and should be prosecuted to the fullest extent of the law. If we want to enhance deterrence, we should strengthen enforcement resources to increase the rate of criminal investigation, prosecution and convictions of these fraudsters.
▶ 1:31:20Sen. Duckworth: The mistake we must avoid is allowing a minority of criminals to dictate the redesign of the v.a. Disability benefit system into a bureaucratic black box that is more frustrating and less fair and will leave more veterans weeding and dying, to get benefits they have earned. Since we met at walter reed, I've been disappointed, colonel gade. You and I were there together, suffered together, recovered together.
▶ 1:31:51Sen. Duckworth: I'm disappointed in watching your journey to becoming one of the leading critics of the entire concept of disability compensation for disabled veterans. I do feel that you believe you are simply offering disabled veterans of some tough love, that everyone else is too afraid to give, to achieve the success you've been fortunate enough to earn. Your rhetoric in downplaying the severity of the reality of the invisible wounds of war runs the risk of doing more harm than good.
▶ 1:32:19Sen. Duckworth: Portraying disabled veterans as a group of takers who happily never work again for 30 $100 a month is condescending and disrespectful to these heroic americans. Disabled veterans want to work for more than just money. They are driven by a sense of mission, purpose and meaning.
▶ 1:32:38Sen. Duckworth: Your characterization of disabled veterans who accept disability compensation as being moochers trapped by the system advances a very damaging stereotype that shames many veterans into not looking for benefits at cost to themselves and loved ones. There is some irony of the v.a. Is being accused of being too trusting and generous and focused on enhancing efficiency for disabled veterans by a paper whose owner is famous for what you leading a fast fortune by adopting a core management principle of obsessive customer focus.
▶ 1:33:10Sen. Duckworth: My question to the panel is simple. Two disabled veterans deserve worse treatment from the united states government -- do disabled veterans deserve worse treatment from the united states government?
▶ 1:33:20Ranking Member Blumenthal: No they don't.
▶ 1:33:22Mr. Gallucci: No they did not.
▶ 1:33:28Sen. Duckworth: Should congress assume every veteran applying for disability benefits is guilty of fraud?
▶ 1:33:32Mr. Retzer: They shouldn't because they are not. -- prove beyond a reasonable doubt to obtain what are quite modest disability compensation benefits? >> no.
▶ 1:33:49Sen. Duckworth: We must never forget that congress and via have worked hard for many decades to end the status quo where the v.a. Benefits system was hostile, combative and inefficient. My larger fear is that our committee indulging in efforts to demonize the benefits system will lead to us creating a -- lead to us creating harmful guardrails at the cost of scores of eligible disabled veterans giving up and abandoning efforts to secure benefits they earned when they served our country.
▶ 1:34:20Sen. Duckworth: Would any of the witnesses testifying on behalf of vso elaborate on that threat?
▶ 1:34:35Mr. Gallucci: I will happily take that question. As I said in my remarks and our submission for the record, we have deliberately worked to make it easier for veterans to access the benefits that they have earned. Those of us who have worn the uniform have seen it, where peers of ours struggled for the care for the diseases or the health conditions that they are suffering with.
▶ 1:35:02Mr. Gallucci: In addition to -- our organization is advocating for aircrews, that they are signed into law, that they are studying their exposure to toxic chemicals. Submariners are speaking very vocally about the unique challenges of submarine service and the exposures they have. Make no mistake, we all knew that military service was dangerous.
▶ 1:35:31Mr. Gallucci: But as we have focused on honoring the contract, it was in our contracts, required to serve in combat or other hazardous situations and then entitled to receive pay allowances and other benefits as provided by law and regulation. To have a discussion where it is portraying veterans accessing that system as if we are somehow exploiting loopholes and it is an honor system -- it is trying to pit veterans against americans, other americans.
▶ 1:36:02Mr. Gallucci: It is something we should not tolerate, especially when such a small percentage of the population volunteered for that dangerous job that has occupational hazards that others can just walk away from.
▶ 1:36:12Sen. Duckworth: The data is clear and not just from the v.a. But other not-for-profit's that the majority of veterans claiming benefits are truthful and accurate. Not fraudulent or false. I think we need to keep that in mind. Thank you Mr. chairman.
▶ 1:36:29Chair Moran: Senator duckworth, thank you. I thank all of our witnesses and I want to highlight for the committee, and perhaps for my own satisfaction, there is no doubt about the controversy that rises from this washington post article.
▶ 1:36:48Chair Moran: I have great faith in the witnesses that we have here, the veterans who have talked to us, the information we have received suggests that this committee is capable of hearing from veterans and responding to the fonts expressed in that article.
▶ 1:37:08Chair Moran: I also have sufficient faith in my colleagues here, many who have served, some who have served and earned disability, that we have capability as this committee to sort this out and also hear from someone who has a different point of view, so that we can come to a conclusion, probably more than one, about how we improve the system and make certain that veterans who served and those who are disabled by that service receive the compensation as well as care
▶ 1:37:41Chair Moran: That they are entitled to. So I am pleased we've had this hearing and are having this hearing and I think it has value, to try and sort out how we make things sufficiently better for those who serve our country. I want to ask a couple of questions and then a vote has been called and we will bring this hearing to a conclusion. First of all, miss mason, senator blackburn asked about the inspector general's report.
▶ 1:38:12Chair Moran: Are there any particular reports that are pending on this topic of disability that you would like to highlight that would be important for the v.a. To come into compliance or explain why they are not pursuing the inspector general's recommendations?
▶ 1:38:29Ms. Mason: We have about 30.
▶ 1:38:32Chair Moran: All of them of equal importance?
▶ 1:38:34Ms. Mason: All of them but I think we have two or three that are particularly pending on disability issues but we have some audit work that we are getting ready to start by merrily around quality review and automation, particularly in concerns we have around whether the right information is in the automation system.
▶ 1:39:01Ms. Mason: And then to the reports we've already discussed today on pact act and a couple of other areas in disability. Our fraud teams and audit teams work closely together. Where they see gaps on other sides, the fraud team investigates and the audit team does their audit work.
▶ 1:39:27Ms. Mason: -- are primarily on the quality aspect, as well as the complication of overall disability review.
▶ 1:39:36Chair Moran: In your previous work at the department of veterans affairs, anything that you learned in that capacity that would be important for us today?
▶ 1:39:46Ms. Mason: In my current seat I look at everything through the eyes of the ig but I can tell you, looking at those, I can look back over the 30 years from starting as a manager, going to my time as judge and chairman where I can see many things the v.a. -- that congress has put in place, and I see the impact and effect of that on our veterans.
▶ 1:40:14Ms. Mason: Articulate what I say is the lack -- what I see is the lack of controls and oversight within all of v.a. But particularly for this hearing, particularly in vba and areas from compensation, pension, we could go down the list.
▶ 1:40:30Chair Moran: I would like to highlight for my view, a great level of respect for the role of the inspector general and the role of the government accountability office in this committee and this congress, being able to do its work. I'm developing a good working relationship with you, miss mason.
▶ 1:40:51Chair Moran: I had a good working relationship with your predecessor and my view is the efforts by both of these agencies are hugely valuable to the well-being of veterans that we all try to serve.
▶ 1:41:04Ms. Mason: We do talk often, both you and I, and Ms. curda and her team.
▶ 1:41:11Chair Moran: Thank you both. Mr. gallucci, you did something a moment ago that I was going to ask you to do. I wanted to know what a member of the service believes, when they enlist, their contract is, with the united states government, the department of veterans affairs, with our country, our government.
▶ 1:41:40Chair Moran: When someone enters the service, what is it that they expect in return?
▶ 1:41:46Mr. Gallucci: In the simplest terms, if we are going to live up to these other requirements to obey all lawful orders, subject to the military justice system, serving in combat and hazardous situations, that we will be taken care of if something goes wrong on the government's time and dime.
▶ 1:42:08Mr. Gallucci: In the washington post story, talking about toenail fungus, that was there designed to really get people into thinking that's common, that's happening to a lot of americans. You get athlete's foot, you treat it with something I don't know.
▶ 1:42:26Mr. Gallucci: The issue is we are talking about military service, especially ground forces that focused so heavily on foot health and hygiene because when I was deployed to iraq, living out of a humvee for the first couple of months, personal hygiene was sparse and difficult. I talked to a veteran before coming into this hearing who has dealt with a systemic fungal infection since he served in the marine corps.
▶ 1:42:56Mr. Gallucci: This is real, it is an occupational hazard. It may sound odd to a reader of the washington post who never served, but it is why it is service-connected. A veteran who is on medication that causes liver damage because it started out as a foot fungal infection, toenail fungus, yes that is service-connected, it is a clear occupational hazard of military service.
▶ 1:43:23Chair Moran: Thank you. Those individuals, they recognize that at the moment they enlist?
▶ 1:43:35Mr. Gallucci: They don't know all of them but they know the military is dangerous. The job is to destroy our enemies. We know it is dangerous going in, but we believe that with the contract we signed, if something goes wrong that we will be taking care of.
▶ 1:43:53Chair Moran: Dr. gade did raise this topic of work and I certainly share the view that work is important to the well-being of every human being. It is a way we are getting satisfaction, hopefully from what we do. I always think it is something within us that gives us purpose and a meaning -- a sense of meaning and value. Dr.
▶ 1:44:19Chair Moran: Gade indicates there is a seemingly disincentive from the disability system to work. But aside from that suggestion or connection, there are a lot of things that the department of veterans affairs is entrusted to do and should be doing to help veterans find meaningful employment.
▶ 1:44:46Chair Moran: I saw a group of fort riley soldiers who were about to end their time in the military service, spent time in wichita, kansas, learning about opportunities for their future. There is a significant demand for the skill set and integrity and moral values of a soldier, a member of our military.
▶ 1:45:11Chair Moran: There is demand for that work, and yet we may not be taking sufficient advantage of the opportunity, of the person believing military service could provide value to a company. We have a program in kansas to interest soldiers as they depart for agriculture, to become farmers. There is a demand for those kinds of employment opportunities.
▶ 1:45:42Chair Moran: What are we missing in trying to make certain that work is honored? Aside from the suggestions of Dr. gade.
▶ 1:45:54Mr. Villanueva: Thank you Mr. chairman.
▶ 1:45:56Chair Moran: I was worried you were being ignored.
▶ 1:46:01Mr. Villanueva: There is a lot of good panelists here and I don't want to step on anyone's toes when it comes to agreeing with each other but everything -- everyone -- one thing everyone on this panel could agree with is every veteran wants to work and if they are hampered by a disability, that they are given every incentive and opportunity to return to work.
▶ 1:46:30Mr. Villanueva: I bring up the irony, it should be pushed more than any other program they have out there for veterans, who want to get back out to work. That includes doing things like removing -- that goes for education by the v.a. To all veterans to say especially those being medically discharged or retired, push that program and say if you want to get back out to work, it is available.
▶ 1:47:02Mr. Villanueva: We've been on record about this. We would love to work with yourself, the rest of the members of the committee to see how we can do that.
▶ 1:47:10Chair Moran: Is there opportunities that are presented to veterans who have a disability beyond the normal programs to work -- to provide education or workforce training to veterans generally?
▶ 1:47:26Mr. Villanueva: There are. Not a lot of the veterans who when they leave the service, know that there is a disability with them. It comes up years and years later. Myself, I went out and despite disabilities, I decided to take up blue-collar work for the first five years and it caught up to me.
▶ 1:47:53Mr. Villanueva: Only after that time did I find out or even attempt to use my g.I. Bill and many years later did I even hear about the irony. It should be pushed. By the v.a.
▶ 1:48:05Chair Moran: Thank you you, I look forward to working with you. Senator banks?
▶ 1:48:13Sen. Banks: Ms. curda, the disability claims process is dysfunctional and defunct no doubt. An initial claim takes up 100 days on average but appeals can stretch on for years. My office worked on one case for example for a claim that took eight years to be decided. How are v.a.'s efforts to improve that process coming along?
▶ 1:48:37Ms. Curda: I mentioned earlier, one of the issues that places v.a. On the high risk list is there are challenges with managing network loads including appeals. This has been going on for decades, where various surges come along on the initial claims aside.
▶ 1:48:58Ms. Curda: Veterans who are denied appeal those claims and that creates additional pressure on the appeals aside and then when veterans choose to go before a judge, that it is the longest amount of time that a veteran will experience. There are other choices but that one in particular can take a long time. Currently v.a. Is not meeting its goals for various appeals options. They are exceeding them.
▶ 1:49:26Ms. Curda: I think what they are doing is we are engaging with them on this high-risk issue for a number of years now and most recently, they have developed, to predict their workloads through more sophisticated modeling. That is certainly true on the initial claims aside.
▶ 1:49:47Ms. Curda: I think they are trying to look more on the appeals side and better protect what is coming in and when you predict, you can plan and you can get the resources that you need to get the work done. They are moving along, they still are somewhat lacking in their capacity to really fix the problems, but we were close to moving up there on the high-risk issue last year and then the budget issue came along and we had to rethink that.
▶ 1:50:20Ms. Curda: They have made progress in terms of their ability to plan for workloads so that when things do change -- and they will change -- they are in a position to better deal with it.
▶ 1:50:33Sen. Banks: A key tool in the process was created in the 1940's. Some elements of the schedule have never been updated. The v.a. Has been trying to update it for years. Which conditions and body parts ratings schedules are the most outdated and what problems does that cause?
▶ 1:50:54Ms. Curda: I would say the issue is that they haven't all been comprehensively updated. There have been small changes over the years but they haven't taken a comprehensive look -- there are 15 body systems, all of these are organized in different body systems. Of the 15 they have comprehensively updated 11 of them and there are four that remain in various states of regulatory development.
▶ 1:51:23Ms. Curda: The four that remain are dental disorders, respiratory illnesses, ear and auditory issues and neurological conditions. So the problem that creates -- you can see a little bit of this in the washington post article -- you would -- you might see what appears to be inequities in how different conditions are compensated.
▶ 1:51:49Ms. Curda: In particular when this study -- think about it, and the 1940's, people hadn't even heard of ptsd. That may be compensated differently than someone with an amputation. It is thinking through what that compensation should be. The other issue is earnings laws. The earnings part of it has never been comprehensively updated -- updated.
▶ 1:52:20Sen. Banks: I want to move on. I'm glad the oag -- oig investigates compensation fraud but the examples in the washington post article aren't subtle. They are glaring. The vietnam veteran who pretended to be blind for 29 years while he continued to drive. The bodybuilder who pretended to walk with a cane and wore a diaper. A veteran who claimed paralyzing anxiety and inability to work while he was running a bar in costa rica. The v.a.
▶ 1:52:47Sen. Banks: Claims are presented of who claimed to be homebound and milk the agency out of benefits for five years while working there. These fraud cases shouldn't take years to crack and it makes me wonder how widespread that problem really is. How prevalent do you think outright disability compensation fraud really is?
▶ 1:53:08Dr. Gade: Outright disability fraud is actually quite rare, as miss mason pointed out earlier. A bigger problem is the problem of lax oversight and easily exaggerated conditions and no follow-up. I went on reddit yesterday and typed in how do I get 100% disability? I only have 10% now. Here is what reddit said.
▶ 1:53:39Dr. Gade: Go with a bbq that you filled out yourself. Write the explanations that apply to you, submit that to your examiner at the beginning of the appointment and have a copy in front of you. Answer the questions based on the answers you gave on the dbq. It is widespread that people know the dbq exists. They know if they claim this severity, they get this disability. If they claim this severity, they get this and if they claim this, they get this.
▶ 1:54:09Dr. Gade: It is widespread knowledge, a quiet thing the washington post article never even discussed.
▶ 1:54:13Sen. Banks: Thank you my time has expired.
▶ 1:54:16Chair Moran: Let me see -- before we conclude this hearing -- does anyone have the sense that they wanted to say something they did not get the chance to say or correct anything that you said that you wish you hadn't?
▶ 1:54:29Ms. Mason: I would like to jump in real quick. The v.a. Oig looks at pretty much everything for fraud as well as the oversight. One particular area that I think senator banks just touched on are the dbqs. Let me be clear. The dbq's are a problem publicly and internally.
▶ 1:54:57Ms. Mason: Because of the lack of controls, we have specific reports to this, that vba is not following up on with their internal contracts and dbq's. It is the pot calling the kettle black. There are a lot of issues facing the dbq's. Those continue internally and externally.
▶ 1:55:21Ms. Mason: Our recommendation is that the committee consider looking at all dbq's and setting some standards at your level.
▶ 1:55:29Chair Moran: Thank you. Anyone else?
▶ 1:55:33Dr. Gade: Briefly and I'm sorry that she departed earlier. Senator duckworth and I were in the hospital together. She was injured two months before I was. I wish we could have that conversation that she directed to me in a two-way direction but unfortunately I had to sit here. What I believe about mental health reform is that the system should better address invisible wounds like ptsd but without incentivizing long-term disability.
▶ 1:56:05Dr. Gade: Ptsd is curable, it is possible to recover from and lead a full and thriving life. But a veteran who is labeled 100% permanent and total before efforts have been made to get better is one whose life is made worse by that system. That has been my argument until my dying day. I am sorry that senator duckworth missed that.
▶ 1:56:28Chair Moran: Anyone else? I didn't expect anyone to take advantage of my suggestion. You can't allow me to miss my vote.
▶ 1:56:38Mr. Villanueva: I will make this quick. The most -- as a person like many people on this panel today, we remember the history and the history goes back a ways but when we look at the civil war pension program, that these folks came back to, after a while, the articles in the news
▶ 1:57:09Mr. Villanueva: And the public opinion shifted away from it is the governments fault, making it too hard and they put a glaring light on the veterans in the doctors and lawyers and they scrapped the program. As we all know, we went from that to the spanish-american pension program which preceded the bonus vouchers of the 19 third or's -- 1930's.
▶ 1:57:37Mr. Villanueva: Thousands of veterans camped out for days and some of them lost their lives for their benefits. As we move forward in this discussion, we should always keep that in mind so that it never happens again. If there is a program that can be improved, we should all work together to make those improvements.
▶ 1:57:59Chair Moran: Thank you. A good place to end the hearing, thank you. I want to again thank each member of the committee. You have five legislative days to submit any written statements or questions for the record. Any senator who would like to submit a question for the record to today's witnesses needs to -- each member has five legislative days to make statements or questions for the record.
▶ 1:58:31Chair Moran: Any senator who would like to submit a question for the record for today's witnesses please do so in a timely manner. I ask our witnesses to respond to any questions for the record following today's hearing in a timely manner as well. With that, this hearing is adjourned.