Providing More Timely and Accessible Care for Returning Servicemembers

As of October 2008, over 33,000 servicemembers have been wounded in action, resulting in serious injuries such as amputations, traumatic brain injury (TBI), and post-traumatic stress disorder (PTSD).  We have identified a number of weaknesses with the health care returning servicemembers are receiving as well as the complex and cumbersome disability systems they must navigate.  While improvement efforts have started, identifying and treating servicemembers for specific combat-related health conditions, providing timely and accessible disability services, and addressing continuity of care issues are critical challenges facing our nation and will require sustained attention, systematic oversight by the Departments of Defense (DOD) and Veterans Affairs (VA), and sufficient resources.  We have identified and reported on the following key challenges:

• While returning servicemembers and veterans may have a range of health care needs, many servicemembers have been exposed to combat conditions that increase their risk of experiencing a TBI or developing PTSD. Identification and treatment of TBI and PTSD is critical; however DOD and VA face challenges screening, diagnosing, and treating TBI and PTSD.
  
  
• DOD and VA operate separate disability evaluation processes for wounded servicemembers and veterans, respectively, that together may take months or years to complete. Since November 2007, the agencies have been piloting a joint process for determining disability benefits, but whether their efforts have been successful has not been determined.
  
  
• Over 850,000 servicemembers have left active duty and are eligible for health care and potentially other benefits from VA.  In recent years, problems have been identified with DOD and VA efforts to coordinate care and services for this population, including managing their transition from DOD to VA’s health care system, and expediting their access to VA disability benefits.
  
  
• DOD and VA also are in the process of setting up a new interagency program office that will play a crucial role in accelerating their efforts to achieve electronic health records and capabilities that allow for full interoperability between the two departments’ systems. However, the departments’ plan for achieving interoperability by September 2009, as required in law, is incomplete because many milestones have yet to be determined.

^ Back to topWhat Needs to Be Done

• The Army should explore options for improving its disability evaluation process and its servicemember satisfaction survey.

  Highlights of GAO-08-1137 (PDF)

• DOD and VA should establish criteria for determining whether their pilot of a joint process for determining disability benefits should be widely implemented, and take steps to sustain management attention on pilot evaluation and implementation.

  Highlights of GAO-08-1137 (PDF)

• VA needs to better manage the Benefits Delivery at Discharge program, which expedites VA disability benefits for servicemembers leaving the military, and DOD needs to coordinate with VA to improve servicemembers’ access to this beneficial program.

  Highlights of GAO-08-901 (PDF)

• VA needs to expeditiously evaluate the clinical validity and reliability of its TBI screening tool.

  Highlights of GAO-08-276 (PDF)

• DOD needs to require a review of medical records as part of its pre-deployment health assessment.

  Highlights of GAO-08-615 (PDF)

• DOD and VA should give priority to fully establishing the Joint Interagency Program Office and finalizing the implementation plan for achieving fully interoperable electronic health record systems.

  Highlights of GAO-08-954 (PDF)

^ Back to topKey Reports

DOD and VA: Preliminary Observations on Efforts to Improve Care Management and Disability Evaluations for Servicemembers

GAO-08-514T, February 27, 2008

Summary (HTML)   Highlights Page (PDF)   Full Report (PDF, 29 pages)   Accessible Text

VA Health Care: Mild Traumatic Brain Injury Screening and Evaluation Implemented for OEF/OIF Veterans, but Challenges Remain

GAO-08-276, February 8, 2008

Summary (HTML)   Highlights Page (PDF)   Full Report (PDF, 55 pages)   Accessible Text   Recommendations (HTML)

VA and DOD Health Care: Administration of DOD's Post-Deployment Health Reassessment to National Guard and Reserve Servicemembers and VA's Interaction with DOD

GAO-08-181R, January 25, 2008

Summary (HTML)   Full Report (PDF, 18 pages)   Accessible Text

Electronic Health Records: DOD and VA Have Increased Their Sharing of Health Information, but More Work Remains

GAO-08-954, July 28, 2008

Summary (HTML)   Highlights Page (PDF)   Full Report (PDF, 48 pages)   Accessible Text   Recommendations (HTML)

DOD Health Care: Mental Health and Traumatic Brain Injury Screening Efforts Implemented, but Consistent Pre-Deployment Medical Record Review Policies Needed

GAO-08-615, May 30, 2008

Summary (HTML)   Highlights Page (PDF)   Full Report (PDF, 48 pages)   Accessible Text   Recommendations (HTML)

Information Technology: DOD and VA Have Increased Their Sharing of Health Information, but Further Actions Are Needed

GAO-08-1158T, September 24, 2008

Summary (HTML)   Highlights Page (PDF)   Full Report (PDF, 29 pages)   Accessible Text

Military Disability System: Increased Supports for Servicemembers and Better Pilot Planning Could Improve the Disability Evaluation Process

GAO-08-1137, September 24, 2008

Summary (HTML)   Highlights Page (PDF)   Full Report (PDF, 54 pages)   Accessible Text   Recommendations (HTML)

DOD and VA: Preliminary Observations on Efforts to Improve Health Care and Disability Evaluations for Returning Servicemembers

GAO-07-1256T, September 26, 2007

Summary (HTML)   Highlights Page (PDF)   Full Report (PDF, 32 pages)   Accessible Text

Defense Health Care: Oversight of Military Services' Post-Deployment Health Reassessment Completion Rates Is Limited

GAO-08-1025R, September 4, 2008

Summary (HTML)   Full Report (PDF, 20 pages)   Accessible Text

Veterans' Disability Benefits: Better Accountability and Access Would Improve the Benefits Delivery at Discharge Program

GAO-08-901, September 9, 2008

Summary (HTML)   Highlights Page (PDF)   Full Report (PDF, 54 pages)   Accessible Text   Recommendations (HTML)