By Patrick Yoest, CQ Staff

The head of a congressionally mandated commission on veterans' disability benefits was questioned Thursday on the commission's proposal for regular mental health checkups for veterans.

Retired Army Lt. Gen. James Terry Scott, chairman of the Veterans' Disability Benefits Commission, testified before the Senate Veterans' Affairs Committee on commission recommendations to overhaul the Veterans Affairs Department's disability benefits system.

The recommendations ranged from changes to disability payments to account for quality of life to the development of new criteria for determining disability payments for veterans with post-traumatic stress disorder and traumatic brain injury.

In several areas, the commission diverged from outside advice given to it by the non-profit Institutes of Medicine and the Center for Naval Analysis. In particular, the commission recommended a medical reevaluation "every two or three years" for veterans with post-traumatic stress disorder - a concept that went against the Institutes of Medicine's study findings.

Senate Veterans Affairs Chairman Daniel K. Akaka, D-Hawaii, asked Scott how the committee determined when to accept or reject outside advice, specifically focusing on question of whether to provide routine mental health evaluations.

The Institutes of Medicine "didn't think there should be a template that said every two to three years, everyone should be looked at," Scott conceded, but added that "if we don't tell [veterans] to do it on a certain interval, they might not do it at all."

Scott said mental ailments require "a lot more careful monitoring" in many cases. The commission recommendation has given some veterans' groups pause, because they believe mental health re-evaluations could be a means to reduce benefits for individual patients.

"If you would do it, and it appears it's solely being done to decrease benefits, it's going to hamper benefits, and have a negative impact," said American Legion deputy director Steve Smithson.

But by and large, the commission recommendations have met with approval by veterans' service organizations.

The commission has recommended that Congress temporarily increase veterans' benefits by up to 25 percent to account for quality of life - a suggestion seen as a boon for severely-disabled veterans.

Scott has said his commission favors a sliding scale of benefit increases for quality of life would top off at a 25 percent increase for completely disabled veterans.

Lawmakers are considering recommendations of both Scott's commission and a presidential commission headed by former Kansas Sen. Bob Dole (1969-96) and former Health and Human Services Secretary Donna Shalala as templates for possible changes.

House Veterans Affairs Chairman Bob Filner, D-Calif., has suggested changing the veterans' disability benefits system to one that presumes disability claims' validity - forcing the Veterans Affairs Department to automatically grant benefits to veterans seeking claims and audit a percentage of the claims later. But there has been little enthusiasm within the Senate panel for Filner's proposal.

Even incremental changes to the disability benefits system have not come quickly in the past. Sen. Richard M. Burr, the ranking Republican on the Veterans' Affairs panel, noted that a commission headed by Gen. Omar Bradley made similar recommendation in 1956.

More than 50 years later, relatively few changes have been made, and veterans complain that the department is arbitrary and slow in awarding disability benefits.

Any major changes could prove costly. Scott has estimated that the "quality of life" benefits could cost up to $3 billion.

It is unclear whether the department has authority under current law to overhaul its disability compensation system. Akaka, in his opening statement, said that changes to the current system will not be dealt with quickly.

Congress "must undertake a thoughtful and deliberative review and analysis of the many matters at issue and then work to develop legislation," Akaka said.

Smithson, as well as representatives from the Veterans of Foreign Wars and the Iraq and Afghanistan Veterans of America, praised the work of Scott's commission.

Gerald T. Manar, deputy director of the Veterans of Foreign Wars' National Veterans Service, said that the commission took a science and evidence-based approach to their studies, without attempting to reinvent the entire disability compensation system.

"They realized, I think, that if you throw it out, if you start from scratch, you wind up creating a brand new set of problems," Manar said.

Source: CQ Today Online News
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