date has been closing the benefit gap. service members no longer wait six to nine months to receive compensation they have learned. with all the achievements, we are not satisfy. we are not meeting the requirement for every single service member. we will continue to work with d.o.d. to improve our systems and processes until we achieve all of our objectives in 100 days for each service member. i will often refer to cases or claims here today. let me assure you, i never lose sight of the fact that behind a claim is a service member and his or her family who depend on v.a. to get it right. we will continue to partner with d.o.d. to effectively and efficiently get him or her back to their unit to continue military service or, if discharged, provide the benefits they have earned. as partners, we will overcome

the remaining challenges together to achieve the seamless transition service members deserve. this is a commitment we must meet. i look forward to answering any questions you may have. >> thank you very much. mr. bertoni. >> chairman murray, good morning. i'm pleased to discuss the department of defense to improve the performance of the evaluation system. since it started, we have monitored the evolution of this process. my statement today is based on the ongoing work for this committee and focuses on ides meeting goals and performance. in summery, overall time has worsened with the average number of days for claims to 394 days

last year. it is well above the stated goal of 295 days. during the same period, the active duty cases decreased from 63% to 19%. with the exception of the physical evaluation phase, we fell short with the medical evaluation board, transition to benefits phases. in 2011, only 20% of active duty cases met the targeted goal of obtaining a decision. v.a. assessed service member satisfaction in surveys. computing average scores of satisfaction. in fact, using an alternative

calculation that eliminates mutual responses, we found satisfaction rates lower in d.o.d. reports. they have under taken a number of actions. many have been identified in prior work. for example, prior recommendation has a robust process. more frequent contact with the secretaries of departments. regular meetings chaired by the chief of staff and v.a.s chief of staff. v.a. holds its own biweekly conferences with local staff responsible for their portion of the process. the departments are working to address long standing medical board in staff challenges. the army is in the midst of a hiring process to double the board including liaisons and

personnel. they have tripled staffing. departments are working to address limitations in their automated systems including taking steps to electronically track and monitor case progress and improve quality of the data that we found problematic. various sites continue to rely on ad hoc and redundant processes to manage the cases. the current tracking system presents staff from entering erroneous data. it will remain a challenge going forward. to further expedite it, we have an in-depth review. identify further streamline opportunities. such an effort could yield short and long term recommendations for improvement. a timetable is yet to be

established. in conclusion, the merger of two evaluation systems shows promise for expediting service members. nearly five years out, delays continue to affect progress. the cause is not fully understood. improve processing and prevent bottlenecks are promising. we will continue to assess d.o.d. and v.a.s progress in the areas. they do the work for the committee. this concludes my statement. i will answer any questions you may have. >> thank you very much. i want to let the committee members know, following the revelation that possibly hundreds of soldiers at lewis mccord had their ptsd diagnosis changed because they didn't want to spend the money on the care the service members would receive. i asked the committee to do a study into the system. we are at the interim point of

the investigation. staff reviewed 121 cases from 23 different ides sights. they have focused on cases from mental health diagnosis and ptsd in particular. i'm troubled by what they found exaggeration of symptoms similar to what we saw at madigan without documentation of standardized interview techniques. they have encountered v.a. examinations in relation to traumatic brain injury. it contained errors, which in some cases impacted the level of benefits the veteran should have received. before we begin today's questions, i am entering the results of this interim investigation and there will be more to come. dr. rooney, let me start with

you. we have had discussions in the past regarding the joint disability evaluation system and the challenges service members face going through the process. recently, it's come to my attention the service members involved with the disability evaluation process are facing retribution and unsupportive behavior from the chain of command. i have heard from service members who were forced to participate in activities in direct violation of doctors orders who have been disciplined while struggling with behavior health conditions and struggled to get access to care because their leadership would not cooperate with the treatment requirements. i think you agree with me, that is completely unacceptable whether in a warrior transition unit or not, leaders have to understand the medical issues and the process they are going through. they have to provide the

leadership and support the men and women need. so, i want to begin with you by asking you, dr. rooney, what needs to be done to provide supportive and compassionate leadership for the injured service members forced to wait for a disability decision? >> clearly, the information you just shared is troubling on many levels. i would be very interested in speaking with you or your staff to actually determine where the issues are occurring and make sure that, in fact, the leadership does know which is the department and leadership that cannot be tolerated. we must understand what is necessary for the care. that there are no stigmas associations with being able to address behavioral health or mental health issues. it's a department's position. if there are issue that is you mentioned, not only do we need to find out where they are so we can work with that leadership

and correct that situation. we will continue with ongoing work at all levels of commands, not just the senior level. we understand it needs to go through the command level of every insulation to ensure the situation you described are not occurring. >> well, we need to make sure that's happening. as we all know, these are very challenging situations for the soldiers. any retribution shouldn't be tolerated. i will share those with you. i want to make sure system wide leaders throughout the chain of command to the bottom are clearly understanding what they are going through and are not having any kind of repercussions on those individuals. >> absolutely. >> mr. gingrich, from the perspective of someone who served in many leadership positions in the military, what can we do to educate the leaders on the issues facing the young men and women?

>> madam chairman, a lot of things the army is doing, they have started as we were told by gao, they are bringing in layers up to the vice chief of staff. they have involved a discussion group, major general, all the way up and included v.a. in every one of the discussion groups. getting the information out is the biggest key and the biggest challenge we have. the secretary right now, yesterday, spoke to the sergeant major academy in the army. the sergeant majors are understanding this is a problem we have to take on as two departments, not just one. i think that education is happening. >> we have a lot of work to do. >> yes, ma'am, we do. >> dr. rooney. there's no doubt the events at madigan have shaken the trust and confidence of service members on the disability evaluation system. i believe transparency and sharing information about the

ongoing evaluations happening today and actions from the army and d.o.d. are taking to remedy the situation will go a long ways toward restoring trust in the system. i wanted to ask you today, what we have learned from the investigations that the army conducted into the forensic unit at madigan. >> as you pointed out earlier, 196 reevaluations completed of which 108 of those have been diagnosed as having ptsd. before, they had not. >> let me just say they had been diagnosed with ptsd. when they went through system, they were told they did not. now re-evaluating they are going back saying yes, you did. >> more than half. >> correct. there are 419 that have been determined to be eligible for reevaluation. 287 from the original group that

was looked at. as you know, the army actually opened it up to see anybody else that would have gone through the process while forensic psychologists were being used. that was 419 eligible for ree l reevaluation. three in progress and 12 being scheduled. what we learned from that is clearly, the process is put into place at that time, did not function as designed. evidence did not show that there was a mean spirited attempt but really to create similar diagnose kn diagnosis. they are re-evaluating all the cases where we have a similar situation. what we are doing from that point is not only learning from what army is doing but looking at where we are using the new standards in many ways, advances in the medical and behavioral

health areas to better diagnose ptsd. also, then, we will take the lessons learned across the other services as well. since army that has greatest majority of people going through we will take the lessons learned from there and apply those across to all the services. >> i really appreciate the army's announcement they are going to do a comprehensive review of the behavioral health system wide. i believe that is the first and important major step for the army to be doing. i did want to ask you, i have been told about the issues we were seeing at madigan were not system wide. the secretary announced a comprehensive view across all systems. if we didn't believe it was a system wide problem, what led the army to look at comprehensive review? >> we have had numerous conversations.

i believe the use of the forensic psychiatrist was isolated to madigan. that's where i believe that comment that it wasn't system wide. that type of additional part -- >> the forensic system wasn't system wide. system wide, we have issues with people not being diagnosed correctly. >> we want to look across the system. if we have issues, we identify those and get the individuals back into the system. it was a forward leaning approach to say we need to look across the system. not that we are convinced that similar problems exist. it's the right thing to do. we saw a number of these reevaluations ended up with diagnosis change. it's the right thing to do. >> i think it's extremely important to find anybody who was misdiagnosed to get them cured. we will continue to focus on this. >> with that, i'll turn it over to senator boseman.

>> yes, ma'am. with your permission, i would like to defer to senator burr then come back. >> great. >> i thank my colleague. madam chairman, thank you for this hearing. mr. gingrich, i share your cold. it's not fun. dr. rooney, do you disagree with the testimony today? >> sir, we look at the gao as a partner to help us evaluate what we are doing. they brought up good points in their report. of course, when you are using statistics we may look differently at a particular statistic. however, there was nothing in there that we didn't think helped us further understand where emphasis needs to be. there are improvements. we have been open about saying this is a system that needs significant improvement. the gao said the same thing. so, we are looking to continue

to work with them, take the information they provided. it gives us a road map to ensure we are putting resources to it. we take their report and internal analysis that goes deeper to say are the improvements -- are the resources making improvements to the system that we all know and agree. >> do you disagree with any of the testimony? >> no, sir. in fact, i look forward to the discussions we had before the testimony and the report. i believe anytime somebody gives you insight to what you are doing you can take care of one more veteran or service member to make sure their life is better. we need to look at it and make it happen. >> we are all in agreement that we are just south of 400 days in the cycle of applications being processed. 395 or 394. in may, they committed to

revising the ids so that it could be completed in 150 days and went further, to agree to explore options for it to be 75 days. now, i have had too many of these hearings. we have them every year. we hear the same thing. oh, gosh, look at what we are doing. i have heard the most glowing progress reports from both of you, then i get the reality that the days haven't changed. you have met some improvement in certain areas. i commend you on that. the timeliness goals in areas have been better. but, the reality is, we have a broken system. five years into it and i hear testimony where we are starting to begin to review our business processes. well, why did it take five years to get to this? what can you convey to me today that is concrete that tells me a

year from now, we are not going to be at 393 days when you said earlier we are instituting i.t. changes this summer that will improve or times by 30 or 40. i thought you were going to say percent. you said days. so, now, my expectations are, if we implement what you said, we are going to be down to 360 days, which exceeds the it by 110 days over what the goal was for today. so, share something with me telling me we are actually going to do this. >> sir, that was one of the steps. the i.t. solutions are not the only steps. it was indicating army hired 1218 people so we are also adding people to the process.

>> is this the first individuals we have hired in the five years? >> it's the largest group of people we have hired. >> we have hired people? we have plussed up and the overall time of completion went up, not down. >> many of these changes, sir, are fairly recent. >> okay. >> lieutenant general, the army deputy chief of staff called the process fundamentally flawed, and disjointed. do you agree with him? >> i have sat next to my colleague many times. we have had the discussion. i believe we are acknowledging it is a system that while initially designed and conceived to be smooth and transparent, we have not received the result. >> what are we doing to change it? >> as both my colleague and i indicated, at this point, we are looking case by case. we are following cohorts through each step of the process to see

when we add people to it, are we actually improving the times. i'm not saying we are not able to improve it for those already in the system. we have to make sure we are tracking the new ones in to say did we, in fact, cut the time down. it is going step by step. that process. >> i don't want to seem adversari adversarial, doctor. i think we're all after the same goal. but you just agreed with a statement that general bostick made where he basically said this system can't be fixed. now if you agree with that, my question is very simple. it is time for us to start over again, to take a blank sheet of paper and say how do we design this in a way for the benefits of the service members? the number one priority, number one priority for both. i don't question that. who are caught in a system that is unacceptable today from a standpoint in the length of time, from the standpoint of the accuracy that senator murray talked about. and i guess, you know, my

question to you would be if given a blank slate, would the army design ides the same way or would you do it differently? and if your answer is differently, then for god sake's, let's do it. tell us what we can do to be partners to change this in a way that it works versus to keep a structure of something that individuals who are involved in it like general bostick say fundamentally flawed. adversarial, disjointed. that's not the relationship we want with our service members that are going through. the chairman has been very kind to me. i just want to ask one last question, and this is to mr. gingrich. you made the statement, i think, in your testimony that va has the capacity to make compensation as early as they

choose to after a service member is discharged. is that accurate? >> we can make compensation the day after they're discharged. that is correct, senator. >> the day after? >> right. by law we cannot do compensation until they have been discharged. >> how long on average has it taken for the first va check to arrive for a servicemen who went through the ides is discharged from the military? not the decision letter from the va, but the actual check? >> right now it's taking too long. it's taking about 60 days. part of the reason -- it's not an excuse, but part of the reason is we do it by month. so if the person is discharged before the pay system is set up, you've eaten 30 days. we're working through that. and i think one of the things that the vta will give us is they'll give us the information we need electronically at the discharge so we can speed that process up. i'm very confident that we're going to get very close to the 30-day goal. and by the way, vta, dan and i

talked. vta will be in place in june. and that process will not only allow us to track the payment, it will also allow us to track the ratings and the discrepancies in the ratings. >> the chair has been very kind, and i appreciate it. and i would ask would you share with us the data that shows us that 60-day average for payment. >> i will do that, sir. >> thank you, chair. >> thank you very much, senator tester? >> thank you, madam chair. i want to go back to what senator burr was asking about. and i'll start with you, dr. rooney. the things need to be changed at ides? >> yes. >> mr. gingrich, do things need to be changed at ieds? >> yes, sir. >> could you, and i don't want to know them now, but could you get back to the committee we your recommendations on what needs to be changed in ieds? >> yes. >> yes, sir. >> okay.

i would anticipate that the changes would add to this simplifying and consolidating as your goals were when this was set up between the va and dod, would it not? i just want to make sure? the changes would add to the simplification. yes? >> yes. >> good. >> mr. bertoni, as you look at ieds right now, its goal was to simplify and consolidate. has it simplified was the first question. >> i would say yes. >> okay. >> when you look at what was happening under the legacy system versus now, it's much more simplifyler. >> much more simpler. is there an opportunity through this system to get feedback from

service members and address their questions and concerns about this? is that part of the system? >> there is a survey mechanism whereby service members are surveyed after each phase of process. the medical evaluation board, physical evaluation board and transit, yes. >> and that's pretty user friendly from your perspective? >> i don't know about user friendliness. it's four questions per phase, 12 questions. our concern is the limited number of folks who are actually receiving that survey. in principle, everyone is eligible to receive it. but if you don't opt to do that early on at the med phase, you're excluded from the latter phase. we're limiting folks who have a chance to weigh in on timeliness, transparency and other factors do. >> you think it would be important to get that in to be expanding the opportunities? >> i think it absolutely would be a good idea to revise and look at how they're surveying service members right now. >> i don't want to get out of my

lane here, but i'm going to for a second with madigan. you said 198 folks. 108 had their diagnosis changed. were those people -- was their rating done under ieds? >> many of them were. some of them were under the old process. so those that were before roughly '08 would have been before the old process. >> okay. so how many of the 198 -- do you have those figures broke out? i guess what i want to get at is to have over half the folks not get the proper rating is to say that it doesn't match up with our goals is an understatement. the question is ieds actually doing an accurate job of making the assessment for the disability, or is it not doing as good a job as the old system? >> actually, those people before, since i said most of

them were before '08, that would be the old system. >> yes. >> and it is adding the forensic psychiatrists in it and it was a different aspect to the system. so the new process, and frankly the protocols and the fact that our departments have an integrated mental health strategy for how to do this should have and by all data that we have seen improved that significantly under the new process. >> okay. so does that mean all the folks that got rated before 2008 we should call them back up and have them rerated? >> in essence, that's what the army is doing at this point. and we're going to take the lessons learned, as i indicated to senator murray. >> and what about the other branchs of services? >> across the other branches. >> a large number of the ones who were misdiagnosis order had their diagnosis changed inaccurately were after 2008, after the forensic psychology system was put in place. >> okay. i appreciate that. i just -- i mean we get -- we

get a lot of calls on this kind of stuff. and although i appreciate folks calling their senator to get this squared away, what it tells me is there is an inherent problem here. and so -- and then when you combine that with the fact that we've got missed diagnosis over 50%, we've got to -- i mean that's not acceptable. it's got to be fixed. and if it's a fact that we bring in a forensic psychologist and that fixes the problem, that tells me and we're talking one person, right? >> actually, that was the issue was adding that additional layer. that's when the initial diagnosis were changed. and then we had a review again. so that piece, adding forensic psychiatrist in the process has been stopped, and that does not occur any place across the department. >> all right. i mean -- look, i've got a lot of questions. my time is long passed.

well, i look forward to your recommendations on what can be done to improve ieds. i certainly appreciate the work you're trying to do. but we're not where we need to be by a long shot. and so, i mean, when i heard your testimony, there was good stuff here, and you should be touting the stuff you do well. but man, oh, man, we've got a long ways to go. and i mean, don't you think? >> absolutely. >> and so how do we get to a point? what do we need to do? is it manpower? is it more professional people? what is it? we got folks coming back, and the numbers are going to get more and more with the afghanistan drawdown, which is good. but the question is these folks need help. they need help early. that really saves money long-term, especially with unseen injuries. and where do we go? i mean where do we go to get this fixed? >> sir, as you indicated