Military Disability System:

Improved Monitoring Needed to Better Track and Manage Performance

GAO-12-676: Published: Aug 28, 2012. Publicly Released: Sep 19, 2012.

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What GAO Found

Case processing times under the Integrated Disability Evaluation System (IDES) have increased over time, and measures of servicemember satisfaction have shortcomings. Since 2008, annual average processing times for IDES cases have steadily climbed, while the percentage of cases meeting established timeliness goals declined. Average case processing times reached 394 and 420 days for active and reserve component members in fiscal year 2011--compared to goals of 295 and 305 days, respectively, and just 19 percent of active duty and 18 percent of guard or reserve servicemembers completed the process and received benefits within established goals. Of the four phases comprising IDES, the medical evaluation board phase increasingly fell short of timeliness goals, while the physical evaluation board phase, although meeting goals, was taking increasingly more time to complete. With respect to servicemember satisfaction with the IDES process, GAO found shortcomings in how these data are collected and reported, such as unduly limiting who is eligible to receive a survey and computing average satisfaction scores in a manner that may overstate them. Department of Defense (DOD) officials told GAO they are considering alternatives for gauging satisfaction with the process. DOD and Veterans Affairs (VA) are taking steps to improve IDES performance, but progress to date is uneven and it is too early to assess their overall impact. For example, VA increased resources for completing exams and disability ratings while the Army is hiring additional staff for its medical evaluation boards. VA has met exam timeliness goals in the past several months, but other resources have yet to translate into lower processing times. DOD and VA are pursuing system upgrades so that staff and managers at IDES facilities can better track and manage the progress of servicemembers' cases. IDES officials have been working with the military services to correct case data that were inaccurately entered into VA's IDES tracking system, but have not yet identified a permanent solution to improve the accuracy of data input. Finally, DOD, with VA's assistance, is in the early stages of an in-depth review of the entire IDES process and its supporting IT systems. This effort is intended to improve understanding of how each step contributes to overall processing times and identify opportunities to streamline the process and supporting systems. However, timeframes for completing the review or issuing recommendations have yet to be established.

Why GAO Did This Study

Since 2007, DOD and VA have jointly operated IDES--which is intended to expedite benefits for injured servicemembers. IDES replaced the departments' separate processes for evaluating servicemembers for fitness and disability. Initially a pilot at 3 military treatment facilities, IDES is now in place at military treatment facilities worldwide. In previous reports, GAO identified a number of challenges as IDES expanded to more facilities, including staffing shortages and difficultly meeting timeliness goals. In light of IDES' expansion, GAO was asked to examine: (1) the extent to which DOD and VA are meeting IDES timeliness and servicemember satisfaction performance goals, and (2) steps the agencies are taking to improve IDES performance. GAO analyzed IDES timeliness and customer satisfaction data, visited six IDES sites with varying performance, and interviewed DOD and VA officials.

What GAO Recommends

To improve monitoring of IDES timeliness and satisfaction, GAO recommends that DOD and VA work together to (1) develop plans for completing the ongoing business process review and implementing any resulting recommendations and (2) improve the accuracy of case information at the point of data entry; and that (3) DOD consider alternative approaches to measuring satisfaction. DOD and VA concurred with GAO's recommendations.

For more information, contact Daniel Bertoni at (202) 512-7215 or bertonid@gao.gov.

Recommendations for Executive Action

  1. Status: Open

    Comments: As part of its process review, DOD collaborated with IDES subject matter experts in the military services to identify capability gaps and business needs in the current IDES environment. This information was documented in a Joint Disability Evaluation System problem statement, which is in the process of being reviewed by DOD components. Among the issues to be addressed are case management, tracking, reporting, and electronic data exchange. GAO will continue to track the implementation of this effort.

    Recommendation: To ensure that servicemember cases are processed and are awarded benefits in a timely manner, we recommend that the Secretaries of Defense and Veterans Affairs work together to develop timeframes for completing the IDES business process review and implementing any resulting recommendations.

    Agency Affected: Department of Defense

  2. Status: Open

    Comments: In fiscal year 2013, VA stated that it provided input on proposed recommendations to improve the IDES that resulted from a DOD-led process review. VA did not report involvement in any related activities in fiscal year 2014, but DOD has yet to implement the results of its process review.

    Recommendation: To ensure that servicemember cases are processed and are awarded benefits in a timely manner, we recommend that the Secretaries of Defense and Veterans Affairs work together to develop timeframes for completing the IDES business process review and implementing any resulting recommendations.

    Agency Affected: Department of Veterans Affairs

  3. Status: Open

    Comments: DOD did not provide new information in FY 2014. However, it previously reported that it revised its survey methodology to ensure more service members are eligible to respond and to use probably sampling to reduce costs. GAO will continue to monitor how DOD implements its survey and reports its findings.

    Recommendation: To improve DOD's ability to measure servicemembers' satisfaction with the IDES process, the Secretary of Defense should develop alternative approaches for collecting more meaningful and representative information in a cost effective manner.

    Agency Affected: Department of Defense

  4. Status: Closed - Implemented

    Comments: VA and DOD have implemented various efforts to improve their oversight of Veterans Tracking Application (VTA) timeliness data and address accuracy issues. For example, the departments regularly held joint training sessions on the use of VTA, which were modified over time to address data error trends in VTA. VA also conducted training sessions in 2013 on how to properly enter data and correct any errors, and DOD reported that it conducted additional training at IDES sites as needed regarding unique or advanced VTA challenges. Further, VA published revised IDES guidance in March 2014 in its Compensation and Pension Manual, and expects this guidance to increase consistency in IDES, including with VTA compliance. In addition, both departments reported efforts to increase monitoring and oversight of VTA timeliness data. For example, VA held regular teleconferences in which it shared best practices regarding VTA and discussed error trends. VA and DOD also worked together to identify additional VTA functionality that would help users monitor their cases. As a result, VA reported releasing an update to VTA in February 2014 that contained new capabilities that will help staff track their caseload. VA also built into VTA the ability to automatically alert VA Military Service Coordinators when they have cases that are nearing the claims development stage deadline. For its part, DOD worked to lessen both delays and errors between the transition and benefit phases by creating the capability to enter servicemembers' separation dates directly into VTA and upload DD Form 214 discharge documentation into VA's systems. In addition to these improvements and ongoing measures, VA reported undertaking several one-time reviews to confirm the accuracy of insufficient exam report data and make corrections to the status of IDES cases as needed.

    Recommendation: To ensure that IDES management decisions continue to be based upon reliable and accurate data, the Secretaries of Defense and Veterans Affairs work together to develop a strategy to continuously monitor and remedy issues with VTA timeliness information. This could include issuing guidance to facilities or developing best practices on preventing and correcting data entry errors; and developing reporting capabilities in VTA to alert facilities to potential issues with their data.

    Agency Affected: Department of Defense

  5. Status: Closed - Implemented

    Comments: VA and DOD have implemented various efforts to improve their oversight of Veterans Tracking Application (VTA) timeliness data and address accuracy issues. For example, the departments regularly held joint training sessions on the use of VTA, which were modified over time to address data error trends in VTA. VA also conducted training sessions in 2013 on how to properly enter data and correct any errors, and DOD reported that it conducted additional training at IDES sites as needed regarding unique or advanced VTA challenges. Further, VA published revised IDES guidance in March 2014 in its Compensation and Pension Manual, and expects this guidance to increase consistency in IDES, including with VTA compliance. In addition, both departments reported efforts to increase monitoring and oversight of VTA timeliness data. For example, VA held regular teleconferences in which it shared best practices regarding VTA and discussed error trends. VA and DOD also worked together to identify additional VTA functionality that would help users monitor their cases. As a result, VA reported releasing an update to VTA in February 2014 that contained new capabilities that will help staff track their caseload. VA also built into VTA the ability to automatically alert VA Military Service Coordinators when they have cases that are nearing the claims development stage deadline. For its part, DOD worked to lessen both delays and errors between the transition and benefit phases by creating the capability to enter servicemembers' separation dates directly into VTA and upload DD Form 214 discharge documentation into VA'?s systems. In addition to these improvements and ongoing measures, VA reported undertaking several one-time reviews to confirm the accuracy of insufficient exam report data and make corrections to the status of IDES cases as needed.

    Recommendation: To ensure that IDES management decisions continue to be based upon reliable and accurate data, the Secretaries of Defense and Veterans Affairs work together to develop a strategy to continuously monitor and remedy issues with VTA timeliness information. This could include issuing guidance to facilities or developing best practices on preventing and correcting data entry errors; and developing reporting capabilities in VTA to alert facilities to potential issues with their data.

    Agency Affected: Department of Veterans Affairs

 

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