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VA Disability Benefits: Actions Needed to Address Challenges Reserve Component Members Face Accessing Compensation

GAO-24-105400 Published: Oct 30, 2023. Publicly Released: Oct 30, 2023.
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Fast Facts

Members of the National Guard and the Reserves can claim Veterans Affairs disability benefits. But they may struggle to prove that disabilities are service-related when they only serve part-time—making it harder for them to access benefits.

Although DOD and VA have guidance about disability benefits for those in the reserves, it doesn't cover the importance of documenting how health conditions are related to time on duty. Also, gaps in VA data make it difficult to verify these claims.

We recommended that DOD and VA improve their guidance and data sharing to help those who served in the reserves with this issue, and more.

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Highlights

What GAO Found

The Department of Veterans Affairs (VA) approved 11 to 20 percent fewer initial disability compensation claims from members of the reserve components—the Reserves and National Guard—than the active components (i.e., full-time active-duty military) each year from 2012 through 2021, the most recent data available. VA and Department of Defense (DOD) officials were unaware of this difference. Reserve component approval rates remained lower across characteristics such as military rank and age, but the size of the difference sometimes varied.

Active and Reserve Component VA Disability Compensation Claim Approval Rates

Active and Reserve Component VA Disability Compensation Claim Approval Rates

DOD and VA partially addressed challenges reserve component members face accessing disability compensation. Disability compensation claims generally must include evidence of a health condition that developed during military duty and led to a disability. Stakeholders—who study or work with reserve component members—identified challenges related to reserve component members' timely documentation of their health conditions and VA claims processors' ability to obtain evidence to support their claims. For example:

  • All 15 stakeholders told GAO that reserve component members do not always understand the importance of immediately documenting health conditions to support any future disability compensation claims. DOD and VA guidance does not address this knowledge gap.
  • Thirteen stakeholders and several claims processors told GAO that finding evidence needed to support reserve component claims, such as service dates, is difficult. One form lists active-duty service but not reserve component members' two-week annual training. DOD designed a new form that will list dates of annual training, but the military services have not fully applied sound planning practices to implement it. VA claims processors also lack a reliable data source for the dates of monthly weekend drills.

Guidance on documenting health conditions, efficient rollout of DOD's new form, and better VA data on service dates could help reserve component members prove that their disabilities are connected to their military service. Without this proof, VA claims processors will likely deny disability compensation claims.

Why GAO Did This Study

Over one-third of the U.S. military serve in the reserve components. In return for their service, the nation has committed to compensate veterans for service-connected disabilities. The Identifying Barriers and Best Practices Study Act includes a provision for GAO to study reserve component members' access to VA disability benefits.

This report examines VA's approval rates for reserve and active component disability compensation claims and how DOD and VA addressed stakeholder-identified challenges facing reserve component members in accessing disability compensation, among other topics.

GAO analyzed VA data; reviewed relevant federal laws, DOD and VA policies, and other documents; and interviewed VA and DOD officials and 15 selected stakeholders, including researchers and veterans service organizations.

Recommendations

GAO is making 14 recommendations, including that DOD and VA develop guidance for reserve component members on documenting health conditions; the military services fully apply sound planning practices to implement the new form; and VA ensure claims processors have data on reserve component members' dates of training. DOD concurred and VA concurred or concurred in principle with GAO's recommendations.

Recommendations for Executive Action

Agency Affected Recommendation Status
Department of Veterans Affairs VA's Under Secretary for Benefits should ensure that VBA develops a mechanism, such as a document that lists known reliability issues with VADIR, to better communicate to federal and non-federal users the limitations of its incomplete data, particularly the unreliable variables on military personnel records from before 1985. (Recommendation 1)
Closed – Implemented
VA agreed in principle with this recommendation and has addressed it. VBA's Office of Performance Analysis & Integrity coordinated with VADIR staff by creating a one-page document for purposes of sharing with future consumers of VADIR data. This document explains the VADIR scope limitation cited in our recommendation--that VADIR data on military personnel are unreliable before 1980--and gives the reasons why. This aligns with the results of our own reliability testing of VADIR data, which found that data on military personnel were unreliable before 1980.
Department of Defense The Secretary of Defense should work with the Secretary of Veterans Affairs to develop guidance, such as outreach materials, brochures, or trainings, which: (1) makes reserve component members aware of their potential eligibility for disability compensation under various duty statuses; (2) explains how reporting health conditions when they occur can affect subsequent eligibility for disability compensation; and (3) explains the importance of obtaining and maintaining sufficient documentation of duty status and medical treatment received. (Recommendation 2)
Open
DOD agreed with this recommendation. They will work with VA to develop guidance and outreach materials to ensure that service members have the resources and knowledge to safeguard their rights and benefits. Collaboration will involve the Office of the Under Secretary of Defense of Personnel and Readiness, in consultation with the Military Departments. We will monitor DOD's progress in these efforts.
Department of Veterans Affairs The Secretary of Veterans Affairs should work with the Secretary of Defense to develop guidance such as outreach materials, brochures, or trainings, which: (1) makes reserve component members aware of their potential eligibility for disability compensation under various duty statuses; (2) explains how reporting health conditions when they occur can affect subsequent eligibility for disability compensation; and (3) explains the importance of obtaining and maintaining sufficient documentation of duty status and medical treatment received. (Recommendation 3)
Open
VA agreed with this recommendation. VA will ensure documentation is available that addresses all three components of the recommendation. Once finalized, they will work with DOD to provide this guidance through the interagency structure for the Transition Assistance Program. We will monitor the progress of these efforts.
Department of Defense The Secretary of Defense should ensure that DOD's reserve components make the guidance on reporting and documenting health conditions for the purposes of disability compensation prominently available to reserve component members. (Recommendation 4)
Open
DOD agreed with this recommendation. Once DOD and VA finish collaborating to produce guidance and outreach materials, DOD plans to direct the Secretaries of the Military Departments to make the final products prominently available to their Reserve Component members. We will close this recommendation when this effort is complete.
Department of Veterans Affairs VA's Under Secretary for Benefits should make the guidance on reporting and documenting health conditions for the purposes of disability compensation prominently available to reserve component members. (Recommendation 5)
Open
VA agreed in principle with this recommendation and is committed to making this guidance available. VA stated that, while it has limited access to Reserve Component members to make guidance available to them before they transition from Reserve service, they will work with DOD to provide guidance to promote alignment and implement this recommendation (along with recommendation 3). We will monitor the progress of these efforts.
Department of Defense The Secretary of Defense should ensure the Director of ODEI clarifies policies for military service assessments of their reserve component Military Equal Opportunity programs, to reduce medical bias, which in turn could help improve reserve component members' access to disability compensation. (Recommendation 6)
Open
DOD agreed with this recommendation. ODEI plans to clarify policy in the next revision of DoD Instruction (DoDI) 1350.02 for which the Secretaries of the Military Departments are responsible for ensuring their Reserve MEOs are assessed. ODEI will coordinate with the Military Departments on the frequency of assessment for the Reserve MEO programs. The next revision is expected in Fall 2024. We will monitor DOD's progress to complete this effort.
Department of Defense The Secretary of Defense should ensure the Director of ODEI conducts oversight reviews of the military services' Military Equal Opportunity programs, in accordance with DOD policy, to reduce medical bias, which in turn could help improve reserve component members' access to disability compensation. (Recommendation 7)
Open
DOD agreed with this recommendation. ODEI plans to coordinate with the Military Departments to establish a schedule to assess the effectiveness of the Military Services' MEO offices, starting in FY 2025. ODEI also plans to coordinate with the Defense Equal Opportunity Management Institute to develop a standardized assessment methodology to help ensure consistency in the assessment process. We will monitor DOD's progress on these efforts.
Department of the Army The Secretary of the Army should develop and document plans so the Army can implement the new DD Form 214-1 by February 2025. Such plans should fully apply sound planning practices, such as (1) identifying resources; (2) developing activities and timelines; (3) establishing roles, responsibilities, and coordination; (4) conducting a risk assessment; and (5) establishing performance management, such as goals and indicators to measure progress. (Recommendation 8)
Open
DOD agreed with this recommendation. We will monitor DOD's progress to implement it.
Department of the Air Force The Secretary of the Air Force should develop and document plans so the Air Force can implement the new DD Form 214-1 by February 2025. Such plans should fully apply sound planning practices, such as (1) identifying resources; (2) developing activities and timelines; (3) conducting a risk assessment; and (4) establishing performance management, such as goals and indicators to measure progress. (Recommendation 9)
Open
DOD agreed with this recommendation. We will monitor DOD's progress to implement it.
Department of the Navy The Secretary of the Navy should develop and document plans so the Navy can implement the new DD Form 214-1 by February 2025. Such plans should fully apply sound planning practices, such as (1) identifying resources; (2) developing activities and timelines; (3) establishing roles, responsibilities, and coordination; (4) conducting a risk assessment; and (5) establishing performance management, such as goals and indicators to measure progress. (Recommendation 10)
Open
DOD agreed with this recommendation. We will monitor DOD's progress to implement it.
Department of the Navy The Secretary of the Navy should ensure the Commandant of the Marine Corps develops and documents plans so the Marine Corps can implement the new DD Form 214-1 by February 2025. Such plans should apply sound planning practices, such as (1) identifying resources; (2) developing activities and timelines; (3) establishing roles, responsibilities, and coordination; (4) conducting a risk assessment; and (5) establishing performance management, such as goals and indicators to measure progress. (Recommendation 11)
Open
DOD agreed with this recommendation. We will monitor DOD's progress to implement it.
Department of Veterans Affairs VA's Under Secretary for Benefits should work with DOD to ensure VA claims processors have ready access to a reliable source of data verifying reserve component members' dates of service and duty status. (Recommendation 12)
Open
VA agreed in principle with this recommendation. VA noted that, while DOD is responsible for ensuring the data are collected and accurate, they will work with DOD to ensure that claims processors have access to all available data. We will monitor the progress of these efforts.
Department of Veterans Affairs VA's Under Secretary for Benefits should monitor differences in initial disability compensation claim approval rates between active and reserve component members, including trends over time, and use this information to inform whether course corrections, additional interventions, or analyses are needed to address challenges facing reserve component members in accessing disability compensation. (Recommendation 13)
Open
VA agreed in principle with this recommendation. VA will develop a report to monitor the approval ratings on claims for disability compensation for reserve component veterans in comparison to the active duty components. VA will solicit input from the Advisory Committee on Disability Compensation on how to address any identified disparities. The agency will also commission a study to examine the approval ratings of claims for disability compensation among Selected Reserve (Reserve and National Guard) component veterans in comparison to their active duty counterparts. We will monitor the progress of these efforts.
Department of Defense The Secretary of Defense should ensure that that the Under Secretary of Defense for Personnel and Readiness, in consultation with VA's Under Secretary for Benefits, uses information from VA about differences in initial disability compensation claim approval rates between active and reserve component members, including trends over time, to inform whether course corrections, additional interventions, or analyses are needed to address challenges facing reserve component members in accessing disability compensation. (Recommendation 14)
Open
DOD agreed with this recommendation. DOD's Office of the Under Secretary of Defense for Personnel and Readiness (P&R) began monthly meetings with VA in November 2023. Upon receiving VA's report comparing trends in Active and Reserve Component veterans' disability compensation claim approval rates, P&R plans to organizing a working group to analyze the VA information, conduct internal research, discuss issues, and develop corrective actions for any disparities identified. DOD estimates this work will be completed by October 31, 2024, with any needed implementation guidance to be issued afterward. We will monitor the progress of these efforts.

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Topics

Access to health careArmed forces reservesVeterans disability benefitsDisability compensationHealth careMilitary forcesPension benefitsPension claimsPhysical disabilitiesVeteransVeterans affairsVeterans benefitsVeterans claims