Comparison of Selected Recommendations of the President's Commission on Returning Wounded Warriors (the Dole-Shalala Commission) and the Veterans' Disability Benefits Commission

Comparison of Selected Recommendations of the
President’s Commission on Returning Wounded
Warriors (the Dole-Shalala Commission) and the
Veterans’ Disability Benefits Commission
March 10, 2008
Christine Scott
Specialist in Social Policy
Domestic Social Policy Division
Sarah A. Lister
Specialist in Public Health and Epidemiology
Domestic Social Policy Division

Comparison of Selected Recommendations of the
President’s Commission on Returning Wounded
Warriors (the Dole-Shalala Commission) and the
Veterans’ Disability Benefits Commission
Summary
This report compares selected recommendations of the President’s Commission
on Care for America’s Returning Wounded Warriors (PCCWW), often called the
Dole-Shalala Commission in reference to its co-chairs, and the Veterans’ Disability
Benefits Commission (VDBC). The VDBC was established in 2004 to study veterans’
benefits in a broad context. The PCCWW was established in 2007 following reports
of problems among injured servicemembers returning from Iraq and Afghanistan
with medical rehabilitation and access to benefits. The PCCWW was charged to
focus specifically on the needs of these individuals.
The recommendations presented in this report are those that relate to the
transition of injured servicemembers from military service to civilian life and/or
veteran status. This report does not examine certain other recommendations, such as
those in the VDBC report regarding benefits for survivors of deceased
servicemembers, or regarding evaluation of presumptive disability, i.e., establishing
service connection for certain long-term health effects of hazardous exposures. As
this report is limited to a comparison of the final recommendations of the PCCWW
and the VDBC, it will not be updated.

Contents
Overview ........................................................1
Charges to the Commissions.........................................2
Recommendations of the Commissions.................................3
Additional CRS Reports............................................4
List of Tables
Table 1. Comparison of Selected Recommendations
of the PCCWW and VDBC......................................5

Comparison of Selected Recommendations
of the President’s Commission on
Returning Wounded Warriors
(the Dole-Shalala Commission) and the
Veterans’ Disability Benefits Commission
Overview
This report compares selected recommendations of the President’s Commission
on Care for America’s Returning Wounded Warriors (PCCWW),¹ often called the
Dole-Shalala Commission in reference to its co-chairs, and the Veterans’ Disability
Benefits Commission (VDBC).² The recommendations presented are those that
relate to the transition of injured servicemembers from military service to civilian life
and/or veteran status. This report does not examine certain other recommendations,
such as those in the VDBC report regarding benefits for survivors of deceased
servicemembers, or regarding evaluation of presumptive disability, i.e., establishing³
service connection for certain long-term health effects of hazardous exposures.
Congress, the two commissions, and others have determined that certain
programs and systems that involve both the Department of Defense (DOD) and the
Department of Veterans Affairs (VA) are particularly problematic in providing
continuity and quality of care and services to injured servicemembers. In January
2008, Congress passed the National Defense Authorization Act for Fiscal Year 2008
(P.L. 110-181). Titles XVI and XVII of the act address matters related to the care
and treatment of servicemembers and former servicemembers (i.e., veterans) who
were wounded, or who contracted an illness, while serving on active duty. Among
the problems addressed in the act are the efficient maintenance and transfer of
servicemembers’ health and benefits records between the departments, and the
separate evaluations of disability by each department. Efforts to address these and
other transition problems were already under way in both departments, partly in
response to the recommendations of the PCCWW, the VDBC, and several other

¹ President’s Commission on Care for America’s Returning Wounded Warriors (PCCWW),
Serve, Support, Simplify, main report, and subcommittee reports and survey findings, July

2007, at [http://www.pccww.gov/].

² Veterans’ Disability Benefits Commission (VDBC), Honoring the Call to Duty: Veterans’
Disability Benefits in the 21^st Century, October 2007, at [http://www.vetscommission.org/].
³ The PCCWW report does not contain recommendations regarding survivor benefits or
presumptive disability. These matters are addressed in VDBC recommendations 8.2 through

8.3, and 5.8 through 5.27, respectively.

commissions or task forces. These legislative and administrative actions constitute
the first wave of responses to the recommendations of these bodies. Further
congressional and administrative actions are anticipated. As this report is limited to
a comparison of the final recommendations of the PCCWW and the VDBC, it will
not be updated.
Charges to the Commissions
The commissions were given different charges. The PCCWW was established
by Executive Order 13426 in March 2007,⁴ and was to focus on the needs of a
specific population, namely, seriously injured servicemembers returning from combat
theaters in support of Operations Enduring Freedom and Iraqi Freedom (OEF/OIF).
The commission was asked to look broadly at services and benefits provided by all
relevant Cabinet departments — principally the Departments of Defense (DOD) and
Veterans Affairs (VA) — as well as the private sector, and at a broad slate of services
and benefits, including health care, disability, traumatic injury, education,
employment, and other benefits. The PCCWW was to study individuals’ experiences
as servicemembers and, for those who were retired or separated from military service,
their transition from military to civilian and/or veteran status, problems in providing
services and benefits across that transition, and subsequent experiences in civilian
life. Though the PCCWW’s recommendations were to apply narrowly to seriously
injured OEF/OIF servicemembers, it could prove difficult, politically and
administratively, to implement the recommendations in this fashion. Doing so could
run counter to existing policies, such as compensating service-connected disabilities
equally whether or not they are combat related, and prioritizing groups of veterans
to receive VA health care.
The VDBC was established in Title XV of the National Defense Authorization
Act of 2004 (P.L. 108-136) to study benefits provided to veterans and their survivors
to compensate for service-connected disabilities and deaths. The VDBC was to
consider these benefits regardless of the time or manner in which a disability or death
occurred, and whether it occurred during a conflict or during peace time. While the
VDBC examined certain transition issues for injured OEF/OIF servicemembers who
were retired or separated from military service, this was not its principal focus. The
VDBC examined services and benefits for veterans across their lifespans, making a
more comprehensive assessment of the full complement of veterans’ benefits than
did the PCCWW, but a less comprehensive assessment of DOD services, benefits,
authorities and policies.

⁴ White House, “Executive Order: Establishing a Commission on Care for America’s
Returning Wounded Warriors and a Task Force on Returning Global War on Terror
Heroes,” March 6, 2007, at [http://www.whitehouse.gov/news/releases/2007/03/20070306-

3.html].

Recommendations of the Commissions
The PCCWW made six broad recommendations, each with several specific
action steps directed to the Congress, DOD and/or VA, and published a matrix of the

23 action steps in its main report.⁵ The six broad recommendations are as follows:

1. Implement comprehensive recovery plans for returning injured
servicemembers.

2. Restructure the military and veterans disability and compensation systems.

3. Improve care for people with post-traumatic stress disorder (PTSD) and
traumatic brain injury (TBI).

4. Strengthen support for families.

5. Transfer patient information across the DOD and VA systems.

6. Support Walter Reed Army Medical Center (WRAMC) until its closure.

The VDBC made 113 recommendations, also directed to the Congress, DOD
and/or VA, designating 13 of them as priority recommendations.⁶ Recommendations
were made in the following broad categories:
^!disability evaluation and compensation;
^!determining eligibility for benefits;
^!appropriateness of the benefits;
^!appropriateness of the level of benefits;
^!survivors and dependents;
^!disability claims administration;
^!transition; and
^!establishing an executive oversight group to implement
recommendations.
The attached Table compares selected action steps from the PCCWW and
recommendations from the VDBC that relate to the transition of injured
servicemembers from military service to civilian life and/or veteran status. Since the
PCCWW focused on these individuals, all of its action steps are discussed, and the
table is organized according to the PCCWW’s six broad recommendations. The table
does not include all of the VDBC recommendations, but only those that relate to the
transition of injured servicemembers or that are otherwise comparable to
recommendations of the PCCWW. Each table entry notes the entity (Congress, DOD
and/or VA) to whom the recommendation is directed. Bracketed notations show the
relevant numbered recommendation(s) from the PCCWW and VDBC respectively.
Because the commissions had distinct charges and areas of emphasis, head-to-
head comparison of their recommendations must be made with care. For example,
the commissions largely agreed on the proposed end point for a revised disability

⁵ PCCWW main report, p. 28, table.
⁶ VDBC full report, pp. 378-395, and executive summary, pp. 12-15. One commissioner’s
separate views on four of the commission’s recommendations are published as Appendix
L in the full report.

compensation system, namely, that DOD would evaluate the fitness of injured
servicemembers for continued duty, while VA would evaluate for disability
compensation. But the commissions differed in their priorities for implementing this
revised system, reflecting their focus on different populations. When comparing
PCCWW and VDBC recommendations, it must be borne in mind that unless
otherwise stated, PCCWW recommendations would apply, at least initially, only to
injured OEF/OIF servicemembers and veterans, while VDBC recommendations
would apply to all servicemembers or veterans, including those from previous
conflicts, who are otherwise eligible for the service or benefit being discussed.
Additional CRS Reports
The following CRS Reports discuss the variety of DOD and VA programs and
benefits that are addressed by the commissions and referred to in this report:
^!CRS Report RL33991, Disability Evaluation of Military
Servicemembers;
^!CRS Report RL33537, Military Medical Care: Questions and
Answers;
^!CRS Report RS22366, Military Support to the Severely Disabled:
Overview of Service Programs;
^!CRS Report RL33446, Military Pay and Benefits: Key Questions
and Answers;
^!CRS Report RL33449, Military Retirement, Concurrent Receipt,
and Related Major Legislative Issues;
^!CRS Report RL33985, Veterans’ Benefits: Issues in the 110th
Congress;
^!CRS Report RL33993, Veterans’ Health Care Issues;
^!CRS Report RL33113, Veterans Affairs: Basic Eligibility for
Disability Benefit Programs;
^!CRS Report RL33323, Veterans Affairs: Benefits for
Service-Connected Disabilities;
^!CRS Report RS22666, Veterans Benefits: Federal Employment
Assistance;
^!CRS Report RS22804, Veterans’ Benefits: Pension Benefit
Programs;
^!CRS Report RL34371, “Wounded Warrior” and Veterans
Provisions in the FY2008 National Defense Authorization Act;
^!CRS Report RL34169, The FY2008 National Defense Authorization
Act: Selected Military Personnel Policy Issues;
^!CRS Report RL31760, The Family and Medical Leave Act: Recent
Legislative and Regulatory Activity; and
^!CRS Report RL34055, Walter Reed Army Medical Center:
Realignment Under BRAC 2005 and Options for Congress.

CRS-5
Table 1. Comparison of Selected Recommendations of the PCCWW and VDBC
^Pro^vⁱ^sioⁿ^{PCCWW Reco}^m^m^e^nda^tioⁿ^s^VDB^{C Reco}^m^m^e^nda^tioⁿ^s
^M^ANAG^E^M^E^N^T^/^INDIVIDUAL^RE^COVE^{RY PL}^ANS
^e^w^D^{OD an}^d^VA:^Dev^e^{lop in}^teg^r^{ated care team}^s^of^h^ealth^{care, s}^o^{cial w}^o^rk^{DOD a}^{nd VA:}^C^r^{eate an}ⁱⁿ^ten^s^iv^{e cas}^{e m}^aⁿ^a^g^e^m^eⁿ^t^prog^ram^f^o^r
^an^d^v^o^catioⁿ^a^{l reh}^a^b^ilitatioⁿ^staf^f^,^to^co^o^r^dⁱⁿ^a^{te h}^ealth^{care an}^d^{access to}^s^e^v^e^rely^dis^a^{bled v}^e^teran^s^{, w}^ith^{a lead ag}^en^cy^{. [10.3]}
^ben^e^f^its^f^o^{r s}^e^rv^icem^em^bers^{. C}^r^{eate in}^divⁱ^du^al^Recover^{y Plans}^f^o^{r each}
^s^e^ri^ou^s^l^yⁱⁿ^j^u^{red s}^e^rvⁱ^cem^em^{ber, i}ⁿ^cl^u^dⁱⁿ^g^pl^an^s^dev^e^l^{oped ret}^r^oactⁱ^v^el^y
^f^o^{r an}^y^s^e^rv^icem^em^bersⁱⁿ^j^u^{red s}ⁱⁿ^{ce th}^{e beg}ⁱⁿⁿⁱⁿ^g^of^{OEF or OIF w}^h^o
^m^a^y^{still b}^eⁿ^e^f^{it f}^r^o^m^th^em^{. Dev}^e^lo^p^{a co}^r^p^{s o}^f^tr^ain^e^d^Int^e^r^agency
^Recover^{y C}^oor^di^nat^or^s^{to im}^plem^en^{t th}^{e R}^ecov^e^ry^P^l^an^s^.^[1]
ⁱ^{ki/CRS-RL34408}^e^m^a^{nager/Recovery}^{DOD a}^{nd VA:}^In^t^e^rag^eⁿ^c^y^R^ecov^e^ry^C^oordiⁿ^a^t^o^rs^s^h^ou^l^d^{be of}^fⁱ^cersⁱⁿ^T^h^{e co}^m^mⁱ^ssioⁿ^d^o^e^{s n}^o^{t co}^m^m^eⁿ^t^sp^ecifⁱ^cally^oⁿ^th^{e af}^f^iliatioⁿ^o^r
^g/w^o^r^dina^t^o^r^th^{e Co}^m^mⁱ^ssioⁿ^ed^Co^r^p^{s o}^f^th^{e U.S. P}^u^b^{lic Health}^Ser^v^{ice, in}^th^e^creden^tⁱ^a^l^s^of^t^h^{e propos}^{ed l}^{ead ag}^en^cy^.
^s^.or^Dep^a^rtm^eⁿ^t^o^f^Health^an^d^Hu^m^aⁿ^Serv^{ices, cro}^ss-^train^e^d^b^y^{DOD an}^d
^le^ak^VA^{. [1}^]
^://wiki^I^L^I^T^Y^{: RAT}^ING^{AND RAT}^ING^PROCE^S^S
^h^ttp^os^ed^en^d^s^t^ate^C^on^gres^s^,^D^O^D^,^an^d^V^A^:^Co^m^p^letely^r^e^str^u^ctu^r^{e th}^{e d}ⁱ^sab^ility^an^d^Co^ng^{ress, DOD, a}^{nd VA:}^Realigⁿ^th^{e d}ⁱ^sab^ility^ev^alu^a^tioⁿ^p^r^o^{cess so}
^co^m^p^ensatio^{n sy}^stem^s,^so^that^DOD,^thr^o^{ugh its ser}^v^{ice b}^r^anches,^th^{at th}^{e s}^e^rv^{ice bran}^ch^es^determⁱⁿ^{e f}^itn^es^s^f^o^{r du}^ty^{, an}^{d s}^e^rv^icem^em^bers
^m^aⁱⁿ^tain^{s au}^th^o^r^ity^to^d^e^ter^mⁱⁿ^{e f}^itn^{ess f}^o^r^coⁿ^tin^u^e^d^m^ilitar^y^ser^v^ice,^w^h^o^ar^{e f}^o^uⁿ^d^uⁿ^f^{it ar}^{e r}^e^f^e^r^r^ed^to^VA^f^o^r^dⁱ^sab^ility^r^a^tin^g^.^A^l^l
^an^d^VA^d^e^ter^mⁱⁿ^{es d}ⁱ^sab^ility^r^a^tin^g^s^an^d^{all r}^e^su^ltin^g^co^m^p^en^satioⁿ^an^d^coⁿ^d^itioⁿ^s^th^{at ar}^{e id}^en^tif^ied^{as p}^a^r^t^o^f^{a sin}^g^l^{e, co}^m^p^r^e^h^eⁿ^s^iv^{e m}^e^dⁱ^cal
^b^e^nef^its.^I^f^{DOD f}ⁱ^nd^{s the ser}^v^icem^em^b^e^r^unf^it,^{DOD p}^r^o^v^id^{es annuity}^ex^amⁱⁿ^ation^s^h^ou^{ld be rated an}^{d com}^p^en^s^a^{ted. [}^Prio^rity
^p^a^y^m^en^{ts b}^a^sed^so^lely^oⁿ^r^aⁿ^k^an^d^y^ear^{s o}^f^ser^v^{ice. VA}^’^s^dⁱ^sab^ility^Recom^m^e^ndatⁱ^{on 7.12}^{] (R}^ecom^m^eⁿ^d^{ed action}^s^{to ach}^iev^e^th^is^en^{d s}^t^ate
^sy^stem^co^m^p^en^{sates f}^o^r^tr^an^sitioⁿ^co^{sts an}^d^lo^{st q}^u^ality^o^f^lif^{e in}^ad^d^itioⁿ^f^o^llo^w^.^{See, in}^p^a^r^ticu^l^ar^{, “}^R^estr^u^c^tu^r^e^VA^dⁱ^sab^ility^p^a^y^m^en^ts.”)
^to^lo^{st ear}ⁿⁱⁿ^g^s^p^o^t^en^{tial. [}²^]⁽^R^eco^m^m^eⁿ^d^ed^actioⁿ^s^to^ach^iev^e^th^{is en}^d
^{state f}^o^llo^w^.^{See, in}^p^a^r^ticu^l^ar^{, “}^R^estr^u^c^tu^r^e^VA^dⁱ^sab^ility^p^a^y^m^en^ts.”)
^Co^ng^r^e^ss:^Clarif^y^th^{e o}^b^j^ectiv^{es o}^f^th^{e DOD an}^d^VA^dⁱ^sab^ility^VA:^T^h^{e VDB}^{C m}^a^k^e^{s 2}¹^ad^d^itioⁿ^a^{l r}^eco^m^m^eⁿ^d^atioⁿ^s^r^e^g^a^r^dⁱⁿ^g
^prog^ram^s^{. [2]}^admⁱⁿⁱ^s^t^ration^of^th^{e propos}^{ed dis}^a^bility^com^p^en^s^a^tion^s^y^s^t^em^{. [4.3 -}
^4.23]

CRS-6
^Pro^vⁱ^sioⁿ^{PCCWW Reco}^m^m^e^nda^tioⁿ^s^VDB^{C Reco}^m^m^e^nda^tioⁿ^s
^{use o}^f^disa^bilit^y^C^oⁿ^g^{ress, DO}^{D, a}^{nd VA:}^P^C^C^W^W^recom^m^eⁿ^d^s^en^h^aⁿ^cem^en^ts^of^Co^ng^{ress, DOD, a}^{nd VA:}^B^eⁿ^e^f^its^s^h^ou^{ld be aw}^{arded s}^o^lely^accordin^g
^dⁱ^sab^ility^co^m^p^en^satioⁿ^selectiv^ely^f^o^r^co^m^b^at-ⁱⁿ^j^u^r^ed^OEF/OI^F^to^th^{e sev}^e^r^ity^o^f^th^{e d}ⁱ^sab^ility^{, r}^e^g^a^r^d^{less o}^f^w^h^eth^e^r^th^{e in}^j^u^r^y^w^a^s
^s^e^rv^icem^em^bers^{. [2]}ⁱⁿ^cu^{rred or th}^{e dis}^eas^{e w}^a^s^con^t^ract^{ed du}^rin^g^com^b^{at or train}ⁱⁿ^g^,^{or in}
^w^a^rtim^{e or peacetim}^{e. [5.3]}
^{le m}^e^dica^l^{DOD a}^{nd VA:}^Dev^e^{lop a s}ⁱⁿ^g^l^{e com}^p^reh^eⁿ^s^iv^{e, s}^t^an^{dardized m}^e^dical^{DOD a}^{nd VA:}^Serv^icem^em^b^e^{rs b}^eⁱⁿ^g^coⁿ^s^id^ered^uⁿ^f^{it b}^y^{DOD sh}^o^u^ld
ⁱⁿ^ati^oⁿ^ex^amⁱⁿ^atioⁿ^,^to^b^e^ad^mⁱⁿⁱ^stered^b^y^{DOD, th}^{at w}^o^u^l^d^serv^{e b}^o^t^h^DOD’^s^{be g}ⁱ^v^eⁿ^{a s}ⁱⁿ^g^l^{e, com}^p^reh^eⁿ^s^iv^{e ex}^amⁱⁿ^ation^,^an^{d all iden}^tif^ied
^f^itn^{ess ev}^alu^a^tioⁿ^,^an^d^VA^’^sⁱⁿ^{itial d}^e^ter^mⁱⁿ^atioⁿ^o^f^dⁱ^sab^ility^{. [}²^]^coⁿ^d^itioⁿ^s^sh^o^u^ld^b^e^r^a^ted^an^d^co^m^p^en^sated^.^[^Prio^{rity Reco}^mmen^d^a^tioⁿ
^7.12^]^Coⁿ^d^u^c^{t a co}^m^p^r^e^h^eⁿ^s^iv^{e m}^u^ltid^iscip^lin^ar^y^m^e^dⁱ^cal,
^ps^y^c^h^o^logⁱ^{cal, an}^{d v}^o^cation^a^{l ev}^alu^a^tion^of^each^v^e^teran^applyⁱⁿ^g^f^o^r
^dⁱ^sab^ility^co^m^p^en^satioⁿ^{at th}^{e tim}^{e o}^f^ser^v^{ice sep}^a^r^a^tioⁿ^.^[⁴^.1⁰^]
ⁱ^{ki/CRS-RL34408}^DOD:^Man^d^{ate th}^{at s}^e^paration^ex^amⁱⁿ^ation^s^{be perf}^orm^e^{d on}^all
^g/w^s^e^rvⁱ^cem^em^bers^{. [10.6]}
^s^.or
^le^ak^-eval^u^a^ti^on^of^bilit^y^VA:^Re-^e^v^a^lu^{ate v}^e^ter^aⁿ^s^’^dⁱ^sab^ility^statu^s^ev^er^y³^y^ear^{s. [}²^]^VA:^R^e^-^e^v^a^lu^{ate in}^divⁱ^du^als^w^ith^P^T^{SD ev}^ery^{2 — 3 y}^ears^{to g}^a^u^g^e^treatm^eⁿ^t^ef^f^ectiv^en^es^s^an^{d en}^cou^r^ag^{e w}^e^lln^es^s^.^[^Prio^rity
^://wiki^Recom^m^e^ndatⁱ^{on 5.30}^]
^h^ttp^Admⁱ^nis^t^ration^VA:^{Update an}^{d k}^{eep cu}^rren^{t th}^{e VA}^SR^{D to ref}^l^{ect in}^j^u^ries^s^eenⁱⁿ^VA:^U^p^d^a^t^e^t^h^e^V^A^SRD^,^b^e^giⁿⁿⁱ^{ng w}ⁱ^t^h^m^e^nt^a^l^he^a^l^t^h^aⁿ^d^ne^ur^o^l^o^gⁱ^c^a^l
^o^{r Ra}^tⁱ^ng^{OIF/OEF in}^j^u^{red s}^e^rv^icem^em^bers^{, an}^{d m}^odern^con^cepts^of^th^{e im}^{pact of}^body^s^y^s^t^em^s^,^{to prioritize th}^{e rev}ⁱ^sⁱ^on^of^s^c^h^e^du^les^f^o^{r P}^T^{SD, oth}^e^r
^bilit^{ies (}^VASRD)^dⁱ^sab^ility^oⁿ^q^u^ality^o^f^lif^{e. P}^o^st-^t^r^a^u^m^{atic str}^e^{ss d}ⁱ^so^r^d^er⁽^P^T^S^D)^an^d^m^eⁿ^t^{al d}ⁱ^so^r^d^er^{s, an}^d^T^B^I^.^A^f^ter^estab^lishⁱⁿ^g^p^r^io^r^{ities f}^o^r^r^e^vⁱ^sioⁿ^o^f
^trau^m^a^{tic brain}ⁱⁿ^j^u^ry^(T^B^{I) are m}^eⁿ^tion^e^{d s}^p^ecifⁱ^cally^{. T}^h^{e com}^mⁱ^s^sⁱ^on^th^{e r}^e^m^aⁱⁿⁱⁿ^g^sy^stem^{s, r}^e^vⁱ^{se th}^{e r}^e^m^aⁱⁿ^d^e^r^o^f^th^{e sch}^e^d^u^{le, co}^m^p^letin^g
^doesⁿ^o^{t s}^tipu^l^{ate a s}^p^ecifⁱ^{c tim}^{etable f}^o^{r rev}ⁱ^sⁱ^on^s^.^{Update th}^{e VA}^SR^D^t^h^{e rev}ⁱ^sⁱ^on^f^o^{r al}^l^body^s^y^s^t^em^s^wⁱ^t^hⁱⁿ^fⁱ^v^e^y^ears^.^[^Prio^rity
^{to ref}^l^{ect m}^odern^uⁿ^d^ers^t^an^din^g^of^P^T^{SD an}^{d T}^B^{I. [2]}^Recom^m^e^ndatⁱ^{on 4.23}^{] Dev}^e^{lop s}^p^ecifⁱ^{c VA}^SR^{D ratin}^g^{criteria f}^o^r
^PT^S^D^.^[^Prⁱ^o^rⁱ^t^y^Recom^m^e^ndatⁱ^{on 5.28}^]
^a^sse^ssm^eⁿ^t^o^f^DO^D^{No com}^p^{arable recom}^m^eⁿ^d^ation^.^DOD:^R^eas^s^e^s^s^an^y^s^u^ch^ratin^g^s^of^s^e^rv^icem^em^bers^{to determ}ⁱⁿ^{e if}^th^ey
^bilit^y^ra^tⁱ^ng^{s o}^f^{are equ}^{itable. [7.11]}

CRS-7
^Pro^vⁱ^sioⁿ^{PCCWW Reco}^m^m^e^nda^tioⁿ^s^VDB^{C Reco}^m^m^e^nda^tioⁿ^s
ⁱ^dua^l^{No com}^p^{arable recom}^m^eⁿ^d^ation^.^VA:^Elig^ib^ility^f^o^r^I^U^b^eⁿ^e^f^{its sh}^o^u^ld^h^a^v^e^{a co}ⁿ^s^isten^t^b^a^{sis. Rev}ⁱ^{se th}^e
^{ployability (I}^U)^VA^{SRD to}^acco^m^m^o^d^a^{te in}^dⁱ^vⁱ^d^u^{al in}^ab^ility^to^w^o^rkⁱⁿ^b^a^{sic ratin}^g^,
^w^ith^o^u^{t n}^eed^f^o^r^I^U^r^a^tin^g^.^Red^u^{ce I}^U^b^eⁿ^e^f^{its g}^r^ad^u^a^lly^r^a^th^er^th^an
^ter^mⁱⁿ^atin^g^ab^r^u^p^tly^{. [}⁴^.1²^an^d^Prⁱ^o^rⁱ^t^y^Recom^m^e^ndatⁱ^ons^{7.4 and 7.5}^]
^B^I^LITY^:^C^O^M^P^EN^SA^TIO^N
^ruct^{ure VA disa}^bilit^y^Co^ng^r^e^ss:^Restr^u^ctu^r^{e VA}^dⁱ^sab^ility^p^a^y^m^en^{ts to}ⁱⁿ^clu^d^{e tr}^an^sitioⁿ^Co^ng^r^e^ss:^Disab^ility^co^m^p^en^satioⁿ^sh^o^u^ld^co^m^p^en^{sate f}^o^r^:⁽¹⁾^w^o^r^k
^en^ts^p^a^y^m^en^{ts, ear}ⁿⁱⁿ^g^s^-^l^o^{ss p}^a^y^m^en^{ts, an}^d^q^u^ality^o^f^lif^{e p}^a^y^m^en^{ts. (}^S^ee^dⁱ^sab^ility^{; (}²⁾^lo^{ss o}^f^ab^ility^to^en^g^a^g^eⁱⁿⁿ^oⁿ^-^w^o^r^k^lif^{e activ}^{ities; an}^d⁽³⁾
^ad^d^itioⁿ^a^{l in}^f^o^rm^atioⁿ^f^o^{r each}^b^e^lo^w^.^{) T}^r^an^sitioⁿ^p^a^y^m^en^{ts w}^o^u^l^d^lo^{ss o}^f^q^u^ality^o^f^lif^{e. [}⁴^.1^{, 4}^.²^,⁴^.³^]
^co^v^e^r^livⁱⁿ^g^ex^p^eⁿ^s^{es f}^o^r^dⁱ^sab^l^ed^v^e^ter^aⁿ^s^an^d^th^eir^f^a^m^ilies.
^Earⁿⁱⁿ^g^s^-^l^o^{ss p}^a^y^m^en^{ts w}^o^u^l^d^b^e^gⁱⁿ^w^h^en^tr^an^sitioⁿ^p^a^y^m^en^{ts en}^d^,^an^d
ⁱ^{ki/CRS-RL34408}^ceas^{e w}^h^en^{Social Secu}^rity^ben^e^f^its^f^o^{r retirem}^en^{t beg}ⁱⁿ^.^Earnⁱⁿ^g^s^los^s
^g/w^pay^m^en^ts^{are in}^ten^d^{ed to m}^a^k^e^u^p^f^o^{r an}^y^low^e^{r earn}ⁱⁿ^g^capacity
^s^.or^r^e^m^aⁱⁿⁱⁿ^g^af^ter^tr^ainⁱⁿ^g^.^Qu^ality^o^f^lif^{e p}^a^y^m^en^{ts w}^o^u^l^d^co^m^p^en^{sate f}^o^r
^le^akⁿ^oⁿ^-^w^o^rk^-^r^{elated ef}^f^ects^of^perm^an^en^{t ph}^y^s^{ical an}^{d m}^eⁿ^t^al^ser^v^ice-^coⁿⁿ^ected^dⁱ^sab^{ilities. [}²^]
^://wiki^sⁱ^ti^on^p^aym^en^ts^V^A^:^P^r^o^v^id^{e tr}^an^sitioⁿ^p^a^y^m^en^{ts to}^dⁱ^sab^l^ed^v^e^ter^aⁿ^s^an^d^th^eir^f^a^m^ilies,^Co^ng^r^e^ss:^C^r^{eate a s}^e^v^e^rely^dis^a^{bled s}^t^abilization^allow^aⁿ^{ce th}^{at w}^o^u^l^d
^h^ttp^eith^er^th^r^{ee m}^oⁿ^t^h^s^o^f^b^a^{se p}^a^y^f^o^r^th^o^s^{e r}^e^tu^rⁿⁱⁿ^g^to^th^eir^co^m^m^uⁿ^ities^allow^f^o^{r u}^p^{to a 50% in}^creas^{e in}^basⁱ^{c m}^oⁿ^t^h^l^y^VA^com^p^en^s^a^tion^f^o^{r u}^p
^w^ith^o^u^{t receiv}ⁱⁿ^g^coⁿ^tin^u^e^d^reh^a^b^ilitatioⁿ^,^o^r^{, f}^o^{r th}^o^s^{e receiv}ⁱⁿ^g^{to 5 y}^ears^{to addres}^s^th^{e real ou}^t-^of^-^pock^e^{t cos}^t^s^abov^{e th}^{e com}^p^en^s^a^tion
^loⁿ^g^e^r^-^ter^m^r^e^h^a^b^ilitatioⁿ^o^r^ed^u^catioⁿ^an^d^tr^ainⁱⁿ^g^p^r^o^g^r^a^m^s^,^{rate at a tim}^{e of}ⁿ^{eed, to s}^u^pplem^en^{t, to th}^{e ex}^ten^t^{appropriate, an}^y
^loⁿ^g^e^r^-^ter^m^p^a^y^m^en^{ts to}^co^v^e^r^f^a^m^ily^livⁱⁿ^g^ex^p^eⁿ^s^{es. Co}^m^mⁱ^ssioⁿ^a^cov^e^rag^e^uⁿ^d^{er T}^r^au^m^a^{tic Serv}^icem^em^bers^’^Grou^{p L}ⁱ^f^e^In^s^u^ran^{ce. [7.7]}
^stu^d^y^to^d^e^ter^mⁱⁿ^{e ap}^p^r^o^p^r^{iate lo}ⁿ^g^e^r^-^ter^m^p^a^y^m^en^{t lev}^e^{ls. [}²^]
^l^M^o^nt^hly^{No com}^p^{arable recom}^m^eⁿ^d^ation^.^Co^ng^r^e^ss:^C^oⁿ^s^{ider in}^creasⁱⁿ^g^Special^M^o^nt^hl^y^Co^m^p^eⁿ^sa^tⁱ^o^{n b}^e^ne^fi^t^s^,
^m^p^ensa^tioⁿ^w^h^er^{e ap}^p^r^o^p^r^{iate, to}^ad^d^r^{ess th}^{e m}^o^r^e^p^r^o^f^o^uⁿ^d^im^p^{act o}ⁿ^q^u^ality^o^f^lif^e
^o^f^th^{e d}ⁱ^sab^{ilities su}^b^j^{ect to}^sp^{ecial m}^oⁿ^t^h^l^y^co^m^p^en^satioⁿ^.^[⁶^.1^an^d
^Prⁱ^o^rⁱ^t^y^Recom^m^e^ndatⁱ^{on 7.8}^]

CRS-8
^Pro^vⁱ^sioⁿ^{PCCWW Reco}^m^m^e^nda^tioⁿ^s^VDB^{C Reco}^m^m^e^nda^tioⁿ^s
^alⁱ^t^{y of l}ⁱ^f^{e p}^aym^en^ts^V^A^:^Mo^v^e^sw^if^tly^to^u^p^d^a^{te an}^d^k^eep^cu^r^r^eⁿ^t^th^{e d}ⁱ^sab^ility^r^a^tin^g^Co^ng^r^e^ss:^Revⁱ^ew^an^cillar^y^b^eⁿ^e^f^{its to}^d^e^ter^mⁱⁿ^{e w}^h^er^{e ad}^d^itioⁿ^a^l
^s^c^h^e^du^{le (s}^{ee th}^{e prior ref}^e^ren^{ce to th}^{e VA}^SR^{D) to ref}^l^{ect cu}^rren^t^b^eⁿ^e^f^{its co}^u^l^d^im^p^r^o^v^{e d}ⁱ^sab^l^ed^v^e^ter^aⁿ^s^’^q^u^ality^o^f^lif^{e. [}⁶^.1^an^d
ⁱⁿ^j^u^rⁱ^{es an}^d^m^o^d^e^rⁿ^coⁿ^cep^{ts o}^f^th^{e im}^p^{act o}^f^dⁱ^sab^ility^oⁿ^q^u^ality^o^f^Prⁱ^o^rⁱ^t^y^Recom^m^e^ndatⁱ^{on 7.8}^]^W^h^{ile th}^{e p}^r^o^g^r^a^m^{is r}^e^vⁱ^sed^to
^lif^{e. [}²^]^acco^m^p^lish^th^{is, co}ⁿ^s^id^{er an}^im^m^e^dⁱ^{ate in}^{crease (u}^p^to²⁵^%^{) in}^dⁱ^sab^ility
^com^p^en^s^a^tion^.^[7.6]
^I^L^I^T^Y^{: OT}^HE^{R B}^E^NE^FIT^S
^ca^tⁱ^oⁿ^a^l^reha^b^ilit^a^t^ioⁿ^VA:^Dev^e^lo^p^f^l^ex^ib^ility^w^ithⁱⁿ^th^{e p}^r^o^g^r^a^m^b^y^allo^wⁱⁿ^g^v^e^ter^aⁿ^s^to^Co^ng^{ress a}^{nd VA:}^Req^u^ir^{e v}^o^catioⁿ^a^{l assessm}^en^{t in}^th^{e d}^e^ter^mⁱⁿ^atioⁿ
^s^u^s^p^en^{d train}ⁱⁿ^g^{or atten}^d^part-^tim^{e, w}^ith^th^{e approv}^{al of}^th^{e R}^ecov^e^ry^o^f^elig^ib^ility^f^o^r^Iⁿ^dⁱ^vⁱ^d^u^{al Un}^em^p^l^o^y^ab^ility⁽^I^U)^b^eⁿ^e^f^{its. [}⁴^.1⁴^]
^Co^o^r^dⁱ^na^t^o^r^aⁿ^d^vo^c^a^tⁱ^o^na^l^c^o^unse^l^o^r^{. P}^r^o^v^id^{e b}^oⁿ^u^s^{es f}^o^r^co^m^p^letioⁿ
^o^f^st^a^g^e^s^o^f^vo^c^a^tⁱ^o^na^l^t^r^aⁱⁿⁱ^ng.^[²^]^VA:^Revⁱ^ew^th^{e 1}²^-^y^ear^lim^itatioⁿ^f^o^r^v^o^catioⁿ^a^{l r}^e^h^a^b^ilitatioⁿ^f^o^r
ⁱ^{ki/CRS-RL34408}^ser^v^ice-^coⁿⁿ^ected^v^e^ter^aⁿ^s^an^d^,^w^h^en^ap^p^r^o^p^r^{iate, r}^e^vⁱ^{se th}^{e lim}^itatioⁿ
^g/w^oⁿ^th^{e b}^a^{sis o}^f^cu^r^r^en^{t em}^p^l^o^y^m^eⁿ^t^d^a^{ta, f}^uⁿ^c^tioⁿ^a^{l r}^e^q^u^ir^em^en^{ts, an}^d
^s^.orⁱⁿ^dⁱ^vⁱ^d^u^{al v}^o^catioⁿ^a^{l r}^e^h^a^b^ilitatioⁿ^an^d^m^e^dⁱ^{cal n}^eed^{s. [}⁴^.1²^]^Dev^e^lo^p
^le^ak^an^d^{test in}^cen^tiv^{e m}^o^d^e^{ls to}^p^r^o^m^o^t^{e v}^o^catioⁿ^a^{l r}^e^h^a^b^ilitatioⁿ^an^d^a^r^e^tu^rⁿ^to^g^aⁱⁿ^f^u^{l em}^p^l^o^y^m^eⁿ^t^am^oⁿ^g^v^e^ter^aⁿ^s^f^o^r^w^h^o^m^th^{is is a r}^ealistic
^://wiki^g^o^{al. [4.13]}
^h^ttp^c^are^C^on^gres^s^:^Estab^lish^lif^etim^{e T}^r^icar^{e b}^eⁿ^e^f^{its elig}^ib^ility^f^o^r^all^DOD:^R^e^m^o^v^e^T^r^{icare requ}^irem^en^ts^f^o^{r copay}^s^an^{d dedu}^ctibles^f^o^r
^com^b^at-ⁱⁿ^j^u^r^{ed s}^e^rv^icem^em^bers^f^o^uⁿ^d^uⁿ^f^{it f}^o^{r con}^tin^u^e^{d s}^e^rv^{ice, an}^d^s^ever^{ely injur}^e^{d s}^e^r^v^icemember^s^an^d^th^eir^f^a^m^{ilies. [}¹⁰^.¹⁷^]
^th^eir^d^e^p^eⁿ^d^en^{ts. [}²^]⁽^C^u^r^r^eⁿ^tly^{, th}^{is b}^eⁿ^e^f^{it is av}^ailab^l^{e o}ⁿ^ly^to^th^o^s^e
^f^o^uⁿ^d^uⁿ^f^{it w}^ith^dⁱ^sab^ility^r^a^tin^g^s^o^f³⁰^%^o^r^g^r^eater^.)
^T^h^{e com}^mⁱ^s^sⁱ^on^’^s^propos^{ed en}^{d s}^t^{ate w}^o^u^l^{d elim}ⁱⁿ^{ate DOD dis}^a^bility^Co^ng^r^e^ss:^Elimⁱⁿ^{ate th}^{e ban}^on^con^c^u^r^ren^t^{receipt. VDB}^C^recom^m^eⁿ^d^s
^{D a}^{nd VA disa}^bilit^y^p^a^y^m^ents,^{having DOD p}^r^o^v^id^{e an annuity}^p^a^y^m^ent,^sim^ilar^to^m^ilitar^y^th^{at s}^e^rv^icem^em^bers^w^h^{o are s}^e^{parated bef}^o^{re 20 y}^ears^of^s^e^rv^{ice f}^o^r
ⁱ^t^s^retⁱ^r^{ed pay}^,^bas^e^{d on}^ran^k^an^{d y}^ears^of^s^e^rvⁱ^{ce, w}ⁱ^t^h^on^l^y^t^h^{e V}^A^b^eⁱⁿ^g^m^e^dⁱ^cally^uⁿ^f^{it receiv}^e^{DOD retirem}^en^{t an}^d^VA^dⁱ^sab^ility^b^eⁿ^e^f^its
^p^r^o^v^idⁱⁿ^g^{a d}ⁱ^sab^ility^p^a^y^m^en^{t. [}²^]^coⁿ^c^u^r^r^eⁿ^tly⁽ⁱ^{.e., w}^ith^o^u^{t o}^f^f^s^et)^,^r^e^g^a^r^d^{less o}^f^th^eir^dⁱ^sab^ility^r^a^tin^g^,
^an^d^th^{at p}^r^io^r^ity^b^e^gⁱ^v^eⁿ^to^v^e^ter^aⁿ^s^sep^a^r^a^ted^o^r^r^e^tir^ed^w^ith^f^e^w^e^r^th^an
²⁰^y^ear^{s o}^f^ser^v^{ice an}^d^eith^er^{a ser}^v^ice-^coⁿⁿ^ected^dⁱ^sab^ility^r^a^tin^g^g^r^eater
^th^an⁵⁰^%^{, o}^r^{a co}^m^b^at-^r^elated^dⁱ^sab^ility^{. [}^Prio^{rity Reco}^mmen^d^a^tioⁿ
^6.14^]^Elimⁱⁿ^{ate th}^{e Su}^r^v^iv^o^r^B^eⁿ^e^f^{it P}^l^an^/Dep^en^d^eⁿ^c^y^an^d^Iⁿ^d^e^mⁿ^ity
^C^o^m^p^en^s^a^tion^of^f^s^{et f}^o^{r s}^u^rv^iv^ors^of^retirees^an^{d in}^-^s^ervⁱ^{ce death}^s^.
^[^Prio^{rity Reco}^mmen^d^a^tioⁿ^8.2]

CRS-9
^Pro^vⁱ^sioⁿ^{PCCWW Reco}^m^m^e^nda^tioⁿ^s^VDB^{C Reco}^m^m^e^nda^tioⁿ^s
^l^Securit^y^benefⁱ^t^s^Co^ng^ress:^Iⁿ^r^e^str^u^ctu^rⁱⁿ^g^VA^dⁱ^sab^ility^co^m^p^en^satioⁿ^,^earⁿⁱⁿ^g^s^lo^ss^Co^ng^r^e^ss:^For^s^ever^{ely injur}^e^{d veter}^ans^{, con}^s^{ider elim}ⁱⁿ^atin^g^th^{e Social}
^com^p^en^s^a^tion^w^o^u^l^{d en}^{d u}^pon^retirem^en^{t an}^{d receipt of}^{Social Secu}^rity^Secu^r^ity^Disab^ility^Iⁿ^su^r^aⁿ^{ce (}^SSDI⁾^elig^ib^ility^r^e^q^u^ir^em^en^{t o}^f^h^a^vⁱⁿ^g
^r^e^tir^em^en^{t b}^eⁿ^e^f^{its. Co}^m^p^en^satioⁿ^f^o^r^lo^{st q}^u^ality^o^f^lif^{e w}^o^u^l^d^coⁿ^tin^u^e^w^o^rk^{ed a m}ⁱⁿⁱ^m^u^mⁿ^u^m^{ber of}^qu^art^e^rs^{. [10.16]}
ⁱⁿ^r^e^tir^em^en^{t. [}²^]
^{DOD a}^{nd VA:}^In^clu^d^{e th}^{e Departm}^eⁿ^t^of^L^a^{bor an}^{d th}^{e Social Secu}^rity
^A^d^mⁱⁿⁱ^str^a^tioⁿⁱⁿ^th^{e J}^oⁱⁿ^{t Ex}^ecu^tiv^{e Co}^uⁿ^c^{il to}^im^p^r^o^v^{e th}^{e tr}^an^sitioⁿ
^p^r^o^{cess. [}¹⁰^.²^]^Mak^e^tr^an^sitioⁿⁱⁿ^g^ser^v^icem^em^b^e^r^s^aw^ar^{e o}^f^SSDI^.
^[10.15]
^-T^RAUM^AT^{IC ST}^RE^{SS DISORDE}^{R (PT}^S^{D) AND T}^RAUM^AT^{IC B}^{RAIN INJ}^{URY (T}^B^I⁾
^SD^Co^ng^ress:^En^{able all Iraq an}^{d A}^f^g^h^aⁿⁱ^s^t^an^v^e^teran^s^w^h^{o n}^{eed P}^T^SD^VA:^Dev^e^lo^p^{a “}^h^o^{listic ap}^p^r^o^ach^{” to}^P^T^{SD, in}^v^o^lvⁱⁿ^g^tr^eatm^eⁿ^t^,
ⁱ^{ki/CRS-RL34408}^{care to}^receiv^e^{it f}^r^o^m^th^{e VA}^{, w}^ith^o^u^{t w}^a^itin^g^f^o^{r en}^ro^llm^en^{t o}^r^com^p^en^s^a^tion^,^an^{d v}^o^cation^a^{l as}^s^e^s^s^m^en^{t, an}^{d in}^clu^dⁱⁿ^g^clos^er
^g/w^dⁱ^sab^ility^ev^alu^a^tioⁿ^,^an^d^r^e^g^a^r^d^{less o}^f^th^eir^p^r^io^r^ity^statu^s^{. [}³^]^co^o^r^dⁱⁿ^a^tioⁿ^o^f^th^{e Veter}^aⁿ^s^Health^A^d^mⁱⁿⁱ^str^a^tioⁿ⁽^VHA⁾^an^d^Veter^aⁿ^s
^s^.or^B^e^ne^fi^t^s^A^d^mⁱⁿⁱ^st^r^a^tⁱ^o^{n (}^V^B^A⁾^,^wⁱ^t^h^r^e^-e^xa^mⁱ^na^tⁱ^o^{ns c}^o^nd^uc^t^e^d^e^v^e^r^y
^le^ak^tw^o^to^th^r^{ee y}^ear^{s. [}^Prⁱ^o^rⁱ^t^y^Recom^m^e^ndatⁱ^{on 5.30}^{] T}^h^{e com}^mⁱ^s^s^ion^als^o^m^a^ke^{s r}^e^c^o^m^m^e^nd^a^tⁱ^o^{ns r}^e^ga^r^dⁱ^{ng b}^e^ne^fi^t^s^,^t^r^aⁱⁿⁱ^{ng a}ⁿ^d^c^e^r^tⁱ^fⁱ^c^a^tⁱ^o^{n o}^f
^://wiki^raters^{, an}^{d data collection}^an^{d res}^earch^{, in}^clu^dⁱⁿ^g^res^earch^on^th^e^r^e^latioⁿ^s^hⁱ^p^b^e^tw^een^m^ilitar^y^sex^u^a^{l assau}^{lt an}^d^P^T^{SD. [}⁵^.2⁹^-⁵^.³³^]
^h^ttp
^{force and trai}^ning^{DOD and VA:}^Es^t^a^blⁱ^s^h^an^{d ex}^pan^dⁿ^e^t^w^ork^s^of^ex^pert^sⁱⁿ^PT^S^D^an^d^VA:^Estab^lish^{a stan}^d^a^r^d^ized^tr^ainⁱⁿ^g^p^r^o^g^r^a^m^f^o^r^clin^ician^s^w^h^o
^T^B^I^,^to^ex^p^aⁿ^d^tr^ainⁱⁿ^g^,^an^d^to^d^e^v^e^lo^p^o^r^dⁱ^ssemⁱⁿ^a^{te clin}^{ical p}^r^actice^con^d^u^c^{t ps}^y^c^hⁱ^{atric ev}^alu^a^tion^s^f^o^{r com}^p^en^s^a^tion^an^{d pen}^s^ion^ph^y^s^ical
^g^uⁱ^delin^es^{. B}^o^th^departm^eⁿ^t^s^m^u^s^t^w^o^rk^{to redu}^{ce th}^{e s}^tig^m^a^as^s^o^ciated^ex^am^s^{[5.32], an}^{d a certif}^ication^prog^ram^f^o^{r raters}^w^h^{o h}^aⁿ^d^{le P}^T^SD
^w^ith^P^T^{SD. [}³^]^claim^s^{. [5.33]}
^DOD:^A^ddres^s^s^h^ort^a^g^e^s^of^m^eⁿ^t^al^h^eal^t^h^prof^es^sⁱ^on^al^s^.^[3]
^VA:^{Update th}^{e VA}^SR^{D to ref}^l^{ect m}^odern^uⁿ^d^ers^t^an^din^g^of^P^T^{SD an}^d^VA:^Dev^e^{lop s}^p^ecifⁱ^{c VA}^SR^{D ratin}^g^{criteria f}^o^{r P}^T^{SD, an}^{d prioritize th}^e
^T^B^{I. [2]}^revⁱ^sⁱ^on^of^{criteria f}^o^{r oth}^e^{r m}^eⁿ^t^{al dis}^o^rders^an^{d T}^B^{I. [}^Prio^rity
^Recom^m^e^ndatⁱ^ons^{4.23 and 5.28}^]

CRS-10
^Pro^vⁱ^sioⁿ^{PCCWW Reco}^m^m^e^nda^tioⁿ^s^VDB^{C Reco}^m^m^e^nda^tioⁿ^s
^{FOR FAM}^I^L^I^E^S^{OF INJ}^URE^{D SE}^RVICE^M^E^M^B^E^R^S
^{No com}^p^{arable recom}^m^eⁿ^d^ation^.^Co^ng^r^e^ss:^A^u^t^h^ori^{ze an}^{d f}^uⁿ^d^V^A^t^o^es^t^a^blⁱ^s^h^an^{d prov}ⁱ^d^{e s}^u^pport
^ser^v^{ices f}^o^r^th^{e f}^a^m^{ilies o}^f^sev^e^r^e^lyⁱⁿ^j^u^r^e^d^v^e^ter^aⁿ^s^sim^ilar^to^th^o^s^e
^p^r^o^v^id^ed^b^y^{DOD, su}^ch^{as co}^uⁿ^s^elin^g^,^trav^{el an}^d^p^e^{r d}ⁱ^em^b^eⁿ^e^f^{its, an}^d
^as^sⁱ^s^t^an^{ce w}^ith^em^ploy^m^eⁿ^t^an^{d h}^ealth^{care w}^h^en^relocatin^g^{to as}^sⁱ^s^t^an
ⁱⁿ^j^u^{red s}^e^rvⁱ^cem^em^{ber. [10.12]}
^Co^ng^r^e^ss:^P^r^ov^{ide lif}^etim^{e T}^r^{icare com}^p^reh^eⁿ^s^iv^{e h}^ealth^{care an}^d^Co^ng^r^e^ss:^Ex^ten^d^elig^ib^ility^f^o^r^VA^’^s^aid^e^an^d^atten^d^an^{t b}^eⁿ^e^f^{it to}
^t^s^ph^arm^acy^ben^e^f^its^{to s}^e^rv^icem^em^bers^f^o^uⁿ^d^uⁿ^f^{it becau}^s^e^of^s^e^v^e^relyⁱⁿ^j^u^{red activ}^e-^du^ty^s^e^rv^icem^em^bers^w^h^{o are in}^m^e^{dical h}^o^{ld or}
^com^b^at-^r^{elated in}^j^u^ries^{, an}^{d th}^{eir de}^p^e^nd^eⁿ^t^s^.^[²^]^M^a^ke^c^o^m^b^a^t^-i^nj^ur^e^d^T^e^m^p^o^r^ar^y^Disab^ility^Retir^ed^Lⁱ^{st (}^T^DRL⁾^statu^s^p^eⁿ^dⁱⁿ^g^dⁱ^sch^a^r^g^e.
^s^e^rv^icem^em^bers^elig^{ible f}^o^{r res}^p^{ite care an}^{d aide an}^{d atten}^d^an^{t care in}^{[6.3] A}^d^j^u^s^t^th^{e am}^ouⁿ^t^of^pay^m^en^{t f}^o^{r aid an}^{d atten}^d^an^{ce to f}^u^lly^pay
^DOD’^{s T}^r^{icare Ex}^ten^d^ed^C^a^{re Health}^Op^tioⁿ^p^r^o^g^ram^.^[4^]^f^o^r^th^{e ex}^ten^t^o^f^assistan^{ce r}^e^q^u^ir^ed^{. [}⁶^.2^]^Ex^ten^d^elig^ib^ility^f^o^r^th^{e VA}^’^s
^Civ^ilian^Health^an^d^Medⁱ^{cal P}^r^o^g^r^a^m^to^car^eg^iv^er^{s, an}^d^cr^{eate a}
ⁱ^{ki/CRS-RL34408}^careg^iv^{er allow}^aⁿ^{ce f}^o^{r careg}^iv^ers^of^se^ve^r^e^l^y^dⁱ^sa^b^l^e^d^ve^t^e^r^a^ns.^[⁸^.¹^]
^g/w
^s^.or^DOD:^Elimⁱⁿ^{ate T}^r^{icare co-}^p^ay^s^an^{d dedu}^ctibles^f^o^{r s}^e^v^e^relyⁱⁿ^j^u^red
^le^ak^ser^v^icem^em^b^e^r^s^an^d^th^eir^f^a^m^{ilies. [}¹⁰^.¹⁷^]
ⁱ^ning^a^{nd co}^unseling^D^O^D^a^{nd VA:}^P^r^o^v^id^{e f}^a^m^{ilies o}^f^ser^v^icem^em^b^e^r^s^w^h^o^r^e^q^u^ir^e^Se^e^r^e^c^o^m^m^e^nd^a^tⁱ^o^{n 1}⁰^.¹²⁽ⁱ^{n ge}^ne^r^a^l⁾^a^b^o^v^e^.
^://wiki^loⁿ^g^-^ter^m^p^e^r^s^oⁿ^{al car}^{e w}^ith^ap^p^r^o^p^r^{iate tr}^ainⁱⁿ^g^an^d^co^uⁿ^s^elin^g^f^o^r^th^eir
^h^ttp^careg^ivⁱⁿ^g^roles^.^[4]
^m^ily^a^{nd M}^e^dica^l^Co^ng^r^e^ss:^L^eⁿ^g^t^h^eⁿ^t^h^{e F}^M^L^A^peri^{od f}^o^{r j}^ob-^prot^ect^{ed u}ⁿ^p^ai^{d l}^eav^e^{No com}^p^{arable recom}^m^eⁿ^d^ation^.
^v^e^{Act (FM}^L^A)^f^r^om^t^h^{e cu}^rren^t^{12 w}^o^rk^w^eek^s^t^o^{6 m}^oⁿ^t^h^s^{(26 w}^eek^s⁾^f^o^{r ot}^h^e^rwⁱ^s^e
^elig^ib^{le sp}^o^u^{ses an}^d^p^a^r^eⁿ^t^{s car}ⁱⁿ^g^f^o^rⁱⁿ^j^u^r^e^d^ser^v^icem^em^b^e^r^s^{. [}⁴^]
^AL^T^H^INFORM^AT^{ION M}^ANAG^E^M^E^N^T^{AND SHARING}
^e^nera^l^D^O^D^a^{nd VA:}^W^ithⁱⁿ^{12 m}^oⁿ^t^h^s^{, m}^a^k^e^patien^t^{data m}^o^{re acces}^sⁱ^ble^{DOD a}^{nd VA:}^Ex^pedi^t^e^dev^e^l^opm^en^t^an^{d i}^m^pl^em^en^t^a^tⁱ^oⁿ^of
⁽ⁱⁿ^itially^{, in}^vⁱ^ew^ab^{le f}^o^r^m⁾^.^A^{ll essen}^{tial h}^ealth^{, ad}^mⁱⁿⁱ^str^a^tiv^{e, an}^d^co^m^p^atib^{le in}^f^o^r^m^atioⁿ^sy^stem^{s in}^clu^dⁱⁿ^g^{a d}^e^tailed^p^r^o^j^{ect m}^aⁿ^a^g^e^m^eⁿ^t
^b^eⁿ^e^f^{its d}^a^{ta m}^u^{st b}^e^im^m^e^dⁱ^ately^vⁱ^ew^ab^{le b}^y^an^y^clin^ician^,^allied^plan^th^{at in}^clu^d^es^s^p^ecifⁱ^{c m}^iles^t^on^es^an^{d lead ag}^en^cy^as^sⁱ^gⁿ^m^en^t.
^h^eal^t^h^prof^es^sⁱ^on^al^{, or prog}^ram^admⁱⁿⁱ^s^t^rat^o^{r w}^h^{o n}^eedsⁱ^t^.^C^oⁿ^tⁱⁿ^u^e^t^h^e^[^Prⁱ^o^rⁱ^t^y^Recom^m^e^ndatⁱ^{on 10.11}^{] Im}^prov^{e electron}ⁱ^{c in}^f^o^rm^ation^record
^w^o^rk^uⁿ^d^{er w}^a^y^{to create a f}^u^llyⁱⁿ^{teroperable in}^f^o^rm^ation^s^y^s^t^em^th^at^tr^aⁿ^sfe^r^{s a}ⁿ^d^a^d^d^r^e^{ss issue}^s^o^f^lo^st,^mⁱ^ssing,^aⁿ^d^una^sso^cⁱ^a^t^e^d^p^a^p^e^r
^w^{ill m}^{eet th}^{e lo}ⁿ^g^-^ter^m^ad^mⁱⁿⁱ^str^a^tiv^{e an}^d^clin^{ical n}^eed^{s o}^f^{all m}^ilitar^y^records^.^[10.10]
^p^e^r^s^oⁿⁿ^e^{l o}^v^er^tim^{e. Dev}^e^lo^p^{a p}^l^an^f^o^r^{a u}^s^er^-^f^r^ien^d^ly^{, tailo}^r^e^d^w^e^b
^p^o^r^{tal w}^ith^ser^v^{ices an}^d^b^eⁿ^e^f^{its in}^f^o^r^m^atioⁿ^f^o^r^ser^v^ice-^m^e^m^b^er^s,^DOD:^T^o^ex^{pedite claim}^s^proces^sⁱⁿ^g^,^prov^{ide an}^au^th^en^{ticated electron}ⁱ^c
^v^e^ter^aⁿ^s^{, an}^d^f^a^m^ily^m^e^m^b^er^{s. [}⁵^]^D^D^{214 f}^o^rm^t^o^V^A^{. [10.9]}

CRS-11
^Pro^vⁱ^sioⁿ^{PCCWW Reco}^m^m^e^nda^tioⁿ^s^VDB^{C Reco}^m^m^e^nda^tioⁿ^s
^ng-term^{health effects}^{No com}^p^{arable recom}^m^eⁿ^d^ation^s^.^{DOD a}^{nd VA:}^Im^prov^{e th}^{e data lin}^k^a^g^e^betw^een^th^{e electron}ⁱ^{c h}^ealth
^{hazard ex}^pos^u^res^r^eco^r^d^d^a^{ta sy}^stem^{s u}^s^ed^b^y^Do^{D an}^d^VA^{, in}^clu^dⁱⁿ^g^cap^ab^{ilities f}^o^r
^h^aⁿ^d^lin^gⁱⁿ^dⁱ^vⁱ^d^u^{al so}^ld^ier^ex^p^o^s^u^r^{e in}^f^o^r^m^atioⁿⁱⁿⁱⁿ^dⁱ^vⁱ^d^u^{al h}^ealth
^records^.^{[5.23] Dev}^e^{lop a data in}^terf^{ace th}^{at allow}^s^VA^{to acces}^s^th^e
^electr^oⁿⁱ^{c ex}^p^o^s^u^r^{e d}^a^{ta sy}^stem^{s u}^s^ed^b^y^Do^{D. [}⁵^.2⁵^]^A^d^d^itioⁿ^a^l
^r^e^c^o^m^m^e^nd^a^tⁱ^o^{ns r}^e^ga^r^dⁱ^{ng p}^r^o^c^e^s^s^e^s^{to def}ⁱⁿ^e^s^e^rv^ice-^conⁿ^ected
^illn^{esses th}^{at m}^a^y^ar^{ise m}^aⁿ^y^y^ear^{s f}^o^llo^wⁱⁿ^g^ex^p^o^s^u^r^{e. [}⁵^.8^-⁵^.2⁷^]
^WAL^T^E^R^RE^E^D^ARM^{Y M}^E^DICAL^CE^NT^E^R^(WRAM^{C) UNT}^IL^IT^{S CL}^OSURE
^D^OD:^A^ssu^r^e^th^{at W}^R^A^M^{C h}^a^{s th}^{e r}^e^so^u^r^{ces it n}^eed^{s to}^m^aⁱⁿ^tain^a^{No com}^p^{arable recom}^m^eⁿ^d^ation^s^.
^s^t^an^{dard of}^ex^cellen^{ce in}^bothⁱⁿ^patien^t^an^{d ou}^tpatien^t^{care. Im}^plem^en^t
^tailo^r^e^dⁱⁿ^cen^tiv^{e p}^ack^ag^{es to}^en^co^u^r^ag^{e civ}^ilian^h^ealth^car^{e an}^d
^admⁱⁿⁱ^s^t^rativ^{e prof}^es^sⁱ^on^als^{to con}^tin^u^e^w^o^rkⁱⁿ^g^th^{ere an}^{d to en}^able
ⁱ^{ki/CRS-RL34408}^recru^itm^en^{t of}ⁿ^e^w^prof^es^sⁱ^on^als^,^asⁿ^{eeded. [6]}
^g/w^E^{OF SE}^RVICE^M^E^M^B^E^R^{S FROM}^T^H^E^M^I^L^I^T^ARY
^s^.or^nduct^-^rela^t^ed^{No com}^p^{arable recom}^m^eⁿ^d^ation^.^Co^ng^r^e^ss:^C^h^an^g^e^th^{e ch}^aracter-^o^f^-^d^is^ch^arg^e^s^t^an^{dard to requ}^{ire th}^at
^le^ak^rg^e^w^h^en^anⁱⁿ^di^vⁱ^du^alⁱ^s^di^s^c^h^a^rg^{ed f}^r^om^hⁱ^s^{or h}^e^{r l}^a^s^t^peri^{od of}^actⁱ^v^e
^://wiki^s^e^rvⁱ^{ce w}ⁱ^t^h^{a bad con}^d^u^c^t^{or di}^s^h^on^orabl^e^di^s^c^h^a^rg^{e, i}^t^bars^al^l^ben^e^fⁱ^t^s^.^[5.1]
^h^ttp
^{No s}^t^rictly^com^p^{arable recom}^m^eⁿ^d^a^tioⁿ^.^Fo^rⁱⁿ^j^u^r^e^d^ser^v^icem^em^b^e^r^s^,^Co^ng^r^e^ss:^A^d^eq^u^a^tely^f^uⁿ^d^an^d^m^aⁿ^d^{ate th}^{e T}^r^an^sitioⁿ^A^ssistan^ce
ⁱ^t^s^th^{e requ}^irem^en^{t f}^o^{r cas}^{e m}^aⁿ^a^g^e^m^eⁿ^t^(s^{ee dis}^c^u^s^sⁱ^on^of^cas^e^P^r^o^g^r^a^m^thr^o^ugho^{ut the}^m^ilita^r^y^to^eⁿ^sur^e^tha^t^a^{ll se}^r^v^ic^e^m^e^m^b^e^r^s^a^r^e
^m^aⁿ^a^g^e^m^eⁿ^t^{/ recov}^e^ry^plan^s^abov^{e) w}^o^u^l^{d en}^h^aⁿ^{ce s}^e^rv^icem^em^bers^’^kⁿ^o^w^l^edg^{eable abou}^{t ben}^e^f^its^bef^o^{re leav}ⁱⁿ^g^th^{e s}^e^rv^{ice. [10.4]}
^kⁿ^o^w^l^edg^e^of^an^{d acces}^s^{to ben}^e^f^its^f^o^{r w}^h^ich^th^ey^w^e^{re elig}^{ible. [1]}
^DOD:^Req^u^ir^{e a m}^aⁿ^d^ato^r^y^b^eⁿ^e^f^{its b}^r^iefⁱⁿ^g^to^{all sep}^a^r^a^tin^g^m^ilitar^y
^p^e^r^s^oⁿⁿ^e^{l, in}^clu^dⁱⁿ^g^Reser^v^{e an}^d^Natioⁿ^a^{l Gu}^ar^d^co^m^p^oⁿ^en^{ts, p}^r^io^r^to
^di^s^c^h^a^rg^{e f}^r^om^s^e^rvⁱ^{ce. [5.7]}
^{DOD a}^{nd VA:}^B^eⁿ^e^f^{its Deliv}^er^y^{at Disch}^a^r^g^{e sh}^o^u^ld^b^e^av^ailab^l^{e to}^all
^dis^a^{bled s}^e^paratin^g^s^e^rv^icem^em^bers^{, to in}^clu^d^{e Nation}^a^{l Gu}^{ard, R}^e^s^e^rv^e,
^an^d^m^e^dⁱ^{cal h}^o^ld^p^a^tien^t^{s. [}¹⁰^.⁵^]^Mak^e^tr^an^sitioⁿⁱⁿ^g^ser^v^icem^em^b^e^r^s
^aw^ar^{e o}^f^So^{cial Secu}^r^ity^Disab^ility^Iⁿ^su^r^aⁿ^{ce. [}¹⁰^.¹⁵^]