[Congressional Record Volume 153, Number 100 (Wednesday, June 20, 2007)]
[Senate]
[Pages S8077-S8078]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Ms. SNOWE:
  S. 1670. A bill to amend title 10, United States Code, to improve the 
management of medical care for members of the Armed Forces, to improve 
the speed and efficiency of the physical disability evaluation system 
of the Department of Defense, and for other purposes; to the Committee 
on Armed Services.
  Ms. SNOWE. Mr. President, I rise today to proudly join my friend and 
colleague Senator Blanche Lincoln in the introduction of the 
Servicemembers' Healthcare Benefits and Rehabilitation Enhancement Act 
of 2007.
  In March, I was able to visit one of Maine's returning soldiers who 
has been assigned outpatient care at the Walter Reed Army Medical 
Center. We spoke about the many issues and obstacles faced by our 
wounded troops as they struggle not only to recover from their 
injuries, but to prepare themselves for their future. During our 
meeting, this soldier covered many of the pitfalls faced by troops as 
they confront the bewildering processes of medical and physical 
evaluation boards without the benefit of anyone to advocate on their 
behalf. In fact, he aptly described the process as an ``adversarial'' 
system that onerously demands wounded soldiers to provide the ``burden 
of proof '' for their claims.
  In response, we have crafted this legislation in order to remedy a 
variety of flaws that currently plague the military health care system, 
including: Inequitable disability ratings, a lack of advocacy within 
military outpatient facilities, inadequate mental health treatment, and 
inefficient transition from the DOD to the VA.
  First off, our bill would address the concerns I have heard from a 
number of returning troops from my home State of Maine and across this 
Nation who have gone without the proper advocacy and case management 
for medical benefits during their stay at military outpatient 
facilities. It is inexcusable that our returning heroes are often 
forced to navigate the esoteric physical disability evaluation system, 
PDES, within an adversarial atmosphere.
  The measure we are proposing would require the Secretary of Defense 
to provide each recovering servicemember in a military medical 
treatment facility with a medical care manager who will assist him or 
her with all matters regarding their medical status, along with a 
caseworker who will assist each servicemember and his or her family in 
obtaining all the information necessary for transition, recovery, and 
benefits collection. Further, provisions we included will create a DOD-
wide ombudsmen office to provide policy guidance to, and oversight of, 
ombudsman offices in all military departments and the medical system of 
the DOD. Only then, will our returning servicemembers recover within an 
atmosphere that is based upon advocacy.
  Additionally, recent news reports and independent analysis have 
revealed troubling statistics regarding rampant inaccuracies within the 
military disability ratings system. According to Pentagon data analyzed 
by the Veterans' Disability Benefits Commission, since 2000, 92.7 
percent of all disability ratings handed out by physical evaluation 
boards, PEBs, have been 20 percent or lower. Under the current policy, 
those who receive disability ratings under 30 percent and have served 
less than 20 years of military service are discharged with only a 
severance check, deprived of full military retirement pay, life 
insurance, health insurance, and access to military commissaries.
  Further evidence of a troubled disability ratings system shows that 
since America went to war in Afghanistan and Iraq, fewer veterans have 
received disability ratings of 30 percent or more, inferring that the 
DOD may have lowered the ratings for injured troops who would have 
otherwise received a host of lifelong benefits. On top of that, it 
currently takes an average of 209 days for troops to complete the PDES 
process by receiving notification of potential discharge and a 
subsequent disability rating.
  As a means of fixing these blatant flaws within the military 
disability ratings system, this legislation consolidates the physical 
evaluation system by placing the informal and formal physical 
evaluation boards under one command, as a method of streamlining and 
expediting the process. Our troops deserve timely care and efficient 
treatment upon their return home, and therefore, no recovering 
servicemember should be forced to endure lengthy delays in a medical 
hold or holdover status due to bureaucratic inefficiencies.
  The bill also requires that physicians preparing each individual 
medical case for all physical evaluation boards report multiple 
diagnosed medical impairments that, in concert, may deem a 
servicemember to be unfit for duty. Under the current system, the U.S. 
Army, for example, only rates physical impairments that individually, 
cause a servicemember to be deemed unfit for duty, ultimately 
dismissing ailments that may significantly hinder a servicemember's 
ability to continue his or her service in the military or find gainful 
employment in the civilian sector.
  Over the past year, the American public has also become acutely aware 
of the effects of traumatic brain injury, TBI, which has become the 
signature injury of the wars in Iraq and Afghanistan, affecting 
thousands of returning servicemembers. Therefore, it is now more 
imperative than ever for both the DOD and the VA to implement mental 
health treatment policies that accurately diagnose and adequately treat 
debilitating mental health injuries among our injured troops.
  Our bill addresses these issues by including a provision that 
requires all servicemembers who are expected to deploy to a combat 
theater to receive a mental health assessment that tests their 
cognitive functioning within 120

[[Page S8078]]

days before deployment, a mental health assessment within 60 days after 
deployment, to include a comprehensive screening for mild, moderate, 
and severe cases of TBI. Additionally, all servicemembers will receive 
a third mental health assessment at the time of their predischarge 
physical.
  The measure we are putting forward today also aims to update the 
current disability ratings system used by the military and the VA to 
include the effects of TBI and posttraumatic stress disorder, along 
with any other mental health disorders that may affect our Nation's 
returning warriors. The Secretary of Veterans Affairs would be required 
to issue a report to Congress detailing a plan to update the Veteran's 
Administration Schedule for Ratings Disabilities, VASRD, to align its 
disability ratings to more closely reflect the effects of mental health 
disorders, including TBI and PTSD on the modern workforce.
  The Servicemembers' Healthcare Benefits and Rehabilitation 
Enhancement Act of 2007 also calls on the Secretaries of Defense and 
Veterans Affairs to provide Congress with a report detailing plans to 
increase the role of eligible private sector rehabilitation providers 
for assisting the VA in providing comprehensive post acute inpatient 
and outpatient rehabilitation for TBI and PTSD, if in certain 
instances, the VA is unable to provide such services.
  The Veterans Health Administration is, unequivocally, the foremost 
expert in providing mental health treatment for our recovering 
servicemembers, yet in varying circumstances, the VA may require 
additional health care coverage in remote areas. All of our returning 
heroes, despite the severity of their mental health ailments, or their 
location geographically, deserve every available option for 
rehabilitative services, to ensure that they never go untreated.
  Additionally, to help ease the transition from the military health 
care system to the VA system, both the DOD and the VA must adopt and 
implement a unified electronic medical database. Interagency database 
compatibility would not only increase medical efficiency, but it would 
significantly ease the transition into civilian life for injured or 
retiring servicemembers who deserve timely and effective health care. 
Therefore, our legislation establishes and implements a single 
electronic military and medical record database within the DOD that 
will be used to track and record the medical status of each member of 
the Armed Forces in theater and throughout the military health care 
process, and will be accessible to the VA through the joint patient 
tracking application, JPTA. This electronic records system will be 
identical to the VistA system, currently used by the VA, which has 
served as a model of excellence for electronic medical databases among 
our Nation's health community.
  I have nothing but the utmost respect for those brave Americans who 
served in uniform with honor, courage, and distinction. The obligation 
our Nation holds for its servicemembers and veterans is enormous, and 
it is an obligation that must be fulfilled every day. We must always 
remain cognizant of the wisdom laid forth by President George 
Washington, when he stated, ``The willingness with which our young 
people are likely to serve in any war, no matter how justified, shall 
be directly proportional as to how they perceive the Veterans of 
earlier wars were treated and appreciated by their country.''
  At a time when over 600,000 courageous men and women have returned 
from combat in both Iraq and Afghanistan, I believe it is now up to 
Congress to do everything in its power to answer the call of our men 
and women who have nobly served our Nation in uniform, to ensure that 
they receive the heroes treatment they rightly earned and rightly 
deserve. Again, I want to thank my colleague, Senator Lincoln, for her 
assistance in making this a stronger bill and bringing it before the 
Senate. I strongly urge my colleagues to support this legislation.
                                 ______