[Congressional Record Volume 153, Number 175 (Tuesday, November 13, 2007)]
[Senate]
[Pages S14248-S14253]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                           VETERANS DAY 2007

  Mr. AKAKA. Mr. President, over the past weekend, our Nation observed 
Veterans Day, a day to commemorate the connection between the American 
people and America's veterans. This connection is something that the 
American people are always aware of at the bottom of their hearts, 
though it may not always be in the front of our minds as we go about 
our daily lives.
  We Americans often define ourselves by the freedoms we enjoy. 
America's veterans are men and women who sacrificed some of their own 
freedoms to serve and defend our Nation. The connection between these 
two groups--the defended and the defenders--may not always be visible, 
but it cannot be denied. Veterans Day gave us the opportunity to recall 
that connection, to honor those who wore the uniform of our country.
  As chairman of the Committee on Veterans' Affairs, it has been my 
privilege to work alongside other leaders in answering a simple 
question: How do we best honor veterans? Having so recently celebrated 
Veterans Day, I am pleased to report on the committee's work in the 
areas of legislation and oversight to try to answer that question.
  The Committee on Veterans' Affairs has worked diligently to fulfill 
its oversight and legislative responsibilities, demonstrated in part by 
our hearing and meeting schedule. We have held 40 hearings and 
meetings, including 7 field hearings, since our organizational meeting 
in January. The committee has heard from 220 witnesses, and reported 4 
nominees to the Senate, each of whom was later confirmed.
  At our committee's very first meeting, I discussed my agenda to work 
with other members to bring the Department of Defense and the 
Department of Veterans Affairs together to provide a seamless 
transition for veterans from DOD to VA. We focused on seamless 
transition and set an agenda to pursue the issue in the coming year.

[[Page S14249]]

These actions were taken long before the horrible news reports about 
conditions at Walter Reed shocked the country into action. Our 
foresight positioned the committee, in collaboration with the Senate 
Armed Services Committee, to craft legislation that attacked the flaws 
within the DOD and VA systems. I am pleased that our legislative 
responses were incorporated into the National Defense Authorization 
Act. I look forward to seeing them become law.
  Two weeks after the organizational meeting, the committee held its 
first hearing, which was on VA and DOD cooperation and collaboration. 
We heard testimony from officials from VA and DOD, as well as the 
personal stories of veterans who slipped through the cracks during 
their transition from military service to veterans status. This would 
be the first of a number of hearings the committee would hold on VA and 
DOD cooperation and collaboration. Later hearings on this issue focused 
on specific areas such as health care, education, information 
technology, and benefits.
  In February, I contacted DOD on behalf of VA's Polytrauma Center 
health care providers so as to ensure that VA providers had easy and 
appropriate access to DOD's Joint Patient Tracking Application. This 
medical information sharing application is important to data sharing 
between VA and DOD. I was pleased when DOD responded shortly 
thereafter, providing assurance that they would resume their important 
data sharing practices.
  The decision to focus on cooperation and collaboration between DOD 
and VA was made well before news broke on the deplorable conditions at 
Walter Reed. As these news stories moved questions about veterans care 
into the forefront of America's attention, our committee put our focus 
on the total system of care, involving DOD and VA.
  Shortly after the press revelations of problems at Walter Reed Army 
Medical Center, I visited Walter Reed, along with my good friend and 
colleague, Senator Carl Levin, chairman of the Senate Armed Services 
Committee. On the way back to the Capitol from that visit, we agreed to 
hold an unprecedented joint hearing of the Armed Services and Veterans' 
Affairs Committee on the issue of DOD-VA cooperation and collaboration. 
On April 12, we held that hearing, further pursuing answers both about 
what was happening at Walter Reed and how we could fix it and about the 
overall state of the relationship between the two Departments.
  From that hearing and subsequent work on the problems at Walter Reed 
and elsewhere in both the DOD and VA systems, and how those problems 
affected wounded servicemembers, it was clear that a commonsense 
approach was needed.
  One specific focus of that effort was on how to reform the DOD 
disability system so as to promote greater uniformity among the 
services and between the services and VA. On April 30, I introduced S. 
1252, a bill that would mandate a number of changes to the DOD 
disability evaluation system, including uniform use of the Veterans 
Affairs rating schedule across the military services, inclusion of all 
conditions which render a member unfit when making a disability rating, 
uniform training of Medical Evaluation Board/Physical Evaluation Board 
personnel, and accountability by DOD to ensure compliance with 
disability rating regulations and policies.
  Just as veterans and servicemembers benefit when VA and DOD work 
together, the Committee on Veterans' Affairs and the Senate Committee 
on Armed Services saw an opportunity to collaborate on legislative 
solutions. All of the provisions of S. 1252 were included as part of S. 
1606, the joint SVAC and SASC proposed Dignified Treatment of Wounded 
Warriors Act of 2007, which was later included in the 2008 National 
Defense Authorization Act.

  While demands on VA have dramatically increased over recent years, VA 
funding has not. To allow the hard working men and women of VA to do 
their jobs without having to worry about whether there will be 
sufficient funding, we have sought a substantial increase to VA 
funding. I am pleased that the funding level in VA's fiscal year 2008 
appropriations bill amounts to the largest funding increase in the 
history of the Department.
  The appropriations bill also includes significant increases that will 
enable the Veterans Benefits Administration to pay for up to 3,100 new 
full-time employees. I hope the VBA will use these funds to attack the 
current backlog of veterans' claims aggressively. I will continue to 
work with my colleagues to enact this historic and long overdue 
increase in funding for veterans.
  In working on the legislative front, the committee has taken a 
collaborative approach with other Members of the Senate and the House 
of Representatives. Our focus has been on getting good law enacted, 
whatever the vehicle. I am pleased to report on the committee's 
progress on many pieces of legislation, some of which have already been 
enacted into law.
  As we continue to pursue adequate funds to pay for the true cost of 
war, we must also recognize that the nature of the battles our troops 
are fighting has changed as well. VA health care must be better 
prepared to address traumatic brain injury, the signature wound of the 
current war. To improve VA's diagnosis, treatment, and rehabilitation 
for traumatic brain injuries, I introduced S. 1233, the proposed 
Traumatic Brain Injury and Health Programs Improvements Act of 2007. 
This bill, amended to include a number of other health care provisions, 
was reported by the committee. In addition, many of the provisions of 
S. 1233 were later incorporated into the Wounded Warriors Act and the 
National Defense Authorization Act.
  S. 1233 would increase access to VA health care for combat veterans, 
extending the period of eligibility during which recently released or 
discharged combat veterans have unfettered access to VA care from 2 to 
5 years. This provision will help ensure that these newest combat 
veterans have more time to identify and deal with invisible wounds, 
such as traumatic brain injury and PTSD. Another key provision of the 
bill relating to the treatment of invisible wounds is a requirement 
that VA provide a servicemember with a mental health evaluation within 
30 days of making such a request.
  S. 1233 also would enhance care for older veterans already in the VA 
system. It would repeal the 2003 VA regulation which barred Priority 8 
veterans, so-called ``higher-income'' veterans, from enrolling in the 
VA health care system, essentially re-opening the system to these 
veterans. Many issues have been raised this year with regard to access 
to VA care for veterans residing in more rural areas, and S. 1233 
includes an entire section aimed at looking at ways to increase access 
for rural veterans.
  I am also very proud of the provisions in S. 1233 that seek to expand 
and enhance services for homeless veterans. We all recognize the sad 
reality that veterans suffer disproportionately from homelessness. S. 
1233 would not only increase the resources available to community-based 
entities that provide reintegration services to those who are already 
homeless, it would also provide supportive services to low-income 
veterans to help prevent homelessness.
  This bill also contains a significant increase in the travel 
reimbursement benefit paid to certain veterans who are forced to 
commute long distances to access care at VA facilities. The current 
mileage reimbursement rate is only 11 cents per mile, and this rate has 
not been increased since 1978. The committee bill would increase the 
rate to 28 cents per mile--a substantial increase and one that will 
hopefully help ease the financial burden for those who have to travel 
sometimes hundreds of miles to get to a VA hospital or clinic.
  Two other health care bills that I introduced this year are currently 
moving through the committee process--S. 2160, the proposed Veterans 
Pain Care Act of 2007, and S. 2162, the proposed Mental Health 
Improvements Act of 2007. The committee is scheduled to mark up both of 
these bills, along with two others, tomorrow. I hope to see each of 
them passed by the end of this year.
  For too many veterans, returning home from battle will not bring an 
end to conflict. They will return home, but the things they have done 
and seen in combat will follow them. Invisible wounds such as PTSD are 
complicated and can manifest themselves in many different ways. Studies 
have estimated that as many as 1 out of every 5 Iraq

[[Page S14250]]

war veterans are likely to suffer from readjustment issues. It is clear 
that action is necessary on the part of Congress to ensure that VA is 
equipped to deal with these issues.
  In April, the committee held a hearing dedicated to veterans' mental 
health concerns and VA's response. We heard very compelling testimony 
from witnesses who suffered the consequences of invisible wounds in 
their families and their own lives. Randall Omvig spoke of his son's 
suicide upon returning from Iraq. Tony Bailey spoke of his son's 
struggle with substance abuse, and of his ultimate death from it. 
Patrick Campbell shared his own experience with PTSD and the 
experiences of his fellow servicemembers. Their touching and often 
painful stories put human faces on an issue that is to often reduced to 
numbers.

  The proposed Mental Health Improvements Act is a direct outgrowth of 
that hearing and the testimony given by those who have suffered with 
mental health issues and by their family members. The bill addresses 
the immediate needs of veterans by ensuring high quality mental health 
services at VA facilities and in their communities. The measure also 
seeks to address the plight of veterans who suffer both from PTSD and 
substance abuse.
  S. 2160, the proposed Veterans Pain Care Act of 2007, would enhance 
VA's pain management program. It is estimated that nearly 30 percent of 
Americans--some 86 million people--suffer from chronic or acute pain 
every year. A recent study conducted by VA researchers in Connecticut 
found that nearly 50 percent of veteran patients that are seen at VA 
facilities reported that they experience pain regularly.
  While pain increases in severity with age, it is also a growing 
problem among younger veterans who have been injured in the wars in 
Iraq and Afghanistan. Many of these veterans are coming home with 
severe injuries--often traumatic brain injuries--that require intensive 
rehabilitation. In some cases, younger veterans will have to live with 
the long-term effects of their injuries, of which pain is a large and 
debilitating part.
  Pain management is an area of health care that by many accounts is 
not yet to up to par, in both the private and public sectors. S. 2160 
would standardize VA's pain management program on a national, 
systemwide level, by requiring VA to establish a pain care initiative 
at every VA health care facility. Every hospital and clinic would be 
required to employ a professionally recognized pain assessment tool or 
process, and ensure that every patient who is determined to be in 
chronic or acute pain is treated appropriately. The bill also calls for 
comprehensive research on pain management to improve care for chronic 
pain.
  During this session, I introduced S. 1163, the proposed Blinded 
Veterans Paired Organ Act of 2007, a bill that would offer enhanced 
benefits to veterans who suffer from service-connected impairment of 
vision. The bill was amended in committee and the language that was 
favorably reported to the full Senate was inserted into H.R. 797, the 
House companion, and passed on November 2. The Senate-passed H.R. 797 
would broaden the benefit eligibility requirements for two distinct 
groups of veterans with impaired vision due to service--those with 
service-connected blindness in one eye who subsequently suffer loss of 
vision in the other eye later in life and those who receive special 
monthly compensation for multiple disabilities, including vision 
impairment.
  The amended bill also includes a series of provisions that would 
enhance memorial and burial benefits for veterans and private 
cemeteries, including permanently authorizing VA to provide government 
headstones or markers for the privately marked graves of veterans 
interred at private cemeteries; instructing VA to design a medallion or 
other device to signify a decedent's veteran status, to be placed on a 
privately purchased headstone or marker, as an alternative to a 
Government-Furnished headstone or marker; extending the time limit for 
States to be reimbursed for the unclaimed remains of veterans; and 
authorizing $5 million for operational and maintenance expenses at 
State cemeteries. The provisions in the bill are fully paid for through 
legislative repeal of a Court of Veterans Appeals decision which 
inappropriately extended a needs-based benefit to a population that 
Congress did not intend to receive it.
  Because inflation erodes the value of the dollar, Congress is 
responsible for adjusting compensation for service-connected 
disabilities. This year I sponsored S. 423, the proposed Veterans' 
Compensation Cost-of-Living Adjustment Act of 2007. The veterans' COLA 
legislation ensures that the purchasing power of veterans' benefits, 
including compensation for veterans and assistance for their survivors, 
is maintained. This annual COLA is done in recognition of the Nation's 
gratitude towards veterans young and old for their service and 
sacrifices.
  As the sponsor of the Senate version of this bill, I was pleased to 
support the passage of the House companion, H.R. 1284. I applaud 
Congress and the President for their work in making it law as of 
Monday, November 5, 2007. I hope veterans, including the 17,000 
recipients of compensation who are served by VA's Honolulu Regional 
Office, benefit from this demonstration of our appreciation.
  Oversight investigations carried out by committee staff uncovered 
concerns in the veterans' benefits system as well. To improve the 
benefits system, the committee reported S. 1315, the proposed Veterans' 
Benefits Enhancement Act of 2007. This bill would improve veterans' 
life insurance, adaptable housing, education benefits, and provide the 
committee with more oversight data. It would also address a 60-year 
wrong that is still being done to Filipino veterans who served under 
the U.S. Armed Forces during World War II.
  In the years since the end of the Second World War, Filipino veterans 
and their advocates, especially my distinguished colleague, Senator 
Inouye, have worked tirelessly to secure these veterans the status they 
were promised when they agreed to fight under U.S. command in defense 
of their homeland and to protect U.S. interests in the region.
  This bill would also more than double the maximum amount of Veterans 
Mortgage Life Insurance that a service-connected disabled veteran may 
purchase from $90,000 to $200,000. The VMLI program was established in 
1971 and is available to those service-connected disabled veterans who 
have received specially adapted housing grants from VA. In the event of 
the veteran's death, the veteran's family is protected because VA will 
pay the balance of the mortgage owed up to the maximum amount of 
insurance purchased.
  The measure would also establish a new program of insurance for 
service-connected disabled veterans that would provide up to a maximum 
of $50,000 in level premium term life insurance coverage. This new 
program would be available to service-connected disabled veterans who 
are less than 65 years of age at the time of application. Under the new 
program, eligible service-connected veterans would be able to purchase, 
in increments of $10,000, up to a maximum amount of $50,000 in 
insurance.
  S. 1315 would also increase the amount of supplemental life insurance 
available to totally disabled veterans by 50 percent, from $20,000 to 
$30,000. This provision stems from S. 643, the proposed Disabled 
Veterans Insurance Act of 2007, which I introduced in February of this 
year. Many totally disabled veterans find it difficult to obtain 
commercial life insurance. This legislation will give totally disabled 
veterans better life insurance, a small measure of support for veterans 
who sacrificed so much.
  In addition, this bill would expand eligibility for retroactive 
benefits from traumatic injury protection coverage under 
Servicemembers' Group Life Insurance. This insurance program went into 
effect on December 1, 2005. All insured servicemembers under SGLI from 
that point forward were covered under traumatic injury protection 
regardless of where their injuries occur. However, individuals 
sustaining traumatic injuries between October 7, 2001, and November 30, 
2005, which were not incurred as a direct result of Operations Enduring 
or Iraqi Freedom, are not eligible for a retroactive payment under the 
traumatic injury protection program. S. 1315 would expand eligibility 
to these individuals.

[[Page S14251]]

  The reported bill would allow for home improvements for totally 
disabled servicemembers prior to release from active duty. This 
provision is very important because many servicemembers return home to 
finish their rehabilitation and recuperation prior to discharge from 
the military. Their homes need to be adapted so that they can live 
comfortably and independently.
  S. 1315 also contains a number of provisions derived from S. 1215 
which I introduced on April 25 that would make four small but necessary 
changes in existing laws relating to education and employment. First, 
it would restore the funding cap on the amount of funding available for 
State Approving Agencies to the fiscal year 2007 level of $19 million. 
Without this restoration, these entities that assist VA in approving 
programs of education would be facing a reduction of more than 30 
percent beginning in fiscal year 2008. It is particularly important for 
SAAs to have adequate resources as more veterans return to civilian 
life and begin to use their educational benefits.
  Second, it would update the special unemployment study required to be 
submitted by the Secretary of Labor to the Congress by requiring that 
it cover veterans of Post 9/11 Global Operations. It would also require 
the report to be submitted on an annual, rather than a biennial, basis. 
By updating this report, we will have more data available to us on more 
recent groups of veterans those who served and are serving in the Gulf 
War and Post 9/11 Global Operations. This should better help us assess 
the needs of current veterans entering the work force and develop 
appropriate responses.
  Third, the bill would extend for 2 years a temporary increase in the 
monthly educational assistance allowance for apprenticeship or other 
on-the-job training. Eliminating the temporary increase would mean a 
monthly benefit rate cut on veterans enrolled in this type of training 
and remove marketable incentive to encourage individuals to accept 
trainee positions they might not otherwise consider.
  Finally, the bill would provide for a waiver of the residency 
requirement for State veterans' employment and training directors. By 
giving the Secretary of Labor the ability to waive the 2-year residency 
requirement, this provision would help ensure that the best qualified 
individuals from any state may be considered for SDVET vacancies.
  Both S. 1233 and S. 1315 were reported to the Senate in late August 
and have been pending floor action ever since. It is most unfortunate 
that we have been unable to reach agreement to proceed to their 
consideration, due in part to an abrupt and unexpected change in the 
minority committee leadership. Late last week, just days before 
Veterans Day, the other side of the aisle affirmatively blocked 
consideration of this important legislation that has the support of a 
majority of the members of the Veterans' Affairs Committee. Let me be 
clear--I do not expect all Members to support or agree with these 
bills, only to allow for their consideration by the full Senate. If 
members have amendments to offer, bring them forward. We can then craft 
an agreement under which the Senate might do its work and debate these 
bills.

  One final legislative item that I wish to mention--recently, I worked 
with my colleague Senator Webb on a matter of symbolic and real 
importance to servicemen and women as well as to veterans. Concerned 
that the Department of the Army was in a rush to replace the Tomb of 
the Unknown at Arlington National Cemetery, I introduced an amendment 
to the National Defense Authorization Act requiring the Army to prepare 
a comprehensive report for Congress before any further action could be 
taken. I am hopeful that this provision will be in the final agreement 
on the NDAA and look forward to the report, and its recommendations on 
how to best steward this national treasure.
  As chairman of the Senate Veterans' Affairs Committee, I am mindful 
of the employment issues facing veterans, members of the Guard and 
Reserves, and their families as they seek to move from the military to 
the civilian workforce. Making this transition is never easy, and for 
younger veterans it can be particularly difficult. For members of the 
National Guard and Reserves, returning to a job they previously held 
may be challenging for a variety of reasons. For family members, the 
uncertainty of multiple and extended deployments poses different 
obstacles. Finally, the obstacles facing those who are disabled during 
their service can sometimes seem overwhelming. The needs of these 
individuals deserve our utmost attention and resources.
  The committee has held two oversight hearings on employment issues 
this session. The more recent of the two hearings focused specifically 
on the Uniformed Services Employment and Re-employment Rights Act of 
1994, or USERRA. As our troops are returning home from battle, many of 
them seek to return to the jobs that they held prior to their military 
service, particularly those serving in Guard and Reserve units. I must 
admit to being particularly upset at the volume of USERRA claims 
related to Federal service. It is simply wrong that individuals who 
were sent to war by their government should, upon their return, be put 
in the position of having to do battle with that same government in 
order to regain their jobs and benefits.
  It is well known that veterans make good employees. Despite the 
challenges many face, veterans across the country are working and 
excelling in the labor force. They know how to work and they bring with 
them a wealth of expertise and experience. I believe the employment 
data supports my belief since rates of unemployment for veterans 
generally are lower than their nonveteran counterpart. However, the 
rate of unemployment for younger veterans and those recently separated 
from active duty tends to be higher than their nonveteran peers. I 
pledge to continue to pursue these issues aggressively in the months 
ahead.
  The issues regarding veterans' educational benefits are especially 
important to me. Having attended college at the University of Hawaii 
under the original World War II GI bill, I know the value of this 
important benefit first hand.
  The complexity and the importance of the issues surrounding the 
various education assistance programs administered by VA have been 
heard at two hearings this session. I plan to build off of the findings 
from both hearings for the committee's future work in this area. 
Educational assistance benefit has an important role in terms of a 
readjustment benefit for returning veterans and servicemembers. 
Properly tailored, these same benefits form an important keystone in 
recruiting and retaining high caliber young men and women in the Armed 
Forces. The balance between these twin goals is very complex and needs 
careful examination.
  I am concerned that the current structure of benefits has some flaws. 
It is disturbing to me that servicemembers who are in the line of fire 
and who place their own safety in jeopardy in service to our country 
have to pay for their educational benefits. It is also disturbing that 
members of the Guard and Reserve who complete multiple deployments in 
combat situations run the risk of having no educational benefits 
available to them.
  I do not expect to see a quick or easy answer for veterans' education 
benefits reform. I believe we will need to build a foundation for 
cooperation, compromise and consensus building. That will take some 
time. But I believe this process has begun, and that by working 
together, we will be able to develop something that is really 
meaningful to veterans, their families, and their futures.
  As I noted earlier, the committee held seven field hearings over the 
year. The first, chaired by Senator Brown, was held on May 29, 2007, in 
New Philadelphia, OH, and focused on the issues facing veterans in the 
rural areas of Appalachia. Two months later, the committee held its 
second field hearing, chaired by Senator Testor, again focusing on the 
needs of rural veterans. This hearing was held on July 21, 2007, in 
Great Falls, MT. These hearings, along with the insights of our 
committee members, enabled the committee to develop and mark up 
legislation to address certain issues facing rural veterans.
  On August 17, 2007, Senator Murray chaired a field hearing in Tacoma, 
WA. The hearing focused on the mental health care services available to 
veterans and servicemembers in the State of Washington.

[[Page S14252]]

  In August, I chaired a series of field hearings in my home State of 
Hawaii, on the islands of Maui, Oahu, and the Big Island. These 
hearings brought high-ranking VA officials from Washington, DC, to 
examine the state of VA services for Hawaii's veterans and returning 
servicemembers.
  On August 28, 2007, the committee held a field hearing in Augusta, 
GA, on cooperation and collaboration between VA and DOD, chaired by 
Senator Isakson. The specific focus of the hearing was on VA and DOD 
care for wounded servicemembers returning from Afghanistan and Iraq.
  The committee has also carried out aggressive oversight activity 
during this session. Since January, the majority staff has conducted 95 
days of oversight involving 28 trips to 18 states as well as to Korea, 
Guam and American Samoa. Oversight investigations have included visits 
to nine separate VA regional offices.
  During these nine visits, oversight staff reviewed a total of 119 
individual veteran claim files, including 45 claim files for members of 
the National Guard and various Reserve units. Claims were selected for 
review based upon claims for service-connected disability due to 
traumatic brain injuries, posttraumatic stress disorder, or 
musculoskeletal conditions. In particular, the reviews were conducted 
to identify any systemic problems impeding the fair and efficient 
adjudication of veterans' claims.
  On a national level, one of the most critical issues identified by 
the claims review was a VA regulation which resulted in the denial of a 
rating higher than 10 percent for almost all traumatic brain injuries, 
or TBI, claims. As noted earlier, TBI has been described as a signature 
wound of the current conflicts. Medical evidence supports the view that 
severe long-term consequences can result from blast injuries 
involving improvised explosive devices, or IED, such as those used in 
Iraq and Afghanistan. Despite this, VA adjudicators believed that they 
could not authorize a rating in excess of 10 percent, or $115 per 
month, because of a current VA regulation.

  Upon learning of this problem, I contacted VA's Under Secretary for 
Benefits, Daniel Cooper, to ask why veterans with migraine headaches 
were eligible for higher disability ratings than combat veterans with 
TBI. I was pleased when Under Secretary Cooper informed me that VA 
adjudicators have been instructed to stop limiting ratings to 10 
percent if not warranted. However, because Under Secretary Cooper's 
instruction is not binding upon the Board of Veterans Appeals or the 
United States Court of Appeals for Veterans Claims, I also wrote to the 
Acting Secretary for Veterans Affairs, Gordon Mansfield, to ask that 
the ``10 percent and no more'' regulation be rescinded. I understand 
that VA is now working on new regulations for the adjunction of TBI 
claims which will hopefully resolve this matter. I will continue to 
monitor these claims and VA's actions.
  In addition to the restrictive instruction in the rating schedule, it 
appears that neither the military services nor VA are providing 
comprehensive and thorough evaluations of veterans with mild and 
moderate TBI. While veterans who are being treated at polytrauma 
centers appear to be getting appropriate diagnosis and treatment, this 
is not true for veterans with significant, but less severe injuries. I 
believe that it is imperative that veterans with silent wounds, such as 
mild and moderate TBI have a comprehensive evaluation of their signs 
and symptoms by appropriate medical specialists. New data, such as the 
recently released information from VA that nearly 6 percent of the 
veterans from Iraq and Afghanistan screened have sustained traumatic 
brain injuries, adds to the importance of legislation that improves 
VA's ability to respond aggressively.
  Review of service medical records for claims involving PTSD indicated 
poor follow-up, assessment and referral of servicemembers who endorsed 
symptoms of PTSD on postdeployment surveys. This matter has been noted 
by the GAO and others. In some cases, veterans were discharged for a 
``personality disorder'' which was not manifested prior to combat 
exposure and with no evaluation of classic PTSD symptoms. In other 
cases, veterans with significant psychiatric symptoms were not 
considered for a military disability retirement, but were awarded 
benefits by VA upon discharge.
  The committee's oversight investigations indicate that VA generally 
did a better assessment of claims for service-connected PTSD than the 
military services. However, for some disorders, VA will not grant 
service-connection for the small number of veterans who were diagnosed 
with PTSD during military service without independent verification of 
the stressor which gave rise to the diagnosis by military doctors. Some 
veterans who served in Iraq, but did not receive a medal acknowledging 
their participation in combat, have experienced difficulty establishing 
their ``personal participation in combat'' in order to validate the 
existence of a combat stressor.
  Under current law, veterans who allege disabilities related to their 
combat experience may prove their claim without presentation of 
official military documents. In order to clarify this issue and provide 
combat veterans with the benefits intended, I recently introduced S. 
2309, the proposed Compensation for Combat Veterans Act. This bill 
would provide that service in a combat zone, recognized as such under 
the Internal Revenue Code, shall be sufficient proof that the veteran 
engaged in combat for purposes of the relaxed evidentiary requirement. 
I hope that we will be able to address this issue in the coming months.
  There is no question that the Guard and Reserve have experienced 
difficulties due to our current combat engagements, in a fashion quite 
similar to branches such as the Army and Marine Corps. There is some 
concern that members of the National Guard and Reserve units receive 
less favorable consideration of their service-connected claims than 
members of the Armed Forces. While oversight investigations did not 
substantiate allegations of less favorable treatment for Guard and 
Reserve claimants, other issues may require further analysis. Many 
regional office staff reported significant difficulties in obtaining 
copies of the medical records of members of the Guard and Reserve. As a 
result, I wrote to the National Guard Bureau to express my deep concern 
about a policy that I had been told exists in some states that requires 
National Guard members to sign a release form before their Service 
Medical Records can be shared with VA for purposes of adjudicating a 
claim for compensation benefits. Acting upon my request, the National 
Guard Bureau sent guidance to the field that removes the requirement 
that servicemembers sign release forms to have their records provided 
to VA.
  VA cannot be expected to end the benefits backlog if it lacks the 
staff to adjudicate veterans claims. While VA froze hiring in this 
area, there has been an increase in the number and complexity of claims 
received. As a consequence, the backlog has ballooned beyond already 
disconcerting levels. Although the infusion of additional monies for 
staff should improve the situation, some offices have too few 
experienced staff compared to the number of new hires. Oversight 
studies have found that less experienced staff is more likely to make 
errors on veterans' claims.
  In some cases, service medical records are maintained in an 
electronic format and are not provided to VA adjudicators in any form. 
In other cases, medical reports are scanned into the Veterans Health 
Administration electronic records, but are not able to be viewed by VA 
adjudicators who use a CAPRI system to access VHA records. I have 
questioned VA about the need to make these records available to VBA and 
am awaiting a response.
  While the committee does much direct oversight, as chairman, I also 
rely on the VA's inspector general. Indeed, the IG has consistently 
served as the committee's right hand in the execution of our oversight 
responsibilities. In the last year alone, the IG has provided us with a 
number of professional inquests and reports on issues of critical 
importance to veterans' health care. In the areas of traumatic brain 
injury, mental health, and substance abuse, among others, the IG has 
identified the problems and solutions with an insightfulness that few 
can match. The IG has also responded to my investigation requests in an 
efficient and collegial manner. The IG is, without question, the 
central gear in VA's internal

[[Page S14253]]

controls and quality assurance mechanism.
  All American's have a role to play in honoring veterans. Ordinary 
citizens give in extraordinary ways, such as volunteering at VA 
hospitals and VA shelters, and supporting local Veterans Service 
Organizations. For those of us who serve in Congress, we have a special 
privilege and responsibility to honor veterans by ensuring that they 
receive the benefits and care they have earned through service. This 
Congress has done much for veterans already, but there is more to be 
done.
  The Committee on Veterans' Affairs will continue to do its share 
throughout this Congress. To name just two items of pending business, 
we will hold a markup tomorrow on pending legislation, including a bill 
that is designed to improve significantly VA's programs which address 
the mental health needs of veterans, especially those recently returned 
from combat, and second, the Committee is preparing to consider the 
nomination of Dr. James Peake to become Secretary of Veterans Affairs.
  I close with this thought: On the battlefield, one never leaves 
behind a fallen comrade. Similarly, veterans should never be left 
behind by a system designed to care for and honor them. We cannot stand 
by while veterans who have fought for our country have to fight to get 
the care and benefits they have earned through their service. The 
Committee on Veterans' Affairs will respond to whatever challenges may 
arise in our work on behalf of those who rose up to defend and serve 
our Nation. To our veterans: Our thoughts, prayers, gratitude, honor 
and pride are with you, not only on Veterans Day, but always.

                          ____________________