[Congressional Record Volume 163, Number 89 (Tuesday, May 23, 2017)]
[House]
[Pages H4475-H4476]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




IMPROVING THE TREATMENT OF MEDICAL EVIDENCE PROVIDED BY NON-DEPARTMENT 
               OF VETERANS AFFAIRS MEDICAL PROFESSIONALS

  Mr. ROE of Tennessee. Mr. Speaker, I move to suspend the rules and 
pass the bill (H.R. 1725) to amend title 38, United States Code, to 
improve the treatment of medical evidence provided by non-Department of 
Veterans Affairs medical professionals in support of claims for 
disability compensation under the laws administered by the Secretary of 
Veterans Affairs, and for other purposes, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 1725

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. REPORT ON PROGRESS OF DEPARTMENT OF VETERANS 
                   AFFAIRS ACCEPTABLE CLINICAL EVIDENCE 
                   INITIATIVE.

       (a) In General.--Not later than 180 days after the date of 
     the enactment of this Act, the Secretary shall submit to the 
     Committee on Veterans' Affairs of the Senate and the 
     Committee on Veterans' Affairs of the House of 
     Representatives a report on the progress of the Acceptable 
     Clinical Evidence initiative of the Department of Veterans 
     Affairs in reducing the necessity for in-person disability 
     examinations and other efforts to comply with the provisions 
     of section 5125 of title 38, United States Code.
       (b) Contents of Report.--The report required by subsection 
     (a) shall include the following:
       (1) The number of claims eligible for the Acceptable 
     Clinical Evidence initiative during the period beginning on 
     the date of the commencement of the initiative and ending on 
     the date of the submittal of the report, disaggregated by 
     fiscal year.
       (2) The total number of claims eligible for the Acceptable 
     Clinical Evidence initiative that required a medical examiner 
     of the Department to supplement the evidence with information 
     obtained during a telephone interview with a claimant.
       (3) Information on any other initiatives or efforts of the 
     Department to further encourage the use of private medical 
     evidence and reliance upon reports of a medical examination 
     administered by a private physician if the report is 
     sufficiently complete to be adequate for the purposes of 
     adjudicating a claim.
       (4) The anticipated impact on the timeline and accuracy of 
     a decision on a claim for benefits under chapter 11 or 15 of 
     title 38, United States Code, if the Secretary were 
     prohibited from requesting a medical examination in the case 
     of a claim in support of which a claimant submits medical 
     evidence and a medical opinion provided by a private 
     physician that is competent, credible, probative, and 
     otherwise adequate for the purpose of making a decision on 
     that claim.
       (5) Recommendations on how the Department can measure, 
     track, and prevent the ordering of unnecessary medical 
     examinations when the provision by a claimant of a medical 
     examination administered by a private physician in support of 
     a claim for benefits under chapter 11 or 15 of title 38, 
     United States Code, is adequate for the purpose of making a 
     decision on that claim.

     SEC. 2. ANNUAL REPORT ON SUBMITTAL OF PRIVATE MEDICAL 
                   EVIDENCE IN SUPPORT OF CLAIMS FOR DEPARTMENT OF 
                   VETERANS AFFAIRS BENEFITS.

       Not later than March 1 of fiscal years 2018 through 2024, 
     the Secretary of Veterans Affairs shall submit to Congress a 
     report that includes, for the calendar year preceding the 
     year in which the report is submitted, the following for each 
     regional office of the Department of Veterans Affairs:
       (1) The number of times a veteran who submitted private 
     medical evidence in support of a claim for compensation or 
     pension under the laws administered by the Secretary was 
     scheduled for an examination performed by Department 
     personnel because the private medical evidence submitted was 
     determined to be unacceptable.
       (2) The most common reasons why private medical evidence 
     submitted in support of claims for benefits under the laws 
     administered by the Secretary was determined to be 
     unacceptable.
       (3) The types of disabilities for which claims for benefits 
     under the laws administered by the Secretary were mostly 
     commonly denied when private medical evidence was submitted.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Tennessee (Mr. Roe) and the gentleman from Minnesota (Mr. Walz) each 
will control 20 minutes.
  The Chair recognizes the gentleman from Tennessee.


                             General Leave

  Mr. ROE of Tennessee. Mr. Speaker, I ask unanimous consent that all 
Members may have 5 legislative days in which to revise and extend their 
remarks and to insert extraneous material in the Record on H.R. 1725, 
as amended.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Tennessee?
  There was no objection.
  Mr. ROE of Tennessee. Mr. Speaker, I yield myself such time as I may 
consume.
  H.R. 1725, as amended, was introduced by my good friend Mr. Walz, the 
ranking member of the Committee on Veterans' Affairs.
  This bill addresses a very serious issue. When a veteran files a 
claim for disability benefits, VA may need a medical opinion regarding 
whether the injury or illness is service connected and, if it is, the 
extent of the veteran's disability. The problem is that the VA often 
schedules a medical disability examination when one might not be 
needed.
  Many times, a veteran will submit medical evidence from a private 
doctor with enough information for VA to decide the claim, but we hear 
about cases where VA still requires a VA examination. Ordering 
unnecessary disability examinations is a waste of time and resources. 
It takes doctors away from taking care of their patients and conducting 
other disability examinations.
  H.R. 1725, as amended, would require VA to provide reports to 
Congress about its use of private medical evidence. This information 
will be used to help us find ways to make the disability examination 
more efficient for veterans.
  I urge my colleagues to support H.R. 1725, as amended.
  Mr. Speaker, I reserve the balance of my time.
  Mr. WALZ. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise in support of this piece of legislation.
  I want to thank the chairman personally for bringing this forward and 
for being very eloquent in his words on what this does. It is 
appropriate that it is part of this block of legislation dealing with 
appeals reform also.
  I thank the folks who have worked on this for years: Mr. Denham, Mr. 
Langevin, Ms. McSally, Mr. Johnson, Mr. Costello, Ms. Kuster, Mr. 
Higgins of New York, and Ms. Shea-Porter.
  As originally introduced, this bill sought to change a current 
requirement stipulating that initial physical examinations of those 
seeking to file disability claims must be conducted by the VA. It was 
to allow veterans to see a local doctor.
  Again, as the chairman so clearly pointed out, it was to relieve some 
of the pressure on the VA, while recognizing we have quality, ethically 
trustworthy physicians in the private sector who can deliver some of 
these services. The idea was that requiring the VA to accept private 
medical evidence from a qualified physician would ease the benefit 
process in rural communities, expedite diagnosis of disabilities, and 
reduce the wait times and the backlogs.
  This is a problem that we have been working on for many years. We 
introduced similar language in 2013, 2014, and 2015.
  I would like to thank all my fellow members, both on and off the 
committee, and those who are no longer in Congress for working toward 
this. I am especially thankful to Chairman Bost and Ms. Esty for having 
worked with me to tighten the scope of this bill to address the cost 
that the Congressional Budget Office scored it to.
  As it is now, the bill requires an annual report on how veterans 
obtain private medical evidence in support of their claim, how often it 
is rejected, and why. It is my hope that this data will help build our 
case for mandating that the VA accept all credible private medical 
evidence. We cannot let the perfect be the enemy of the good and need 
to get started gathering this data as soon as possible.
  As we also work to improve the appeals process today, making it more 
convenient for veterans to get and submit medical evidence, this 
component will be important. By continuing our work on this issue, 
veterans will be able to complete their claims faster; start receiving 
the benefits that they have earned faster; and make sure that the 
stress you heard about with 20 years of waiting, much of that time

[[Page H4476]]

seeing private physicians and gathering evidence to support the very 
claim that is being denied, this piece of legislation should make sense 
with that.
  Again, Mr. Speaker, I thank everyone involved with this. I urge my 
colleagues to support this piece of legislation, H.R. 1725.
  Mr. Speaker, I yield back the balance of my time.
  Mr. ROE of Tennessee. Mr. Speaker, I wholeheartedly endorse this 
bill.
  Mr. Walz, Sergeant Major Walz, speaks with great passion about it. He 
has the Mayo Clinic in his district. I can't imagine an evaluation at 
the Mayo Clinic by physicians there wouldn't be adequate for the VA.
  I wholeheartedly support this bill, H.R. 1725, as amended. I urge all 
Members to also support it.
  I yield back the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from Tennessee (Mr. Roe) that the House suspend the rules and 
pass the bill, H.R. 1725, as amended.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill, as amended, was passed.
  The title of the bill was amended so as to read: ``A bill to direct 
the Secretary of Veterans Affairs to submit certain reports relating to 
medical evidence submitted in support of claims for benefits under the 
laws administered by the Secretary.''.
  A motion to reconsider was laid on the table.

                          ____________________