The single separation exam  program is designed to provide a single physical exam that can be used to  meet the physical exam requirements of the military services and VA. In September 1998, DOD’s  Assistant Secretary of Defense for Health Affairs issued a policy to the  Assistant Secretaries for the Army, Navy, and Air Force stating that  servicemembers who leave the military and intend to file a claim for VA  disability benefits should undergo a single physical exam for the military  services and VA.

	VA and the Military Services Have Established Some Single Separation Exam Programs, But Program Monitoring Is Lacking Despite Plans for Expansion

Since 1998, VA and the military services have collaborated to establish  single separation exam programs using various approaches to deliver the  exams, including those used in the original pilot program. However, while  we were able to verify that the exams were being delivered at some  installations, DOD, its military services, and VA either could not provide  information or provided us with inaccurate information on program sites. Although VA reported that 28 of 139 BDD sites had programs in place as of  May 2004, we found that 4 of the 8 sites we evaluated from VA’s list did not  actually have a program in place. Nonetheless, VA and DOD leadership  continue to encourage the establishment of single separation exam  programs and have drafted a new MOA that contains a specific  implementation goal to have programs in place at all of the BDD sites by  December 31, 2004—an ambitious goal given the seemingly low rate of  program implementation since 1998 and the lack of accurate information  on existing programs. However, when we evaluated programs at 8 of these installations, we  found that 4 of the installations did not actually have programs in place. For example, the draft MOA delegates  responsibility for establishing single separation exam programs to local VA  and military installations, based on the medical resources—including  physicians, laboratory facilities, examination rooms, and support staff— available to conduct the exams and perform any additional testing. In fiscal year 2003, the military services administered  separation exams for an estimated one-eighth of servicemembers who left  the military. Another challenge to establishing  these programs is that some military officials told us that they need their  resources, such as space and medical personnel, for other priorities,  including ensuring the health of active duty servicemembers. The Military Services May Not Benefit from Single Separation Exam Programs Due to Their Infrequent Use of Separation Exams

Despite increased convenience for individual servicemembers, the military  services may not benefit from single separation exam programs—designed  to eliminate the need for two separate exams—because the military  services usually do not require servicemembers who are leaving the  military to have separation exams. 1.) Although the 1998 MOU encouraged the establishment of these programs  for servicemembers leaving the military and filing VA disability claims,  some local military officials told us that their installations did not  currently have these programs because they decided to use available  resources to support other efforts, such as conducting wartime training  and ensuring that active duty servicemembers are healthy enough to  perform their duties. Military Staff Turnover Creates Challenges for Maintaining Established Single Separation Exam Programs

Because single separation exam programs require coordination between  personnel from both VA and the military services, staff changes or  turnover can make it difficult to maintain existing programs. Conclusions

Since 1998, VA and DOD’s military services have attempted to establish  single separation exam programs in order to prevent duplication and  streamline the process for servicemembers who are leaving the military  and intend to file a disability claim with VA. To obtain information on the challenges associated with establishing  single separation exam programs, we identified and visited military  installations that did not have single separation exam programs. 2.
Why GAO Did This Study

Servicemembers who leave the military and file disability claims with the Department of Veterans Affairs (VA) may be subject to potentially duplicative physical exams in order to meet requirements of both the Department of Defense's (DOD) military services and VA. To streamline the process for these servicemembers, the military services and VA have attempted to coordinate their physical exam requirements by developing a single separation exam program. In 1998, VA and DOD signed a memorandum of understanding (MOU) instructing local units to establish single separation exam programs. This report examines (1) VA's and the military services' efforts to establish single separation exam programs, and (2) the challenges to establishing single separation exam programs. To obtain this information, GAO interviewed VA and military service officials about establishing the program; evaluated existing programs at selected military installations; and visited selected installations that did not have programs.

What GAO Found

Since 1998, VA and the military services have collaborated to establish single separation exam programs. However, while we were able to verify that the program was being delivered at some military installations, DOD, its military services, and VA either could not provide information on program locations or provided us with inaccurate information. As of May 2004, VA reported that 28 military installations had single separation exam programs that used one of five basic approaches to deliver an exam that met both VA's and the military services' requirements. However, when we evaluated 8 of the 28 installations, we found that 4 of the installations did not actually have programs in place. Nonetheless, VA and DOD leadership continue to encourage the establishment of single separation exam programs and have recently drafted a new memorandum of agreement (MOA) that is intended to replace the 1998 MOU. Like the original MOU, the draft MOA delegates responsibility for establishing single separation exam programs to local VA and military installations, depending on available resources. However, the draft MOA also contains a specific implementation goal that selected military installations should have single separation exam programs in place by December 31, 2004. This would require implementation at 139 installations--an ambitious plan given the seemingly low rate of program implementation since 1998 and the lack of accurate information on existing programs. Several challenges impede the establishment of single separation exam programs. The predominant challenge is that the military services may not benefit from a program designed to eliminate the need for two separate physical exams because they usually do not require that servicemembers receive a separation exam. As of August 2004, only the Army had a general separation exam requirement for retiring servicemembers. The other military services primarily require separation exams when the servicemember's last physical exam or medical assessment received during active duty is no longer considered current. In fiscal year 2003, only an estimated 13 percent of servicemembers who left the military received a separation exam. Consequently, the military services may not realize resource savings by eliminating or sharing responsibility for this exam. According to some military officials, another challenge to establishing single separation exam programs is that resources, such as facility space and medical personnel, are needed for other priorities, such as ensuring that active duty servicemembers are healthy enough to perform their duties. Additionally, because single separation exam programs require coordination between personnel from both VA and the military services, military staff changes, including those due to routine rotations, can make it difficult to maintain existing programs.