VA Has Taken Steps to Provide Services to Seriously Injured Servicemembers as a High Priority

In our January 2005 report on VA’s efforts to expedite VR&E services for  seriously injured servicemembers returning from Afghanistan and Iraq, we  noted that VA instructed its VBA regional offices, in a September 2003  letter, to provide priority consideration and assistance for all VA services,  including health care, to these servicemembers. To identify and monitor those whose injuries may result in a need for VA  disability and health services, VA has asked DOD to share data about  seriously injured servicemembers. VA has been working with DOD to  develop a formal agreement on what specific information to share. In the absence of a formal arrangement for DOD data on seriously injured  servicemembers, VA has relied on its regional offices to obtain information  about them. In its September 2003 letter, VA asked the regional offices to  coordinate with staff at MTFs and VA medical centers in their areas to  ascertain the identities, medical conditions, and military status of the  seriously injured. VA and DOD jointly developed a  clinical practice guideline for identifying and treating individuals with  PTSD. The guideline includes a four-question screening tool to identify  servicemembers and veterans who may be at risk for PTSD. VA Faces Significant Challenges in Providing Services to the Seriously Injured

VA faces significant challenges in providing services to servicemembers  who have sustained serious physical and psychological injuries. For  example, in providing VR&E services, individual differences and  uncertainties in the recovery process make it inherently difficult to  determine when a seriously injured servicemember will be most receptive  to assistance. In our January  2005 report, we stated that DOD expressed concern about the timing of  VA’s outreach to servicemembers whose discharge from military service is  not yet certain. Further, VA is challenged by the lack of access to systematic data  regarding seriously injured servicemembers. VA and DOD generally concurred with our recommendations. Inaccurate data limit VA’s  ability to estimate its capacity for treating additional veterans and to plan  for an increased demand for these services. Related GAO Products

VA Health Care: VA Should Expedite the Implementation of  Recommendations Needed to Improve Post-Traumatic Stress Disorder  Services. VA Vocational Rehabilitation and Employment Program: GAO  Comments on Key Task Force Findings and Recommendations. Major Management Challenges and Program Risks: Department of  Veterans Affairs.
Why GAO Did This Study

More than 10,000 U.S. military servicemembers, including members of the National Guard and Reserve, have been injured in the conflicts in Afghanistan and Iraq. Those with serious physical and psychological injuries are initially treated at the Department of Defense's (DOD) major military treatment facilities (MTF). The Department of Veterans Affairs (VA) has made provision of services to these servicemembers a high priority. This testimony focuses on the steps VA has taken and the challenges it faces in providing services to the seriously injured and highlights findings from three recent GAO reports that addressed VA's efforts to provide services to the seriously injured. These services include vocational rehabilitation and employment (VR&E) and health care for those with post-traumatic stress disorder (PTSD).

What GAO Found

VA has taken steps to provide services as a high priority to seriously injured servicemembers returning from Afghanistan and Iraq. To identify and monitor those who may require VA's services, VA and DOD are working on a formal agreement to share data about servicemembers with serious injuries. Meanwhile, VA has relied on its regional offices to coordinate with staff at MTFs and VA medical centers to learn the identities, medical conditions, and military status of seriously injured servicemembers. For servicemembers with PTSD, VA has taken steps to improve care including developing with DOD a clinical practice guideline for identifying and treating individuals with PTSD. The guideline contains a four-question screening tool, which both VA and DOD use to identify those who may be at risk for PTSD. VA faces significant challenges in providing services to seriously injured servicemembers. For example, the individualized nature of recovery makes it difficult to determine when a seriously injured servicemember will be ready for vocational rehabilitation, and DOD has expressed concern that VA's outreach to servicemembers could affect retention for those whose discharge from military service is uncertain. VA is also challenged by the lack of access to DOD data; although VA staff have developed ad hoc arrangements, such informal agreements can break down. Regarding PTSD, inaccurate data limit VA's ability to estimate its capacity for treating additional veterans and to plan for an increased demand for these services.