The process  involves four main phases: the Medical Evaluation Board (MEB), the  Physical Evaluation Board (PEB), transition out of military service  (transition), and VA benefits. This phase involves four stages: (1) the  servicemember is counseled by a DOD board liaison on what to expect  during the IDES process; (2) the servicemember is counseled by a VA  case manager on what to expect during the IDES process and medical  exams are scheduled; (3) medical exams are conducted according to VA  standards for exams for disability compensation by VA, DOD, or  contractor physicians, and (4) exam results are used by the MEB to  identify conditions that limit the servicemember’s ability to serve in the  military.an impartial medical review by a physician not on the MEB, or both. 3). IDES Processing Times Increased Over Time, While Measures of Servicemember Satisfaction Have Shortcomings

		Overall IDES Case Processing Times Steadily Increased Since the Start of IDES

IDES timeliness has worsened since the inception of the program. Since  fiscal year 2008, the average number of days for servicemember cases to  be processed and receive benefits increased from 283 to 394 for active  duty cases (compared to the goal of 295 days) and from 297 to 420, for  reserve component cases (compared to the goal of 305 days) (see   fig. In fiscal year 2008, an average of 63 percent of cases for active  duty servicemembers and 65 percent for reservists completed the  process and received benefits within the timeliness goals; by fiscal year  2011 this was down to 19 and 18 percent respectively (see fig. Along with increasing average  processing times, the percentage of cases meeting goals for most phases  has generally declined (see fig. DOD officials recently told us that they will consider alternative  survey eligibility requirements, including working with the Office of  Management and Budget for permission to interview veterans. Recent Actions and Ongoing Initiatives May Improve IDES Performance, but It Is Too Early to Assess Their Overall Impact

		DOD and VA Took Steps to Address Previously Identified IDES Challenges

DOD and VA have undertaken a number of actions to address IDES  challenges—many of which we identified in our past work. Some  actions—such as increased oversight and staffing—represent important  steps in the right direction, but progress is uneven in some areas. The secretaries of DOD and VA have met several times since  February 2011 to discuss progress in improving IDES timeliness and  have tasked their agencies to find ways to streamline the process so  that the timeliness goals can be shortened. The report  also recommended that DOD and VA establish a committee to improve  the accuracy of posttraumatic stress disorder ratings. Improving local IDES reporting capability: DOD and VA are implementing  solutions to improve the ability of local military treatment facilities to track  their IDES cases, but multiple initiatives may result in redundant work  efforts. As a result, staff at IDES sites we  visited reported having to enter the same data into multiple systems. Officials said this diagram would  allow them to better understand and identify overlaps and gaps in  data systems. Finally, DOD is also developing guidance to expand implementation of an  expedited disability evaluation process for servicemembers with  catastrophic, combat-related conditions by allowing it to be operated at  more military treatment facilities. 2) To improve DOD’s ability to measure servicemembers’ satisfaction with  the IDES process, we recommend that the Secretary of Defense develop  alternative approaches for collecting more meaningful and representative  information in a cost effective manner. Further, while VA concurred with our recommendation that it  work with DOD to develop timeframes for completing the IDES business  process review and implementing any resulting recommendations, VA  stated that DOD is leading the business process review, and therefore  should develop the timeframes for completing the review. Appendix I: Objectives, Scope, and Methodology

In conducting our review of the Integrated Disability Evaluation System  (IDES), our objectives were to examine (1) the extent to which the  Departments of Defense (DOD) and Veterans Affairs (VA) are meeting  IDES performance goals, and (2) steps DOD and VA are taking to  improve IDES performance. Review of IDES Timeliness Data

To determine the extent to which IDES is meeting established timeliness  goals, we analyzed data collected through VA’s Veterans Tracking  Application (VTA) database. Appendix II: Additional Timeliness and Satisfaction Analyses

This appendix provides additional information on the timeliness of the  IDES process and servicemember satisfaction with it. Overall IDES Timeliness: Processing Times and Percent of Cases Meeting Timeliness Goals

Average IDES processing times for completed cases resulting in benefits  generally worsened since 2008, especially for active duty cases,  regardless of whether cases are grouped by the fiscal year in which they  were completed (fig.
Why GAO Did This Study

Since 2007, DOD and VA have jointly operated IDES--which is intended to expedite benefits for injured servicemembers. IDES replaced the departments' separate processes for evaluating servicemembers for fitness and disability. Initially a pilot at 3 military treatment facilities, IDES is now in place at military treatment facilities worldwide. In previous reports, GAO identified a number of challenges as IDES expanded to more facilities, including staffing shortages and difficultly meeting timeliness goals. In light of IDES' expansion, GAO was asked to examine: (1) the extent to which DOD and VA are meeting IDES timeliness and servicemember satisfaction performance goals, and (2) steps the agencies are taking to improve IDES performance. GAO analyzed IDES timeliness and customer satisfaction data, visited six IDES sites with varying performance, and interviewed DOD and VA officials.

What GAO Found

Case processing times under the Integrated Disability Evaluation System (IDES) have increased over time, and measures of servicemember satisfaction have shortcomings. Since 2008, annual average processing times for IDES cases have steadily climbed, while the percentage of cases meeting established timeliness goals declined. Average case processing times reached 394 and 420 days for active and reserve component members in fiscal year 2011--compared to goals of 295 and 305 days, respectively, and just 19 percent of active duty and 18 percent of guard or reserve servicemembers completed the process and received benefits within established goals. Of the four phases comprising IDES, the medical evaluation board phase increasingly fell short of timeliness goals, while the physical evaluation board phase, although meeting goals, was taking increasingly more time to complete. With respect to servicemember satisfaction with the IDES process, GAO found shortcomings in how these data are collected and reported, such as unduly limiting who is eligible to receive a survey and computing average satisfaction scores in a manner that may overstate them. Department of Defense (DOD) officials told GAO they are considering alternatives for gauging satisfaction with the process. DOD and Veterans Affairs (VA) are taking steps to improve IDES performance, but progress to date is uneven and it is too early to assess their overall impact. For example, VA increased resources for completing exams and disability ratings while the Army is hiring additional staff for its medical evaluation boards. VA has met exam timeliness goals in the past several months, but other resources have yet to translate into lower processing times. DOD and VA are pursuing system upgrades so that staff and managers at IDES facilities can better track and manage the progress of servicemembers' cases. IDES officials have been working with the military services to correct case data that were inaccurately entered into VA's IDES tracking system, but have not yet identified a permanent solution to improve the accuracy of data input. Finally, DOD, with VA's assistance, is in the early stages of an in-depth review of the entire IDES process and its supporting IT systems. This effort is intended to improve understanding of how each step contributes to overall processing times and identify opportunities to streamline the process and supporting systems. However, timeframes for completing the review or issuing recommendations have yet to be established.

What GAO Recommends

To improve monitoring of IDES timeliness and satisfaction, GAO recommends that DOD and VA work together to (1) develop plans for completing the ongoing business process review and implementing any resulting recommendations and (2) improve the accuracy of case information at the point of data entry; and that (3) DOD consider alternative approaches to measuring satisfaction. DOD and VA concurred with GAO's recommendations.