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  caseworker 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. PEB phase: In this subsequent phase, decisions are made about the  servicemember’s fitness for duty, disability rating and DOD and VA  disability benefits, and the servicemember has opportunities to appeal  those decisions. DOD and VA established timeliness goals for the IDES process to provide  VA benefits to active duty servicemembers within 295 days of being  referred into the process, and to reserve component members within 305  days (see fig. 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

Overall IDES timeliness has steadily worsened since the inception of the  program. Since fiscal year 2008, the average number of days for  servicemembers cases to be processed and to 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 cases (compared to the goal of 305 days). Relatedly, the proportion of cases meeting timeliness goals decreased from  more than 63 percent of active duty cases completed during fiscal year 2008  to about 19 percent in fiscal year 2011 (see table 1). However, it is too early to tell the  extent to which these results will continue to hold. Several factors may contribute to delays in this final phase. Officials could not provide data on  the extent to which these factors had an impact on processing times for  pending cases, but said that once errors are detected and addressed,  reported processing times are also corrected. However,  shortcomings in how DOD measures and reports satisfaction limit the  usefulness of these data for making IDES management decisions. DOD  suspended the survey in December 2011 because of financial  constraints, but officials told us they plan to resume collecting satisfaction  data in fiscal year 2013. 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 GAO identified in 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 of streamlining the process so that  the goals can be reduced. 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 solutions may result in  redundant work efforts. Meanwhile, DOD has also been piloting its own tracking system  at 9 IDES sites. As a result, staff at IDES sites we visited reported  having to enter the same data into multiple systems. The agencies have begun a business process review to  better understand how IDES is operating and identify best practices for  possible piloting. Ultimately, according to DOD officials, this business process review could  lead to short- and long-term recommendations to improve IDES  performance, potentially including changes to the different steps in the  IDES process, performance goals, and staffing levels; and possibly the  procurement of a new information system to support process  improvements. Concluding Observations

By merging two duplicative disability evaluation systems, IDES has  shown promise for expediting the delivery of DOD and VA benefits to  injured servicemembers and is considered by many to be an  improvement over the legacy process it replaced. I would be pleased to respond to any questions that you or  other Members of the Committee may have at this time.
Why GAO Did This Study

Since 2007, the DOD and VA have operated the IDESwhich combines what used to be separate DOD and VA disability evaluation processes and is intended to expedite benefits for injured servicemembers. Initially a pilot at 3 military treatment facilities, IDES is now DODs standard process for evaluating servicemembers fitness for duty and disability worldwide. In previous reports, GAO identified a number of challenges as IDES expanded, including staffing shortages and difficulty meeting timeliness goals.
In this statement, GAO discusses initial observations from its ongoing review of the IDES, addressing two key topics: (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 the performance of the system. To answer these questions, GAO analyzed IDES timeliness and customer satisfaction survey data, visited six IDES sites, and interviewed DOD and VA officials. This work is ongoing and GAO has no recommendations at this time. GAO plans to issue its final report later in 2012.

What GAO Found

Case processing times under the Integrated Disability Evaluation System (IDES) process have increased over time, and measures of servicemember satisfaction have shortcomings. Each year, average processing time for IDES cases has climbed, reaching 394 and 420 days for active and reserve component members in fiscal year 2011well over established goals of 295 and 305 days, respectively. Also in fiscal year 2011, just 19 percent of active duty servicemembers and 18 percent of guard or reserve members completed the IDES process and received benefits within established goals, down from 32 and 37 percent one year prior. Of the four phases comprising IDES, the medical evaluation board phase increasingly fell short of timeliness goals and, within that phase, the time required for the militarys determination of fitness was especially troubling. During site visits to IDES locations, we consistently heard concerns about timeframes and resources for this phase of the process. 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 satisfaction. Department of Defense (DOD) officials told us they are considering alternatives for gauging satisfaction with the process.
DOD and Veterans Affairs (VA) have taken steps to improve IDES performance, and have other improvement initiatives in process, but progress is uneven and it is too early to assess their overall impact. VA increased resources for conducting disability ratings and related workloads. The Army is hiring additional staff for its medical evaluation boards, but it is too early to see the impact of these additional resources. DOD and VA are pursuing system upgrades so that staff and managers at IDES facilities can better track the progress of servicemembers cases and respond to delays more quickly; however, multiple upgrades may be causing redundant work efforts. DOD officials also told us they have been working with the military services to correct case data that were inaccurately entered into VAs IDES tracking system, but have not yet achieved a permanent solution. Finally, DOD is in the early stages of conducting an in-depth business process review of the entire IDES process and supporting IT systems, in order to better understand how each step contributes to overall processing times and identify opportunities to streamline the process and supporting systems.