The Department of Veterans Affairs is in the news over a serious scandal. But the focus on VA hospitals obscures a separate but massive problem in the VA’s disability-benefits system, whose function should be to treat and rehabilitate veterans to enhance their ability to work.
There are huge backlogs of disability claims, increasing numbers of medical conditions that count as disabilities, and, most important, a set of bureaucratic procedures at the Veterans Benefits Administration that cost hundreds of millions of dollars and create all the wrong incentives for recovery. There’s one common thread with the other VA scandal: In both cases, the agency’s genuine desire to serve veterans has exceeded its ability to deploy a system that works well in practice.
Here is how the disability system works: A veteran who has a specific problem, such as hearing loss or post-traumatic stress disorder or a spinal injury, must show that it occurred during military service. This makes the veteran eligible for a “service-connected” disability rating, which rises with the severity of the condition.
The rating ensures care at a VA medical center and a monthly cash payment — for life — ranging from $2,816 for a veteran rated at 100 percent (a total incapacity to work) down to $129 for a 10 percent disability .
The current system — which was established in 1917, before modern treatments became available — was never intended to promote rehabilitation. Instead, it presumes that service-connected conditions mean a permanent earnings loss. To some degree, this philosophy encourages veterans to see themselves as incapacitated.
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