Massive VA Omnibus Bill Feeds Controversy
WASHINGTON, DC — A massive VA omnibus bill is facing unexpected hurdles in Congress and has split veterans service organizations, with some saying it sets a dangerous precedent for how medical disability is calculated, while others argue that its current benefits outweigh future dangers.
The Taking Care of America’s Veterans Act (TCAVA) is compiled from many smaller pieces of legislation, containing more than 60 provisions in its draft text. Those include some high-profile legislative efforts, such as the Major Richard Star Act, which would raise payments for spouses and family members of deceased servicemembers, as well as for catastrophically injured veterans requiring in-home aid under medical supervision. It also ends the so-called wounded warrior tax, which reduces retirement pay for veterans who are medically retired from combat injuries and receiving disability. The vote on that legislation was blocked several times by Republicans, who demanded an offset of the estimated $10 billion over 10 years cost.
The TCAVA also includes: support for caregivers providing at-home bowel and bladder care; access to new technology for spinal-cord injured veterans; grants to provide service dogs; requiring VA to report on the use of hyperbaric oxygen therapy; and instructing VA to identify and validate biomarkers associated with repetitive low-level blast exposure and its link to traumatic brain injury.
By lumping all of these into one omnibus bill, the goal was to bypass the roadblocks that held up legislation like the Richard Star Act. However, the provision in the bill designed to offset the cost—a reform that lowers disability ratings for sleep apnea and tinnitus on future disability claims—has pitted veterans’ advocates against each other, with some VSOs, veterans and members of Congress calling for that section to be stripped out.
Under the proposed rule, the disability rating for sleep apnea where the condition is being effectively treated could be lowered to 0%. Tinnitus would be removed as a stand-alone condition and considered for a rating only if it’s associated with a service-connected condition. The rating for tinnitus is already capped at 10%, regardless of severity.
About 763,000 veterans receive benefits for sleep apnea and 3.6 million for tinnitus. While their benefits would remain unchanged, the rule would impact all future veterans, as well as current ones who file a claim after the change goes into effect. According to a VA analysis, it could cut as much as $57 billion in benefits from 1.5 million veterans over the next decade. VA has said that it plans to implement the rating change for tinnitus, regardless of whether the TCAVA passes.
In a letter to VA Secretary Doug Collins, Senate Democrats condemned the proposed rule change, as well as the language in the omnibus bill.
“VA must make clear it will not punish veterans seeking effective sleep apnea treatments or deny veterans with service-connected tinnitus the benefits and health care they have earned,” they wrote. “By writing these cuts into statute, the legislation would permanently implement the very policies that veterans, medical experts, and veterans service organizations have overwhelmingly opposed.”
Earlier this year, VA published an interim final rule that would have allowed the department to lower veterans’ disability ratings if their condition improved under treatment. It resulted in a swift backlash from veterans’ advocates, who said that it would force veterans to choose between their health and their benefits, giving them an incentive not to get treatment. The response was so universally negative that VA backed down from the rule change.
Some of the same VSOs that stood up against the earlier change are in favor of the omnibus bill going forward, even though its language on lowering ratings for sleep apnea is similar to VA’s earlier proposal.
“Legislating changes to the Veterans Affairs Schedule for Rating Disabilities (VASRD) is not a standard path, and under ordinary circumstances it is not an approach we would support. Ideally, Congress would advance these long-overdue priorities without requiring offsets from future disability compensation,” they wrote. “Unfortunately, the current environment is far from ideal and veterans, families, survivors, and caregivers have already waited years across multiple Congresses and administrations for action on provisions that maintain strong bipartisan support.”
They urged Congress to make sure the bill’s language remains such that veterans currently receiving compensation will not be impacted.
Kyleane Hunter, PhD, MA, CEO of the Iraq and Afghanistan Veterans of America (IAVA) warned that leveraging future veterans’ benefits to pay for current initiatives sets a terrible precedent.
“Today it’s tinnitus and sleep apnea. Tomorrow, it could be PTSD, migraines, toxic exposure conditions, or any other disability that becomes a tempting budget target,” she said. “Congress should not set the precedent that earned disability compensation can be reduced whenever lawmakers need an offset.”