The Department of Veterans Affairs is the second largest government agency. The Secretary of the VA has an operational responsibility to support our Veterans and a moral obligation to ensure that those who defend and protect American interests are returned from service as contributing members of society.
To explore what it takes to transform one of America’s biggest bureaucracies, Fran Racioppi sat down with the Secretary of the VA, Doug Collins. As a former US and Georgia Congressman, and a Chaplain having served in both the Air Force and Navy, Secretary Collins knows what a Veteran needs and how to navigate Washington to get it done.
The Secretary and Fran broke down the pillars of VA support: including the VA Health Care System, the Disability and Pension process, education support programs like the GI Bill and Vocational Rehab, the importance of Veteran-Owned Businesses, and the no down payment VA mortgages.
Most importantly the Secretary shared his vision to stop Veteran suicide and why despite spending billions to reduce it over the years, we must forge a path that actually works.
Fran has personally leveraged almost every single pillar of support the VA has to offer. And although it hasn’t always been perfect, Secretary Collins explains why the VA leads industry in many domains and how under his leadership the VA will be held to a defined standard of excellence.
This episode is about bridging the gap between military service and civilian life, the responsibility the VA has in supporting our nation’s most important asset, and why Veterans are critical to American strength.
The Jedburgh Podcast is brought to you by University of Health & Performance, providing our Veterans world-class education and training as fitness and nutrition entrepreneurs.
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The Jedburgh Podcast and the Jedburgh Media Channel are an official program of The Green Beret Foundation.
The opinions presented on The Jedburgh Podcast and the Jedburgh Media Channel are the opinions of my guests and myself. They do not necessarily reflect the opinions of the Green Beret Foundation and the Green Beret Foundation assumes no liability for their accuracy, nor does the Green Beret Foundation endorse any political candidate or any political party.
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Secretary Collins, welcome to the Jedburgh Podcast.
Excited to be here.
We’re in your office. It’s awesome to be here. First time in the VA and in the headquarters of the VA, but a long-time user of the VA services. I’ll tell you that this morning, when I got up and I really started digging into how we were going to frame out this conversation, I went through and I pulled up all of the services that the VA provides. I’m going to tell you, because we’re going to get into it. I think I’ve leveraged almost every pillar that the VA uses, and I know that I’m going to ask you some hard questions about some of the stigmas around the VA, but I will say before we start that if you understand how the VA operates, it can be life-changing because it has for me.
I think so. I think that’s the thing that’s most misunderstood. There are so many misperceptions about the VA. Over the years, it’s changed. Over the years, it’s had its ups and downs. I’ve said all along that the modern VA was influenced by Vietnam. The Vietnam veteran who came back and was not treated in a way that was sufficient, probably is the best way to put it. They caused a revolution at that point in what the VA was looking like.
I think we’re in the middle of another one right now. I think there’s a generation of warriors that have come out that are now pushing us in a direction that is bumping up against the old DC mentality of bureaucracy and money, and people solve everything. We’re finding that it’s not. I’m excited about where we are. There’s a lot we can do. I will just say this at the start of this for anybody that if you’re only going to catch the first few minutes of the show, at least hear me say this.
I know that there are going to be some people who are going to watch this and say, “Collins is full of crap. This is not, I hadn’t got my stuff.” Everybody’s going to have a problem. There’s not a business or a hospital in this world that doesn’t have some issues that we never, but what I’m committed to doing is fixing those problems. It’s not going to happen overnight. It’s not going to happen. Some of it’s going to happen overnight, but most of it’s going to take time to get there because when you have a 450,000-person department, almost 400 of that is in the VHA side, it takes a while to unlearn the bad habits, so to speak.
We can also just contextualize the scale of the organization. We’re talking about supporting over sixteen million veterans’ medical services to about 9 million of those, 172 medical facilities, over 1300 outpatient sites. In 2024 alone, the VA paid $173 billion in disability compensation and pensions, and the indications are certainly better than what I’ve researched on Google. We’re looking at a request of somewhere over 440 billion going into 2026 to fund operations.
It’s going to be closer to about half of a trillion. We’re getting close. We’re the largest physical department in the federal government. We’re bigger than the standing army. Active duty army, we’re bigger than the active duty army. One of the reasons is that there are a couple who spend more money than we do. That’d be HHS because they got the federal health programs and stuff, and DoD, which of course combines the services under their one roof. Again, it’s a massive undertaking, and anybody thinks that you can turn this on a dime. I was one who was hoping we could say some things you could turn quickly. We’re turning it, but this is an aircraft carrier turning. It’s in my pontoon boat on linear.
I think it’s important to note that not only operationally, the size and scale are absolutely massive, and one of the largest. When you talk about the moral side of America’s commitment to its veterans, you are talking about America’s commitment to its people and society. When we look at asking our young Americans to serve their country and join the military, I often say that we have a duty to those people. We have a duty to not only leverage their capabilities while in service, but then return them to society as a better version of themselves to contribute to society. That’s where the VA really steps in.
It does. I think that’s what’s become over time, a harder and harder issue for us. It’s not that we cannot, but I think there are a lot of issues. One of the big things that I told Pete is just about this. Pete and I talked a good bit, and I said, “Pete, you’ve got to understand if they have a bad experience with you, then they’re going to have a warped experience of what they’re going to get in the VA and vice versa.
If they’ve had a parent or something that had a bad experience in the VA, then this is going to affect recruitment and everything else.” We’ve always viewed this from my perspective since I’ve been here, and VA and Defense are fraternal twins. We do the same people just in different functions of their lives. I think that’s something that transition is a huge issue that we have to deal with. I make the comment all the time, DoD owns it.
I get blamed for it. We’re trying to fix that because I think Pete’s dead on, the president’s dead on. He gave us very different visions, I guess. He wanted the Secretary of Defense to have a warrior ethos mindset, fight and win our wars, which was always what we were supposed to have done. He told me to take care of our veterans. Those are very similar in what they say, but they’re very committed, as you said, to taking care of those veterans and making sure that the military experience in their life is a plus and not a negative when they get out.
You took the seat and were confirmed in February of this year, 2025. You’re the 12th secretary of the VA. Why’d you want to lead the VA?
Outside of when the president calls and says, “Do you want to lead the VA?” It’s hard to say no, but why? Have you ever met the president? I haven’t. It’s hard to say no to him. He is a very charismatic person and a great leader. For me, there was a lot of discussion about places I could serve and help. Lisa and I, frankly, were very happy with what we’re doing. There was some stuff I was taking care of from my time in Congress.
I worked a lot with criminal justice reform. I worked with intellectual property. It was good, but I saw what this country needed, and I knew that President Trump needed to come back in. He and I talked about it. When it came up and the discussion of veterans came up, he said, “I believe God takes you down a different path and you may not know why you’re doing it at the time, but it reveals itself in time.” I can show that in earlier parts of my career as well.
For this one, I’m the first cabinet-level secretary of the VA who had been a member of Congress since the very first back 35 years ago. It’s been a long time. I understand the Hill. We can agree, disagree. I appreciate the folks up there, but I’ve been where they’re at. It’s not a new thing for me. It’s not like, “I don’t know what you do. I know exactly what they do.” I think that it is very important for us to work together as a department, but also, I’ve been a veteran.
I’ve been in the military now for 24 years, Air Force. I was in there for about two and a half, roughly, so with the Navy. I actually served with the Marines while I was in the Navy. I’m a chaplain. I have a lot of experience. I’ve deployed, and I’ve been to those areas. For me, it became a culmination of saying, “This is a perfect place for this, but also to take a perspective that we’re going to put veterans first.” I come at it not as wanting to keep an agency together, so to speak, in the sense of agency first. We’re a service organization that takes care of veterans.
I think the experience that you bring when you look, as you said, from the Hill and from the military allows you to identify with the demographic that you’re serving. When you look at the folks who are coming through the VA system, they have to navigate this very complex organization. Being inserted into the top, if you don’t really understand how that happens, it makes your job a lot more complicated.
You’re much more. I say this, I’ve got great employees, and look, we’ve done a lot of change. We’ve got more changes coming, but I do think there are people here who legitimately want to do a good job. I’ve never doubted that. I think we have a system, though that came upon itself as it grew, that was based more toward the organization than it was the mission of the organization.
For me, understanding, especially for eight years as a Congressman, I was on that end of the people calling your congressman because I’m ticked off at the VA. Sixty percent of all calls, depending on some more and some offices, 60% of every time the phone rings at a congressman’s office, it’s about a VA issue, VA health, VA benefits, VA something. It’s always something about 60%. Every time that you deal with this, we have to deal with it over and over and over again.
60% of the time the phone rings at a congressman’s office, it is about a VA issue.
I saw some of this because I was able to bring some of that in to say, “Look, we’ve had to deal with this. Why are we dealing with this? What are the cultural problems that we need to address?” That’s good for me. It also makes me not dependent. I say this in a good way. I’m not dependent on the career mindset here. Now that I respect them, I’m so glad we have 30, 40, and 25-year veterans. I want them to stay here and be with the VA and help us serve veterans.
I also look at it. My favorite question here is why? Why are you doing this? Why is this? What was really disturbing in some ways was that early on, I would ask why, and they couldn’t give me an answer. Sometimes it’s because I stopped it pretty quickly. It was well, “This is the way we do it.” I said, “That is not an answer.” The answer is “Why do we do it? How does it affect a veteran?” I think that’s called some ruffles.
Me with the Hill. As I said, I understand what they need to do. I understand the politics they have to play, but VA is not going to be the whipping post for anybody anymore. If we’re doing something wrong, we’ll fix it, but you’re not going to lie about us. I’ve been taking a very aggressive stance on that.
Let’s talk about the biggest, let’s call it a pillar of VA services, healthcare. You knew what you were out of the garden. It’s also the most complex. You’re talking about medical services through clinics and medical centers, physical wellness programs, and specialized medical care. I’m a veteran. I have 100% total and permanent disability. I have access to the VA resources. I also have private healthcare. Why should I go to the VA?
I think it’s your choice. I think you should come to VA because of the benefits you’ve earned, and you’re going to get quality, outstanding healthcare. If you’re not, then we’re going to raise the bar for that. I think that’s the big issue. I think there are some things that, frankly, the VA does better than private healthcare. I think the VA is more specialized toward veterans. I think we’ve got to do a better job of that.
I don’t think we express that enough, especially when it comes to polytrauma, when it comes to orthotics, when it comes to prosthetics, it becomes those issues that are very much unique to the military environment. I think there are certain things, especially when it comes to the newness of nature. The issues of burn pits, the issues of toxic exposure, which your normal doctor may or may not understand or see, are not that they don’t get it, but it’s not a question that they ask on the twenty other patients they see in the day.
It’s a good thing to have that, which is why we’ve opened it up, and that’s why we’re at the VA. I don’t see us as in competition with private medicine. In fact, if you want to participate in that, then we have the community care program. We have the best medical interest standard that we’ve allowed, which will allow you and the doctor at the VA to decide where you want to get that care. For us, it’s not a here or there. I believe we have a great product.
I believe we have people who are getting better at it. Look, I’ll go back to my first statement. There’s going to be some out there saying, “Mine was terrible.” I get it. Also, I’ve heard this a lot. I’ll see the comments because we actually started something here, and I’ll branch off here for a second. I have a pretty large social media presence. I’ve done this media for years. What we’ve done and what we found in the first little bit here is that as we were active on social media on all of our platforms, we were starting to get a generation of warriors and a veteran who was commenting on our section.
Before me, we were, I don’t say we’re ignoring it, but they didn’t have a big press. We’re actually now engaged with these comments for many and are actually solving problems. That’s for me, a responsive VA. That’s a VA that gets it. I guess about two weeks ago, three weeks ago, had timeframe-wise, one of my section leaders who actually said they had called someone and that they had gotten the letter that it was their goodbye letter. We were able to get to them, and they’re alive today. VA is a special place because we get to take care of special people. That’s why I believe that the VA plays such a vital role in our communities.
For the record, I’ve gotten healthcare at the VA in New York, in LA, and also in Brooklyn. I had a stroke in my eyes in Iraq. One other guy and I were in the C-17 on the way to Germany. That was interesting.
Where’d you come out of Iraq? Where were you?
When that happened, I was down in Basra. They flew me to Balad. My first deployment was in Balad. We got some of the same way. I always like to call it a nerd, but I don’t know what they call it. That’s just quick creep.
Why didn’t you get more of that?
That place was an interesting one. I also spent three days in the hospital, and the Los Angeles VA, as well, where I went in and just wasn’t feeling well and came out 3 or 4 days later. It’s always been there. One of the things that has been a stigma as we’ve gone through the years is wait times. There have been a number of cases that have been reported and talked about over time where veterans’ health has gotten worse and deteriorated. Some have taken their lives when they were in the VA process. How are you working to reduce those wait times and get that care to them?
Let’s take it a couple of different ways. Number one, we want to get to people as quickly as we possibly can, and we’re going to, that’s why we’re doing it with community care, getting them out to the community quicker. Increasing our doctors, increasing our extended hours. We’ve added over a million hours of extended service in the VA just in the last few months. A million hours that were not there before, they can go after hours on Saturdays and stuff.
Also, interestingly enough, and because you do this and you do this podcast well, if I were sitting here and my name was something else and I ran the HCA, the Health Care Center of America, and you were to ask me about wait times, I’d say, “What are you talking about?” No other hospital system in the world judges wait time. None. It’s not even a comment on their fact sheet. What they judge on quality and how they get it.
That’s how they know that they’re working. One of the things is, and I’m trying to do right now for us, because I think it is a problem that we’ve got to address. We’ve to do better at getting appointments scheduled. This is part of that cultural issue that I’m having to fix, that we don’t have to have everything touched 2 or 3 times when we can do it one time. We trust our doctors. We get the schedules done. What is happening is when we judge ourselves by standards that are easily one-off, what I like to call it.
I got a call from a guy the other day, who was somebody I’ve known for a while. I said, “My appointment got canceled.” I said, “My
cardiologist canceled mine the other day, too.” I get it. Things happen. We’re trying to get it to a system that works as well. Our standards are going to be higher than the community in every way we possibly can, but sometimes that may not be fast enough for some. Yes. When it comes to suicide, let’s take a very different approach.
When it comes to critical care, when it comes to urgent care, suicide, mental health, we’re breaking down those barriers now that if we see somebody that needs to get into a resident, we’re doing that same day or less. That’s become a really big focus of what we’re doing. I think there are two things we have to look at. Wait times are something that came from Congress because Congress decided. Rightfully so, I was there when we passed the Mission Act and everything. The old saying in the military is that what gets measured gets done. How do you measure something to know that we’re effective?
They came up with wait times because it’s the only way they could actually do it. Quality is amorphous at times. That’s where we’re coming in. Backlog on disabilities is the other. I think it’s something for us to continue to work toward making sure everybody has that quick access. We’re doing that by opening clinics, doing those things. Also, I’m concerned not only with getting people in, but also with the quality of care that they’re getting, as other hospitals are measured as well.
I’m glad you brought it up, that’s what I was going to go next. When you look at a hospital like the New York VA in New York City on 23rd and 1st. The Manhattan facility. That facility is partnered as a teaching hospital with NYU Langone. I’m familiar, I’ve been in there a lot of times. When you go in there, there’s actually a sense of calm I felt. Also, like going to NYU for school, I was like, “Where aren’t there yet?” Why is a partnership with some of the premier medical institutions in the country really important to the VA and the creation of these teaching hospitals to be able to get in front of the vendors?
There’s a lot to be gained there. Let me start with this. I’ve been accused, especially by members of the other party and others, that the college just wants to privatize the VA. They’re so full of crap. No, we’re not privatizing the VA. One of the bigger reasons, aside from the fact that the VA is always going to be here for our veterans. We’re the largest trainer of doctors in the country. Our residencies and everything, graduate matter of education would be in deep trouble if we didn’t have the VA because we train so many doctors.
The partnership that you talked about goes back to my position of veteran first policy and it’s saying putting veterans where they need to be is why are we doing stuff and taking resources from other things we could be doing when we have somebody, a partner that we could partner with and do it better or do it as good and give new expertise and get our veterans the best care. I’ll show an example. I’ve already started looking at this.
We have veterans hospitals that sit across the street from world-class cancer centers. One of the things I had early on, one of those hospitals will say, “We’re having trouble recruiting oncologists.” I said, “No kidding. They’re across the street at the war in a world-famous kind of guy.” I said, “Why are we trying to compete with them? Let’s partner with them. We can see better results and better healthcare.” To me, it’s what he’s doing the best for the veteran and the taxpayer to say, “Let’s give the best quality we can.”
I want to circle back on suicide. You brought up a couple of times here, and veteran suicide. For years, we talked about this 22 a day. That number has been reduced now to somewhere between 17 and 18 a day as well.
I’ll just be honest with you. Some will take exception. You can always set it as high as 38 to 40. It depends on how you classify the desk.
That’s fair. The stat we can look at, too. Veterans are two times more likely than civilians to take their own lives. Why do you think that veterans are two times more likely to take their own lives than civilians?
About you going to dig into my chaplaincy. I don’t know my lawyers out here. It’s a lot of things. I’m going to break it into a couple of parts here. Number one, one of the things that people don’t know is that this is a statistic that we’ve seen being played out and documented. The shorter the service time, the higher the risk for suicide. In other words, what we have seen is that a 3 to 5 year or 8 year enlistment or service over time is a statistically much higher percentage of death by suicide.
At some point in their life, here’s what’s really interesting. They go back all the way to the Vietnam era. Even once we serve shorter terms in Vietnam at 60 or older, if they die by suicide, it is still the same as a shorter term. I would have thought it would be with the ones who’ve been in for 16, 20, 25 years, seen everything, and all that were more hired. Typically, it’s not. What that tells me is that for those of us who came through the military, I was thinking about something, this is going to sound maybe funny to you.
What was one of the things that there’s something that I do most every morning that reminds me of officer training, and it’s ironing my shirt. If I do it in the morning, I iron my shirt. Why is that so? I can remember my gunny Marine yelling at us, “This is how you keep your uniform. This is how you do any broad in there.” It just ingrained in me. We instill in you to be a military member. We ingrain in you the need to fight this nation’s wars.
What we don’t ingrain in you is how to handle what you will see in that. How does that stress the family, and how does that stress the ops tempo? How does that stress on other things to come out of that? I think one of the reasons that we see this in our transition, while we’re redoing everything that we think of our whole suicide prevention program, now we have a new leader coming in. We’re questioning everything that we’re doing because we were spending $588 million on prevention, and the numbers have changed in 2008.
The government instills to a person how to be military member and the need to fight this nation’s wars. What is not ingrained in them is how to handle what they see in that.
Something along the way needs to change. We’re changing that part, but now we’re also saying, “Are we getting them out of the DoD system in a way that we can help them? You’ve worked with the day.” Especially some of the younger members who are coming out, they went for educational benefits. They went for something else. They got out, they sit through those TAPS programs. They sit through that end of the day, “Yeah.”
At the end of the day, they have issues that they’re not dealing with. They go out, and they don’t have healthcare. They don’t have a doctor to go to. We’re trying to make that transition almost seamless. If you’ve already earned the benefit, we can get you into VA health so that we have you there for preventative care and everything else. I think that the biggest issue is that they get out of a situation, in good or bad, and we have to be honest about this.
Some have good memories of their service, and some have bad memories. It’s a unit cohesion. There’s a knowledge of what we’re doing. All of a sudden, within a day or a week, you don’t have that anymore. Nobody’s going to call you and see if you show up for work. Ain’t nobody going to come and say, “You’re AWOL if you don’t get out of the bunk.” I think that is the transition that we were going to have to continue to work on to give them an experience where they see something worth fighting for in their own life.
I didn’t even know that the VA had a healthcare program when I was in service. It was one of my last days going through the transition program. I have to go to all the offices. I think I was in the DAV, the Disabled American Veterans office. That was one of the boxes that had to be checked. Everyone in that building, ten plus years at Fort Carson, didn’t even know that building existed. I went in there, and I don’t know, the sun was coming in at the right angle, the guy sitting over there, and birds singing. I was on my way out the door, and he said, “Did you happen to check out the VA healthcare program?”
I stopped and said, “What?” At that point, I hadn’t gone through any of the disability stuff. He’s like, “You got three years for free.” All of a sudden, that changed my whole perspective because one of the challenges that I knew I was going to face in about 24 to 48 hours was the fact that I had no healthcare. All of a sudden, I’m like, “Once I drive to New York, I can just go there and start working with them.” That’s exactly what I did. I think creating that knowledge and creating that ability to get people in their transition process to fully understand that is going to be really important.
One of the things we’re actually looking at, and we’re not there yet, and I know there might be some tuning in and say, “How do you do that?” Look, we’re working on it, but one of the things is just to make it a seamless transition. We’re looking at it. If you’re already eligible, we already know you’re eligible. That’s the issue with coming out and doing it. We’re just going to transition you right out of DoD health, right into the HA health. Now you don’t have to use us.
You don’t have to come to the VA if you don’t want to, but we’re already going to have the stuff there so that when you come applying and say, “I’m ready to do this.” We can begin that process without a delay. We do have an issue with our health records management system right now. DoD went ahead and standardized on one of their program a few years ago. They had problems getting it up, and it’s still an issue. DHA health has its own issues right now.
Before I got here, we put a pause on trying to get our health records management system up. We spent billions of dollars. We’ve got six sites that are spun together at best. We’re trying to get that up to speed. That is a problem with our community. That’s why some of your folks who are tuning in will say, “I go to my community care doctor, and they don’t get paid or they cannot get approvals.” That’s part of the issue. We’re working through that right now, but I would rather it be that if you come out of VHA or Defense Health, you go right into VHA.
We’re making a special emphasis on this one. This one is one that’s a little bit harder, but we’re working on it. If you’re already at DoD and you have a TBI, you have a concussion injury, you already had a diagnosis of depression, I’m wanting to make it to where 6 to 8 weeks before that 24 hours, your DoD doctor and your new VHA representative are putting you together so that there’s a seamless transition that it’s a warm handoff and you go straight to your never a day. I don’t want a day to go by that a veteran who has a need for help doesn’t feel like they have it. That’s the goal that I have.
It would have been incredibly helpful to have that process like that because I felt like I had to start over. I still dealt with the eye issue that I had. I had a herniated disc in my back, and I’m in the VA, having to start over. “Here’s how it started. Here’s what happened.” All of a sudden, you’re doing all the same tests.
It takes a while to get the record transferred and everything. That’s the frustration level, and some will quit. I’m encouraging if you’re tuning in and you just transition out, don’t quit. Stick with it. We’re going to get it as quickly as we can, but don’t quit. It’s not worth your quitting. I’ll say this to younger veterans coming out. We’ve got some, they come in, and if I came back in later, but I mean, if you come in after college, you come in after high school, you’re 38, 40 years old, you’re 20 plus years in, you’ve done a lot of things.
You go out and get another job, and they provide healthcare. You’re still going to have your benefit. You still got that. In another twenty years, you may not have that job. Were you going to do healthcare then? I think this is something that we need to make sure that people are involved in and know that they have the benefit. We’ll never push it on anybody, but it’s there for them if they want it.
Let’s go to the next biggest pillar of support, disability and pension. It’s also a big topic amongst our
veterans. This is the crux of that transition piece, especially for those specifically in the GWOT generation who are in the phase of retirement. I went in 2003. I’m going to the retirement ceremonies of my peers and those who are still in our senior leadership, and they’re going to begin to transition here. Whether you like it or not, your military service is going to come to an end.
It’s got an indite.
Historically, and through my own lens, it felt like navigating the disability process was like going out into the ocean at night and navigating through the stars. I wasn’t in the Navy, so you can imagine that. The complexity behind the road in a circle. It took me 4 to 5 years to really get through that process. I was smiling when you were talking about don’t quit, because I initially came out and the VA said, “You got ten percent,” and I’m like, “Ten percent, I have glaucoma in my eye that came out. I was literally standing in Iraq, and this happened to me.”
It’s like, “Not service-connected. That’s not possible.” I went and got an advocate at the VA because someone said through some random conversation, “There’s an advocate office on like the eighth floor.” I remember walking up, finding the advocate, and saying, “Can you help me?” They got me to 40. Still, I don’t think that we’re there. I went to the Wounded Warrior Project.
Wounded Warrior Project got me to 90. I found the Green Beret Foundation and grant will talk a little bit more about their veteran support through their disability program in a second, but they got me into a hundred. All these folks had to get involved in my case to get there. Yet it felt like this is a process that’s repeated thousands of times every single year, every single day, and transitioning veterans. Why does it feel like it was the first time?
It’s because, for the way our system is set up, many times it is. I think this is a problem that we’re addressing. One of the things you said, though, is something that I have spoken at almost every major VSO convention. I’ve talked about this on everything else. Let me just flag this by saying, “I appreciate every organization that is helping my veterans navigate a very convoluted process. I appreciate them so much.”
Also, there’s a certain point in time in life where I don’t want them to ever have to do this again. They shouldn’t have to be there. You’ve earned the benefit of your service to this country. There should be a simple process that allows the disability raters to look at your case, to look at your medical records, and to say, “Yes, this is an issue. Maybe we need to ask a few more questions here.” It is a lot statutory-driven. This is a lot of it though is internal to how we’ve developed to carry out what Congress intended.
Part of it is that there’s a culture of, “I think go through the process. You didn’t have this quite filled out.” What we’re trying to do now is a combination of working with our raiders and working with our VBA to look at it from not only a filtered perspective using technology. One of the things that we get into a lot of and where you had, is going through your CMP exams. “You said you have this, where you have to go to a doctor to get approved.” The crazy part is that most of the time, and probably in your case as well, it was in your medical record to start with. I can save probably billions of dollars.
If I just had something to look through the records and say, “I see it here. We’re done.” We don’t need to send you out to another party to go through this exam process, which, for many, is hard to deal with. Those are the kinds of things that we’re looking at right now to say, “How do we fix this and make it better?” I go back to this, and it’s probably still in our forums right now.
I’m still trying to figure out how to take this out. There’s actually a forum. If you go back to your first days of doing disability, there was a whole forum that asked for your military history. “Why in God’s name do I need that? All I need is your name, your DoD 214, and your social security number. I can find anything I want to know about you. Why do I need you to write that out?” Those are the little things that get people frustrated, that they then have to turn to these great organizations that I appreciate for helping.
My goal is to get to something else. The VA needs to be simple enough that a veteran of any skillset and ability can navigate this system quickly and efficiently. We also have to make sure that we’re out here taking care of that. Some people are not being led along as well in that process. Those are the kinds of things we have to deal with. We’re dealing with the board, we’re dealing with a lot of things, but it just needs to be simpler than what it is.
You’re seeing success, though. I want to highlight some of that. In fiscal year 2025, the government fiscal year started in October, so we’re coming up on the end of that, but you’ve processed over two million disability benefit claims. That’s a fourteen percent increase over last year in 2024. There’s almost a 62% approval rating. That’s supporting over 1.3 million veterans and their families. The average is a bit over seventeen percent faster than in previous years. Do you think that it’s a people change? Is it a process change? Is it technology change that has really led to that increase?
Yes. I think it’s yes. I just say this is a wild, crazy guy who sits in this office, who relentlessly will not let us be average. You’re getting a preview of something that this department is going to get here in the next little bit. We’re going to live up to a standard. We’ve had a remodeling standard. I live to a standard. The standard is we’re going to be excellent. I’ve told this to our hospitals.
We have the CMS ratings, which all hospitals go through. There’s no reason because we have one set of patients. We have veterans who should have anything less than a four. It’s on a 1 to 5 scale. We had ones before last year that we actually got them up to twos. Our 3s and 2s, we’re going to get to 4s and 5s. I’d only set up a standard less. Now that means we’re going to have to put people there. We’re going to do things to do that, but it’s a culture shift.
VBA to drop that, by the way, I got you a bar. We’re going to be closer. That was in August. Those numbers are coming out on me, and we’re going to blow all records out of process disability claims. The big thing was, when I got here in February, we had 260,000 plus what we call the backlog, which is over 125 days. We set forth in about March, 1st, or April, saying, “We’ve got to get this down, and here’s how we do it.”
We put people over time, everything else. We’ve been able to drop that under 150,000 in less than four and a half months, focused attention, and get it done. Now, very soon, the lowest that has been in five years is going to be on the new standard with PAC, and everything else is probably going to be a standard it’s never been to. The other issue is they will, “What about all claims?” There were over a million pending claims. We’ve dropped that down to about 700,000 now. We’re making progress. People are getting answers now. Not everybody’s going to get the answer they want. That is because of certain deals, and it’s not just saying, “I have it, you get it.”
That’s just the system’s design that way. The system is designed to get you to a place that, if it wasn’t right, then we’ll look at it again. I’m very proud of what we’re doing over at VBA. It’s difficult. Everybody thinks, I’ll just use your example. “What happened here? It must’ve happened.” Yes and no. There have been examples where it may not have been. By the law, we cannot do that, but we’re trying to bend toward what is best for that veteran and get them the help that they need.
One of the areas where the Green Beret Foundation has been successful in the partnership with the VA specialization. Green Beret Foundation was still the only special operations veteran service organization accredited by the VA to process claims. We’re super proud of that. We have a number of veteran service officers who sit in one of the active duty groups. What that has allowed is really to reduce what the story I told you of walking in and having somebody make an offhanded comment.
Now, part of the transition process of every Green Beret as they out-process the special forces active duty group is to go sit down with the veteran service officer, who’s then going to say, “Here’s how we’re going to line you up.” They’re going to then advocate, and they’re going to process their claim as any of the VA disability claims processors would know. As the Green Beret Foundation, a specialized veteran service organization, how can we better partner with the VA to advocate for the special, unique cases that we may see from special operations?
I think just make it known. You use a special term here, but I mean, it’s you know what you’re seeing, the uniqueness of your group, the uniqueness of what they’re seeing, the uniqueness of their mission, if you would. One of the things I find is patterns, and I think that helps us all if we say, “Here’s a pattern we’re seeing,” and then get that information to our VBA folks and say, “We’ve had this now showing up in about ten cases here.”
I say, “This is the way we’re interpreting here. Here’s the way that the law is. Is there something we can fix here? If there’s a need to either change the law or change the regulation.” I think that’s where the real special relationship can come in for not just the Green Beret Foundation, but others, is to say, “What do we see that can be fixed? I’m open to ideas.” I meet with all organizations.
If they’re helping veterans and they’re doing it the right way, they’re doing it ethically, they’re doing it above board, morally, everything else, we’re going to meet with them. We’re going to say, “We’ll partner with you to help.” We have great relationships with our standard, the big eight VSOs, and everybody. We still work with them, and we want to continue to partner with them.
I’ve spoken most at the convention, but there are a lot of nonprofits and other organizations that are providing very specific help in not only the special operator community, but also other communities as well, that we are willing to learn from. Especially when it circles back to, as you said earlier, suicide, especially in those areas of how do we get those who are dealing with PTSD, dealing with TBIs. They specialize in this even more so than we can on a grand scale. We want to see those continue to flourish. There are a lot of organizations out there that do that.
I’m to make the intro to our president and CEO and our chairman, so I would love to set up a conversation with them about that. They’re to pump you for grant money, too. “They can apply. What’s great about it is that I separate myself from contracts and grants. God bless you. We see that, how do you find those?” Let’s talk about education. The education programs that come out of the VA are critically important. I leveraged in my transition service, both the GI Bill and vocational rehab.
I talked to a lot of people even today, and they’ll say, “I want to go to school.” I say, “You go to vocational rehab.” “I don’t know what vocational rehab is.” It’s like, “Vocational rehab was critical along with the GI Bill in paying for my NYU MBA.” In addition to the policies that came out around loan forgiveness for a permanent internal disability, which happened during President Trump’s first term, where do you see the educational benefits going? What is your guidance to that division of the department to better support the veterans who are looking to increase their education?
One is just letting people know again, continually, that it’s out there. One of the things that we don’t talk about enough is that sometimes the veteran gets out, and they really don’t want to go back to school. That benefit they can transfer to kids. There are abilities in there. It can help a whole generation of a family take pressure off of college, pressure off of technical schools, those kinds of things that.
You brought up something, though, that’s an area that we’re very proud of. It works very well in our system. You have some organizations at schools where we deal with it. Sometimes payments get delayed. You work through those, but for the most part, it’s a program that actually really works. I think learning is the key to most anything. I learn every day here. If you quit learning, you’re really in trouble. You’ve also brought up something else.
Our vote rehab, our VRE program, is something that has suffered under the previous administration. Unfortunately, through some just bad choices that were made, we’re getting ready to increase the numbers there again, hopefully several hundred to get more people involved in how they can use their fine new skills, get that issue that after. I see in a bigger picture going forward over the next few years, I see a big need in our veteran community to gain skills that those who don’t want to go to college, those who don’t want to go to traditional liberal arts, can expand their skills into electrical and plumbing.
We’re in desperate need of those trades, and they’re paying very well. The other thing is, I think we’re trying to help with states and giving guidance on how to break through the certification barrier. This idea that the government has to certify everything is in the way they do it is is a barrier. Can we get states, and I’ve already talked to a couple of state legislators in different states, on how we can not lower the standards of it, but accept a military standard that was a certificate, like whether it be firefighter, EMT, and then let it transfer over into the civilian workforce. It’s a huge area of education, but I think it’s something we need to do.
As an entrepreneur, I’ve also been able to leverage the skills that I learned through the vocational rehab program because the VA has since been transferred to the SBA, but the VA, for a long time, held accreditation for the service disabled veteran owned businesses. There are so many set-asides that are coming out of not only the federal level, but the States, and specifically in New York state, there’s a lot of focus on veteran-owned businesses and getting them involved.
Those certifications that we’ve been able to gather through those programs have been really critical. You talked about the trades. I had an opportunity to sit down with the former Sergeant Major of the Army, Daniel Dailey, where we talked about the trades and the importance of getting people out of service and going into the trades. I think that’s where they can go into vocational rehab and say, “I want to be an electrician. I want to be a plumber, and we work a lot with the unions in New York City. They do pay.”
Probably very well. You look at it, and we can also give them benefits on actual tools and equipment that they need that they wouldn’t have to put out of pocket. If you need this to get this education, those are the kinds of things that are encompassed in some of what we do in that area. I think sometimes when somebody mentions education, they only think of the one-way street, or before you go to school or a community college, where I think we’ve got to broaden that definitely.
President Trump has done a great job of revitalizing a manufacturing economy in this country that is going to need those critical skills. It may not be the old manufacturing we think of in the processing of computers, chips, and other stuff. All that is going to be a part of what we do. We’re going to be at the cutting edge, as best we can, on making sure the veterans are getting that ability.
The final piece, when we look at the VA pillars, is the home loan piece, which also leverages.
Again, I’m very proud of our home loan stuff. It’s probably one of the easiest. We’re having same-day approvals. That’s just something that’s revitalized a whole generation of folks who have to buy that home. We just got interest rates down, which hopefully will happen soon. That’ll even encourage that even more. The VA is right there for them.
The no-money-down is certainly very helpful in being able to do that. We spoke earlier about your career prior to coming into this role, both as a state congressman and as a US congressman. Also, your time in both the Navy and the Air Force, as you sit in the seat here, there’s been a lot of discussion about the reduction in forces. I think the VA was initially directed to reduce by about 80,000. Now it’s, I think, 30,000 is the number they’re looking at. Two-part question, number one, how is that reduction going to affect the VA’s ability to serve the veterans? Also, number two, as you look across the organization, from a leadership perspective, what are you asking of the team members?
Number one, this is an understanding we need to have, is that we were never, in a sense of saying, you have to get rid of 80,000 people. It’s just like anything. If you have a goal, you’ve got to set a goal. The goal was 15%. We’re the largest organization. I have departments that are secondary or third departments in areas that are bigger than 90% of businesses in this country. They have a thousand people in this one department.
When we looked at our total force, what happened was that we were hiring a lot of people and doing things, and our numbers were going the wrong way. I just say this clearly, our backlog was going up, if you want to go back to wait times, wait times are going up, we weren’t getting referrals in the community, because we weren’t using community care. All this is an issue right here. I looked at it and said, “If we have all these people and all this money, why is this getting worse?”
I told our senior leadership one day, “If I went back to 2000, I would go back ten years, which we were hundreds of billions less in budget and 100,000 people fewer than people, and told you that in ten years, this will be what the budget looks like. This is what the staffing will look like. You would have all pitched a party.” You would have thought with the “We’re going to be Mayo Clinic. We’ll have everything we possibly need.”
They couldn’t have imagined the size we got, but it went the wrong way. Why? It’s because we kept internally doing it in ways that would hold us back. We put ourselves first and not the veteran first. We had about 30,000, and we’ll be about 30,000 down by the end of September this fiscal year. All of it came from early retirements and people voluntarily leaving. We never had to fire people to get down to that number. We also protected almost 350,000 jobs and said, “For the most part, you’re not eligible for this.”
If you weren’t in there, maybe you were a doctor, but why not do direct care? We may let you go. If you were a doctor in direct care, you weren’t going anywhere. The second part of your question is, how has it affected what we do? Our disability claims have dropped over a hundred thousand. Our wait times are, in a measurement, especially like mental health, down from 30-something days.
When I first got here at 18, 14 days on normal mental health, emergency mental health is happening within 24 hours. I’m hearing anecdotal stories when I’m at town halls. I go to town halls with open questions. “I’m getting my question answered. I’m getting my community referral. Best medical interest now, let me go to my community daughter. I didn’t have to wait through.”
We also cut out the secondary referral. In other words, when the PAC doctor said, “You had to do that, we’re going to refer you to get that second opinion.” Cut that out altogether. Just go straight to the person. In all of this, anytime you lose people or anytime that sounds difficult, you have to look at your organization, though. Our organization is working.
I think the numbers show that it’s working to do what we’re supposed to be doing, and we’re servicing veterans in the best way we possibly can. It’s not a matter. We’ve measured the wrong metric in the VA for too long. We measured the metric in the VA of how many full-time equivalents we have and how much our budget is. I measure it, and are our veterans getting the care and the claims and the help that they’ve already earned? That’s the only metric that I use.
VA must measure whether veterans are getting the right care and the claims they deserve.
What’s your leadership guidance to your staff?
Keep working hard, do your job. Be the leader that you’re supposed to be. I’ve told our senior leaders that I had all the VAMC directors in Dallas on the first of July. I said, “One, be leaders. Quit sitting there saying, I cannot do some, you’re a leader. You’re a senior leader in a hospital. Make it happen.” Work with your folks. If you need something, then push it up. I’ve told our leaders, “I’ve told everybody from the newest maintenance staff up, you will never get fired in this department for trying something.
If you’re trying and it was working, you keep trying. If you’re trying to fail, no worries. I’ll come and pick you back up and put you back on the stone and let you go again.” We’ve got to get out of this mindset of I cannot. We’ve got to get a service mindset that says, “We’re here for veterans. We’re going to do it any way we can.” I’ll have their back.
They go do the job. I’ll have their back. Our hospitals, our disability claims, that’s operations. All of us are supporting. I’ll fight the battles on Capitol Hill. The president’s already been fighting battles for them. Our budget was an increase. When other budgets were getting cut, ours was in. We actually had an increase because we knew we had to take care of our veterans. For my leadership team, at all levels, middle management, everybody, what does it take to do your job?
I ask a question of this all the time, “What’s the one thing that you could change right now that you get up every day, and I’m sure you, even your organization, why don’t we do this?” I tell them, “If you’ve got something like that, you’ve been doing for a while, change it.” Often, this department has been so scared. It seems like making change and talking about change. I have to run it up the chain. Why? When you were in the unit, the Green Beret, where did you solve military problems? At what level?
The lowest level.
Lowest level. I’ve had stuff come to my desk, and I’m saying, “Are you kidding me? Are you really asking me to make this decision? It should have been solved at the middle management of a hospital.” What we’re saying is go do your job. I’m proud of our boys. I’ll fight for them all day long. I want them to be leaders. I don’t want them to be paper pushers. I don’t want them to just go along to get along. I don’t want them to have a job that they just get up and go to. I want them to be happy that they get to serve the best client in the world, which is our veterans. I want them to have every will to do that. We’re going to give it to them in the best way we can.
Last question, test question. Is the word veteran capitalized?
In my mind, it is. Yes.
Mine too. People challenge me all the time, but now I heard it from the secretary.
Veteran is veteran. It’s capitalized. VA eventually is. I think that goes to the whole thing of what we do in VA. I think my last comment on that is, talking about this leadership issue, talking about everything else. For the longest time, you may have heard this, and you’ve been to several VAs. You had this old saying, “If you’ve been to one VA, you’ve been to them all.” That’s the biggest lie that’s ever been out there.
We have 170 hospitals that, unfortunately, decided to act like 170 different startups. I have told them, “If you have VA on the side of your building, you are one unit.” We are one team. We’re proud to be one team. I don’t expect them to be a startup. I expect them to have standardization across the units. I expect them to live up to the standards. I expect them to help each other. They’re not in competition with our local doctors and not with other VAs. It’s one of those unit cohesion things for me that we, as a VA, are going to stop doing individual stuff. We’re going to start collectively being the behemoth that we are in the healthcare world, with the largest doing what we do.
Let’s make sure we do it. We’re going to start. I’m in the middle of college football season now. I’m very happy. We’re going to walk it down. We’re going to act like we’ve been here because we have been, and we’re going to continue to do it over and over and over again. The VA, my hope is to instill a passion in them that they’re so proud to wear that VA shirt. They’re so proud to walk in there because they’re taking care of the best veterans, and our veterans are going to see it.
Leadership starts with having a vision, creating a mission, executing an excellent level against that, and having a defined standard. That’s what we learned in the military at every level. That’s what you’re instituting here at the VA. Mr. Secretary, I thank you so much for taking some time to speak with us and share where we’re going, where we’ve been, and what we have to look forward to. VA has been a big part of my life, my transition, and I know that I wouldn’t be sitting here with you. If it wasn’t for the VA, I would continue to look forward to where it goes under your leadership.
Always glad to share the vision of this department.
Thank you. I appreciate it.
Green Beret Foundation
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