A Humvee accident in Iraq about nine years ago left Navy veteran Benjamin Host with 23 screws in his head and a quarter of his skull reconstructed.
Today he is juggling college and a full-time job while trying to navigate two of the biggest bureaucracies in the U.S. government: He must shuttle between doctors from the Defense and Veterans Affairs departments for similar services to maintain his health care, disability and retirement benefits.
"There's a VA clinic five or ten miles away from the military base, but yet they can't communicate," Host, 30, of Oxnard, Calif., said in a phone interview. "You can't even get the medical treatment places to talk to each other."
The divide between the two agencies has frustrated veterans and may be affecting their medical care. While the VA has been criticized for bottlenecks in disability claims, lawmakers and veterans' advocates say the Pentagon is falling short on its responsibilities to returning troops even as it's starting to cut $37 billion this year under a process known as sequestration.
"The Defense Department has been trying to stick it to retirees for years," said Joe Davis, a spokesman for the Kansas City, Mo.-based Veterans of Foreign Wars. "They thank you for your service, but once you go out the door, you move into the expense ledger. They would like nothing more than to take all retirees off their books and send them to the VA."
Defense officials will try to save $1.8 billion this year by putting as many as 680,000 workers on 11 days of mandatory unpaid leave starting in July, which may affect services to veterans and their families.
The Pentagon's Tricare health program faces a funding crisis by August because of sequestration, raising concerns that retirees and others won't be able to get care, according to a May report from Democrats on the House Appropriations Committee led by Rep. Nita Lowey of New York.
Some 44 percent of the more than 700,000 Pentagon civilian employees in fiscal 2011 were veterans, according to a February report from the U.S. Office of Personnel Management. That means as many as 317,000 veterans who work for the Defense Department may have to give up a portion of their salaries when they take unpaid days off under sequestration plans.
Although the VA itself is shielded from the automatic cuts under sequestration, the personnel reductions at the Pentagon may hinder efforts to address the claims backlog, which has resulted in hundreds of thousands of veterans waiting more than four months for disability payment decisions.
The VA had almost 875,000 pending requests for disability and pension payments as of May 20. About two-thirds of the requests were more than 125 days old, the agency's target for timely processing.
It has taken about 250 days to process a claim, according to a February document by Allison Hickey, VA undersecretary for benefits, and Frederick Vollrath, a Pentagon official. Almost 175 of those days are spent "trying to secure" military service treatment records, according to the memo obtained by Bloomberg.
The memo "was a retrospective look at how long it previously took to gather service members' record data," Cynthia Smith, a Defense Department spokeswoman, said in an email.
The Pentagon is beginning to implement an agreement with the VA that requires the military to gather all records and certify them as complete within 45 days, she said.
Frank Kendall, undersecretary of defense for acquisition, told reporters on May 22 that the military wasn't a "major factor" in the claims backlog.
President Obama directed the two agencies in 2009 to create a "seamless" electronic records system to track a soldier's health from enlistment to burial.
Five days after his re-election, Obama renewed his push for a solution as he spoke about the obligation to take care of the nation's veterans and their families.
"No veteran should have to wait months or years for the benefits that you've earned, so we will continue to attack the claims backlog," Obama said in a Veterans Day speech at Arlington National Cemetery on Nov. 11. "We won't let up."
Instead, the VA and Pentagon have engaged in what House lawmakers described as a "bureaucratic back and forth." In a May 22 letter to Obama, 20 representatives led by Jeff Miller, R-Fla., who chairs the House Veterans' Affairs Committee and Mike Michaud, D-Maine, the panel's ranking minority member, asked the president to step in and end it. The claims delays, they said, may be impacting veterans' health.
Their request came the same day that Defense Secretary Chuck Hagel announced the military would buy a separate system for health records. His plan immediately drew criticism from lawmakers and advocates who have pressured the two agencies to build a single system.
VA Secretary Eric Shinseki and then-Defense Secretary Leon Panetta had earlier scrapped efforts to build a single records system and said they would instead work to combine electronic health data. They partly blamed costs.
The automatic cuts may worsen the claims backlog, said Rick Weidman, executive director of policy and government affairs for Silver Spring, Md.-based Vietnam Veterans of America.
About 60,000 of the Pentagon workers facing furloughs are employees of the Tricare military health program. The plan has 9.6 million beneficiaries, including more than 4.5 million military retirees and their family members.
Everything the military does "is being affected by sequestration," the Defense Department's Smith said. Even so, the military wants to minimize the effects that furloughs may have on its efforts to reduce the claims backlog, she said.
Kevin Dwyer, a spokesman for Tricare, said he wasn't able to identify what type of workers in the health program will be furloughed.
If military records personnel across the Pentagon are furloughed, veterans may wait even longer for decisions on disability payments, Weidman said.
"The cuts at the Department of Defense will impact veterans pretty heavily," Weidman said in a phone interview. "You can beef on the VA all you want, but more than half of the wait time for veterans' benefits claims comes from developing the case and getting evidence from the Defense Department."
VA officials are trying to determine whether the furloughs will affect the Pentagon's ability to provide records, said Josh Taylor, a VA spokesman. The veterans agency works with "numerous" Pentagon workers who handle disability claims. They include staff in service units as well as those in military hospitals and clinics, he said in an e-mail.
Defense cuts may also result in delayed payments to care providers and "potentially some denial of medical services," Ashton Carter, the Pentagon's deputy secretary, said during an August 2012 hearing of the House Armed Services Committee.
The department's health funding "will likely be exhausted by August 2013," according to the House Appropriations Committee report.
It's unclear whether military retirees and their families will have difficulty getting care if the Pentagon delays payments to contractors such as Minnetonka, Minnesota-based UnitedHealth Group Inc., Louisville, Ky.-based Humana Inc. and Woodland Hills, Calif.-based Health Net Inc.
The three insurers have Tricare contracts to coordinate medical services.
Tricare doesn't expect to stop paying claims, spokesman Dwyer said in an e-mail. Even so, it can't require health-care companies and professionals "to continue to provide services in the unlikely event that payment of claims is delayed or suspended," he said.
Host, the Navy petty officer third class who's recovering from a skull injury, said that former troops should be shielded from bureaucratic hassles as they seek rehabilitation.
"It takes somebody with a whole lot of marbles to stay on top of this," he said. "And most of the time people with severe injuries don't have that capacity."