Tammy Duckworth, a former Hawai'i resident and Illinois National Guard pilot who lost both legs when a rocket-propelled grenade hit her helicopter in Iraq, said the Veterans Affairs Department is "not ready" to treat amputee patients with the same kind of high-technology as Walter Reed Army Medical Center.

Duckworth, now director of the Illinois Department of Veterans Affairs, told the Senate Veterans Affairs Committee that when she was transferred to the VA hospital in Hines, Ill., the prosthetics department, "which, while eager to meet my needs, was many decades behind in prosthetics technology."

"Much of the technology is expensive and most of the VA personnel are not trained on equipment that has been on the market for several years, let alone the state-of-the-art innovations that occur almost monthly in this field," said Duckworth, who has two high-tech prosthetic legs and is the first double amputee to test a new powered knee.

Duckworth said the VA should expand an existing program to allow amputees to use private prosthetic practitioners and make it part of an overall effort for the VA and Defense Department health systems to work together better and with civilian medical systems.

The House last week approved an additional $1.7 billion for the VA as part of an emergency spending bill to fund the wars in Iraq and Afghanistan. The Senate is expected to vote later this week on its version of the bill with at least $1.76 billion for the VA.

However, the VA funding could be caught in a fight between Congress and President Bush over an effort by Democrats to set a timeline for withdrawal of troops. Bush has threatened to veto the legislation.

At today's hearing, Sen. Daniel Akaka, D-Hawai'i, chairman of the Senate Veterans Affairs Committee, asked about ways to smooth the transition of soldiers who are wounded in Iraq and Afghanistan from active-duty status with the military to veteran status with the VA.

"There is much talk about seamless transition, but it is far from clear that the talk is matched by effective action," Akaka said. "Why is it that the Defense Department and VA still cannot make the handoff of wounded service members effectively?"

Wounded soldiers are suffering needlessly while undergoing care because no one is serving as their advocate with the Defense Department and VA bureaucracies, said Jonathan D. Pruden, a former Army captain injured in Baghdad in 2003. Pruden had 20 operations between 2003 to 2006, including one in which his right leg was amputated.

At one point, Pruden said he saw "one of my men dragging his nerve damaged foot and asked why he wasn't wearing a much needed ankle-foot orthotic. He told me that the sergeant at the orthopedics clinic didn't have one his size."

Denise Mettie of Selah, Wash., said her son, Evan, suffered serious brain injuries during his second tour with the Army in Iraq last year.

Mettie said she faced bureaucratic obstacles in getting proper care for her son soon after he was transferred to a VA hospital in Seattle. The facility wasn't prepared to handle traumatic brain injuries and he had no overall treatment plan, she said.

Mettie recommended the military allow more time for patients with traumatic brain injuries to adjust to their situations before they are medically retired from active duty. She also called for the VA and Defense Department to make better use of private facilities for treating and rehabilitating injured soldiers.

"It is unfair to deny us access to the same level of care that you would choose for your children," she told the committee.