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  • AO BWN Battle Exposure

     

    • Tens of thousands of Navy Veterans are excluded from VA benefits related to Agent Orange exposure during the Vietnam war.
    • A bill making its way through Congress would extend benefits to cover blue-water Veterans, who were stationed in ships off the Vietnamese coast.
    • Early this month, VA Secretary Robert Wilkie sent a letter to lawmakers asking to stop the bill, saying its provisions are based on sympathy instead of science.
    • Veterans and their advocates are firing back, flooding the Senate with letters supporting the bill.

    Veterans groups are pushing a bill making its way through Congress that would extend VA benefits to tens of thousands US Navy Veterans who were potentially exposed to Agent Orange while serving off the coast of Vietnam. The bill is the latest glimmer of hope for Veterans who have fought for decades to receive the benefit, and would finally recognize their exposure to the toxic herbicide but come at an estimated cost of $5.5 billion to US taxpayers.

    The VA is attempting to delay this provision, saying that this vast increase in health care costs should only come after more study, which is likely to publish next year.

    "Science does not support the presumption that blue water Navy Veterans were exposed to Agent Orange," said VA Secretary Robert Wilkie in a letter to the Senate. The letter is yet another roadblock facing Vietnam Veterans who claim their health has suffered due to exposure.

    But the Veterans are fighting back. As of Thursday morning, Sen. Johnny Isakson, chairman of the Veterans affairs committee, has received at least three letters from advocates urging the Senate to pass the bill. They say the VA is "cherry-picking" evidence and overestimating the bill's true cost.

    Agent Orange was one of several chemical herbicides used during the Vietnam War to destroy enemy cover and food crops. Although primarily delivered via aircraft, the defoliant was also carried on vehicles, back-mounted equipment, and sprayed from ships.

    Operation Ranch Hand lasted about a decade before a scientific study reported that one of the chemicals caused birth defects in lab animals. The military stopped its use of herbicides in 1971; throughout the next decade Veterans began reporting instances of cancer and birth defects in their children.

    The legitimacy of their claims would be argued for the next 20 years, until the Agent Orange Act of 1991 directed the VA to conduct research into the chemical's potential side effects. In the decades since, Vietnam Veterans have slowly started to gain recognition of their Agent Orange exposure and its sometimes life-threatening consequences.

    As recently as 2010, the VA extended the list of diseases it would recognize as being linked to the herbicide. Just three years ago, the agency started accepting claims for Veterans who served in Agent Orange-contaminated aircraft in the post-Vietnam era.

    But since 2002, the VA took what advocates and Veterans say was a step backwards by invalidating claims presented by blue-water Veterans, saying there was no conclusive scientific evidence that the Vets, who served in warships off the coast, were ever exposed to Agent Orange.

    VA: Too much money, not enough science

    The question is whether the Veterans were exposed to the herbicide through chemical runoff that made its way into the South China Sea and was then converted into drinking water through the ships' distillation plants.

    Where the ships were located makes all the difference.

    The VA discredits arguments that US ships made water close enough to land to have used contaminated water. According to the Institute of Medicine, which is now known as the National Academy of Medicine, any chemical runoff would likely have been diluted by coastal waters before reaching the ships' intakes. But, as reported in extensive coverage by ProPublica, Veterans have said ships often distilled water well within that range.

    Surprisingly, both sides of the ordeal — the VA, which claims blue water Veterans were not exposed and Veterans advocacy groups that say they were — use the same IOM study to argue their side.

    That's because the IOM merely states it is "possible" the Navy Vets were exposed.

    The VA now says that's exactly why they should wait before extending benefits to blue-water Veterans.

    In a Senate hearing on August 1, Dr. Paul Lawrence, the VA under secretary for benefits, noted this as just one of three reasons the VA opposes the bill.

    One of the provisions would increase the fee charged to borrowers under the VA's home loan program. Lawrence said the VA is opposed to "increasing the costs that some Veterans must pay to access their benefits."

    He also maintained that the increased loan fees could not offset the costs associated with an extension of Agent Orange-related benefits. Secretary Wilkie's letter reinforced this idea, stating that Congress had underestimated the health care costs by a whopping $5.4 billion. He also argued that the addition of tens of thousands of eligible Veterans would only exacerbate an already extensive backlog of Agent Orange-related claims.

    These arguments echo one made in July, just days before the Senate hearing, by former VA Secretary and Vietnam Navy Veteran Anthony Principi. In an op-ed published in USA Today, Principi argued that Congress should stand on the side of science and pass "sensible laws that maintain the integrity of our legislative process."

    Veterans and advocates say that's 'poppycock'

    The Veterans won't face this battle alone.

    The Senate is hearing from a resounding chorus of supporters who say the VA is using a typical stall tactic.

    "These Vietnam Veterans have waited too long. It is time for us as a country to do the right thing," former VA Secretary Dr. David Shulkin wrote. Dr. Shulkin, who was fired by President Donald Trump in late March, said this bill is not driven by sympathy as the VA claims, but by a conscientious desire to uphold "our country's responsibility for caring for those who have borne the battle."

    Another letter, cosigned by four Veterans organizations, pointed out that it was the VA's "erroneous decision" to disqualify blue-water Veterans in the first place, and that the science is on their side.

    "The IOM found that there is not a scientific basis to exclude blue water Navy Veterans," the letter said.

    In his letter addressed to the Senate, Dr. Shulkin recognized the legitimacy of both sides of this nuanced issue.

    "The answer must not be to simply deny benefits," he wrote. "When there is a deadlock, my personal belief is that the tie should be broken in favor of the brave men and women that put their lives on the line for all of us."

    The Blue Water Navy Vietnam Veterans Act soared through the House of Representatives with a vote of 382-0. When — or even if — it will become law now rests in the hands of the Senate which, as of Thursday, has yet to decide.

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  • CALVET HOMES

     

    CalVet is in the process of updating the rules for admission eligibility at our eight California Veterans Homes.

  • Congress

     

    After years of false hopes and disappointments from Congress, military personnel with at least 20 years of service who did not spend more than 179 consecutive days on federal active duty received an early Christmas present from both Congress and the president.

    President Barack Obama signed into law on Dec. 16 legislation known as the Jeff Miller and Richard Blumenthal Veterans Health Care and Benefits Improvement Act of 2016 that grants Veteran status for National Guard soldiers and airmen and reservists from all branches of service.

    Earlier this month, the 114th Congress approved legislation to expand the legal definition of a Veteran for guardsmen and reservists who honorably serve or had served in the military for 20 years but were never called up for federal active duty for an extended period of time.

    VICTORY FOR VETERANS

    “I still think it falls somewhat short, but it is a step in the right direction. A person in the guard or reserves who spends 20 years of good service at a minimum would get around 1,260 days on duty or about 3.5 years of honorable service.” Brig. Gen. Bill Burks, the adjutant general forNevada.

    "This legislation is a victory for Veterans. While we still have work to do, I am proud of how we have moved the ball forward in a bipartisan way," said Rep. Tim Walz, D-Minn., a retired National Guard sergeant major.

    Since first coming to Congress, Walz — along with members of the Nevada delegation to include Sen. Dean Heller, outgoing senator and Senate Minority Leader Harry Reid and Congressmen Mark Amodei and Joe Heck, both Army Veterans — has fought tfor this legislation to honor guardsmen and reservists.

    In Nevada for example, the state recognizes guardsmen and reservists as Veterans without the requirement of 179 days of federal active duty. No one, though, welcomed the news more than Brig. Gen. Bill Burks, the adjutant general for Nevada.

    "I still think it falls somewhat short, but it is a step in the right direction," he said in an email to the Lahontan Valley News. "A person in the guard or reserves who spends 20 years of good service at a minimum would get around 1,260 days on duty (63 days times 20 years) or about 3.5 years of honorable service.

    "I know all enlistments are now for eight years (active, guard and reserve), but if you can manage that as a period of two to three years active duty enlistment and spend the remainder in the IRR (Individual Readiness Reserve), you are considered a Veteran even if you never leave the United States. So you can see the disparity in the systems.

    "Lastly, I don't know of any guard member that only does the one weekend a month and two weeks a year anymore. I think the average nationwide is well over a 100 days for the average guard member."

    Kat Miller, director of the Nevada Department of Veteran Services, said the legislation provides for no additional benefits other than permitting those who are entitled to retired pay for nonregular service to be referred to as Veterans.

    "Nevada is ahead of the federal government in acknowledging members of the Guard and Reserve as Veterans," she said. "In fact in 2013 Gov. (Brian) Sandoval signed Assembly Bill 266, which established that in Nevada members of the National Guard and Reserve forces are defined as "Veterans" if they have been assigned to duty for a minimum of six continuous years, even if they are not military retirees."

    Sen. Dean Heller said the passage of the bill and the president's signature "have been a long time coming." He said guardsmen and reservists take the same educational courses and perform the same type of training.

    "I am very grateful to honor those who honor their country," Heller said in a phone interview with the LVN. "This will serve them well. These men and women work hard and serve hard. They did what they had to."

    Likewise, Amodei said Walz's legislation bill is common sense legislation and lawmakers persevered to pass this law.

    "It's the right thing to do," said Amodei, who represents Congressional District 2 in Northern Nevada. "The folks in the Guard and Reserve will now be acknowledged."

    Both Reid and Heck did not comment on the bill's passage.

    NO EXTRA BENEFITS

    The National Guard Association of the United States has been a big proponent of attaining Veterans status for guardsmen and reservists.

    "The current definition has long been out of date," said retired Maj. Gen. Gus Hargett, NGAUS president. "It fails to recognize the deterrence value of training and readiness to our national security. Many of those affected underwent arduous, even dangerous, training. They helped win the Cold War. Others worked in direct support of those who did deploy. Yet our nation tells them that they aren't Veterans."

    NGAUS vigorously pushed for the change for six years. It easily passed in the House in every session only to be halted in the Senate by fears that an expansion of the definition would raise the cost of Veteran entitlement programs.

    The House and Senate actually approved the change last year, but the language was not identical. This forced the two chambers to come up with a compromise provision, which they did last week.

    John Goheen, director of Communications for NGAUS, served on active duty and has worked alongside guardsmen and reservists.

    "All of us should be called Veterans. We all served," he said, adding many guardsmen and reservists served with distinction.

    Because of the provision of the law, Goheen said the newly minted Veterans will not be eligible for additional benefits, a point echoed by Miller.

    "However, neither the Federal nor the state legislation affects eligibility at our cemeteries or at the Nevada State Nursing home," Miller pointed out. "Our cemeteries and nursing home must follow federal eligibility guidelines in order to receive federal reimbursement. This legislation did not change current Federal law which only permits National Guard and Reserve members to be buried at the cemeteries if they have served two continuous years on active duty, died while in the line of duty, or if they were officially retired from the guard of reserve."

    Miller also said a Veteran must have had 90 days of active duty military service to receive care at a state Veterans home,

    LAW AFFECTS THOUSANDS IN NEVADA

    Retired Nevada Army Guard Command Sgt. Maj. Wayne Willson said the bill will affect millions of guardsmen and reservists across the United States, and thousands of military personnel in Nevada who never worked in an AGR (Active Guard Reserve) full-time federal status or deployed for more than 179 days. Willson said not too many Guardsmen deployed to Vietnam although the Nevada Air Guard received orders to activate airmen when the North Koreans seized the USS Pueblo in 1968. Fewer than 51,000 Guardsmen received a call up to Desert Shield/Desert Storm in 1990-1991. The massive deployments, though, began in 2002 and 2003 when the military deployed both active duty and reservists to Iraq and Afghanistan.

    Retired Nevada Army Guard Maj. James M. Ludlow of Fallon spent 22 years in the National Guard but never deployed more than 179 days. During his career, he commanded several Carson City units and traveled overseas numerous times for training including to the Republic of Korea and Panama.

    "It bothered me a little bit," Ludlow said about the federal government's lack of recognition for Guardsmen and Reservists. "People served only two years in active duty were called Veterans," said Ludlow, an engineering officer who has the equivalent of more than six years of military service. "When I served in the Guard, we were eligible for federal call-up."

    Ludlow said he was glad when he heard Congress passed the legislation and the president signed it.

    Chief Warrant Officer 4 Joe Dolan of Carson City spent 41 years in the Nevada Army Guard, most of that time as a state technician. Although technicians wear the uniform and must take the same courses as their active-duty counterparts, they are considered as civilian state — not federal — employees. Most technicians worked in Carson City, Reno and Las Vegas.

    "This is certainly good news," said Dolan, who served as both an administrative and safety officer.

    Overall, Miller said the legislation is important for recognition.

    "I personally would like to see the federal government expand eligibility for burial and nursing home benefits to all those who serve in the Guard and Reserve … not just our retirees," she said. "These patriotic men and women volunteered to serve our nation and our state in times of both restless peace and war; the fact that they were not called up to do so in no way detracts from their willingness to serve."

    ADDITIONAL PROVISIONS

    In addition to the provision for federal status, the bill also included the following provisions:

    HR 2691 – Authorizes the VA to provide burial and funeral benefits to Veterans if there is sufficient evidence to establish that they deserve the benefit, even if the Veteran had not filed paperwork with the VA previously.

    Sections of HR 1338 – Requires VA to report to Congress on the interment of unclaimed remains of deceased Veterans to ensure they are treated with dignity and respect.

    HR 2531 – Fixes a component of the Fry Scholarship (for surviving spouses of post-9/11 Service Members who die in the line of duty) so that recipients from 2001-2005 can receive the full benefit they are entitled to.

    According to the congressman's office, the bill also had about 60 other provisions improving VA-provided services to homeless Veterans, VA construction management, the Vocation Rehabilitation and Employment program, and access to care in the Veterans Health Administration.

    Source

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  • VA secretaries spar

     

    WASHINGTON — The fight over extending benefits to “blue water” Veterans who served on ships off the coast of Vietnam is now pitting former Veterans Affairs secretaries against each other, adding to the confusion over Congress’ next steps.

    Last week, four former VA secretaries — Anthony Principi, Jim Nicholson, James Peake and Bob McDonald — wrote to the Senate Veterans’ Affairs Committee urging lawmakers not to grant presumptive illness status to roughly 90,000 blue water Veterans who claim exposure to the chemical defoliant Agent Orange, saying there is insufficient proof for their cases.

    “(This legislation) is based on what we believe to be inconclusive evidence to verify that these crews experience exposure to Agent Orange while their vessels were underway,” the group wrote. “We urge the committee to defer action … until such a study is completed and scientific evidence is established to expand presumptions to those at sea.”

    The recommendation is in line with arguments laid out by current VA Secretary Robert Wilkie earlier this month. Department officials have argued that granting the presumptive status to Veterans could upend the system by establishing new, non-scientific criteria for awarding benefits.

    But advocates for the Vietnam Veterans have argued that scientific proof of exposure is impossible given that proper sampling was not done decades ago, as the ships patrolled the waters around the South China Sea.

    They say rare cancers and other unusual illnesses clustering among the blue water Veterans should be enough to spur action from Congress.

    Earlier this year, members of the House agreed. They overwhelmingly passed legislation that would require VA officials to automatically assume those Veterans were exposed to Agent Orange for benefits purposes, the same status granted to troops who served on the ground in Vietnam or on ships traveling upon inland rivers.

    Under current department rules, the blue water Veterans can receive medical care for their illnesses through VA but must prove toxic exposure while on duty to receive compensation for the ailments. Advocates have argued that VA officials are systematically denying those claims.

    In a letters to Wilkie and the committee this week, John Wells — counsel to the Blue Water Navy Vietnam Veterans Association — blasted the department’s stance as unfair and inhumane.

    “Whether (the opposition) is due to bureaucratic intransigence or incompetence I do not know,” he wrote. “The bottom line, however, is that they have misrepresented and ‘cherry picked’ evidence to support their flawed position. That is a stain on the national honor.”

    Wells and other advocates have an ally in at least one former VA leader. David Shulkin, who was fired by Trump earlier this year, petitioned the Senate committee this week to move ahead on the issue, calling it a matter of honoring the Veterans’ sacrifice.

    “As Secretary, I was faced with the dilemma of what to do when there was insufficient evidence to make a reasonable conclusion,” he wrote. “I stated then — and continue to believe — that in the absence of reliable data to guide a decision, the answer must not be to simply deny benefits.

    “When there is a deadlock, my personal belief is that the tie should be broken in favor of the brave men and women that put their lives on the line for all of us.”

    Moving ahead with the legislation could prove expensive for the department. House officials estimated the cost of extending benefits to be about $1.1 billion over 10 years, but current VA officials have insisted the total is closer to $5.5 billion.

    For now, the legislation remains stalled in the Senate Veterans’ Affairs Committee. Chairman Johnny Isakson, R-Ga., has said the issue is among his top priorities but has also voiced concerns about whether the House measure as written covers the cost and scope of the problem.

    Wilkie is scheduled to appear before the committee on Sept. 26 to discuss a host of reform efforts at the department since he took over the top leadership post on July 30.

    Source

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  • Dental Coverage

    Military retirees eligible for the new dental and vision coverage — as well as active duty families eligible for the new vision benefit — can start researching their options in earnest now, with the release of new rates for 2019.

    The enrollment period for coverage under the Federal Employee Dental and Vision Insurance Program, or FEDVIP, is Nov. 12 to Dec. 10, but the time to start comparisons is now, said Kathy Beasley, director of government relations, health affairs, for the Military Officers Association of America.

    For retirees, the FEDVIP replaces the Tricare Retiree Dental Program, which ends Dec. 31. In order to have dental and vision coverage on Jan. 1, retirees must sign up during the enrollment period. Active duty families are still eligible for dental coverage under Tricare, but if they want the new vision coverage, they must sign up during the enrollment period.

    “We want to get this information out as soon as we can to give people extra time to make their decisions,” Beasley said, noting the Office of Personnel Management had provided the information early, in advance of being published on Tricare.benefeds.com. The rate information is available here, and will be available in early October on the website, along with a comparison tool that helps in making the choice.

    The rates and options vary among the different plans, but according to Beasley, officials with the Office of Personnel Management said the average gross dental premium for 2019 increases by 1.2 percent compared to rates for 2018. That does vary; for example, the FEP BlueDental rates for 2019 are decreasing on average by 6.8 percent for the high option and by 7.8 percent for the standard option, according to William A. Breskin, senior vice president of government programs for the Blue Cross Blue Shield Association.

    The actual premium will depend on the plan chosen, but across the carriers, the average dental premium rates for 2019:

    Average biweekly dental premium*

    Average monthly dental premium*

    Self

    $17.41

    $37.73

    Self + 1

    $34.14

    $73.97

    Self + family

    $49.23

    $106.68

    *Actual premium may be higher or lower

    *Actual premium may be higher or lower

    The average vision gross premium is decreasing by 2.8 percent in 2019.

    The actual premium will depend on the plan chosen, but across the carriers, the average vision premium rates for 2019:

    Average biweekly vision premium*

    Average biweekly vision premium*

    Self

    $5.10

    $11.05

    Self + 1

    $10.23

    $22.16

    Self + Family

    $14.75

    $31.96

    *Actual premium may be higher or lower

    *Actual premium may be higher or lower

    It’s difficult to compare costs under the new plan with current costs under the Tricare Retiree Dental Program because the TRDP is a “one size fits all” program.

    Beasley said many MOAA members have said they looked at the 2018 FEDVIP prices compared to TRDP, and can’t find the exact same coverage and prices for comparison purposes. The FEDVIP offers a variety of different plans and options, with 10 different companies offering dental options for dental coverage, and four different companies offering vision coverage.

    She said officials at OPM, the Defense Health Agency, military service organizations and Veterans service organizations have joined forces in the last few months to get the word out to retirees about the new retiree dental plan options, but some apparently don’t know about the changes. She said she was in Huntsville, Alabama, giving a briefing, and about half of the retirees she spoke to had heard about the changes.

    As retirees evaluate their choices for the new dental plan, Beasley suggests that if they like their current dentist, they should ask their dentist whether they accept a FEDVIP plan, and talk about next year’s dental needs.

    “Your dentist knows your dental health and what you might anticipate in the future," she said. "Do your due diligence and look at the pricing. Use the plan comparison tool, and make your decision based on that.”

    Source

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  • Ind Unemploy

     

    As a VA claims processor, Veterans often ask me about Individual Unemployability (IU), also called Total Disability based on Individual Unemployability (TDIU). The following is a more formal version of what I tell them.

  • Justice 003

     

    SAN DIEGO – Michael Vanden Brink pleaded guilty today to stealing thousands of dollars in benefits intended for the widow of a military Veteran. During his plea before U.S. Magistrate Judge Jan M. Adler this morning, Brink admitted that after the widow’s death in 2004, he converted her benefits paid out by the Department of Veteran’s Affairs to his own use.

    Brink, 57, acknowledged that H.C.C., the spouse of a deceased Veteran, began to receive Dependency and Indemnity Compensation benefits in 1972. Sometime prior to March 2004, H.C.C. began to receive those benefits via direct deposit into a bank account in both her name and Brink’s.

    Brink acknowledged that H.C.C. died on June 30, 2004, at her home in Oceanside, California, and that he was aware of her death and that her benefits should have ceased immediately upon her death. Brink further acknowledged that he knew that he was not entitled to H.C.C.’s benefits, and that he knew that the money rightfully belonged to the United States.

    As a part of his plea, Brink admitted that he received a monthly bank statement for the account, and that he never informed the bank that H.C.C.’s monthly benefits should cease. Instead, Brink admitted that from July 1, 2004 until February 26, 2014, only he had access to and control of all funds in the bank account, and that during that time he converted a total of $145,035 in United States’ money to his own use.

    “For almost a decade, this defendant stole thousands of dollars intended to help the families of our brave men and women in uniform,” said United States Attorney Adam L. Braverman. “This prosecution demonstrates the commitment of the United States Attorney’s Office to protecting the integrity of programs for our Veterans and their families.”

    “This investigation demonstrates the OIG’s commitment to aggressively pursue individuals who defraud VA programs. The VA OIG will continue to identify criminal activity in order to protect the integrity of VA programs.” said Special Agent in Charge A.E. Pleasant, U.S. Department of Veterans Affairs, Office of Inspector General, Criminal Investigations Division, Western Field Office.

    As a part of his plea agreement, Brink agreed to pay $145,035 in restitution to the Department of Veteran’s Affairs. Brink faces up to 10 years in federal prison and a fine of up to $390,060 at his sentencing hearing before U.S. District Judge John A. Houston on December 10, 2018.

    DEFENDANT                       Case Number 18-cr-3894      

    Michael Vanden Brink           Oceanside, CA.

    SUMMARY OF CHARGES

    Theft of Public Property – Title 18, U.S.C., Section 641

    Maximum penalty: 10 years’ imprisonment, $390,060 fine, restitution

    AGENCIES

    U.S. Department of Veteran’s Affairs, Office of Inspector General – Criminal Investigations Division

    Source

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  • TRICARE Logo

    By law, the TRICARE Retiree Dental Program (TRDP) will end on Dec. 31, 2018. New dental plan options for those enrolled in TRDP will be available through the Federal Employees Dental and Vision Insurance Program (FEDVIP). FEDVIP vision coverage will also be available for the first time.

    In case you missed the September webinar, join the TRICARE webinar on Oct. 11, from 2 to 3 p.m. ET, to learn about new dental and vision coverage under FEDVIP. The “New Dental and Vision Coverage Options for TRICARE Beneficiaries” webinar will discuss who is eligible for FEDVIP, as well as how and when to enroll.

    There’s no automatic enrollment into a new dental plan once TRDP ends. For 2019 dental coverage, retirees and their family members must take action to enroll in a FEDVIP plan. All beneficiaries eligible for TRDP are eligible for FEDVIP dental coverage. Visit the FEDVIP website for dental plan options.

    If you’re eligible, your first chance to enroll in FEDVIP is during the 2018 Federal Benefits Open Season. This runs from Nov. 12 through Dec. 10, 2018. Your coverage will then start Jan. 1, 2019.

    Retirees, retiree families, and active duty families are eligible for FEDVIP vision coverage. This year’s FEDVIP open season is also your first chance to enroll in a FEDVIP vision plan. If you enroll during open season, your coverage will start Jan. 1, 2019. Visit the FEDVIP website for vision plan options.

    Register to join us on Oct. 11 to learn more about the TRDP transition to FEDVIP and what the change means for you. A Q&A led by the presenters will follow the presentation.

    Keep updated on all of the TRICARE changes. For the latest on changes to TRICARE, visit TRICARE News and TRICARE Changes.

    Source

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  • VA Report

    Jeff Sweeney and Galen Warman were not surprised by the findings. Any of them.

    Not by the first report issued by the Office of the Medical Inspector, or the second, or the third, released last week in an investigation into the Manchester VA Medical Center’s competency and procedures.

    “They’re notorious for covering things up,” said Sweeney, 40. “I am fed up for having to fight for everything and I’m fed up being in pain all the time, but I’m not surprised.”

    Their skepticism is easy to understand, since the Office of the Medical Inspector is the VA’s own investigative arm. That’s why they think the OMI essentially shouted, “Nothing to see here,” in its recent findings, when it ruled on a variety of issues, including suspected mistreatment, misdiagnosis and slow response times connected to Myelopathy, a compression of the spinal cord.

    Sweeney and Warman both live in Concord, were both injured while serving their country and both sought medical help for their severe back and neck pain. They’ve moved on, started new lives, learned to live with their pain, and the ongoing process of an organization investigating itself has dulled their senses.

    “It falls in line with what they’ve been trying to do,” Warman told me. “I expected this all along, so no one is plowing new ground.”

    Indeed, this is old ground. Warman suffered back and neck injuries in a construction accident 30 years ago and a car wreck in 2007. Sweeney’s truck was hit by an improvised explosive device in Iraq in 2011.

    They both have since gotten some relief through surgery, but years had passed before they received the proper care, and they still have plenty of aches and pains.

    That’s why the whistleblowers we’ve been hearing about since the summer of 2017, the ones with those medical and nursing degrees – the ones who documented incompetency and delays in treatment and immoral record keeping and a poor monitoring system on degenerative spinal conditions – won’t let this go.

    In fact, they remain fighting mad, complaining about the conflict of interest they’ve seen as part of the VA’s investigation and the lack of accountability since the story exploded in the Boston Globe.

    “It’s what they do, like a damage control system,” said whistleblower Dr. Ed Kois, head of the spinal cord clinic at the Manchester VA. “They say they’re going to investigate, bring in the OMI knowing they’ll do a lengthy investigation and then wash their hands.”

    The Office of Special Counsel, an independent entity that oversees the OMI, isn’t buying it. In a prepared statement emailed to me, the OSC’s special counsel, Henry Kerner, wrote that “clear discrepancies undermine the assertion that VA leadership was open to concerns and worked to ensure Veterans receive timely care.”

    Those words were golden to Kois and Stewart Levenson, the Manchester VA’s former Medicine Department chairman, who were the loudest whistleblowers among the 12 staff members who came forward.

    They want you to know they are not doctors with axes to grind, nor are they trying to further their careers, working as self-promoters, promised by an outside government entity to expose trouble at the VA.

    Kois says he hasn’t been promised a better parking spot, and Levenson insists he did not come aboard to boost his chances of winning a seat in the U.S. House of Representatives.

    Kois’s parking spot remains unchanged, and he’s still courting the press, trying to make as much noise as possible. And Levenson did not win in the primary election, yet he’s writing op-eds and calling columnists back so these problems don’t fade from view.

    “All these investigative bodies descended on Manchester and you would think more would have been done,” Levenson said by phone. “But how can you investigate yourself? It was garbage. You can’t explain it away.”

    Added Dr. Ted Daly, another reputable whistleblower: “I’m flabbergasted by their conclusions.”

    Levenson, Kois and the others cited dirty surgical instruments, flies in the operating room and mismanagement up top, but it was the mistakes made on patients with compressed spinal cord problems that were the most alarming and damaging.

    Kois called it a “perfect storm” of factors. The Manchester VA had no neurosurgeons, forcing patients to the Boston VA in West Roxbury, which was overworked and not able to give the proper care.

    Record keeping between Boston and Manchester failed to clearly show who needed surgery, and a doctor named Muhammad Huq, the former head of the spinal cord clinic at the Manchester VA, was found to be cutting and pasting notes in medical charts, meaning information remained unchanged for years.

    Some whistleblowers and staff felt that upper management was more concerned with ratings and budgets than actual care, which led to the ouster of top officials once the story broke.

    Caught in this perfect storm were nearly 100 patients with spinal cord problems, many of whom were never properly treated. Some ended up in wheelchairs, others were forced to use canes, and still others simply had to endure pain needlessly for years, for a condition that one doctor said often goes untreated in third-world countries like Nigeria.

    But certainly not here in the U.S.

    Try telling that to Warman, 67, an Army Veteran who later served in the Air National Guard. His back pain went undiagnosed for years at the Manchester VA, leading to an endless supply of painkillers and a drastic change in lifestyle.

    “They were not forthcoming on how to treat it,” Warman told me. “It was like, ‘Take two of these in the morning and have a nice day.’ I was addicted to painkillers.

    “I tried to have some kind of life and I kept asking for help and getting none,” Warman continued. “They said they were not responsible.”

    Kois, new to the facility, first examined Warman in 2015. His response after viewing an MRI was “Holy s---.”

    “It showed he had severe narrowing of the spinal canal,” Kois said. “I sent him for further evaluation and he had surgery and I saw him again and he was doing great.”

    Pain remains, but Warman is strong enough to work at Cumberland Farms and deliver newspapers.

    And then there’s Sweeney. After midnight, riding in the lead truck in a convoy of at least 30 vehicles, he heard a bang, saw a flash and, after running for cover and the adrenaline rush had worn off, awoke with his back “killing me.”

    The Manchester VA sent him for physical therapy, which did nothing. Neither did steroids. Surgery was performed in Boston, but Sweeney awoke in even more pain.

    He was told during subsequent checkups that the pain was a normal part of the recovery process, but the pain grew worse and he later was let go from his job with the Department of Transportation for missing eight months.

    Sweeney said the VA eventually stopped taking his calls. He contemplated suicide. He drank a lot of beer. Then he went to see Kois, who took a CAT scan and told Sweeney, “I want you in my office, now.”

    Sweeney pulled out his phone and showed me what Kois had shown him: a picture of his spine, with a screw inserted into bone, which was fine, and another screw penetrating a nerve, which was not.

    “Permanent nerve damage caused by the VA,” Sweeney said. “I didn’t put that screw in there myself.”

    But following 14-hour surgery to remove the misplaced screw at New England Baptist Hospital, Sweeney’s life changed.

    “I was shocked that I was walking,” Sweeney said. “I went for a walk with the nurse and I felt good walking around. I’ll have contact with Dr. Kois for the rest of my life, if I can. Dr. Kois saved my life.”

    There’s still pain, though. Sweeney has been taking steroid injections since January. He installs natural gas lines and hopes surgery in the future will return him to some sense of normalcy.

    And, soon, his story and that of five others from across the country will be told in a documentary called, The Care They’ve Earned, an unflinching look at flaws and holes in the VA system.

    Advanced screenings have been shown in selective theaters this summer. Sweeney didn’t know the film’s release date around here, and its producer, Justin Springer, was unavailable for comment.

    Sweeney showed me a trailer on his phone, which included that CAT scan, the one that clearly showed those two screws in his back.

    “I hope people see it,” Sweeney told me. “I lived it and it was still an eye-opener for me.”

    Source

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  • Donald Trump 001

     

    President Trump to issue executive order requesting mental health coverage for a 12 month period for all service members as they leave the military, administration officials say in briefing.

    • Evidence 002

       

      One of the major aspects of developing a disability claim with the VA is gathering and submitting relevant evidence to help support it. The VA has what is called a duty to assist, however, it can be extremely beneficial to also gather your own evidence during the claims process. By submitting various forms of evidence, you provide the VA with more information and different angles for them to view your case. The type of evidence you should consider submitting will depend greatly on the disabilities that you are experiencing and at what step of the process you are at.

      Types of Evidence

      Service Records/Service Medical Records

      When trying to initially get your claim service connected, you have to show an in-service event that led to your disability. The easiest way to prove this in-service event is with your service records and medical records, if the event is documented. Whether it is a physical injury, or a mental one, having it documented in your service records can be a huge stress reliever when it comes to managing your VA claim. If the in-service event is not documented in your service record, don’t give up on your claim! There are other pieces of evidence that can be used to help prove your claim.

      Service records can also be beneficial when you need to prove you were in a certain location during a specific time period. For example, for the VA’s presumptive illnesses, you may need to show that you were in Vietnam or Thailand between 1962 and 1975, or that you were stationed at Camp Lejeune between 1953 and 1987, or even possibly that you served in the Southwest Asia Theater during the Gulf War. Your service record should contain any documents that show what units you were assigned to and the location of each. These documents can include, but are not limited to, orders, travel vouchers, re-enlistment paperwork, and awards.

      Expert Medical Opinions

      Medical opinions can be useful, whether you are trying to show service connection for a disability, or if you are requesting an increased rating. Medical opinions allow for an outside doctor to review your claims file and meet with you to discuss your disabilities, symptoms, and the limitations you suffer because of it. They can provide the VA with a detailed medical account to show diagnosis and severity.

      Employment Information

      When filing for increased compensation based on unemployability, it is required to disclose your employers of the last five years that you actually worked. By giving the VA the employer’s name and address, it allows them to send the employer a form to verify when you worked there, your total income earned, the type of work you did, and anytime you lost due to illnesses. Basically, they are verifying all of the information that you included on the form 21-8940, but they want to hear it from the employer. You can expedite this step by sending your previous employers a form 21-4192 when you first file for individual unemployability.

      Buddy Statements

      Buddy statements can be helpful at any point in your process with the VA. If you are trying to get service connected or receive a higher rating, a buddy statement can prove to be your best piece of evidence. Generally, buddy statements will come from close family members or friends who have witnessed your disabilities and the change they have caused in your life. Buddy statements can also come from fellow service members, and can be beneficial if you are trying to prove a specific location or an event in service. They can help to corroborate the facts to the VA and provide an additional outlook on your situation.

      Deck Logs

      Deck logs can be vital to a Navy Veteran’s claim, especially when they need to show that they were part of the Brown Water Navy, serving within the inland waterways of Vietnam. For these Veterans, the deck logs for their ship during the time they were deployed to Vietnam can be requested and used to show on what days their ship was inland and what specific bay or waterway they were in. Deck logs can also be used to help prove a stressor that may have occurred on board on the ship. For example, if there was an active shooter on the ship and a Veteran developed PTSD and is now trying to get it service connected, the deck logs can be used to prove the incident occurred and provide the details of the situation.

      Dependent Benefits

      If you are trying to obtain additional compensation for your dependents, there is also evidence required for these benefits to be granted. When you file for dependents with the VA, you must complete a form 21-686c. With this form, you list any current and prior marriages, as well any prior marriages of your spouse. You also list any children who may qualify for benefits. To prove you have a spouse, you may be required to submit your marriage certificate and any prior divorce decrees. To claim children, you may be required to submit their birth certificate, so it is helpful to know where these documents are and have them ready to avoid further delay with the VA.

      Source

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    • TRICARE Logo

       

      If you’re eligible for TRICARE, you can choose from a variety of plans. This gives you options for where and how you seek medical care. But how do you decide which plan or plans are best for you and your family members? The TRICARE website can help you learn what health plans you may be eligible for and compare plan features and costs. This will help you choose the right TRICARE plan for you and your family.

      Find a TRICARE Plan

      If you aren’t sure what health plans you may be eligible for, start by using the TRICARE Plan Finder. Answer a few simple questions, and the tool will display the choices of plans you may be eligible for based on who you are and where you live. You can do this for yourself or for family members. Remember that different family members may be eligible for different plans.

      Compare Plans

      If you want to compare several health plans, you can compare their features side-by-side using the Compare Plans tool. Simply select the plans you’re interested in learning more about. The results will display in a table, allowing you to compare the main features and costs of each plan, including:

      • Cost for a primary or specialty care visit
      • Annual deductible
      • Maximum out-of-pocket costs
      • Enrollment requirements
      • Annual fee
      • Locations where the plan is available

      Take command of your health by making informed decisions about your TRICARE benefit. The TRICARE Plan Finder and Compare Plans are just two helpful tools that make it easier to determine the right health plan for you and your family.

      Source

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    • DVA Logo 019

       

      Today the U.S. Department of Veterans Affairs (VA) announced a series of immediate actions to improve the timeliness of payments to community providers.

    • DVA Logo 005

       

      Supplemental Income for Wartime Veterans

      VA helps Veterans and their families cope with financial challenges by providing supplemental income through the Veterans Pension benefit. Veterans Pension is a tax-free monetary benefit payable to low-income wartime Veterans.

      Eligibility

      Generally, a Veteran must have at least 90 days of active duty service, with at least one day during a wartime period to qualify for a VA Pension. If you entered active duty after September 7, 1980, generally you must have served at least 24 months or the full period for which you were called or ordered to active duty (with some exceptions), with at least one day during a wartime period.

      In addition to meeting minimum service requirements, the Veteran must be:

      • Age 65 or older, OR
      • Totally and permanently disabled, OR
      • A patient in a nursing home receiving skilled nursing care, OR
      • Receiving Social Security Disability Insurance, OR
      • Receiving Supplemental Security Income

      Your yearly family income must be less than the amount set by Congress to qualify for the Veterans Pension benefit. Learn more about income and net worth limitation, and see an example of how VA calculates the VA Pension benefit.

      Additional Pension Allowances

      Veterans or surviving spouses who are eligible for VA pension and are housebound or require the aid and attendance of another person may be eligible for an additional monetary payment.

      How To Apply

      You can apply for Veterans Pension online or download and complete VA Form 21P-527EZ, “Application for Pension”. You can mail your application to the Pension Management Center (PMC) that serves your state. You may also visit your local regional benefit office and turn in your application for processing. You can locate your local regional benefit office using the VA Facility Locator

      To apply for increased pension based on A&A or Housebound payments, write to the PMC that serves your state and provide medical evidence, such as a doctor’s report, that validates the need for an increased benefit.

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    • Website Updates 002 

    • Going Back to School

       

      Welcome to The Bridge, a regular column from Andrea N. Goldstein on the experience and challenges of transitioning from the military to civilian life.

      I was drunk at a Korean karaoke bar in Bahrain when I decided I was going to leave the Navy. I made up my mind when between songs, I overheard someone who was about to take terminal leave say, “If you know you’re not going to stay in for twenty, leave sooner rather than later.”

      It wasn’t a knee-jerk decision. I planned my exit from the Navy well in advance (and publicly on Task & Purpose). I wanted to go to the graduate school of my choice full-time on the timeline that I dictated. Like many others, I also wavered about when I’d leave. After deployment, I dropped my papers to resign my active duty commission and started grad school applications. I left active duty two years ago, and in May, I graduated from the Fletcher School of Law and Diplomacy at Tufts University.

      Conventional wisdom about being a Veteran in school focuses on benefits or jokes about being an older student. And most of it holds up, no matter the kind of program, whether you’re a first-time, first-generation college student, or getting a Ph.D. But here’s what nobody tells you:

      Trauma has an incubation period

      I didn’t realize how some of the worst days of my service had profoundly affected me until the second semester of my first year, when I started white-knuckling the desk in the back of the lecture hall in one of my classes. I didn’t serve in direct combat, and the kinds of missions I supported don’t make the news unless something goes horribly wrong. I felt like I didn’t deserve to feel the anxiety that lived in my bones. It took interviewing hundreds of women Veterans for my thesis, including a handful who had a similar military experience to me decades earlier, to realize that we were struggling with some of the same issues and that was okay.

      For many Veterans, the college or graduate school application process is the first time they have to tell their story, and that often brings up a lot of challenging memories. Know this, and use it to grow stronger.

      Take care of your health. Seriously.

      The military broke most of us somehow—and for many, it takes a while before we notice. Get enrolled at the local VA for healthcare before your semester starts. I was able to do well in school because VA Boston helped me get healthy. You can choose not to use the VA, but it’s always better to have and not need than to need and not have.

      Self-advocate: I was admittedly not great at this. All schools have a point of contact for disability accommodation, and your needs can look different. I hated asking for accommodations, but was always relieved they were in place when I needed them.

      Self-advocacy is exhausting and choosing expediency may be the best thing for your self-care, even if it impacts your grades. Chronic pain is a rude roommate who does not care when you have midterms. At times, getting an extension so I could get through a flare was a godsend. At other times, I took B’s on some papers in my last semester that I could have gotten A’s on because I decided being done was better for my health and self-care.

      Veterans in academia matter

      Veterans use their experience to forge new research agendas. Pat Tillman Scholar Gretchen Klingler, who learned Iraqi Arabic in the Air Force, is currently conducting research with Iraqi women through her studies in anthropology at Ohio State. Another Tillman Scholar, Texas A&M medical student Andrew D. Fisher, left the Army and started a group to promote Stop the Bleed, which brings lessons learned about bleeding control from the battlefield to local communities. For my master’s thesis, I interviewed women Veterans to understand why women Veterans are less likely to self-identify in their communities—and learned that there’s hardly any qualitative research on women Veterans.

      As Veterans, we often complain that the civilian world doesn’t know or care enough about us. If we are not part of the conversation, it will take place behind our backs or not at all. In academia, we can spearhead the research that informs the public and shapes policy.

      You need fellow Veterans more than you think

      Marginalized Veterans are often the first to self-select out of being part of the Veteran community. Why would we continue to try to be part of an organization that mistreated us? As a Veteran, I found my tribe. Particularly among Pat Tillman Scholars and fellow Veteran classmates at Fletcher, I members of the military community who, like me, felt out of place on active duty.

      That said, don’t just stay in the Veterans bubble—seek social experiences that make you uncomfortable. I met some my best friends in graduate school in an a capella group, and through a recurring happy hour the Veterans club had with former Peace Corps volunteers (we called it “War & Peace.”)

      Where you go to school really matters

      Going back to school directly after the military gave me the opportunity to reflect in a way that I would not have known I needed had I gone straight to work. My courses taught me a vocabulary that helped frame past experiences and gave me tools to accomplish more than I could have imagined. I had time to network, work a summer internship at a top company, and figure out what I didn’t want to do.

      Don’t rush. If you’re on unsure footing on your path, take the time to conduct research and spend some time in community college. Seek support from Service to School, Warrior-Scholar Project, and Posse Foundation Veterans Program. Aim high, and you may end up somewhere that changes the trajectory of your life.

      Source

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    • Robert Wilkie 10

       

      WASHINGTON — Robert Wilkie is slated to appear before lawmakers this week for the first time since he took over as secretary of the Department of Veterans Affairs two months ago.

      The Senate Veterans’ Affairs Committee scheduled a hearing, “State of the VA: a 60 Day Report,” for Wednesday afternoon, where senators are expected to ask Wilkie about his plans for implementing several major, congressionally mandated reforms.

      Wilkie, a former Pentagon official, was sworn in June 30 after months of political infighting under former VA Secretary David Shulkin. His dismissal this spring led to an exodus of other VA leaders.

      Veterans groups are looking to Wilkie to bring stability to the embattled agency, and they expect to hear Wednesday how he plans to do it.

      “I think he’s really walked into a tough situation,” said Bob Wallace, executive director of Veterans of Foreign Wars. “He’s really got a full plate in front of him, but I think he’s capable of meeting the challenge. I think he’s the right person at the right time for the VA.”

      Here are a few issues Wilkie is likely to be asked about.

      Implementing the VAMission Act

      Chanin Nuntavong, a director with the American Legion, said Wilkie has “huge undertakings” to tackle at the VA. The biggest could be implementing the VA Mission Act, a $52 billion, far-reaching bill approved in June that overhauls the VA’s private-sector care system and extends benefits to more Veteran caregivers.

      Most of what’s in the Mission Act is supposed to be implemented by June 2019, but there are already concerns about whether the VA will meet that goal.

      The Mission Act outlined dozens of deadlines for the VA to submit progress reports to Congress. Three reports were due Sept. 4. Of those, two were several days late and one still hadn’t been submitted as of Tuesday, according to the office of Sen. Jon Tester, D-Mont., the ranking Democrat on the Senate Veterans’ Affairs Committee.

      The missing report pertains to the VA’s progress with extending benefits to Veteran caregivers. The Mission Act mandates that the VA provide benefits, such as monthly stipends, health care and medical training, to caregivers of Veterans injured before May 7, 1975.

      “VA needs to be hitting these early milestones if it’s going to meet the later ones,” Tester said at a Sept. 5 hearing. “It needs to do better.”

      Concerned Veterans for America, a conservative advocacy group, has also expressed concern about the VA meeting the deadlines, particularly those regarding the new program for private-sector medical care.

      “It’s important for the VA to meet these deadlines to show that one, they’re taking this seriously, and two, they’re going to be transparent about it and show they can be trusted,” said Dan Caldwell, executive director of CVA. “If they can’t meet a deadline on a report for Congress, how can they be trusted to run the whole program?”

      The Mission Act does away with the Veterans Choice program, which was created in 2014 to allow some Veterans to receive medical care in the private sector, but only when they live more than 40 miles driving distance from a VA facility or their wait for a VA appointment would be more than 30 days.

      Some claim the Choice program was implemented hastily, and many Veterans thought the rules were too rigid. Under the Mission Act, Choice expires in June, and a new system is supposed to take its place.

      Source

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