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  • Tricare provider

     

    Some Tricare beneficiaries still have problems trying to get medical care, and officials have taken actions to try to improve the performance of contractors, said Navy Vice Adm. Raquel Bono, director of the Defense Health Agency.

    Officials are closely monitoring the performance of the two U.S. Tricare contractors, Humana Military in the East region, and Health Net Federal Services in the West region, said Bono, speaking at a family forum Monday at the 2018 AUSA annual meeting.

    She said she recently was impressing upon some senior spouses that “it’s extremely important to me that we get the type of performance we need” from the contractors.

    And, she told them, “While I may not look like it, I can be a bad ass.”

    Defense health officials have issued several corrective action plans to the contractors, among other things. Through August, the contractors were meeting contract requirements at a level of about 80 percent.

    She said there are still challenges with the accuracy of the contractors' provider directories. Defense health officials have issued corrective action plans to both contractors regarding these issues. Families have had trouble finding area doctors and other medical providers who are in the Tricare network.

    Officials also issued a corrective action plan to Health Net regarding its customer call centers. Humana has corrective action plans regarding claims processing, correspondence, autism care/Applied Behavior Analysis therapy.

    Tricare underwent massive changes in January, as three regions were reduced to two, and Tricare Select replaced Tricare Standard and Extra. There have also been increases in some co-pays and some pharmacy costs.

    Help spread the word

    Bono asked for the help of those in the audience – which included many military spouses – in getting the word out about important changes coming up.

    There are new requirements for those who are retiring. To keep Tricare with no break in coverage, the service member must re-enroll within 90 days of retirement.

    There are new open enrollment seasons affecting three benefits, all of which will be held Nov. 12 to Dec. 10:

    • Those in Tricare Prime or Select who like their plan don’t need to do anything. But anyone wishing to switch from Prime to Select, or vice versa, must do so during that open season. Until now, families could switch at any time. But once the open season is over, a switch can be made only for a qualifying life event. A few examples of those are moving, retiring, separating from active duty, getting married, having children, and getting divorced. (Tricare.mil/openseason)
    • The Tricare Retiree Dental Program ends Dec. 31. To have dental coverage for themselves and their family members through the government in 2019, retirees must enroll in the FEDVIP plan during that open enrollment season which starts Nov. 12. (Tricare.benefeds.com)
    • Retirees and their family members and active duty family members (not active duty) will also have access to new vision coverage under the FEDVIP, during that open enrollment season which starts Nov. 12. (Tricare.benefeds.com)

    Source

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  • Charities Honored

     

    A new charity that pays for and helps organize reunions for combat Veterans has received a $50,000 grant, the highest honor in this year’s Newman’s Own Awards competition.

    “The prevailing narrative about my Veteran generation is wrong. We are not broken, we don’t need to be fixed, we don’t need over-engineered solutions. We just need each other,” said Marine Corps Veteran James Ferguson, founder of the Warrior Reunion Foundation of Cockeysville, Maryland, in accepting the award at the Pentagon Friday.

    In just over a year, the foundation has provided seven reunions to soldiers who deployed to combat together. The eighth reunion is scheduled for November.

    While the reunions so far have involved units in the post-9/11 conflicts, their eligibility spans all generations of Veterans — soldiers in any unit who served together in any combat zone during any armed conflict.

    This marks the 19th year of the awards, sponsored by Newman’s Own, the Fisher House Foundation, and Military Times. Since the program was launched in 1999, Newman’s Own and Fisher House Foundation have contributed $1.9 million to 179 organizations for their innovative programs to improve quality of life in the military community.

    Five organizations were awarded a combined total of $200,000 in a ceremony Friday at the Pentagon.

    The organizations’ work “transcends the 50 people, 1,000 people, 100 people” they touch in their work, said Joint Chiefs Chairman Marine Gen. Joseph Dunford. “It’s sending a message that you value our Veterans,” he said.

    And this message has an impact on retention and on recruiting, as Veterans in the community encourage younger generations to serve, he said.

    The ability of the United States to sustain the high quality all-volunteer force “is really about the loud and clear message that we respect, value and appreciate the service of those in uniform,” he said.

    “Your service is inspiring and your example is humbling,” said Dave Coker, president of Fisher House Foundation told the organizations. “Your efforts to improve the quality of life in the military community is what we’re celebrating today.”

    Newman’s Own, founded by Navy Veteran and actor Paul Newman in 1982, has donated more than $530 million to thousands of charities, donating all the profits and royalties from the sale of its food products.

    “Our giving is at its best when we meet organizations like those here today that address the needs that fall in between the pillars of what’s already in the establishment,” said Jeffrey Smith, vice president of operations for Newman’s Own, Inc. “In many ways, our giving and your doing has the connective tissue” that enables solutions to come together, he said.

    Andrew Tilghman, executive editor of Military Times, noted that over the years, the Newman’s Own award winners have provided a snapshot in time of what service members and Veterans need most — such as groups sending care packages overseas, and providing funding for phone calls, and providing various forms of support for families of deployed service members in the early 2000s. Today, the groups are focusing more on the long-term transition of Veterans.

    While the all-volunteer force has been an historic success, he said, sometimes it’s taken for granted.

    “This extraordinary American institution needs support, but the Defense Department can’t do it all alone," he said. “It’s organizations like these honored here today that are helping to do just that, by contributing to and strengthening the social contract between the American people and the service members and Veterans who volunteered to protect them.”

    Ferguson said his organization is helping to support those long-term needs by helping combat comrades easily reconnect, sharing experiences only those in the same unit may understand. They pay for the reunions and help guide unit members through the planning process.

    The warrior reunions are often held outdoors, in environments more similar to a field environment, with the Veterans sleeping in cots under tents. They share stories around bonfires and during activities; they hear from experts from support organizations serving a variety of needs; they do service projects; and they hold memorial services for the fallen in their unit. Often, some of their Gold Star families attend.

    The reunions are modeled after the first one Ferguson organized for his Marine unit in 2015, which he started because he needed to spend time with his fellow Marines.

    Judges in the competition are Dunford’s wife Ellyn, Tammy Fisher, Suzie Schwartz and Lynn Pace, all trustees of the Fisher House Foundation, and Smith from Newman’s Own.

    Those receiving awards of $37,500 are:

    • Code Platoon,Chicago,Illinois. Provides software coding training to help local Veterans and military spouses pursue careers as professional software developers. Students can use their GI Bill benefits or apply for scholarships. Classes of eight to 12 students spend 60 to 80 hours a week for 14 weeks. The course is a mix of lectures, advanced coding training in Python and Ruby on Rails and team projects.
    • West Virginia Health Right, Inc.,Charleston,West Virginia. Provides free dental care to low income West Virginia Veterans without dental coverage, through their Veteran’s Dental Program. The care includes cleanings, exams, fillings, extractions and dentures. This grant will be used to help fund a program that will use a mobile dental clinic traveling to six rural counties and the onsite dental clinic at their main office, treating 500 Veterans in need.
    • Healing Warriors Program,Boulder,Colorado. A nonprofit clinic that provides non-narcotic Integrative Care therapies to treat pain and symptoms of post-traumatic stress in Veterans, active duty members and their families throughout the Colorado Front Range and southern Wyoming. Their mission is to advance the well-being through these evidence-based Integrative Care services and education.
    • Vets on Track Foundation, Inc.,Garrisonville,Virginia. Furnishes homes for Veterans who have been placed into permanent housing after living on the streets or in a shelter. This “Fresh Start” program volunteers turn these houses into warm, loving homes with everything from sofas, beds, dining room tables and chairs, dishes and silverware, to pictures, pillows and blankets.

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  • Jeff Dettbarn

    IOWA CITY, Iowa – Radiology technologist Jeff Dettbarn said he knew something was wrong at the Department of Veterans Affairs hospital in Iowa City, Iowa, when a patient arrived in February 2017 for a CT scan, but the doctor’s order for it had been canceled.

    “To have a patient show up for a scan and not have an order – you’re like, ‘What the heck is going on?’ ” he told USA TODAY in an interview.

    Dettbarn started collecting cancellation notices for diagnostic procedures such as CT scans, MRIs and ultrasounds.

    “I knew something was not right,” he said. “Because none of them were canceled by a physician.”

    Cancellations of more than 250,000 radiology orders at VA hospitals across the country since 2016 have raised questions about whether – in a rush to clear out outdated and duplicate diagnostic orders – some facilities failed to follow correct procedures. At issue is a concern over whether some medically necessary orders for CT scans and other imaging tests were canceled improperly.

    The VA inspector general is auditing mass cancellations at eight VA medical centers “to determine whether VA processed radiology requests in a timely manner and appropriately managed canceled requests,” VA Inspector General Michael Missal said.

    Those hospitals are in Tampa and Bay Pines, Florida; Salisbury, North Carolina; Cleveland; Dallas; Denver; Las Vegas; and Los Angeles.

    After receiving inquiries from USA TODAY, a ninth was added – Iowa City.

    In Iowa City, Dettbarn alerted the hospital’s compliance officer about his concerns. He is now facing disciplinary proceedings and contends they are an effort to retaliate against him.

    The VA declined to comment on disciplinary proceedings without Dettbarn’s written consent to discuss personnel matters, which he did not provide.

    This much is clear: in sworn testimony in the disciplinary proceedings against Dettbarn, Iowa City administrative staffer Lisa Bickford saidshe and other employees were told by the hospital’s chief radiologist that they needed to “clean” up a backlog of incomplete diagnostic orders, some dating back years.

    The staff responded by “annihilating” thousands of orders in a matter of weeks, Bickford said.

    Bryan Clark, a spokesman for the Iowa City hospital, acknowledged the facility failed to follow national VA guidelines for diagnostic order cancellations but said that happened in only a “small number of instances” and “anything closed improperly was reviewed” and actions were taken to try to ensure Veterans received any needed exams. He said the process was intended to “ensure the quality and safety of the care delivered to Veteran patients.”

    The VA said many of the orders were outdated or duplicated. The agency said it welcomes the oversight and is working with the inspector general to improve cancellation guidelines. VA officials said efforts to close the loop on test orders with physicians and Veterans surpass private-sector practices.

    Laurence Meyer, the chief doctor overseeing specialty care for the national VA, told USA TODAY he didn’t want to comment on how individual VA hospitals handled cancellations, but he acknowledged “we’ve received word that a few places haven’t been following the directive as intended.”

    “We’ve sent out teams and have reviewed and are aggressively working to fix that,” he said.

    The VA’s guidelines on order cancellations have undergone revisions in the past few years.

    In 2016, hospitals were told to try contacting patients multiple times before cancellations. Last year, the rules required review by a radiologist or the ordering provider before canceling. If the tests were still needed, patients should be contacted to schedule them. Since last year, hospitals have been required to establish a fail-safe "triage" process, such as written verification of review by providers.

    Concerns about diagnostic test order cancellations have also been raised at the VA hospital in Tampa. Employees estimated they canceled thousands of radiology orders without checking first with doctors or patients, according to depositions in a discrimination lawsuit brought by four ultrasound technicians.

    Those technicians told USA TODAY they worry Veterans may have gone months, if not a year or longer, before they or their doctors realized tests weren’t performed – if they realized at all. Technologist Erin Tonkyro noted that risk factors for many Veterans are higher than for other patients.

    “Cancer grows very quickly, and our patients are not like those patients on the outside – it doesn’t mean that cancer doesn’t happen in private practice. But our Veterans have been exposed to such a large amount of toxic environments like Agent Orange; now we’re talking about the burn pits that have happened overseas,” Tonkyro said.

    ‘We knew it was bad’

    At the Tampa facility, radiology managers began tackling outstanding orders in fall 2016.

    As many as 10 people were tasked with the job, one administrative staffer testified in a deposition in the technicians’ lawsuit. Multiple employees testified they canceled orders by date and did not consult any doctors before doing so, nor was there patient contact.

    They disabled office printers because of the volume of cancellations – one employee estimated they canceled thousands of radiology orders, according to testimony.

    “That’s when we really started getting worried,” said Tonkyro, who attended the depositions with her co-plaintiffs, ultrasound technologists Yenny Hernandez, Kara Mitchell-Davis and Dana Strauser. “We knew it was bad, but we had no idea the magnitude of how bad it was.”

    Strauser told USA TODAY that administrators went beyond past orders and canceled future ones. Those could have been follow-up scans for Veterans who might have been at risk of developing medical conditions, such as cancer recurrence.

    “Doctors will put an order in for six months in advance and sometimes even a year in advance, and we were getting cancellations of those future orders,” she said.

    In a statement issued by VA spokesman Curt Cashour, the VA declined to comment on what happened in Tampa, citing the litigation. “However, we are confident the James A. Haley Veterans’ Hospital has processes and procedures in place to provide the best care possible for our patients,” the statement said.

    The Tampa Bay Times first reported the technicians’ concerns in July, and the hospital’s chief of staff, Colleen Jakey, wrote to providers the following month asking them to review canceled orders, according to a copy of the correspondence obtained by USA TODAY.

    “We believe appropriate action was taken,” Jakey wrote, adding that a review of a random sample of cancellations did not turn up any cases of harm to Veterans. “This is a second-level review of these orders to confirm that each of these patients received the appropriate care and/or follow up.”

    The technicians told USA TODAY some doctors have since reordered canceled exams but won’t know whether Veteran patients suffered any harm from the delays until they are performed and assessed.

    ‘An important patient safety issue’

    VA hospitals came under increasing pressure to address outstanding diagnostic orders after a conference call that national officials convened with radiology managers across the country in January 2017. More than 325,000 orders for scans of Veteran patients had not been completed nationwide.

    The VA’s top radiologist, Robert Sherrier, called it “an important patient safety issue” in a presentation for the call.

    “Ordered studies are not being performed on Veterans, and providers may not be aware that the ordered study has not been completed,” he said.

    In a dozen states, there were VA medical centers with more than 5,000 outstanding orders, his presentation said. The numbers reached 29,000 in Columbia, S.C.; 21,000 in Cleveland; and 12,000 in Washington.

    Radiology Orders

    Some dated back to the 1980s, but others were only months old. VA officials said that in some cases, staff may not have been able to contact Veterans to schedule exams. In other cases, Veterans may not have shown up, possibly because their ailments had gone away. Some orders may have been duplicates ordered by two different doctors.

    Others may have been tests that were still needed – to monitor tumors or follow up on emergency room visits, for example.

    A panel of medical and ethics specialists conducted thousands of chart reviews, Meyer said, and determined orders for exams due to be performed before June 2015 could be canceled outright without jeopardizing Veteran health.

    Orders due after that date required further steps to ensure patient safety.

    The national call to action triggered a dramatic reduction in pending exam orders overdue by two months or longer. As of last month, the VA said, there were 31,000 nationwide.  

    ‘We look terrible’

    At the Iowa City VA hospital, Bickford said the chief of radiology – who also was the top radiology official in the Midwest for the VA – told her after the conference call in January 2017 that the facility had more outstanding orders than any other VA in the region.  

    “He came to (us) and said, ‘We’ve got to get this cleaned up now. I mean, we look terrible,’ ” Bickford said. So she and other staff “went through and started annihilating orders,” she testified in the disciplinary proceeding against Dettbarn.

    Any radiology orders more than 60 days past due were considered “invalid” and “expired,” Bickford testified. That is at odds with VA guidelines at the time requiring doctor reviews.

    Cancellation records reviewed by USA TODAY show that in some instances, she and other staff canceled future orders.

    In one case, a nurse practitioner ordered an ultrasound for September 2017 as a six-month follow-up for a Veteran with a history of kidney stones. An X-ray technician canceled it in June 2017, calling it an “expired” order.

    That same month, records indicate, Bickford canceled an order for a follow-up CT scan to monitor a Veteran’s lung nodules. The test wasn’t due to be performed until September 2017. Also in June, she canceled a CT to monitor fluid in a patient’s lung not due until November 2017. Records show Bickford selected “patient failed to contact clinic” in both cases. None of the records reviewed by USA TODAY contained personal information identifying patients.

    In the disciplinary case against Dettbarn, his supervisors alleged he was “disruptive” and didn’t send one patient’s images to be interpreted – accusations he denied. The investigation was initiated soon after he reported his concerns about the order cancellations.

    The Office of Special Counsel, a federal agency tasked with protecting whistle-blowers, is investigating, according to a letter from the office.

    Bickford declined to comment and referred questions to the Iowa City VA. In her sworn testimony, she blamed scheduling clerks for not indicating on orders that exams were scheduled. That led employees to assume there was a “dead order” even though a patient had a future appointment, she said, but she estimated that occurred only “maybe a half a dozen times.” When patients arrived for appointments, the errors were discovered, new orders were created and the exams went ahead, she said.

    The chief of radiology, Stanley Parker, did not respond to a message seeking comment at a number listed in public records. In his deposition in the case, he testified that he believed physician-review would have been done before canceling.

    Clark, the hospital spokesman, said Bickford's testimony about “annihilating” orders was not in context and referred to the “success of the process to right size the number” of outstanding radiology orders at the hospital.

    Clark said he doesn’t know how many orders were canceled at the facility because officials didn’t track it, but he said more than 4,000 were canceled in January and February 2017 in the southern part of the Midwest region.

    Clark said “most” canceled orders were from before 2015, though he didn’t know how many. He said “some” exam orders were “canceled without following proper policies or procedures.”

    In those instances, Clark said, “appropriate personnel actions were taken to correct the behavior, and staff reviewed the cancellations to ensure every order that required action was appropriately reviewed by a radiology provider.”

    Dettbarn has been detailed to a job collating VA records since July 2017. He said that whatever happens to him, he wants the public to know about what he called a “horrible shortcut” administrators took to improve the numbers. Dettbarn said Iowa City officials should do a clinical review like the Tampa VA to ensure Veterans weren’t harmed.

    “It’s so far beyond wrong what was done,” he said. “This is someone’s health care, this is their body, their life you’re screwing with, and people are playing doctor that aren’t physicians.”

    Source

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  • Robert Chesser

     

    While “lend me your ears” may have been written by Shakespeare in the 16th century, it came true in a literal sense for a Veteran.

    Navy Veteran Robert Chesser received a new prosthetic ear, created for him by prosthetist David Trainer, to replace the ear he lost to cancer. The custom-made auricular prosthesis, as the silicone ear is more properly called, is one of many different prostheses Trainer has made for Veterans at James A. Haley Veterans’ Hospital over the last several years.

    Chesser was first diagnosed with squamous cell cancer on his right ear about three years ago. Since then he has endured 15 operations, two rounds of radiation treatment and a round of chemotherapy. The first surgeries were done in an attempt to save his ear, but the spreading cancer forced doctors to complete remove his outer ear, leaving him with his hearing but also with a large hole on the side of his head where the ear used to be.

    “I ended up with cancer in the whole ear area and down my jaw and my neck, the whole nine yards, and that’s when I lost the ear,” Chesser said. “They said, ‘That’s alright, never mind, they’ll fix you one up.’”

    He was referred to the Dental Service, which works with Veterans like Chesser.

    “We deal with restorations of head and neck cancer patients, both intraoral and extraoral (inside and outside the mouth) defects,” said Maxillofacial Prosthodontist Dr. Nicholas Goetz, who said he works primarily with patients needing restorations in the mouth. “There’s a lot of complex, large cases that I do, so David is able to come in here and do a great job for our patients with extraoral prostheses. They’re very time consuming, so it’s a great help for us.”

    The 73-year-old Veteran had did have some problems that complicated and delayed the day he could receive his new ear. Radiation had weakened the bone structure in the part of his skull that would normally be used to place pins usually used to attach the ear, and the surgery left him with an area of exposed bone that prevented the use of a prosthesis.

    Home treatments with homeopathic medicines helped bring skin back over the bone, while it was decided to use an adhesive to hold the prosthesis in place.

    Trainer, who has been making prosthetic ears, noses and eyes for patients for 35 years, has worked with the VA for the last several years out of his office in Naples, Florida. He drives almost 170 miles each way for at least three visits with the patient before the final prosthesis is ready.

    “On the first visit, I take an impression of both sides (including the left ear). With that I, then, I create models from which I sculpt the opposing ear for Mr. Chesser,” Trainer, who received his training in his native England, said. “I come back to the VA, I try that on, make sure it looks right, fits, everything is correct. Then I go back and I make a mold of that wax ear, then replace the wax with silicone. Then on the last visit I extrinsically paint it and fit it on the patient.”

    While he spends and average of an hour-and-a-half with the patient on each visit, it will normally take him four to five hours to sculpt the wax ear, then another two days making the mold and the silicon ear. He uses medical grade silicon that can be left attached for days at a time with no ill effect for the patient.

    For Chesser, Trainer brought three different silicone ears in different shades so he could most closely match the Veteran’ skin tone. Selecting one, he then laid out his paints and began the process of matching the patients skin tone, mottling and even vein structure found in his remaining ear.

    Trainer, who said he is not artistic, “… but I can copy well,” Constantly checking the copy against the real ear, Trainer worked for more than an hour before he was satisfied that the copy was as close to the original as possible.

    Using silicone adhesive to attach the prosthesis and petroleum jelly to smooth the edges. In the opinion of everyone in the room, it was almost impossible to tell the real ear from the prosthetic one, even to Chesser, who first put on his glasses and then sat looking at both ears in a hand mirror.

    For Trainer, each person who receives one of his prostheses makes his day.

    “It’s always a joy. For the last 35 years, I tend not to see people as patients. I call them my big happy family because you’re entering a very intimate part of their world,” Trainer said. “It’s something that they don’t want everybody to know about, so you’re forming a very close relationship with them, and as long as that person is happy at the end of the day, I’m very happy.”

    Chesser, who said he’s maintained a positive outlook during his entire ordeal, seemed happy enough that he joked with his wife when the session was finished.

    “I can’t wait until the day when she’s yelling at me, and I can take the ear off, lay it on the table, and tell here, ‘Talk to the ear.’”

    Source

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  • Fix VA Nursing Homes

     

    WASHINGTON – Six Veterans’ groups are calling on the Department of Veterans Affairs to improve the quality of care at its nursing homes following a story by USA TODAY and The Boston Globe detailing “blatant disregard for Veteran safety” at a VA nursing home in Massachusetts.

    “Anybody who respects Veterans should be angered by this,” American Legion National Commander Brett Reistad said. “America’s Veterans deserve better.”

    The groups, who together represent nearly 5 million members, said Veterans who risked their lives for our country shouldn’t have to risk their lives in VA nursing homes.

    In Brockton, Massachusetts, investigators found two nurses asleep during their shifts, even though the facility knew it was under scrutiny and inspectors were coming to visit, looking for potential signs of patient neglect. A whistleblower had reported that nurses and aides did not empty the bedside urinals of frail Veterans, they failed to provide clean water at night and didn’t check on the Veterans regularly. The VA said the napping nurses no longer work at the facility.

    The story was the latest in an investigation by USA TODAY and the Globe that revealed care at many VA nursing facilities was worse than at private nursing homes in the agency’s own internal ratings, kept secret from Veterans for years.

    The stories detailed disturbing examples of substandard care – a Veteran with undiagnosed scabies for months, another struggling to eat in Bedford, Massachussetts; and a third sitting for hours in soiled sheets and another writhing in pain without medication in West Palm Beach, Florida.

    A Navy Veteran was declared dead after he walked out of a supposedly secure VA nursing home and was never found in Tuskegee, Alabama. An Army Vet landed in intensive care suffering from malnutrition, septic shock and bed sores after a stay at a VA nursing home in Livermore, California.

    “The stories being reported about the treatment of some individual Veterans at these facilities are nothing short of horrifying,” said Rege Riley, national commander of American Veterans, known as AmVets. He called on VA Secretary Robert Wilkie to “take swift and transparent action to fix this.”  

    Veterans of Foreign Wars, Disabled American Veterans, Paralyzed Veterans of America and Vietnam Veterans of America joined AmVets and the Legion in calling for action. Together, the groups are known as the “big six” and wield considerable clout in Washington.

    “The VA must address and correct these issues,” said Garry Augustine, executive director of Disabled American Veterans.

    VA 'striving to improve'

    VA spokesman Curt Cashour said the residents the VA typically cares for are sicker than those in private nursing homes, making “achieving good quality ratings more challenging.” He said that overall, VA nursing homes “compare well” with the private sector.

    “We look forward to briefing each of these groups in the near future regarding these crucial facts,” Cashour said, adding that the VA is “continuously striving to improve all of its health care facilities.”

    The VA has 133 nursing homes across the country that serve 46,000 Veterans annually.

    Newly released VA data show that 95 of them – about 71 percent – scored worse than private nursing homes on a majority of quality indicators, such as rates of infection, serious pain and bed sores.

    Roughly the same number, 93, received only one or two stars out of five for quality in the agency’s own ratings.

    In a scathing statement declaring those facilities “failures,” VFW National Commander Vincent “B.J.” Lawrence said the VA “must improve its delivery of quality care at these facilities.”

    "(Veterans') families deserve to know that their loved ones – their heroes – are not being abandoned or abused, and America needs to be reassured that the VA is honoring our nation's promise to those who have borne the battle," he said.

    Call for transparency

    Reistad, the Legion's commander, added, “We not only expect VA to fix these problems immediately, but we want transparency.” On Sunday, after his group met with VA officials, he said he is confident they will work with the Legion and the other groups to “institute needed improvements.”

    The VA released the quality information on its nursing homes only after learning in June that USA TODAY and the Globe planned to publish it. The agency still has not released the results of inspections.

    “Why not?” asked Rick Weidman, co-founder of Vietnam Veterans of America. He said his group often has to “fight like hell with VA in order to get information.”

    The reports can include instances of neglect or poor conditions that can be a tip-off to current and prospective residents about problems at a facility.

    “I don’t see how Veterans are best served by the VA not being open about the level of care it’s providing,” AmVets spokesman John Hoellwarth said.

    Cashour said the VA is working with an outside contractor who conducts the inspections, Wisconsin-based Long Term Care Institute, to remove patient information from its reports before they are released, maybe by the end of the year.

    Private nursing homes have three years’ worth of inspection reports posted on a federal website, Nursing Home Compare.

    Lawmakers demand answers

    In September, Congress passed and President Donald Trump signed into law legislation requiring the VA to publish quality ratings going forward. The law does not mention inspection reports.

    The Republican-led House VA Committee launched an investigation of VA nursing home care after the initial USA TODAY and Globe reports, but a spokeswoman, Molly Jenkins, said the probe won’t be finished in time to hold a hearing this year as anticipated. The Democrat poised to take over the committee in January, Rep. Mark Takano of California, said it is a “critical issue that will continue to be a priority.”

    In Massachusetts, home to two, one-star VA nursing homes – in Bedford and Brockton – lawmakers are demanding to know what steps the VA has taken to improve patient care there and at other facilities around the country.

    “The continued care lapses at VA facilities raise questions about whether concrete, lasting measures are being implemented to prevent misconduct from occurring again – or whether certain VA facilities are unable to institute changes necessary to provide our Veterans with the care befitting their service to the country,” Sens. Ed Markey and Elizabeth Warren, both Democrats from Massachusetts, wrote in a letter to Wilkie.

    They demanded the most recent report from the Long Term Care Institute inspection of the Brockton VA nursing home.

    “The fact that we can’t treat Americans who put their lives on the line with dignity when their lives are on the line here at home later in life is disgusting,” said Rep. Seth Moulton, D-Mass, a Veteran who receives his medical care at the Bedford VA.

    Source

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  • Vets Get Billed

     

    Approximately 1,300 disabled Veterans were overpaid thousands of dollars under a Veterans Affairs Department education benefits program last year and now must figure out a way to pay that money back.

    Why? Mostly because staff at VA regional offices didn’t check emails, a recent investigation by the VA Office of Inspector General has found.

    The overpayments happened during the 2016-2017 academic year under the VA’s second-largest education program, Dependents’ Educational Assistance, which pays up to $1,224 for schooling per month to spouses and children of totally and permanently disabled Veterans or deceased service members.

    Veterans who are 100 percent service disabled are eligible to receive monthly stipends of $266 for each college-aged child they have in school as part of their disability check from the VA. But these benefits cannot overlap with DEA.

    Yet, in it at least 70 percent of cases during the 2016-17 school year, they did, in large part because emails from Veterans claim examiners were going unread at many VA regional offices.

    Now, Vets who were overpaid owe VA a total of $4.5 million for the department’s mistake — an average of more than $3,400 each.

    This represents “a hardship for seriously disabled Veterans,” the report states.

    In its review of all 58 VA regional offices, Office of Inspector General auditors found that as of May 2018, 25 had an approximate total of 4,600 unread emails dating back to August 2016. The majority of these emails, 67 percent, were about DEA benefits and potentially required adjustments to Veterans’ claims to keep them from being overpaid.

    In interviews recorded in the report, VA staff at seven of these offices said they had not been monitoring mailboxes related to the DEA program before the audit.

    For example, a representative from the Oakland, California, office “stated that the mailbox had not been monitored for three years because managers had been reassigned, but not their mailbox monitoring duties.”

    Another in Houston said the DEA inbox was “not considered a workload priority” because of other workload targets the office was required to meet, according to the report.

    Already, the VA has instituted a new policy requiring regional offices to check DEA-related emails twice a month, Susan Carter, a spokesperson for the agency, said in an email.

    Additionally, the VA Office of Field Operations has committed to sending weekly reminders to check the emails to the regional offices and will likely incorporate oversight of this into future site visits, according to the report.

    Joe Plenzler, a spokesman for Wounded Warrior Project, said the organization is concerned about the impact these overpayments will have on the affected Veterans and plans to work with VA on the department’s plans to remedy the situation.

    “We would hope that the VA would avoid any significant disruptions or financial burdens on the recipients,” he said in an email.

    Carter said the agency has already identified the Veterans who were overpaid and expects to complete all payment adjustments by June 30. Veterans will have several payment options available.

    “VA is implementing improvements that will focus on the timely establishment of compensation adjustments, ensuring receipt of DEA program benefit notifications by VA regional office staff, and promptly identifying and rectifying payment duplications,” Carter said.

    The inspector general’s report also recommends VA move to an electronic system to better identify when there’s a potential for Veterans to get paid out of both programs in order to cut down on overpayments.

    If delays continue, the report states, the VA could end up paying another $22.5 million in improper payments over the next five years.

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  • 3 charged

    Federal authorities filed charges Wednesday against three Bell County residents in an alleged scheme to defraud the U.S. Department of Veterans Affairs.

    A Temple couple — Christopher Sebek and Melissa Sebek — and Killeen resident Jeffrey Pearson, 55, are each charged for their alleged roles to defraud the VA of about $250,000.

    Christopher Sebek, 55, operations supervisor in the Engineering Department at the Olin E. Teague Veterans’ Medical Center in Temple, and Pearson, owner and operator of Whitetail Industrial Parts and Service, a Temple VA contractor, are both charged with one count of conspiracy to defraud the government and one count of theft of government property.

    Melissa Sebek, also 55, owner and operator of MS. Bookkeeping Services, faces a separate but related charge of one count of theft of government property.

    The charges were announced late Wednesday by Waco-based U.S. Attorney John F. Bash of the Western District of Texas and Special Agent in Charge James Ross of the VA Office of Inspector General Criminal Investigations Division, South Central Field Office.

    The charges resulted from VA investigations that uncovered a scheme at the Temple VA motor pool to secretly profit from VA purchase orders.

    According to a preliminary report obtained by the Austin American-Statesman in November, investigators claimed they uncovered a complex scheme involving the VA motor pool that had funneled business to a Killeen firm, Whitetail Industrial Parts and Service, that made at least $400,000 by padding purchases with 30 percent surcharges. More than $1.3 million reportedly was funneled through Whitetail.

    The report, which also detailed alleged abuses of power and other possible criminal actions, prompted U.S. Rep. John Carter, R-Round Rock, to demand answers on questionable activities at the Temple VA, part of the Central Texas VA Medical Center.

    Carter sent a letter to Department of Veterans Affairs Secretary David Shulkin and VA Inspector General Michael Missal last year and said he expected changes

    “Our military men and women have bravely served our nation, and I expect the VA system to provide the very best care when they return to civilian life,” Carter wrote. “I am encouraged by Central Texas VA Health Care System Director Christopher Sandles’ strong condemnation of the behavior by these employees, including his comment that a ‘day of reckoning’ has come for those employees that have mistreated Veterans.

    The scheme to defraud the Temple VA began in February 2012, according to court records.

    Christopher Sebek and Pearson allegedly agreed to steal money from the Temple VA. Over a five-year period, they allegedly submitted fraudulent invoices for payment reportedly for goods and services designated for the VA medical center. Sebek reportedly presented bogus invoices to the VA from his wife’s company.

    Those invoices, however, were used by Sebek to pay for personal items and to cover Pearson’s 30 percent commission on each invoice. Court records allege that Sebek stole two VAMC credit cards and used them to pay for personal expenses.

    If convicted, the defendants each face up to five years in federal prison on the conspiracy charge and up to 10 years in federal prison on the theft charge. All three will receive summonses for their initial appearance in federal court in Waco.

    Assistant U.S. Attorney Greg Gloff is the prosecutor in the case.

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  • 3 deaths found

     

    FAYETTEVILLE, Ark. (AP) — A Veterans Affairs hospital official says investigators have discovered 11 significant errors and three deaths in more than 30,000 cases originally seen by a pathologist officials say was working while impaired at the VA hospital in Fayetteville, Ark.

    Veterans Health Care System of the Ozarks spokeswoman Wanda Shull said Monday the families of the deceased veterans have been notified. Previously, investigators said one death was potentially the fault of Dr. Robert Morris Levy, who has denied working while impaired.

    Eleven errors merited institutional disclosure, meaning mistakes in patient care that could or did result in "death or serious injury." Officials have discovered 1,119 total errors, but not all resulted in change to clinical care.

    Pathologists have now reviewed 14,980 cases, just under half of the total cases dating back to 2005.

    Source

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  • 3 Marines killed

     

    WASHINGTON — The Pentagon says the remains of three U.S. Marines killed when their helicopter was shot down during the Vietnam War will be buried next week at Arlington National Cemetery.

    The Defense POW/MIA Accounting Agency announced Friday that the remains of the three men will be buried as a group with full military honors next Thursday. The three men are: Capt. John A. House II, of Pelham, New York; Lance Cpl. John D. Killen III, of Davenport, Iowa; and Cpl. Glyn L. Runnels Jr., of Birmingham, Alabama.

    The Pentagon says their remains were identified in March 2017.

    Military officials say House, the oldest at 28, was the pilot of the Sea Knight helicopter that crashed after being hit by enemy fire on June 30, 1967. Four others also were killed, including 18-year-old Killen and 21-year-old Runnels.

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  • BWN Vets 43 Yrs Later

     

    • 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.

    Operation Ranch Hand

    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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  • GI Bill 002

     

    Thousands of Veterans who attended a vocational school or college that closed will have their benefits restored under the "Forever GI Bill," experts say.

    Lawmakers this month sent an expanded GI educational benefits bill, known as the "Forever GI Bill" to President Donald Trump's desk to sign.

    The Forever GI Bill, which passed the U.S. Senate unanimously, is estimated to cost more than $3 billion over 10 years.

    "It restores benefits to Veterans who were impacted by school closures since 2015 and has special benefits for our reservists, surviving dependents and Purple Heart recipients," said Veterans Affairs Secretary David Shulkin in a statement.

    The new law will also eliminate the 15-year limit on educational benefits for new enlistees. As the bill's nickname implies, Veterans will no longer have a time limit for completing their education.

    Since the GI Bill's creation in 1944 during World War II, it has been updated several times to help Veterans pay for college and training. The last expansion, the post-9/11 Veterans Educational Assistance Act, often called the post-9/11 GI Bill, was eight years ago.

    The 2009 expansion increased Veteran student enrollment at colleges, says Liang Zhang, a professor at New York University's Steinhardt School of Culture, Education, and Human Development, who studies higher education policies. Zhang found in his recent study that the last expansion increased enrollment rates by 3 percentage points from comparing the 2005-2008 period with 2010-2015.

    According to the 2017 annual report by the Department of Veterans Affairs, 79 percent of Veterans who enrolled in a higher education program in 2016 were beneficiaries from the post-9/11 program.

    "If the last GI Bill had a significant enrollment, then we could probably expect an increase in general enrollment by the current expansions," Zhang says.

    [Explore ways community colleges serve Veterans.]

    Veteran advocacy groups say Trump is expected to sign the Forever GI Bill. Here are five big changes once the bill becomes law.

    1. Veterans whose colleges shut down in the middle of the semester will have their benefits restored. The closure of several colleges and universities in 2015 and 2016, many of which were for-profit, adversely affected many student Veterans, experts say.

    "So those who were attending ITT when it closed will have a full restoration of the benefits and be able to use the benefit at a different school," says James Schmeling, executive vice president of District of Columbia-based Student Veterans of America, a nonprofit advocacy group.

    But this benefit is not just for those who attended ITT Technical Institute, it also applies to service members who attended a postsecondary institution that closed after January 2015. According to the Congressional Budget Office, $50 million will go toward restoring benefits to thousands of Veterans next year.

    2. New service members can use the benefit throughout their lifetimes. The caveat is it's only for those who were discharged on or after Jan. 1, 2013.

    For those who meet this cutoff, the expansion will eliminate the 15-year time limit to use these benefits.

    Experts say this will enable more Veterans to complete college or higher education courses for a career, which are necessary for wage gains.

    3. The expanded benefits emphasizeSTEM programs. The expansion encourages Veterans to enroll in science, technology, engineering or math degrees through financial incentives.

    [Discover how Veterans can afford pricey private university tuition.]

    Schmeling says student Veterans often voice that they had to choose other fields since some STEM bachelor's degrees can take up to five years to complete.

    "They were choosing other degrees that they could complete during the availability of their GI benefit. So extending them allows them to take STEM more seriously than they might have before," he says.

    Veterans interested in these fields will be eligible to receive either nine months more of educational benefits or up to $30,000 in a lump sum, the maximum amount.

    While many of the bill's provisions go into effect next year, this provision won't be available until August 2019.

    4. All Purple Heart recipients sinceSept. 11, 2001 are now eligible for educational benefits. Previously, many reservists who were injured during active service didn’t meet the full requirements for the GI Bill.

    With this expansion, 1,500 Purple Heart recipients will become eligible for GI benefits, Veteran advocates say.

    5. GI Bill entitlements can be transferred to another dependent or spouse. Veterans will be able to transfer the remainder of their entitlement to another dependent in cases where the dependent who initially received the transferred benefits dies.

    A dependent will also be able to transfer the remaining benefits to another dependent after the death of the Veteran, too.

    "It's not really a large expansion, but it's a humanitarian need for those who need to transfer," Schmeling says.

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  • 7 Investigates

     

    PITTSVILLE, Wis. (WSAW) – More than two years after 7 Investigates witnessed a disabled north central Wisconsin Veteran tell his congressional representatives about U.S. Department of Veterans Affairs loopholes leaving Veterans liable for their own emergency medical bills, some of those same lawmakers are now seeking reelection as the loopholes remain.

    In the summer of 2016, disabled Pittsville Gulf War Veteran Jerry Zehrung told staff for Sen. Tammy Baldwin, Sen. Ron. Johnson, and Rep. Sean Duffy about VA leaders not guaranteeing emergency bill payments if Veterans are treated at their closet non-VA emergency room. And Veterans not being able to purchase extra health insurance at a discount, like every other eligible American, in case VA insurance does not cover their emergency bill.

    "Everyday this legislation is delayed is another day another Veteran has to ask themselves 'should I go the ER or should I wait?" Zehrung said in February.

    Zehrung said the loopholes kept him from going to the ER twice over the last couple years, after he dislocated his hip that was injured during his war service, and back in 2016, when he woke up with blood on his pillow.

    "I wasn't worried about my heath at that moment. I was worried about is my family's financial future going to be destroyed," Zehrung said in 2016.

    What Zehrung did not know is his, and so many other Veterans’ stories, are tied into 86-year-old Minnesota Air Force Veteran Richard Staab's story.

    In 2010, the VA secretary was ordered to cover emergency medical bills Veterans are "personally liable" for. However, the VA denied Staab's claim one year later because he went to his closest non-VA ER when a heart attack and stoke almost killed him. In the end, he was left with a $48,000 out-of-pocket bill.

    "And for the VA to call that non-emergent, that's just ridiculous," Staab’s lawyer Jacqueline Schuh said in January.

    Staab became the face of this loophole when he sued and won his appeal. However, the VA kept appealing until last year.

    In January, Schuh thought the legislative fix, now called the ‘Staab Rule,’ meant thousands of Veterans could finally be reimbursed for their emergency room bills. Wisconsin lawmakers also told 7 Investigates they hoped Veterans would not have future billing problems.

    "And so there is a process going forward to pay those bills," former VA Sec. David Shulkin told 7 Investigates in January.

    However, today, Schuh said Staab still has not been reimbursed. And another one of Staab's emergency medical bills, from last year, is now tied up in a lawsuit.

    As Staab, again, faced denials, this summer a new video showed up on the VA's emergency medical care webpage. There, the VA laid out what emergency bills they will cover under the Staab Rule.

    For Veterans whose emergencies are related to a disability from their service, the VA now says they will pay, "As long as the VA was not reasonably available."

    In the past, however, national VA call centers can end up telling Wisconsin Veterans "reasonable" emergency care is located hours away from where they live.

    "Emergency room care within the VA system for me is Pittsville to Madison. Pittsville to Madison is over 120 miles away,” Zehrung said in 2016. “So, while I'm having a massive heart attack, I should go to Madison for ER care?"

    For Veterans, whose emergencies are not related to an injury from their time in service, there is more fine print, including requiring the Veteran to have received, “Care at a VA facility in the last 24 months.”

    If the Veteran also has extra, private health insurance, the VA says it cannot pay "similar payments" to "co-pays, coinsurance, and deductibles."

    Sen. Baldwin’s office tells 7 investigates as a result of the Trump Administration’s Veterans Affairs Department’s interpretation of what is “similar payment,” the VA is denying emergency medical reimbursements.

    Sen Baldwin told 7 Investigates the VA’s interpretation, "Is severely limiting reimbursements to our Veterans."

    Sen. Baldwin, and six other senators expressed their frustration about how the VA is interpreting the Staab Rule in a letter sent to VA Office of Regulatory Policy and Management Director Michael Shores back in March.

    During her Feb. interview with 7 Investigates, Baldwin hinted another law may eventually be necessary if the Staab Rule did not work like lawmakers feel it should.

    "Given the bi-partisan group of senators I'm working with, I think there will be a commitment to introduce legislation," Baldwin said in Feb.

    In an anonymous VA Public Affairs statement, department staff reiterated how they are, “Prohibited by law from reimbursing an otherwise eligible Veteran’s copay, cost share or deductible he or she owes to a health-care plan.”

    For the VA to make those payments, the staff member said, “Congress would need to amend this section of the law.”

    While the statement did not address the use of the VA’s use of the term “similar payments” in denying payments, they did say Veterans have to provide, “Documentation that their remaining financial liability for a claim is other than a copay, cost share or deductible.”

    7 investigates has learned the MISSION Act, which Baldwin, Duffy and Johnson all supported when it became law in June, might be a potential starting point for fixing future payments.

    Part of the current law allows Veterans to receive walk-in care at urgent care-type clinics, if that medical facility receives federal funding.

    “I am continuing my work with a bipartisan group of Senators to build off of the MISSION Act and move a legislative fix forward that can pass with support from both parties,” Baldwin told 7 Investigates.

    Sen. Ron Johnson has not said if he would support that, but his spokesperson Aaren Johnson tells 7 Investigates the senator does support extending emergency room reimbursements back to 2010, when the Emergency Care Fairness Act was signed into law.

    Rep. Sean Duffy’s spokesperson Mark Bednar did not offer comment on using the MISSON Act as a framework for an emergency care billing fix, but did say, “The congressman supports providing comprehensive emergency care coverage for Veterans when the VA is a secondary payer.”

    While Duffy's Democratic opponent Margaret Engebretson said she would support expanding the MISSION Act to including emergency care, the campaign manager for Baldwin’s Republican challenger, state Sen. Leah Vukmir, did not answer that question, only saying she supports more options.

    Full Statements

    From Sen. Tammy Baldwin:

    “We need to make sure that when our nation’s Veterans need emergency care, they can get the care they need. If they need emergency care they should be able to go to any emergency room to get it, and I believe their VA health care should cover it. I strongly disagree with the way the VA is implementing the Staab rule and unfortunately, the Trump Administration is severely limiting reimbursements to our Veterans. Given the fact that the VA refuses to implement the final rule as it should be, I am continuing my work with a bipartisan group of Senators to build off of the MISSION Act and move a legislative fix forward that can pass with support from both parties.”

    From Sen. Ron Johnson’s Deputy Press Sec. Aaren Johnson:

    - Senator Johnson supported the VA MISSION Act. This law includes language that directs the VA Secretary to improve Veteran access to walk-in/urgent care (became law in June).

    - Senator Johnson’s staff has reached out to the VA for an update on the status of the January 2018 Staab rule and emergency care coverage for Veterans. The senator supports the VA extending its January 2018 rule on emergency room reimbursements to apply to claims that have been filed since the Veterans’ Emergency Care Fairness Act was signed into law in 2010.

    From Rep. Sean Duffy’s spokesperson Mark Bednar:

    - Congressman Duffy applauds the Trump administration for finally ending the Obama administration’s lawsuit to avoid paying for Veterans’ emergency care. Congressman Duffy and his staff have been in contact with the VA for an update on the Staab rule, including swift implementation of the reimbursement policies that are now fully in place. Congressman Duffy has also reiterated to the VA that he supports further changes to provide reimbursement for Veterans prior to the April 2016 court case.

    - The VA’s secondary-payer laws are clear about the VA’s inability to pay things like co-pays, deductibles, and co-insurance for Veterans who hold other health insurance (OHI), and the Staab rule is not related to that.

    - The VA already covers emergency room care for Veterans at non-VA facilities if the Veteran does not have other health insurance (OHI), and Congressman Duffy supports that. Congressman Duffy also supports providing comprehensive emergency care coverage for Veterans when the VA is a secondary payer, which is now the law thanks to the new Staab Rule.

    From Duffy Democratic Challenger Margaret Engebretson: "The intent of the Congress is clear - individuals with VA care should be reimbursed for expenses incurred when receiving necessary treatment at community emergency rooms. I will join with bipartisan efforts to close any remaining loopholes in VA rules regarding reimbursement for emergency room visits, and I will support legislation to accomplish this goal, if needed."

    From State Sen. Leah Vukmir Campaign Manager Jess Ward: “As a military mom, Leah Vukmir knows our Veterans deserve high quality emergency care. Right now, there are only two VA emergency departments in Wisconsin, and it is ludicrous to think a Veteran from Superior should receive emergency care in Madison or Milwaukee. Unfortunately, too much federal red tape gets in the way, and Leah is committed to ensuring our Veterans have more access and more options in emergency situations.”

    VA Public Affairs statements

    Q: What is your response to Sen. Baldwin’s statement?

    A: Based on VA’s interpretation of Title 38 United States Code 1725(c)(4)(D), Reimbursement for Emergency Treatment, VA is prohibited by law from reimbursing an otherwise eligible Veteran’s copay, cost share or deductible he or she owes to a health-care plan. For VA to make such payments, Congress would need to amend this section of the law.

    Q: When are Veterans eligible for Staab Rule reimbursements?

    A: Veterans may receive reimbursement for emergency claims when it is determined that their episode of care meets the eligibility criteria outlined in 38 Code of Federal Regulations 17.1002, Substantive Conditions for Payment or Reimbursement. Additionally, Veterans will need to provide documentation that their remaining financial liability for a claim is other than a copay, cost share or deductible. When this occurs, VA will be able to reimburse as secondary payer to a Veteran’s other health insurance.

    Q: How many reimbursement requested under the Staab rule have been received in total since Feb. 1, 2010. Of this number, how many requests have been denied? What is that specific breakdown for the state of Wisconsin.

    A: Once the rulemaking published and the pending claims processed, these claims became part of our normal workload. They are not tracked separately.

    Q: How many Staab rule reimbursement requests have been received since January of this year? Of this number, how many requests have been denied? What is that specific breakdown for the state of Wisconsin.

    A: Once the rulemaking published and the pending claims processed, these claims became part of our normal workload. They are not tracked separately.

    Q: Are cases dating back to Feb. 1, 2010, when the Veterans Emergency Care Fairness Act of 2009 was signed into law, eligible for reimbursement? Or are you only reimbursing claims after April 8, 2016, when an appeals court ruled in favor of Richard Staab.

    A: Following the court’s decision in the Staab case, VA held claims pending from the date of the decision, April 8, 2016, to the date VA published the interim final regulation, January 9, 2018, when processing for these claims began. All of the held claims were processed earlier this year. At this point, VA will process any claims received and will consider them under the revised authority.

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  • Suicidal Veterans 002

    Washington (CNN)Burdened by suicidal thoughts, Justin Miller, a 33-year-old Veteran from Minnesota, reached out to the Department of Veterans Affairs in February for help, telling responders on the VA crisis line that he had access to firearms.

    Miller was advised to visit his local VA emergency department, which he did immediately.

    According to an inspector general report, Miller was admitted to the Minneapolis mental health unit after he described in detail symptoms of severe emotional anguish to VA clinicians.

    After four days under observation, he was discharged.

    Miller exited the hospital upon being released from care but never left the facility's grounds that day.

    Police found him dead in his car from a self-inflicted gunshot wound less than 24 hours later.

    With the permission of Miller's parents, Minnesota Democrat Rep. Tim Walz, the ranking member of the House Veterans Affairs Committee, shared this tragic story during a hearing on Capitol Hill on Thursday as lawmakers addressed the issue of suicide prevention among Veterans and former service members.

    "It is infuriating to know that there is a possibility that Justin's death could have been prevented. It should outrage us all that an entire health care system failed at something so serious and that it claimed to be their highest clinical priority," Walz said.

    Investigators were unable to determine "that any one, or some combination, was a causal factor" in Miller's death, despite identifying several "deficits in care provided to the patient."

    However, the investigation did find that staff members at the Minnesota medical center, including the suicide prevention coordinator, did not properly follow protocol while handling Miller's case and, according to Walz, failed to utilize the three-step REACH VET process, in which a clinician can assess a Veteran's risk of suicide so that he or she receives the proper level of care.

    "This is profoundly unacceptable," the Minnesota Democrat said about the inspector general's findings, which he called "deeply disturbing."

    And that frustration was only compounded by the fact that this was not the first time the inspector general had investigated many of these shortcomings.

    "The finding that the Minneapolis VA failed to sufficiently sustain relevant recommendations OIG made in 2012 should outrage us all," he said.

    Paul Sherbo, a spokesman for the Minneapolis VA Health Care System, told CNN that their "deepest condolences go out to Justin Miller's family and loved ones" and said that in response to his suicide and the inspector general's review, they have redoubled their efforts "to ensure every Veteran receives the best possible care. This includes improving care collaboration across departments and disciplines -- from initial treatment and planning to discharge and medication management -- and engaging family members in Veterans' mental health treatment plans, whenever possible."

    Sherbo added that the Minneapolis VA Health Care System has started implementing the inspector general's recommendations and would complete all but one this year. He also encouraged Veterans in crisis to visit the nearest VA health care facility, where they can receive same-day urgent primary and mental health care services, and provided the 24-hour national suicide prevention hotline: 1 (800) 273-8255.

    Young Veterans at risk

    The circumstances surrounding Miller's death, including his age and the use of a firearm, also seem to highlight two of the major issues related to Veteran suicide, according to data outlined in a new report released by the VA on Wednesday.

    The suicide rate among younger Veterans who, like Miller, fall between the ages of 18 and 34, continues to increase, a VA analysis of suicide data from 2005 to 2016 reveals.

    "Rates of suicide were highest among younger Veterans (ages 18--34) and lowest among older Veterans (ages 55 and older). However, because the older Veteran population is the largest, this group accounted for 58.1 percent of Veteran suicide deaths in 2016," the report says.

    The use of firearms as a method of suicide also remains high, according to the data, as the percentage of suicide deaths that involved firearms rose from 67% in 2015 to 69.4% in 2016.

    Although the overall number of suicides among Veterans decreased slightly between 2015 and 2016, the VA is bracing for an increase over the next five years as thousands of Vietnam Veterans enter mid-60s, joining what is already the largest age group.

    Additionally, VA officials acknowledged that the average daily number of Veterans who take their own lives has held steady for years despite efforts to combat the problem.

    "In 2016, about 20 current or former service members died by suicide each day. Of these, six had been in recent VA health care and 14 had not," VA spokesman Curtis Cashour told CNN, explaining that Wednesday's suicide prevention report defines Veterans "as those who had been activated for federal military service and were not currently serving at the time of their death."

    "VA also presents the yearly suicide count of never federally activated former Guardsmen and Reservists," he said.

    This report "simply reiterates what many of us have known for a long time: that our fight to end the tragic epidemic of Veteran suicide is far from over," Walz said in a statement.

    "We must continue to work together to provide Veterans with immediate access to quality, culturally competent mental healthcare and make bipartisan progress toward eliminating Veteran suicide entirely," he said.

    VA officials have said they would prefer to move away from using the per-day metric as an indicator of suicide rates, arguing that it does not account for changes in population size and can be misleading.

    But for now, lawmakers and department officials seem to believe that number appropriately underscores the severity of the issue.

    "Most of us have heard VA's staggering and heartbreaking statistic that every day, twenty Veterans end their own lives. Twenty," Republican Rep. Phil Roe, chairman of the House Committee on Veterans' Affairs, said during Thursday's hearing ahead of testimony from several suicide prevention experts.

    "We also know that over the past several years VA has invested significant resources towards addressing that number which stubbornly has not changed... We have the expertise. We have the support of the President. We can and must reduce suicide among Veterans. There is no excuse not to," he said.

    Where is the money going?

    President Donald Trump's recently confirmed VA Secretary Robert Wilkie told Senate lawmakers Wednesday that suicide prevention is a top priority for the department under his leadership and noted that the VA published "a comprehensive national Veteran suicide prevention strategy that encompasses a broad range of bundled prevention activities to support the Veterans who receive care in the VA health care system as well as those who do not come to us for care."

    He also highlighted the executive order signed by Trump in January intended to assist service members and Veterans during their transition from uniformed service to civilian life, "focusing on the first 12 months after separation from service, a critical period marked by a high risk for suicide."

    But despite a new budget of more than $200 billion, some critics argue that the VA continues to spend its money in the wrong ways.

    "Senior leaders like awareness campaigns and spend millions of dollars on them. They make a big splash in the media. It is measurable in how many outputs -- "views" or "hits" websites or social media pages get --- but does not generate outcomes," according to Jacqueline Garrick of the Whistleblowers for America.

    "These campaigns do not work because they cannot change behavior," she said in a statement to Congressional lawmakers.

    Rajeev Ramchand, a suicide prevention expert at the Rand Corp., told CNN that "while it may make people feel good, there is very little evidence that public awareness campaigns have a significant impact on suicide rates.

    "We do have evidence that public screening at emergency departments can reduce future suicide attempts," he said.

    However, he did note that areas with less evidence "should not be ignored as a comprehensive view of Veteran suicide prevention requires a thorough understanding of the environment where those events are occurring."

    In addition to developing and addressing the limitations around analytical tools like REACH VET, Ramchand told CNN that there are also a lot of things that "we know work," including initiatives that promote screening patients at emergency departments and then identifying those who are high-risk so that they receive the appropriate care.

    "Promoting quality evidence-based care... we know these things work, so let's get people to do them and do them more systematic way," he said.

    Troubling allegations

    In a written statement submitted to Congress, Garrick also said that her organization has been contacted by several VA employees who shared troubling accounts of workplace dysfunction that are having a direct impact of the quality of care provided and seem to undermine the programs currently in place.

    "At one VA medical center, a suicide prevention coordinator reported that they do not have time to complete suicide assessments or write prevention plans with every Veteran who potentially needs one because of the case load and its complexity," Garrick said.

    "She had 35 patients at one time. Administrators directed to note patients as 'moderate risk' for suicide so as not to raise red flags in the system. When a Veteran died by suicide on VA property, her supervisor refused to conduct a root cause analysis because that would be too time consuming," she added.

    According to Garrick, this VA employee asked to remain anonymous due to fear of retaliation for speaking out.

    CNN has independently contacted the employee and agreed withhold their name and place of work at the request of the individual.

    When asked for comment about the broader issue raised in the whistleblower statement, VA spokesman Curtis Cashour would only say: "VA asked CNN for specific details regarding these allegations so the department could look into them, and CNN could not provide them."

    "CNN's publishing of such vague allegations without any details that would allow the department to investigate them is highly irresponsible because it does nothing to help fix any issues that may exist and could actually discourage Veterans from seeking VA care," Cashour said.

    Griffin Anderson, a spokesman for the Democrats on the House Veterans Affairs Committee, told CNN that lawmakers take the allegations in the Whistleblowers of America report seriously and that the statement "certainly alludes to an alarming and unacceptable trend that we are going to look into."

    While the committee has not received a formal complaint pertaining to this specific allegation, Anderson said that lawmakers would work with the suicide coordinator in question to pursue an OIG investigation should they come forward.

    Source

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  • Migraine

     

    For sufferers of migraines, the term “bad headache” doesn’t come close to describing their experience. The pounding, pulsing ache can take over the entire head. Migraines can be relentless, affecting vision and balance, coursing to the stomach and beyond, and lasting for days or weeks if untreated.

    “A higher percentage of women than men suffer from migraines,” said Briana Todd, clinical psychologist, Psychological Health Center of Excellence. “Research suggests women experience them approximately two to three times more frequently.”

    According to National Institute of Health National Institute of Neurological Disorders and Stroke, researchers believe migraines result from fundamental neurological abnormalities caused by genetic mutations at work in the brain. Navy Lt. Cmdr. Kent Werner, who recently served as chief of the neurology clinic at Ft. Belvoir Community Hospital, said migraines are caused when a circuit in the brain fires when it should not.

    “The location of the pain is likely dependent on which circuit is active, but sometimes the active circuitry spreads, like a fire, to other nerve centers that control balance, nausea, sensitivity to light, hearing, and balance and vertigo,” said Werner. “It’s quite an interesting disease and the range of presentations is broad.”

    The National Institutes of Health reports 18 percent of all adult women in the U.S. suffer from migraines. According to Todd, many migraines in women are related to a drop in estrogen levels, particularly around a woman’s menstrual cycle. It’s just one of the triggers and warning signs that may precede a migraine.

    “Tracking triggers is a key component of managing migraines,” said Todd. “Many times people feel as though they are coming out of nowhere.”

    According to the U.S. National Library of Medicine, triggers may include aged cheese and meats, alcohol, monosodium glutamate or MSG, citrus fruits, chocolate, spicy foods, or foods or drinks containing aspartame. Caffeine can also be a trigger, although acute treatment of headaches with caffeine is sometimes effective.

    Todd said there are many strategies to managing migraines, such as avoiding or limiting the triggers and promoting relaxation.

    “A trigger in one person may not be a trigger for another,” said Werner. “Disruption of sleep and elevated stress are known to increase migraines, and those triggers run rampant in the military.”

    Todd said triggers are personalized for each individual, and in the case of a women’s menstrual cycle impacting migraines, there are things the woman can do around that time, such as adjust lifestyle factors.

    Werner agrees simple lifestyle changes can reduce the frequency of migraines. For example, he said the NIH has linked exercise to reductions in migraines. In addition, regular, adequate sleep (seven to eight hours a night) leads to fewer headaches. Managing anxiety and stress can also significantly reduce migraines. Some service members have found success with acupuncture, acupressure, and diet change, said Werner.

    Conventional approaches can also help. Werner typically starts his patients with supplements, such as vitamin B-2, magnesium, or coenzyme q10. These are available over the counter and have been effective for some participants in clinical trials.

    However, if lifestyle changes and the other approaches described are ineffective, medications are available. Werner said some women have found success controling migraines with birth control pills. In addition, several over-the-counter medications have proved effective as a timed strategy just before menstruation.

    Prescription blood pressure and anti-seizure drugs can be prescribed by a primary care provider. In addition, Botox injections or other medications have been used, and last year, Werner said, the U.S. Food and Drug Administration approved the first medication developed specifically to prevent migraines.

    If the pain associated with a migraine persists and interferes with your daily routine, Werner suggests you go to urgent care or the emergency room. A primary care doctor can also refer service members to a neurology specialist for further tests.

    “Doctors are actively pursuing novel therapies and testing them in clinical trials, which is important to keep in mind,” Werner said. “We do not stop until we help you find the treatment that is right for you.”

    Source

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  • Vet Suicide Conv

     

    WASHINGTON — Melissa Bryant said the 5,520 flags placed along the National Mall Wednesday to illustrate the toll of Veteran suicide this year alone were more than just a visual reminder of the scope of the problem.

    “When we came out here this morning to plant these flags, every one of us had a friend or family member in mind,” said Bryant, chief policy officer for Iraq and Afghanistan Veterans of America. “Some of us standing here could have been one of these flags, but for an intervention.”

    The event — which has become an unfortunately annual occurrence for Veterans advocates — is part of a broader push in recent weeks by lawmakers, Veterans groups and Veterans Affairs officials to bring the issue of suicide among former military members back into public consciousness.

    Last month, VA officials released new data that showed the overall rate of suicides among Veterans has held steady at around 20 a day for roughly a decade, but researchers are seeing a troubling increase in the rate of younger Veterans taking their lives.

    Those realities come despite a concerned push in recent years by policy makers who have increased crisis intervention and mental health treatment resources for Veterans.

    Rep. Mark Takano, D-Calif., and vice ranking member of the House Veterans’ Affairs Committee, said the next step for Congress is to ensure that VA facilities are properly staffed to respond to the needs of suicidal Veterans, and to better identify what programs are working to help stem the problem.

    Last week, in a hearing before that committee, health experts said they see a gap in integrating those lessons learned into local community services, to provide a broader safety net for Veterans in distress.

    But to help fix that gap that, advocates said, they need to remind the public of the problem.

    “I have seen far too many Veterans and members of my community fall to suicide,” Said Kristen Rouse, founding director of the New York City Veterans Alliance, at Wednesday’s event. “What we see behind us represents a national crisis … These are Veterans from your home state, from your hometown, from your home city.”

    During Wednesday’s event — held between the Capitol building and the Washington Monument, in an area with heavy tourist foot traffic — dozens of onlookers stopped to take pictures of the display and talk to the advocates involved.

    Stephanie Keegan, whose son Daniel served in Afghanistan but died in 2016 because of delays in receiving treatment for his post-traumatic stress disorder, said she was grateful to share her families struggles with those visitors.

    “It absolutely makes a difference,” she said. “Not enough people understand the problem and the consequences of our wars. As a country, we need to pay more attention.”

    To contact the Veteran Crisis Line, callers can dial 1-800-273-8255 and select option 1 for a VA staffer. Veterans, troops or their families members can also text 838255 or visit VeteransCrisisLine.net for assistance.

    Source

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  • Donald Trump 023

     

    By all accounts, 2018 has been an eventful year and it has been especially so for Veterans. As noted by the departing chairman and soon to be ranking member of the House Veterans’ Affairs Committee, Phil Roe (R-Tenn.), the House passed more than 80 Veterans bills, 30 of which were signed into law.

    Many of these laws centered around creating a culture of transparency and accountability for the Department of Veterans Affairs (VA).

    To this end, the year 2018 is also significant for Veterans because it is the 30th anniversary of VA being elevated to a Cabinet department. In 1988, when the Department of Veterans Affairs Act was being considered before Congress, John Glenn (D-Ohio), the chairman of the Senate Governmental Affairs Committee, stated that he wanted VA’s elevation to Cabinet status to be more about substance than symbolism.

    At the time, the stated goal of those in favor of elevating VA to a Cabinet department was to bring more accountability to VA, at a time when a House Government Operations Subcommittee investigation found that “[i]nternal VA reports indicate that the VA has covered up serious deficiencies” in its processes.

    Skeptics of Cabinet status, including those at the National Academy of Public Administration (NAPA), felt that there was “little evidence that the vitally mission of providing for the present and future needs of our Veterans would be materially improved” by the elevation. As stated by GAO in response to their report, “VA urgently needs to address its serious management problems, regardless of its status.”

    Similarly, NAPA conveyed further concern that Cabinet status would, in effect, served only to “enhance the status of the agency’s senior officials” and that it would not “significantly improve either access to the president, the adequacy of necessary resources for the organization, management and delivery of high-quality services and benefits.”

    Thirty years later, VA’s elevation to a Cabinet department seems to be exactly what Glenn advised against, a symbolic gesture that, unfortunately, ultimately lacked substance.

    The concerns highlighted by critics in 1988 could easily be said about today’s VA. Problems surrounding VA management persist, despite Cabinet status, as evidenced by the recent debacle over inaccurate GI bill payments and confusion over how or even whether VA would fix them, as well as the failure to spend millions of dollars earmarked for Veterans suicide prevention, despite the seriousness of the epidemic.

    Similarly, current VA critics would argue that Cabinet status has indeed enhanced the status of senior officials without increasing access to the president or significantly improving how quality benefits and services were delivered.

    If this were not the case, significant pieces of legislation recently passed, such as the Department of Veterans Affairs Accountability and Whistleblower Protection Act, would have been completely unnecessary.

    And, despite this law, Congress is still focused on accountability for VA leadership, focusing on issues such as the elimination of reassignments for personal gain and prevention of moving managers around in lieu of disciplining them, showing that the issue is still not completely resolved.

    With regard to improving the quality of benefits and services, VA has, overall, fared slightly better. As a recent Annals of Internal Medicine article highlighted, VA hospitals often perform at least as well as non-VA hospitals and in certain markets, performed even better.

    Nonetheless, VA’s Cabinet status and increased clout have not been able to solve the agency’s issues surrounding access to care. In response, Congress passed the Mission Act in June 2018 to facilitate Veterans’ access to care in the community, but as highlighted by the 115th Congress’s final hearing on Veterans’ issues — a joint House and Senate hearing on the Act’s implementation — VA currently lags sorely behind important benchmarks set by the law for implementing the legislation.

    As noted by Senate Veterans’ Affairs Committee ranking member, Jon Tester (D-Mont.), the Mission Act was “passed... with the best of intentions, but it could be a train wreck, too.”

    Like the Mission Act, the Department of Veterans’ Affairs Act in 1988 was passed by Congress with the best of intentions. However, as we reflect on thirty years of Cabinet status, the elevation of VA, sadly, appears to have been more train wreck than accountability measure.

    So what happens next?

    De-elevating VA from its current Cabinet status is not practical. The traditional means of ensuring accountability, such as through the passage of legislation and Congressional oversight, has thus far proved to be only mildly effective. And calls from Veterans themselves about what they need from VA itself have largely gone unheeded.

    One idea that is seldom discussed would be downsizing some parts of the VA by redistributing several business lines to other government agencies, rather than privatizing parts of VA or continuing to increasing its funding.

    To this end, the Social Security Administration already has infrastructure in place to adjudicate disability benefits claims and could absorb parts of the Veterans Benefits Administration.

    Likewise, the government has laws and regulations in effect for providing healthcare through Medicare, Medicaid and Tricare and parts of thus parts of the Veterans Health Administration could be absorbed by the Department of Health and Human Services or the Department of Defense.

    As we have seen with the VA’s ballooning budget over the past 17 years, bigger is not always better. Thus, instead of fighting over politically impractical ideas such as privatization or unrealistic budgets, the time is right to discuss government reorganization, instead.

    Source

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  • Robert Wilkie 10

     

    In a wide-ranging interview with NPR, Secretary of Veterans Affairs Robert Wilkie said his department is on the mend after a tumultuous 2018.

    "I do think it is better, because the turmoil of the first half of this year is behind us, the waters are calmer. We're not where we need to be, but we're heading in that direction," he said.

    Early in Donald Trump's presidency, the VA was considered an island of stability in an unpredictable administration.

    Secretary David Shulkin was a hold-over from the Obama administration, already familiar with the VA's massive bureaucracy. Bipartisan reforms moved through Congress with relative speed, and Trump could point to a list of legislative accomplishments.

    But the president fired Shulkin last March after weeks of intrigue during which VA political appointees plotted openly to oust him. Trump's first nominee to replace Shulkin, Rear Adm. Ronny L. Jackson, sank under accusations of misconduct (which are still being investigated by the Pentagon).

    Numerous high-ranking officials left the department, and records showed that friends of the president outside of government - who weren't even Veterans - had been lobbying Trump at Mar-a-Lago on how to run the VA.

    Wilkie takes charge

    After a stint as acting VA secretary, Robert Wilkie was confirmed by the Senate last July. Since then, Wilkie says he's been "walking the post," visiting as many VA facilities as he can. And he's reached the same conclusion as many of his predecessors.

    "I have been incredibly impressed by the caliber of VA employee I've encountered everywhere, from Alaska to Massachusetts to Florida," Wilkie told NPR's Steve Inskeep.

    "I have no quarrel with the quality of medical care our Veterans receive. My biggest problem is actually getting them into the system so that they can receive that care, which means the problems are primarily administrative and bureaucratic," said Wilkie, himself a Veteran of the Navy and a current Air Force reservist, who counts generations of Veterans in his family.

    "I am the son of a Vietnam soldier. I know what happened when those men and women came home," Wilkie said. "So that is incredibly important to me."

    Wilkie is navigating an important moment for the VA – while major reforms have already been passed by Congress, he's the one who has to implement them. And plenty of political controversy hides in the details.

    The VA Mission Act of 2018 was signed into law in June. It's intended to consolidate about a half-dozen programs The VA uses to buy Veterans private health care at a cost of billions of dollars, into one streamlined system.

    Critics fear that leaning too much on private care will bleed the VA's own medical centers, and lead to a drop in quality there – and amounts to a starve-the-beast strategy of privatization.

    Wilkie says that won't happen and is not President Trump's goal, but he has yet to present a budget for expanded private care to the White House and to Congress.

    "You're not going to privatize this institution. I certainly have never talked about that with anyone in this administration," Wilkie said.

    Resisting outside influence

    Wilkie also maintains that he has had little contact with the group of outside advisers who meet with the president at Mar-a-Lago, including CEO of Marvel Comics Ike Perlmutter and Florida doctor Bruce Moscowitz. Records show they had extensive communication with the previous VA secretary, sometimes influencing policy decisions.

    "I met with them when I was visiting the West Palm Beach VA - my first week as acting (secretary), and have not had any meetings with them ever since that day," Wilkie said. "I'll be clear. I make the decisions here at the department, in support of the vision of the president."

    Despite rumors that Wilkie would clear out many of the Trump political appointees who clashed with former secretary Shulkin, he said he didn't expect more staffing changes.

    The one notable departure is Peter O'Rourke, who was acting secretary for two months while Wilkie went through the confirmation process. O'Rourke clashed repeatedly with Congress and the VA's inspector general. Wilkie himself cited a Wall Street Journal report that O'Rourke is poised to go and said he's "on leave."

    "I think there will be an announcement soon about a move to another department in the federal government – I know that he's looking for something new," said Wilkie, "He's on leave."

    Another major new plan that Wilkie must implement is a $10 billion, 10-year plan to make the VA's medical records compatible with the Pentagon's.

    He once again mentioned his father's experience as a wounded combat Vet.

    "He had an 800-page record, and it was the only copy, that he had to carry with him for the rest of his life. He passed away last year," said Wilkie.

    "One of the first decisions I made as the acting secretary was to begin the process of creating a complete electronic health care record that begins when that young American enters the military entrance processing station to the time that that soldier, sailor, airman, Marine walks into the VA."

    But that process has actually been underway for a decade – with little to show and about a billion dollars already spent on the effort. The non-partisan Government Accountability Office says it's in part because neither the Pentagon nor the VA was put in charge of the effort — which is still the case. Wilkie says he has signed an agreement with the Pentagon to jointly run it with clear lines of authority.

    "I think we'll have more announcements later in the year when it comes to one belly-button to push for that office," he said.

    As for staff shortages, another perennial complaint at the VA, Wilkie acknowledged there are 35- to 40,000 vacancies at the agency.

    "We suffer from the same shortages that the private sector and other public health services suffer from, particularly in the area of mental health," he said.

    New legislation passed this year gives Wilkie the authority to offer higher pay to medical professionals.

    "I'm using it to attract as many people as we can into the system," said Wilkie

    But Wilkie also added that he was shocked, upon taking the post, that it's not clear how many additional people are needed – because it's not even clear how many people are working at VA.

    "I had two briefings on the same day and two different numbers as to how many people this agency employs."

    Wilkie says he's in the process of finding out the answer to that question, and many others, as he starts his second 100 days in office.

    Source

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  • Cabins for Homeless

     

    The cabins will house up to 21 Veterans and were built on land leased from theU.S. Department of Veteran Affairs.

    TOGUS — Tim Buckmore is delighted by his new digs, even if the cable TV hasn’t arrived yet.

    Until this summer, Buckmore, 57, was one of dozens of homeless Veterans living in Maine. Now, he’s among 19 Veterans who have moved into small houses on a quiet corner of the VA Maine Healthcare Systems-Togus campus.

    For at least seven years, various organizations and agencies have been developing the so-called “Cabin in the Woods” housing project, which cost $5.1 million to build and is located on 11 acres of land that have been leased from the U.S. Department of Veterans Affairs.

    On Friday, they celebrated the project’s opening with a ribbon-cutting ceremony that was attended by more than 100 guests and dignitaries. The project is part of a larger effort to end Veteran homeless and was developed by Volunteers of America Northern New England, a Brunswick-based group.

    Of the roughly 2,280 people who were homeless in Maine last year, 131 were Veterans, according to U.S. Census data compiled by the U.S. Interagency Council on Homelessness.

    Multiple Veterans who have received new housing through Cabin in the Woods said Friday they appreciated the natural surroundings and lack of noise pollution on the 11-acre property, where 21 cabins have been built. Each of the properties are free-standing and contain one or two bedrooms. The site also includes an office and community space, and is within walking distance of the medical facilities on the 500-acre hospital campus.

    Buckmore, who worked as a generator mechanic in the U.S. Army from 1983 to 1989, has been intermittently homeless for the last three years. He first learned about Cabin in the Woods from a social worker at the Bread of Life Ministries’ Veterans shelter in Augusta. Now, he particularly appreciates the quiet natural setting and the radiant heating that comes out of the floor of his one-bedroom cabin.

    “This is really nice and quiet,” said Buckmore, a Gardiner native, during a tour of the pre-furnished home. “I’d like to see more of these go up.”

    This past summer, Buckmore suffered two strokes and now uses a cane and wheel chair to move around. As someone who has worked in the mental health field and been diagnosed with depression, anxiety and bipolar disorder, he also hopes the new housing will bring stability to a vulnerable population of Veterans.

    “There’s a high suicide rate among homeless Veterans,” he said. “Something like this can help take their mind off anything bad they’re thinking about.”

    Buckmore’s one qualm, he said, is that Spectrum has yet to run cable television to the new homes. But he added, “That could be a blessing in disguise.”

    Multiple groups provided funding and donations for the Cabin in the Woods project, including the Maine State Housing Authority, the U.S. Department of Housing and Urban Development, the Home Depot and T.D. Bank Charitable foundations. At the ceremony on Friday morning, officials from some of those groups delivered prepared remarks.

    There were also speeches by two members of Maine’s congressional delegation, U.S. representatives Chellie Pingree and Bruce Poliquin, and delegates for U.S. senators Susan Collins and Angus King. Also attending the event was Poliquin’s predecessor as representative of Maine’s 2nd District, Mike Michaud, who served as chairman and ranking member of the House’s Committee on Veterans Affairs.

    Another speaker was Ryan Lilly, the former director of the Togus system who was recently elevated to another role in the U.S. Department of Veterans Affairs: director of its New England systems.

    Just as some cities have eradicated poverties in their homeless populations, Maine is trying to do the same, Lilly said. After the ceremony, he said the Togus campus still has between 30 and 50 acres that could be developed and that the agency is now considering whether it could lease out land for a similar project oriented toward seniors.

    “It was our first experience with this process,” Lilly said. “We’re thinking about what we can do next.”

    While there are other housing developments for Veterans around the country, Lilly said that Cabin in the Woods is unique because it’s in a secluded area and its units are individual homes, as opposed to apartments.

    Another Veteran to benefit from the new housing project is Jesse McGahuey, 41, who last month moved into a two-bedroom cabin with his wife Sheena, 33, and their 5-year-old son, Jerrick. While living on federal land isn’t a perfect arrangement, they said that the arrangement has made it considerably easier for McGahuey to attend his weekly medical appointments at Togus.

    McGahuey suffered a series of injuries during and outside his service in the U.S. Army from 2000 to 2002. As a child, he suffered a brain injury. Then, when he was working as a heavy equipment operator while stationed at Fort Lewis in Washington, he was pulled under a piece of machinery, injuring his legs and back. Finally, in 2014, he was working at an oil-change business in Waterville when a driver accidentally lost control of her car, giving McGahuey a head injury and exacerbating the previous problems.

    After that 2014 accident, McGahuey lost the ability to work or pay for housing. Since then, his family has spent long periods camping outside. They were one of the first families to apply for housing in Cabin in the Woods, and they’re now able stay there with subsidized rental costs.

    Now that some stability has been reintroduced to their lives, McGahuey hopes that he can start taking classes at a community college and working again, even if it’s part time. His wife, Sheena, is unable to work and receives disability payments because of medical problems she suffered when giving birth.

    “This does ease the pressure of it,” Sheena McGahuey said. “It does help.”

    Source

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  • AO Presumption Policy

     

    For Vietnam Veterans, having a medical condition presumed related to Agent Orange exposure is linked to greater use of Veterans Affairs health care.

    That is the main finding of a study by researchers with the War Related Illness and Injury Study Center (WRIISC) at the VA New Jersey Healthcare System. They say the results show that a law passed by Congress nearly 30 years ago has largely met its goal: helping affected Veterans get the care they need.

    The study results appeared in May 2018 in the journal Medicine.    

    Agent Orange linked to 14 conditions

    Agent Orange is a chemical defoliant that was sprayed by the U.S. during the Vietnam War to kill plants and clear land. It was contaminated with dioxin, which is known to cause cancer and other conditions. Twenty million gallons of Agent Orange were sprayed during the Vietnam War. About 2.7 million U.S. military personnel may have been exposed.

    Veterans are eligible for compensation from the Veterans Benefits Administration if they have a service-connected disability. The higher the disability rating, the more compensation they are due. Veterans with higher service-connected disability ratings also have greater access to no-cost health care through the Veterans Health Administration. However, it is often difficult to prove direct service connection for Agent Orange-related conditions because they may develop years after exposure.

    To address this problem, Congress passed the Agent Orange Act of 1991. The act directed VA to presume service-connected disability for conditions the National Academy of Sciences deemed related to Agent Orange. Veterans with these conditions qualify if they were in Vietnam between Jan. 9, 1962, and May 7, 1975.

    Seven non-cancer conditions have been designated as presumptively service-connected for Vietnam Veterans: chloracne (a severe acne-like skin condition), ischemic heart disease, Parkinson’s disease, peripheral neuropathy, porphyria curtanea tarda (a skin condition that causes blisters, hair growth, and discoloration), AL amyloidosis (an immune-system disorder that can damage the organs), and Type 2 diabetes. Several forms of cancer are also included: chronic b-cell leukemias, Hodgkin’s disease, multiple myeloma, non-Hodgkin’s lymphoma, prostate cancer, respiratory cancers, and soft-tissue sarcoma.

    Veterans with connected conditions use VA health care more often

    To find out how this policy affected VA health care use, the researchers looked at 2013 data on 85,699 Vietnam Veterans. They found that those with one or more diagnoses of a presumptive condition were more likely to have multiple disabilities than those without one of the named conditions. While they were less likely to have a 100 percent disability rating than those with no presumptive condition, they were more likely to have individual unemployability. This means they cannot maintain employment because of service-connected disability.

    Of those with any presumptive condition, 73 percent had Type 2 diabetes. About 44 percent had ischemic heart disease, and 16 percent had some form of cancer.

    Looking at health care usage, the researchers found that 35 percent of those with a presumptive condition had five or more primary care visits in fiscal year 2013. Only about 15 percent of those without a presumptive condition had this many visits.

    Forty-five percent of the presumptive condition group had five or more specialty care visits, compared with 15 percent of those without presumptive conditions. Of the presumptive-condition patients, 37 percent had at least one mental health visit, compared with 16 percent for those without any of the conditions.

    In other terms, those with presumptive conditions were more than twice as likely as those without the conditions to be frequent users of primary and specialty care in the VA health care system. They were also more likely to visit emergency rooms than the other group.

    The study shows that Agent Orange legislation has been effective, write the researchers, at lowering “the threshold for accessing [Veterans Benefits Administration] and [Veterans Health Administration] benefits for Vietnam Veterans who may have been exposed to dioxin.” The findings highlight the importance of presumptive service connection in serving Veterans, they conclude. The results may also indicate that Vietnam Veterans with these service-connected conditions are more likely than those without these conditions to choose VA for their care.

    Dr. Dennis Fried, corresponding author on the paper, summed up the importance of the results: “In our era of increased Veteran choice with regard to health care delivery sites and greater integration of VHA and community care, these findings support the importance of VHA provision of services for conditions possibly related to military service.”

    For more information on Agent Orange exposure, visit VA’s Agent Orange website. To learn more about VA research concerning Vietnam Veterans, visit www.research.va.gov/topics/vietnam.cfm.

    Source

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  • Dave Zielinski

     

    The Vietnam War has claimed another soldier.

    His name was Dave Zielinski — a former Providence cop and lawyer. He was 71 and a direct casualty of his Vietnam service.

    That’s not journalistic sentiment. It’s the official view of the Veterans Administration.

    Zielinski died of leukemia. The government declared it a result of Agent Orange.

    The link is so strong that all soldiers with that form of cancer, and a list of other syndromes, are considered to have service-related disabilities.

    Steve Kelley, a retired Rhode Island National Guard colonel, told me a few days ago that his friend, Dave Zielinski, had lost his battle.

    Kelley knew him well, through Zielinski’s service beyond Vietnam.

    Zielinski grew up in the Hartford Park Housing Project, raised by a single mom and never making it through high school. But with the discipline he’d learned in the war, he moved up the ranks of the Providence police and graduated from law school. And Kelley got him to put on an Army uniform again as a JAG — Judge Advocate General’s Corps — officer with the Guard.

    Kelley feels there’s an image in America of Vietnam Vets left hobbled by war and an unwelcoming homecoming. Both traumas are legitimate. But Zielinski, he says, is a reminder that most overcame it to lead inspiring lives.

    Zielinski told me in January that returning Vets like him were indeed “treated as lepers.” When applying for a job as a cop, he didn’t even mention his service — he thought it might hurt him.

    It didn’t. He became a police major.

    Then he got the law degree and went on to work for Rhode Island’s secretary of state, and then the federal government as watchdog looking for misconduct.

    He later joked: “If anybody knows anything about corruption, it’s someone from Rhode Island.”

    I interviewed him about his cancer battle, reaching him by phone in New Bern, North Carolina, where he and his wife, Jeanne, had retired.

    But their hearts remained in Rhode Island, and he told me he began each day reading The Providence Journal online.

    The chemo was rough, but Zielinski had always been a fighter. He opened up to me about it to raise awareness. He hoped his story would prompt fellow Vietnam Vets to explore the Agent Orange connection if they faced health problems.

    His buddies, he said, kept him alive in Vietnam; maybe he could return the favor today.

    In the end, the wounds left in him by Agent Orange were too much.

    Although the rules don’t allow it, Kelley thinks his friend Dave should join the other 58,000 names now on the Vietnam Memorial wall. It took 50 years, but Kelley feels it’s still a “combat-related” death.

    Kelley wrote me a week ago to say Zielinski had taken a bad turn. A few days ago, he wrote again to say another soldier had paid the ultimate sacrifice.

    Zielinski’s wife, Jeanne, sent a message to let folks know.

    “I held his hand while he passed into the hands of God,” she wrote.

    She thanked everyone for their prayers. She said he’d run a good race in his years, and touched many lives.

    Kelley said Jeanne had returned “Davie” back to Rhode Island; he will be laid to rest as a soldier, with full military honors at Rhode Island Veterans Memorial Cemetery.

    Let it be noted here how many other realms Dave Zielinski touched too — the city of Providence as a police officer, the federal government as a servant, and as a life-force among family and friends.

    Kelley is sure his will not be an unvisited grave.

    Source

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  • AO Ships Logs

     

    During the Vietnam War, hundreds of U.S. Navy ships crossed into Vietnam’s rivers or sent crew members ashore, possibly exposing their sailors to the toxic herbicide Agent Orange. But more than 40 years after the war’s end, the U.S. government doesn’t have a full accounting of which ships traveled where, adding hurdles and delays for sick Navy Veterans seeking compensation.

    The Navy could find out where each of its ships operated during the war, but it hasn’t. The U.S. Department of Affairs says it won’t either, instead choosing to research ship locations on a case-by-case basis, an extra step that Veterans say can add months — even years — to an already cumbersome claims process. Bills that would have forced the Navy to create a comprehensive list have failed in Congress.

    As a result, many ailing Vets, in a frustrating race against time as they battle cancer or other life-threatening diseases, have taken it upon themselves to prove their ships served in areas where Agent Orange was sprayed. That often means locating and sifting through stacks of deck logs, finding former shipmates who can attest to their movements, or tracking down a ship’s command history from the Navy’s historical archive.

    “It’s hell,” said Ed Marciniak, of Pensacola, Fla., who served aboard the USS Jamestown during the war. “The Navy should be going to the VA and telling them, ‘This is how people got aboard the ship, this is where they got off, this is how they operated.’ Instead, they put that burden on old, sick, dying Veterans, or worse — their widows.”

    Some 2.6 million Vietnam Veterans are thought to have been exposed to — and possibly harmed by — Agent Orange, which the U.S. military used to defoliate dense forests, making it easier to spot enemy troops. But Vets are only eligible for VA compensation if they went on land — earning a status called “boots on the ground” — or if their ships entered Vietnam’s rivers, however briefly.

    The VA says Veterans aren’t required to prove where their ships patrolled: “Veterans simply need to state approximately when and where they were in Vietnam waterways or went ashore, and the name of the vessel they were aboard, and VA will obtain the official Navy records necessary to substantiate the claimed service,” VA spokesman Randal Noller wrote in an email.

    Once the VA has that documentation, the vessel is added to a list of ships eligible for compensation, streamlining future claims from other crewmembers. But proactively searching thousands of naval records to build a comprehensive list of eligible ships — as some Veterans have demanded — “would be an inefficient use of VA’s resources,” Noller said.

    But because the historical records are sometimes missing or incomplete, Veterans groups say the fastest and surest way to obtain benefits is for Vets to gather records themselves and submit them as part of their initial claims.

    More than 700 Navy ships deployed to Vietnam between 1962 and 1975. Veterans have produced records to get about half of them onto the VA’s working list, with new ships being added every year. Still, Veterans advocacy groups estimate about 90,000 Navy Vets are not eligible to receive benefits related to Agent Orange exposure, either because their ships never entered inland waters, or because they have yet to prove they did.

    Joseph Pires, 68, spent 2 1/2 years working to convince the VA that his ship, the aircraft carrier USS Bennington, should be added to the list.

    He reviewed the daily deck logs to find the latitude and longitude recordings and read officers’ descriptions of the ship’s movements. He found a listing for Dec. 26, 1966, when the ship entered Qui Nhon Bay Harbor to pick up comedian Bob Hope and his troupe for an onboard Christmas show.

    “Now I had the proof,” he said.

    He submitted it to the VA, waited a year and received an email on Dec. 31 notifying him the Bennington had been added to the VA’s list. That makes about 2,800 crew members aboard the ship on those two days eligible for benefits if they have illnesses associated with Agent Orange.

    Now Pires is waging the next battle: His personal application for benefits, based on his prostate cancer and ischemic heart disease, has been pending for nine months.

    “They put everything on your shoulders,” said Pires, who serves as the Bennington’s historian.

    Pires, of Calabash, N.C., is among more than 4,000 Vietnam Veterans and family members from across the country who’ve shared Agent Orange-exposure stories with ProPublica and The Virginian-Pilot over the past several months.

    The importance of proving to the VA which ships went inland during the war was underscored last month, when the VA rejected a request from Veterans and members of Congress to extend benefits to all Navy Veterans who served within 12 miles of the Vietnamese coast, the so-called Blue Water Veterans. Those Vets believe they were exposed to Agent Orange even if they stayed off the coast, arguing that their ships sucked in water tainted with the herbicide, which contains the dangerous chemical dioxin, and used it for showering, cooking and cleaning.

    When Congress passed the Agent Orange Act in 1991, the VA initially approved benefits for any sailor who had earned the Vietnam Service Medal. But in 2002, it began denying sick Blue Water Navy Vets compensation for Agent Orange exposure, maintaining that the placement of a comma in the original legislation made a distinction between those who served on the ground in Vietnam and those who served elsewhere.

    Last year, the U.S. Court of Appeals for Veterans Claims directed the VA to review its rules for compensating Blue Water Navy Veterans. In February, 10 months later, the VA affirmed its policy of providing benefits only to those who served on land or in inland waters. If anything, the VA tightened its policy by excluding ships that entered certain bays and harbors that had previously been accepted.

    The VA estimates it would cost taxpayers $4.4 billion over the next decade to provide benefits to all Blue Water Veterans, but its policy of excluding them has complicated the task of determining who’s eligible for compensation.

    By 2006, Veterans had begun presenting evidence of those ships’ activities, and the VA began granting Agent Orange benefits to Blue Water Veterans on a case-by-case basis. A couple years later, Veterans advocates succeeded in convincing the VA to use the evidence submitted by individual Veterans to maintain a list of approved ships.

    John Rossie, executive director of the Blue Water Navy Vietnam Veterans Association and a Vietnam Veteran, agreed to help the government collect information from affected Veterans, hoping to speed up the process. He said he put out a message in 2009 telling Navy Vets that if they sent him their ship’s deck logs, he would get them to the VA.

    “A month later, I smacked myself on the forehead, because I started getting buried under boxes full of these deck logs.”

    The first published list came out in January 2010 and had 16 ships on it.

    As Veterans have come forward with records — and as the VA has conducted its own searches — the agency has added a few dozen ships each year. More than 430 ships are listed now. The pace has slowed, but Rossie is confident more need to be added.

    “It’s been a lot of work,” Rossie said. “A lot of individuals have invested a lot of hours in this.”

    To make the process easier, Blue Water Vets pressed for legislation in 2013 that would have required the Navy to pull all of the deck logs and compile an accurate accounting of which ships spent time inside Vietnam’s border. That bill passed the House, 404–1, but didn’t advance in the Senate.

    A year later, in 2014, advocates got the House to insert language into the National Defense Authorization Act that would have required the same thing. John Wells, a Louisiana lawyer who has spent more than a decade advocating for Blue Water Veterans, said the language was stripped from the Senate version after the Navy objected, contending it would cost the service $5 million to conduct a study to locate each ship.

    The Navy did not answer questions for this story.

    Marciniak, the Veteran from Pensacola, says he was fortunate. He’d held onto paperwork proving that he’d spent time in Saigon before flying back to the U.S.

    That yellowing page spelling out his orders was enough to prove to the VA that the 76-year-old Navy Vet was eligible for compensation after he was diagnosed with type 2 diabetes and heart disease a few years ago. The claim was approved in 2013, a year and a half after he initiated the process.

    Others he served with aboard the Jamestown, a research vessel, off the coast of Vietnam had a harder fight. The ship, along with the USS Oxford, intercepted enemy radio traffic and frequently sent crew members ashore to deliver sensitive information to commanders on the ground. As a result, the ships’ activities were classified, making it more difficult for Veterans to come up with records proving where they served.

    Former Oxford and Jamestown crewmembers were eventually able to get their hands on declassified command reports that included details about the trips ashore. Those records helped get both ships added to the VA’s list in 2011.

    “Even with the ship listed, it took the VA more than 18 months before they approved my claim,” Marciniak said. “I’ve written letters for three widows addressed to the VA explaining how the the Jamestown operated and describing our regular courier runs, because their husbands’ died before they were able to get VA compensation.”

    Another challenge: Veterans who were denied benefits before their ships were added to the list must start the process all over again. “The problem there,” Rossie said, “is these guys are sick and dying. They don’t have a lot of time to jump through hoops.”

    Rory Riley-Topping, a consultant and former staff director for the House VA Subcommittee on disability assistance and memorial affairs, said the VA has many pressing issues to deal with — health care wait times, construction delays, benefits backlogs. “Bureaucracies that are large are not known for their efficiencies, and this is a great example of bureaucracies being shortsighted and not understanding the big picture. A lot of people thought this issue would go away, and obviously it didn’t.”

    For John Kirkwood, the push to get the amphibious command ship USS Mount McKinleyadded began in March 2010 when he went to the VA hospital in San Diego because he wasn’t feeling well. He spent 40 days in the hospital after a heart attack. His wife and stepdaughter initiated a claim for benefits. A little over a year later, it was denied because he couldn’t prove he was in Vietnam or exposed to Agent Orange.

    Kirkwood wasn’t able to get deck logs from the National Archives or the Navy. Both said they didn’t have them and had no idea where they were. “I didn’t know what the hell to think at that point,” said Kirkwood, a 66-year-old retired auto body technician.

    In May 2011, he posted a note on the ship’s website that read, “I was a shipmate of yours on the last cruise of the Mount McKinley in 1969. The purpose of this comment is to see if any of you remember going into Da Nang harbor on that cruise for liberty, parties at China Beach and water skiing in the harbor behind the Captain’s Gig.”

    Emails began streaming in from shipmates he knew and those he didn’t. “I remember going ashore,” one wrote in an email he shared with ProPublica and The Pilot.

    “You are not the first one to ask these questions,” another wrote.

    Kirkwood also found a cruise book in his garage, which is essentially a scrapbook of the tour. “I was able to take photocopies out of there showing that we actually went to Da Nang Harbor,” he said. “I can’t make up a cruise book.”

    A fellow shipmate sent him a calendar he kept, showing the ship was anchored in Da Nang Harbor over 60 days of that cruise. Kirkwood’s own claim for benefits was approved in January 2013. Kirkwood then forwarded his documentation to Rossie, who forwarded it to the VA. The ship was added to the VA’s list in July of that year.

    “Sometimes I felt I was fighting a losing battle, but I’m persistent,” Kirkwood said.

    Others are still fighting. Brad Davidson began researching the process in November after being diagnosed with two conditions associated with Agent Orange.

    Davidson, who declined to disclose his specific health troubles, remembered going ashore for leisure breaks multiple times during his deployment aboard the destroyer USS Brinkley Bass in 1970, but he had no records to prove it. He tracked down the deck logs, which showed the ship spent time anchored in Da Nang Harbor, Cam Ranh Bay and Ganh Rai Bay, but nothing in the handwritten notes mentioned crew members being ferried ashore during those stops.

    “That is a problem, trying to get a clear recollection all these years later,” said Davidson, 69, who lives near Chicago. “And beyond that, getting hard evidence. … They don’t make it easy.”

    Earlier this year he got in touch with his crew’s reunion group, and a few former shipmates responded with photographs of crew members at a beach party at Cam Ranh.

    His memories from that time are a blur, Davidson said, but that afternoon spent drinking beer on a beach 46 years ago could be the difference between receiving thousands of dollars per year in disability benefits and receiving nothing.

    “I think we’ve certainly convinced ourselves,” Davidson said. “But we’re not sure what it’s going to take to get us on the VA’s list. We think it’s enough, but we don’t know for sure what the VA requires.”

    He faces an uphill battle. Generally, the VA hasn’t accepted photographs to prove a Veteran spent time on the ground in Vietnam. Davidson hopes the agency makes an exception in his case.

    “I don’t really have time to wait and find out.”

    ProPublica and the Virginian-Pilot are interested in hearing from Veterans and family members for our ongoing investigation into the effects of Agent Orange on Veterans and their children. Share your story now at propublica.org/agentorange or hamptonroads.com/agentorange.

    Source

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  • Heath Sommer

     

    A psychologist at Travis Air Force Base in California was found guilty on Friday of sexually assaulting military officer patients who were seeking treatment for post-traumatic stress disorder, The Daily Republic reported.

    Heath Sommer may face up to 11 years and eight months in prison after receiving a guilty verdict on six felony counts of sexual assault, according to the Republic.

    Sommer used a treatment known as “exposure therapy” to lure his patients, who were military officers who had experienced previous sexual assaults, into performing sexual activity, the Republic reported.

    According to charges brought by Brian Roberts, the deputy district attorney who prosecuted the case, Sommer raped his patients through “fraudulent representation that the sexual penetration served a professional purpose when it served no professional purpose,” the Republic reported.

    One of Sommer’s reported victims, an Air Force colonel, testified that Sommer made her eat dirt and leftover Chinese food from his fridge to replicate her memories of the dirty training facility in Afghanistan where she was sexually assaulted, the Republic reported.

    According to the Republic, Sommer then told her she needed a “positive and loving” sexual experience before taking her to his bedroom and having sex with her while his wife waited in the kitchen.

    Sommer is set to be sentenced on January 25, 2019, according to the Republic.

    Source

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  • New Commissioner

     

    The Alabama Board of Veterans Affairs today selected retired Rear Admiral W. Kent Davis as the next commissioner of the Alabama Department of Veterans Affairs.

    Davis will replace Clyde Marsh, who retired late last year. Marsh, who was also a retired rear admiral, had served as commissioner of the Department of Veterans Affairs for 13 years.

    Davis, an Alabama native, began his Navy career as a supply corps officer aboard the battleship U.S.S. Missouri in 1986. He retired from the Navy in October 2016.

    Davis is the chief communication officer at Air University at Maxwell Air Force Base in Montgomery, a civilian job he has held since August 2017.

    Davis worked as city manager for the city of Anniston from 2016 to 2017. He was deputy superintendent of the U.S. Department of Homeland Security’s Center for Domestic Preparedness in Anniston from 2014 to 2016.

    In 2012, Davis served as director of public affairs for U.S. detention operations in Afghanistan.

    Davis is a 1985 graduate of Louisiana State University and has a law degree from Georgia State University, where he graduated second in a class of 157 students in 1998. He has worked as an attorney for the Department of Homeland Security and as a public affairs officer for the Navy Reserve.

    The Veterans Affairs Board voted to authorize Gov. Kay Ivey, who is chairman of the board, to officially offer the position to Davis and negotiate a salary and start date. That will happen next week, according to Ivey spokesman Daniel Sparkman.

    Source

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  • Amputees in High Heels

     

    Researchers from the Department of Veterans Affairs have played roles in a number of scientific and medical breakthroughs that have had a profound impact on modern life: the liver transplant, the nicotine patch and artificial lungs, to name just three.

    And now, as they seek to meet the needs of an increasingly diverse population of wounded and disabled Veterans from the current era of war, VA design experts say they're going beyond barebones medical needs and aiming to help Vets live more comfortably, with technology adapted to their lifestyle and interests. It's work that requires them to listen to Veterans more closely and involve them and their feedback in the development process to a greater extent than ever before.

    One example of this work can be seen at the Office of Research and Development of the Department of Veterans Affairs, where they've come up with a 3D-printed ankle and foot device for a prosthetic leg to give amputees adjustable heels.

    Thanks to this research, stilettos are no longer out of the question for Veteran amputees. Outside researchers at Johns Hopkins University and elsewhere have developed similar devices, but Dr. Andrew Hansen of the Minneapolis VA Healthcare System said the VA's "Shape & Roll" prosthetic foot is unisex.

    "This study focused on high heels, but the results work just as well for cowboy boots," Hansen said in a VA release.

    The adjustable-heel prosthetic was an example of VA's commitment to research in areas that haven't been pursued by the private sector, said Dr. Rachel Ramoni, the VA's chief research and development officer.

    "Actually, there's a couple of things going on with 3D printing; you can print a foot for every type of shoe," Ramoni told Military.com.

    The foot-ankle prosthetic also demonstrates a willingness at the VA to take feedback from wounded and disabled Veterans themselves on what they need to accommodate the lifestyles they wish to return to or pursue, she said.

    Ramoni also cited current research into upper-arm prosthetics for women as an example of this work.

    "That's a small segment of the population; it's a small market," Ramoni said. "It's not an area where somebody would say 'Well, it's an obvious money making opportunity.' So it might not be good business, but it's the right thing to do."

    The other challenge with research on upper-arm prosthetics for women is that so little work has been done in the field previously, Ramoni said.

    "The sizing of the prosthetic is a big deal," she said, and "we don't know about women's upper arm satisfaction, because all of the surveys were designed for men."

    The work on adjustable heels and the upper-arm prosthetic research are among more than 2,000 projects involving 3,400 researchers now underway at the Office of Research and Development. ORD operates on a budget of about $722 million from the VA, supplemented by contributions from the National Institutes of Health, the Department of Defense and others, for a total of about $1.5 billion, Ramoni said.

    The money is being spent with a new emphasis on listening to Vets regarding where they want the research to go, Ramoni said.

    A Disabled Vet Tackles Design

    Dr. Rory Cooper was an Army sergeant in Germany in 1980 when he lost the use of his legs from spinal cord injuries in a bicycle accident.

    He now is a director and senior research career scientist for the Human Engineering Research Laboratories, a VA Rehabilitation Research and Development Center and home of the VA Technology Transfer Assistance Program.

    Cooper is also a Paralyzed Veterans of America distinguished professor at the University of Pittsburgh. As such, he is an advocate for what leaders in his field call "participatory action engineering," or, more simply put, listening to the people you're trying to help.

    Cooper said his frustration with the ivory-tower approach to human engineering grew out of his own experience trying to get a better wheelchair.

    "I was trying to solve some of my own problems," he said of his approach to design research. He found that he and other Veterans often were in "isolation" from the researchers.

    Cooper said that surveys and talking to the Veterans themselves are "ways to initiate the design process, rather than having somebody sitting at their desk or surfing their computer, trying to understand what you want."

    Designers and researchers should "start by asking [the Veterans]... to prioritize," Cooper said.

    He said his current research was focused on robotics, artificial intelligence and what he called "adaptive reconditioning technology" to help Veterans participate in sports and recreation.

    One such example: a robotic bed. One of the little-known everyday problems for disabled Veterans, and their caregivers, is getting in and out bed, Cooper said.

    "If you don't have the use of your arms or legs, or you're weakened, that's a huge problem," he said.

    The bed is currently a work in progress, but Cooper said the initial thought was to have a "chair-into-bed kind of a docking system, and the chair kind of puts you into the bed while a conveyer pulls you into the bed."

    A Secret Weapon: Veterans

    The VA has a major advantage over the teaching hospitals and the private sector in conducting wide-ranging tests and surveys that require huge numbers of volunteers, said Ramoni, the VA's chief research officer.

    "Veterans are absolutely core to our program," she said. "Our program is able to make these discoveries because of the thousands of VA patients volunteering here," and "what we do is driven by their needs."

    Outside researchers, she said, often ask how they can learn from current VA practices and how VA scientists get so many people involved in the development process.

    "We say what we have is not something you can learn; that you have a population of Veterans who want to continue to serve their fellow Veterans and the entire nation by participating in these studies," Ramoni said. "It's just amazing to me how committed Veterans are to continuing to serve and continuing to make discoveries that will help everybody."

    The Next Big Breakthrough

    Ramoni noted that VA's ongoing Million Veteran Program (MVP) on genome research has now enrolled more than 670,000 Veteran volunteers, to make it by far the world's largest genome database.

    In the program, begun in 2011, participants donate blood, from which DNA is extracted. Then a baseline and periodic follow-up surveys track the Veterans' military careers, and their health and lifestyles.

    The research seeks to determine whether the genetic information in the database could hold keys to preventing and treating diseases.

    "We believe MVP will accelerate our understanding of disease detection, progression, prevention and treatment by combining this rich clinical, environmental and genomic data," former VA Secretary Dr. David Shulkin said.

    The MVP research opened the possibility for determining whether genetic factors were contributors to PTSD and Gulf War illness, Ramoni said.

    Many Veterans shared the same experiences in the same places in combat, and others were in the same places in the Gulf War; some developed PTSD and Gulf War illness, others didn't, Ramoni said.

    "The question we all ask is, why is that? Are there genetic markers for PTSD susceptibility, or are there genetic markers for Gulf War illness? Genes might help reveal that," she said.

    Source

    #veterans #military #amputees #womenvets

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  • Bryan Perry

     

    An Army Veteran was left to die from a drug overdose while in the custody of an Oregon sheriff’s office as deputies laughed and filmed the entire ordeal, according to videos released Thursday.

    • Bryan Perry, a 31-year-old Iraq War Veteran and Purple Heart recipient, was arrested along with his girlfriend on suspicion of drug use. In the video, he is seen thrashing and groaning in pain while in custody on October 4, 2016, while Clackamas County Sheriff’s Office deputies are heard laughing and mocking his behavior.
    • “We should go show this to his girlfriend and be like, ‘You love this?,'” one deputy suggests, an apparent reference to Perry’s affirmation of love for his girlfriend before they were led to separate holding cells, according to 18 pages of documents released sheriff’s office along with the video.
    • Perry became unresponsive around 11:45 pm and was rushed to the hospital, where he was pronounced dead at around 12:16 am. An autopsy revealed that Perry had amphetamines and methamphetamines in his system at the time of his death, although he had told police he’d used heroin and bath salts at the time of his arrest.
    • The video and documents only came to light following a wrongful death lawsuit filed by Perry’s family and a resulting public records request from The Oregonian newspaper.
    • “I cannot comment on the pending lawsuit, which focuses primarily on Mr. Perry’s medical care provided by the Jail medical contractor,” Clackamas County Sheriff Craig Roberts said in a statement. “But I will say this: The laughter, substance, and tone of several comments heard from my employees in that video were inappropriate, and do not conform to our professional standards.”

    You can watch the entire video below. Warning: It’s disturbing — and infuriating.

    (Click on the source link at the bottom to view the video)

    Source

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  • AZ Homeless Vets

     

    An annual event sponsored by the Sonny Montgomery VA Medical Center is working to connect Mississippi's homeless Veterans with services they desperately need. MPB's Desare Frazier reports.

    Forty-year old Roselyn Hutton, is a U.S. Navy Veteran from Utica. When she was going through a divorce and attending college, Hutton says her G.I. Bill benefits didn't cover the cost of living during breaks, holidays and summers. She and her 9-year old son ended up going from house to house staying with people. Hutton sought help from the homeless program at the Sonny Montgomery VA Medical Center in Jackson.

    "And I was able to utilize their services in order to be able to sustain life and still be able to go to school and still drill a little while and still take care of my son," said Hutton.

    Hutton, says she now works as a medical supply technician at the VA facility and she's a homeowner. Hutton is at the medical center's annual Standdown event in Jackson encouraging homeless Veterans to take advantage of all the services available. Kimberly Moore is with the medical center. She says state and community agencies link Veterans with services that include finding a job, housing and medical care. Moore wants to make it convenient for them.

    "To prevent Veterans from having to go here for one thing, another place for another, bringing all the services under one roof. This is where Veterans can come, they can fellowship with their fellow Veterans, relax, and just get back on their feet with this resources," said Moore.

    Moore says 150 to 200 homeless Veterans attend the program. Navy Vet Roselyn Hutton tells them:

    "We deserve it. We served this country. It's important to know what benefits and what things are available to us," said Hutton.

    A Standdown event is scheduled for September 29, in Greenville.

    Source

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  • Antibiotic Resistance

     

    More than 400,000 Americans get sick every year from infections caused by antibiotic-resistant foodborne bacteria, according to CDC estimates. People who are infected with antibiotic-resistant bacteria may experience more severe illness, including hospitalization and death, because these infections can be harder to treat. Learn what CDC is doing and how you can protect yourself and your loved ones from these types of infections.

    Antibiotic Resistance and Food Production

    Antibiotic resistance is the ability of bacteria to resist the effects of an antibiotic. This means that bacteria are not killed by the antibiotic and can continue to grow. About one in five resistant infections are caused by germs, such as Salmonella and Campylobacter, from food and animals.

    Improving antibiotic use can help slow antibiotic resistance.

    Antibiotics are medicines that kill bacteria. They are extremely important in treating serious bacterial infections in people. However, bacteria can become resistant to antibiotics when these drugs are given unnecessarily to people or animals who don’t require them. Improving antibiotic prescribing and use is critical to ensure that bacteria don’t become resistant to antibiotics. Prescribers should only treat people and animals with antibiotics when they need them for medically sound reasons.

    All humans and animals have bacteria in their gut. When they are given antibiotics, many of these bacteria are killed, but the resistant ones may survive and multiply. This is why the responsible use of antibiotics is so important in both humans and animals.

    When animals are slaughtered and processed for food, the bacteria from the animal can contaminate meat or other products. Bacteria also can spread from animal feces (poop) to the environment, which can then contaminate soil and water used to grow fruits and vegetables. Food and the environment can get contaminated with bacteria in these ways, including with bacteria that are resistant to antibiotics.

    People can get resistant infections by handling or eating raw or undercooked meat or produce contaminated with resistant bacteria. They can also get sick from contact with animal poop, either through contact with animals and animal environments, or through contaminated drinking or swimming water.

    What CDC is doing

    CDC is working to prevent infections caused by antibiotic-resistant bacteria by:

    • Tracking resistant infections and studying how resistance emerges and spreads.
    • Detecting and investigating antibiotic-resistant outbreaks quickly to solve, stop, and prevent them.
    • Determining the sources of antibiotic-resistant infections that are commonly spread through food and animals.
    • Strengthening the ability of state and local health departments to detect, respond to, and report antibiotic-resistant infections.
    • Educating consumers and food workers on prevention methods, including safe food handling, safe contact with animals, and proper handwashing.
    • Promoting the responsible use of antibiotics in humans and animals.

    Protect yourself and your family

    There are steps you can take to help protect yourself and your family from antibiotic-resistant foodborne illnesses.

    • Take antibiotics only when needed.
    • Follow simple Food Safety Tips:
    • COOK. Use a food thermometer to ensure that foods are cooked to a safe internal temperature: 145°F for whole beef, pork, lamb, and veal (allowing the meat to rest for 3 minutes before carving or consuming), 160°F for ground meats, and 165°F for all poultry, including ground chicken and turkey.
    • CLEAN. Wash your hands after touching raw meat, poultry, and seafood. Also wash your work surfaces, cutting boards, utensils, and grill before and after cooking.
    • CHILL. Keep your refrigerator below 40°F and refrigerate foods within 2 hours of cooking (1 hour during the summer heat).
    • SEPARATE. Germs from raw meat, poultry, seafood, and eggs can spread to produce and ready-to-eat foods unless you keep them separate. Use different cutting boards to prepare raw meats and any food that will be eaten without cooking.
    • Wash your hands after contact with poop, animals, or animal environments.
    • Report suspected outbreaks of illness from food to your local health department.
    • Review CDC’s Traveler’s Health recommendations when preparing to travel to a foreign country.

    Source

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  • Suicide Prevention Month

     

    The Army is committed to the health, safety, and well-being of its Soldiers, Department of the Army civilians, and families. To emphasize this commitment, the Army is joining the nation in observing September as National Suicide Prevention Month.

    Every person has a responsibility and commitment to reach out and help fellow Soldiers, civilians, or family members who need the strength of the Army. Together, a difference can be made by helping those who are at risk and suicides can be prevented.

    Effective suicide prevention requires everyone to be aware of the risk factors for suicide and know how to respond.

    If a person seems suicidal, the time to take action is now. Talk to that person before it is too late. Be direct and talk openly. Listen, and allow them to express their feelings.

    Battle buddies are the front line in surveillance and detection of high-risk behavior. Be a buddy, learn the warning signs of suicide, and find out how to help someone threatening suicide.

    Employ ACE

    Ask, care, escort, or ACE, is an easy-to-remember acronym that any Soldier, leader, family member, or civilian can use.

    • Ask your buddy – Have the courage to ask the question, but stay calm. Ask the question directly, “Are you thinking of killing yourself?”
    • Care for your buddy – Remove any means that could be used for self-injury. Calmly control the situation; do not use force. Actively listen to produce relief.

    Escort your buddy — Never leave your buddy alone. Escort to the chain of command, a chaplain, a behavioral health professional, or a primary care provider.

    Know the signs

    Do you know the warning signs for suicide?

    If anyone you know exhibits the following signs, get help as soon as possible by contacting a mental health professional or by calling the National Suicide Prevention Lifeline at 800-273-TALK.

    • Threatening to hurt or kill oneself or talking about wanting to hurt or kill oneself.
    • Looking for ways to kill oneself by seeking access to firearms, available pills, or other means.
    • Talking or writing about death, dying, or suicide when these actions are out of the ordinary for the person.
    • Feeling hopeless.
    • Feeling rage or uncontrolled anger or seeking revenge.
    • Acting reckless or engaging in risky activities.
    • Feeling trapped.
    • Increasing alcohol or drug use.
    • Withdrawing from friends, family, and society. This includes feeling anxious or agitated, being unable to sleep, or sleeping all the time. It also includes experiencing dramatic mood changes or seeing no reason for living or having no sense of purpose in life.

    Source

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  • Army Vet Survives

     

    Adam Greathouse is an Army Veteran, corporal in the Third Infantry Division, Field Artillery.

    In 2001, near the end of his duty day in Kosovo, his sergeant gave him the rest of the day off so he took a nap. When he woke up, he couldn’t move. There was pressure on his chest and he started hallucinating.

    He was sent to a German university hospital where his organs started failing, his heart became enlarged, tubes going in and out of his body, all while he passed in and out of consciousness. He had no control. With the magnitude of trauma to his body, having lost oxygen to his brain, he suffered a traumatic brain injury (TBI).

    Suffering from a severe anoxic event that damaged many organs including his lungs and brain, he went into a coma lasting two months. He was diagnosed with a traumatic brain injury (TBI) including partial amnesia, memory loss, and physical paralysis.

    Uncertain of his condition, months went by and depression set in. Beaten to the core both physically and mentally, he lay there broken, waiting to die. He had lost more than half his body weight and was frail with hardly any muscle mass.

    Mental toolbox pulled him through

    With the help of VA, Greathouse has learned to adapt to the disabilities caused by the TBI over the years. He pulls tools from his mental toolbox to handle life’s situations and to maintain his current active lifestyle. Each night, he sets cell phone alarms to make sure he is on time in the morning. He does brain training games before bed.

    Today he helps other Veterans conquer challenges as an ambassador at the National Veterans Summer Sports Clinic. His first VA Adaptive Sports event was the National Disabled Veterans Winter Sports Clinic in 2012, which he followed up with the National Veterans Summer Sports Clinic later that year.

    Drives five hours to volunteer

    In 2014, he started volunteering at the Huntington VA Medical Center in West Virginia as the first voluntary recreational therapy peer support specialist, driving more than three times a week over two and a half hours each way.

    He was very involved with sports before his injuries, so he continues to eat right and stay active. In social settings, he says he must be fully present to not deter his concentration, knowing how many distractions are all around him.

    Volunteering weekly has given him a sense of purpose.

    “I know that when I was in the process of going through it if someone I should have been able to count on said they were going to be there and they didn’t show up, then I would know the whole system failed and I would never come back. I’m not going to let that happen,” he said.

    “Suddenly, BAM, I’m a soldier again,” Adam said, after sharing how much these clinics have brought him back from the darkest days of his life.

    He frequently takes his children out surfing and snowboarding, knowing how many years he missed, watching them from the sidelines, unable to walk. He bought his first house in 2017 and is fixing it up with his dad. You can’t miss him in the crowd, just look for the man with the biggest smile.

    “It’s an honor to be here and watch my brothers and sisters grow in confidence every day. By the end of the week, they have permanent smiles! It’s a life saver, a game changer,” Adam said of the 2018 Summer Sports Clinic.

    “My life was spared for a reason. I couldn’t have done it on my own. I have three people to thank for getting me through it: My mom for her fierce faith in God, my nurse in Germany who put up a picture of my kids, reminding me of why I should fight, and my nurse case manager in Huntington, Cheryl, who pushed me past my own limits.”

    Greathouse was also named as a Veteran of the Day.

    Source

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  • Ask A Vet

     

    Here is the first thing to know about Veterans: No single voice can represent them. Each service member is shaped not only by their race and gender, but also the branch of the military they chose, the rank they held, where and if they deployed, and so much more. The breadth and variety of our experiences in our big ol’ machine of war are immense, and it would be foolhardy to let some jackass who rolled around Iraq in a tank 15 years ago speak for everyone.

  • Ask A Vet 002

     

    Welcome to Ask A Veteran, a place for civilians (or anyone!) to ask questions about the military or Veterans issues.

    Alex asks: I teach social studies in a public high school in NYC. I did not serve. Many of my students see military service as their only chance to change their prospects for the future. They idealize the benefits the recruiters describe without, I fear, giving real thought to what comes with their signature. I’m looking for some questions to ask kids (and their parents/extended family, who are often supportive of enlistment) to get them to contextualize what they’re signing up for and to get them to be thoughtful about what military service would likely mean for them.

    First, allow me to applaud your dedication to your students. Anyone brave enough to face teenagers every day and still care about their future is someone who should walk tall in this forum. You live life in constant danger of being owned by those Juul-wielding savages and somehow are still invested in their betterment as people. I salute you.

    Now, on to the matter hand: If my read on your question is correct, you are trying to approach this matter with sensitivity and an open mind, but the underlying vibe I get is, “How can I convince these kids not to sign up for military service?” Of course, given the lack of interest and accountability in the Forever War from our government (and, by extension, the American populace), your concern is not unfounded. You’re also right to be skeptical of recruiters; they are under enormous pressure to meet their recruitment quotas, and that pressure manifests in selling dreams that often go unfulfilled.

    But consider, for a moment, the benefits of military service that your students find appealing. An enlistment bonus? It may be more money than that student has ever seen before — and possibly more than the family has ever seen before (which may explain the parental support for enlistment). Money for college? Frankly, going through college as an adult on the G.I. Bill seems to me like a better recipe for success than starting to accrue student loan debt at age 18.

    I am, admittedly, a tainted source on this matter. My father, an Air Force pilot, was the first person in my family to graduate from college thanks to the military. I went to an expensive university not because my family had money, but because I had four years of my life to give to the Marines. I grew up believing that the military was a way for bright people from humble roots to gain entry into the middle class, and because I am able to look back on the benefits it gave me — tenacity, courage, confidence, character — I am unable to discourage others from the path.

    Back to your students. We mustn’t forget the strongest siren song of all: The promise of adventure and world travel. This promise can deliver, or it can bite you in the ass. Or both. I often joke that the Marine Corps gave me a tour of the world’s deserts, but the specifics are more interesting than the punchline they serve. For three years, I lived a ten-minute drive from Joshua Tree National Park; the Mojave is mountainous and full of hardy plant life that erupts in color during the short spring when the hard rains release the smell of creosote. I spent the month after 9/11 in the Western Desert of Egypt — long flat stretches of brown sand punctuated by rock formations that were both easier and harder to navigate than the Mojave, depending on your map skills. In Kuwait, where we staged before the invasion of Iraq, the only feature was the horizon. Kuwait can go eat shit.

    And that still only scratches the surface of what I saw and learned in four years. I lived in Kentucky and developed a taste for bourbon thanks to the Armor Officer Basic Course at Fort Knox. I’ve been to Australia with the best friends I’ll ever have; we taught locals the dice game Ship, Captain, Crew. I’ve crossed the Indian, Pacific, and Atlantic Oceans on Navy ships. I’ve flown in helicopters and driven tanks and landed on a beach in a hovercraft. I can hit a man-sized target from 500 yards with an M16 using only iron sights. What might a civilian life have offered me out of college? Safety, I suppose. But less of everything that was vibrant and meaningful, and nothing that made me who I am today.

    I do not mean to whitewash the danger. It is a deadly job even in peacetime. A good friend of mine, John Wilt, a lieutenant who was my classmate both in high school and at the Marines’ Basic Officer Course, was killed in an aircraft accident when he was at flight school. One of my Marines was airlifted from Twentynine Palms to the Naval Medical Center at Balboa after he got his head partially crushed during routine maintenance of an Abrams tank; he lived after surgeons cut open his skull to relieve the swelling from his brain.

    Combat is worse, of course. I have the benefit of hindsight about my experience because I didn’t get shot in the head like my buddy Brian McPhillips. I have the luxury of nostalgia because, unlike my friend Andy Stern, my life didn’t end with an IED exploding in my face. My lot in life is to go around repeating their names to people who can never know them. As my body gives way to middle age, their names are as familiar and well-worn as a rosary, but their pictures always stop me in my tracks. The youth of the dead is breathtaking, and I can barely believe that I stood shoulder to shoulder with them — that I was ever so young, and believed myself invincible.

    You said you were looking for questions to ask kids that would “get them to contextualize what they’re signing up for.” But I’m not sure that’s possible. How can you give young people wisdom without experience? They will be drawn to the military the way I was drawn to it — for the benefits, yes, but also to fill a hole inside them, a deep-seated craving to challenge and prove themselves. They will be drawn to service knowing, intellectually, that it is dangerous, but without really believing that the danger can touch them. Their peers will drive recklessly or do drugs or similarly dangerous things, and none of them will ever believe that harm can come to them. It is a feature of youth, not a bug.

    I do not wish to discourage your noble effort, but I don’t want you tilting at windmills, either. I will leave you, and your students, with the best reflection I have on my military service: It is a wonderful thing to have done, but it was often miserable to do. Or, more succinctly: It is a great thing to do with your life — if it doesn’t kill you.

    Source

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  • James Woods

     

    Updated: After actor James Woods used his Twitter account to call attention to a Veteran who sent a distressed tweet, authorities located the man who had tweeted he was contemplating death by suicide.

    "After numerous attempts to locate (Andrew) MacMasters yesterday, several of our officers were able to make contact with him to verify his well-being as well as ensuring that the appropriate resources were made available to him in reference to his tweet," Maitland (Fla.) Police Department Lieutenant Louis Y. Grindle told USA TODAY.

    The "Salvador" actor, 71, alerted the Orlando Police Department Monday night and asked authorities to perform a wellness check on MacMasters, a former Marine.

    "A man named Andrew MacMasters just said on @Twitter that he is sitting in a parking lot and is going to kill himself," Wood tweeted to his nearly 2 million followers. "He’s sitting with his dog, a black lab, possibly in a WalMart parking lot."

    Woods' plea for help included a screenshot from MacMasters' Twitter account, which has since been deleted.

    "I'm on Twitter every day, I retweet all the time but this is the first tweet I've ever written," user @macmasters_a tweeted Thursday. "I'm (a) good guy, I'm a Veteran, I love America. I'm gonna kill myself tonight. I've lost everything I have nobody, nobody cares."

    Woods responded to MacMasters' cry for help in a series of tweets, initially asking the Veteran to "tell me where you are."

    "We can talk. I don’t care what anybody thinks. Do you? Let’s have a conversation. Just you… and I," Woods said in one tweet to MacMasters, adding in another, "I’m following you now, so you can DM me. We can talk privately. Or we can talk openly right here. Lot of people worried about you right now."

    The actor tried to engage the distraught Veteran: "Someone said you’re Andrew. In Orlando? Im not trying to trap you. Let’s just talk. You also have your dog. Your little schnoot. Boy or girl?"

    "So think about this. A lot of Vets, I understand, have come to where you are tonight," Woods continued. "If you could just push this decision off tonight, at least, maybe you would also inspire another Vet to seek help. You could save another man, too. By waiting to do this."

    In 2016, the most recent data available, the Department of Veterans Affairs said about 20 Veterans a day take their own lives, a suicide rate 1.5 times greater than Americans who never served in the military. And Veterans accounted for 14 percent of all adult suicide deaths in the U.S. in 2016, even though only 8 percent of the population has served.

    In a last-ditch effort, the actor tried to comfort MacMasters. "I’m driving cross country. Sitting in a motel room. I have all night. I know that sounds dorky, but here I am! I would love to talk. Just talk. I won’t push you into anything," he said.

    Once it was clear the suicidal Veteran could no longer be reached on Twitter after deleting his social media account, Woods turned to his followers to gather information on MacMasters' location.

    The "Casino" actor learned his home address and forward it to authorities in Maitland, Florida, who promptly checked his residence. MacMasters was not there.

    "If only Andrew could see the THOUSANDS of fellow Americans who are pulling for him. It’s like he’s lost behind enemy lines and we are cheering him home, willing him to survive," Woods tweeted. "Andrew, do this for the 'other 21' Vets a day who don’t make it home from the darkness. Stay alive!"

    Woods continued to update the search on Twitter, sharing tweets from people who notified MacMasters' family, including the Veteran's mother and brother.

    Maitland Police Public Information Officer Lt. Louis Y. Grindle informed USA TODAY Tuesday morning that authorities were able to reach MacMasters, though his whereabouts are unknown.

    "Our agency was able to make contact with him by phone earlier this morning, where he advised he was OK but did not wish to have contact with law enforcement," the emailed statement read. "Our officers are still working to try and physically locate him to determine his well-being."

    Woods, who frequently uses his Twitter page to share his conservative political views, recently used his account to help link people together with family members following the California wildfires.

    Source

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  • Beer and Wine

     

    With beer and wine for sale at 12 commissaries nationwide, sales seem to be chugging right along -- pun intended.

    Beer and wine hit some commissary shelves for the first time ever in July as Pentagon officials explore ways to lure more customers into stores. Operated through a partnership with the military exchange system much like the one under which commissaries carry tobacco, proceeds from sales go back to the exchange, not to the commissary.

    Since the initial rollout, the system has sold about $150,000 in beer and wine, Kevin Robinson, a Defense Commissary Agency (DeCA) spokesman, said in an email.

    The items are currently carried only on store shelves, not in cooler cases. And if what's available at Port Hueneme, California, is any indication, selection is very limited. In mid-September, that store had only a selection of light beers and low-cost red and white wine bottles and boxes.

    Robinson said the system hasn't yet received enough feedback to determine whether patrons like that selection.

    It is "still too early yet to gauge overall patron response since this rollout is still within the 90-day initial deployment to 12 stores," he said.

    Officials also haven't announced a rollout of beer and wine at stores outside the 12 pilot locations, although an April 27 Pentagon memo states that availability systemwide will occur "efficiently and expediently thereafter" after the 90-day test.

    Source

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  • Best Jobs

     

    When returning from active duty and transitioning to civilian life, one of the first things a soldier must do is find a job. While military service provides many critical skills that can translate well into civilian jobs, sometimes the transition itself and communicating those skills to a non-military hiring manager is a big challenge to overcome.

    Sadly, for many Veterans, this can be a battle, even after fighting for our country for years. According to the Bureau of Labor Statistics, the unemployment rate of Veterans is dropping, declining from 4.3 percent to 3.7 percent in 2017. However, of those Veterans who are unemployed, 59 percent are between the ages of 25 and 54, which indicates the working-age Veterans are the ones having the biggest problem finding work. Also, even younger Veterans, those between the ages of 18 and 25, continue to have a hard time both finding and keeping a job.

    That may sound like poor statistics, but the truth is that programs assisting both Veterans and employers are helping to make a difference. The key is to help Veterans connect with those programs so they can find the training they need and the available jobs that are hiring people with their skill sets.

    Also, some jobs are perfectly suited for members of the military. All it takes is a little knowledge about how to translate military skills to the civilian workforce and find jobs that build on your skills. This guide is designed to help today’s Veterans overcome the challenge of finding a job, translate their abilities into marketable skills, and land a civilian job where they can thrive.

    Translating Military Skills into a Civilian World

    In the military, you learn discipline, leadership, strategic thinking, efficiency, and in many cases, highly technical skills. All of those skills have real-world applications that are valuable in the civilian workforce, but it’s not always easy to see how. Here are some tips to make it easier for you to capture your military skill and translate them into a new civilian life.

    Find Work in Fields Similar to Military Jobs

    First, start looking for work in fields that have similar work to the work you did in the military. Some places to look include:

    • Put physical fitness to work in constructionThe construction industry can be a great place for Veterans to find work. Since the military builds temporary and permanent structures regularly, many Veterans already have experience in this field.
    • Use physical fitness in landscaping.
    • Tap into military strategy in law enforcement. Soldiers have already proven that they can work in tense, stress-filled scenarios, and law enforcement jobs put those skills to good use.
    • Embrace tech training in technology-centered jobs. Today’s soldier works in a high-tech environment, and many get on-the-job training using sophisticated computer navigation, surveillance, logistics, data, and communication systems, which can land them good jobs in the tech world after discharge.
    • Use military skills in car or aircraft mechanic jobsWorking on aircraft and military vehicles in the field is good preparation for similar maintenance and repair work in the civilian world.

    Understanding the Challenges of Civilian Job Searches

    While many jobs are perfectly suited for military people, finding them can be a challenge for many Veterans who might never have made a resume or been on a job interview before. Here are some of the specific challenges that Veterans sometimes face when starting a job search and ways to mitigate these challenges.

    • Understand the mind shift from “we” in the military culture to “me.” This is, perhaps, one of the biggest shifts that a member of the military can make mentally. In the military, you are a part of a group, where everything is done for and with the group. The military teachers “service before self,” which can make it difficult to learn to promote yourself as you must do in a civilian job. While you still need to be a team player, your focus needs to shift inward a bit in civilian work.
    • Be prepared to negotiate your salarySoldiers have little room for negotiation for their salary and benefits packages. Civilian job hunters do. Before accepting a salary that you are being offered, make sure it is fair, and be willing to negotiate for better or different terms.
    • Know that civilian jobs aren’t always secureOne of the benefits of living in the military is the fact that, as long as you follow the rules and stay fit, you have job security. You know what is expected of you, and if you can perform those expectations properly, you won’t have to fear for your job. This is not the case in the civilian world. Companies can downsize or go bankrupt with little notice, leaving you in search of a new job. Staying connected to the job market and keeping skills up to date will help reduce the risk.
    • Learn to think outside the box. In your military career, your job was to obey orders without question. Working with your new civilian work team will be different. Thinking creatively to find solutions to problems, rather than just following orders, is encouraged in civilian workplaces.
    • Learn to sell a personal brandAfter shifting from “we” to “me” in your focus, you must learn how to sell yourself as a personal brand. Determine who you are as a worker, and craft everything you use in your job search around that.

    For more information about starting this transition, visit:

    Embrace the Advantages of Being a Veteran

    As you start the search for a civilian job, it’s important to know that there are several significant benefits to your Veteran status, beyond the financial and other perks you got with your discharge. The skills, character training and abilities you learned in the military will give you a distinct advantage in your job search. The key is knowing how to highlight them well. Here’s a closer look at how to embrace these advantages as you search for a job.

    • Acknowledge that Veterans have many skills that translate into civilian jobs. The key to making those skills work for you as you search for a job is learning how to pinpoint them.
    • Take note of the high-level technology training you have receivedIn general, most Vets have more high-technology training than their similarly-aged peers. Make sure that you highlight this in your resume and interviews.
    • Perform a skills inventory to identify important skills. A skills inventory looks at the skills you have and how they might translate into your civilian life.
    • Use a Military-to-Civilian Translator. O-Net has an excellent tool that will help you translate your military experiences into beneficial skills for civilian employment. Simply type in your military job code or title into the translator, and a list of matching civilian job skills is generated that you can add to your resume.
    • Use your Field Service Record to detail your skillsAfter leaving the military, Veterans will receive a Field Service Detail. This will showcase the training and skills learned during the time in the military. This can be proof to potential employers of your abilities.
    • Understand the advantages of being physically fitMembers of the military must stay in good physical health to perform their military service. This can be a benefit to them in their search for a civilian job.
    • Embrace the confidence that comes from being in the military. Being a skilled fighter or filling another role in the military brings confidence and a high level of resiliency.
    • Highlight the benefit of being able and willing to relocate. Moving is simply a way of life for members of the military. You can highlight your flexibility for a quick location change, and if you still have relocation benefits from the military, be sure to mention this. This saves your hiring manager money if they are recruiting over a long distance.
    • Focus on your educationOne of the perks of being in the military is the education you receive throughout your training. Focus on this as one of the benefits of hiring you. Take advantage of all of the potential certifications and licenses you can train for while in the military, and then add them to your resume.

    For more information about the benefits of a military career in your civilian job search, visit:

    Learning to Mitigate Disadvantages Veterans May Have

    Unfortunately, civilian job searches for Veterans are not without their challenges. Knowing what these challenges are and having a plan to mitigate them will make them slightly less of an issue as you head out there in search of a job.

    • Realize that your military skills may have different names in civilian jobs. Even though they translate well into civilian jobs, your military jobs may not be called the same thing. Find out what the layman’s terms are for the military skills you have obtained, and then use the right jargon when you head into your interview.
    • Recognize the real problem of civilian disconnectThere is a disconnect between members of the military and their families and the general population. Lack of understanding of military culture and an inability to accept the civilian way of things can create problems in job searches. Recognize this problem, and learn to make an effort to overcome it in your interactions with civilian employers.
    • Understand that hiring managers may not appreciate military experienceHiring managers who are not familiar with the military may not fully appreciate all of the benefits of hiring a Veteran. You must learn to convey those benefits in your resume and your interview, appearing confident and skilled.
    • Learn the interview skills you needPeople who join the military right out of school may never have any formal job interviews or job interview training. Find a way to practice for interviews, so you appear confident and capable.
    • Find ways to quantify achievementsSuccessful interviews will have numbers to back skills. Take a look at your skills inventory, and find ways to quantify any of the skills that you have. This is often an excellent way to highlight leadership skills in particular. Saying you led a squadron of 100 men shows your leadership potential. However, make sure to phrase your experience in a relatable way. Instead of saying you lead a squadron, say you were responsible for or managed a group. This is phraseology that hiring managers look for and understand.
    • Build a resume that highlights the right experiencesYour experience in the military is a benefit, but you must build a resume that highlights it correctly. Focus on the skills, rather than the time spent serving, so your resume stands out.
    • Overcome preconceptions about hiring Veterans. Unfortunately, some hiring managers have preconceptions about Veterans. They hear stories about Vets that are fighting PTSD or dealing with severe injuries and resulting handicaps, may fear to hire a Veteran. The best way to fight these misconceptions is to communicate your value well and talk candidly about your military experience when interviewing.
    • Highlight the right soft skills to overcome missing work experienceSometimes Veterans lack the practical, real-world work experience that hiring managers want, but they can overcome this with the soft skills their military careers gave. Don’t underestimate the value of soft skills, like problem-solving, leadership, working well under pressure, discipline and ability to work as a team, that you earned in the military. Highlight these in your resume and interview.

    For more information about disadvantages that Veterans often face when transitioning to civilian work, read these:

    Common Jobs That Require Skills Veterans Typically Have

    When seeking a civilian job, you need to look for two things. First, you need to look for a career field that utilizes the skills you have. Second, you need to look for a career field with excellent potential growth. Here are some career fields that offer both to Veterans who are entering the job force again. Several career fields do both. Here are some to consider:

    • Construction – The construction industry is seeing explosive growth as the economy continues to improve after the recession. The Bureau of Labor Statistics anticipates job growth as high as 14 percent. Construction has opportunities for both men and women, with an average annual salary of over $62,000. Construction work builds on skills like organization, leadership and physical abilities that many members of the military have.
    • Operations Managers – Operation managers, help companies improve the efficiency of their operations. They often coordinate work between different departments and may manage people. Other titles for this job may include manager or superintendent, and the potential pay is as high as $100,000 per year on average. This particular field has a slightly lower projected job growth of around 9 percent. The leadership experience that many receive in the military is a benefit in this field.
    • IT Systems Manager – Combining IT experience with leadership experience, an IT systems manager helps oversee the computer activities of an organization or company. Like construction, IT Systems Manager jobs have a much higher than average rate of growth, with growth expected at around 12 percent. Veterans who worked with technology and pursued an IT education while in the service will be ready to take these jobs.
    • First Line Supervisor Mechanics – This job field combines mechanic skills with leadership skills. First line supervisor mechanics supervise teams of mechanics in repair shops or fleet management. This particular job field has an anticipated growth rate of between 5 and 9 percent, but it is a field where military skills are readily accepted as hiring managers to understand the combination of real-world and leadership skills that military leaders have.
    • Cyber Security Analyst – This field is seeing tremendous growth as cyber attacks are increasing exponentially. Many military members who work in IT already have on-the-job experience in fighting cyber attacks, since the military’s systems are prime targets for hackers. This makes this field a strong one for the right Veterans. The best benefit of this field? The job growth potential is 28 percent, and the expected annual salary is over $90,000 on average.
    • Software Applications Developer – The in-depth IT training that often goes along with military service gives Veterans the right tools to develop apps and software. This is a high demand field as companies are constantly in need of new software to reach their target markets and perform internal functions. High job growth potential of 24 percent and an average salary of over $100,000 added to the appeal of this line of work.
    • Electricians – Electricians are always in demand, as people need trained professionals to help them with electrical work. Many Veterans get electrical training as part of their military careers, making this a natural transition. The expected job growth in this field is around 9 percent, with average salaries of over $50,000.
    • Diesel Technicians – The fleet industry is facing a shortage in diesel technicians, which means these jobs are going to be easy to come by shortly. Veterans who have experience working on military equipment can easily translate those jobs into diesel engine work. Diesel techs get slightly higher pay than regular mechanics, and the job growth potential is expected to be around 9 percent.
    • Aircraft Technician – For soldiers who worked on military aircraft, a career in the aircraft repair industry is a natural transition. Though the job growth isn’t expected to be tremendous in this field, job security should remain, as there will always be a need to fly people and product around the world. The average salary in this field is around $60,000.
    • Web Developer – If you have creativity and love technology, consider a career in web developing. You won’t need any training other than learning how to code to tackle this job, so your military training should suffice. The explosive job growth potential, expected to be around 15 percent, combined with the entrepreneurial opportunities in this field make it a great choice for Veterans.
    • Security Systems Technician – No one understands security quite like someone who has served in the military. These professionals install, repair, maintain and program security systems for homes and businesses. It has a job growth potential of around 14 percent.
    • Landscaper Architects – The ability to create beautiful landscaping is always in high demand, and a military member’s physical fitness and creativity can translate well into this work. Landscape architects can expect to earn around $65,000 per year on average, and growth is steady in this field.
    • Law Enforcement – A skilled soldier can also be a skilled law enforcement officer. This field has income potential of an average of $62,000 and average, steady growth potential. The rigorous physical and personal qualifications are easy for most members of the military to meet after their tours on active duty.

    Other fields tap the potential that Veterans have, but do not have the same income growth potential. Some places that are seeing slower growth and demand that you may wish to avoid searching in include:

    • Agriculture – Farmers, rangers and agricultural management jobs are on the decline. While these jobs do tap some of the skills of Veterans, you will want to consider a different field in your job search if you’re looking for job security.
    • Data Entry – If you can type quickly, data entry is a good field, but it sees a decline in demand. You will be better off putting those typing skills to use elsewhere.
    • Food Service Managers – Your mess hall experience may make you highly qualified for this field, but you won’t find much demand anymore.
    • Computer Operators – IT jobs are often a good fit for members of the military, but general computer operator jobs are on the decline. Perhaps this is because most office personnel now know how to operate a computer properly. Consider more in-depth training to help you find computer work.

    In addition to finding the right field to work in, Veterans also must choose the right geographic area to settle in where jobs in that field are plentiful. Here are some tips that might help.

    • Look near big cities for IT and management jobs. Big cities tend to attract tech and manufacturing companies, both of which need IT pros and managers.
    • See where development is occurring. Development means the need for construction work and skilled mechanics, so look for areas of the country that are seeing explosive growth.
    • Reach out to potential employers before making a move. It’s not uncommon for someone to find a job then move, so consider applying for jobs in your skill set then choosing your location once you’ve found work.

    For more help finding the right city for your job search, visit:

    Getting Trained and Qualified for New Jobs

    Many jobs require qualification or certification, which is an important step in the transition between military life and civilian life. Here are some tips to help you find and acquire the certifications you may need for your future career success.

    Medical jobs are also popular among members of the military, particularly those who work as medics, doctors or nurses during their military service. Some certifications for this field include:

    • American Nurses Credentialing Center Certifications

    Mechanics, HVAC repair technicians, and other skilled labor professionals will need certification. Consider these options:

    Finally, don’t overlook the value of civilian life training programs. These can help you adjust to a new life as a civilian after years of military service. Some programs to consider include:

    • Soldier for Life Transition Assistance for the Army

    Programs to Help with Training and Certification

    Thankfully for Veterans, many organizations offer programs to help them achieve certification or receive job training. These programs, most of which are free, can help you get the certificates or licenses you need to launch a successful civilian career path. Take advantage of these programs to help you make sense of the transition period. Here are some organizations who specialize in training Veterans for civilian jobs.

    • Veterans’ Employment and Training Service – A service from the Department of Labor, VETS offers some programs that assist Veterans in making the transition to civilian jobs, including job training programs.
    • Assistance from the VA – The Department of Veterans Affairs offers apprenticeship opportunities that allow Veterans to get the training they need on the job while pursuing their civilian careers.
    • Hire Heroes USA Training Programs – Hire Heroes USA has some training programs available to help members of the military get back into the working world or start a new career after their time in service.
    • Free Apprenticeship Programs for Veterans – GI Jobs lists some free apprenticeship programs designed specifically for Veterans.
    • Career One Stop – Career One Stop offers some tools and opportunities for Veterans seeking to transition into civilian life.
    • Onward to Opportunity – This program partners with local universities and private sector organizations to provide no-cost, industry-focused training, and career skills education for those transitioning from active duty to civilian life. Onward to Opportunity also provides training to military spouses.
    • Veterans Inc. Employment & Training Program – This is a nationally-recognized program that helps Veterans get and keep jobs, partnering with businesses and educational institutions in New England to provide training, career assessment, job search support, and job placement services.
    • Free Custodial and Janitorial Certification for Veterans – HirePatriots.com offers a comprehensive list of free certification courses for Veterans that allow them to learn important skills for cleaning and custodial jobs.
    • Leaderquest IT and Cyber Security Training – This program focuses on training Veterans for IT and cybersecurity jobs. After finishing the training, Vets will be qualified as Department of Defense 8570/8140 credentialed IT professionals.
    • Cisco Veterans Program – The Cisco Veterans Program provides both networking and job search opportunities as well as the Cisco Networking Academy, that helps them learn important IT skills.
    • Power 4 Vets – This program from IncSys, Inc., is designed to help Veterans find careers in the energy sector through online training programs and job placement services for Veterans.
    • Veterans Multi-Service Center – The Veterans Multi-Service Center offers on-site training programs that give Veterans the skills they need for jobs that are currently in demand. Each Veteran who attends the program gets a job developer who serves as a case manager to help the Veteran ultimately find a job.

    For more help with training and certification, visit:

    Entrepreneurship Opportunities for Veterans

    Not all job opportunities require Veterans to work with companies. Often the skills and abilities learned in the military translate well into starting one’s own business or other entrepreneurial opportunities. The extraordinary discipline that members of the military gain throughout their service can make them skilled business owners because they can stick to a task through completion. Branching out on your own to start a business can be quite intimidating. Here are some important considerations to make if you are seeking the entrepreneur path.

    • Determine your level of riskBeing an entrepreneur is not without its risk. Determine if you are willing to shoulder that risk. Do you have financial savings to fall back on, or would you be putting your entire family at risk if your business endeavor fails? Is that a risk you are willing to take?
    • Consider your skill set. What skills do you have that could translate into a business opportunity? Look at the skills inventory you created and ask yourself how those would translate into a business.
    • Consider your interests and passionsMost entrepreneurs are successful because they are passionate about what they do. What are you passionate about? Is this something that you could turn in to a business?
    • Look into fundingIt takes money to start a business, but luckily there are some funding sources you can consider to get the funds you need to start your business. Research your options to determine where the money will come from.
    • Get some business training. Being an entrepreneur requires some business knowledge and understanding. Get some business training if you lack in this area.

    For Veterans who would like to branch out and start their businesses, some resources exist to help. Here are some opportunities and resources for Veterans who are considering entrepreneurship.

    • Institute for Veterans and Military Families Free University Entrepreneurship Training – IVMF organizes some entrepreneurship training options for Veterans, including the Entrepreneurship Bootcamp for Veterans with Disabilities, as well as a similar program for Veterans families and one for female Veterans. The main program includes a 30-day online course followed by a 9-day residence program.
    • Patriot Boot Camp – The Patriot Boot Camp is a program that trains Veterans, active duty military and their spouses on the principles of entrepreneurship. This is a three-day boot camp hosted in numerous cities to teach Veterans how to become innovators, entrepreneurs, and creators in the modern economy.
    • Launch Lab Online from Bunker Labs – Launch Lab Online gives Veterans the jump start they need to start their businesses. It provides entrepreneurship education through videos and online courses, as well as homework and self-assessments designed to let you determine how far your learning has taken you.
    • StreetShares Foundation Veteran Small Business Award – The StreetShares Foundation provides grants to Veterans who are ready to start their businesses. Veterans with businesses that are legal entities that are poised to have a social impact on the Veteran community can apply for awards which are as big as $15,000.
    • VetToCEO – VetToCEO offers online education programs specific for Veteran entrepreneurs. What makes these programs unique is the fact that they are taught by Veteran entrepreneurs who clearly understand the need in the field. They are free and available online for convenience, though the core entrepreneurship program is offered on occasion in in-person meetings.
    • Small Business Administration’s Office of Veterans Business Development – This branch of the SBA offers small business programs to Veterans, including services like business training, counseling, referrals, and transitioning services. They have programs designed for all Veterans, including women Vets, reserve and National Guard members, and disabled Veterans.
    • Office of Veterans Affairs Veteran Entrepreneur Portal – The Veteran Entrepreneur Portal gives Vets direct access to the resources they need to work through entrepreneurship.
    • Center of Excellence for Veteran Entrepreneurship – The Center of Excellence for Veteran Entrepreneurship offers resources for Veteran entrepreneurs for every step of the process.

    For more information about entrepreneurship for Veterans, visit:

    Conclusion

    The days and months after a Veteran leaves active duty service and starts searching for a civilian job are an important time. This is when a Veteran can dip into that military experience to use it in search of a new job. With the right knowledge and understanding, as well as the myriad of resources available to today’s Vets, you can put your military training to good use, overcome the obstacles associated with transitioning and start a career that is rewarding and financially beneficial. As long as you understand the challenges you face and how to mitigate them best, you will come out on top with the best possible civilian job.

    Source

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  • Big Change Benefits

     

    Improved Pension with Aid and Attendance

    First, John explains the VA’s Aid and Attendance benefit. If a Veteran served at least 90 days of active duty, with one of those days being during a period of war, that person is a “wartime Veteran.” If that wartime Veteran needs help with their activities of daily living, and the costs associated with that care outweigh the Veteran’s ability to pay for it, then the VA will potentially kick in some extra money.

    Technically, this benefit is called the improved pension with aid and attendance, but most people just call it aid and attendance.

    It’s not only available to the Veteran, but it is also available to the surviving spouse of the Veteran, if they were married at least one year, married to the Veteran at the time of the Veteran’s death, and not remarried.

    This income can be a life-saver, especially if it makes it possible for the Veteran or survivor to live in a facility that can care for their needs.

    The Changes

    A few of the rules about eligibility for the Aid and Attendance benefit have changed. This includes clarification of the assets test, and a look-back period for any transfer of assets.

    Clearly Defined Assets Test

    This is a need-based benefit. In the past, the assets test for this benefit was very vague. One of the new rules is that there is bright line rule for net worth. There is now a clearly defined $123,600 limit on countable assets in order to qualify for this benefit.

    John is concerned about how some of the changes are written. For example, a home is not a countable asset, but it is the home plus two acres. This means that folks who live on larger lots, or own extra land, will have a more complicated situation.

    There is also a strange way that the VA is now calculating income as part of that net worth. In determining your assets, the VA will now look at something called your “income for VA purposes.” This takes your annual income, minus your unreimbursed medical expenses, and adds that to your net worth. This does not make any sense – there is no other context in which you included someone’s income in their net worth.

    Adding A Look-back Period

    The biggest change is that historically, the VA did not have a penalty for transferring assets. They now have a 3 year look-back period, similar to Medicaid. Any transferred that occurred in the 3 years prior to your application , any gift that happened during those 3 years, they can penalize you up to 60 months in the future.

    The penalty period is calculated by taking the amount of the gift, and divide that by the maximum aid and attendance benefit for a single person with one dependent, which is about $2,170 per month. The VA won’t provide benefits for the number of months you’ve been penalized.

    This only applies to gifts that are over the asset limit.

    The maximum penalty can be no longer than five years.

    This creates a tricky situation where you have to be sure that you wait at least the three years after transferring any assets or else you may find yourself penalized for longer than the look-back period.

    What This Means For You

    The big takeaway from these changes is that if you may be eligible for this benefit, you might need to do some advance planning. In the past, there was no reason to plan until you were going to apply for the benefit. Because of these changes, you might want to take some actions in advance to ensure you are eligibility for this benefit when the time comes.

    Source

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  • Robert Wilkie 13

     

    U.S. Veterans Affairs Secretary Robert Wilkie doesn’t want any sunlight on his agency’s “shadow rulers.” By blowing off a recent congressional document request, Wilkie is blocking the public from determining whether a secretive trio of outsiders is calling the shots at the VA.

    Wilkie was just confirmed by the Senate in late July. His handling of the data request from the House Veterans’ Affairs Committee raises serious questions about his judgment so early in his tenure. After the scandal involving clinic wait times, public faith in the VA is lagging. Yet Wilkie’s stunning refusal last month to turn over the documents undermines trust even further, creating the damning perception that his priority isn’t Veterans but protecting the three outsiders, all of whom belong to President Donald Trump’s glitzy Mar-a-Lago club.

    The Pulitzer Prize-winning ProPublica news organization first reported about the behind-the-scenes decisionmakers in a story published Aug. 7. E-mails and other documents obtained through the Freedom of Information Act revealed that the three have “leaned on VA officials and steered policies affecting millions of Americans.” They weighed in on high-level staffing changes, meddled with a major software contract and pushed the agency to make a seismic and expensive push — outsourcing care to private providers.

    One of the three also wanted the agency to bring in his son to develop an app. Despite this access to agency inner circles, none of three men ever served in the military. Nor is their expertise relevant. The three men are: Marvel Entertainment Chairman Ike Perlmutter, attorney Marc Sherman and Bruce Moskowitz, a doctor who runs a company catering to wealthy medical patients.

    The congressional request for additional documents, filed on Aug. 8 by Rep. Tim Walz, the Veterans’ Affairs Committee’s ranking member, is sensible. The documents obtained by the reporters may have been redacted. The congressional request would also go beyond the correspondence the reporters were able to obtain through the Freedom of Information law. A thorough review is a must, especially when Veterans sense that “an ideological war is being waged within the VA below the radar of the media and of the public,’’ said Paul Rieckhoff, founder and director of the Iraq and Afghanistan Veterans of America advocacy group. “Veterans’ healthcare, benefits and general well-being are ending up as collateral damage.”

    Yet on Sept. 15, Wilkie tersely declined the House committee’s document request. His reasons do not hold up to scrutiny. He said the documents are the subject of ongoing litigation. Yet that lawsuit was filed after the congressional committee’s data request. And its existence does not exempt the agency from complying with the committee’s request.

    Walz, who is also the Minnesota DFL gubernatorial candidate, gave a deadline extension — until Oct. 31 — in a forceful letter this month. It is Wilkie’s best interest to meet that. Failure will sour the VA’s relationship with a key oversight committee and will only accelerate the public trust deficit in him and the agency.

    A noncommittal response this week from a VA spokesman about whether Wilkie will release the documents did not inspire confidence. Wilkie made a mistake saying no once. He owes it to his agency and more important, to the 9 million Veterans served by VA medical facilities, to correct course.

    Source

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  • VA Qtrly Research

     

    Dr. Steve Martino is chief of psychology at the VA Connecticut Healthcare System and professor of psychiatry at Yale School of Medicine. He specializes in the treatment of patients with substance use disorders, including those with co-occurring conditions. He also does research in the area of implementation science and how to move best practices into real-world clinical settings.

    Dr. Marc Rosen is an addiction psychiatrist at the VA Connecticut Healthcare System and professor of psychiatry at Yale School of Medicine. He is the director of addiction recovery services at VA Connecticut, and conducts research on substance use disorders and related problems for affected Veterans.

    KEY POINTS:

    • Dr. Rosen and his team conducted a pilot study that used the VA compensation and pension exam to engage Veterans who were applying for a service-connected disability because of musculoskeletal pain.
    • The pilot study showed that Veterans assigned to brief counseling were more likely to obtain pain treatment at a VA facility than those receiving the usual compensation and pension exam without additional counseling.
    • The pilot study also showed that when Veterans with risky substance use were assigned to counseling, they were significantly less likely to engage in risky use than those not assigned to this counseling.
    • The new study involves delivering the counseling by phone from a single hub site to Veterans having compensation exams throughout New England.

    VARQU spoke with the two researchers about their work on chronic pain management among Veterans.

    The Department of Defense, National Institutes of Health, and VA have just co-funded a large grant to study non-drug approaches to pain management. What is the significance to the VA health system?

    Dr. Rosen: This project has the potential to engage Veterans early in non-opioid pain treatment, and interrupt what can really be a harmful and dangerous course.

    How did VAConnecticut become part of the larger grant?

    MR: There are about 600,000 post-9/11 Veterans who are service-connected for back or neck pain. We had a developmental grant to intervene with people who were applying for service connection for musculoskeletal disorders. In the pilot study, most of the Veterans applying for service-connection for musculoskeletal disorders had considerable pain and impairment, and a high proportion were engaged in risky substance use. We found that they were amenable to intervention and that it helped them engage in VA pain-related treatment.

    Dr. Martino: In addition, we also found that as a result of the early intervention, Veterans reduced their risky substance use, as well. So we thought that this was a very promising approach to bring forward to the grant application.

    Can you tell us about your study, "Screening, Brief Intervention, and Referral to Treatment for Pain Management"?

    MR: That's the title of the study, actually; it’s not the title of the grant. I like the title of the grant better, it's more descriptive. The title is actually a pretty good summary: "Engaging Veterans Seeking Service Connected Payments in Pain Treatment."

    So why is that a good point in time to have this discussion with Veterans? Why not in the clinician's office?

    SM: Well one of the main reasons is these Veterans may not be in the health service system of the VA. They are reporting problems they are experiencing, and may not be aware of the services they could avail to help themselves. There's traditionally been a limited amount of information provided to Veterans at the point at which they are seeking a disability compensation exam, just because the nature of the exam is really determination for disability, not a clinical assessment.

    Marc's work has been fairly innovative in trying to use this as a point to provide Veterans who are seeking disability evaluations an opportunity to learn more about what is available to them and try to engage them in various services. And so that's why we think this is a great opportunity to work with Veterans who are experiencing chronic pain and who may have risky substance use—to try and get them engaged in services that they currently are not participating in.

    Can you walk us through a brief description of this intervention?

    MR: We talk to the Veterans a little bit about their claim: We ask them about their pain and inform them of the variety of services available at the VA health care system. We explain that pain treatment can involve not only medication, but also attending to other aspects of whole-body health. We then allow that many people in pain drink or use drugs to relieve their pain, and ask the Veteran about the extent of his or her substance use.

    There's a format for this type of brief substance use counseling that Dr. Martino is an expert in. We follow that format to engage Veterans in reducing their substance use. That style of working with people is based on motivational interviewing. And so a large part of what we are doing is to motivate Veterans to participate in non-drug treatments, and commit to reducing or stopping their risky substance use. And engaging in specialized addiction services if that makes sense and they are willing to do so.

    Part of the counseling involves not giving people exactly what they are expecting. The Veterans are coming for a compensation claim, and we are trying to say, "Hey, there are also some treatments available here that you are entitled to—that you've earned." We are also taking Veterans whose presenting complaint is pain and saying, "Substance use is something that could make your pain worse. Here are some ways you might want to think about that." We think that Veterans who have filed a claim are at a teachable moment.

    How is motivational interviewing different from a traditional doctor/patient interaction?

    SM: Motivational interviewing has been around for several decades. It began in the risky alcohol use field, and then has cut across all types of behavioral problems where motivation is part of the issue—particularly in the medical field. So the style of interaction really involves being very patient-centered, being empathic, collaborative, being compassionate to the needs of patients, and in particular being attentive to the ways in which patients speak about their problems that might support them making a change.

    So what people do when using motivational interviewing as a framework is try to illicit or draw out people's reasons for change and get people to elaborate more about those matters, such that they talk themselves into changing based on their own motivation. It's a way of helping people talk themselves into changing based on what is unique about their own experiences.

    You mentioned whole-body wellness earlier. Many studies show that opioids are not effective for long-term pain. What are some of the other treatments that might help patients deal with their pain?

    MR: There are non-opioid medications. There are various physical treatments like physical therapy, exercise and activity, chiropractic services. There are mind-body based treatments like yoga and mindfulness. And there are psychological treatments like cognitive behavioral therapy and relaxation techniques. And finally, treating other issues that make pain worse: poor sleep makes pain worse, depression makes pain worse. Treating conditions that we know how to treat well can make a big difference.

    SM: The mantra is that people need multi-modal pain care, and that the idea of medication as the sole form of treatment for chronic pain relief is misguided. We are trying to help people find a variety of ways in which they can approach pain treatment in order to get the best possible outcomes.

    MR: There is a vicious cycle that people in pain can get into, in which they become less active, which is depressing. They don't sleep well which worsens their overall physical condition, which worsens their pain. A lot of these treatments involve interrupting that vicious cycle.

    Can you tell us about the different phases of your study?

    SM: For all of these grants, there is an initial preparation phase where we have to meet certain milestones to prepare for the pragmatic trial. That's a two year process. And at the end of the two years, those grantees who are successful in meeting their milestones presumably will continue to be funded for a four-year pragmatic trial. And we fully expect to be successful and be funded for pragmatic trial.

    We have several things that we will be doing in phase one. First because we will be moving from the pilot trial which was done at VA Connecticut to all eight medical centers in VISN 1, we will get a grip on how pain care services and addiction services are delivered at each of those medical centers.

    We will be doing semi-structured interviews and qualitatively analyzing them, to appreciate the various factors that are at play at each medical site. We'll be talking with community medical providers and administrators and primary care folks, including nurse care managers, and anyone else who can tell us what's unique about their medical center.

    We will also be pilot testing this early intervention with five Veterans at each of the medical centers. The original trial was done face-to-face, in person. For this trial we will be using a hub-and-spoke model—so they'll be clinicians based in VA Connecticut who will be delivering the intervention entirely by phone. We want to see how that goes and if there are any adjustments that we need to make before we go to the full trial.

    Another key feature of the two-year preparation phase is it is very hard to characterize Veterans' use of non-drug treatments. There aren't codes for many of these treatments in the electronic medical record. So we have partnered with investigators from George Washington University to use what's called natural language processing, to develop algorithms that will basically use computer programs to screen CPRS (Computerized Patient Record System) for Veteran's use of non-drug treatment modalities.

    Another important piece of this study is the cost-effectiveness. How much is this all going to cost? And what kind of impact will this have on the budgets of medical centers, if they wanted to implement this if we were to be successful? So we also have a health economic component to this, and we will also be devising our methods for costing out everything for the trial.

    If this all works, would it be something that the clinicians could provide at the different medical centers, or would it be delivered through telehealth?

    SM: One of the reasons why we decided to do this within a VISN is because the VA is organized in regions—networks of medical centers organized together. Our hope would be if we could demonstrate this hub-and-spoke model, centered in a VISN, is effective, then it could be replicated in many other VISNs across the country. So we would be advocating for a telehealth means of administering this, which would provide greater access to people who may not be able to physically get to a medical center or who receive most services at rural sites across the country.

    MR: One feature of the VA that would facilitate the adoption of this is that VA regions receive capitated payments for each Veteran, but the amount of payment is based on what services the Veteran receives. So if a Veteran comes to a hospital and only has a compensation and pension exam, that region gets a limited amount of money. If providers engage the Veteran in treatment, the region gets more money for that Veteran. So unlike in some other healthcare systems, the region doesn't lose money by providing more comprehensive care.

    What are your long-term goals for this study?

    MR: Our first goal is to test the intervention as proposed. We tested this at a single site: It was done through face-to-face encounters, and it was promising. This next study is needed to see if it works in a setting in which we are treating many more people by phone, which is likely going to be less expensive and more easily spread throughout the region.

    So the first goal is to evaluate the cost and benefits of this intervention, and see what works in the real world, not just in a research setting.

    If it does works, then we would like to see it rolled out nationwide. We are not testing in some super complicated, super expensive form that couldn't be done anywhere else. We are testing it as a relatively simple phone call and evaluation and referral. The hope is, if the results merit it, that this will be adopted in other regions.

    SM: That last point I think is very important. The way we are studying this is consistent with the way that services are often delivered in VA. So we are hoping that this will make it attractive to the broader health care system because they will be able to relate to it. From an implementation standpoint, it won't be discrepant with what is commonly done here.

    MR: Sometimes it is hard to get health care systems to do things that will bring long-term benefits because the problems are subtle or the harms are long term. The harm from the opioid epidemic isn't subtle, and there's a real consensus that we need to treat pain better, and intervene early. In this case, I don't think it will be hard to convince decision makers that early, better pain treatment is necessary; this is a cause that people have embraced.

    SM: The other feature of this study that I think will be attractive to providers is we are creating a model where the providers are not going to be asked to do much more than what they are already doing. We are creating a system that complements what they are doing. One of the things that you hear constantly when you try to bring more behavioral interventions into medical centers is "We are too busy." They are very taxed. Asking them to do one more thing that is often seen as outside of their usual scope of practice is a difficult ask. So this is something that we think clinicians have not only embraced as a goal, but have embraced because it is not taxing all the other duties and responsibilities that they have.

    Source

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  • Burn Pit Widower

     

    It was in 2009 when Brian Muller first met his wife, Amie.

    "We actually met at a music venue. And at the time I was playing music in a band and she had some friends there that were at the event," Muller, 45, from Woodbury, Minn., recalls in a recent interview with Fox News. "Her friends forced her to go out. I forced myself to go out and just to see some music."

    He remembers how they discussed her service with the Minnesota Air National Guard.

    "We ended up talking about what she does with the military," he says, "and at that time, she was doing a project to make video memorials for gold star families. Families that lost loved ones in Iraq or Afghanistan or any type of war."

    "She asked me to write a song for those videos. And that's how we kind of started our relationship, as-- friends, and then it developed from there."

    Brian has never served in the military but was impressed by Amie's service -- including her two tours in Iraq.

    "She wanted to fly, and she joined the Air Force. And she got deployed and had her life kind of uprooted there for a while."

    Amie was stationed at the Iraqi air base in Balad during both of her tours in 2005 and 2007. While her active service was already behind her, the effects from her time on that base still lingered.

    "She didn't really want to talk about her time over there," Brian says. "Anytime a door would slam or a loud noise, she'd get startled very easily. She had a lot of PTSD [episodes] from just little things."

    A decade after returning from Iraq, Amie's physical health also suffered. She was diagnosed with Stage III Pancreatic Cancer.

    "I still remember Amie getting the call, and she looked at me," Muller says about the day they found out about her diagnosis back in April 2016.

    "We walked around the corner just to make sure the kids didn't see. I could tell by the look in her face how scared she was. And I just kind of listening in to the call. And we just started shaking.

    Both she and Brian believed it was related to her exposure to open-air burn pits used to destroy trash generated on the base. Nearly every U.S. military installation in Iraq during the war used the crude method of burn pit disposal, but Balad was known for having one of the largest operations, burning nearly 150 tons of waste a day.

    The smoke generated from these pits hung above Amie's barracks daily.

    "She talked about the burn pits even before she got cancer," Muller recalls, "and how the fact that they would change the filters on these ventilation systems quite frequently. And every time they'd change it would just be this black soot, so thick that you would think you'd have to change it every hour."

    "After she told me what they were burning, you know, all I thought about is all the campfires that we had in our backyard. You don't burn Styrofoam. You don't burn plastic. We all know that, but they were burning all those things. Highly toxic."

    As early as Operation Desert Storm in 1991, burn pits were used at U.S. military bases in Iraq. At the height of the Iraq War in 2005, more than 300,000 troops were stationed there and potentially exposed to the smoke and fumes from burn pits.

    Thousands of Veterans and former contractors returned from the Middle East and have developed rare cancers, respiratory problems, and blood disorders from what they claim are their exposure to toxins from the flaming pits. More than 140,000 active-service members and retirees have put their names on a Burn Pit Registry created by the Department of Veterans Affairs.

    After Amie was diagnosed and her treatment began, she and her family went public with her story in the hopes that it would bring awareness to the dangers she and countless Veterans faced after what they believe was a result of burn pit exposure.

    Amie succumbed to her illness just nine months after she first diagnosed.

    In her absence, Brian continued Amie's work in raising awareness by sharing her story. He also worked closely with Sen. Amy Klobuchar, D-Minn., toward getting "The Helping Veterans Exposed To Burn Pits Act" -- a bipartisan bill recently presented in Washington and signed by President Trump -- passed.

    The bill will help fund a new center by the Department of Veterans Affairs that will study the effects of burn pit exposure and eventually assist with treatment plans. He also started the Amie Muller Foundation, which helps other Veterans who were diagnosed with pancreatic cancer.

    "I just hope that our Vets are going to get the help they need," Brian says, "and it's not going bring back Amie, my wife, but it's going to get Veterans the help they need."

    But recent findings show that the Pentagon was aware of the dangers of burn pits during the height of the war in Iraq.

    Fox News recently obtained a series of memos drafted by top officials at Balad during the same years that Amie served at the base. The authors of the documents -- which include commanding officers as well as environmental officials -- stated that the operation of burn pits was a danger to those stationed there and that precautions needed to be taken urgently to improve conditions.

    "In my professional opinion, there is an acute health hazard for individuals," reads a line from one memo written by a Bioenvironmental Engineering Flight Commander and the Chief of Aeromedical Services at Balad in 2006. "There is also the possibility for chronic health hazards associated with the smoke."

    The memo also includes an assessment of the pits in Balad where one environmental inspector said that Balad's burn pit was "the worst environmental site I have personally visited."

    After inquiries by Fox News regarding the memos, Officials for the Department of Defense said that they would look into the matter and explained their procedural policy and that open-air burn pits are to be operated in a manner that prevents or minimizes risk.

    "DOD does not dispose of covered waste in open-air burn pits during contingency operations except when the combatant commander determines there are no feasible alternative methods available," reads the statement provided by a Defense Department spokeswoman. "DOD minimizes other solid waste disposal in open-air burn pits during contingency operations. Generally, open-air burn pits are a short-term solution. For the longer term, we use incinerators, engineered landfills, or other accepted solid waste management practices whenever feasible."

    Muller finds the memos troublesome.

    "I don't understand why they didn't do something," he says after being shown a copy of the memos. "These are people that volunteered to serve our country, and it just disgusts me to see memos like that, from high ranking officers that expressed this concern."

    Muller adds that the underlying issue is a lack of accountability.

    "The issue is they were doing something they shouldn't have done, that they constantly warned was an environmental hazard," he says. "And our Vets are getting sick. Our Vets are dying."

    "You know, there was a fellow that did a video--'Delay, Deny and Hope You Die.' And that's kind of what's been going on. They're delaying this as long as possible so that they won't have to deal with as many claims, because most of them will die before they do anything about it."

    Muller also believes that Amie would have never fallen ill if it wasn't for the fact that she was stationed at Balad.

    "I don't think she would have gotten cancer. I really don't. Maybe she would have later in life. Maybe it would have been some other type of cancer. I don't know," he says. "But something caused inflammation -- for something to grow in her body for a long period of time before it was ever seen and diagnosed. There was something going on with all of the Vets when they got back."

    In a recent interview with Fox News, Gen. David Petraeus, the former commander of U.S. Central Command and Multi-National Force-Iraq in 2007, offered an explanation when asked about why burn pits were used on military bases, conceding that the realities of war kept concerns about how to dispose of waste a low priority at that time.

    "At that time we weren't worried about burn pits," The general said back in September. "We were worried about just getting enough water for our troops in the really hot summer. We were looking forward to the time where we might get some real food, real rations, as opposed to MREs and so forth."

    The general also expressed that the U.S. has a commitment toward helping those Veterans.

    "It's a sacred obligation," Petraeus said. "But comparing what our VA does to any other country's care of Veterans... this is the gold standard. Certainly, a gold standard that can always improve, without question. This is an issue, though, where we have a sacred obligation, and we need to meet that obligation."

    Muller believes the general's recent comments to be a sign of a move in the right direction.

    "When you start seeing men in uniform, or women in uniform, people higher up in the military starting to voice their concerns, you know we're making progress."

    Source

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  • Jim Sherman

     

    COLORADO SPRINGS, Colo. (KKTV) - Hundreds of Veterans in our community who are turning 65 years old will need to find a new doctor. Right now, they go to Evans Army Hospital on Fort Carson. Fort Carson told our 11 Call for Action team they are making changes to make room for an influx of active duty soldiers.

    Jim Sherman, a 64-year-old Veteran, gets his care at Evans Army Hospital. But he got a letter saying when he turns 65, because he is eligible for Medicare and TRICARE, his coverage will change and that he will no longer be able to see his doctor at Evans.

    "I was discharged almost 40 years ago, and since that time, that's where I've received my care," Sherman said. "I'm down there -- not every week, maybe every other week, and definitely every month."

    "To just kick everybody to the curb, is not right," he added.

    We reached out to Fort Carson and they told us about 365 letters were sent out to beneficiaries.

    Evans Army Community Hospital said in a statement: "Our mission atEvansArmyCommunityHospital is to ensure the medical readiness of active-duty Soldiers atFortCarson. Due to the increased assignment of Soldiers toFortCarson, Evans is reaching its capacity to provide quality healthcare to our beneficiaries. Evans is notifying beneficiaries approaching their 65th birthday about changes to their healthcare eligibility within the medical treatment facility. Once beneficiaries turn 65, their coverage becomes TRICARE for Life after they enroll in Medicare Part A & B. TRICARE for Life is a Medicare-wraparound coverage for TRICARE-eligible beneficiaries. We are trying to provide beneficiaries sufficient time to find primary care providers in the local community before they turn 65. TRICARE for Life beneficiaries will continue to receive Emergency Care and other services on a space-available basis atEvansArmyCommunityHospital, such as the Pharmacy, Laboratory and Radiology."

    If patients are over 65 and have been getting care at Evans for more than a year, they can stay at the hospital.

    "I am where I want to be," said Sherman. "That's really the only home that I've ever known for hospital care."

    Jim turns 65 in January. He applied for an exception and is waiting to find out if he can stay at Evans.

    In the next two years, Fort Carson said they expect to see an increase of about 1,000 soldiers and 1,500 family members.

    Source

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  • Wait Times 002

     

    The VA Debt Management Center just announced it reduced call wait times by over 75 percent while also increasing calls taken by 40 percent from 2016 to 2018.

    As part of the agency’s Veteran-focused initiatives, they agency reduced call wait times from 21 minutes in 2016 to under 5 minutes during 2018. The initiatives include increasing staff levels, improving technology, and driving better employee development.

    “The team at the DMC has enhanced services to our Veterans,” said VA Secretary Robert Wilkie. “It’s our mission to take care of our Veterans, no matter what their needs are. DMC is in concert with our priority of improving customer service and will continue to gather customer feedback through direct feedback, surveys and outreach in FY19 to further enhance the Veterans’ experience.”

    According to the press release:

    For the past three years, DMC received around 1 million calls annually with an average call wait time of about 21 minutes. In FY 2017, DMC launched a series of internal efficiencies and process improvements to enhance contact center capabilities.

    Initiatives included enhancing staffing levels to meet demand, enhancing contact center technology, focusing on employee development and engagement, and implementing an automated 12-month payment plan.

    These Veteran-focused initiatives represent a 79 percent reduction over two years to the average time for waiting and a 40 percent increase of actual calls taken. These are all indicators of successful initiatives providing a better experience for Veterans and VA employees.

    The DMC’s inbound contact center serves as the central point for Veterans and their family members to make payment arrangements, or receive guidance regarding the collection process on overpayments which could include debts created from education or pension payments.

    Debt counselors at the DMC work with callers in a professional and service-oriented manner to help them understand their options to address overpayments with Veterans either through extended repayment plans, the dispute process, compromise process or waiver process

    DMC’s contact center provides debt counseling for the Veterans Benefits Administration, and consolidated collection services of non-health care debt for Veterans Health Administration and National Cemetery Administration, enabling these entities to focus resources on accomplishing their core missions.

    DMC has provided centralized debt collection programs of Veteran benefit overpayments since 1975 and became a fee-for-service Enterprise Center in 1996.

    This is great news for Veterans trying to deal with the agency as a debt collector.

    LACK OF INFORMATION

    What is not great is the amount of information the agency publishes for Veterans dealing with the Debt Management Center for the first time. The agency gives us little information about how to advocate for yourself and what elements of your fact set to focus on when creating your argument – – whether for a waiver or to plainly dispute the alleged debt in full.

    They instead focus on how to pay and how to submit a waiver with no limited discussion of disputing the alleged debt in full.

    Ever have a run in with DMC? If you have a debt story, I would like to hear it below.

    Any idea how the Fair Debt Collection Practices Act might apply to VA or one of its contractors attempting to collect an illegitimate debt from a disabled Veteran?

    Source

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  • Unsterile Tools

     

    When the Department of Veterans Affairs released the annual ratings of its hospitals this fall, the facility in Atlanta dropped to the bottom, while the one in West Haven, Conn., shot to the top. It was something of a mystery as to why.

    The Atlanta hospital was downgraded to one star from three on the agency’s five-star scale, even though there had been only a “trivial change” in its quality data from the year before, according to the department. The Connecticut hospital climbed to five stars from three, even though numerous operations had to be performed elsewhere or canceled at the last minute because of problems with sterilization of surgical tools, according to an internal assessment and other accounts cited by Senator Richard Blumenthal in a letter to the agency.

    Veterans Affairs set up the rating system in 2012 in the hope of pushing its hospitals to improve, and it has been increasingly aggressive in using the ratings to hold hospital managers accountable. Leaders with low ratings can be ousted, as happened last week in Atlanta, where the chief of staff and heads of the emergency department, primary care and clinical access services were removed because of low scores.

    But former senior officials at the agency and experts in health care metrics say the system can be confusing, and so arbitrary that hospitals may gain and lose stars based only on statistical error. More than a dozen hospitals improved care but lost stars; another did not improve and gained one.

    What is most worrisome to some experts is the role that the star ratings now play in grading performance of hospitals and their managers. They say it creates an incentive to conceal problems rather than grapple with them, in order to collect bonuses or sidestep penalties.

    “It’s a big mistake,” said Dr. Ken Kizer, a former under secretary for health at Veterans Affairs who is widely credited with pioneering the use of health care quality metrics at the agency.

    Dr. Kizer said that it made sense to track quality measures when the goal was improving patient outcomes, and the agency had made important strides in that way. But he said that using the data to single out hospitals for discipline could lead to problems like the 2014 wait-time scandal, when managers who could not meet goals for prompt scheduling of patient appointments started keeping secret off-the-books waiting lists.

    “It’s the same pathology that perverted things then,” Dr. Kizer said. “As soon as you tie metrics to pay or performance, they become subject to gaming.”

    The gaming can put patient care on the line. At the hospital in Roseburg, Ore., administrators turned away some of the sickest patients to keep them from affecting the facility’s scores, doctors there have said.

    The chief of surgery at another Veterans’ hospital in a major metropolitan area said in an interview that administrators discussed whether the hospital should not perform certain operations because they could impact the hospital’s quality statistics.

    “That kind of thinking is driven by these ratings,” said the surgeon, who spoke on the condition of anonymity, adding that he feared being fired if he spoke publicly. “My life right now is continuously filling out reports and going to meetings, trying to figure out how to improve the numbers.”

    There is broad consensus in health care that quality should be tracked and reported, but little agreement on the best way to do it. As in education and law enforcement, a drive to collect data and use it to direct strategy has led to both improvements and frustrations. Often, experts say, the way care is measured can alter the care itself, and not always for the better.

    The Department of Veterans Affairs defended its hospital rating system, saying in a statement that it “has been successful in moving systemwide performance upward.” But the department declined to make key officials available to discuss the system.

    The ratings may soon take on even more importance. A law signed in June may allow more Veterans to get care from private providers if Veterans’ hospitals fall short of performance standards.

    Veterans Affairs has been tracking hundreds of health care metrics for decades, but it had no overall performance gauge for its 146 hospitals until 2012, when it started using a process called Strategic Analytics for Improvement and Learning, or Sail, to combine many of the metrics into a single score. Executive performance and pay were tied to Sail scores in 2015 in the wake of the wait-time scandal.

    The department has reported steady improvement in Sail scores, noting in September that 71 percent of Veterans’ hospitals did better this year than in 2017. But experts say some of that improvement may exist only on paper.

    The former quality director of a large Veterans’ hospital with a five-star rating, who spoke on the condition of anonymity to avoid harming a continuing relationship with the agency, said the hospital employed two analysts whose full-time job was to find ways to improve the Sail data. Some of their work focused on spotting ways that services could be improved, but much of it focused on finding ways to improve the numbers, such as by changing how patients’ conditions were entered in hospital records. “We learned how to take the test,” the director said.

    Sail was designed by Dr. Peter Almenoff, a longtime hospital administrator who was moved to a quality control post in the department in 2008 despite questions about his track record. This spring he was also put in charge of the team that revamps hospitals that get low ratings.

    The department refused multiple requests to interview Dr. Almenoff, and he did not respond to direct inquiries seeking comment.

    Veterans Affairs now relies on Sail to warn about failing hospitals. But Dr. Stephan Fihn, who was the department’s chief quality and performance officer before he retired this year, says the system is not reliable.

    “It has serious flaws and always has,” Dr. Fihn said. “The first is statistical: The numbers may not be mathematically sound. Second, it’s not transparent and lacks independent oversight.”

    A draft internal evaluation in 2014 found that combining dozens of metrics into a single Sail score was “akin to adding apples and oranges and trying to express the total as the number of pineapples.”

    An outside audit in 2015 found that many of the score’s ingredients had “never been assessed to see if they were actually valid measures of quality,” and that hospitals could gain or lose a star solely from statistical error.

    According to the report, 70 percent of Veterans’ hospital directors interviewed by the auditors with a promise of anonymity said Sail scores did not accurately reflect the quality of their hospitals.

    The New York Times contacted eight Veterans’ hospitals, including those in Atlanta and West Haven, asking to interview their directors about Sail. None were willing.

    “A lot of people don’t like this system, but they won’t speak up because they are afraid of what will happen,” Dr. Fihn said.

    Problems in measuring health care quality are not confined to Veterans’ hospitals. A 2015 comparison of four popular commercial systems used by private hospitals found their ratings so inconsistent that not one of the 844 hospitals examined earned a top rating from all four.

    Medicare tried to institute a five-star hospital grading system, but postponed releasing the latest results indefinitely in July after several hospitals threatened to sue, saying the grading method was inaccurate.

    Veterans’ hospitals, however, do not have that option, nor can they choose among commercial rating systems.

    The department says its star ratings help keep Veterans informed. But Dr. David Shulkin, who was President Trump’s first secretary of Veterans affairs, says the stars are not much help in gauging progress from year to year or in making comparisons with nearby civilian hospitals, because Sail grades Veterans’ hospitals on a national curve.

    “It’s not useful for our patients. It’s confusing. I wanted to move away from Sail,” said Dr. Shulkin, who clashed with political appointees in the department and was dismissed by Mr. Trump in March.

    Agency employees say that only Dr. Almenoff and a few members of his staff know exactly how the system weighs and adjusts the 60 publicly available measures that go into a score.

    “That’s the problem with Sail — what happens to make the scores is invisible,” Dr. Fihn said. “A person could move the stars arbitrarily, and you would have no way of knowing.”

    That lack of transparency became a problem for Lisa Nashton, who is in charge of tracking quality at the Veterans’ hospital in Columbia, S.C.

    After the hospital received one star, Dr. Almenoff visited the facility in 2016 to brief the staff on ways to improve. While he was there, Ms. Nashton said, she took him out to dinner to talk more about quality metrics.

    The effort seemed to pay off. The hospital got its rating up to three stars that year, and it looked forward to a similar rating in 2017, Ms. Nashton said, because it had sustained its quality measures at basically the same level.

    So when the word came that the hospital had actually lost a star, “it was a gut punch,” she said. “I kept going over the numbers again and again. I compared us to other hospitals. The math didn’t make sense.”

    Ms. Nashton said she then alerted the department’s Office of Accountability and Whistleblower Protection that Sail was statistically unsound and open to gaming, and submitted a lengthy paper showing how a host of problems made the system a “credibility crisis waiting to happen.”

    The reply came nearly a year later: The department planned to take no action.

    Source

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  • Vets Teamed to Raise Millions

     

    On October 19, 2018, a crowd of over 700 guests gathered at Pier Sixty at Manhattan's Chelsea Piers for one reason: to help provide mental healthcare to the men and women who fight for our freedoms. During their 6th annual gala, Headstrong, an organization that provides cost-free, stigma-free, and bureaucracy-free mental healthcare to post-9/11 military Veterans, put on a fun-filled event — and raised over $2 million in the process.

    Headstrong is making a huge impact on the Veteran community.

    "We have served over 750 Veterans over 16,000 therapy sessions by 150 best-in-class clinicians in 23 cities across the country. All through private donations. Simply incredible," said Army Veteran and Headstrong Executive Director Joe Quinn."

    During the event, three Veterans seeking treatment through Headstrong, Amanda Burrill, Derek Coy and James Byler, opened up about their struggles and successes in finding effective mental healthcare. Their stories inspired the hundreds in attendance.

    Despite the seriousness of the organization's goals, the night wasn't without a good dose of levity — after all, it was more than a fundraiser, it was a celebration. World War II Veteran and former POW, Ewing Miller, was celebrating his 95th birthday — and he did so by being served cake by actor Jake Gyllenhaal and late night host Seth Meyers.

    Ewing Miller served from 1942 to 1945. On February 5, 1945, his aircraft was shot down — he was the sole survivor. He endured capture by the Germans until he was eventually freed by legendary military leader, General George S. Patton. Ewing earned several decorations during his time in service, including the Purple Heart, the Air Medal with two clusters, the POW Medal, the World War II Victory Medal, and the European-African-Middle Eastern Campaign medal.

    When the lights finally dimmed on the evening's celebrations, Headstrong had raised over $2 million, which will be used to directly improve the lives of many post-9/11 Veterans that are struggling with mental health — and it's a cause worth championing. Marine Veteran and Founder of Headstrong, Zach Iscol, said,

    "When you put goal-oriented Veterans together with top mental healthcare providers, they get better. The panic attacks go away, the anxiety goes away, the anger goes away, the self-medicating goes away…they blossom."

    To learn more about Headstrong, their initiatives, and what you can do to support Veteran mental healthcare, visit their website.

    Source

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  • Disabled Vets

     

    What's Not Talked About?

    Throughout the history of warfare, service members have been placed in unimaginable situations, often situations in which they have to make difficult decisions. Frequently, decisions made during deployment have lifelong consequences. Many Veterans have expressed a desire to be the person they were before they experienced trauma, and they often try to suppress or avoid memories of the trauma they have lived through. However, the use of avoidant coping strategies has been found to be counterproductive in the long run. By attempting to avoid the traumatic events service members have experienced, they end up exacerbating the intensity and frequency of their trauma memories and the sequelae and symptoms of those memories over time.

    Some Veterans are able to move past trauma with minimal dysfunction in their lives; however, for others, the traumatic event creates havoc and chaos. Trauma symptoms can become so problematic that they result in family discord, divorce, social dysfunction, significant substance use, employment difficulty, physical health difficulties, legal problems, and more. And the disruption of service members’ lives as a result of trauma symptoms is hardly uncommon. Due to the dysfunction and negative impact of trauma and its symptoms in the lives of service members, the VA has recognized and developed the VA disability rating system. The disability rating system considers both physical and mental health-related conditions. The more areas of a Veteran’s life that are impacted (i.e. social and occupational difficulty or physical limitation and/or pain), the more financial compensation that Veteran potentially could be warranted. I am a firm believer that Veterans are entitled to every dollar that they are afforded and then some...Many can argue that the lifelong implications and symptoms that Veterans have to endure cannot be quantified or compensated with a dollar amount. The VA does its best to equitably compensate Veterans based on their level of dysfunction. However, if the Veteran could eliminate the disabling experience that initiated their impairing symptoms, it is possible that they could exceed the amount of their VA compensation by functioning optimally in the civilian sector. Essentially, they would be able to have a greater positive economic impact and earn a higher living wage if they did not experience disabling symptoms. Given the high level of training military members receive, the values, discipline, and structure instilled by military training and service often lead most Veterans to make dependable, hard-working, and effective employees.

    Disability Rating System

    According to the VA Disability Rating System, in the year 2000, the average compensation provided to Veterans through the disability rating system was about $20 billion for 2.3 million Veterans. In 2013, that number rose to 3.5 million Veterans receiving $54 billion in compensation. This number has continued to rise over the last several years and will hopefully continue to do so, enabling Veterans to receive the compensation they deserve. A major reason for the spike in Veterans receiving compensation is the continued 14-year wars in Iraq and Afghanistan. When service members are sent to war and later return home, there are often significant consequences to service—economics being one of them. Unfortunately, many Veterans who are still in need of services and compensation for VA benefits have not taken advantage of the services offered. Many factors impact Veterans’ decisions not to seek care— a main one being stigma. Two examples of stigma are: one, a Veterans’ hesitation to seek mental health services due to being perceived as “weak” or “vulnerable;” and, two, the possibility of having negative career or job implications as the result of potentially impairing symptoms. As I have said in a previous blog, it takes a nation to build a military and go to war. And, it takes a nation to welcome them home. Compensating our Veterans for their service is the first of many steps that should be afforded to Veterans for their sacrifice. If we send people to war, it is a fundamental imperative that we take care of them when they come home. The tide is changing, and the VA has gone to great lengths to decrease wait times for compensation and pension evaluations so that Veterans are streamlined through the process. There is no perfect system, and the pendulum has and is continuing to shift in the right direction so that our brothers and sisters in arms are taken care of.

    To specify the rating system with an example, if a Veteran diagnosed with PTSD has a 50 percent service-connected disability rating and they have a spouse and one child, they would receive $978.64 each month. Yearly, that is roughly $11,745. The pay for a Veteran that is 100 percent serviced-connected increases significantly. They would approximately $3200 monthly. Although this money is not taxed, many Veterans still struggle to make ends meet. Anecdotally, there is a misconception that if a Veteran receives a 100 percent service connection, they will be able to live a “lavish” lifestyle. That is simply not true. This money can definitely help decrease financial distress, however, many Veterans still struggle to pay for things they and their families need.

    Once a Veteran receives a disability rating and compensation is provided, there can be fear that the disability rating might be decreased or taken away if the VA finds evidence the Veteran’s symptoms have improved to a more manageable level. Once Veterans receive a service-connected percentage of disability, it is not a fixed rate for life—although it could be. The VA has the right to decrease the compensation rate if the Veteran shows material improvement in their ability to function in daily life whether that be in relation to a physical or mental health-related condition. According to the Department of Veteran’s Affairs Service Connected Disability website (2017), if a Veteran has less than a 100 percent disability rating, has been receiving compensation for less than five years, and has shown medical and social improvement, the VA can reduce the percentage of disability and compensation based on the evidence found. However, if a Veteran has been receiving benefits for longer than 20 years, it is considered a continuous rating and the VA cannot lawfully reduce the rating. At 10 years, a Veteran’s rating cannot be terminated, but it can be reduced. If a Veteran’s disability rating is reduced, a Veteran has the option of requesting a reexamination, and they should contact a Veterans’ Service Organization representative to advocate on their behalf.

    The VA provides great and well-needed services, and they save lives every day. Unfortunately, some Veterans walk away from the VA dissatisfied and displeased. There is no perfect mental health and medical system, and the disability rating scale is not perfect either. There is no one program that provides a “fix all” solution. What it will take is public and private partnerships moving forward in order to maximize reach and expand access, frequency, and quality of care.

    Many Veterans who receive benefits fear their benefits may be taken away at any point in time. Unfortunately, this fear of disability ratings potentially being lowered if there is substantial evidence that the Veteran has made improvement deters people from seeking and fully engaging in well-needed treatment. For instance, if a service-connected Veteran engages in an evidenced-based trauma-focused treatment for PTSD that has been shown to reduce symptoms upon full completion, and as a result of that treatment their overall dysfunction decreases, that Veteran could be at risk of decreased disability ratings if that improvement is documented and gathered during a medical evaluation. Veterans who know the disability rating system may be deterred from seeking care at the VA because of that potential. The more dysfunction one has, the more money they receive; so increased symptomology is incentivized and reinforced. If Veterans struggle with employment and optimal functioning, it makes sense that those Veterans may not want to show improvement. This is one lens to look through.

    Unfortunately, there is no perfect solution to this problem. However, there has been plenty of debate about possible solutions. One solution discussed would be to extend the time period between the rating system from the initial evaluation and reevaluation. This solution could assist with decreasing stigma and reducing the fear of losing a percentage rating with the potential benefit of encouraging people to fully engage in well-needed treatment. This would allow Veterans to seek a high standard of care, receive benefits, and practice their skill-sets learned with a longer time to adjust for life stressors that may continue to exacerbate symptoms. If there is no reoccurrence of symptoms, then one may experience a reduction in compensation. If there continues to be notable impairment, then the percentage of disability rating could stay the same or increase. Another potential solution is to continue the private-public partnership so that Veterans can receive care outside of the VA. If Veterans fear that making progress would jeopardize their disability rating when seeking care at the VA, those concerns are potentially lessened with treatment in the private sector. These issues about disability ratings and improvement in functioning are only a few of the many issues debated in the current Veterans’ issues climate. Although they are hotly debated, the pendulum is moving in the right direction by placing our Veterans first.

    Source

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  • Charity for Vets

     

    To hear Army Veteran Troy D. Walker tell it, Dog Tag Furniture’s mission to aid Vets began after a service buddy killed himself and the family couldn’t afford a funeral.

    The Department of Veterans Affairs can only provide a few hundred dollars, the Minnesota man told “Fox and Friends” on Sept. 23, 2017.

    “The body was going to go unclaimed and be put in a baggie,” Walker said.

    Walker recalled going into debt to help pay his friend’s funeral costs and then realized no organizations existed to solely help fund Veterans' funerals.

    Roughly six years later, Dog Tag Furniture builds and sells wooden American flags and other patriotic products, billing itself on social media and TV interviews as an organization funding Veteran funerals via donations and wooden flag sales.

    “The money goes to pay for the funerals of these families who cannot afford one,” Walker told “Fox and Friends” during a return appearance on Nov. 22, 2017.

    “I hold the personal responsibility to make sure every dollar I received goes out to funerals," he said.

    But now, Walker, his wife Ranemma and Dog Tag Furniture are under investigation by the FBI and U.S. Postal Service amid allegations of money laundering and wire fraud in “a scheme to defraud donors who made charitable donations to their company,” according to court records.

    “Troy Walker...both solicited donations to Dog Tag Furniture and sold wooden flags to customers of Dog Tag Furniture by falsely representing to donors and customers that Dog Tag Furniture was a charitable organization and that all of the proceeds of donations and sales would be used to provide funerals for military Veterans,” according to a sworn affidavit attached to a federal search warrant request from last month.

    “Instead of using their money to pay for funerals for military Veterans, Troy and Ranemma Walker used a significant portion of the money for their own purposes," the affidavit added.

    “Personal purchases” allegedly included tattoo parlor payments, private school tuition for the Walkers’ children, $9,000 at Disney resorts, $5,000 in “food and entertainment expenses” and $7,000 to a law firm representing the couple “in connection with a dispute with the City of Norwood Young America,” according to the affidavit, which Military Times obtained from the U.S. Department of Justice.

    Walker has not been charged with a crime and the federal probe into misconduct allegations noted in the affidavit continues, according to Department of Justice officials.

    Although the charity received about $490,000 in sales and donations from August 2017 to July 2018, Dog Tag Furniture allegedly covered the expenses of just two funerals at a total cost of $3,295, federal authorities allege.

    Walker, 38, declined to comment on the allegations through Robb Leer, his Minneapolis-based spokesman.

    Dog Tag Furniture’s criminal defense attorney, Marsh Halberg, did not dispute some of the spending allegations detailed in the affidavit but said “the Walkers were sloppy in the use of their private checkbooks and the corporate checkbook.”

    The Walkers paid for other funerals, but those payments came out of their private accounts, he said.

    Because federal authorities have seized their electronic records “we’re kind of handicapped in that,” Halberg said.

    “They were not living an affluent lifestyle,” Halberg said. “These people were not used to that. They weren’t business savvy in that sense.”

    The Walkers did take a Disney trip, Halberg said, but the organization’s board of directors “encouraged them to do that.”

    The federal search warrant affidavit claims that Walker told radio host Glenn Beck during an April interview that his organization pays an average of $3,600 per funeral and has funded about 200 of them but law enforcement "has found no evidence of Dog Tag Furniture providing any funds for other funerals, including the funerals Walker specifically referenced on social media, such as…an unnamed female Minnesota National Guard member” and two others.

    About $17,000 in Dog Tag Furniture funds instead went to pay Walker’s mortgage “after the residence went into foreclosure in or about August 2017,” according to the affidavit.

    “In lieu of salary, the organization paid for basic living expenses so they could continue to live,” defense attorney Halberg said. “They did pay for mortgages and food.”

    Dog Tag Furniture was founded in 2015 as a for-profit corporation, according to the federal search warrant affidavit.

    It was initially created to provide a second income to bankroll a future trip to Disney World, but turned altruistic after Walker’s friend killed himself, according to the organization’s website.

    Walker applied for tax-exempt, non-profit status in September 2017 and received an approval letter from the Internal Revenue Service in February, a copy of which was shared with Military Times.

    Although walker told Beck during his radio interview that neither he nor his wife drew salaries from Dog Tag Furniture, about $90,000 was transferred from the organization’s checking account to the Walkers' personal coffers between August 2017 and July 2018, according to the affidavit.

    The transfers occurred when "the Walkers’ personal bank accounts had limited other sources of income,” wrote Christine Kroells, a U.S. Postal Inspector, in her affidavit seeking a search warrant.

    The affidavit states the couple received unemployment benefits and what appeared to be worker’s compensation payments in 2017 and 2018, but Walker denies they received unemployment assistance.

    During the Nov. 22, 2017, appearance on Fox and Friends, Walker said he nearly lost his home a few months earlier but “a donor stepped forward and got me caught up on my mortgage” after his initial appearance on the show.

    “I was getting into so much debt with this flag building business,” he added.

    That contribution was part of a flood of Dog Tag Furniture purchases and donations Walker reported receiving after his first Fox and Friends appearance. Dog Tag Furniture’s website crashed after that first appearance, he said, with folks sending pledges ranging between $5 and $5,000.

    “Within five minutes of me being on the show I found out my voicemail can only hold 112 messages,” he added.

    While welcoming him back for his second spot on the show, Fox host Ainsley Earhardt announced that “Troy’s website received over $100,000 in sales, thanks to you, our amazing, generous viewers," in the hours following the first appearance.

    “I love that even when you were in dire straits, you use all the money still to pay for funerals, because you get your paycheck from the military,” Earhardt said.

    “Thank you for fighting for our country,” she added.

    Dog Tag Furniture portrays itself as an organization where Veterans help Veterans.

    Its logo features two hanging military identification tags forming a “22,” an oft-reported estimate of how many Veterans kill themselves each day, and Walker notes his Army service in videos on the organization’s website.

    “I was a ’19-Kilo,’ which translates to Abrams tank crewman,” Walker said in one website video. “Yes, I drove around the big beast of the battlefield.”

    But military service records show it’s been a long time since Walker drew Army pay.

    Walker enlisted in 1999 and left active duty in 2002, and his most recent rank change was to private, or E-1, in November of 2001, according to service records.

    Walker disputed the 2001 demotion in an email forwarded by his spokesman.

    “After 9/11 some of us didn’t get paid due to the pentagon (sic) damage, I wasn’t paid for almost 4 months and told my commander no pay, no training and walked off post until I got paid,” Walker wrote. “After I got paid, I was given an article 15 for AWOL and reduced from E-4 to E-3 and promoted back in a few months, not sure why it says E-1???”

    Walker said he served in the “Inactive Reserves” until 2009, when he was honorably discharged. Army officials reported he was in the Individual Ready Reserve from 2002 to 2007.

    Army officials said he was administratively separated from the service but declined to characterize the nature of his discharge.

    When Military Times requested a copy of Walker’s DD214 discharge form or other service records that might shed light on the alleged discrepancies, his spokesman wrote in an email that “since Feds searched and seized his computers and files late last month — Troy was left without any hard copy paper files or his hard drive to access files like this from.”

    “All my battle buddies have seen my interviews and have NEVER publicly disputed anything I said in regards to my service,” Walker said in an email forwarded to Military Times.

    The federal search warrant executed last month does not appear to be the only time law enforcement has searched Walker’s home.

    Carver County Sheriff’s Office deputies combed it as well, according to an April press release from the agency.

    In March, authorities said Walker provided Carver County deputies with a suspicious email he asserted was written by an official from his town of Norwood Young America, about an hour’s drive from Minneapolis.

    But deputies determined the message had been sent through Walker’s own IP address, “suggesting the email had come through Walker’s own computer(s),” the press release states.

    An email from someone named “Jacob” also claimed Norwood Young America officials were harassing Walker but county investigators found it also came from Walker’s IP address, the agency wrote.

    Like federal probes, local investigations often peter out without prosecutors indicting their targets.

    Angella Erickson — the criminal division manager for the Carver County Attorney’s Office — told Military Times that the matters raised in the sheriff’s release remain under investigation but there are “no current pending charges” against Walker or his wife.

    In an email shared with Military Times through his spokesman, Walker said the Carver County allegations are “actually what started this investigation.” In fact, he wrote, the county charges “were dismissed shortly after for lack of evidence” and he blamed local prosecutors for instigating the wider federal probe.

    “Since they could not get me on those charges, they called the FBI,” he continued. “That is why our books are so (wacky) is because they keep getting taken.”

    Erickson disputed Walker’s allegation and said local officials did not contact federal law enforcement about him.

    “To my knowledge, the Carver County Sheriff’s Office is not involved with any investigation by the FBI,” she said.

    Defense attorney Halberg said Dog Tag Furniture is “pausing everything” because of “negative publicity.”

    Source

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  • Heriberto Hartnack

     

    Before Heriberto Hartnack became Eddie — the man with a knack for solving the U.S. Department of Veterans Affairs’ bureaucratic maze and the go-to contact for struggling Veterans in Collier — he was the new guy.

    And Veterans seeking help at the Collier County Veteran Services Office to secure their federal benefits had no time for a newbie.

    “Nobody wanted to see me,” recalled Hartnack, 65.

    Instead, they asked to meet with his boss. A month into his new gig, a frustrated Hartnack contemplated quitting. Then his boss ordered a Veteran to see Hartnack.

    “Give me a chance,” Hartnack pleaded with the Korean War Vet.

    The ex-Marine had received only 20 percent disability pay. But Hartnack knew that based on the man’s experiences during the war, he should be at 100 percent. He reopened the case and within six months, he got his client there.

    “He was the happiest guy,” Hartnack said.

    Hartnack can’t remember the man’s name. But it earned him a nickname he hasn’t shed.

    “He was the one who called me Eddie,” Hartnack said with a chuckle.

    Word of Hartnack’s competence soon spread among Veterans. "Go see Eddie" became the message passed on from one to the next. Since he got his start with the Veteran Services office in 1996, Hartnack estimated, he has helped thousands of Veterans receive the benefits they deserve.

    Now, 22 years later, Hartnack, an Army Veteran who worked in logistics for the military, is retiring from his job as manager for Veteran Services. His official last day will be Wednesday, Jan. 2, but by Friday morning, Dec. 28, his transition to retirement already had begun.

    The awards that decorated the walls in his small office on the second floor of the county’s health building already had been taken down. Letters to the editor thanking him for his services were still plastered across his overhead office cabinets. He told a caller he could still meet him Friday.

    “Today is my last day,” he told the caller. “Want to come see me here today?”

    County Commissioner Donna Fiala, first elected in 2000, has sent Veterans to see Hartnack to get help. The word she associates with him is “devoted.”

    “The buck always stopped with him,” Fiala said. “He never put things off.”

    Collier’s various Veterans organizations also sang his praises, Fiala said.

    “Eddie would go out of his way to help....,” she said. “It was always about the Veterans.”

    Throughout his career, Hartnack did more than just try to secure the maximum disability benefits for Veterans. He helped Veterans get the medals they deserved, even decades after their service. He would assist loved ones left behind by Veterans who had died. He even played matchmaker.

    Rita Habighorst, 92, of Estero, credits Hartnack, in part, for encouraging her and Art Habighorst, 94, to marry in November. Both were widowed and had been together for about five years. And both came to Hartnack for help; Art as a World War II Veteran and Rita as the former spouse of a World War II Vet.

    Every time the couple came to see him, Hartnack encouraged them to get married, Rita Habighorst said.

    “Eddie convinced us. He said that we were too happy together and there was no reason why we couldn’t....,” she recalled. “Eddie could see that we were in love all the time.”

    The Habighorsts count Hartnack and his wife, Emelina, among their friends now. The office where Hartnack has spent more than two decades helping Veterans will miss him greatly, Rita Habighorst said.

    “He’s a great, caring person,” she said. “He cares and he does details and he doesn’t forget. And that’s what is so important. Today’s life is everybody’s a number, and Eddie made sure that we were a person.”

    Hartnack lists the late-in-life love story as one of his favorite memories of his career.

    Another cherished accomplishment is putting together a welcome-back-home parade for Vietnam War Veterans during last year’s July Fourth celebration in Naples. Hartnack has a particular soft spot for Veterans of that war and had been working for years to make the parade happen.

    “The reason I focus more on them is because when they came back home, they weren’t welcome,” Hartnack said, referring to Vietnam War Veterans. “They were spit on.”

    Part of what likely made Hartnack so successful in helping Veterans, said Lee Rubenstein, commander at American Legion Post 404 on Marco Island, was that he was a Veteran himself. Hartnack was “very dedicated” and “a master” of getting Veterans their benefits, he said.

    “He gets Veterans what they deserve and not the runaround,” said Rubenstein, 71.

    Rubenstein, who is 70 percent disabled and was helped by Hartnack, would bring him in to speak to fellow Veterans.

    “It was a chance for the Veterans to ask a lot of direct questions without getting tied up with the VA” and the bureaucracy, he said.

    Getting Veterans the disability benefits they deserve was often the difference between Veterans living a good life or not, Rubenstein said.

    “I think his service to the Veterans of Collier County is priceless,” he said.

    Although he’ll be “sorely missed,” Rubenstein said Hartnack’s replacement, Alexandra Scardino, is “excellent.”

    “He’s trained Alex to do all the right things,” he said.

    Hartnack agrees. He has trained Scardino since she became a service officer for the county a few years ago.

    “I’ve been mentoring her and (the) other service officer, and I noticed that she cares,” Hartnack said. “One of the issues here is if you really care. You have to work from the heart.”

    Hartnack said he will miss his Veterans. He still plans to help them in his spare time, working as a volunteer at local Veterans organizations.

    To him, the office he served in for more than two decades is the best place to work in the county.

    “You enjoy working every day,” Hartnack said. “I’ve been working here 22 years. I never had a day where I said, ‘I don’t feel like working,’ because I knew I was going to help someone.”

    Source

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  • Justice 005

     

    MISSOULA—A Columbia Falls man accused of stealing government benefits by overstating his disabilities admitted fraud and theft charges in federal court on Dec. 12, U.S. Attorney Kurt G. Alme said.

    John Cicero Hughes, 46, pleaded guilty to theft of government money and Social Security disability insurance fraud.

    U.S. Magistrate Judge Jeremiah C. Lynch presided and will recommend that Hughes’ plea be accepted by U.S. District Judge Dana Christensen, who is assigned to case.

    Hughes faces a maximum 10 years in prison, a $250,000 fine and three years of supervised release. Sentencing is set for April 12, 2019. Hughes is released.

    The government intends to seek restitution for the Veterans Administration and the Social Security Administration for an estimated loss totaling $830,061, with the understanding that Hughes will dispute that figure and that a judge ultimately will determine loss and restitution before imposing sentence.

    If the case had proceeded to trial, the government would have presented the following information as evidence:

    Hughes, a Navy Veteran, was determined in 2009 to be 100 percent disabled by the VA based on confirmation of a prior diagnosis that he suffered from multiple sclerosis. Hughes represented he had total loss of both hands and feet in addition to other maladies. From 2009 through July 2018, Hughes received more than $7,000 a month from the VA.

    In addition, because the VA had rated Hughes 100 percent disabled, he qualified for SS disability insurance benefits. The Social Security Administration paid Hughes and some of his family members about $1,400 a month from 2009 until the present.

    During the nine-year period, Hughes misrepresented the nature and extent of his disabilities to VA doctors and other health professionals by claiming he could not drive or walk more than a few steps, had double vision, had little to no feeling in his left arm and leg, could not shop for himself or prepare his own meals and was essentially bound to either his bed or a motorized wheelchair.

    An investigation found that Hughes drastically overstated his symptoms and limitations. In June 2017, the VA and SSA began an investigation into the extent of Hughes’ disability, which culminated in a Compensation and Pension Examination on Jan. 23, 2018 in Helena.

    During the examination, Hughes claimed he had not driven since 2008 without adaptive equipment and did not drive to Helena for the appointment. He said he could not walk more than a few steps and chose to remain in a wheelchair during the entire exam. He also said he could not shop for himself, was essentially house-bound, had almost no feeling in his left arm and leg and could not open his left hand because of spasticity caused by MS.

    Unbeknownst to Hughes, law enforcement officers surveilled Hughes when he arrived for the appointment, recorded and monitored the entire exam and surveilled him when he left the VA. Officers saw Hughes drive himself to the appointment in a truck with no adaptive equipment and walk into and out of the VA. Hughes then drove himself around Helena, running errands, including walking with a cane around a grocery store and using both hands to play machines at a local casino.

    Agents also surveilled Hughes’ activities in the Flathead Valley in 2017. Agents saw Hughes drive a car and a Harley Davidson motorcycle several times, walk distances he had claimed for years he could not cover and do chores, including climbing a ladder during a snowstorm to brush snow off the roof of a recreational vehicle.

    On Aug. 1, 2017, Hughes received a direct deposit of $7,056 from the VA into his bank account. The same day, agents observed Hughes drive his motorcycle to and from a car wash and walk about 50 feet without a cane.

    When agents interviewed Hughes at his residence in February 2018, he stuck to his story about the extent of his disabilities but admitted to driving a motorcycle in the summer of 2017 and to driving to the VA exam in January. He eventually admitted to making some misrepresentations to the examiner at the VA and told the agents, “If it was wrong, it was wrong.”

    Assistant U.S. Attorney Timothy Racicot is prosecuting the case, which was investigated by VA’s and SSA’s Offices of Inspector General.

    Source

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  • Research Funding

    Today, the president signed a bill that increases federal research funding and takes important steps to better support our nation's care partners. Through its tireless advocacy work, the Parkinson's community played a role in the passage of this important law.

    Law Bolsters Funding for Research

    A critical provision provides funding for the National Neurological Conditions Surveillance System. This database will capture demographic information on people living with neurological diseases, which is key to helping researchers target their work and increase understanding of these conditions. While it was signed into law in late 2016, the database was never funded or implemented. But with the passage of this bill, it now can become a reality. (As the law does not specify which diseases the National Neurological Conditions Surveillance System will track, the Foundation is working with the Centers for Disease Control and Prevention, which will house the database, to push for the inclusion of Parkinson's.)

    The law also includes a $2 billion funding increase for the National Institutes of Health (NIH). The NIH is the largest public funder of Parkinson's research, investing $169 million in the disease in 2017. This funding boost is key to supporting the foundational research the agency carries out to better understand, diagnose and treat various health conditions.

    Throughout 2018, the Parkinson's community made a strong push for these funding priorities. Thousands of people with Parkinson's and their loved ones sent their lawmakers more than 46,000 emails asking for money for the database and the NIH. These funding successes are a testament to the critical work of Parkinson's advocates across the country.

    New Council Seeks to Better Support Care Partners

    Another significant provision in the law provides $300,000 to fund activities outlined in the RAISE Family Caregivers Act. This act was signed into law in January 2018, thanks in part to the advocacy efforts of the Parkinson's community, and directs the government to create a national strategy to better support the estimated 40 million care partners across the country. The $300,000 will be used to create a Family Caregiving Advisory Council, which will identify actions that communities, providers, policymakers and others can take to better assist care partners.

    We encourage you to reach out to you legislators to thank them for passing this law. This helps members of congress better understand how they can use their votes to pass bills that positively impact our community. You can quickly send your lawmakers an email on our website.

    Source

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  • Congressman Wants Answers

     

    ST. PETERSBURG, Fla. (WFLA) - Alarmed by an 8 On Your Side investigation of a Veteran mistreated by the VA, Florida Congressman Gus Bilirakis made a beeline to his home state to get answers and offer help.

    The Pinellas County Representative wants to know why VA doctors couldn't figure out what is wrong with Veteran Mike Henry.

    "This is a Veteran, we've got to give him the best possible treatment you can get," Congressman Bilirakis stated.

    Last week, 8 On Your Side revealed Henry languished in pain for months under VA care.

    That changed quickly when Henry visited Tampa General Hospital, where he was diagnosed with a neurological disorder within an hour.

    Henry suffers from a condition in which nerve cells in his brain trigger uncontrollable muscle contractions in his face, neck and shoulder.

    It causes intense pain and swelling.

    "It actually feels like somebody has a knife, a steak knife in here, and they're just slowly twisting," Henry said as he pointed to his temple.

    According to Henry, one Bay Pines doctor called him a faker and accused him of being after drugs.

    "Then he grabs me right here, my neck was swollen and he's shaking me around. And then I said, 'what are you doing? Are you crazy?' He goes, 'oh you're talking normal now, you're just a faker, I told you that's what you were,'" Henry recalled.

    Henry explained what he experienced at the VA's C. W. Bill Young Medical Center at Bay Pines to Congressman Bilirakis.

    "We want to help them. I told them I'll help them, whether they want to stay with the VA at Bay Pines or transfer possibly to Haley or get private care, I'm here to help," Congressman Bilirakis said.

    The home visit left Mike and Shelly hopeful, especially since Bilirakis offered one of his staff to accompany Mike.

    "He would like to go with Mike to his next VA appointment and he's going to follow up with us," Shelly Henry added.

    Henry has a medical background. He hopes to sit with the VA to discuss mistakes he thinks the Bay Pines made.

    "Then maybe that would let them know, 'ah ha, maybe this is something we need to look at,'" Henry explained.

    The Henrys are thankful someone is watching out for them.

    "I will be forever grateful for you guys for doing this and hopefully you guys aren't just covering my case, you'll help some of the other Veterans and let the people know they have a voice," Henry added.

    "You have been wonderful," Shelly Henry said. "Thank you so much, I really hope this helps other Veterans.

    Now that a Congressman is watching over Mike Henry's case, he is hopeful a more meaningful dialogue will take place with Bay Pines about his care and treatment.

    Source

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  • Vet went without diagnosis

     

    ST. PETERSBURG, Fla. (WFLA) - An 8 On Your Side investigation into why the Department of Veterans Affairs failed a Pinellas County Veteran has two Congressman demanding answers.

    Rep. Gus Bilirakis (R) FL and Rep. Charlie Crist (D) FL want to know why doctors at the C.W. Bill Young VA Medical Center couldn't figure out what was wrong with Mike Henry.

    They also want to know if this Veteran was mistreated while he was a patient at Bay Pines.

    Mike Henry told 8 On Your Side that one VA doctor called him a faker and drug seeker and even grabbed and shook him.

    The VA says it investigated that allegation but can't confirm it.

    After months of tests it also couldn't confirm what was wrong with Mike Henry.  

    Congressman Gus Bilirakis labels it VA incompetence.

    "It's inexcusable for the Veteran to have that type of pain," Rep. Bilirakis said.

    Following 8 On Your Side's Thursday report detailing the inability of Bay Pines to diagnose Henry's problem, Congressman Crist is reaching out "to ensure he is receiving the medical care, support and assistance he needs."

    So is Bilirakis.

    "I'll go over to his house and talk to him personally," explained the congressman.

    "That way I get a better understanding of what happened and I hear directly from him and his wife and then we'll go to work for him."

    Henry's medical issues flared up in June.

    Severe swelling in his shoulder, neck, and face, caused excruciating pain.

    Why couldn't VA doctors figure it out?

    In an email Bay Pines told us, "The symptoms Mr. Henry presented....were evaluated...laboratory tests and imaging results were not conclusive."

    Nonetheless a VA doctor concluded, "This patient has no active neurological disease to require further attention from our neurology service."

    "I'm thinking I'm going to sit here and die," Henry stated.

    He left Bay Pines and went to Tampa General Hospital.

    Within an hour, doctors quickly determined a neurological problem triggered uncontrollable muscle contractions.

    According to Henry, one VA doctor called him a faker and a drug seeker.  

    "Then he grabs me right here, my neck was swollen, and he's shaking me around and then I said, 'what are you doing? Are you crazy?' He goes, 'oh you're talking normal now, you're just a faker, I told you that's what you were,'" Henry explained.

    The VA contends it investigated the allegation and could not substantiate it.

    His wife Shelly says Henry suffered tremendously at the VA.

    "It breaks my heart to see that happen to anybody, especially him and especially Veterans," Shelly explained.

    "The way Veterans are treated, they're treated like garbage. They're treated like garbage in this country, especially by the VA. It's really sad."

    An email from Bay Pines claims it offered to refer Henry to outside specialists but he declined.

    He contends that is just not true. He says the VA did not approve visits its doctors recommended.

    An email sent to the Bay Pines Chief of Staff by Shelly pointed out they ran up medical costs of close to $200,000 visiting outside specialists.

    The VA states Henry left the hospital against medical advice.

    Nursing notes show his attending physician said, "they've tried everything, now they will try nothing and see how bad it gets."

    At that point, Henry decided it was time to leave.

    Source

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  • Bad Paper Vets

     

    For an estimated 500,000 Veterans, being put out of the military with an other than honorable discharge is a source of shame and an obstacle to employment. "Bad paper," in most cases, means no benefits or health care from the Department of Veterans Affairs — even when the problems that got them kicked out were linked to PTSD, traumatic brain injury or military sexual assault.

    But last month, Connecticut opened state VA resources to Vets who can show that one of those conditions is linked to their discharge. For Veterans like Thomas Burke, now a youth minister at Norfield Congregational Church, it's part of a long path to recovery.

    "When I first started looking for jobs, I did not want to be a youth minister to kids, because my PTSD stems from a traumatic event where I failed children," says Burke.

    Burke did two combat deployments with the Marine Corps within the space of one year. After a rough tour in Iraq, he found himself in southern Afghanistan, based in a tiny village, living close to civilians. Burke had been trained in the local language, and he connected with the village kids. In one photo, Burke is in combat gear, playing with 15 laughing boys on a dusty road. He says local boys helped out — they would tell them where IEDs were. He grew to love them and they loved him back.

    "They'd bring us bombs," he says. "On one of those occasions they were bringing us [a rocket-propelled grenade], and it ended up exploding on them."

    When Burke heard the blast, he and other Marines rushed out to find eight of the kids from that photo dead.

    That sent him into a spiral — the local hashish was plentiful and many soldiers used it. Burke started smoking heavily and got caught.

    Suddenly a promising young Marine was getting kicked out with an other than honorable discharge — a sort of scarlet letter for a Veteran, which many say is worse than never having served at all.

    Burke was flown to his home base in Hawaii, where a mix of prescriptions and street drugs made things worse. Then, he flew back home.

    "I took a plane to Connecticut and slit my wrists in a state park," he says.

    Veterans with an other than honorable discharge have higher rates of suicide. They're at higher risk of homelessness. Mental health issues can snowball with economic ones: When employers ask about military service, they also ask about discharge status — so for job prospects, it is worse than never having served.

    "These individuals up till now were denied clinical support services and other programs and benefits, and we believe in many cases may have resulted in a worsening of their conditions," says Thomas Saadi, Connecticut's commissioner for Veterans affairs.

    Saadi says it makes both moral and practical sense to help these Vets before they're in crisis. And that's what Connecticut is now doing, thanks in part to the efforts of Veterans like Burke.

    After Burke's failed suicide attempt, the VA made a rare exception, and he was able to get services. He started down a different path — to become a pastor.

    And he joined a push to change the law around other than honorable discharge. He found allies in the state Legislature, like Republican Rep. Brian Ohler, also a combat Vet.

    "When we testified before the Veterans Affairs Committee, [Thomas] and I were sitting right next to each other," says Ohler. "And I said the only difference between Thomas and I is a piece of paper — one that says honorable discharge and the other that says other than honorable."

    It took years of lobbying, but as of last month, Connecticut Veterans whose other than honorable discharge is linked to PTSD, brain injury or sexual assault will qualify for state health care and benefits, including tuition to state schools.

    The national VA is changing too — earlier this year Sen. Chris Murphy, D-Conn., pushed through legislation that makes VA mental health care available nationwide to Veterans with other than honorable discharges, though it has been slow to roll out.

    For Burke, helping get recognition and treatment for other bad-paper Vets has been part of feeling whole again. When he hears kids laughing, it still triggers memories of Afghanistan, but he can smile through them now.

    "The opportunity to work with children fills me with the spirit and life and joy in a way that I can't even explain, because it also makes me recognize how far I've come from the person who got back from war," says Burke.

    Source

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  • Vets Felony Charges

     

    Majority in Felony Veterans Treatment court appear for drug, alcohol offenses

  • Vet Pensions

     

    VIRGINIA BEACH, Va. (WAVY) -- 10 On Your Side is helping Veterans prepare for a new rule that goes into effect on Thursday, Oct. 18.

    According to the U.S. Department of Veterans Affairs, pensions will change beginning Thursday for those of you using long-term care services.

    Shannon Laymon-Pecoraro, a lawyer with Hook Law Center, says failing to plan is planning to fail when it comes to these changes.

    "In a region like ours that is home to so many military Veterans, we think it’s important to tackle this issue head-on so people can start to address these changes before they take effect," Laymon-Pecoraro said.

    Laymon-Pecoraro is referring to Veterans like Frank Rough, a retired senior chief who served in Vietnam.

    "I planned all my life for retirement and to have that possibly taken away so I could have Veterans benefits is crazy," said Rough.

    Rough is talking about changes that could make it more difficult to qualify for certain important benefits, according to Hook Law. That's why Rough and other Veterans attended a Hook Law seminar regarding the changes.

    The VA pension program is a needs-based benefit for wartime Veterans who served at least 90 days active duty service, who have limited or no income, who are 65 and older and who may have a permanent and non-service connected disability.

    What's at risk? According to Hook Law, aid and attendance pension up to $2,170 per month for a Veteran and spouse -- which is money that could be used for long-term care.

    With the new rules, assets cannot exceed $123,600 to get the long-term benefits.

    According to the seminar presentation, gifts that you made in the past 36 months -- either to a family member or to an irrevocable trust and an investment in an annuity -- would be penalized with the new rules.

    This means you could be prohibited from qualifying for VA pension benefits for up to five years, depending on the amount of the gift.

    "I'm getting older and I may need long-term care and if I go into long term care and they start taking the money I've saved - that's awful," said Rough.

    So, what should you do between now and Oct. 18?

    Laymon-Pecoraro said, "Assess are there any significant transfers you want to make or any assets you want protected so that you can then qualify for this benefit if you think you may need within the next 3 to 5 years."

    It is important to note this change does not affect all Veterans.

    According to Hook Law, if you are receiving VA service-connected disability or compensation payments, your benefits will not be affected.

    Source

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  • Salathiel Gaymon Sr

     

    More than a year after her father died in his car in the parking lot of the Wilmington Veterans Administration Medical Center, Shelatia Dennis still struggles to understand why.

    Salathiel M. Gaymon Sr.'s body was found April 25, 2017, more than 17 hours after he walked out of the facility after his regular treatment in the Hemodialysis Unit.

    Dennis believes her father shouldn't have been discharged without having his condition assessed more closely.

    Gaymon's death prompted an investigation by the Department of Veterans Affairs Office of Inspector General, which published a report in September that judged the VA harshly but didn't place blame.

    The unit nursing staff did not appropriately monitor the patient's medical status, the report said, but could not "substantiate" that the care contributed to his death.

    An autopsy indicated that Gaymon had cardiovascular and kidney disease and "probably" suffered a fatal cardiac arrhythmia.

    The report did say that based on the available information and review of the electronic health record, quality of care concerns were identified related to Gaymon's clinical management while in the dialysis unit.

    Changes at the VA

    Wilmington VA Medical Center Director Vincent Kane said a day doesn't go by that he and his staff don't think about the events leading up to the tragedy. He was appointed shortly after Gaymon's death.

    The OIG report and internal analyses sparked changes in staffing and procedures, including many within the dialysis unit and police department.

    "If we could go back in time and know what we know now, I'm confident this wouldn't happen," Kane said. "We're committed to never letting something like this happen again."

    Chief among the 14 recommendations from the OIG was having the proper number of staff members in the Hemodialysis Unit and providing continuous education in all areas of the unit.

    According to Kane, that has happened and is now ongoing.

    "We've added a tremendous amount of staff since my arrival," said Kane. "We want to make sure we have processes and staffing in place to prevent tragedies moving forward."

    The police department has a new chief and those involved in the Gaymon tragedy were disciplined.

    Appointed rounds directed by VA policy were not done, meaning no one noticed Gaymon.

    "Those rounds should have happened. It's devastating to us," Kane said. "We've added more cameras and a training officer to make sure officers are compliant."

    A man of principles

    Dennis described her father as a man whose love of family was matched only by his love of God.

    She said he had no problem expressing the love and pride for his family and was an affectionate man who couldn't encourage his kids and grandchildren enough.

    But Dennis said her father also was all about advocacy and justice and often spoke out against injustices in the world. That is why one of his favorite musicians was Bob Marley, she said.

    Dennis believes what happened to her father was an injustice.

    "The quality of care that he was given was very poor," Dennis said recently from her Dover home on what would have been her father's 64th birthday. "It seems like anything that could have gone wrong did go wrong. It makes me so angry that they could get away with this."

    Questionable discharge

    Dennis said her father's blood glucose readings were through the roof that day in the Hemodialysis Unit, he was administered the wrong medication at the wrong time, his blood pressure was critically high and he was allowed to be discharged.

    "He was not OK," she said. "How could they not see something was wrong? If they had, maybe we wouldn't have had to have a funeral in May."

    Gaymon had been a regular patient at the Wilmington VA Medical Center since 1997 after he was diagnosed with diabetes. His medical records indicate he was often "noncompliant" in his treatment regimen and his diabetes was "uncontrolled" from 1997 to 2017.

    Dialysis was initiated in early 2016, and a few months later a kidney specialist ordered a blood sugar reading prior to each of his dialysis treatments.

    Critical to Gaymon's treatment were differences of opinions about unit policies concerning the patient's finger-stick blood sugar check.

    Gaymon's blood sugar was obtained 38 minutes after starting dialysis and it was shown to be critically high.

    According to the OIG report, a unit registered nurse believed it was acceptable to test the blood sugar within an hour of beginning treatment.

    The Office of Inspector General staff found no such policy.

    The OIG determined that the combination of the timing of the blood glucose test, which found Gaymon's blood sugar critically high and sparked a "routine" call for insulin rather than "stat," or immediately, resulted in more than a two-hour difference in treatment.

    The OIG report said the nursing staff did not check Gaymon's blood glucose before releasing him.

    Contributing issues

    Policies regarding treatment of Gaymon's critically high blood pressure also were called into question by the report.

    Gaymon was given medication to bring down his high blood pressure and then released 18 minutes thereafter.

    The medication given reduces blood pressure within 30 to 60 minutes, with the maximum decrease occurring within two to four hours, the report said.

    The report also said there was no evidence that staff conducted a full clinical assessment or provided Gaymon with instructions regarding the effects of the medication, including drowsiness and a recommendation not to drive.

    Dennis said video from the facility showed an unsteady, unhealthy individual in medical distress as her father walked out of the dialysis unit and fell on the hood of his car before getting in it.

    "The report was more confirmation," she said. "We already had a gut feeling that there was very poor quality of care and that there was definitely negligence on their part. We just didn't understand to what extent."

    Undignified death

    Dennis believes that even though the nurses and doctors failed her father, the Department of Veterans Affairs Police had an opportunity to "pick up the slack had they been doing their job."

    If police had done timely rounds in the parking lots as policy requires, they would have noticed Gaymon sitting in his car in a no-parking zone in valet parking.

    A hospital volunteer came across Gaymon in his car and alerted police.

    "If they would have noticed him within an hour, that might have been enough time to alert the doctors and get some help," Dennis said. "There was no dignity in the way he died."

    The officers were supposed to walk or drive the facility every hour, "so long as they are not on another call or doing a report.”

    The report said the facility's police officers violated policies by leaving the patient’s car in a visible illegal parking spot for more than 17 hours.

    Dennis recognizes her father's death affected changes, but said she will forever hold the facility accountable for taking her father away "too soon."

    "There were so many opportunities for people to make decisions that would have supported his life being sustained," Dennis said. "The healthcare was obviously the first misstep. But if the police force would have been doing its job, my father might still be alive today."

    Source

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  • HERB EXPOSURE

    Veterans who served at Fort Drum, New York during certain years may have been exposed to Agent Orange, a toxic herbicide used during the Vietnam War.

    DOCUMENTSSHOW HERBICIDES WERE TESTED ATFORT DRUM

    A document from the Department of Defense (DoD) shows that a formulation of 2,4-D and 2,4,5-T, the two ingredients in Agent Orange, were tested by the U.S. Army Chemical Corps in an approximately four square mile area of Fort Drum in the summer of 1959. According the document, thirteen drums totaling 715 gallons of Agent Purple, made up of concentrated butyl esters of 2,4-D and 2,4,5-T, were sprayed by helicopters over 2,560 acres of Fort Drum.

    COURT ISSUES DECISION DETAILING HERBICIDE USE ATFORT DRUM

    The Court of Appeals for Veterans Claims recently issued a decision in a case in which a Veteran claimed service connection for multiples conditions due to exposure to Agent Orange at Fort Drum. The Court’s decision discussed numerous documents that the Veteran submitted for his claim which detail the use of Agent Orange and other herbicides at Fort Drum as early as 1959 up to the 1970s.

    SUMMARY OF THE CASE

    The Veteran served in the United States Army from February 1971 to December 1972. He then entered the US Army Reserves and spent two weeks training at Fort Drum, New York in August 1974. In December 2004, he applied for service connection for diabetes mellitus, a heart condition, hypertension, and erectile dysfunction due to exposure to Agent Orange at Fort Drum. He was denied service connection and eventually appealed twice to the Court of Appeals for Veterans Claims.

    VETERAN SUBMITTED EVIDENCE OF AGENT ORANGE ATFORT DRUM

    To support his claim of exposure to Agent Orange, the Veteran submitted a report from the Chemical Systems Laboratory at Aberdeen Proving Ground dated for July 1981, which discussed investigators finding ten five-gallon metal cans which contained chemicals found in Agent Orange. The report discussed how the herbicides were not properly stored at the base. The report also detailed testing in 1961 of an “experimental defoliant mixture” along the road of the base, and an herbicide that was similar to Agent Orange being used during the 1950s up to the early 1970s. Finally, from 1969 to 1978, herbicides similar to Agent Orange were also used along certain roads in the main impact area of Fort Drum.

    According to the documents detailed in the Court’s decision, Agent Orange was not only tested at Fort Drum, but it was also used for maintenance and to increase visibility around the base.

    Source

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  • Depression awareness

     

    Behavioral health experts say frequent deployments and other aspects of military life can contribute to clinical depression, a condition that negatively impacts mood and behavior. Depression may be more common in the armed forces community than among the civilian population, but it seems to me we still have a culture that may prevent service members from seeking help.

    If depression is something you don’t want to talk about, then let me tell you about my brother. Army Sgt. 1st Class Ruben Leal joined the Army in 1975 and became a tanker, a year after I enlisted and became a Special Forces medic. Ruben always had a smile on his face. He was outgoing and athletic, and also technically and tactically proficient on the job. He was a highly respected and decorated soldier, selected to participate in elite fraternal organizations such as the Sergeant Audie Murphy Club.

    Ruben considered me, his older brother, to be his hero. But truthfully, Ruben was mine. Both of us had come a long way from our troubled childhood.

    By December 1991, I was a senior ROTC instructor in San Antonio, and Ruben was a platoon sergeant at Fort Hood. He’d returned from a deployment in the Gulf War several months earlier. We were less than 200 miles apart, but it might as well have been 2,000. We were both so busy that we didn’t see each other as often as we should have.

    During our telephone conversations, my brother never talked about struggling with depression. Ruben was a proud man, and back then, it wasn’t really the Army’s way to focus on behavioral health issues after deployment – or really, ever.

    Still, I was a trained medic, and Ruben was my brother. When he died by suicide Dec. 4, 1991, I felt tremendously guilty. I realized the signs of depression were there, and I had missed them. I’d missed all of them.

    I don’t blame the military for Ruben’s death. I recognize his combat deployment experiences may have been a contributing factor in triggering a clinical depression that had roots in our dysfunctional upbringing. Since his death, I’ve struggled with depression, too. But I’ve gotten help, and I want to encourage others to do so as well.

    Three years after my brother’s death, I retired from the Army and used my GI benefits to earn accreditation as a licensed vocational nurse. Then I completed a two-year registered nurse program. I’ve dedicated the past eight years of my career to helping patients in the Warrior Transition Unit. A lot of injuries we’re seeing today aren’t only physical injuries, they’re also behavioral health injuries.

    This is my mission now: to encourage everyone to recognize the signs of clinical depression so they can get help -- for themselves or for others. Those signs include feeling negative, worthless, or guilty; loss of interest in previously enjoyable activities; sleeping too little or too much; or feeling restless or anxious.

    Today, my eyes and ears are open to people who are struggling. I ask them, “Do you want to talk to me about it? If you do, I’m ready to listen. But if you don’t, let’s find someone for you to talk to, now. I’ll walk with you. I’m here to help.”

    I tell people with depression that there’s hope. There are a lot of things we can do as health care providers, as senior leaders, as clergy. We can help you, we can get you to the right people. Please let us help you. Opening up is the first step.

    We’re all in this together. I ask you to reach out to help someone else. I ask you to reach out to help yourself.

    Source

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  • Hill and Ponton Logo

     

    When it comes to VA disability compensation, the goal for most Veterans is getting a 100 percent rating. The road to a 100 percent rating can be long and confusing. There are also different ways to get to a 100 percent rating. Below we will discuss the different types of 100 percent disability ratings.

    Total disability based on 100 percent scheduler rating: This is when a Veteran’s single service-connected disability or alternatively, the Veteran’s combined service-connected disabilities total to 100 percent.

    Total Disability/Individual Unemployability:

    Better known as TDIU or IU is a type of rating that can be a bit more complicated than just a regular 100 percent scheduler rating. TDIU is considered once a Veteran has made a request to be paid at the 100 percent rate even though his or her disabilities do not combine to 100 percent. A Veteran may file a claim for this rating when he or she is unable to maintain substantially gainful employment because their service-connected disability keeps them from doing so. Substantially gainful employment for VA purposes is defined by the amount of earned from an employed position. The total amount of earnings from a job is considered gainful if they are above the poverty level. It is also defined as competitive employment where a non-disabled individual may ear a comparable income to the particular occupation in the same area.

    In order to qualify for TDIU or IU, a Veteran must have one disability rated at 60 percent or one disability rated at 40 percent with enough additional disabilities that combine to a rating of 70 percent or above. It is important to keep in mind that just because the initial criteria for IU are met, does not mean that a 100 percent disability rating will be awarded. A Veteran will need to provide medical evidence that shows that they are unable to work in both a physical and a sedentary work environment.

    Temporary 100 Percent Disability Rating:

    This rating is given to Veterans who have been hospitalized for 21 days or longer or had surgery for a service-connected disability that requires at least a 30 day convalescence period. The VA will pay the Veteran at the 100 percent rate for the extent of the hospital stay or convalescence period.

    Permanent and Total Rating:

    The permanent and total rating is given when the VA recognizes that a Veteran’s service-connected disabilities have no probability of improvement. This means that the Veteran will remain at the 100 percent rating permanently without the need for future examinations.

    Veteran often times make the mistake of requesting a permanent and total rating because they want the Chapter 35 educational benefits for their dependents. It is important to keep in mind that whenever a permanent and total rating is requested, all service-connected disabilities will be subject for re-evaluation. If improvement is noted during a re-examination, a reduction from the 100 percent rating may be proposed. It is important to note that most ratings are not considered permanent and are subject to future review.

    Source

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  • Da Nang

     

    The dioxin contamination of soil in Da Nang was worse than expected, experts said at a conference reviewing the cleanup on Tuesday.

    The event, organized by the National Steering Committee for Post-war Clearance of Ordnance and Toxic chemicals and USAID, shared some details on dioxin cleanup at the Da Nang International Airport, a U.S. air base during the Vietnam War.

    Pham Quang Vu, head of the Air Force and Air Defense’s Military Science Division, said earlier calculations had underestimated the actual contamination at the airport.

    He said the actual amount of contaminated soil is 162,500 cubic meters and not 72,900 cubic meters as earlier estimated.

    Anthony Kolb, chief of USAID’s environmental remediation unit, explained that experts only took soil samples from the surface and from that determined the depth to which the dioxin could have penetrated.

    The dioxin had percolated three meters deeper than expected, he said at the conference in Da Nang.

    Vu said the miscalculation could be attributed to the fact this was the first time this particular technology was used to remove dioxin from the soil on such a large scale. It involves heating the contaminated soil while covering it in concrete.

    The finding could help make future dioxin assessments more accurate, especially at another ongoing cleanup project at the Bien Hoa Air Base in the southern province of Dong Nai. Bien Hoa is considered one of the worst dioxin-contaminated spots, with some 850,000 tons of soil feared contaminated.

    "We expect to cleanse 500,000 cubic meters of contaminated soil in Bien Hoa, meaning 50 hectares of land," Chung said.

    Since 2012, when the Da Nang project was initiated, it has cleaned 94,600 cubic meters of soil at the airport, reducing the dioxin level from 1,200 parts per trillion (ppt) to below 150ppt, and has placed 68,000 cubic meters of contaminated soil in the southwestern part of the airport, which contained less than 1,000ppt of dioxin, under long-term management. Dioxin concentration of 100ppt is considered high.

    Kolb of USAID said 32.4 hectares of land has been cleaned.

    "This project is the most ambitious we have ever undertaken."

    Da Nang has been off the official list of dioxin contaminated spots in Vietnam after the cleanup, Vu said.

    The cost of the work is budgeted at around $108.5 million, with $106 million coming from ODA grants.

    Vietnam still has 28 dioxin hotspots, including airports in several cities and provinces which were used by the U.S. military during the Vietnam War.

    The government hopes to complete the task of decontaminating the country’s soil by 2030.

    Dioxins and dioxin-like compounds were contained in Agent Orange, which was sprayed by the U.S. military from 1961 to 1971 to clear jungle hideouts of Vietnamese soldiers. Some 80 million liters of the deadly defoliant are said to have been sprayed over 78,000 square kilometers (30,000 square miles) of Vietnamese territory.

    The chemical, which stays in the soil and at the bottom of lakes and rivers for generations, was later found to be capable of damaging genes, causing deformities in the offspring of exposed individuals.

    The Vietnam Red Cross estimates 2.1 to 4.8 million Vietnamese were directly exposed to Agent Orange and other chemicals that have been linked to cancers, birth defects and other chronic diseases since the war.

    Source

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  • Agent Orange 004

     

    GRAND RAPIDS, Mich. — A chemical sprayed on troops by the US military during the Vietnam War is continuing to impact the lives of Veterans and their families. One Michigan Vietnam Veteran is teaming up with the group Vietnam Veterans of America to do something about it.

    Philip Smith conducts meetings like this one Saturday in Grand Rapids throughout Michigan to warn Veterans about a silent killer many of them are unaware of Agent Orange.

    Smith serves as the director for Vietnam Veterans of America.

    “When Admiral Zumwalt was alive and he was the Admiral of the Navy.” “’He says don’t spray that stuff ‘well guess what we did and the ultimate factor is the disease that came down with it afterward,” he said.

    It was a herbicide used to eliminate forest cover and crops during the Vietnam War. Agent Orange is a toxic chemical that’s known to be associated with several illnesses and diseases. Many of them are considered deadly.

    “I’ve got a charcoal foot now because of it which went crooked. I had open heart surgery a little less than two years ago because of it,” said Jeron Hendricks, a Vietnam War Veteran.

    Hendricks served in Vietnam and says he now suffers from a number of illnesses impacting his legs and heart, but he was only able to receive compensation from the Veterans Administration four years after being able to prove his conditions were in fact related to the herbicide Agent Orange.

    “If things start happening to you, your family members, or relatives and nobody can figure it out well it’s a good chance if you were in service that this is part of that reason,” Hendricks said.

    And the chemical is just one of the Tactical Use rainbow herbicides impacting America’s Veterans. Information that the Vietnam Veterans of America are sharing by setting up presentations such as this in hopes of getting Veterans the knowledge they need to get the proper care and money that they deserve.

    “A lot of them are coming forward now saying ‘well I got some of these symptoms what do we do,” and that’s where Phil comes in he helps them get a claim into the VA and they get compensated for it and it also puts them on the record that they’re Agent Orange,” said Ken Rogge, the VVA Michigan first vice president.

    Over the last few years, more Veterans have come forward with claims about Agent Orange related illnesses and now signs of its impact are reaching past the Veterans to children, grandchildren and into further generations.

    To learn more about Agent Orange click here.

    Source

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  • Vet Benefits

     

    Different government programs have different Veteran criteria

    There is no standardized legal definition of "military Veteran" in the United States. Veteran benefits weren't created all at one time. They've been added one at a time for more than 200 years, and each time Congress passed a new law authorizing and creating a new Veteran benefit, it included eligibility requirements for that particular benefit.

    Whether or not one is considered a "Veteran" by the federal government depends upon which Veteran program or benefit one is applying for.

    Veterans' Preference for Federal Jobs

    Veterans are given preference when it comes to hiring for most federal jobs. However, in order to be considered a Veteran for hiring purposes, the individual's service must meet certain conditions.

    Preference is given to those honorably separated Veterans (this means an honorable or general discharge) who served on active duty in the Armed Forces. Retirees at or above the rank of major or equivalent are not entitled to preference unless they qualify as disabled Veterans.

    For more information about the Veteran's Preference Hiring Program, see the Federal Government's Veteran's Preference Web Page.

    Home Loan Guarantee

    Military Veterans are entitled to a home loan guarantee (within dollar limits) when they purchase a home. While this is commonly referred to as a "VA Home Loan," the money is not actually loaned by the government. Instead, the government acts as a sort of co-signer on the loan, and guarantees the lending institution that they will cover the loan if the Veteran defaults. This can result in a substantial reduction in interest rates, and a lower down payment requirement.

    For more information, see the VA's Home Loan Guarantee Web site.

    Burial in a VANational Cemetery

    To qualify as a Veteran for the purposes of burial in a VA National Cemetery also depends on the conditions and period of service. Any member of the Armed Forces of the United States who dies on active duty is obviously eligible.

    Any Veteran who was discharged under conditions other than dishonorable is usually eligible as well.

    Service beginning after September 7, 1980, as an enlisted person, and service after October 16, 1981, as an officer, must be for a minimum of 24 continuous months or the full period for which the person was called to active duty (as in the case of a Reservist called to active duty for a limited duration) to qualify for VA National Cemetery burial.

    Undesirable, bad conduct, and any other type of discharge other than honorable may or may not qualify the individual for Veterans benefits, depending upon a determination made by a VA Regional Office. Cases presenting multiple discharges of varying character are also referred for adjudication to a VA Regional Office.

    For more criteria for burial at Arlington National Cemetery can be viewed on the VA's National Cemetery's Web Site.

    Military Funeral Honors

    The Department of Defense (DOD) is responsible for providing military funeral honors. "

    Upon the family's request, every eligible Veteran receives a military funeral honors ceremony, to include folding and presenting the United States burial flag and the playing of Taps. The law defines a military funeral honors detail as consisting of two or more uniformed military persons, with at least one being a member of the Veteran's parent service of the armed forces.

    For more information, see the DoD's Military Funeral Honors Web site.

    Active DutyMontgomery GI Bill

    In all cases, the ADMGIB expires 10 years after discharge or retirement. To be eligible, one must have an honorable discharge. To retain MGIB benefits after discharge, in most cases, one must serve at least 36 months of active duty, if they had a four-year active duty contract, or at least 24 months of active duty, if they signed up for a two or three-year active duty contract (there are some exceptions to this rule).

    For complete details, see our ADGIB Article.

    Post-9/11 GI Bill

    If you have at least 90 days of aggregate active duty service after September 10, 2001, and are still on active duty, or if you are an honorably discharged Veteran or were discharged with a service-connected disability after 30 days, you may be eligible for this VA-administered program. See details.

    Service-Disabled VA Life Insurance

    To be eligible for basic Service-Disabled Veterans Insurance (S-DVI), a Veteran must have been released from active duty under other than dishonorable conditions on or after April 25, 1951. He/she must have received a rating for a service-connected disability and must be in good health except for any service-connected conditions. An application must be made within two years of the granting of service-connection for a disability.

    For complete details, see the VA Life Insurance Web site.

    VA Disability Compensation

    Disability compensation is a benefit paid to a Veteran because of injuries or diseases that happened while on active duty or were made worse by active military service. It is also paid to certain Veterans disabled from VA health care.

    The amount of basic benefit paid varies depending on the nature of your disability. Note: You may be paid additional amounts, in certain instances, if:

    • you have very severe disabilities or loss of limb(s)
    • you have a spouse, child(ren), or dependent parent(s)
    • you have a seriously disabled spouse

    For complete information, see the VA's Disability Compensation Web site.

    VA Disability Pension

    Disability Pension is a benefit paid to wartime Veterans with limited income who are no longer able to work.

    You may be eligible if:

    • you were discharged from service under other than dishonorable conditions
    • you served 90 days or more of active duty with at least 1 day during a period of wartime. (However, anyone who enlisted after September 7, 1980, generally has to serve at least 24 months or the full period for which a person was called or ordered to active duty in order to receive any benefits based on that period of service)
    • you are permanently and totally disabled, or are age 65 or older
    • your family income is below a yearly limit set by law

    VA Medical Care

    The Veterans Health Administration (VHA) provides a broad spectrum of medical, surgical, and rehabilitative care to eligible Veterans.

    If you have a discharge other than honorable, you may still be eligible for care. As with other VA benefits programs, the VA will determine if your specific discharge was under conditions considered to be other than dishonorable.

    The length of your service may also matter. It depends on when you served. There’s no length of service requirement for:

    • Former enlisted persons who started active duty before September 8, 1980, or
    • Former officers who first entered active duty before October 17, 1981

    The number of Veterans who can be enrolled in the health care program is determined by the amount of money Congress gives VA each year. Since funds are limited, VA set up priority groups to make sure that certain groups of Veterans are able to be enrolled before others.

    For more information, see the VA's Health Care Web site.

    Source

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  • DoD FDA working together

     

    In a move to better serve the unique needs of the nation’s warfighters, leaders from the U.S. Food and Drug Administration and the Office of the Assistant Secretary of Defense for Health Affairs signed a memorandum of understanding to foster and prioritize the development of critical medical products.

    The signing of the memorandum formalizes the partnership between the FDA and the Department of Defense that was authorized under a law enacted by Congress in 2017. Under this law, DoD is able to request help in speeding up development and review of products used to diagnose, treat, or prevent serious or life-threatening diseases and conditions faced by service members. It also allows for emergency use of medical products for threats that pose a specific risk to service members, including biological, chemical, radiological, or nuclear agents.

    The FDA will continue to work with DoD to evaluate how to best access medical products that serve the military’s medical needs and rush review of priority DoD medical products. The FDA will also provide advice for the development and manufacturing of these products, and examine those that are already under development to determine which will streamline review.

    The memorandum directs specific actions between the agencies, including semi-annual meetings at the senior-leader levels, quarterly meetings with FDA centers, and collaborations on emergency use of products.

    Dr. Terry Rauch, acting deputy assistant secretary of Defense for Health Readiness Policy and Oversight, said the memorandum enables the Military Health System to speak through one voice with the FDA on strategic issues and to move forward on urgent needs with a prioritized DoD list for the FDA to focus on.

    “DoD and FDA have always been committed to safe and effective products for our service members, and this [memorandum] really solidifies the needed relationship to provide these most effectively,” said Rauch. “We have already seen increased readiness due to the collaborative efforts with the approval of three medical products since the release of the law.”

    The FDA has approved the use of an auto-injector for nerve agent exposure, a prophylactic drug for malaria, and the RECELL system for point-of-care skin regeneration in trauma patients. These products were approved after the release of the law, and the memorandum strengthens these efforts even further, he said.

    “These products are critical to warfighter readiness in deployed environments and to the far-forward care settings that we face,” said Rauch. “Battlefield trauma and prolonged field care are at the forefront of challenges in military medicine.”

    Earlier this year, the FDA granted emergency use authorization for DoD’s use of freeze-dried plasma. Rauch described it as a life-saving product designed for austere environments, which can now be used in a much more streamlined process under the authorization. In addition, the FDA approved a new malaria prophylactic drug, tafenoquine, in August.

    “The FDA has been incredibly helpful and forward-leaning with all aspects of interaction on DoD medical product development,” said Rauch. “We are grateful that there is an increased interest by the leadership to drive collaboration, and we are leveraging that interest to the fullest.”

    Source

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  • Dominoes

     

    Recreational therapist Lauren Reynaga had never played dominoes before her internship and subsequent employment with VA North Texas.

  • Dothan Closes

     

    DOTHAN, Ala. (WDHN) - Dothan's Veterans Affairs clinic is closing, leaving thousands of military Veterans with major questions about where they will receive health care in the future.

    Nov. 30, 2018, will be the final day of operation for the Alexander Drive location across from Southeast Alabama Medical Center.

    There are contracted employees along with a small number of actual federal government employees in this facility.

    Once it closes, almost 5,000 patients — military Veterans — will be forced to use other VA options.

    WDHN is committed to finding more answers as to what the future holds for local VA patients.

    Source

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  • Agent Orange 003

     

    For decades, the military and the VA have repeatedly turned to one man to guide decisions on whether Agent Orange harmed Vets inVietnam and elsewhere.

    His reliable answer: No.

    A FEW YEARS AGO, retired Maj. Wes Carter was picking his way through a stack of internal Air Force memos, searching for clues that might help explain his recent heart attack and prostate cancer diagnosis. His eyes caught on several recommendations spelled out in all capital letters:

    “NO ADDITIONAL SAMPLING …”

    “DESTROY ALL …”

    “IMMEDIATE DESTRUCTION …”

    A Pentagon consultant was recommending that Air Force officials quickly and discreetly chop up and melt down a fleet of C-123 aircraft that had once sprayed the toxic herbicide Agent Orange across Vietnam. The consultant also suggested how to downplay the risk if journalists started asking questions: “The longer this issue remains unresolved, the greater the likelihood of outside press reporting on yet another ‘Agent Orange Controversy.’”

    The Air Force, Carter saw in the records, had followed those suggestions.

    Carter, now 70, had received the 2009 memos in response to public records requests he filed after recalling the chemical stench in a C-123 he crewed on as an Air Force reservist in the years after the Vietnam War. He’d soon discovered that others he’d served with had gotten sick, too. Now it seemed he’d uncovered a government-sanctioned plan to destroy evidence of any connection between the aircraft, Agent Orange and their illnesses. And the cover-up looked like it had been set in motion by one man: Alvin L. Young.

    Carter had gotten his first glimpse of “Dr. Orange.”

    Young had drawn the nickname decades earlier as an Air Force expert on herbicides used to destroy enemy-shielding jungle in Vietnam. Since then — largely behind the scenes — the scientist, more than anyone else, has guided the stance of the military and U.S. Department of Veterans Affairs on Agent Orange and whether it has harmed service members.

    Young tested the weed killer for the Air Force during the war, helped develop a plan to destroy it at sea a decade later — a waste of good herbicides, he’d said — then played a leading role in crafting the government’s response to Veterans who believed the chemicals have made them sick. For a while, he even kept a vial of Agent Orange by his desk.

    Throughout, as an officer and later as the government’s go-to consultant, Young’s fervent defense hasn’t wavered: Few Veterans were exposed to Agent Orange, which contained the toxic chemical dioxin. And even if they were, it was in doses too small to harm them. Some Vets, he wrote in a 2011 email, were simply “freeloaders,” making up ailments to “cash in” on the VA’s compensation system.

    Over the years, the VA has repeatedly cited Young’s work to deny disability compensation to Vets, saving the government millions of dollars.

    Along the way, his influence has spawned a chorus of frustrated critics, including Vets, respected scientists and top government officials. They argue that Young’s self-labeled “investigations” are compromised by inaccuracies, inconsistencies or omissions of key facts, and rely heavily on his previous work, some of which was funded by Monsanto Co. and Dow Chemical Co., the makers of Agent Orange. Young also served as an expert for the chemical companies in 2004 when Vietnam Vets sued them.

    “Most of the stuff he talks about is in no way accurate,” said Linda S. Birnbaum, director of the National Institute of Environmental Health Sciences, part of the National Institutes of Health, and a prominent expert on dioxin. “He’s been paid a hell of a lot of money by the VA over the years, and I think they don’t want to admit that maybe he [isn’t] the end all and be all.”

    Birnbaum, whose agency studies how environmental factors affect health, questions how Young’s training in herbicide science qualifies him to draw some conclusions. “He is not an expert when it comes to the human health effects,” she said.

    Others complain that Young spent years using his government authority to discount or resist new research, then later pointed to a lack of research to undercut Vets’ health claims.

    “For really almost 40 years, there has been a studious, concerted, planned effort to keep any study from being done and to discredit any study that has been done,” said Jeanne M. Stellman, an emeritus professor at Columbia University. Stellman, a widely published Agent Orange researcher, has repeatedly clashed with Young and the VA.

    There’s a reason. In an era in which the military and the VA are facing a barrage of claims from Vets alleging damaging chemical exposures, from burn pits in Afghanistan to hidden munitions in Iraq, Stellman said Young provides a reliable response when it comes to Agent Orange: No.

    Anyone who set foot in Vietnam during the war is eligible for compensation if they become ill with one of 14 cancers or other ailments linked to Agent Orange. But Vets with an array of other illnesses where the connection is less well established continue to push for benefits. And those Vets who believe they were exposed while serving elsewhere must prove it — often finding themselves stymied.

    It’s not just the Vets. Some of their children now contend their parents’ exposure has led to their own health problems, and they, too, are filing claims.

    In recent years, Young, 74, has been a consultant for the Department of Defense and the VA, as well as an expert witness for the U.S. Department of Justice on matters related to dioxin exposure. By his own estimate, he’s been paid “a few million” dollars over that time.

    “He’s an outstanding scientist,” said Brad Flohr, a VA senior advisor for compensation, defending the agency’s decision to hire Young in spite of the controversy surrounding his work. “He’s done almost everything there is. He’s an excellent researcher into all things, not necessarily just Agent Orange.”

    In an interview and emails, Young defended his role. To date, he said, there’s no conclusive evidence showing Agent Orange directly caused any health problems, only studies showing a statistical association. It’s an important distinction, he says.

    “I’ve been blamed for a lot of things,” Young said. He likened the criticism he faces to Republican presidential nominee Donald Trump’s smearing of “Crooked Hillary” Clinton after 30 years of public service: “They say, ‘Crooked Young.’”

    Young said he believes most sick Vets are simply suffering from the effects of old age, or perhaps war itself, rather than Agent Orange. It’s a point even critics say has some validity as Vets have grown older during the benefits battle. His critics, he said, are as biased against the herbicide as he is accused of being for it. “Who’s an impartial expert? Name one for me, by all means.”

    When Carter came across Young’s name, he knew nothing of the controversy that surrounded him. He also had no need for benefits related to Agent Orange: He was already receiving full disability compensation from the VA for a back injury suffered during the first Gulf War.

    Reading the memos after his 2011 cancer diagnosis, it seemed clear there was a link between Agent Orange and illnesses plaguing those who’d flown aboard C-123s.

    But to get answers — and to help others get benefits — he’d have to take on Dr. Orange.

    IN THE SUMMER OF 1977, a VA claims worker in Chicago took a call from the sobbing wife of a Veteran claiming “chemicals in Vietnam” had caused his cancer. The woman mentioned a mist sprayed from above to kill plants on the ground. The claims specialist, Maude DeVictor, called the Pentagon and was transferred to Capt. Alvin Young, who knew more about the chemicals used in Vietnam than perhaps anyone.

    By then, Young, who’d gained an appreciation for herbicides on his family’s farm, had a doctorate in herbicide physiology and environmental toxicology and had spent nearly a decade studying defoliants for the Air Force. In 1961, the U.S. began spraying millions of gallons of herbicides across Vietnam’s thick jungles. Then, in 1971, it halted the effort after the South Vietnamese media reported a surge in birth defects in areas where the chemicals had been used — a political decision, according to Young, who didn’t believe the claims.

    DeVictor peppered Young with questions on the phone that day. Within weeks, she’d identified more than two dozen other Vets who believed their contact with Agent Orange had made them sick. DeVictor prepared a memo on what she had learned and shared her findings with a reporter, spurring national media attention on Agent Orange for the first time.

    “Dr. Young was very helpful. Without him, I wouldn’t have known anything,” said DeVictor. She was later fired by the VA; she claimed for speaking out about the herbicide.

    Young publicly refuted many of the comments attributed to him — especially those suggesting Agent Orange might have harmed Vets — and criticized media reports that he felt sensationalized the risks. But the episode was a turning point, moving Young from the Air Force’s internal herbicide expert to public defender of Agent Orange.

    Over the next decade, as concern grew about the effects of Agent Orange, Young was repeatedly promoted to positions of increasing influence, despite public clashes with prominent politicians and some federal health experts. In 1980, an exasperated Rep. Tom Daschle, D-South Dakota, who later became the Senate’s Majority Leader, challenged Young’s testimony before a House subcommittee by rattling off recent studies and media reports that suggested Vets had suffered because of Agent Orange. “I really find it somewhat interesting,” Daschle said, “that they are all wrong and he is correct.”

    Moments earlier, Young had said he didn’t doubt the competency of other authors, they just couldn’t match his 12 years of analyzing records. “It is a very complex issue,” he said.

    Young’s genial, almost folksy style belied a resolute confidence that while his listeners’ opinions might differ, no one knew Agent Orange as well as he did.

    In a 1981 Air Force research paper titled “Agent Orange at the Crossroads of Science and Social Concern,” Young questioned whether some Vets were using Agent Orange “to seek public recognition for their sacrifices in Vietnam” and “to acquire financial compensation during economically depressed times.” The paper earned him an Outstanding Research Award from the Air Force’s staff college.

    The same year, the Air Force assigned Young to serve as director of the VA’s new Agent Orange Projects Office, in charge of planning and overseeing initial research into emerging health claims. Here, too, he attracted congressional ire. Sen. Alan Cranston, R-California, warned the VA’s chief medical director in 1983 that Young’s dismissive comments about possible health risks might cause the public to doubt the “sincerity of the VA’s effort.”

    Soon after that, the White House tapped Young to serve as a senior policy analyst for its Office of Science and Technology Policy, giving him broad influence over the nation’s policy on dioxin. Over the next several years, the Reagan administration was accused of obstructing, stalling and minimizing research into Agent Orange.

    In 1986, another House committee faulted Young for undermining a planned study of chemical company workers exposed to dioxin. Young maintained that previous studies conducted by Monsanto and Dow of their workers “might have been enough,” the panel’s report said.

    Young recently denied interfering with that research but took credit for helping to shut down a major Centers for Disease Control and Prevention study of Vietnam Vets in 1987 that sought definitive evidence of a link between health issues and Agent Orange. Young said data on who had been exposed wasn’t reliable enough, though others argued that military records on spray missions and troop movements would have sufficed.

    In the end, answering the question of who was exposed was taken out of the hands of the scientists. Under pressure from Vets and their families, Congress passed the Agent Orange Act. Signed into law by President George H. W. Bush in 1991, it presumed that all Vets were exposed if they set foot in Vietnam during the war or traveled in boats on its rivers. And it provided compensation for them if they had certain conditions linked to exposure.

    In Young’s view, the Vets won; the science lost. By his final years at the White House, he was tiring of the battle. Young said emotions had risen so high he began “receiving threats to my family, threats to me.”

    CARTER DIDN’T SERVE IN VIETNAM and thus wasn’t covered by the Agent Orange Act. His connection to the herbicide began in 1974, when for six years he served as a crew member on a C-123 as part of his reserve duty at Westover Air Reserve Base in Massachusetts.

    During the war, C-123s criss-crossed southeast Asia, mostly ferrying troops and supplies. A few dozen were modified for spraying herbicides and insecticide. Back home, most were stripped of the spray gear, cleaned and put into service with the Air Force reserves.

    For Carter, the planes were an exhilarating break from his civilian marketing gig — even though when they flew through rain clouds, water seeped into the cabins and they were always too hot or too cold. He often flew on a C-123 that had been nicknamed “Patches” because it was hit almost 600 times by enemy bullets in Vietnam — then patched up with metal. Over the years, he served as an aeromedical evacuation technician, flight instructor and flight examiner.

    Even then, Patches’ former duties in Vietnam worried Carter and other reservists, who complained about the overpowering odor coming from it. But after an inspection, he said, “the wing commander assured us that the aircraft was as safe as humanly possible.”

    Patches was sent in 1980 to the National Museum of the Air Force near Dayton, Ohio, where it was displayed outside because of its chemical odor. Then, in 1994, during a restoration attempt, Air Force staff toxicologists said samples from the plane showed it was “heavily contaminated” with the dioxin TCDD, an unfortunate byproduct of manufacturing Agent Orange. Later, other planes were also found to be contaminated.

    But no one alerted Carter or any of the 1,500 to 2,100 reservists who’d flown them at least two weekends a month plus two weeks a year, often for years. Instead, most of the contaminated planes were quarantined in Arizona at Davis-Monthan Air Force Base, a sprawling airplane graveyard nicknamed “the Boneyard.” In 2010, at Young’s recommendation, they were destroyed.

    One year later, when Carter learned he had prostate cancer, his best friend from the reserves found out he did, too. With a few phone calls, Carter quickly tallied five from his old squadron with prostate cancer. The sixth he called had died. His squadron commanders and others tied to the planes also had Agent Orange-related illnesses.

    “Nearly two months into this project,” Carter wrote on a blog he kept, “it seems I have trouble finding crewmembers who don’t have AO-illnesses!”

    DECADES AFTER the last of the military’s Agent Orange was supposedly incinerated aboard a ship in the Pacific Ocean, Army Vet Steve House went public in 2011 with a surprising claim: He and five others had been ordered in 1978 to dig a large ditch at a U.S. base in South Korea and dump leaky 55-gallon drums, some labeled “Compound Orange,” in it. One broke open, splashing him with its contents. More than three decades later, House was suffering from diabetes and nerve damage in his hands and feet — ailments that researchers have associated with dioxin exposure.

    Around the same time House came forward, other ailing Vets recounted that they, too, had been exposed to Agent Orange on military bases in Okinawa, Japan.

    The Pentagon turned to a familiar ally.

    “I just heard back from Korea and the situation has ‘re-heated’ and they do want to get Dr. Young on contract,” one defense department official wrote to others in June 2011, according to internal correspondence obtained by ProPublica and The Virginian-Pilot through the Freedom of Information Act.

    By then, Young had established a second career. From his home in Cheyenne, Wyoming, he and his son ran a sort of Agent Orange crisis management firm. His clients: the federal government and the herbicide’s makers — both worried about a new wave of claims.

    In 2006, under contract for the Defense Department, Young had produced an 81-page historical report listing everywhere Agent Orange had been used and stored outside of Vietnam, and emphasizing that even in those places, “individuals who entered a sprayed area one day after application … received essentially no ‘meaningful exposure.’” Among the scholarly references cited were several of his own papers, including a 2004 journal article he co-authored with funding from Monsanto and Dow. That conflict of interest was not acknowledged in the Defense Department report.

    In an interview, Young said the companies’ financial support essentially paid the cost of publishing, but did not influence his findings. He and his co-authors, he said, “made it very clear” in the journal that Dow and Monsanto had funded the article. “That doesn’t mean that we took the position of the companies.”

    The Pentagon also hired Young to write a book documenting its history with herbicides. Published in 2009, the book made Young Agent Orange’s official biographer.

    In 2011, facing the new claims involving South Korea and Okinawa, the Defense Department asked Young and his son to search historical records and assess the evidence. In both cases, they concluded that whatever the Vets thought they’d seen or handled, it wasn’t Agent Orange. Young’s son did not respond to a request for comment.

    Alvin Young dismissed the claims of House and other Vets from Korea, saying he found no paperwork that showed the herbicide had been moved to their base. “Groundless,” Young told the Korea Times newspaper in 2011.

    In Okinawa, Young was similarly dismissive, even after dozens of barrels, some labelled Dow Chemical Co., were found buried under a soccer field. The barrels were later found to contain high levels of dioxin. But Young told the Stars and Stripes newspaper, they were likely filled with discarded solvents and waste.

    Young never spoke to the Vets in either case.

    “Why would I want to interview the Veterans, I know what they’re going to say,” Young told ProPublica, saying he focused on what the records showed. “They were going to give the allegation. What we had to do is go and find out what really happened.”

    In 2012, Young’s firm was hired again, this time by the VA, in part to assess the claims of other groups who believed they’d been sickened by their exposure to Agent Orange. One was led by Carter, a man whose determination appeared to match Young’s.

    “Mr. Carter,” Young recalled recently, “was a man on a mission.”

    FROM ALMOST THE MOMENT Carter came upon Young’s name in the Air Force documents, he’d been consumed by the scientist’s pivotal role. He began documenting Young’s influence on a blog he’d set up to keep fellow C-123 reservists informed. “Memo after memo from him showed exquisite sensitivity to unnecessary public awareness … what he calls ‘misinformation’ about Agent Orange. Best to keep things mum, from his perspective,” Carter wrote in a July 2011 post.

    An Agent Orange activist who heard about Carter’s efforts sent him an email exchange between Young and a Veteran named Lou Krieger. Krieger had been corresponding with Young about herbicide test sites in the United States and had mentioned that he believed the controversy over the C-123 aircraft represented “another piece of the puzzle.”

    In a flash of anger, Young had written back, “The only reason these men prepared such a story is that they are hoping they can cash in on ‘tax free money’ for health issues that originate from lifestyles and aging. There was no exposure to Agent Orange or the dioxin, but that does not stop them from concocting exposure stories about Agent Orange hoping that some Congressional member will feel sorry for them and encourage [the VA] to pay them off.

    “I can respect the men who flew those aircraft in combat and who made the sacrifices, many losing their lives, and almost all of them receiving Purple Hearts,” Young wrote, “but these men who subsequently flew them as ‘trash haulers,’ I have no respect for such freeloaders. If not freeloading, what is their motive?”

    Young’s response offended Carter. He pressed his Freedom of Information Act campaign with renewed vigor, requesting a slew of new records from the Air Force and the VA. He later filed lawsuits, with the help of pro-bono lawyers, against the agencies for withholding documents. The government eventually gave him the records and paid his lawyers’ fees.

    Carter worked the non-military world as well, soliciting letters from doctors, researchers and government officials who had expertise with toxic chemicals, some of whom had clashed with Young in the past. Several responded with letters supporting his cause, even a few who worked for federal agencies.

    The head of the Agency for Toxic Substances and Disease Registry, a part of the CDC, wrote in March 2013 that based on the available information, “aircrew operating in this, and similar, environments were exposed to TCDD [dioxin].”

    And a senior medical officer at the National Institute for Environmental Health Sciences wrote, “it is my opinion that the scientific evidence is clear” that exposure to dioxin is not only possible through the skin but has been associated with a number of health conditions, including cancer, heart disease and diabetes.

    Carter also found support in Congress from Sen. Richard Burr, R-North Carolina, and Sen. Jeff Merkley, D-Oregon, who began writing the VA regularly to advance Carter’s cause.

    He sent missive after missive filled with his findings and the letters of support he’d received to the prestigious Institute of Medicine, a congressionally chartered research organization hired by the VA to assess the science behind the claims of Carter and other C-123 Vets. If the VA was going to grant them benefits, Carter realized, he had to first convince this group of researchers that he was right.

    “It didn’t take long to realize that the VA had a lot of resources working against us and we found none working for us,” he said.

    One of those resources was Young, whom the agency had given a $600,000 no-bid contract to write research reports on Agent Orange.

    Young had approached the VA in 2012, offering to assess Vets’ claims that they’d been exposed to herbicides outside of Vietnam and weren’t covered by the Agent Orange Act.

    Over the next two years, Young and his son wrote about two-dozen reports examining issues such as whether Vets who served in Thailand, Guam or aboard Navy ships off the coast of Vietnam could have been exposed. In most cases, they concluded exposure was unlikely. The reports buttressed the VA’s rejection of claims by members of those groups, just as Young’s Pentagon reports were cited to deny those of individual Vets.

    In November 2012, Young turned in the first of several reports discounting the claims of Carter and his group. “All the analytical and scientific studies suggested that if they were exposed, that exposure was negligible,” he wrote. Although some samples taken from the C-123s showed minimal traces of dioxin, it was nothing to be concerned about, Young wrote, since dioxin sticks to surfaces and was unlikely to affect anyone who came in contact with the planes.

    Though Young dismissed the Vets’ claims, Carter’s campaign clearly bothered him. In a June 2013 email to a VA staffer, Young criticized the Air Force for releasing all of his correspondence to Carter.

    A couple months later he wrote: “You and I knew that the preparations of these investigative reports were going to show that in most cases the allegations are without any evidence. We can expect much more media interest as more and more Veteran claims are rejected on the basis of the historical records and science.”

    Young’s contract with the VA and emails were later disclosed to Carter as a result of his FOIA requests and a lawsuit against the VA. The emails showed that Young had also discounted the opinions of other experts, including the VA’s own researchers when they linked Agent Orange to prostate cancer.

    “It is clear the VA researchers do not understand what really occurred in Vietnam,” he wrote in May 2013 to several VA leaders, “and that the likelihood of exposure to Agent Orange was essentially negligible.”

    FOR THREE YEARS, Carter and Young had circled each other. Carter in his blog and in at least one intemperate email; Young in dismissive reports and notes to the VA. Finally in June 2014, they were face to face in Washington D.C. where an Institute of Medicine panel would weigh the evidence to determine which man was right.

    They lived just 45 minutes apart — Young in Wyoming and Carter in Colorado — but had never met. Now they sat next to each other to deliver testimony.

    Carter, who was now in a wheelchair, told panel members that their task should be straight-forward: Did the evidence show — more likely than not — that he and his crewmates had been exposed? “I’m probably the only bachelor’s degree person in this room, but I know the airplane,” he said.

    Young, who followed him, gave a rundown on the planes’ uses during the Vietnam War and their return to this country. He then defended the destruction of the planes, leaving out his role as the consultant who told the military to do it.

    “Those aircraft had been out there for almost 25 years. How long do you maintain an aircraft?” he said, adding later, “Those aircraft had a stigma.”

    Young had been at odds with the IOM before. An earlier panel had embraced a method to estimate troop exposure to Agent Orange, angering Young and his allies who didn’t believe it was possible.

    But the hours-long hearing on C-123s, in which an array of experts spoke, ended with no hint of which way the panel was leaning. As the months wore on without a decision, Carter began to wonder if he had wasted the past few years of his life. “I wasn’t a grandpa or a retiree or a hobbyist or a churchman, the things that usually follow in retirement,” he said. “I was ill and I was tired. It’s a lot of money. Every time I went back to Washington, there goes another fifteen hundred bucks.”

    Finally, on a crisp January morning in 2015, the IOM was ready to announce its decision. Carter and his wife Joan had flown in and now they sat holding hands in a conference room. Joining them were VA and Air Force officials, members of the IOM staff and journalists. Four lawyers who had helped him showed up too, as well as supportive congressional aides. Young, the man who’d fueled his quest, wasn’t there.

    At the front of the room, Emory University’s nursing school dean began to deliver the results of the institute’s report. Carter heard the words “could have been exposed,” and knew he’d won. “That was the moment that I really understood.” Carter and his wife squeezed hands, then hugged with happiness and relief when the meeting ended.

    The committee had rejected Young’s position that the dioxin residue found on interior surfaces of the C-123s would only have come off with a chemical wipe, dismissing that claim as “conjecture and not evidence-based.” His argument that dioxin wouldn’t be absorbed through a crew member’s skin was also wrong, the committee determined, and appeared to be based on an irrelevant Dow-funded study of contaminated soil. Further, Young’s overall description of the chemical properties and behavior of TCDD, a dioxin contaminant, were “inaccurate.”

    Joan Carter said it was her husband’s most meaningful mission, “a kind of a legacy of some good work, some definitive good work that he could leave behind.” It allowed him to help “a far greater circle of fellow Veterans, most of whom he never met.”

    Within weeks, Young protested to the IOM that it had “ignored important historical and scientific information … some material was misinterpreted, and there was a failure to focus on the science instead of who or what agency provided the information.”

    The IOM stood by its findings, and several months later, the VA approved disability benefits for the ailing C-123 Veterans. In a statement, VA Secretary Robert McDonald called it “the right thing to do.”

    In an interview, Young said the IOM panelists got it wrong — a retort he’s used for decades whenever his findings have been challenged.

    “Unfortunately,” he said, they “did not have a good handle on the science.”

    THE IOM’S DISMISSAL of Young’s findings has not dampened the military’s reliance on him.

    The Pentagon once again has signed Young on as a consultant, this time to track where herbicides were used at bases in the United States.

    Pentagon officials declined to answer detailed questions about Young’s work, including how much he’s been paid. Spokesman Lt. Col. James B. Brindle would only say that Young is the “most knowledgeable subject matter expert” on Agent Orange and that his personal views “are not relevant to the historical research he was contracted to perform.”

    While the VA didn’t renew Young’s contract when it expired in 2014, a VA official said the department wouldn’t hesitate to hire him again if he was the most qualified person. Flohr, the VA senior advisor, said Young was chosen for his expertise — not his position on the Vets’ exposure. “It was purely scientific, the research he did,” he said, “no bias either way on his part or our part.”

    In a subsequent statement, the VA said it makes decisions on Agent Orange “only after careful and exhaustive reviews of all the medical/scientific evidence. … Our obligation remains to the Veterans we serve.”

    Young’s continued work for the government comes as a surprise to those who squared off against him a generation ago. “As a physician, as a dioxin scientist, as an Agent Orange researcher, as a Vietnam-era Veteran, I’m just appalled by that personally,” said Dr. Arnold Schecter, who has written a major textbook on dioxin and who has feuded with Young.

    Today, despite his loss to Carter, Young is unwavering in his belief that his research is “great.” Among his few regrets: Putting controversial opinions — such as calling C-123 reservists freeloaders — in emails that could be obtained through public records requests.

    Young said he, too, was exposed to Agent Orange while testing the chemicals over the years, and in that way has a deeply personal interest in the research.

    “Give me some credit,” Young said. “Hell, I’ve got 40 years working out there on these issues. I have a great deal of experience. … Am I wrong? I could be wrong. I’ve always said I don’t understand it all.”

    Source

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  • Video Visits

     

    This summer, VA launched a telehealth expansion initiative that includes significantly increasing the number of outpatient providers capable of offering video visits. VA Video Connect is an application that uses the camera on your phone, tablet or computer to create a secure connection with a member of your VA care team from the comfort of your home or wherever is convenient for you.

    If you’re a Veteran who is interested in using VA Video Connect, first consult with your VA care team to see if video appointments can be part of your care plan. Video appointments will display in your list of appointments in VA Online Scheduling. You can check to see if your facility currently participates in VA Online Scheduling at this link.

    How Do I Get Started?

    Before a VA Video Connect appointment is scheduled, a provider must determine if a video appointment is appropriate for you. Your provider will discuss the logistics and details of the video visit, and designated staff members will assist you to determine how you will connect to a video visit at home.

    Video visits are currently being scheduled for patients by designated scheduling staff. In the future, Veterans will be able to schedule video visit appointments through the VA Online Scheduling application.

    When your appointment is scheduled, you will receive an email with a link to join a virtual medical room. In the coming months, that link will also be available in VA Online Scheduling when you view your upcoming appointments.

    If you’re using a non-iOS system (e.g., desktop, laptop, Android device, etc.), just click the appointment link at your scheduled day and time to start your video visit. If you plan to use an iOS device for the video visit, you must install the VA Video Connect App on your device. You can find iOS download information on this page of the VA App Store and read more about how to get started with VA Video Connect in this My HealtheVet article.

    If you need help with VA Online Scheduling or VA Video Connect, call the VA Help Desk at 1-877-470-5947 (for TTY assistance, dial 711). The Help Desk is open weekdays from 7 a.m. – 7 p.m. CT.

    Feedback Wanted

    Finally, VA wants to hear about your experiences trying VA Video Connect and VA Online Scheduling. The feedback will help us make future improvements to the applications.

    • For VA Video Connect, go to the app’s page on the VA App Store and click the “Feedback To VA” tab.
    • The VA Online Scheduling Feedback tab is located under the User Menu when you are logged into the application.

    Both brief feedback forms include a few questions and an opportunity to provide comments. Your comments are anonymous and valuable to our app development teams.

    Source

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  • Xmas Light Display

     

    Christmas light viewings are an American pastime. Families load up in cars and drive through neighborhoods every December, appreciating the time, effort and money holiday-minded homeowners put into decorating.

    But for residents on one street in Old Bridge, New Jersey, the twinkling decorations are quickly becoming a hot-button issue.

    Tom Apruzzi, the man behind the apparent controversy, has set up his epic display every Christmas season for 15 years, according to NJ.com. This year’s display boasts a whopping 70,000 lights.

    Apruzzi’s impressive Christmas display can bring in 1,000 people a night, but it’s not to turn a profit. Donations are collected, but the funds given to charities. His previous light shows have raised tens of thousands of dollars for Veterans and cancer-stricken children.

    Despite the cheerful atmosphere and massive charitable giving, not everyone is happy with Apruzzi’s annual hobby. His car and home have even been vandalized.

    And now, city officials are demanding the Christmas light artist pay a $3,000 fine every day he runs the display for the public, reports CBS News.

    “They want me to pay for the police, they also want me to pay for shuttle service from a private parking lot and bus people in that they want me to pay for,” Apruzzi explained.

    Old Bridge Mayor Owen Henry is standing his ground on the fine, citing concerned neighbors who have had to deal with huge crowds stomping through their peaceful neighborhood.

    It also brings up policing and first-responder concerns. Firefighters, ambulance crews and police cars could have a difficult time accessing the area if families and their vehicles clog the street.

    Although previous years saw smaller crowds that could easily be handled by auxiliary police officers, the number of visitors has swelled beyond the limitations of the street itself. Some nights, there are so many cars that they line both sides of the street, forcing viewers to walk in the middle of the road.

    If the fine isn’t paid, the city government may have no choice but to shut down the display. This could effectively end the yearly tradition unless Apruzzi forks over thousands of dollars.

    Apruzzi started a fundraiser to help with the costs. Called “Save the lights,” it aims to pay the costs imposed by the city. As of Friday morning, his GoFundMe page had received over $4,000 in donations.

    Interestingly, the Apruzzi family and city residents met with the City Council weeks before the lights even went up. The fundraising page says “they received a unanimous vote to proceed, WITHOUT any stipulations.”

    There are two sides to every story. The Apruzzi family donates tens of thousands to charity while spreading holiday cheer and joy to an entire town. To upset neighbors, this doesn’t justify the flashing lights and throngs of people.

    Despite this, Apruzzi isn’t backing down.

    “We are not shutting down the Christmas lights show,” he defiantly said. “Period.”

    Source

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  • CO Homeless Vets

     

    HUD, VA team up to places homeless Vets in permanent housing

    Funding from the U.S. Housing and Urban Development and the Veterans Affairs departments will help provide permanent homes to about 100 homeless Veterans in Colorado.

    The $782,869 in rental assistance announced this week comes from the HUD-Veteran Affairs Supportive Housing program, which combines rental assistance from HUD with case management and clinical services by the VA.

    “We are lucky to have such strong partnerships with the VA and housing authorities throughout the state and the Rocky Mountain region, all of whom work together to build on the success of the HUD-VASH Program,” HUD Rocky Mountain Deputy Regional Administrator Eric Cobb said in a statement.

    As part of the program, VA medical centers assess Veterans experiencing homelessness before referring them to local housing agencies for vouchers. The decisions are based on a variety of factors, including the duration of homelessness and the need for longer term, more intensive support.

    Veterans participating in the HUD-VA housing program rent privately owned housing and generally contribute no more than 30 percent of their income toward rent. The VA offers eligible homeless Veterans clinical and supportive services through its medical centers across the U.S., Guam, Puerto Rico and the Virgin Islands.

    Source

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  • VA Nursing Home

     

    BOSTON – Staffers at the Department of Veterans Affairs nursing home in Brockton, Massachusetts – rated among the worst VA nursing homes in the country – knew this spring that they were under scrutiny and that federal investigators were coming to visit, looking for signs of patient neglect.

    Still, when investigators arrived, they didn’t have to look far: They found a nurse and a nurse’s aide fast asleep during their shifts. One dozed in a darkened room, the other was wrapped in a blanket in the locked cafeteria.

    The sleeping staffers became a focal point of a new, scathing internal report about patient care at the facility, sparked by a nurse’s complaint that Veterans were getting substandard care, according to a letter sent late last month to President Donald Trump and Congress by the agency that protects government whistleblowers.

    “We have significant concern about the blatant disregard for Veteran safety by the registered nurses and certified nurse assistants,” agency investigators wrote in a report about the 112-bed facility. The Brockton facility is a one-star nursing home, the lowest rating in the agency’s own quality ranking system.

    VA spokeswoman Pallas Wahl said officials took “immediate corrective action,” and the employees caught sleeping no longer work there.

    The problems at the Brockton nursing home are the latest to surface in a review of VA nursing home care by USA TODAY and The Boston Globe.

    In June, the news organizations revealed the VA’s secret quality ratings showed that care at more than 100 VA nursing homes across the country scored worse than private nursing home averages on a majority of key quality indicators last year.

    In response to questions from USA TODAY and the Globe, the VA released nursing home ratings that had been kept secret for years, potentially depriving Veterans and their families of crucial health care information.

    At the time, the VA said it was releasing inspection reports the agency withheld from the public for nearly a decade. Five months later, none has been released.

    VA spokesman Curt Cashour told USA TODAY that the agency is working with an outside contractor to remove patient information from reports. He said the VA expects to release "publicly redacted versions of the most recent reports" around Christmas.

    That's not good enough for Leslie Roe, whose husband of 38 years walked out of a supposedly secure unit at the VA nursing home in Tuskegee, Alabama, last year and was never found.

    Roe, who had Navy Veteran Earl "Jim" Zook declared dead this year, wants the VA to immediately release three years' worth of inspection reports – the standard for private-sector nursing homes whose reports are posted on a federal website, NursingHomeCompare. 

    "It's just a shame the way the VA is," she said. "It can't help Jim, but maybe it can help just one other person."

    The reports can include incidents of poor care and conditions that can be a tip-off to prospective or current residents and their families about problems with staffing or neglect at a facility.

    "What are they hiding? Why wouldn’t you release it?" asked Amy Leise, whose uncle, Vietnam Veteran Don Ruch, suffered from malnutrition and bedsores last year at a VA nursing home in Livermore, California.

    "It feels like the government is immune from accountability and responsibility, where in other settings that wouldn't be the case," she said.

    VA releases new nursing home ratings

    The VA released an updated set of star ratings. They show 45 of its nursing homes received the lowest one out of five stars for quality as of June 30. That’s down from 58 in March. The VA has 133 nursing homes that serve 46,000 infirm Veterans each year across the country.

    At the nursing home in Brockton, residents were, on average, more likely than residents of other VA nursing homes to deteriorate, feel serious pain or suffer from bedsores, according to agency data. They were nearly three times as likely to have bedsores than residents of private nursing homes.

    Licensed practical nurse Patricia Labossiere said she complained to the Office of Special Counsel, a federal whistleblower agency, this year after supervisors in Brockton ignored her alerts.

    “I am a no-nonsense nurse who took a vow to take care of patients,” said Labossiere, who quit in July. “We are there to be kind and treat others as we would want to be treated. I could not believe that this was how we treat the people that fought for our country.”

    Labossiere said she saw instance after instance of poor patient care at the facility within days after she started working there last December. She told the federal whistleblower agency that nurses and aides did not empty the bedside urinals of frail Veterans. Nurses failed to provide clean water at night and didn’t check on the Veterans regularly, as required, she said. They often slept when they were supposed to be working.

    She offered some specific examples: One patient had trouble breathing because his oxygen tank was empty. Another fell – his feeding tube got disconnected, and the liquid splashed onto the floor – and didn’t appear to have been monitored by staffers for hours.

    The VA investigators did not substantiate those allegations, saying the patient with the empty oxygen tank suffered no ill effects. Investigators couldn’t confirm that the patient who fell had been neglected because the records were shredded “in accordance with the local policy.”

    'Routinely receiving substandard care'

    Wahl, the VA spokeswoman, noted that the investigators “did not find evidence of Veteran harm or neglect.” She said the facility’s one-star rating is undeserved and not an “accurate reflection of the quality of care delivered to our patients."

    The Office of Special Counsel ordered the VA’s Office of Medical Inspector to investigate Brockton after Labossiere’s complaint. The office turned over its report in September to special counsel Henry Kerner, who sent the findings to Trump and Congress on Oct. 23.

    “Because a brave whistleblower came forward, VA investigators were able to substantiate that patients at the Brockton (nursing home) were routinely receiving substandard care,” Kerner said in an emailed statement.

    This is not the first time the Brockton facility has come under fire by the Office of Medical Inspector.

    In 2014, a doctor at the nursing home alleged that three Veterans with significant mental health issues received “inappropriate medical and mental health care.”

    Two of them went years, he alleged, without appropriate treatment. A third allegedly received psychotropic drugs for more than two years against written instructions.

    Investigators largely substantiated the allegations, finding that two Veterans with significant psychiatric issues did not receive adequate treatment for years. They did not substantiate the allegation that a third received improper medication.

    Source

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  • 5 Drs Out at Mn

     

    ATLANTA -- In another blow to Marietta-based MiMedx, the Veterans Affairs Medical Center in Minneapolis has parted ways with four podiatrists and a dermatologist over improprieties with the company's bio-pharma products, a VA spokesman confirmed for The Atlanta Journal-Constitution.

    The company is under fire amid accusations of "channel stuffing" by ex-employees -- lobbying friendly doctors and medical staffers to overstock and over-use products, thereby inflating revenue reports and driving up stocks.

    In May, three South Carolina VA workers were indicted on federal health care fraud charges, accused of excessive use of MiMedx products on Veterans after accepting gift cards, meals and other inducements from a company representative. Two of the three workers were also charged with accepting bribes.

    The company has launched an internal investigation, and in June, MiMedx announced that it will revise more than five years of financial statements. In July, prominent Atlanta businessman Parker "Pete" Petit stepped down as the company's CEO and chairman. The company remains under scrutiny from the U.S. Department of Justice, the U.S. Securities and Exchange Commission, the Food and Drug Administration and the Department of Veterans Affairs.

    Details behind the Minneapolis doctors' departures aren't clear. The spokesman, Ralph Heussner, said the VA proposed terminating all five, but each opted to resign or retire. He confirmed that the proposed terminations involved issues with MiMedx products.

    Huessner explained in an email that the doctors "engaged in behavior that is not in line with the norms and values of the department.

    "VA has made clear that it will hold employees accountable when they to fail to live up to the high standards taxpayers expect from us," the email said, "and that's exactly what we're doing in this case."

    Source

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  • Vet Dies

     

    An 84-year-old Army Veteran in Jacksonville, Florida, died after he reportedly developed a gangrene infection in his genitals. Now his family members allege the nursing home where the Veteran lived ignored his condition until it was too late.

    The Vet, York Spratling, began living at the Consulate Health Care of Jacksonville in December 2016 after his health began to worsen and he was unable to live alone, The Naples Daily News reported. In February 2017, Spratling was rushed to a local emergency room and was informed that his genitals had become gangrenous. Gangrene is dead tissue caused by an infection or lack of blood flow.

    Doctors there told Spratling -- he reportedly had diabetes, a condition which can increase a person’s chances of developing gangrene, according to the Mayo Clinic -- and his family that the man required surgery to remove the dead tissue.

    The doctor "said he had never seen anything like that before, especially in this day and age,” Derwin Spratling, the Veteran's nephew, told the Naples paper. “It really freaked us out.”.

    The man died shortly after the surgery, according to the newspaper.

    Staffers at the nursing home reportedly told state investigators they “could smell [his ] infection from the door to his room,” the newspaper reported, citing reports. But despite the stench, the staff did not document the infection or tell a doctor until five days later, the newspaper said.

    The Veteran was allegedly not being bathed, though nursing home staff claimed that Spratling refused showers.

    “It’s way past obvious. This is so past obvious that it’s mind-blowing,” Derwin Spratling said of his uncle’s condition.

    “His private area, nobody washed that,” Lula Price-Brown, Spratling's sister, told The Naples Daily News.

    “Who was taking care of this man?” she added.

    Investigators later concluded the man’s death was “due to inadequate supervision and medical neglect,” The Naples Daily News reported.

    Despite the findings, however, there has reportedly been no action taken against the nursing home by the Agency for Health Care Administration (AHCA), a state agency that regulates nursing homes in Florida, according to the newspaper.

    What's more, the investigation into Spratling's condition came after AHCA had cited Consulate Health Care three times in the year before the Vet's death, claiming the nursing home did not have “enough nurses to properly care for residents, including showering them,” the newspaper reported.

    It was not immediately clear if Spratling's family plans to take legal action.

    Consulate Health Care did not respond to Fox News’ request for comment on Saturday.

    Source

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  • GI Bill Housing

     

    A group of senators including Kansas Senator Jerry Moran have introduced the proposed Forever GI Bill Housing Payment Fulfillment Act.

    It would ensure the VA reimburses Veterans for missed or underpaid Forever GI Bill housing benefits. During a recent visit to Junction City Moran stated there has been case work where Veterans called indicating they had encountered a problem with their GI Bill and benefits, particularly their housing. “You can be enrolled at a college, a university, a community college and not getting your housing payment through some computer snafu at the Department of Veterans Affairs. Initially it seemed that the VA was going to just look the other way. In fact they announced that the past benefits that were due would not be made up.

    The new bipartisan legislation would ensure the Department of Veterans Affairs reimburses Veterans formissed or underpaid Forever GI Bill housing benefits.

    Source

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  • Dr Barbara Temeck

     

    A career VA administrator and surgeon, Temeck was charged with three counts of improperly writing prescriptions for controlled substances for a friend who also is married to a former high-ranking VA official. Temeck testified that she had been long involved in the friend’s medical care and did nothing wrong. She also says Glassman pursued the case as part of larger VA retaliation against Temeck’s efforts to crack down on how the Cincinnati VA had been run.

  • Director Texas Tech

     

    LUBBOCK, Texas (NEWS RELEASE) - The following is a news release from Texas Tech University:

    In 1988, James Reckner arrived at Texas Tech to teach history. But in his first year, when he asked his class which U.S. general was most closely associated with the Vietnam War and only one student correctly answered Gen. William Westmoreland, Reckner realized how little their generation knew about the conflict.

    As a U.S. Navy Veteran who served two tours in Vietnam, Reckner set out to fix that.

    His initial idea was to teach a course that focused entirely on the Vietnam War, but the University Library didn’t have enough materials to support graduate research. So he called a meeting of local Vietnam Veterans and asked them to help him collect documents the university could make available to students.

    The first contribution, a stack of letters from a soldier to his mother in Slaton, grew to more than 20 million pages of documents, photographs, maps and books now housed in the Texas Tech Vietnam Center and Archive.

    Reckner, who retired from the university in January 2009 after more than 20 years of teaching history, died on Friday (Nov. 16).

    “The Texas Tech University Vietnam Center and Archive exists because of Jim Reckner’s vision and passion as a Vietnam War Veteran and historian,” said Texas Tech President Lawrence Schovanec. “He worked tirelessly to establish what is now a world-class resource regarding all aspects of the American Vietnam experience. The Vietnam Center at Texas Tech will forever be a tribute to his memory and efforts.”

    A memorial service will be held at 10:30 a.m. Nov. 30 at Lake Ridge Chapel and Memorial Designers in Lubbock, 6025 82nd St.

    In June 2008, a delegation from Vietnam’s Ministry of Education and Training visited Texas Tech to finalize an agreement to bring up to 100 Vietnamese graduate students to Lubbock each year. The group came to the United States to identify potential partners to bolster the nation’s developmental efforts and chose Texas Tech because of the strong ties already established through the Vietnam Center.

    “James Reckner was singularly responsible for the creation, growth and development of the Vietnam Center at Texas Tech,” said Donald Haragan, Texas Tech president emeritus. “The center’s mission was focused on the history and scholarly analysis of the war, its cause and ultimate aftermath. Jim’s outstanding work drew the attention of many researchers in the field, which lead to the development of an annual symposium at the university. His efforts had a significant impact on the university as well as the scholarly community studying the Vietnam conflict.”

    Steve Maxner, now director of the Vietnam Center and Archive, remembers Reckner as both a colleague and an inspiration.

    “Jim was an amazing professor, mentor, scholar and friend,” Maxner said. “Over the two decades of his service, he worked with hundreds of graduate students, completely changing the landscape of Vietnam War and military history studies for the nation. Jim also established the Vietnam Center and Archive, which he helped to grow into the largest university program in the country. Jim’s incredible contributions will serve as a daily reminder of his important legacy at Texas Tech, his dedication to his students and his love and passion for the study of the Vietnam War and military history. We miss him and send our prayers and condolences to his family.”

    About theVietnam Center and Archive

    The Vietnam Center and the Sam Johnson Vietnam Archive collect and preserve the documentary record of the Vietnam War, while supporting and encouraging research and education in all aspects of the American Vietnam experience. The Vietnam Center and Archive is under the umbrella of the Institute for Peace and Conflict, along with the Archive of Modern American Warfare, the graduate certificate in strategic studies and the Army and Air Force ROTC programs.

    Source

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  • Gaming the system

     

    The Opinion page in the Christmas edition was an interesting read. First, the “Montana View” claims that “Enzi, Lee let Veterans down”. This regards Agent Orange exposure by Veterans who served in the Navy offshore in Vietnam, and the supposed medical issues they now suffer from that exposure. I can understand that, IF they handled Agent Orange, and IF their maladies can be traced to that handling. All others serving in the fleet during that time period not handling Agent Orange in a manner that exposed them to its toxicity are just gaming the system, in my view, and should not be entitled to medical benefits.

    I was surprised to learn years later that not all service members of that time period were eligible for medical benefits. I guess it was only for those who served in hazardous situations, thus drawing hazardous duty pay, who were eligible for VA benefits. I never thought about it at the time but appreciate those benefits now. So I think Enzi and Lee are right, and have stepped forward to NOT let our country down by NOT letting some Veterans game the system.

    Then, the “Guest View” by Otstot, Tucker, Thomas, and Okland claims Zinke is leaving our public lands vulnerable because Karen Budd-Falen, whom he hired, remains as a deputy solicitor for Interior. They fear she will open vast areas of Interior-managed public lands to instant exploitation and degradation. What poppycock!

    Ms. Budd-Falen supports reasonable development of our natural (commodity) resources on public lands. Roughly half of the west is comprised of federal public lands, and overzealous management of these lands by Federal officials with preservational bents have done significant damage to the industries and communities trying to develop these lands.

    NW Montana, the Troy-Libby area, comes to mind. This started with President Carter, became worse during Clinton’s tenure, and became an abomination with Obama. Beginning with the transplanting of Canadian wolves, Ms. Budd-Falen pushes back on all these snobby, elitist agendas and tries to bring some sense of sanity to our public lands’ management.

    How bad is it? Knowing that the Helena-Lewis & Clark National Forest is now roughly 80% wilderness and wilderness-in-waiting gives some perspective. So yes, knowing that Ms. Budd-Falen remains in a position to fight for reasonable and responsible commodity development of our public lands gives me hope that better times are coming for rural America.

    Source

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  • Gillibrand 002

     

    WASHINGTON — The sponsor of legislation that would help certain naval Veterans who served in the Vietnam War obtain compensation for health complications caused by Agent Orange exposure is hopeful the legislation will move forward, despite expressed opposition from the U.S. Department of Veterans Affairs.

    Naval Veterans who served on the shore of Vietnam do not get compensation from the Veterans Administration for complications caused by exposure to the herbicide Agent Orange, said U.S. Sen. Kirsten Gillibrand, D-N.Y.

    The Agent Orange Act of 1991 only allowed compensation for soldiers who served, boots on the ground, inland or sailors who served on inland water ways, but Veteran organizations are pushing Congress to pass legislation that would add sailors stationed just off-shore during the war, arguing it is possible those sailors could have been exposed.

    “I have known Navy Veterans who have died waiting for this legislation to pass,” said Command Sgt. Maj. Gary Flaherty, director of Columbia County Veterans Services. “There are a lot of unhappy Veterans. There is no question in our minds when those planes flew over spraying Agent Orange it affected the sailors on the deck of ships on the shoreline.”

    In the past, Flaherty said the cancer-causing herbicide could have been carried to ships anchored offshore by wind or into ships’ potable water drawn from the ocean and filtered.

    The House of Representatives passed the Blue Water Navy Vietnam Veterans Act on June 25 with a 382-0 vote.

    The Senate Committee on Veterans Affairs has held the bill since June 28.

    “Senator Gillibrand has had productive conversations with Committee on Veterans Affairs Chairman U.S. Sen. Johnny Isakson, R-Ga., about his concerns and they have discussed ideas for modifications,” according to a statement from Gillibrand’s office. “We are hopeful that Chairman Isakson will produce a bill with small modifications very soon and that the Senate would be able to vote on it without any further delay.”

    The committee held a hearing on the bill Aug. 1 and VA Undersecretary for Benefits Administration Paul Lawrence told members of the committe the department opposes the legislation.

    “We oppose this bill,” Lawrence said. “We know it is incredibly difficult to hear from groups of Veterans who are ailing and ill. There is no conclusive science from the institute of medicine to support claims of exposure.”

    Lawrence arguedthe bill would set a precedent that the department would have to pay Veterans’ claims regardless of the scientific evidence.

    The VA is conducting a health study that compares the health effects on Vietnam Veterans who did not serve inland, including nearly 1,000 Blue Water Navy Veterans, with non-Veteran populations, which will start to be published in 2019, Lawrence said.

    “They have been studying this for 50 years,” Flaherty said. “This is the closest this bill has ever been. It is time to stop stalling, stop studying and give these Veterans what they deserve.”

    Agent Orange exposure can cause many health complications including chronic B-cell leukemias, Hodgkin lymphoma, ischemic heart disease, multiple myeloma, Non-Hodgkin lymphoma, Parkinson’s disease, peripheral neuropathy, porphyria cutanea tarda — characterized by liver dysfunction — prostate cancer, respiratory cancers and soft tissue sarcomas, which attacks muscle, fat, blood and lymph vessels and connective tissues, and diabetes according to the website for the U.S. Department of Veterans Affairs.

    Randy Staats, of Hudson, served as a deckhand on the USS New Jersey from 1967 to 1969 and was anchored off the Vietnam shore during that time at points all along the coast. Staats suffers from diabetes, a condition he has requested compensation for more than 10 times since 1992 and has been denied every time, he said.

    “They just told me I wasn’t going to get it because Blue Water Navy Veterans are not entitled to it,” Staats said. “They are waiting for most of us to die and then they will give it to us. If it was their kids over there, they would have this thing passed already.”

    FUNDING THEBLUE WATER NAVYBILL

    Lawrence also told committee members in August that the VA opposes the way Congress plans to pay for the bill through increasing fees charged as part of the VA Home Loan programs. Veterans with disabilities are exempt from funding fees.

    “The funding plan for [the bill] is unfortunate,” said Greene County Veterans Service Agency Director Michelle Romalin Deyo. “It is disconcerting that the funding for benefits payable to our Blue Water could be at the expense of other Veterans.”

    Under the bill passed by the House rates for Veterans using the loan programs would be as follows:

    • From 2.15 percent to 2.40 percent of the loan amount for loans with no down payment and first-use of the VA guarantee benefit.
    • From 3.3 percent to 3.8 percent of the loan amount for loans with no down payment on subsequent use of the loan benefit.
    • From 1.50 percent to 1.75 percent of the loan amount for loans with a 5 percent down payment.
    • From 1.25 percent to 1.45 percent of the loan amount for loans with a 10 percent down payment.

    “Though the VA Home Loan Guarantee Funding Fee is only collected from Veterans who are not rated by the VA with a service-connected disability with certain exceptions; that doesn’t mean it won’t affect our disabled Veterans,” Deyo said. “Veterans with pending original claims, will generally not be eligible for the funding fee waiver — not until they have a VA Rating Decision of 10 percent service-connected disabled or greater. The funding fee is already a sizable fee.”

    The increases would take effect Jan. 1 next year and return to current levels after Sept. 30, 2026.

    Funding fees haven’t been raised since 2004.

    “In June, the House unanimously approved the Blue Water Navy Vietnam Veterans Act 382-0 and the Senate should follow suit immediately to get these Veterans the benefits they deserve,” said U.S. Rep. John Faso, R-19, who voted for the bill. “After enactment of the Agent Orange Act of 1991, the VA determined that benefits for Veterans made sick by agent orange would only be available to those with “boots on the ground” or served on inland waterways. I believe this determination was wrong.”

    Deyo works with many Blue Water Navy Veterans, and hopes the bill passes soon.

    “We do have a significant population of Blue Water Veterans affected by herbicide exposure-related illnesses considered presumptive for so-called ‘Boots on the Ground’ Veterans,” Deyo said. “So, I am very hopeful that Congress will find another resource, outside of existing VA programs, to make sure our Blue Water Veterans are finally compensated, and all of the corresponding benefits are extended to them and their dependents, without further delay.”

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  • Benefits Earned

     

    That many U.S. Veterans didn’t receive the educational benefits they were owed in recent months is inexcusable.

    What would be an even greater outrage, however, is if the federal government allows these mistakes to persist.

    The Department of Veterans Affairs must develop a clear plan to ensure GI Bill recipients receive their proper housing stipends and other educational benefits as soon as possible. The technology failures that reportedly caused thousands of Veterans to receive late or incorrect benefit payments in 2018 should be swiftly corrected.

    There can be no more excuses.

    So far, VA officials have offered little assurance that the situation is under control. After making a series of confusing statements, VA officials now say all GI bill recipients will receive the full housing payments and other benefits they are owed, retroactively if need be.

    But while the VA committed to correcting some of its computer problems by Dec. 1, 2019, it still looks as if it will be many months before all Veterans are made whole.

    That uncertainty is unacceptable for student Veterans who rely on precise benefit amounts to pay for tuition, food and rent.

    The chaos is particularly uncalled for because the VA had a year to implement changes mandated by the Forever GI bill, as noted by U.S. Sen. Patty Murray, D-Washington, at a recent committee hearing. The agency has said changes to how housing payments are calculated under that bill precipitated the recent IT failures and delays.

    Congress did the right thing by stepping in last month and setting a deadline for the VA to fix its backlog of incorrect payments. But the compliance date of Jan. 1, 2020 remains too far away — especially since the VA was supposed to have already implemented these changes months ago.

    As Murray told VA Secretary Robert Wilkie last month, “These are basic tasks that the VA cannot get wrong.” Murray and U.S. Rep. Derek Kilmer, D-Gig Harbor, recently signed onto a letter calling for an inspector general investigation into the VA’s payment problems.

    To their credit, both houses of Congress also passed legislation to ensure universities won’t penalize students if the VA misses a tuition payment.

    Yet these are steps Congress should have never had to take in the first place. Nor do they fully address whether the VA will be prepared to roll out other new benefits mandated under the Forever GI Bill in the coming months. Those include a benefits extension for students enrolled in science, technology, engineering and mathematics (STEM) programs, which is supposed to take effect in August 2019.

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  • Glyphosate Monsanto

     

    Lead Trial Counsel Reveals Evidence That Led to Historic Win Against Monsanto

    Last month, a jury ruled in favor of plaintiff Dewayne Johnson1,2,3,4,5 in a truly historic case against Monsanto. Mr. Johnson — the first of over 8,000 cases pending against the infamous chemical company which has since been bought by Bayer AG6,7 — claimed Monsanto’s Roundup caused his Non-Hodgkin lymphoma. According to the landmark ruling, Monsanto “acted with malice or oppression” and was responsible for “negligent failure” by not warning consumers about the carcinogenicity of this pernicious weed killer. Monsanto has been ordered to pay $289 million in damages to Johnson.

    In The Highwire video featured below, medical journalist Del Bigtree takes a deep dive into this groundbreaking win, revealing evidence presented to the jury — email correspondence and corporate documents that created a comprehensive narrative of corporate malfeasance and collusion with U.S. regulatory agencies — ultimately leading the jury to give Johnson a quarter of a billion dollars in damages.

    Summary of Monsanto’s Battle to Squash Evidence of Carcinogenicity

    The beginning of the end for Monsanto really began in 2015, when the International Agency for Research on Cancer (IARC), the cancer research arm of the World Health Organization (WHO) and the “gold standard” in carcinogenicity research, reclassified glyphosate as a “probable human carcinogen.”8,9

    This determination was based on evidence showing the popular weed killer can cause Non-Hodgkin lymphoma and lung cancer in humans, along with “convincing evidence” it can cause cancer in animals. In response, Monsanto launched an all-out attack on IARC and its researchers, and even lobbied to strip IARC of its U.S. funding.

    Then, in January 2017, the American Chemistry Council, of which Monsanto is a member, went on to form a front group called Campaign for Accuracy in Public Health Research,10 the express purpose of which is to discredit the IARC and seek to reform the IARC Monographs Program, which evaluates and determines the carcinogenicity of chemicals.11 As reported by the Union of Concerned Scientists on July 11, 2018:12

    “A rider [was added to] the House version of theHHS [Department of Health and Human Services] appropriations bill that would prevent the National Institutes of Health from lending any financial support toIARC unless it agrees to push for reforms atIARC that have been called for by [industry ally U.S. Rep.] Lamar Smith and the House Science Committee at the bequest of the chemical industry.”

    Monsanto Fought — and Lost — Proposition 65 Cancer Warning Label

    Following the IARC’s determination that glyphosate is probably carcinogenic to humans in 2015, California’s Environmental Protection Agency’s Office of Environmental Health Hazard Assessment (OEHHA) announced it intended to list glyphosate as a chemical known to cause cancer under Proposition 65, which requires consumer products with potential cancer-causing ingredients to bear warning labels.

    Monsanto filed formal comments with OEHHA saying the plan to list glyphosate as a carcinogen should be withdrawn. When OEHHA refused to cave, Monsanto sued OEHHA in January 2016 to stop the glyphosate/cancer classification. OEHHA filed a motion to dismiss the lawsuit and a Fresno, California, superior court judge ruled on their behalf in February 2017.

    Alas, Monsanto continued filing legal appeals to block the cancer warning from being implemented. In its latest attempt, Monsanto tried to have a provision of the law removed that allows the OEHHA from taking scientific findings from outside experts — such as the IARC — into consideration.

    Mere days after Johnson’s verdict, Monsanto lost against California yet again. As reported by Sustainable Pulse:13

    “This decision leaves in place lower court decisions upholding a provision of the voter-approved initiative that allows outside expert scientific findings to be considered when adding chemicals to the public list of carcinogens … ‘Monsanto doesn’t have the right to decide which scientific experts are permitted to inform the public about cancer-causing chemicals.

     

    By refusing to consider this case, the Supreme Court has allowed Proposition 65 to keep working the way voters intended when the initiative was passed in 1986,’ said Avinash Kar, senior attorney with the Natural Resources Defense Council.”

    This is another piece of good news, as this means California will be able to require Roundup and other glyphosate-containing products to bear a cancer warning label, and since companies rarely want to go through the extra work of making different product labels for different states, this likely means all Americans will finally be informed of the fact that Roundup is carcinogenic.

    Evidence Shows EPA Colluded With Monsanto to Hide Evidence of Carcinogenicity

    Throughout its legal battles, Monsanto has relied heavily on evidence by the U.S. Environmental Protection Agency (EPA) which, despite IARC findings, has continued to maintain that glyphosate is probably not carcinogenic to humans.

    However, internal documents obtained during the discovery process of Johnson’s case revealed the EPA colluded with Monsanto to protect the company’s interests — actually manipulating and preventing key investigations into glyphosate’s cancer-causing potential. You can review key documents from this case on the U.S. Right to Know website.14

    A 2017 Spiegel article15 also delves into some of this damning evidence, which includes correspondence that clearly reveals Monsanto knew Roundup had safety problems, and in more ways than one:

    “The Monsanto researchers also behaved irresponsibly when it comes to the question of Roundup’s absorption into the body,” Spiegel writes. “In their own animal experiments back in 2002, the company’s experts discovered that ‘between 5 and 10 percent’ of the substance penetrated the skin of rats.

     

    The rate was much higher than expected and the result had the potential to ‘blow’ the ‘Roundup risk evaluations,’ reads one email. As a consequence, the author of the email wrote: ‘We decided thus to STOP the study.’ Laboratory animals also absorbed more Roundup ingredients through the digestive tract than had been hoped for.

     

    Above all, the Monsanto papers show that the experts were very aware of a fact that is often lost in the public debate: In addition to glyphosate, herbicides like Roundup contain other dangerous chemicals that are necessary to enable the active ingredient to penetrate hard plant walls, among other things. These ingredients are often more harmful than the active ingredient on its own.”

    Summary of Johnson’s Case

    In the video featured below, Del Bigtree interviews Baum Hedlund attorney Brent Wisner, lead trial counsel for Johnson and thousands of other plaintiffs who believe their Non-Hodgkin lymphoma — a type of cancer that starts in your white blood cells (lymphocytes), which are part of your immune system — was caused by Roundup exposure.

    More than 500 of these cases are currently pending in a multidistrict litigation (MDL) with the U.S. District Court in San Francisco.16 While the MDL procedure is similar to a class-action suit in that it consolidates pretrial proceedings, each case will get its own jury trial, and the outcomes will vary depending on the strength of the evidence in any given case.

    Johnson’s lawsuit was filed in state court rather than through an MDL and was granted an expedited trial due to the fact that he’s nearing death.17,18,19 In California, if the plaintiff dies, no punitive damages can be awarded, so Johnson agreed to be the first one to take Monsanto on.

    Johnson, a 46-year-old husband and father of two, sprayed an estimated 150 gallons of Roundup 20 to 40 times per year while working as a groundskeeper for the Benicia school district in California, from 2012 through late 2015.20

    Johnson was diagnosed with a rare and deadly form of Non-Hodgkin lymphoma called mycosis fungoides in August 2014. He told his doctor the rash he’d developed that summer would worsen after exposure to the herbicide. His lawsuit, filed in 2016 after he became too ill to work, accused Monsanto of hiding the health hazards of Roundup.

    His court case, presided by Superior Court Judge Suzanne Ramos Bolanos, began June 18, 2018, and ended August 10 with a ruling in his favor.21 As mentioned, the jury awarded Johnson $289 million in damages — an amount that effectively wipes out Monsanto’s reserve fund for environmental and litigation liability, which according to Bloomberg22 totaled $277 million as of August 2018.

    Robert F. Kennedy Jr. on Monsanto’s Corporate Culture and Toxic Legacy

    Wisner is also joined by co-counsel Robert F. Kennedy Jr., who has been an environmental lawyer for 30 years, who commented on Monsanto’s “antidemocratic and antihumanistic” corporate ways, saying:

    “We really were up against an industry that has employed all of the techniques pioneered by the tobacco industry.

     

    Over 60 years, Big Tobacco killed 1 out of every 5 of its customers who used its products as directed, was able to avoid any kind of regulatory interference, because it pioneered these techniques of ghostwriting science, compromising science, corrupting public officials, capturing the agencies that are supposed to protect Americans from pollution, and Monsanto really was part of the group that pioneered those techniques — and also of using ad hominem attacks.

     

    Monsanto is the same company that was making DDT and masterminded and orchestrated the attack on Rachael Carson … [they] tried to personally destroy her, as she died of cancer. On agent orange, it led the fight to deny rights and deny compensation to tens of thousands of American Veterans who had been exposed inVietnam to this terrible chemical.

     

    I’ve been suing one of Monsanto’s chemicals for 35 years, PCBs, which Monsanto is the only producer of. It contaminated theHudson River. In more recent years, I’ve brought a series of lawsuits against Monsanto because of the PCBs put into caulking in American schools. Half the schools built between 1950 and 1977 have calking in their windows filled with PCBs.

     

    Monsanto knew PCB was carcinogenic and an endocrine disruptor and children should never be exposed to it. And it knew PCB was about to be heavily regulated if it got banned. So, it ordered all of its sales forces to … [get rid of it by selling] it for caulking for schools. This is the mentality of a very corrupt corporate culture.”

    Trial Counsels Discuss the Evidence Against Monsanto

    As noted by Kennedy, until now, Monsanto has had a reputation of being untouchable. Wisner finally broke the magic spell with his phenomenal ability to create a comprehensive narrative, showing exactly how Monsanto has been able to get away with murder, and producing the evidence needed to support that narrative.

    As mentioned, Wisner was able to show corporate correspondence and documents that clearly discussed Monsanto’s inability to prove Roundup is noncarcinogenic. In fact, Monsanto toxicologist Donna Farmer, Ph.D., who in 2016 appeared on the TV show “The Doctors” defending the safety of Roundup, years earlier had written an email stating:

    “The terms glyphosate and Roundup cannot be used interchangeably, nor can you use “Roundup” for all glyphosate-based herbicides anymore. For example, you cannot say that Roundup is not a carcinogen … we have not done the necessary testing on the formulation to make that statement.”

    Indeed, as Wisner notes, Roundup is not just glyphosate. It also contains a number of surfactants to solubilize it and other chemicals, and the synergistic action between all of these chemicals has actually been shown to be far more toxic than glyphosate alone.

    This was recently confirmed in tests23 conducted by the U.S. National Toxicology Program (NTP). According to the NTP’s summary of the results, glyphosate formulations significantly alter the viability of human cells by disrupting the functionality of cell membranes. In layman’s terms, Roundup kills human cells.

    Recent research24,25 by the highly respected Ramazzini Institute in Italy also reveals daily ingestion of glyphosate at the acceptable daily dietary exposure level set by the EPA alters sexual development in rats, produces changes in the intestinal microbiome, and exhibits genotoxic effects.

    Wisner made every effort to get Farmer to testify. Not only did she evade being served, when they were finally able to catch her, Monsanto “fought tooth and nail” to prevent her from taking the stand. They ultimately won, and Wisner was not able to get her to testify. Still, email correspondence to and from Farmer was revealing enough.

    Success Became Monsanto’s Downfall

    According to Kennedy and Wisner, the extreme success of Roundup is ultimately what became its downfall. Roundup is now the most widely used agricultural chemical in the history of the world, and its sheer pervasiveness led to increased scientific investigation. With that increased scrutiny by independent researchers, more and more evidence of harm was published.

    Secondly, in 2005 Monsanto started recommending the off-label use of Roundup as a desiccant on non-GMO grains. Essentially, by spraying Roundup on the grain right before harvest, it dries the grain, making it easier to harvest and allows the farmer greater profits, as they’re penalized when grain contains moisture. The greater the moisture content of the grain at sale, the lower the price they get.

    As a result of this successful campaign, farmers began spraying Roundup directly on food preharvest, whereas previously it was primarily used as weed control. This is why we’re now finding glyphosate in just about everything — it’s been found in every processed food tested, in air samples, rain samples, municipal water supplies, soil samples, breast milk and urine.

    Related reading: Toxic Weed Killer Glyphosate Found in Most Foods Sold in the U.S.

    According to Bigtree, two recent studies even revealed the presence of glyphosate in several vaccines, including the pneumococcal, Tdap, hepatitis B (which is injected on the day of birth), influenza and MMR. The MMR vaccine had the highest amounts at 0.8 parts of glyphosate per billion.

    Ironically, one of Farmer’s talking points during her appearance on “The Doctors” was that IARC was looking at the effects of injected glyphosate, which is not how it’s used. Yet now we’re finding vaccines are contaminated with glyphosate, and is in fact injected directly into the bodies of young children.

    Related reading: Monsanto Strikes Again — Tests Confirm Most Vaccines Contain Glyphosate Herbicide

    Kennedy notes the majority of glyphosate used since its inception has actually been used in the last five years alone. And, as contamination has been detected, concern about its safety has been increasingly strengthened. These factors are ultimately what allowed Wisner to present such a compelling case against Monsanto.

    Public Health Impact of Roundup is Likely to be Enormous

    Keep in mind that Johnson’s case is just the beginning. Every day, the law firm of Baum Hedlund is receiving calls from people asking if their cancer might have been caused by Roundup exposure, Kennedy says. Many are farmers, but many are also avid gardeners and people who have used the chemical extensively around their private property.

    Eventually, he believes other disease categories may be added to the growing mountain of lawsuits against Monsanto. Aside from the over 8,000 cases of plaintiffs with Non-Hodgkin lymphoma, the evidence also suggests glyphosate and/or Roundup may be linked to liver cancer (which is now occurring in children), brain tumors and health problems associated with endocrine disruption.

    Indeed, aside from its carcinogenic potential, independent research has connected glyphosate-based herbicides with a growing list of disturbing health and environmental effects. For example, glyphosate has been shown to:

    Affect your body’s ability to produce fully functioning proteins

    Inhibit the shikimate pathway (found in gut bacteria)

    Interfere with the function of cytochrome P450 enzymes (required for activation of vitamin D and the creation of nitric oxide and cholesterol sulfate)

    Chelate important minerals

    Disrupt sulfate synthesis and transport

    Interfere with the synthesis of aromatic amino acids and methionine, resulting in folate and neurotransmitter shortages

    Disrupt the human and animal gut microbiome by acting as an antibiotic

    Destroy the gut lining, which can lead to symptoms of gluten intolerance

    Impair methylation pathways

    Inhibit pituitary release of thyroid stimulating hormone, which can lead to hypothyroidism26,27

    Shocking Evidence of Ghostwriting Revealed During Johnson’s Trial

    In their interview, Bigtree and Wisner discuss some of the most revelatory pieces of information brought up during Johnson’s trial. As mentioned earlier, you can review many of these so-called “Monsanto Papers” on the U.S. Right to Know website.28

    You can also read “Spinning Science & Silencing Scientists: A Case Study in How the Chemical Industry Attempts to Influence Science,”29 a minority staff report dated February 2018, prepared for U.S. House members of the Committee on Science, Space and Technology.

    For example, in a November 1, 2015, email, William Heydens, safety lead for Monsanto, writes to John Acquavella, a former employee: “I thought we discussed previously that it was decided by our management that we would not be able to use you or Larry [Kier] as panelists/authors because of your prior employment at Monsanto …” to which Acquavella responds, “We call that ghostwriting and it is unethical.”

    According to Wisner, after IARC published its findings on glyphosate, Monsanto “orchestrated a public outcry” by convening a “panel of independent experts” who reviewed the data and published an analysis of the evidence. “The problem was, they were written by Monsanto employees and former employees,” Wisner says.

    In the email exchange above, Heydens wanted to remove Acquavella’s name from the report so that people would not know he was part of it, and Acquavella was reminding him that this strategy, which is known as ghostwriting, is unethical, and that they could not do that.

    In the end, the report did list Acquavella as an author, but it specifically states that Monsanto had no influence over the report and did not write any part of it. Yet email correspondence shows Heydens actively writing and editing it. All of this evidence was shown to the jury, and these outright lies are ultimately what prompted them to award punitive damages totaling a quarter of a billion dollars.

    In “The Monsanto Papers: Poisoning the Scientific Well,”30 a paper published in The International Journal of Risk & Safety in Medicine, June 2018, Leemon McHenry writes:

    “The documents reveal Monsanto-sponsored ghostwriting of articles published in toxicology journals and the lay media, interference in the peer review process, behind-the-scenes influence on retraction and the creation of a so-called academic website as a front for the defense of Monsanto products …

     

    The use of third-party academics in the corporate defense of glyphosate reveals that this practice extends beyond the corruption of medicine and persists in spite of efforts to enforce transparency in industry manipulation.”

    The Parry Report

    As mentioned, correspondence by Farmer reveals Monsanto had never actually conducted any carcinogenicity or safety studies on the Roundup formulation. In 1999, Dr. James Parry, a geneticist at Swansea University at the time (he died a year later), was hired by Monsanto to evaluate the genotoxic potential of glyphosate.

    After reviewing the available research, Parry found that “glyphosate is capable of producing genotoxicity both in vivo and in vitro by a mechanism based upon the production of oxidative damage.” In his report, known as The Parry Report, he also noted that: “On the basis of the study of Lioi et al … I conclude that glyphosate is a potential clastogenic,” meaning a mutagenic agent that can break, delete, add or rearrange chromosomes.

    In other words, Monsanto’s own expert was telling them they had a serious problem. Parry noted that the real danger appears to be the synergistic effect between glyphosate and other chemicals in the formula, such as the surfactants, and he told the company they had to study the formulated product as a whole. He also listed specific types of studies he felt needed to be done.

    Internal email correspondence reveals other Monsanto scientists discussed ways in which they might be able to “move Dr. Parry from his position” that glyphosate was toxic. Parry, who had signed a secrecy agreement with the company, never published these findings. What did Monsanto do?

    They avoided the toxicity issues simply by never doing any of the research on the formulation. A September 16, 1999, email from Heydens, himself a Ph.D. toxicologist, reads in part:

    “We want to find/develop someone who is comfortable with the genotox profile of glyphosate/Roundup and who can be influential with regulators and Scientific Outreach operations when genotox issues arise. My read is that Parry is not currently such a person, and it would take quite some time and $$$/studies to get him there. We simply aren’t going to do the studies Parry suggests …”

    The Williams, Kroes and Munro Report

    What’s more, Monsanto buried The Parry Report. Regulators were never informed of its contents. Shortly after The Parry Report was concluded, another report was published, called the Williams, Kroes and Munro Report, which was supposed to be a comprehensive review of the genotoxic profile of glyphosate. It found no problems at all, concluding glyphosate is completely safe.

    Guess which report was sent off to regulators and used by the EPA to support its conclusion that glyphosate is nontoxic? You guessed it: The Williams, Kroes and Munro Report, issued in 2000. During trial, Wisner stressed to the jury that all of this is clear evidence of malice. It proves the company had a conscious disregard for human health.

    The Williams, Kroes and Munro Report also appears to have been of Monsanto’s own making. In an email to Farmer dated February 19, 2015, Heydens writes:

    “A less expensive/more palatable approach might be to involve experts only for the areas of contention, epidemiology and possibly MOA [mode of action] (depending on what comes out of theIARC meeting), and we ghostwrite the exposure tox & genotox sections.

     

    An option would be to add Greim and Kier orKirkland to have their names on the publication, but we would be keeping the cost down by us doing the writing and they would just edit and sign their names so to speak. Recall that is how we handled Williams, Kroes & Munro, 2000.”

    As noted by Wisner, not only did Monsanto bury The Parry Report, which revealed they had a serious health problem on their hands, they ghostwrote a report that claimed the complete opposite. That fabricated “evidence” allowed them to sidestep toxicity concerns for the next 15 years.

    “That is fraud … That’s evil,” Wisner says.

    The jury obviously agreed.

    Science Clearly Demonstrates Glyphosate is Carcinogenic

    “I’m 34 years old. I will try these cases until I’m 90 if I have to,” Wisner says. “If I have to put Bayer in bankruptcy, I will. We have the goods here, and it just shows rampant corporate malfeasance.” Monsanto, meanwhile, insists there are 800 studies produced over the last 40 years showing glyphosate and Roundup is safe.

    “It’s garbage,” Wisner says. “The 800 studies they’re talking about are not about whether it causes cancer. They’re looking at stuff that you have to look at — does it cause eye irritation, does it cause your hair to change color, does it cause skin rashes — all these volumes of tests that test all these random things …

     

    But when it comes to cancer, there’s only been about 13 animal studies and about six or seven epidemiology studies. And when you actually look at the data, actually look at the science, and I showed this jury every single one of those studies.

     

    I walked through them one by one … and with the exception of two or three, they are positive … They show clear correlation. They show that glyphosate causes tumors … creates tumors in mice, that it’s causing Non-Hodgkin lymphoma in humans …”

    One particularly powerful study showed that when people are exposed to Roundup via skin contact (the individuals in this study had been doused with Roundup via aerial sprayings), there’s clear evidence of genetic damage. Every single person that had been exposed to the aerial spray showed evidence off this genetic damage.

    Bayer Bought a Nightmare

    Clearly, Bayer has purchased a nightmare, and may be suffering some buyer’s remorse right about now. Indeed, virtually every single person on the planet is now ingesting and being injected or in some way is exposed to Roundup, and the evidence of serious health consequences just keeps growing. The liability is almost beyond comprehension. Time will tell whether Monsanto’s toxic legacy will put Bayer out of business.

    Related reading: Harvest of Greed – The Merger of Bayer and Monsanto

    In the meantime, it’s up to each of us to take whatever precautions we can to avoid exposure. That includes avoiding using Roundup and other glyphosate-based herbicides at home, convincing local companies to stop using it in public areas and around schools, and by buying organic foods whenever possible and taking steps to detoxify our bodies.

    Wisner brings up more evidence presented in court, and I highly recommend watching the interview in its entirety. Considering the evidence, it’s really no wonder Wisner won this case, and it surely does not bode well for Bayer-Monsanto, seeing how there are many thousands more cases just like it waiting in the wings.

    And, according to Wisner, he has hundreds of documents that are even more damning than those brought to bear during Johnson’s trial, which was rushed to trial. So, he’s confident he will continue to win these cases and, hopefully, change the world for the better.

    Sources and References:

    Source

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  • Justice 002

     

    Company and owner fraudulently misused “service-disabled Veteran-owned small business” status to defraud the Department of Veterans Affairs and Army Corps of Engineers

    NEWS RELEASE SUMMARY – November 21, 2018

    SAN DIEGO, CA – A federal jury today convicted Andrew Otero and his company, A&D General Contracting, Inc. (“A&D”), on charges that they fraudulently obtained $11 million in federal contracts specifically set aside for service-disabled Veteran-owned businesses.

    The evidence demonstrated that Otero had no military experience. Yet Otero (on behalf of A&D) and Veteran Roger Ramsey (on behalf of Action) participated in a conspiracy to defraud the government by forming a joint venture (“the JV”) – and falsely representing that Action and the JV qualified as service-disabled Veteran-owned small businesses (“SDVOSB”). Based on the false claim to SDVOSB eligibility, the conspirators fraudulently obtained approximately $11 million in federal government construction contracts or task orders with the Department of Veterans Affairs (“VA”) and the Army Corps of Engineers (“ACE”).

    As proven at trial, the fraudulent conspiracy involved set-aside contracts that could only be bid upon by legitimate service-disabled Veteran-owned small businesses – a designation that did not apply to Otero or A&D. To appear qualified, Otero and Ramsey initially executed an agreement to create the JV (“the JV Agreement”), which stated that Ramsey’s company (Action) would be the managing venturer, employ a project manager for each of the set-aside contracts, and receive the majority of the JV’s profits.

    However, as proved at trial, six months later, Otero and Ramsey signed a secret side agreement that made clear the JV was ineligible under the SDVOSB program. For example, the side agreement said the parties created the JV so that A&D could simply “use the Disabled Veteran Status of Action Telecom” to bid on contracts. The side agreement also stated that A&D – not Action – would run the construction jobs. They also agreed that “A&D will keep 98% of every payment; Action Telecom will receive 2% of every payment.”

    In addition to the secret side agreement, the evidence demonstrated several ways in which the JV did not operate as a legitimate SDVOSB, but was essentially controlled by Otero and A&D. For example, although Ramsey (a service-disabled Veteran) nominally served as president of Action and the JV, he actually worked full-time for another telecommunications company. Otero and A&D, not Ramsey, controlled the day-to-day management, daily operation and long-term decision making of the JV. Among other things, Otero and A&D appointed an A&D employee as the project manager for every contract and task order.

    “Our nation strives to repay the debt of gratitude we owe to our Veterans by setting aside some government contracts for Veterans with service-related disabilities,” said United States Attorney Adam Braverman. “These unscrupulous contractors abused this program through a cynical and illegal ‘rent-a-Vet’ scheme. They are now being held fully accountable for robbing truly deserving Vets of important economic opportunities.”

    All four defendants are also facing civil charges in United States v. Otero, et al., Case No. 15CV0441-JAH, a case alleging violations of the false claims act based on the similar misconduct.

    The defendants were ordered to appear before U.S. District Judge John Houston for sentencing on February 19, 2019 at 10:30 a.m.

    This case is being prosecuted by Assistant United States Attorneys Rebecca Kanter and Aaron Arnzen.

    CORPORATE DEFENDANTS

    A&D General Contracting, Inc., Santee, California

    INDIVIDUAL DEFENDANTS                                        

    Andrew Otero                                           El Cajon, CA

    Criminal Case No. 17CR0879-BEN

    SUMMARY OF CHARGES

    Count 1:                                 Conspiracy to defraud and commit offenses (18 U.S.C. § 371)

    Maximum penalties: 5 years’ imprisonment; 3 years’ supervised release; a fine of $250,000 or twice the gross gain or gross loss resulting from the offense, whichever is greatest; and a mandatory special assessment of $10

    Count 2-4:                               Major fraud against the United States (18 U.S.C. § 1031)

    Maximum penalties: 10years’ imprisonment; supervised release; a fine of $1,000,000 per count ($5,000,000 total); and a mandatory special assessment of $100

    Counts 5-7:                             Wire fraud (18 U.S.C. § 1343)

    Maximum penalties: 20 years’ imprisonment; a fine of $250,000 or twice the gross gain or gross loss resulting from the offense, whichever is greatest; and a mandatory special assessment of $100

    10, 14:                                     False statements (18 U.S.C. § 1001)

    Maximum penalties: 5 years’ imprisonment; a fine; and a mandatory special assessment of $100

    AGENCIES

    Department of Veterans Affairs, Office of Inspector General

    Source

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  • Gout

     

    Avoiding the Ache and Agony

    Sudden, painful swelling at the base of the big toe is often the first warning sign of gout. It can affect other joints as well. Without treatment, gout can lead to severe joint damage and make it hard for you to move. The good news is, most types of gout are treatable, especially if caught early.

    About 4% of adults in the U.S. have been diagnosed with gout. It’s a form of arthritis—in fact, the 2nd most common form after osteoarthritis. And it’s a growing problem.

    “The prevalence of gout more than doubled nationwide between the 1960s and 1990s, and the increases have continued into the 1990s and 2000s,” says Dr. Hyon Choi, a physician who studies gout at Boston University School of Medicine.

    Experts suspect that climbing rates of obesity and high blood pressure are partly to blame for the rise in gout. Gout has also been linked to other medical conditions, such as kidney problems, diabetes, and heart disease.

    Gout is caused by tiny needle-like crystals that build up in the joints, leading to sudden inflammation and intense pain. The crystals are made of uric acid, a substance that normally dissolves in the blood and passes out of the body in urine. But in people with gout, high blood levels of uric acid allow crystals to form in the joints and sometimes in the kidneys, where they create kidney stones.

    Uric acid comes from the breakdown of substances called purines. Purines are naturally found in your body’s tissues and in many foods. Eating purine-rich foods—such as organ meats, mussels, and mushrooms—can bring on or worsen a gout attack. Alcohol or stress can also trigger an episode.

    Gout symptoms usually arise at night. It normally affects one joint at a time, often in the feet, hands, elbows, or knees.

    “Gout primarily affects men who are middle aged or older,” Choi says. “Postmenopausal women are at risk too, especially if they are obese or have high blood pressure or unhealthy dietary habits, such as drinking large amounts of alcohol or sugary soda.”

    The risk also rises if you have a family member with gout or if you take certain medicines, such as water pills (diuretics) or low-dose aspirin.

    Early gout attacks tend to fade within a week. It may be months or even years before the next attack hits. But over time, gout may appear more often and last longer if left untreated.

    Most people with gout can control their symptoms through lifestyle changes and medications. Non-steroidal anti-inflammatory drugs (NSAIDs) can ease the swelling and pain of sudden attacks. Oral or injected steroids and a drug called colchicine can also help.

    If frequent gout attacks become a problem, doctors may prescribe uric acid-lowering medicines. But once begun, these drugs often must be taken long term.

    “If it’s left untreated, gout can eventually lead to damage and deformity of the joints—a condition called chronic gout,” says Choi. “In general, chronic gout arises only after many years of suffering.”

    If you have repeated attacks of pain and swelling in your joints, talk to a health care provider. “If you have gout, the earlier you’re diagnosed and treated—along with making healthy lifestyle changes—the better off you’ll be,” says Choi.

    Source

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  • Tiny Homes 005

     

    TAMPA, Fla. (FOX 13) - Students and professors with the University of South Florida's School of Architecture and Community Design have partnered with Celebrate Outreach, a group of St. Petersburg-area faith communities, to create "tiny homes" for homeless Veterans.

    After three years of carefully designing and planning, the groups broke ground for their first home on Monday.

    Both USF members and Celebrate Outreach said that they hope the home can signify a fresh start for a very deserving Veteran.

    "We wanted to create a tiny home, but we wanted to go beyond that and create a home that doesn't generate a burden, but allows them to have a normal life," said Josue Robles Caraballo, the faculty and research associate at USF who has helped to lead the tiny homes project.

    photo

    The tiny home has been designed with Veterans in mind. It will be a 500 square-foot structure complete with living spaces, a bedroom, a bathroom, a kitchen and even a washer and dryer. The house will also be made to accommodate any Veteran from any background.

    "Disabilities, PTSD, all the things that these solders go through that then, as Veterans, they suffer through," said Yesenia Vega, a USF student who helped to design the tiny house. "We made a plan that was very open."

    The small size of the tiny home will not only make it easy for a Veteran to maintain, but also easy for them to afford.

    "They're going to be homeowners. The Veteran will need to have some form of monthly subsidy, a steady subsidy. They will need to go through the first time homeowner counseling program, and they'll need to apply for first time homebuyer down payment assistance," said Sabine Von Aulock, the project coordinator with Celebrate Outreach.

    Jabo Stewart, a 94-year-old World War II Veteran, has never been homeless himself. However, he knows firsthand the struggles and challenges Veterans face when returning home.

    "You're gone for three years or four or five years and everything changes in your lifestyle," said Stewart.

    Stewart said he believes the tiny homes might be the helping hand Veterans need to get back on their feet.

    "If I didn't have a home, I would feel horrible," said Stewart. "If anyone could help I would feel very happy and gratified to them."

    Construction on the tiny home is expected to begin soon and will be fully complete within the next six month.

    A Veteran for the home has not yet been chosen. Von Aulock said that another organization will determine which homeless Veteran would be the best candidate for the home as they will need to meet certain requirements.

    Only one home is currently in the construction phase, but the hope is that many more homes will soon follow throughout the St. Petersburg community.

    Source

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  • CBO logo

     

    On May 15, 2018, the Congressional Budget Office transmitted an estimate of the budgetary effects of H.R. 299, a bill to amend title 38, United States Code, to clarify presumptions relating to the exposure of certain Veterans who served in the vicinity of the Republic of Vietnam, and for other purposes, as ordered reported by the House Committee on Veterans’ Affairs on May 8, 2018. Among other things, the act would provide disability compensation to more of the Veterans who served in the territorial seas of Vietnam during the Vietnam War under the assumption that they had been exposed to Agent Orange, a blend of herbicides used by the Department of Defense to remove dense tropical foliage. CBO estimated that those provisions would increase direct spending by about $900 million over the 2019-2028 period.

    The bill that was passed by the House amended the earlier version to expand the nautical area in which Veterans would be presumed to have been exposed to Agent Orange. That change would increase CBO’s estimate of the costs of the legislation by about $250 million to account for the additional Veterans that would be affected.

    Since the original estimate was prepared in May, CBO has obtained new information that would affect future estimates of similar legislation. In total, we expect that accounting for this new information would increase the estimate of the legislation’s effect on direct spending by at least $1 billion over 10 years.

    First, CBO now expects that more Veterans would be affected by enactment of the bill than previously estimated. The Department of Veterans Affairs (VA) already presumes that Veterans who served aboard certain U.S. Navy ships on the dates they were near the coast of Vietnam were exposed to Agent Orange. Using information about the crew size of those listed ships, CBO estimated that about two-thirds of Veterans who served in the geographic area covered by the bill would obtain compensation under current law. Thus, in its estimate for H.R. 299, CBO projected that only one-third of Veterans in the covered population would be newly eligible for disability compensation under that bill.

    We have since learned from additional discussions with VA that there is considerably more uncertainty than we originally anticipated about the number of Veterans that, under current law, VA would presume to have been exposed because of service aboard those vessels. Specifically, there is a greater likelihood that less than two-thirds of Veterans who served in the geographic area covered by the bill would obtain compensation under current law.

    To account for that uncertainty CBO would, in future estimates expect that half of affected beneficiaries would obtain benefits under current law, and thus would not be affected by enactment of H.R. 299. That estimate is in the middle of the range of possible outcomes. Using that updated estimate would mean that fewer Veterans would be expected to receive benefits under current law and more would get benefits as a result of H.R. 299. The increase in the number of affected Veterans would result in additional retroactive payments to Veterans whose disability claims previously have been denied by VA and also would increase the number of recurring disability payments.

    In addition, on the basis of new information from VA, CBO also would increase its estimate of the number of surviving spouses of deceased Veterans who would receive compensation because the cause of those Veterans’ deaths would be presumed to have been caused by exposure to Agent Orange.

    Finally, CBO would estimate that spending subject to appropriation would increase for additional personnel to process disability claims. Such spending would allow VA to handle new claims more quickly. Although H.R. 299 would not require VA to hire more personnel to process these additional claims, the department has indicated that it would need to do so in order to avoid a lengthy backlog.

    CBO will incorporate this new information into its future estimates of the budgetary effects of such legislation.

    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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  • Alzheimer

     

    Over time, people with Alzheimer’s disease become less able to manage around the house. For example, they may forget to turn off the oven or the water, how to use the phone during an emergency, which things around the house are dangerous, and where things are in their own home.

    As a caregiver, you can do many things to make the person’s home a safer place. Think prevention—help avoid accidents by controlling possible problems.

    While some Alzheimer’s behaviors can be managed medically, many, such as wandering and agitation, cannot. It is more effective to change the person’s surroundings—for example, to remove dangerous items—than to try to change behaviors. Changing the home environment can give the person more freedom to move around independently and safely.

    Create an Alzheimer’s-Safe Home

    Add the following items to the person’s home if they are not already in place:

    • Smoke and carbon monoxide detectors in or near the kitchen and in all bedrooms
    • Emergency phone numbers (ambulance, poison control, doctors, hospital, etc.) and the person’s address near all phones
    • Safety knobs and an automatic shut-off switch on the stove
    • Childproof plugs for unused electrical outlets and childproof latches on cabinet doors

    You can buy home safety products at stores carrying hardware, electronics, medical supplies, and children’s items.

    Lock up or remove these potentially dangerous items from the home:

    • Prescription and over-the-counter medicines
    • Alcohol
    • Cleaning and household products, such as paint thinner and matches
    • Poisonous plants—contact the National Poison Control Center at 1-800-222-1222 or www.poison.org to find out which houseplants are poisonous
    • Guns and other weapons, scissors, knives, power tools, and machinery
    • Gasoline cans and other dangerous items in the garage

    Moving Around the House

    Try these tips to prevent falls and injuries:

    • Simplify the home. Too much furniture can make it hard to move around freely.
    • Get rid of clutter, such as piles of newspapers and magazines.
    • Have a sturdy handrail on stairways.
    • Put carpet on stairs, or mark the edges of steps with brightly colored tape so the person can see them more easily.
    • Put a gate across the stairs if the person has balance problems.
    • Remove small throw rugs. Use rugs with nonskid backing instead.
    • Make sure cords to electrical outlets are out of the way or tacked to baseboards.
    • Clean up spills right away.

    Make sure the person with Alzheimer’s has good floor traction for walking. To make floors less slippery, leave floors unpolished or install nonskid strips. Shoes and slippers with good traction also help the person move around safely.

    Minimize Danger

    People with Alzheimer’s disease may not see, smell, touch, hear, and/or taste things as they used to. You can do things around the house to make life safer and easier for the person.

    Seeing

    Although there may be nothing physically wrong with their eyes, people with Alzheimer’s may no longer be able to interpret accurately what they see. Their sense of perception and depth may be altered, too. These changes can cause safety concerns.

    • Make floors and walls different colors. This creates contrast and makes it easier for the person to see.
    • Remove curtains and rugs with busy patterns that may confuse the person.
    • Mark the edges of steps with brightly colored tape so people can see the steps as they go up or down stairs.
    • Use brightly colored signs or simple pictures to label the bathroom, bedroom, and kitchen.
    • Be careful about small pets. The person with Alzheimer’s may not see the pet and trip over it.
    • Limit the size and number of mirrors in your home, and think about where to put them. Mirror images may confuse the person with Alzheimer’s disease.
    • Use dishes and placemats in contrasting colors for easier identification.

    Touching

    People with Alzheimer's may experience loss of sensation or may no longer be able to interpret feelings of heat, cold, or discomfort.

    • Reset your water heater to 120°F to prevent burns.
    • Label hot-water faucets red and cold-water faucets blue or write the words "hot" and "cold" near them.
    • Put signs near the oven, toaster, iron, and other things that get hot. The sign could say, "Stop!" or "Don't Touch—Very Hot!" Be sure the sign is not so close that it could catch on fire. The person with Alzheimer's should not use appliances without supervision. Unplug appliances when not in use.
    • Pad any sharp corners on your furniture, or replace or remove furniture with sharp corners.
    • Test the water to make sure it is a comfortable temperature before the person gets into the bath or shower.

    Smelling

    A loss of or decrease in smell is common in people with Alzheimer’s disease.

    • Use good smoke detectors. People with Alzheimer’s may not be able to smell smoke.
    • Check foods in your refrigerator often. Throw out any that have gone bad.

    Tasting

    People with Alzheimer’s may not taste as well as before. They also may place dangerous or inappropriate things in their mouths.

    • Keep foods like salt, sugar, and spices away from the person if you see him or her using too much.
    • Put away or lock up things like toothpaste, lotions, shampoos, rubbing alcohol, soap, perfume, or laundry detergent pods. They may look and smell like food to a person with Alzheimer’s disease.
    • Keep the poison control number (1-800-222-1222) by the phone.
    • Learn what to do if the person chokes on something. Check with your local Red Cross chapter about health or safety classes.

    Hearing

    People with Alzheimer’s disease may have normal hearing, but they may lose their ability to interpret what they hear accurately. This loss may result in confusion or overstimulation.

    • Don't play the TV, CD player, or radio too loudly, and don't play them at the same time. Loud music or too many different sounds may be too much for the person with Alzheimer’s to handle.
    • Limit the number of people who visit at any one time. If there is a party, settle the person with Alzheimer’s in an area with fewer people.
    • Shut the windows if it's very noisy outside.
    • If the person wears a hearing aid, check the batteries and settings often.

    It may not be necessary to make all these changes; however, you may want to re-evaluate the safety of the person’s home as behavior and abilities change. For more on home safety and Alzheimer’s, read Home Safety Checklist for Alzheimer’s Disease.

    Is It Safe to Leave the Person with Alzheimer's Alone?

    This issue needs careful evaluation and is certainly a safety concern. The following points may help you decide.

    Does the person with Alzheimer's:

    • Become confused or unpredictable under stress?
    • Recognize a dangerous situation, for example, fire?
    • Know how to use the telephone in an emergency?
    • Know how to get help?
    • Stay content within the home?
    • Wander and become disoriented?
    • Show signs of agitation, depression, or withdrawal when left alone for any period of time?
    • Attempt to pursue former interests or hobbies that might now warrant supervision, such as cooking, appliance repair, or woodworking?

    You may want to seek input and advice from a healthcare professional to assist you in these considerations. As Alzheimer's disease progresses, these questions will need ongoing evaluation.

    For more home safety tips, visit the Home Safety Checklist for Alzheimer's Disease.

    For More Information About Home Safety and Alzheimer's

    NIA Alzheimer’s and related Dementias Education and Referral (ADEAR) Center

    1-800-438-4380 (toll-free)

    This email address is being protected from spambots. You need JavaScript enabled to view it.">This email address is being protected from spambots. You need JavaScript enabled to view it.

    www.nia.nih.gov/alzheimers

    The National Institute on Aging’s ADEAR Center offers information and free print publications about Alzheimer’s disease and related dementias for families, caregivers, and health professionals. ADEAR Center staff answer telephone, email, and written requests and make referrals to local and national resources.

    Family Caregiver Alliance

    1-800-445-8106 (toll-free)

    This email address is being protected from spambots. You need JavaScript enabled to view it.">This email address is being protected from spambots. You need JavaScript enabled to view it.

    www.caregiver.org

    Eldercare Locator

    1-800-677-1116 (toll-free)

    https://eldercare.acl.gov

    Source

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  • Military Discounts

     

    Many companies offer military discounts, which is an awesome way to show their appreciation for all military Veterans have done for our country. As a Veteran, I certainly appreciate the gesture, and I try to thank the company offering the discount whenever it is possible. As well-meaning as the military discounts are, however, they sometimes cause problems because there is no general standard among stores regarding discount eligibility. In this article we will cover some helpful information about military discounts, including how to get them, how to find “hidden” military discounts, what to expect, and what to do if the discount isn’t honored.

    Military Discount Eligibility

    Let’s start off with the most important topic – who is eligible for a military discount. This is probably the most debated topic I’ve seen regarding military discounts. Unfortunately, there isn’t one standard. The important thing to remember is that stores aren’t required to give military discounts – it’s a privilege, not a right. The stores set the rules, and we as military members and Veterans, should honor the standards set by the stores. Let’s take a look at some different groups of people who are commonly offered military discounts at various locations:

    • Active duty military
    • Current Guard / Reserve
    • Retirees
    • Military dependents (anyone with a DoD issued military or dependent ID)
    • Veterans (proof of service may or may not be required)

    As you can see, there is a wide range of people in this list. And it doesn’t always make sense. Many stores which offer military discounts do so out of generosity, but sometimes their policies are made without understanding how the military ID card system works. Compounding this is the fact that there isn’t a standard for a national Veterans ID card – yet (legislation has been passed into law, but the cards haven’t been issued yet). As a result, some military discount policies are misguided.

    For example, some stores offer discounts for dependents of active duty service members or retirees, while they don’t offer discounts for Veterans who served, but are no longer on active duty and didn’t reach retirement (this group of people represents the largest group of Veterans).

    I will be the first to say that it doesn’t make sense to give a military discount to a dependent, who is someone who never wore the uniform, then deny a discount to someone who served, but didn’t retire. Yes, spouses and dependents make sacrifices on the home front, but they don’t warrant greater recognition than someone who served in a combat zone, but didn’t remain in the military through retirement. (I am qualified to make this statement as I both both served in a combat zone, and was a military spouse after I separated from the military – my wife served on active duty while I was a civilian).

    But here is the kicker: it doesn’t matter what you or I think – we don’t make the rules. The stores make the rules, and as this is an act of generosity on their part, it’s always best to honor their wishes.

    Finding Hidden Military Discounts

    Many stores publicize military discounts, while others don’t announce them publicly. You will be surprised how often companies will offer you a military discount if you just ask for it. All it takes is a simple question while you are ordering or checking out. Just ask, “do you offer a military discount?” In some cases you will be told no, but sometimes you will be pleasantly surprised. Just ask, and always thank the person if you receive a discount. And if not, no hard feelings. Remember, this is an act of generosity on their part, not a right Veterans deserve.

    *Bonus tip: Your odds of success increase substantially when asking for a military discount on a military related holiday, such as Memorial Day, Fourth of July, Veterans Day or other national holidays. In fact, many stores don’t offer military discounts, except on these holidays.

    Proving Military Service

    After determining eligibility, the next most important thing is to be able to prove you served in the military. If you are on active duty, or are a retiree, then this likely isn’t a problem, as you should have a military ID Card. But proving military service can be a lot more difficult for a military Veteran who didn’t retire, and isn’t receiving disability from the VA.

    Unfortunately, there is currently no standard for proving military service, outside of carrying around your current military or retiree ID card, or a DD Form 214. Carrying your DD Form 214 isn’t always a good idea as it has your Social Security Number and other personal information on it. The good news is Congress has passed a law that will allow Veterans to get an official Veterans ID card through the VA. We don’t have word on when they will begin issuing these ID cards, but it looks like it will be sometime in 2017.

    Here are the current forms of ID cards you can use to show proof of service:

    Again, because there is no standard, some stores only accept certain forms of ID or proof of service.

    What to Do if a Store Doesn’t Honor a Military Discount

    As mentioned above, some military discounts are seemingly misguided regarding who is eligible, and who is not. But it’s not our place to make that judgment. As military discounts are made out of the generosity of the store offering the discount, it’s in our best interest as military members and Veterans to accept a discount with humble thanks when it is offered, and be understanding when it is declined.

    If you believe you should be eligible for a discount, then politely ask to speak with a manager and explain the situation. But always be sure to fully understand the company’s policies on military discounts before doing so (and keep in mind policies may change at any time, so be sure to be up to date).

    One of the biggest complains we have heard is about Home Depot and Lowes discounts. These companies offer military discounts everyday, however, they have changed the eligibility a few times, so the military discounts may only be available to a segment of the military and Veteran population. Be sure to review their corporate policies before arguing with management about the discount you are “entitled to.” Here is the Lowe’s corporate policy.

    Remember, military discounts are an act of generosity, not a right. It is never worth making a scene over getting a military discount.

    Source

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  • GUIDE FOR NEW VETS

     

    When you are ready to make the move away from military service and into civilian life, you face some major adjustments. It’s no secret that military life is extremely different than civilian life, and you may find that the challenges ahead of you are a bit steeper to overcome than you once thought. If you are suffering from a physical or psychological injury as a result of your service, you will find the adjustment is even bigger. So what can you do to make the transition easier?

    Thankfully, you are not alone. You have numerous resources at your disposal that can help you through this transition, and many people who are ready to cheer you on as you make the change. From Veteran transition support organizations to the benefits you are entitled to as a result of your service, you have resources. The key is to plan ahead so you are prepared for what will come in the days ahead.

    Whether you’ve just received your DD214 or know it is coming and the transition is about to begin, knowing what to expect in the days ahead and having a plan for organization will help your transition to go smoothly. From keeping your paperwork organized to knowing what to do to decorate your first home or apartment, everything you need to know to transition with confidence is here, giving you the head start you need to enter civilian life successfully.

    Organize Your Papers

    As a Veteran, you will have many important papers that help you get benefits. From the papers outlining the terms of your discharge to all of the forms that come through as you apply for benefits, you are going to need to keep these things organized and accessible, or you could miss out on important benefits you are due. Here are some strategies you can use to organize your paperwork.

    Military Paperwork

    • Properly safeguard all military paperwork. Whatever storage and organization option you choose for your paperwork, make sure that it is properly secured. Unfortunately, military paperwork is a target for identity thieves.

    • Place documents into a page protector inside a notebook. One of the easiest ways to organize your paperwork is to slip each document into a page protector, then hang the page protector from a notebook. You can then place the notebook in a secure location, like a safe, to keep it protected.

    • Guard your DD Form 214 with care. The DD Form 214, your Report of Separation, is one of the most important documents you have. This is what you use for your benefits, so you need to take extra precautions to keep it safe.

    • Register with the VA. One of the first steps you should take after receiving your discharge documentation is registering with the VA for your health benefits. This will help ensure you have the healthcare coverage you deserve as you move forward with civilian life.

    • Register for a Veterans ID card and carry it with you. Many businesses will offer discounts and perks to Veterans, and showing the Veterans ID Card will give you these benefits. The Veterans ID Card does not qualify you for federal benefits, but it can help with other perks.

    • Hold on to your benefits verification letters. If you apply for or receive any benefits, make sure you hold on to the copies of your benefits verification letters. You may need to refer to these as you receive and collect your benefits.

    • See if your state offers Veterans ID Driver’s Licenses. Many states are now allowing Veterans to have specially designated driver’s licenses that indicate their time of service. Check to see if your state is one of the ones that does, and apply for this license if it is available to you.

    • Protect any paperwork regarding completed training or classes. These documents can help you find employment when you are ready to enter the civilian workforce again. Even those courses that seem irreverent right now may be important later, so keep these in one location.

    Medical Paperwork

    • Keep careful medical records. If you received an injury or suffered an illness while in active duty, you need to keep the paperwork relating to your injury. There are many programs and helps for disabled Veterans, but you need the proper proof. Remember that records can disappear while in transport, so keep paper copies of your medical records in your possession.

    • Create a medical power of attorney and living will. A medical power of attorney outlines the individual who will make decisions for you when you can no longer do so for yourself due to health-related conditions. Choose someone who understands how to work with the VA healthcare system. A living will states your desires for end-of-life care, like resuscitation. Both of these are critical to have on file in a place where your loved ones can access.

    Personal Paperwork and General Guidelines

    • Create the right end-of-life documents. You will need a will, power of attorney, trust and similar documents to ensure your estate is divided the way you wish after your death. Make sure these documents outline the survivor benefits your spouse or children are entitled to receive as part of your Veteran’s benefits. Including this information in your end-of-life documents ensures they d not overlook an important benefit that they should be receiving.

    • Store your documents securely. A safe, a secure public storage facility, a deposit box at a bank or somewhere similar is an important storage option for your paperwork. Keep your paperwork out of the hands of potential identity thieves by storing it well. Consider storing the most vital documents away from your home, or at least having copies of them not at your home, so that you still have them if you lose everything to theft or fire.

    • Protect documents that put your identity at risk. Not all documents are related to your military career. You also need to protect those that contain your personal information. Social Security cards, marriage licenses, birth certificates, passports and other similar documents all need to be kept securely. Veterans are at higher risk for identity theft than others because of the appeal of the benefits they receive, so guard these items carefully.

    • Store financial paperwork. You need to tore tax returns and related proofs, bank statements, investment statements, real estate closing statements, insurance records, receipts for personal property and retirement account information. Your tax returns can be audited up to six years n the past, so hang on to them at least that long. The IRS actually recommends hanging on to your W-2 until you begin receiving Social Security retirement income because this is the only proof of what you paid in.

    For more information about organizing your papers, visit:

    Organizing Your Health

    Keeping your health and healthcare under control is important when you are living a civilian life. Thankfully, most Veterans are able to get medical coverage through the VA. However, you still have some responsibilities to consider as you seek to stay healthy and protect your health in the future. Here are some important considerations to make and steps to take to ensure your health is well taken care of as you enter civilian life.

    VA Healthcare Benefits

    • Find the VA healthcare facility nearest you. The Veterans Health Administration maintains a database of VA healthcare providers. Use that database to find a facility near the location where you plan to settle down for your civilian life. Knowing you have convenient access to healthcare or identifying the place where you will need to travel for your healthcare is important to maintaining your health through your non-military days.

    Finding a Doctor and Accessing Care

    • Understand the VA’s Patient Aligned Care Team approach. VA healthcare is provided through a Patient Aligned Care Team approach, which means you will have several specific providers on your team that provide your care. This will include a primary care provider (PCP), clinical pharmacist, registered nurse care manager, and licensed practical nurse. These providers are assigned to you, so you do not have the option to choose. If you wish to change primary care providers, you will need to talk to your healthcare team leader or a VA patient advocate.

    • Visit your primary care provider to get referrals to specialists. Your primary care provider is a general practitioner who can handle your basic medical care. This provider will be the one who refers you to specialists if you have a disability or medical condition that needs specialized care.

    • Access the Veterans Choice Program if applicable. The Veterans Choice Program gives Vets care through a network of community providers when the VA cannot provide the needed health care in a timely manner. This option requires authorization through the VA, but gives the Veteran greater choice in receiving healthcare.

    Health Considerations for Disabled Veterans

    • Look for transportation services for the disabled. Disabled Veterans may have trouble getting around their communities due to their disabilities. Many communities have disability transportation services that disabled Veterans can tap. Some of these are Veteran-specific, but some are not. Look for this type of service in your community to preserve your mobility.

    • Choose your location based on proximity to care. The VA operates about 1,200 healthcare facilities, but that does not mean one is located near the place you wish to settle. Disabled Veterans who have trouble driving will need to be located near their VA healthcare center, because they will need more regular treatment and care than their non-disabled counterparts. Distance from the healthcare facility could limit their ability to get care.

    • Determine if any specialized care is needed. Certain disabilities, like traumatic brain injuries or post-traumatic stress disorder (PTSD), require specialized care that the average VA medical center may not be able to provide. Look for a facility that offers that type of care as you consider where you will settle for civilian life.

    • Choose a home that is accessible. Accessibility is critical to a disabled Veteran. You may be able to find a home that is already accessible, or you may need to consider a home that can be renovated to be accessible. When shopping for a home, keep mobility needs in mind.

    • Find rental properties that are service animal friendly. Sometimes Veterans benefit from a service animal to help with PTSD or physical disabilities. If you are qualified for a service animal, you will need to choose adequate housing. For renters, find a rental location that allows pets or makes exceptions for service animals. Consider an option that has pet-friendly amenities, like a dog run or pet spa, to ensure you can care for your service animal well.

    • Know your rental property rights if you have a service dog. If you have a service dog, you have the right to have access to “no pets” housing, exemption from monthly pet fees or pet deposits, and exemptions from breed or weight rules. These protections also apply to emotional support animals. That said, you may have an easier time being accepted by your neighbors if you choose a pet-friendly location.

    For more information about your health care options, visit:

    Organize Your Move

    After you are done with your time in service, one of the first things you will need to do is move to your new home. After choosing where you will settle, you need to get organized for your move. Here are some tips that will help.

    Where to Settle

    • Choose the best location to settle. Before you can start shopping for a moving company or packing for your move, you must decide where you will move. Consider the Veterans services you will be using, and choose a location near those benefits.

    • Start the transition from base to dorm. If you’re entering school after your service, consider what college housing will work best for you and what college you will attend, so you can settle in the appropriate place.

    • Choose a location near jobs. If you know what type of job you will be considering for your civilian life, choose a location near the job opportunities you desire. Large cities tend to have more variety of employers than smaller communities.

    Consider How You Will Move

    • Consider taking advantage of the military’s moving services. Veterans who are separating or retiring from active duty are able to receive reimbursement for their relocation expenses. This relocation benefit is typically to pay transportation to their original point of entry. This means that, should you wish to settle somewhere new after your move, you may have to foot some of the bill. Keep in mind that this benefit is allowed for up to one year after your time of service is over.

    • Know how you can get the military to cover your move even if you wish to relocate. This particular decision can be a bit complex, but it is possible for the military to cover the cost of your move to a different location. The Defense Department will consider how far you were initially authorized to move, how much your belongings weigh and how long your service was. Do not write off the option to have military pay for your coverage before checking about this benefit.

    • Handle the move yourself. Even if the military will pay for your move, you have the option to pay for it yourself and ask for reimbursement. This may end up being the cheapest option, particularly if you’re planning to move away from your original location. This is known as a Personally Procured Move.

    Pack and Store Your Belongings

    • Decide who will do the packing. If you’re doing a military move, the moving company will handle your packing for you, so this is a stress you don’t need to take on.

    • Pack your most delicate items yourself. Even if you have a moving company who will handle the move for you, you may wish to pack your more delicate items yourself. While movers are trained to handle delicate items carefully, they may make mistakes. You can avoid tragedy by packing these items yourself. Consider hand-carrying these times as well.

    • Store those items you may not need. If you’re transitioning to a dorm, for example, you won’t be able to bring everything with you. Consider storing items you will not need at your new location, such as your military gear, items for seasons your new location does not have, or items your new home simply is not large enough to store. If you are moving far, pack these into a box marked for storage so you can store them near your new home.

    • Keep critical paperwork handy. The documents you need for your VA benefits, discharge, move and other military needs must be kept out. Should you need a document that’s packed deep in your boxes, you may miss out on something you are eligible to receive. Plan to carry your personal identification documents, marriage, divorce and birth certificates, naturalization paperwork, medically important information, housing information, school records, employment records, and vehicle documents by hand.

    • Declutter before you pack. Moving gives you the chance to get rid of items you will not need at your new location. Consider selling, donating or tossing the items you no longer use, love or need. This will not only make your final move weight lighter, but it will also help you settle into your new place with less clutter.

    • Separate professional gear. Your professional gear does not count against your household weight, so anything you picked up during your time of service that you get to keep should be packed separately to prevent unnecessary weight.

    For more advice about moving as a Veteran, visit:

    Organize Your Career

    Starting your civilian career is an important step after leaving the military, but sometimes it is not easy to get started on the right foot. You received training in the military that actually translates well into the civilian workforce, as well as the soft skills that employers are looking for, but sometimes communicating those benefits to potential new employers is a little challenging. Here are some tips to help you launch a civilian career on the right foot.

    Preparing Your Resume and Elevator Pitch

    • Quantify your experiences. Whenever possible, put numbers with your experience. Instead of simply saying that you led a squadron, indicate that you managed a specific number of people. Numbers are something that a hiring manager can understand.

    • Speak to your employer’s need. Your potential employer has a need that you can fulfill. This is what your resume needs to show. In everything you add, tell your employer what you can do for them. Choose the skills and accolades to include based on this. If you are applying for an office job, your award for marksmanship is not an important item to include.

    Rounding Out Your Training

    • Get the right credentials. Many skilled trades require specific credentials and licenses. Get these in place before you start applying for work.

    Finding Veteran-Friendly Employment

    • Attend a Veteran job fair. Veteran job fairs help Veterans and employers find each other. These give Veterans an excellent opportunity to see local opportunities with Veteran-friendly employers.

    • Work your network. The friendships and network contacts you made in the military can be an excellent source for job information when you are out. Use these network contacts to help in your job search.

    For more information about making the transition to a civilian career and finding a job, visit:

    Organize Your Social Life

    When you are in the military, your social life is built into your career. Everywhere you go, you are surrounded by people. When you move into civilian life, you must be more proactive to get out and about and enjoy socializing. Sometimes, Veterans find it to be a struggle to re-learn how to have a social life. Unfortunately, this loneliness has been linked to depression and even suicidal thoughts in Veterans, so it is important that you learn how to rekindle a social life. Here are some tips to help you get out there and get social.

    • Join a Veteran’s organization in your area. You will find that it is helpful to network and fellowship with others who understand the unique way of thinking that a modern Veteran has. Find a Veteran’s organization in your area to join.

    • Join a sports team. In your civilian life, you are not going to have the regular workouts that you had in the military. Joining a sports team will help you stay in good physical shape, and also give you a connection with your civilian community members that will help you build a new social life outside of the military.

    • Recognize the signs of distress. If you are drinking or using drugs more often than normal, find yourself withdrawing from friends, have difficulty concentrating or deal with intense periods of sadness, you may not be handling the transition to a normal social life as well as you should. These symptoms mean it is time to get some professional help.

    • Find a place to volunteer. One of the reasons the military bonds you made are so strong is because you and your fellow soldiers worked together for a common good. Finding a place in your local community to volunteer can help you create similar bonds with local people, so you can begin building a civilian network.

    • Use Veteran dating sites with caution. There are several dating sites designed for Veterans. While these may be an option to help you find someone to connect with, be cautious. Unless you are looking for a significant other who is also a Vet, you may have better luck with generic dating sites.

    • Don’t dwell on your military experience too strongly while dating. Yes, your military experience is part of who you are, so you should include it when you are looking for a romantic connection, but do not make it the single focal point. You are transitioning to civilian life, so start looking for connections based on mutual interests or similar factors.

    For more information about building a social network after military service, visit:

    Organize Your Home or Apartment

    Civilian life means no more base housing or barracks. It also means the opportunity to decorate and organize a space all your own. Yet after many years of being told where you will live and for how long, you may feel a little overwhelmed with the task at hand. Whether you choose to rent an apartment or move into your first home after your time of service, here are some tips Veterans can use to create a space that is truly yours.

    • Determine what you need. If you have been in the service for an extended period of time, chances are you have pared down your belongings significantly. Take time to take an inventory of what you have and what you will need.

    • Start with the basics. A bed, cooking paraphernalia, seating, a table, and some basic shelving are absolute must-haves. You will also want some bedding, linens and a basic toolkit to help you put together all of your new furniture. Most Veterans will also want a television and media center. Start with these items first, then build your home around it.

    • Decorate slowly. You may find that your decorative sense changes as you start to put furniture and belongings in place and paint the walls the color you want. Don’t be in a hurry to decorate. Consider adding decorative items last as you determine what your style is.

    • Ask for military discounts. Not all businesses advertise their military discounts but don’t be afraid to ask. Many will offer Veterans a break on large purchases, and every little bit you can save will help.

    • Shop for used items. Craigslist and Facebook Marketplace are excellent resources to tap as you search for used items to decorate your home.

    • Use curbside goodies to create vintage treasures. Drive through a neighborhood on garbage day, and you will see many pieces of usable furniture on the curb. Snag some of these items, repaint or recover them, and enjoy a vintage look in your home. For just the cost of some paint, you can have a beautiful, uniquely yours, piece in your new space.

    • Avoid the temptation to fill it too full. Now that you have the freedom to buy what you want for your space, you may find yourself tempted to cram your home or apartment full of stuff. Be careful. Clutter can be stressful and can limit your enjoyment of your new place, so go slowly.

    • Measure multiple times before buying big items. Make sure the couch, bed, television or other items will fit properly in the space. Don’t forget to measure length, width, and height. It’s very difficult to return a couch when you realize it doesn’t actually fit your space, but it is very easy to measure before you buy.

    When You Need Help with Your Home

    • Get help with home repairs from Habitat for Humanity. Habitat for Humanity offers a program that provides repair services to Veterans who do not have the funds to repair their homes. If you need this service, take advantage of it to keep your home in good repair.

    • Apply for an adaptive housing grant. For disabled Veterans who need adaptive accommodations in their homes, the VA offers an adaptive housing grant. This grant will give you money to make the home accessible so you can live in it comfortably, even as a disabled Veteran.

    For more help setting up your first home or apartment, visit:

    Conclusion

    Transitioning from military life to civilian life is a huge adjustment. When you also need to adjust to life with a disability, you face even greater challenges. Planning ahead will help your move go more smoothly. Thankfully, you have a number of resources at your fingertips you can tap into to assist you in the days ahead. For this transition, you may feel like it sometimes, but you are never alone.

    Source

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  • SD 100 Homeless Vets

     

    About 100 homeless Veterans in San Diego County will receive vouchers for subsidized housing through $1.1 million in funds released this week from the U.S. Department of Housing and Urban Development and the U.S. Department of Veterans Affairs.

    The money will fund 50 housing vouchers administered by the city of San Diego Housing Commission and 50 vouchers administered by the San Diego County Housing Authority.

    The new vouchers are in addition to 1,031 vouchers already in use to subsidize housing for San Diego Veterans countywide.

    “We have few responsibilities greater than making sure those who have sacrificed so much in service to their country have a home they can call their own,” HUD Secretary Ben Carson said in a statement Thursday.

    “The housing vouchers awarded today ensure homeless Veterans nationwide have access to affordable housing and the critical support services from the VA,” Carson said.

    Nationwide, $35.3 million has been released to fund 4,077 Veterans Affairs Supportive Housing vouchers. Of that, $18.3 million is going to California for 1,658 vouchers.

    The rental assistance announced Thursday is provided through the HUD-VASH Program, which combines rental assistance from HUD with case management and clinical services provided by the VA.

    “When our neighbors answer our country’s call to service, we must answer their call when they return home,” HUD Deputy Regional Administrator Wayne Sauseda said in the news release. “Together with the VA, HUD remains committed to meeting the supportive housing needs of Veterans, so that, one day, we end Veteran homelessness in San Diego.”

    Since 2008, more than 93,000 vouchers have been awarded and about 150,000 homeless Veterans have been served through the HUD-VASH program nationwide.

    More than 600 public housing agencies administer the HUD-VASH program, and this most recent award includes 22 new agencies, increasing coverage to many communities.

    The program also helps VA Medical Centers assess Veterans experiencing homelessness before referring them to local housing agencies for vouchers.

    Decisions are based on how long a person has been homeless and the need for longer-term care, among other factors.

    Veterans participating in the HUD-VASH program rent privately owned housing and generally contribute no more than 30 percent of their income toward rent. VA offers eligible homeless Veterans clinical and supportive services through its medical centers across the U.S., Guam, Puerto Rico and the Virgin Islands.

    Source

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  • Justice 004

     

    HUNTINGTON, W.Va. – A Huntington man pled guilty yesterday to embezzling over $80,000 of his brother’s Veteran’s benefits. The case was investigated by the United States Department of Veteran’s Affairs Office of Inspector General and the Federal Bureau of Investigation.

    David Washington, 55, was appointed his brother's fiduciary to receive and manage benefits from the Department of Veteran's Affairs. Washington failed to submit accounting reports, which led investigators to question his management. Washington later admitted to mismanagement, including spending his brother's benefits for his own personal expenses. The total amount misappropriated was over $81,000.

    “Our Veterans have sacrificed enough and have earned every dollar this country provides them through benefit programs,” said United States Attorney Mike Stuart. “It’s despicable to think that anyone, much less a family member, would steal benefits from a Veteran for their own personal use.”

    Washington faces up to 5 years imprisonment and a fine of up to $250,000 when he is sentenced in February 2019. United States District Court Judge Robert C. Chambers presided over the plea hearing. Assistant United States Attorneys Gabe Wohl and R. Gregory McVey handled the prosecution.

    Source

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  • Hypertension 001

     

    WASHINGTON – The latest in a series of congressionally mandated biennial reviews of the evidence of health problems that may be linked to exposure to Agent Orange and other herbicides used during the Vietnam War found sufficient evidence of an association for hypertension and monoclonal gammopathy of undetermined significance (MGUS). The committee that carried out the study and wrote the report, Veterans and Agent Orange: Update 11 (2018), focused on the scientific literature published between Sept. 30, 2014, and Dec. 31, 2017.

    From 1962 to 1971, the U.S. military sprayed herbicides over Vietnam to strip the thick jungle canopy that could conceal opposition forces, destroy crops that those forces might depend on, and clear tall grass and bushes from the perimeters of U.S. bases and outlying encampments. The most commonly used chemical mixture sprayed was Agent Orange, which was contaminated with the most toxic form of dioxin. These and the other herbicides sprayed during the war constituted the chemicals of interest for the committee. The exact number of U.S. military personnel who served in Vietnam is unknown because deployment to the theater was not specifically recorded in military records, but estimates range from 2.6 million to 4.3 million.

    Hypertension was moved to the category of “sufficient” evidence of an association from its previous classification in the “limited or suggestive” category. The sufficient category indicates that there is enough epidemiologic evidence to conclude that there is a positive association. A finding of limited or suggestive evidence means that epidemiologic research results suggest an association between exposure to herbicides and a particular outcome, but a firm conclusion is limited because chance, bias, and confounding factors could not be ruled out with confidence. The committee came to this conclusion in part based on a recent study of U.S. Vietnam Veterans by researchers from the U.S. Department of Veterans Affairs (VA), which found that self-reported hypertension rates were highest among former military personnel who had the greatest opportunity for exposure to these chemicals.

    The committee concluded that there was sufficient evidence of an association between exposure to at least one of the chemicals of interest and MGUS, a newly considered condition. This finding is based on a recent study in which investigators found a statistically significant higher prevalence of MGUS in Vietnam Veterans involved in herbicide spray operations than in comparison Veterans. MGUS is a clinically silent condition that is a precursor to the cancer multiple myeloma, but only an estimated 1 percent of MGUS cases progress to multiple myeloma each year.

    While some new studies suggest an association might exist between exposure to the chemicals of interest and Type 2 diabetes, the committee could not come to a consensus on whether this and the other available evidence continued to be limited or suggestive, or merited elevation to sufficient. Both newly and previously reviewed studies consistently show a relationship between well-characterized exposures to dioxin and dioxin-like chemicals and measures of diabetes health outcomes in diverse cohorts, including Vietnam Veteran populations. The risk factors for diabetes, such as age, obesity, and family history of the disease, were controlled for in the analyses of most studies reviewed. However, some members of the committee believed that the lack of exposure specificity and the potential for residual uncontrolled confounding influences complicated attribution of the outcome to the chemicals of interest.

    In addition, VA asked the committee to focus on three health outcomes: possible generational health effects that may be the result of herbicide exposure among male Vietnam Veterans, myeloproliferative neoplasms, and glioblastoma multiforme. The evidence of association for exposure to the chemicals of interest and glioblastoma (and other brain cancers) remains inadequate or insufficient, the committee concluded. While it is appropriate for VA be mindful of the concerns raised about the possible association between Vietnam service and glioblastoma, the outcome is so rare and the information concerning herbicide exposures so imprecise, that it is doubtful that any logistically and economically feasible epidemiologic study of Veterans would produce meaningful results regarding the association between exposures and the disease. For this reason, the committee recommended that VA should focus on fostering advancements to inform improved glioblastoma treatment options.

    There are relatively few studies on the health effects of paternal chemical exposures on their descendants, and none address Vietnam Veterans specifically. Therefore, the committee recommended further specific study of the health of descendants of male Vietnam Veterans.

    Myeloproliferative neoplasms and myelodysplastic syndromes are diseases of the blood cells and bone marrow. The committee’s search of epidemiologic literature yielded only one relevant paper on these diseases -- a study of these cancers in Vietnam Veterans that was reviewed in a previous update. Given this paucity of research, the committee recommended that investigators should examine existing databases on myeloid diseases to determine whether there are data available that would allow for an evaluation of myeloproliferative neoplasms in Vietnam Veterans and others who have been exposed to dioxin and the other chemicals of interest.

    Although progress has been made in understanding the health effects of military herbicide exposure and the mechanisms underlying these effects, significant gaps in knowledge remain. The committee restated recommendations for research activities outlined in previous updates in this series, including toxicologic, mechanistic, and epidemiologic research. Such work should include efforts to gain more complete knowledge through the integration of information in existing U.S. Department of Defense and VA databases.

    The committee noted that the difficulty in conducting research on Vietnam Veteran health issues should not act as a barrier to carrying out such work. There are many questions regarding Veterans’ health that can only be adequately answered by examining Veterans themselves, thereby properly accounting for the totality of the military service experience.

    The study was sponsored by the U.S. Department of Veterans Affairs. The National Academies of Sciences, Engineering, and Medicine are private, nonprofit institutions that provide independent, objective analysis and advice to the nation to solve complex problems and inform public policy decisions related to science, technology, and medicine. They operate under an 1863 congressional charter to the National Academy of Sciences, signed by President Lincoln. For more information, visit nationalacademies.org. A committee roster follows.

    Source

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  • Womens Mental Health

    Women currently comprise approximately 16 percent of the United States military. As of 2016, service women are permitted to serve in any military position for which they meet the gender-neutral performance standards and requirements. These expanded roles have increased the cadre of responsibilities that service women have, as well as increased their potential challenges. As such, it is more important than ever for military leadership, researchers, and health care providers to understand women’s health.

    The Departments of Veterans Affairs (VA) and Defense (DOD) collaborated to host the National VA/DOD Women's Mental Health Mini-Residency Aug. 28-30 in Arlington, Virginia. This mini-residency brought together more than 150 VA and DOD mental health providers so they could gain knowledge and skills in the provision of gender-sensitive care to women Veterans and service members. Specific topics included:

    • Complex trauma
    • Psychopharmacology
    • Safety planning
    • Suicide prevention
    • Compassion fatigue
    • Sexual functioning
    • Impact of health conditions
    • Ostracism, and many others

    During the mini-residency, attendees developed an action plan to disseminate these best practices and facilitate practice change at their local facilities -- to optimize women's mental health care in VA and DOD. Requests from DOD mental health providers to attend in person far exceeded the number of spots available, so we posted all DOD presentations and posters on the mini-residency website for you to read, download and share with colleagues.

    Today also marks the start of Women’s Health Month, a time to highlight women’s health, to include the mental health of service women. Throughout the month, we will showcase some of the exciting presentations from the mini-residency through our Clinician’s Corner blog series.

    Dr. Nancy Skopp, PHCoE research psychologist, will describe the impact of gender stereotypes on diagnosis and treatment. Dr. Laura Miller of the Hines Jr. VA Hospital in Hines, Illinois, will highlight mental health across the female lifespan, and Dr. Margaret Altemus of the Yale School of Medicine in New Haven, Connecticut, will discuss perinatal and postpartum depression. Dr. Lauren Messina of the Consortium for Health and Military Performance will discuss a total force fitness approach to physical and mental health, which can help women and men improve their emotional health and manage symptoms of mental health disorders.

    For updated research and resources, be sure to check out our Women’s Mental Health webpage and follow us on Facebook for more women’s mental health-related posts and resources. Like, comment and share on your channels so we can promote women’s health awareness, and particularly the importance of women’s mental health, during October.

    Source

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  • DVA Logo 29

    CLARKSVILLE, Tenn. – (CLARKSVILLENOW) – The United States Department of Veterans Affairs (VA) has released a data sheet from 2016 that details the suicide rate of Veterans in Tennessee, compared to the Veteran suicide rates in the southern region and the nation; as well as the general suicide rates in Tennessee, the southern region, and the nation.

    There was a total of 156 Veteran suicides in the state of Tennessee in 2016. Broken up by age range, the numbers are as follows:

    • 18-34: 26
    • 35-54: 38
    • 55-74: 66
    • 75+: 26

    By comparison, there were 2,611 Veteran suicides in the southern region, and 6,079 in the nation.

    Further, it was found that there was a total of 1,070 general suicides in Tennessee, 17,011 in the southern region, and 43,427 in the nation.

    There was a Veteran suicide rate (based on per 100,000 people) of 32.8 in Tennessee, 30.6 in the southern region, and 30.1 in the nation. This indicates that Veteran suicide rate in Tennessee was not significantly different from the national Veteran suicide rate.

    Despite that conclusion, it was also found that the Tennessee Veteran suicide rate of 32.8 was significantly higher than the general national suicide rate, which was found to be 17.5. The general suicide rate for the southern region was found to be 18.2.

    You can view the data sheet in its entirety here.

    If you are a Veteran or a family member of a Veteran, and you struggle with depression, there are resources available to help you. If you are in the Clarksville area, one such resource is Soldiers and Families Embraced, or SAFE. SAFE is an organization dedicated to counseling and helping Veterans and Veterans’ families. For more information on SAFE, you can read about some of their methodologies and processes. You can also listen to a Clarksville’s Conversation interview with the executive director of SAFE, Lantz Smith.

    Source

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  • Indiana VA

     

    INDIANAPOLIS — The leader of Indiana’s Veterans affairs agency resigned Friday following reports that he had awarded money to Veterans who worked under him at the agency that was intended to go to Veterans struggling to make ends meet.

    Gov. Eric Holcomb accepted James Brown’s resignation as director of the Indiana Department of Veterans' Affairs, and in a statement he praised the decorated Vietnam Veteran, who had led the agency since 2013.

    "Sgt. Maj. Brown is a good man with a distinguished service record," Holcomb said. "I am grateful for his longstanding service to our state and country."

    Brown’s resignation came a week after reports surfaced questioning the agency’s administration of Indiana’s Military Family Relief Fund, which was created in 2007.

    The fund, which is financed primarily with fees from sales of Veteran license plates and "Support Our Troops" plates, grants money to Veterans to help them pay for food, housing, utilities, medical services and transportation.

    The Indianapolis Star reported that at least 11 agency employees who are Veterans — and many of whom make $40,000 to $50,000 a year — have collectively received about $40,000 in recent years from the fund. One employee received $1,100 for new tires. Another employee’s application was approved the day it was submitted, even though Veterans facing homelessness and job losses were required to wait weeks or months for assistance.

    The newspaper also reported that while Veterans not employed by the state agency who sought funding faced multiple requests for additional information about their requests, documents showed that Veterans who are agency employees faced few such hurdles.

    Indiana’s Veterans Commission approved draft rules Oct. 5 for the fund, but plans to make more changes before submitting a final version to the state Attorney General’s Office for legal review.

    The Indianapolis Star reported that had those draft rules been adopted years ago, Veterans' Affairs employees likely would have been precluded from receiving funds. While the proposed rules do not explicitly prohibit agency employees from receiving money, income limitations based on federal poverty guidelines probably would.

    WRTV-TV reported that while Veterans and their families can get up to $2,500 in funding, records showed that grants of more than $2,500 were awarded to both employees of the agency and the fund itself. It also reported that two Veterans had raised concerns in February about the fund’s administration.

    Most Veterans also were strictly held to a $2,500 lifetime cap on aid, but at least four of Brown's employees who are Veterans received more than that, including the manager of the program, who dipped into the fund multiple times.

    Most of the grants in question were awarded during a period of 2 ½ years when Veterans affairs officials hadn't adopted rules governing the $1.7 million program.

    Brown, who approved the grants, defended his actions, arguing that his employees had a right to the money just as any other Veteran did.

    "There is no great tragedy here," he told the Star last week. "No laws have been broken."

    The State Board of Accounts is now conducting an audit of the program.

    Holcomb, who re-appointed Brown in 2016 as the agency's director and is ultimately responsible for the agency, has said little about the questionable spending. As recently as Tuesday, he would only say that he is awaiting the results of the audit.

    Brown was originally appointed to lead the agency in 2013 by Vice President Mike Pence, who was then Indiana’s governor.

    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.

  • VA Qtrly Research

     

    Dr. Joseph Frank is a primary care physician at the VA Eastern Colorado Health Care System in Denver. He is also a health services researcher at the HSR&D Center of Innovation for Veteran-Centered and Value-Driven Care. His research is focused on improving the safety and effectiveness of chronic pain care for Veterans. As a physician, he is particularly interested in how VA can provide chronic pain care in primary care settings.

    VARQU spoke with Frank about the work he is doing to help Veterans who are living with chronic pain.

    KEY POINTS:

    • Tapering or stopping long-term opioid medications in Veterans who have chronic pain can be a challenging process.
    • The scientific evidence guiding the assessment of the risks and benefits of long-term opioid therapy and/or dose reduction or discontinuation for individual patients is limited.
    • A team-based approach to multimodal pain care could help both physicians and their patients.
    • Further research is needed to identify the systems and resources that are necessary to adequately support physicians and patients as they consider opioid tapering.

    Welcome, Dr. Frank. Can you tell us about the three different lines of research that you are pursuing?

    The first of those is for patients who are taking opioid medications long term. For these patients, the process of stopping or reducing those medications—sometimes referred to as opioid tapering—can be very challenging. We need to understand how to deliver high-quality pain care during and after opioid tapering.

    The second line of research focuses on who delivers this care. As with many chronic conditions, primary-care physicians are most effective when working as part of a team. I am interested in how we should design teams in primary care to deliver pain care that is patient-centered and effective.

    And finally, as a primary care physician, I know it's critical that we help patients get involved in and lead their own plans for pain management. As a researcher, I believe this means we must also help patients get involved in pain research; therefore, I am very interested in how we can better involve patients in all phases of the research process.

    You have received a VA Career Development Award to study tapering opioid medications for patients on long-term therapy. What areas will you be investigating as part of this award?

    We will be investigating several different areas. The first of those is a national survey of Veterans who are on long-term opioid medications to learn more about their perceptions of and experiences with opioid tapering. We know that opioid prescribing rates are decreasing over recent years within VA. But we don't know how these changes are affecting Veterans who have been on these medications long-term. And we don't know what their goals are as it relates to their own use of opioid medications.

    The second aspect of this work is to engage Veterans in the development of a primary care-focused program to support opioid tapering. We will be gathering Veteran stakeholders as well as VA provider stakeholders to conduct a series of meetings and incorporate their perspectives in the development of a program to provide patient-centered opioid-tapering support.

    And finally, the long-term goal is to pilot this intervention and understand what it means for Veterans. As I mentioned, pain care is changing rapidly in the VA. So I think a challenge in the years ahead will be to continue to learn quickly from research that is ongoing and to make sure that the intervention that we are developing will take advantage of the latest science in this area. With our approach to engaging Veterans early in the process, we will have a unique opportunity to incorporate both the latest science as well as Veterans’ experiences to come up with something that is valuable to the Veterans that we serve.

    What is the VA policy for tapering or reducing opioid use in Veterans?

    VA policy is guided by the most recent guidelines released by the departments of Veterans Affairs and Defense. The guideline was released just last year, in 2017. The guideline recommends that for patients who are on long-term opioids, it is important to assess the risks and benefits of ongoing treatment with opioid medications for the individual Veteran. That guideline also notes that it is important to assess the risks and benefits of tapering. This is challenging currently because we don't have much evidence to help providers assess those risks and benefits. So the decision-making is challenging, but importantly should focus on the individual Veterans and their unique needs.

    Importantly, what that policy does not include is a recommendation to reduce opioid dose based on dose alone or without attention to individual risks and benefits. I think a place where we risk getting beyond the evidence, beyond the VA guidelines, and other related guidelines is by unilaterally making changes to medications that don't take into consideration an individual patient's unique needs.

    Can you tell me about the benefits and limitations of using opioid medications long-term for chronic pain?

    I think the goal of using medications, any medications, particularly opioids long-term for a condition like chronic pain, is that they improve function and quality of life. I think we are moving away from measuring pain severity on a simple zero to 10 scale, and trying to think more broadly about individual patients’ long-term goals, especially as it relates to their ability to do the things they want to do. So I think when they are beneficial, it is because they are helping patients function well and improve their quality of life.

    I think important risks often travel alongside those benefits. We have seen in prior studies that people may take these medications with some ambivalence, as they experience both benefits and some side effects. Side effects differ based on the individual patient, but can include decreased energy, cognitive impairment, and some other meaningful side effects that they experience day to day.

    And then I think the risk of serious harms such as overdose or a new opioid use disorder diagnosis are front and center in the minds of policymakers and providers. In our prior work talking with patients, they told us that the pain they experience day to day is more salient than the more abstract risks for future harms. And so it can be a real challenge for physicians and providers to get on the same page prioritizing goals and concerns about potential future harms.

    You published a paper that discussed the scientific evidence on strategies to safely taper opioid medications. Can you tell us what you found?

    This was a systematic review conducted by a great team of VA researchers doing work on this topic. Together, we identified 67 studies that examined opioid tapering and came to three key conclusions. First, the quality of evidence was very low for each of our key questions. Health care systems and health care providers are working to take urgent action to prevent opioid-related harms. However, for patients taking these medications long-term, it's important that we balance this urgency with caution, because we have so little evidence to guide opioid tapering currently.

    I think the second key point is that we found very few studies that addressed the effect of opioid tapering on important adverse events such as overdose. We want to find effective strategies to prevent harms such as overdose, and we need to learn more about how tapering affects this risk.

    And third, we found that opioid tapering may improve pain, function, and quality of life for some patients. Importantly, the fair-quality studies that showed these positive results examined voluntary tapering in the context of multidisciplinary pain management programs. More work is needed to better understand the effects of tapering when it occurs in primary care, which is where most of our pain management is happening in VA.

    In a different study, you interviewed a group of primary care physicians to find out about their experiences with tapering opioid therapy. What did they say are their greatest challenges?

    We conducted focus groups with 40 providers across three health care systems here in Denver, Colorado. We identified three key themes related to their perceived barriers to opioid tapering. First, providers that we spoke with described discussions of opioid tapering with their patients to be uniquely emotionally charged, and at times, exhausting. Health care systems are asking providers to have these conversations more often these days, and it's important that we recognize the impact on providers as well as the impact on patients.

    Second, providers described a sense that they had inadequate resources to support opioid tapering, specifically, but also chronic pain care generally. They described a lack of training specific to this process, as well as a lack of other team members and resources in their clinics and communities.

    And third, they reported that opioid tapering did not go well when there was a lack of trust between their patient and themselves.

    You also mentioned in that study that you identified several best strategies that would help primary care physicians safely taper opioids. What are they?

    In addition to barriers, the primary care physicians that we spoke with also identified strategies that they found helpful. They noted the importance of empathizing with their patients' experiences—both their experience of pain and their concern about making medication changes. We have learned from patients that this process can be very anxiety-provoking. And so providers noted the importance of acknowledging that anxiety.

    Providers also described opioid tapering as a long-term process that benefits from planning and preparation. They described ways in which working with individual patients to think long-term about goals as it relates to the medication was a productive process.

    And finally they reported feeling supported by guidelines and local policies that sought to standardize care processes related to opioid prescribing and opioid tapering.

    What types of strategies would you like to see developed to help primary care physicians work with chronic pain patients and assist them in tapering opioids?

    That's an important question. I think first it takes a team. And in a system like the VA, it will take guidance to help teams develop effective processes in their own local sites. Primary care providers, nurses, psychologists, pharmacists—the list goes on. Each provider has a unique expertise that may be helpful to patients during opioid tapering. The challenge ahead is to create systems that connect each patient with the right team at the right time during opioid tapering and chronic pain management generally.

    The VA is leading in this area with some very interesting work to compare different types of teams and to understand which Veterans benefit from which team structure. It will be important that we learn from those ongoing studies and as researchers try and help leaders in VA integrate those lessons into routine care as quickly as we can.

    I'll mention two other resources that I think are potentially impactful in VA. The first is an important role for peer support. While I as a primary care physician try to help my patients know what to expect during opioid tapering, I think a fellow Veteran who has been through the process can provide practice insights and support that I just can't match.

    And finally, as we discussed, opioid medications are just one tool in the chronic pain toolkit. I think it's important that we continue to improve Veterans' access to the full range of treatments and continue to improve the quality of evidence that guides our approach to multimodal pain care.

    Source

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  • Vets with TBI

     

    Traumatic brain injuries, a frequent consequence of the wars in Iraq and Afghanistan, can lead to such debilitating symptoms as irritability, depression, insomnia, memory deficits—and post-traumatic headaches, which are similar to migraine headaches.

    Migraine is a potentially disabling disorder, causing severe headaches that can last days at a time and pose huge health care costs to the patient and society. A key component of migraines is photophobia, an extreme sensitivity to light. Photophobia can be so harmful that it may force people to wear sunglasses indoors.

    Enter Dr. Levi Sowers, a principal investigator in the Center for the Prevention and Treatment of Visual Loss at the Iowa City VA Health Care System.

    Sowers is leading a study aimed at learning more about regions of the brain that may play a role in migraines and photophobia. He and his team have been focusing mostly on the posterior thalamus. It’s just above the brain stem between the cerebral cortex and the midbrain.

    The main function of the posterior thalamus is to relay motor and sensory signals to the cerebral cortex. It’s also a hub for light and headache pain. Sowers and his colleagues are taking things a step further by zeroing in on a molecule that’s produced in nerve cells of the brain and spinal cord called calcitonin gene-related peptide (CGRP). It plays an important role in triggering migraine headaches.

    The goal of the study is to understand more about how CGRP acts and to apply that knowledge to brain-stimulation techniques, which involve activating and deactivating areas of the brain with electrical, magnetic, or light stimulation. The hope is that precise targeting with stimulation will lower CGRP in the brain and thereby also ease photophobia and headaches.

    Migraine headaches are a neurological disorder

    Currently, nearly 40 million people suffer from migraines, which usually involve a severe throbbing pain on one side of the head. The dilation and constriction of blood vessels were once thought to be the main source of migraine pain. Now, migraine headaches are believed to be one symptom of a greater neurological disorder involving nerve pathways and brain chemicals that is called migraine.

    The Department of Defense and the Defense and Veterans Brain Injury Center estimate that 22 percent of combat casualties from Iraq and Afghanistan involve brain injuries, compared with 12 percent of Vietnam combat casualties. Up to 80 percent of service members who have other blast injuries may also have traumatic brain injuries.

    In the future, Sowers plans to pursue research that explores the level of migraines in Vets with mild, moderate, and severe traumatic brain injury (TBI).

    Current treatments for post-traumatic headache and photophobia are inadequate due to a poor understanding of where CGRP acts in the body to induce headaches, Sowers says. Therapies don’t reduce photophobia between episodes of headache. Successful reduction of light sensitivity in patients with post-traumatic headache may lessen patient discomfort between and during headache attacks, he adds.

    “One of the big questions remaining in the headache field is where CGRP is acting to contribute to migraines,” says Sowers, who is also a research scientist at the University of Iowa. “We hypothesized that CGRP in the posterior thalamus may play an important role in headache-related photophobia. We’re also looking at other regions controlled by CGRP that could be involved with light-aversive behavior. These regions can be targeted by stimulation techniques.”

    He adds: “Every day, targeted brain stimulation methods are getting better and better. This could one day help Veterans. We’re excited about what this holds for the future.”

    In addition to the posterior thalamus, Sowers and his team are looking at the amygdala, the hippocampus, and the cerebellum in relation to photophobia. Any of those regions could be targets for brain stimulation techniques, he says.

    “We believe if we can identify critical areas involved in photophobia, then any of these targeted approaches could one day be effective in treating migraine,” Sowers says. “However, we need to first understand how these brain areas work during states of migraine or post-traumatic headache.”

    The Food and Drug Administration (FDA) has approved certain types of brain stimulation to treat such disorders as anxiety, depression, epilepsy, obsessive-compulsive disorder, Parkinson’s disease, and insomnia. But the FDA hasn’t approved brain stimulation techniques for the treatment of TBI and PTSD.

    Researchers stimulate nerve cells in mice

    Thus far, in lab research, Sowers’ team has identified brain regions that may be critical to photophobia in mice and has found pain and light sensitivity in the rodents that mimic migraines based on similar characteristics in humans. That knowledge could apply to photophobia in people, Sowers says, noting that there are correlates between the brain regions in humans and mice.

    The researchers begin by subjecting the mice to blast-related injuries, the most common type of TBI in Veterans who have served in Iraq and Afghanistan. The team then measures the rodents’ sensitivity to light through use of a light and dark box. The mice are allowed to move freely between a well-lit side of the box and a dark side of the box. The ones more sensitive to light spend more time on the dark side.

    In the mice that are more light-sensitive, Sowers and his team are using a combination of genetic manipulation and light to affect the firing of neurons, or nerve cells. That process is known as optogenetics, a biological technique that involves the use of light to control cells in living tissue, typically neurons. It allows the researchers to target specific brain regions that they believe are involved in triggering post-traumatic headache and to change the firing of nerve cells in those regions. The process also gives the researchers “pinpoint control over the time when we stimulate the nerve cells and which ones we’re stimulating in the brain,” Sowers says.

    The researchers are trying to learn what neurons in a region like the posterior thalamus are doing. They stimulate the neurons by shining a light on that region via a fiber-optic probe that’s inserted into the mouse’s head.

    Both peripheral and central neurons produce CGRP.

    Sowers explains that the investigators have thus far discovered axonal injury, or nerve damage, after blast-induced mild TBI in the posterior thalamus of the mice.

    “Axonal damage means the neurons are damaged, which can cause them to be easily excited,” he says. “In theory, it could lead to light sensitivity in that particular brain region, or heightened sensitivity to pain and other sensory signals in that brain region.”

    Sowers hopes he and others in the medical community can someday use optogenetics to target human brain regions that are involved in triggering post-traumatic headache.

    “That would be really cool,” he says. “In fact, this optogenetic technique has already been used in non-human primates. We’re still many years away from being able to do specific targeting in people. But the goal is when we stimulate these brain regions that correlate with a human then we can go back and possibly target these regions with what we now have to hopefully treat migraine or post-traumatic headache.”

    He and his team hope to publish results later this year.

    Work could also yield insights on PTSD, epilepsy

    Sowers’ work falls under the umbrella of an RR&D grant that has multiple aims related to understanding post-traumatic headache and migraines in Veterans with TBI. In another phase of the grant, he’ll be a senior co-author on a paper in which scientists probed a preclinical model of pain induced by CGRP. They specifically looked at how the molecule is playing a role in spontaneous headache pain in mice, which is facial grimacing, and whether or not that pain can be treated with anti-migraine drugs.

    In an extension of that research, the scientists are injecting CGRP into mice with brain injuries to learn if such trauma makes them more susceptible to migraines and if TBI increases the amount of CGRP in a mouse. The researchers are then testing an antibody that is supposed to attack the CGRP and control light-sensitivity.

    The antibody is similar to a new class of anti-migraine drugs called the CGRP monoclonal antibody. The FDA recently approved the first in this series called erenumab (sold as Aimovig).

    “The drugs we are using look very promising in mice,” Sowers says. “It’s possible that they could be very promising to treat the pain of post-traumatic headache.”

    In addition to post-traumatic headache and migraines, Sowers believes his research may ultimately lead to a better understanding of mental health disorders, such as PTSD, and neurological diseases, such as epilepsy.

    “Veterans with migraine headaches have a strong correlation with PTSD,” Sowers says. “So perhaps insights that we find in our studies of migraines and post-traumatic headache in mice could translate to PTSD research. Also, a number of the brain regions we’re looking at are important for epileptic seizures. So if we understand what CGRP is doing in migraines, perhaps we can use that knowledge to treat or understand other neurological or mental health disorders.”

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  • VA Qtrly Research

     

    Thirteen articles based on outcomes and policy recommendations from VA's Health Service Research and Development state-of-the-art conference on "Non-pharmacologic Approaches to Chronic Musculoskeletal Pain Management" were published in a special supplement of the Journal of General Internal Medicine. The conference brought together experts from VA, the Department of Defense, and the National Institutes of Health to discuss the existing knowledge base on non-opioid therapies for chronic pain.

    The thrust of the SOTA was to review the effects of complementary and integrative health (CIH) on pain and opioid use; discuss the different approaches to chronic pain; and share ideas on the larger topic of non-opioid therapies.

    "Evidence clearly shows that no single therapy is the best approach for a majority of patients with chronic musculoskeletal pain," Drs. Robert Kerns, Erin Krebs, and David Atkins wrote in the introduction. "Like analgesic medication, non-pharmacologic therapies generate meaningful clinical improvement in only a subset of patients."

    Because there is no one best therapy for chronic pain, they recommend that health systems and payers offer multiple options for pain management to patients. CIH therapies like yoga, massage, or mindfulness-based stress reduction are equally as important as structured exercise or cognitive behavioral therapy, they point out.

    It is also important for clinicians to use a multimodal, stepped model of care that allows individual Veterans to try different kinds of therapy, if the first one doesn't work. The researchers suggest that type of multimodal care can be best implemented by primary care physicians who don't just treat patients for pain, but also for other contributing conditions like diabetes.

    Because VA is an integrated health system that provides comprehensive care, wrote the authors, it is well-suited to offer the type of multimodal care that is best for chronic pain patients.

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  • Marine Col Turner

     

    Jim Turner was a decorated Marine who served his nation with honor. But the transition to civilian life proved to be too difficult and like 19 other Veterans every day he took his own life.

    ST. PETERSBURG — On Dec. 10, retired Marine Col. Jim Turner put on his dress uniform and medals and drove to the Bay Pines Department of Veterans Affairs complex. He got out of his truck, sat down on top of his military records and took his own life with a rifle.

    Aside from leaving behind grieving family and friends, Turner, 55, of Belleair Bluffs, left behind a suicide note that blasted the VA for what he said was its failure to help him.

    "I bet if you look at the 22 suicides a day you will see VA screwed up in 90%," wrote Turner, who was well-known and well-respected in military circles. "I did 20+ years, had PTSD and still had to pay over $1,000 a month health care."

    Turner’s death marked the fifth time since 2013 that a Veteran has taken his life at Bay Pines. There were more suicides there during those five years than at the rest of the VA hospitals in the state combined. There were none at the James A. Haley VA Medical Center in Tampa.

    It's unclear how many other Veterans killed themselves during that period at VA facilities around the nation. The government’s second-largest bureaucracy declined a federal Freedom of Information Act request by the Tampa Bay Times for that information last year. In an email Friday afternoon, VA spokeswoman Susan Carter said the agency only started collecting the information a month after the denial.

    From October 2017, to November 2018, there have been 19 suicide deaths at VA facilities around the United States, Carter said. The vast majority of Veteran suicides are off campus and 70 percent of those who take their lives hadn’t sought treatment from the VA, according to VA statistics.

    As for why it keeps happening at Bay Pines, officials there say they don’t have an answer.

    Long before he became a statistic — one of 20 Veterans who die by suicide every day — James Flynn Turner IV was a young man from a wealthy Baltimore family who joined the Marine Corps and reveled in his service to the nation.

    “My brother’s identity was being a Marine,” said Jon Turner.

    Jim Turner flew F-18s and then became an infantry officer, taking part in the invasion of Iraq in 2003. He later served in Afghanistan and spent a decade working at U.S. Central Command at MacDill Air Force Base.

    He left “an enduring legacy of professionalism, commitment and superior leadership which served as a guiding force for all service members whose lives he touched,” said Edward Dorman III, a recently retired Army major general who worked with Turner at Central Command for a decade. “That’s a life worth emulating.”

    When Turner retired, he lost his identity and began to struggle, his younger brother said.

    Those problems exacerbated some of the mental health issues Turner was experiencing from his time in the Marines, said his ex-wife, and led to the dissolution of their 27-year marriage,

    “He came home seemingly fine,” said Jennifer Turner. “It was a couple of years later that he just got more aggressive.”

    It was never anything physical, she said. “He just got agitated very easily. He had nightmares, where he would wake up screaming military stuff.”

    The problems reached a crescendo as Turner was retiring in 2015, his ex-wife said.

    The couple decided to separate. In January 2016, while Jennifer Turner was out of town, Turner grew angry at his son and chased him out of the house with a gun. Pinellas County Sheriff’s deputies responded and detained him under the state’s Baker Act.

    Jennifer Turner believes her ex-husband may have taken his life because he was refused treatment at Bay Pines. Both she and Jon Turner say it was quite possible he became frustrated with having to wait and left without being helped.

    The VA did not comment, citing privacy concerns.

    Others who lost a loved one to suicide at Bay Pines have different theories on why they chose to end their lives there.

    Vietnam War Navy Veteran Jerry Reid, 67, may have driven to the VA to take his own life on Feb. 7, 2013, because he lived alone and didn’t want to have his body found weeks or months later, said his friend, Bob Marcus.

    Joseph Jorden, 57, a medically retired Army Green Beret, likely took his life at Bay Pines on March 17, 2017, not because of poor treatment, but because he felt safe there, said his brother, Mark Jorden.

    But Gerhard Reitmann, 66, who served with the Marines in Vietnam and later as a guard for President Richard Nixon at Camp David, “felt like the VA wasn’t really taking care of him” when he ended his life at Bay Pines on Aug. 25, 2015, said his brother, Stephan Reitmann.

    The mother of Esteban Rosario, 24, who ended his life at Bay Pines on May 8, 2013, could not be reached for comment.

    Regardless of why he took his own life, Turner left behind family and friends, many of whom gathered for a memorial service Friday afternoon in Largo, still struggling with the aftermath.

    "Both of his heartbroken children are currently in school and they have lost their main means of financial support,'' his sister-in-law, Katie Turner, wrote on a GoFundme site set up to help them "In lieu of flowers, the family has humbly requested donations for the children's continued educational expenses. "

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  • PTSD Vets Sue

     

    A federal judge in Connecticut ruled Thursday in favor of thousands of Veterans seeking to sue the federal government alleging they were discharged due to infractions related to untreated mental illnesses and denied Veterans Affairs benefits as a result.

    The Associated Press reports that Senior U.S. District Judge Charles Haight Jr. ruled Thursday that the Veterans, who were given less-than-honorable discharges after service in Iraq and Afghanistan, could move forward with a lawsuit against Navy Secretary Richard Spencer.

    The less-than-honorable discharges, the Veterans allege, made it harder for Veterans who were discharged to receive care for their mental illnesses developed as a result of their service in America's wars.

    The lead plaintiff in the case, Marine Veteran Tyson Manker, sharply criticized the Department of Defense in a statement Thursday following the initial ruling.

    “The fact that the Court has now recognized this class of Veterans is further evidence of the Department of Defense’s disgraceful violation of the legal rights of the men and women who have served their country," Manker said in a statement obtained by the AP.

    “This decision is a victory for the tens of thousands of military Veterans suffering from service-connected PTSD and TBI (traumatic brain injury),” added Manker, who says he was dishonorably discharged after serving in Iraq due to a single use of an illegal drug.

    Students from Yale Law School are reportedly representing the Veterans and have filed a similar suit against the Army, according to the AP.

    Connecticut-based Veterans group National Veterans Council for Legal Redress, another plaintiff in the suit, celebrated the judge's decision in a statement Thursday.

    “We filed this lawsuit to make sure that the Iraq and Afghanistan Veterans with service-connected PTSD do not suffer the same injustices as the Vietnam generation,” group director Garry Monk told the AP.

    “We are thrilled with the court’s decision and look forward to creating a world where it doesn’t take years of wading through unlawful procedures for these Veterans to get relief.”

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  • Keith Thompson

     

    Army Veteran Keith Thompson (pictured above) is no stranger to conquering life’s challenges.

    A 2006 motorcycle accident left the former firefighter in a 27-day coma and paralyzed from the waist down. Not one to be kept down, Thompson strives to be the best at everything he does and that paid dividends at this year’s National Veterans Wheelchair Games (NVWG) held in Orlando, Florida.

    Thompson was awarded the prestigious Spirit of the Games trophy, an award presented to “the Veteran that through their athletic achievement, leadership and support of their fellow Veterans exemplifies the values of the games.”

    To illustrate the award’s significance, Thompson was selected from the record-setting 611 athletes that participated in this year’s games and is the 32nd recipient since the award’s creation in 1987. The theme for this year’s games was “Conquer the Challenge,” and that’s exactly what Thompson did.

    “There are no limits,” said Thompson. “My wife told me I can do anything I want. I just have to do it from a chair.”

    Thompson defines the word competitor. He’s competed in various events over his NVWG career including archery, trap shooting, air rifle, air pistol, 9-ball, shot put, discus, javelin, boccia ball and softball.

    Played through multiple injuries

    While at this year’s games, Thompson attempted to catch a softball hit his way when he fell out of his chair and dislocated his shoulder. Also, in 2016, Thompson competed at the NVWG despite having a broken wrist and torn rotator cuff after being rear-ended by a distracted driver. He truly knows no limits.

    “We are all at the games to compete and leave our best on whatever field we play on,” Thompson said.

    Thompson was introduced to Carl Vinson VAMC when he accompanied a friend to the medical center to check on the status of his benefits. Tamara Jackson, administrative officer for acute care, suggested Thompson also apply for benefits and suggested the Sandersville, Ga. resident consider recreation therapy. It wasn’t long before recreational therapist Charlene James urged Thompson to try adaptive sports and in 2011, he attended his first NVWG.

    When he’s not practicing for the games, Thompson spends time with his wife of 17-years, Janice, and managing his medical transportation service, 3D Enterprises.

    Keith Thompson is no stranger to life’s challenges. However, he is an example all people can emulate when striving for something that seems unobtainable.

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