BAYADA, BAYADA Home Health Care Inc., BAYADA Health LLC and BAYADA Home Care (collectively, the BAYADA Companies), headquartered in Moorestown, New Jersey, have agreed to pay $17 million to resolve allegations that they violated the False Claims Act’s Anti-Kickback Statute by paying a kickback to a retirement home operator by purchasing two of its home health agencies (HHAs) located in Arizona.

The United States alleges that the BAYADA Companies bought the two HHAs to induce referrals to BAYADA of Medicare beneficiaries from retirement communities operated by the seller throughout the United States, and that from Jan. 1, 2014 through Oct. 31, 2020, the BAYADA Companies submitted false claims for payment to Medicare for services provided to beneficiaries referred to BAYADA as a result of the kickback transaction.

“Parties who pay or receive kickbacks in order to induce referrals undermine the integrity of the health care system,” said Acting Assistant Attorney General Brian M. Boynton of the Justice Department’s Civil Division. “This resolution reflects the department’s commitment to protect the right of federal health care program beneficiaries to receive medical care that is not influenced by the financial interests of their health care providers.”

“When healthcare providers make or induce referrals that are based on kickback arrangements rather than the best interests of patients, they risk patient harm, threaten the integrity of federal healthcare programs and violate federal law,” said Acting U.S. Attorney Rachael A. Honig for the District of New Jersey. “The U.S. Attorney’s Office for the District of New Jersey and our partners in the Department of Justice and at the Department of Health and Human Services Office of Inspector General (HHS-OIG) will continue to pursue those who, like BAYADA, offer kickbacks for patient referrals, no matter the disguise those kickback arrangements might wear.”

The Anti-Kickback Statute prohibits parties who participate in federal health care programs from knowingly and willfully offering, paying or receiving any remuneration in order to induce the recommendation of any item for which payment is made in whole or in part under a covered federal health care program. The prohibition extends to asset purchases that are intended to induce referrals.

The settlement with the BAYADA Companies includes the resolution of claims brought under the qui tam or whistleblower provisions of the False Claims Act by David Freedman, who was the former director of strategic growth for BAYADA between 2009 and 2016. Under those provisions, a private party can file a civil action on behalf of the United States and receive a portion of any recovery. As part of today’s resolution, Mr. Freedman will receive more than $3 million. The matter remains under seal as to allegations against entities other than the BAYADA Companies.

The resolution obtained in this matter was the result of a coordinated effort between the Justice Department’s Civil Division, Commercial Litigation Branch, Fraud Section and the U.S. Attorney’s Office for the District of New Jersey, with assistance from the HHS-OIG.

The investigation and resolution of this matter illustrates the government’s emphasis on combating health care fraud. One of the most powerful tools in this effort is the False Claims Act. Tips and complaints from all sources about potential fraud, waste, abuse and mismanagement, can be reported to HHS at 800-HHS-TIPS (800-447-8477).

The matter was handled by Trial Attorney Samson Asiyanbi of the Fraud Section and Assistant U.S. Attorney Daniel Meyler for the District of New Jersey.

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ATLANTA – PruittHealth, Inc. and affiliated entities (“Pruitt”) have agreed to pay $4.2 million to resolve allegations that they submitted claims for home health services that were not covered by the Medicare and Medicaid programs, and that they failed to refund overpayments that they had received from Medicare and Medicaid in a timely manner.

“The Medicare and Medicaid programs depend on providers to submit only those claims that are eligible for reimbursement and to promptly notify the programs if they receive payments to which they are not entitled,” said U.S. Attorney Kurt R. Erskine. “Healthcare providers must not place their own financial well-being ahead of their duties under the Medicare and Medicaid programs.”

“When health care entities seek to boost their profits through improper billing, they undermine the trust taxpayers extend to the health care industry,” said Special Agent in Charge Derrick L. Jackson. “This settlement demonstrates the commitment that our agency and its law enforcement partners have to pursuing those who seek to improperly enrich themselves at the expense of federal health care programs.”

“When funds from programs like Medicare and Medicaid are not used as intended, taxpayers and people who are entitled to those funds suffer,” said Chris Hacker, Special Agent in Charge of FBI Atlanta. “This settlement is the result of the FBI’s commitment to work with our federal and state partners to ensure that federally funded healthcare programs are not abused by providers.”

Home health services consist of skilled care provided to homebound beneficiaries for the treatment of acute illnesses and injuries. As a result of widespread fraud in the submission of home health claims, Medicare and Medicaid began requiring referring physicians to certify in writing, after a face-to-face visit with the beneficiary, that the beneficiary was homebound and needed the skilled care. Medicare and Medicaid also require the physician to devise and sign a plan of care for the beneficiary.

The Government alleges that from January 1, 2011 through June 30, 2012, Pruitt knowingly submitted claims to Medicare and Medicaid for home health services that were not eligible for reimbursement because, among other things, they did not have the required face-to-face certifications or plans of care, and they did not document the beneficiary’s homebound status or need for the home health services. The Government further alleges that Pruitt learned that it had received payments for home health services to which it was not entitled, but failed to disclose its receipt of the overpayments, or refund the overpayments to Medicare and Medicaid in a timely manner.

In reaching its settlement with Pruitt, the Government took into account documents produced by Pruitt indicating that Pruitt subsequently took steps to improve its compliance with the home health requirements of the Medicare and Medicaid programs, including the retention of an outside consultant in January 2013 to conduct an audit of its home health claims, the implementation of a pre-bill review of home health claims between February 2013 and August of 2013, and the implementation of quarterly audits of its home health claims (with more frequent audits as needed) beginning in September 2013 through the present. Pruitt voluntarily produced the results of its 2013 audit to the Government during the investigation. Although the Government has taken these steps into consideration, this is not an indication or concession as to the sufficiency of these compliance measures.

This settlement resolves a lawsuit originally filed in the U.S. District Court for the Northern District of Georgia by Tina Peery (the Relator) under the qui tam or whistleblower provisions of the False Claims Act: United States ex rel. Tina Peery v. UHS-Pruitt Holdings, Inc., et al., No. 1:14-cv-01016-AT. Under the False Claims Act, private citizens may bring suit for false claims on behalf of the United States and share in any recovery obtained by the government. The Relator will receive over $700,000.00 from the settlement.

The claims resolved by the settlement are allegations only, and there has been no determination of liability.

This case was investigated by the U.S. Attorney’s Office for the Northern District of Georgia, the U.S. Department of Health and Human Services Office of Inspector General, The Federal Bureau of Investigation, and the Georgia Medicaid Fraud Control Unit.

The civil settlement was reached by Assistant U.S. Attorneys Neeli Ben-David and Anthony DeCinque, as well as Georgia Assistant Attorney General Sara Vann.

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The group is suing the Department of Veterans Affairs for failing to build affordable housing. The suit claims the VA hasn't lived up to a 2011 agreement to house Veterans.

LEILA FADEL, HOST:

Los Angeles County has long had the country's highest number of homeless military Veterans - nearly 4,000 by last count. And last night, the U.S. Department of Veterans Affairs was hit with a lawsuit by a group of them who say the VA is depriving them of housing. Anna Scott from member station KCRW reports.

ANNA SCOTT, BYLINE: For as long as he can remember, Josh Petitt wanted to join the military, like his dad who served in the Marine Corps and the Army.

JOSH PETITT: When I was about 8 years old, I remember I watched him jump out of a helicopter. You know, I thought it was the coolest thing ever. And yeah, it was one of the main reasons I joined the Army.

SCOTT: Was the experience what you expected once you got in?

PETITT: For the most part. War wasn't what I thought it was going to be like. That was - yeah. I don't know.

SCOTT: Petitt served as an infantry soldier in the Iraq War. He was awarded three Purple Hearts. And after returning stateside, he struggled with PTSD that led to drug addiction.

PETITT: I'd never done methamphetamines till I got back from Iraq. I wouldn't have to sleep, and no sleep means no nightmares. So I thought I found the cure.

SCOTT: We're speaking on a bench outside the homeless shelter where Petitt lives right now on what's known as the West Los Angeles VA. That's a huge medical campus, almost half the size of Central Park. Petitt believes he should be living on this campus in a real apartment, which is why he's now one of 13 disabled homeless Veterans suing VA Secretary Denis McDonough and the VA director in charge of this property.

And this lawsuit is basically a do-over of a case filed in 2011, which hinged on how the government came to own this campus that I'm standing on more than a century ago. It was donated by a wealthy widow on the condition that the property serve as a home for Veterans. The 2011 case alleged that the VA had failed in that obligation. And a few years later, the VA agreed to build 1,200 apartments here for needy Veterans. But looking around, they've only completed a tiny fraction, and this campus still looks a lot like it did seven years ago. There's a hospital, various medical facilities and lots of empty open lawns and some stuff that has nothing to do with Veterans at all, like sports facilities for nearby schools.

MARK ROSENBAUM: We trusted the government to come through, and that turned out to be a grievous error.

SCOTT: Attorney Mark Rosenbaum with Public Counsel worked on that older lawsuit and says the only recourse is to sue again. So he has. The VA couldn't give an immediate response to the lawsuit, but in interviews earlier this year, VA officials have pointed out that they are building the housing. Construction is going on; it's just behind schedule. Why so slow? One reason is money. The VA says it can't pay for the housing because it's a health care agency. Here's the VA director in charge at the West LA campus, Dr. Steven Braverman, in April.

(SOUNDBITE OF ARCHIVED RECORDING)

STEVEN BRAVERMAN: Because of the laws that we have in our country, VA is not allowed to build housing unless it is specifically tied to a treatment program.

SCOTT: So cobbling together the money for this enormous project falls to a team of private developers brought in by the VA. That takes time. But Mark Rosenbaum, the lawyer, rejects those excuses.

ROSENBAUM: That's not just inhumane, and it's not just immoral, and it's not just a set of [expletive] lies. It's also against the law.

SCOTT: The new lawsuit asks the court to force the VA to improve housing access for LA's neediest Veterans quickly because, it argues, for disabled Veterans who see doctors at the West LA VA in one of LA's highest-rent areas, not being able to live on or near the property means they don't get health care.

For NPR News, I'm Anna Scott in Los Angeles.

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Two days before the impending move and Lavon Johnson had yet to pack.

But the Iraq war Veteran didn’t seem too worried as he sat at the piano he’d rescued from the trash two blocks away. He began to play Beethoven’s “Für Elise” along San Vicente Boulevard near Brentwood. His American flag — held up on one side by a hanger attached to his tent — waved in the breeze.

Johnson planned to be the last one out of the Veterans Row encampment, where he has lived for about a year. His way of ensuring that the nearly two dozen unhoused Veterans remaining made it out safe before a scheduled cleanup on Monday.

“It never takes me long to get ready,” the 35-year-old said with a quick smile.

The encampment, adjacent to the historic Veterans Affairs campus in West Los Angeles, has become a focal point for homelessness in the city, with mayoral candidates making visits regularly over the last year. The last census of homeless people in Los Angeles County found roughly 3,900 homeless Veterans among the county’s total of 66,000 people without housing.

Veterans Affairs Secretary Denis McDonough, who visited the encampment in October, said last week that the about 40 Veterans from Veterans Row would be housed by November.

Already by Saturday, 14 people had moved from the sidewalk into tents on the sprawling VA campus, said Robert Reynolds, a Veteran advocate with AMVETS. Another three have registered to go in, but have not yet moved.

Reynolds credited the movement to media attention, McDonough’s visit and the two deaths tied to Veterans Row.

“It’s very frustrating that it’s taken this long,” said Reynolds, an Army Veteran. “This whole thing is a disservice to the Veterans and a disservice to the taxpaying community, because these guys are supposed to have benefits. This property is intended for them. They should be housed here. There’s no reason they should be all over the streets.”

All Johnson has known throughout his life is the military.

Born in Germany to parents in the Army, Johnson went on to enlist in the same branch in June 2004. He was stationed in Ft. Hood and deployed to Iraq in 2006 and 2007.

If you ask him when and how he got to California, he’ll tell you he doesn’t remember. But he can recall what’s happened since he’s been here. Especially the year he’s spent living in the Veterans Row encampment.

“It’s like I was sent here,” Johnson said, as he looked at the 20 remaining tents along the sidewalk.

Asked why he thought it took so long to get the Veterans help, Johnson is quick to answer: “Pride. Money. Nobody wants to admit a mistake was made.”

Around 11 a.m., Johnson rode his bike alongside the tents, popping his head in to check with some of the Veterans. He passed more than a dozen flags and a few signs notifying everyone of the scheduled cleanup.

To those along the line, Johnson is considered the protector. He often stays up at night to make sure everyone is safe. A reminder of the danger is scrawled in blue on a wall: RIP Andre.

This site was connected with two homicides within six months this year. In April, Pedro Flores, 34, was arrested on suspicion of murder and assault with a deadly weapon after he ran over a person living in the encampment, allegedly dragging the man’s body 200 yards under his vehicle. In September, the encampment was the site of a stabbing that killed an unhoused male Veteran.

Reynolds has had more than one nightmare about Veterans getting killed along the street. The Iraq war Veteran once slept in a sleeping bag along the street after not being allowed into a VA program in 2018 because of his service dog.

“I saw Veterans all over the sidewalk, no outreach coming out, police coming through and removing them every couple of weeks,” the 33-year-old said. “I grew up in a large military family and was always taught to respect Veterans. And so seeing this struck the deepest chord. I just couldn’t believe I was seeing people that went to combat sleeping on the sidewalk and dying out here.”

Outside the tents were signs posted about the plight of homeless Veterans: “We fought for you please fight for us.” Black storage bins were placed outside tents with a sheet to document inventory for the move.

Reynolds has helped set up 20 tents on the VA campus, including new cots, blankets and towels for those moving in from Veterans Row. A U-Haul will arrive Monday to help load up everyone’s belongings in order to place them in storage, if needed.

Ronald Estrada-Ortiz, a Marine Corps Veteran, got moved onto the VA campus two days ago. He was able to bring clothing and two backpacks with him.

Estrada-Ortiz enlisted when he was 18 — he graduated from high school on a Wednesday and was a Marine by that Friday — motivated by the events of 9/11.

“I bleed red, white and blue,” he said. “I love this country.”

But he expressed frustration at the length of time it took for Veterans to get help, calling it “a money issue.” He also questioned misperceptions community members might have about the unhoused.

“We just got dealt the wrong hand,” the 35-year-old said.

When ask when he’s supposed to move, Johnson said he is winging it. He doesn’t like making plans anymore.

“Everyone wants me in there,” he said, from his place at the piano. He doesn’t really want to move, but he’d go though because, as he jokes, “these guys can’t watch out for themselves.”

He only plans on taking the “bare necessities” with him. That includes the piano he rescued six months ago.

He points out an information booth on the VA campus. His piano’s new home.

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WASHINGTON (AP) — The number of Veterans in the United States experiencing homelessness dropped by 11% since 2020, the biggest decline in more than five years, the Biden administration reported Thursday.

There were 33,136 homeless Veterans in January of this year, compared with 37,252 in 2020, according to the Point-in-Time count conducted by the departments of Veterans Affairs and Housing and Urban Development as well as the U.S. Interagency Council on Homelessness.

“One Veteran experiencing homelessness will always be one too many, but the … count shows that we are making real progress in the fight to end Veteran homelessness,” VA Secretary Denis McDonough said.

The government count is conducted to capture U.S. homeless population on a single night in January each year but was not fully completed last year due to limits on in-person surveying during the coronavirus pandemic.

The data released Thursday show significant drops each year in homelessness from 2010 to 2016, when the Obama administration made it a top priority to end Veteran homelessness, before mostly leveling off from 2016 to 2020.

Since 2010, when it stood at 76,329, the number of homeless Vets fell by more than 55%.

The Biden administration credited its efforts to reduce Veteran homelessness with help from the $1.9 trillion coronavirus relief package, which boosted the VA’s homeless programs and expanded rental aid and other support for Veterans’ families.

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More about homelessness:

Nearly half of the U.S.’s homeless people live in one state: California

‘Millions of families struggle to keep roofs over their heads’: Biden administration says it’s making progress on America’s housing shortage — but will it be enough?

‘Fighting the pandemic at Skid Row was the toughest challenge of our lifetime — we were trying to save lives while saving ourselves’

Why San Francisco’s homeless population keeps increasing

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The Honoring our PACT Act, will improve health care and benefits for veterans exposed to toxic substances. This comprehensive bill will address herbicide, radiation, and burn pits.

A procedural issue required Congress to amend and pass the PACT Act again. The House has done its job and passed the bill with bipartisan support. Every day this bill is delayed means another day a veteran could get sick and die. The Senate must stop any further delays and immediately pass the Honoring our PACT Act.

Contact your Senators and tell them no more delays, they must bring the Honoring our PACT Act to the floor immediately and vote YES.

TAKE ACTION

SACKETS HARBOR, N.Y. (WWNY) - There was a moment of silence amid holiday season clatter Saturday. For the third year, volunteers participated in a wreath-laying ceremony at the Sackets Harbor Military Cemetery.

Many of the volunteers came from the Combat Vets Morotcycle Association.

“We have to always remember where we came from. When I was in the Army, I would always tell my soldiers, ‘You are part of something bigger than you think you are.’ and that holds true even outside the uniform,” said John Roome of the Combat Vets Military Association.

Jamie Mendelson, the daughter of a Veteran, organizes the event.

“Half the tombstones here are unknown, not given any thought, so it’s nice that we can recognize them for everything they’ve done for us,” said Mendelson.

She partnered with Shari Simmons of Copenhagen’s Simmons Tree Farm.. She donated 450 wreaths this year.

“It’s just really heartwarming to see how much it affects other people. I can make a Christmas wreath like nothing, but when you see it placed on a grave when you see poeple praying over it thinking about it, it kind of gives you a really good meaning to what our Vets have done, especially at Christmas time,” said Simmons.

In addition to honoring Veterans passed, the ceremony also donates to Veterans present.

“This year, we donated $1,000 to feed the Vets, a local Veteran outreach program right in Watertown,” said Mendelson.

Honoring the sacrifices of soldiers one wreath at a time.

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NEW ORLEANS – U.S. Attorney Duane A. Evans announced that SHIVA AKULA (“AKULA”), age 65, of New Orleans, Louisiana was charged by a grand jury on August 5, 2021, in a 23-count Indictment for Health Care Fraud.

AKULA owned and oversaw the day-to-day operations of Canon Healthcare, a hospice facility.

According to the Indictment, AKULA unlawfully enriched himself by submitting and causing the submission of false and fraudulent claims to health care benefit programs, including Medicare. AKULA instructed Canon employees to improperly bill for General Inpatient (“GIP”) services to maximize reimbursement from health care benefit programs, knowing that those services were not medically necessary.

Canon routinely billed physician services with Common Procedural Terminology (“CPT”) Code 99233 for beneficiaries who were receiving GIP services, in addition to the daily per diem rate. CPT Code 99233 is an evaluation and management code, which requires two of the three following components: (1) detailed interval history; (2) detailed examination; or (3) medical decision making of a high complexity. Usually, the beneficiary is unstable or has developed a significant complication or a significant new problem.

Canon routinely billed for physician services for CPT Code 99236 for beneficiaries who were admitted into GIP and remained on GIP for more than 24 hours. CPT Code 99236 should only be billed when a patient is admitted to inpatient hospital care for a minimum of 8 hours, but less than 24 hours and discharged on the same calendar day. In addition, when billing for CPT Code 99236, the physician shall identify that he or she was physically present and that he or she performed the initial hospital care service. The physician shall personally document the admission and discharge notes and include the number of hours the beneficiary remained in inpatient hospital status.

From on or about January 1, 2013, to on or about August 25, 2017, Canon submitted approximately 1,053 claims for CPT code 99236 and was paid approximately $223,601 by Medicare. During that same time period, Canon submitted approximately $2,281,251. These physician services reflected in CPT Codes 99236 and 99233 should not have been billed as a separate line item in addition to the GIP services because they were included within the daily per diem rate that Medicare paid for the GIP services.

From on or about January 1, 2013, through on or about August 25, 2017, Canon submitted claims to Medicare for approximately 1,949 home visits using CPT code 99350 that were purported to have been performed by a doctor, when a doctor did not perform home visits. As a result of these 1,949 home visits, Medicare reimbursed Canon approximated $316,384.

From January 2013 to December 2019, Canon billed Medicare approximately $62,833,346.28 and was paid approximately $47,106,838.94.

If convicted, AKULA faces a maximum of 10 years imprisonment, a fine of not more than $250,000, supervised release of up to 3 years, and a mandatory special assessment of $100 as to each count.

U.S. Attorney Evans reiterated that the Indictment is merely a charge and that the guilt of the defendant must be proven beyond a reasonable doubt.

The case was investigated by the Federal Bureau of Investigation, the Department of Health and Human Services Office of Inspector General, and the Louisiana Department of Justice, Medicaid Fraud Control Unit. The case is being prosecuted by Assistant U.S. Attorney Kathryn McHugh.

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Tarrant County’s John Peter Smith Hospital (JPS) has agreed to pay more than $3.3 million to settle allegations that it violated the False Claims Act by upcoding certain claims submitted to federal healthcare programs, Acting U.S. Attorney Prerak Shah announced today.

The settlement resolves a whistleblower suit filed in 2018 by JPS’s former Director of Compliance Erma Lee, whose complaint asserted that the hospital improperly appended billing modifiers -25, -59, and -XU to hundreds of claims in order to obtain payments to which it was not entitled.

Used properly, these billing modifiers indicate that a provider administered significant care on the same day as another medical procedure that was above and beyond the preoperative and postoperative care “bundled” into the main procedure code.

In her amended complaint, filed in September 2020, Ms. Lee alleged that she alerted hospital leadership that JPS had been improperly adding these modifiers to claims between 70 and 95 percent of the time, in essence routinely double billing for certain aspects of patients’ care. Nevertheless, she claimed, JPS failed to reimburse payors for overpayment stemming from these improperly coded claims.

“When company executives ignored this whistleblower's concerns about improper billing, she took them to the court,” said Acting U.S. Attorney Prerak Shah. “We are proud of the citizens who speak out to protect our federal healthcare programs.”

The allegations resolved by this settlement were originally filed under the qui tam provisions of the False Claims Act, which permits private persons with evidence of fraud to sue on behalf of the government and to share in any proceeds.

Under the Act, the United States may intervene in such an action or permit the whistleblower to pursue it. Although the United States elected not to intervene in the case, it investigated Ms. Lee’s allegations and worked collaboratively with the relator and her counsel in their pursuit and resolution of this case.

Ms. Lee will receive $912,635 as her statutory share of the settlement proceeds.

This matter was handled on behalf of the government by Assistant U.S. Attorney Andrew Robbins on behalf of the Office of the Inspector General for the Department of Health and Human Services.

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A church former members have described as a cult has lost its GI Bill eligibility after two decades of allegedly bilking Bible school students out of millions of dollars of Veterans benefits.

On Monday, officials from state regulatory agencies in Georgia, North Carolina and Texas disclosed that schools connected to the House of Prayer church had been stripped of their eligibility for GI Bill money. The loss of access to GI Bill funds had not been previously reported.

House of Prayer had collected $7 million in Veterans' tuition money over 18 years. In addition, several Veterans told Military.com that they were expected to donate their housing allowances to the church.

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In Hinesville, Georgia, where the church is headquartered, beneficiaries earned $1,500 per month, according to 2022 Department of Veterans Affairs data. The church's other locations include Augusta, Georgia; Tacoma, Washington; Killeen, Texas; and Fayetteville, North Carolina.

A spokesperson for the church did not respond to a request for comment ahead of this story’s publication.

A Military.com investigation detailed how a complex string of businesses connected to the church's leadership had been relying on Veterans and their benefits for nearly 20 years, pushing service members and Veterans to turn over their military paychecks and disability pay, and use their home loan and GI Bill benefits to create revenue for the church.

Those who disagreed with church leadership often had to leave their families behind and relinquish contact, according to several former church members, some of whom called the organization "a cult."

Texas' decision to revoke authorization for the House of Prayer schools came July 21, days after the Military.com investigation was published; North Carolina and Georgia had suspended the schools the month before.

In June, the House of Prayer's five churches were raided by the FBI. Authorities seized computers, church records and cash. All of those facilities are located near major Army installations. No charges have been filed.

The church's Bible schools, which received the GI Bill money, offered no degrees, with Veterans expected to attend until their benefits ran out, according to former students and a former school administrator.

The courses were virtually identical to any typical Sunday school, Arlen Bradeen, who ran the bible schools from 2004 to 2019, told Military.com in a July interview. The classes would often be renamed to subvert GI Bill regulations preventing students from taking redundant classes on the taxpayer's dime, he said. In some cases, church rooms would be rearranged to look like formal classrooms ahead of inspections from the VA, he added.

The GI Bill eligibility decisions came from State Approving Agencies, or SAAs, which serve as the VA's enforcement arm for GI Bill rules. It's a relatively low-profile, state-level bureaucracy, but it oversees what is widely considered one of the federal government's most cherished public programs. Roughly 1 million beneficiaries use the GI Bill, a key recruiting tool for the military, each year, serving as a direct path for service members to reach the middle class.

SAA operations vary from state to state, and the SAAs in Georgia, North Carolina and Texas independently cut off the House of Prayer at different times.

While the agencies have faced criticism in the past for not being more critical of some for-profit schools, some have become more proactive. The District of Columbia's regulatory arm temporarily stripped Howard University of its GI Bill eligibility over paperwork snafus by a school staffer who left the job after Military.com's reporting on the incident.

Veterans Education Success, a Washington, D.C.-based advocacy group that lobbies on military education issues, told Congress that the House of Prayer's alleged scam against Veterans serves as a flashpoint for the need for boosted oversight over the GI Bill and which schools can become approved institutions.

Military.com visited the House of Prayer church in North Carolina, located just outside of Fort Bragg, in August. The church appeared to be abandoned and unkept, with a man sleeping on one of the steps. A store owner in the area said no one had been in the building since the FBI raid. In July, a reporter from this publication was also granted a tour of the Hinesville headquarters, which appeared fully operational. Congregants declined to answer questions or issue comments on the record, but pointed to signs of damage to doors they claimed was caused by federal agents during the raid.

The church may also be operating under other aliases, including The Place of Help and On Fire Missions, according to the church's website and former members.

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As the U.S. continues its race to vaccinate as many people as possible, the House has passed a bill that would grant the Department of Veterans Affairs the authority to vaccinate all Veterans and their caregivers.

It is unclear how quickly the department could distribute the vaccine, but the measure would dramatically expand the scope of who the VA can vaccinate to include all caregivers of Veterans enrolled in various VA programs, and Veterans living abroad who rely on the Foreign Medical Program. There are about 9 million Veterans enrolled in VA care, but there are 18 million total U.S. Veterans, according to the U.S. Census Bureau.

Yet VA would serve as another option for Veterans and their civilian caregivers, as some people are still struggling to find a vaccine or are confused amid conflicting information on eligibility.

The VA Vaccine Act was unanimously passed by House members Tuesday night and now heads to the Senate, where the leaders of the Senate Veterans Affairs Committee have introduced a similar measure.

Mark Takano, D-Calif., the chair of the House VA committee, said that time is precious as the nation still struggles to get the virus under control. Older generations of Veterans are in a high-risk pool, he added.

"We don't have time to waste -- frankly, I'm worried that any delay in passing this legislation may force VA to turn away decorated WWII Veterans," Takano said in a statement.

According to VA, the agency has fully vaccinated about 1 million Veterans, employees and federal partners. VA data shows 78 percent of Veterans are overweight or obese, which puts them at higher risk of severe illness from COVID-19, according to the Centers for Disease Control.

Veterans are sometimes ineligible for VA care because they do not have a service-connected disability or they have incomes above the department's threshold.

Yet the House bill notes that priority will be given to those enrolled in VA care. It is unclear in the legislation how those who otherwise wouldn't qualify for care would be vaccinated and added to the VA's existing distribution system.

"After such a difficult year, stories of vulnerable Veterans being denied life-saving vaccines from VA are painful to hear," Mike Bost, R-Ill, the top Republican on the House VA committee, said in a statement. "The bill gives VA the authority it needs to meet this moment."

The VA may also have to work to counter vaccine skepticism, especially among younger and healthier Veterans and their families who are relatively safe from the worst symptoms of the virus. Nearly one-third of U.S. troops currently serving have refused the vaccine.

In a straw poll of 810 active-duty military personnel, spouses and Veterans, more than half of active-duty families, or 53%, said they did not plan to get the COVID-19 vaccine, citing safety concerns and suspicions over development. Nearly half of Veteran families agreed.

The CDC on Tuesday released preliminary findings that fully vaccinated people appear less likely to carry the virus and infect others who could be vulnerable. The findings also noted that a growing vaccinated population could lead to swifter lifting of virus restrictions.

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WASHINGTON – House lawmakers unanimously approved a bill that would lay the groundwork for the Department of Veterans Affairs to start funding service dog programs and connect Veterans with canines that could be critical for their mental health care.

The Puppies Assisting Wounded Servicemembers for Veterans Therapy Act authored by Rep. Steve Stivers, R-Ohio, would kick-off a pilot program to issue federal grants to nonprofits that provide service dogs to Veterans suffering from mental health issues, and require the VA to assess the effectiveness of dog therapy.

“Our Veterans fought for our freedom, and I’ve heard from many Veterans who say that’s exactly what their service dog gives them – freedom. They’re free to go to restaurants, to fly on planes, to go to the movies, things that post-traumatic stress [disorder] had made impossible,” Stivers said.

Lawmakers on the House and Senate Committees for Veterans’ Affairs have made tackling Veterans suicide a top priority after years of legislative measures and efforts that haven’t stemmed the crisis. Some Veteran advocacy groups frustrated with Congress’ inability to make progress on the issue have called for more creative thinking.

"Congress continues to ignore damning reports released by [The Journal of the American Medical Association] and others regarding our current mental health approaches failing Veterans. We have not heard a peep about it from this leadership.” Joe Chenelly, national executive director of American Veterans, said in a statement last month. “When it comes to curbing suicide the time to act is now...Every day matters and the status quo is untenable.”

The number of Veterans committing suicide dwarfs combat fatalities since 9/11. Between 2005 and 2017, 78,875 Veterans took their own lives, according to the most recent data from VA. In comparison, about 7,000 troops have been killed in combat in Iraq and Afghanistan combined, across two decades.

Nonprofits are one of the only avenues for Veterans to adopt service dogs. The VA doesn’t provide any funds for service or emotional-support animals but concluded a congressionally mandated study on the benefits of dogs for PTSD care in July, according to Christina Mandreucci, a spokeswoman for the department. The results of one part of the study on whether service or emotional-support dogs can help Veterans with PTSD is expected to be released in the summer, and the results on whether dogs can lead to overall health care savings with fewer hospital stays and less reliance on medication is expected by the end of the year.

“Mental wellness does not have a one-size-fits-all solution, which is why VA must provide innovative and out-of-the-box treatments to help Veterans combat these invisible illnesses and thrive in their civilian lives,” said Rep. Phil Roe, R-Tenn., the ranking member of the House VA committee. “There is no question that the companionship and unconditional love offered by man’s best friend can have powerful healing effects on men and women from all walks of life, including our men and women in uniform.”

There is no vote scheduled yet for the Senate version of the measure.

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The House passed a bill Wednesday that would allow the Department of Veterans Affairs (VA) to begin a project connecting service dogs and Veterans.

The bill, if implemented, could be critical step to improve Veterans' mental health care.

The Puppies Assisting Wounded Servicemembers for Veterans Therapy Act, authored by Rep. Steve Stivers (R-Ohio), would launch a program presenting federal grants to nonprofits providing service dogs to Veterans suffering mental health issues. The VA would assess the effectiveness of dog therapy, according to a Stars and Stripes report.

"Our Veterans fought for our freedom, and I've heard from many Veterans who say that's exactly what their service dog gives them – freedom." Stivers said. "They're free to go to restaurants, to fly on planes, to go to the movies, things that post-traumatic stress [disorder] had made impossible."

Lawmakers of the House and Senate Committees for Veterans' Affairs have prioritized Veterans' suicide as a prime issue to address after years of legislative measures and efforts that haven't subdued the crisis, according to the report.

Some members Veteran advocacy groups have expressed frustration with Congress' failure to make immediate progress on the issue, and have called for lawmakers to think outside the box.

Joe Chenelly, national executive director of American Veterans said, "When it comes to curbing suicide, the time to act is now...Every day matters and the status quo is untenable," Chenelly said in a statement last month.

According to the news outlet, the number of Veterans that have taken their lives is staggering. Between 2005 and 2017, 78,875 Veterans have taken their lives, according to recent data from the VA, compared to roughly 7,000 troops killed in Iraq and Afghanistan combined in the past two decades.

Rep. Phil Roe (R-Tenn.), a ranking member of the House VA committee, is in full support of the bill, adding that the companionship of dogs can have "powerful healing."

"Mental wellness does not have a one-size-fits-all solution, which is why VA must provide innovative and out-of-the-box treatments to help Veterans combat these invisible illnesses and thrive in their civilian lives," Roe said.

There is no planned date for the Senate's vote on this bill at this time.

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House lawmakers advanced the largest budget in Veterans Affairs history on Friday, but the spending package faces an uncertain future in the Senate and even tougher odds if it reaches the White House.

That’s because the $241 billion VA funding measure — which also includes about $10 billion more in appropriations for military construction projects — includes language blocking President Donald Trump from transferring certain funds to his controversial military wall project, and money to begin renaming military bases currently honoring confederate leaders.

Both of those topics have prompted presidential Veto threats in the past, and are likely to bog down negotiations to move the appropriations bills ahead in coming weeks.

Ahead of Friday’s 224-189 largely partisan vote on the spending package, House Majority Leader Steny Hoyer, D-Md., urged his Republican colleagues to find a way to work through the differences and avoid the possibility of a partial government shutdown at the start of the new fiscal year, Oct. 1.

“The bill ensures we provide resources to support our Veterans, so critical and across the board, thought to be a moral responsibility,” he said. “Sadly, it will in all likelihood join the more than 275 other House bills languishing in the Republican-controlled Senate.”

The $241 billion in funds for VA roughly matches what White House officials requested in their budget request in February and includes about $105 billion in discretionary spending in fiscal 2021, an increase of about 13 percent from current levels.

While other federal agencies have drastic cuts or limited growth in recent years, the Department of Veterans Affairs has enjoyed substantial yearly increases.

VA was the only cabinet department to have a double-digit percentage spending increase under the president’s fiscal 2021 plan, and would become the second largest federal agency by discretionary spending under that budget outline, behind only the Department of Defense (which boasts nearly six times the VA proposed level of program funding and three times the total level of VA spending.)

In fiscal 2001, the VA budget totaled $45 billion. Ten years ago, it was about $125 billion, a little more than half of the House-passed plan for fiscal 2021.

“Amid a global pandemic, we also made unprecedented VA medical system investments to ensure that every Veteran has access to the top-notch health care that they deserve, including historic spending for women Veterans, mental health, suicide prevention, research, and homeless prevention,” said Rep. Debbie Wasserman Schultz, D-Fla., head of the Veterans panel for the House Appropriations Committee.

“This bill ensures our Veterans and military families are protected, respected, supported and get the highest quality healthcare they deserve.”

To avoid conflicts with federal budget caps, the discretionary funding increases — which cover a host of medical, transition and ongoing support programs — are designated under the plan as emergency funding.

Of the $105 billion in discretionary funding, about $90 billion is set aside for VA medical care. That includes $10.3 billion in funding for mental health care, an increase of more than 9 percent from fiscal 2020, and $661 million for women’s health programs, an increase of 11 percent from the current year.

Lawmakers also included $1.9 billion for homelessness assistance programs targeting Veterans, about $40 million above what the president requested.

The military construction portion of the bill includes nearly $1.5 billion for family housing projects, an increase of about 9 percent from the president’s budget request, and $596 million for Guard and Reserve installation projects, about 5 percent above the president’s request.

The measure also includes about $200 million for perfluorooctane sulfanate and perfluorooctanoic acid cleanup work at various military sites.

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When her Army career was cut short by a medical discharge in 2005, Tasha Berkhalter decided to pursue a degree that she hoped would lead to a career as an FBI agent. The now-defunct, for-profit ITT Technical Institute promised a flexible class schedule that would meet her needs as a working single mother.

Officials at the school also said that her GI Bill benefits would cover the full cost of tuition, she later testified to the Department of Education. Instead, she graduated in 2010 with a degree that companies didn't view as valid and, to her surprise, $100,000 in debt.

"I was sick to my stomach," said Berkhalter, a 41-year-old substitute Spanish teacher based in Lima, Ohio.

Things turned around last year when the Department of Education canceled her federal loan debt through a program for students whose schools have been accused of defrauding them. But the education funding she earned through her time in the Army can't be restored.

Every year, hundreds of thousands of Veterans use GI Bill benefits to pay for college or other educational programs. The funding is meant to be a recruitment tool, an acknowledgment of their service and a springboard to help soldiers transition back into civilian life. But for thousands of Veterans, their post-military lives have been disrupted by poor experiences at for-profit colleges accused of defrauding students.

In recent years, some students who attended for-profit schools have had their loans canceled under a program called borrower defense to repayment, which protects loan holders from having to pay back federal loans to schools that misled them.

Under the Biden administration, more than 1 million students of schools such as ITT Technical Institute, DeVry University and Corinthian Colleges have had billions canceled under the program, including Veterans like Berkhalter.

Last August, the Department of Education announced that it would cancel all remaining federal student loan debt people took out to attend ITT Technical Institute from 2005 to its closure in 2016, resulting in an additional $3.9 billion in cancellation for 208,000 borrowers.

ITT closed in 2016 after the Department of Education blocked the school from admitting new students who used federal financial aid.

"We've had a debate around student loan forgiveness, and that's been a good debate, but we've often left out Veterans' voices who are suffering from the consequences of attending fraudulent institutions," Rep. Mike Levin (D-Calif.), the ranking member of the Economic Opportunity subpanel of the House Committee on Veterans' Affairs, said in an interview.

Legislation introduced last month would restore benefits to Veterans who attended programs that qualified for borrower defense discharges or were found to have defrauded students by state or federal officials. The bill is up for a vote in the House Veterans' Affairs panel's Economic Opportunity subcommittee on Tuesday.

"It's long past time to give our Veteran community the justice that they deserve," said Rep. Delia Ramirez (D-Ill.), the lead sponsor of the bill, during a hearing last month. "We have to ensure that no student Veteran is ever robbed of their benefits again by making sure that we're cutting off any predatory schemes."

Committee staff said they intend for the potential restoration of benefits to be retroactive and that Veterans would not need to apply.

The U.S. has provided educational assistance to Veterans since 1944, when the GI Bill of Rights granted financial support to soldiers returning from World War II. In 2008, Congress passed the Post-9/11 GI Bill to boost benefits.

Under that program, most Veterans are eligible to receive up to four years of tuition payments at public colleges or a set amount per year for private schools. They also receive stipends for housing, books and supplies.

For years, for-profit schools had a financial incentive to enroll more Veterans due to their GI Bill benefits. Under federal law, only 90% of for-profit schools' revenue can come from federal funding such as loans or Pell Grants. Until recently, GI Bill benefits did not count as federal funding, meaning the more GI Bill beneficiaries a school enrolled, the more federal dollars they could secure from other students. Congress closed that loophole in 2021 as part of the American Rescue Plan.

Congress has also sought to make it easier to block poor performers in the for-profit college industry from accessing military educational benefits.

A network of state approving agencies, not the Department of Veteran Affairs, is responsible for screening schools that receive GI Bill funding. In 2020, Congress passed legislation that imposed stricter requirements on schools seeking approval to access VA educational assistance and gave the state approving agencies more power to assess them. Those provisions went into effect late last year.

Robert Muth, a law professor at the University of San Diego and the managing attorney of the school's Veterans Legal Clinic, said closing the 90/10 loophole was an important step toward reducing the incentive to target Veterans. But he also noted that as long as Veterans have had access to educational assistance, there have been companies seeking to deceive them.

"We've done a good job of improving some of the regulatory views with respect to these schools," he said. "The key is going to be that we don't let down our guard."

About 565,000 Veterans received a total of $8.1 billion in education assistance under the current version of the GI Bill in fiscal year 2022. Of the $4.1 billion that went to colleges and universities, about 27% was spent at for-profit schools.

A third of Post-9/11 GI Bill students attended for-profits in 2016, while only 10% of all post-secondary students did, according to a 2019 Congressional Budget Office report. Between 2009 and 2017, eight of the 10 institutions receiving the most Post-9/11 GI Bill funding were for-profits. ITT Technical Institute, the third-highest recipient, received $1.15 billion, adjusted for inflation, between 2009 and 2016, according to the report.

The appeal of for-profit schools is often their ability to work with the schedules of nontraditional students, who tend to be older and have greater financial responsibilities than traditional college students. The schools also advertise their programs as career-focused.

"Veterans get disproportionately victimized primarily because they disproportionately represent all of the characteristics of your nontraditional students," said Barmak Nassirian, vice president for higher education policy at Veterans Education Success, an advocacy group focused on student Veterans' issues.

Brian Whitehead, a 42-year-old Atlanta-based construction equipment rental specialist, enrolled in ITT Technical Institute in 2006 after leaving the Army. The transition was difficult, he said.

"You feel very frightened," Whitehead said of leaving the military. "It's a new horizon, especially when you go in at 18, 19 years old, and then you come out and you've done really nothing else but the military."

He said he remembered seeing ITT Technical Institute ads touting how employable graduates were.

In written testimony submitted to the Department of Education in 2021, he said that the school claimed that 90% of students get jobs after graduating, with salaries around $60,000 to $70,000, and that his GI Bill would cover the cost of his education.

Like Berkhalter, he struggled to find a job with his degree and graduated in 2008 with a federal and private loan balance that has grown to $90,000. Of that, about $52,000 is the product of federal loans that will be canceled through borrower defense.

If he had a second shot at his GI Bill benefits he would "absolutely" go back to school, he said, to pursue a career in social work or counseling.

Berkhalter isn't so sure. She said she'd love to go back to school to get credentialed to become a full-time teacher. But she's older now and has more responsibilities than she did when she left the Army, including her five children. With her student loans cleared and credit improved, she and her husband are expecting to close on a home next month.

Still, she said, having GI benefits restored would be a boon to the students who are willing and able to try again.

"We take a vow when we come into the military to protect and serve," she said. "It's already a lot when you transition out back into the civilian world, and when you come out like that and you're immediately taken advantage of, it just leaves a sour taste in your mouth."

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Military gratitude has led to a seat at Super Bowl LIV.

Houston Texans quarterback Deshaun Watson tweeted on Monday that he’s sending retired Lt. Colonel Roger Miranda of Belton, Texas, to watch the Kansas City Chiefs take on the San Francisco 49ers next Sunday.

He wrote: “Thankful for people like @roger__miranda - a career Army officer - who continues to serve his country by helping troops transition to civilian life. Thanks @USAA & @the_USO for teaming-up with me to provide this soldier 2 tix to #SBLIV. Much deserved. #SaluteToService”

Miranda tweeted back: “I’m absolutely speechless.”

Miranda began his duty as a field artillery officer in 1997.

The Newark, N.J., native also served overseas with deployments to Afghanistan in 2004 and in 2014.

He now works as a technical IT recruiter for a firm in Austin, Texas, and volunteers to help Veterans learn about available jobs in the tech industry.

“With 22 years of military service to his name including multiple overseas deployments, Lieutenant Colonel Miranda is an extraordinary example of what it means to be Army Strong,” Watson said.

Watson will meet military members like Miranda during Super Bowl weekend in Miami at the USAA’s Salute to Service Lounge, open to current military, Veterans and their families.

The Texans lost to the Chiefs in the playoffs in January.

Watson was 31-for-52 with 388 passing yards and two touchdown passes. However, the Texans only scored seven points in the second half and allowed 28 points in the second quarter giving Kansas City a chance to come back and win the game – and they did just that.

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How Can Veterans Earn a 100% Disability Rating & Maximum Compensation?

If you sustained an injury or developed a medical condition following active duty or another type of military service, you may be eligible for VA disability benefits. However, you will need to meet certain qualifications to earn maximum compensation. This process starts with earning a 100 % VA disability rating for benefits.

There are many factors that go into a VA disability rating and full-time benefits, and the application process can be complicated. This guide will break down how Veterans can earn a 100% disability rating and as many monetary benefits as possible.

How Can You Get 100% Disability Rating?

Once an eligible Veteran is granted service-connection for a disability, the next logical question is, “How much money will I receive?” The amount of compensation benefits a Veteran receives depends on the disability rating that the VA assigns.

Disability ratings range from 10% to 100%. The idea behind these ratings is that the Veteran should be compensated according to the impairment that the disability would cause to the average person’s ability to earn a living. This compensation generally comes as monthly payments.

It can be tricky to earn a 100% disability rating when a Veteran has more than one disability. Combining two or more disabilities is a complicated process in which 50% plus 50% does not equal 100% but, rather, 75%. In fact, the closer a Veteran gets to a 100 % VA disability rating, the harder it seems to be to obtain this maximum benefit. For example, once a Veteran is rated 80% disabled, each additional 10% disability only adds 2% to his total rating rather than an additional 10%. (You can use our disability calculator to better understand these numbers.)

Meeting the criteria for a 100 % VA disability benefits on the ratings schedule, or combining multiple disabilities to obtain a 100% rating, can be very difficult. Failure to meet those criteria, however, does not mean that a Veteran is not totally disabled. For this reason, the VA regulations provide for an alternate route to a total disability rating—individual unemployability.

Individual Unemployability

When a service-connected disability, or disabilities, prevents a Veteran from being able to secure and follow substantially gainful employment, he is entitled to a total disability rating based on individual unemployability (TDIU or IU). In determining whether a Veteran qualifies for TDIU, the VA should consider not only whether a Veteran is capable of getting a job but also whether he is capable of keeping a job. Any job that the Veteran is able to secure and follow must also be a job which is “substantially gainful.” In other words, the job that the Veteran is able to do must provide income which places the Veteran above the poverty level. Just keep in mind that “substantially gainful employment” does not include working in a sheltered environment such as a Veteran’s own family business or a sheltered workshop.

IU Qualification

Under the TDIU regulation, a Veteran should automatically be considered for TDIU when there is evidence that his disabilities keep him from working and he has a qualifying disability rating. Under those circumstances, the Veteran should not even have to ask to be considered for TDIU, but we find that the VA often fails to make a determination as to TDIU unless it’s specifically requested by the Veteran. It’s important to note that the VA will probably assign the date that the Veteran asks for this increased rating as the effective date for TDIU. Be aware, however, that you may be entitled to an earlier effective date if you became unable to work earlier than the date that you actually requested that entitlement.

For purposes of the VA regulations, a qualifying rating is either a single service-connected disability with a 60% rating or multiple service-connected disabilities and a total rating of 70%. This is a simplified definition of a qualifying rating as there are many exceptions to this basic rule. For example, if the Veteran injured his back and knees in a single accident, these could be considered a single disability. Similarly, if the Veteran has multiple injuries incurred in a single combat action, these, too, could be considered a single disability.

Regardless of the schedular rating that a Veteran has been assigned for his disability or disabilities, if those disabilities prevent the Veteran from earning a living wage, he is entitled to a total disability rating based on individual unemployability.

VA Compensation Benefits Rates: How Much Compensation Are You Entitled To?

Once the VA determines a Veteran’s disability rating, they will then calculate their specific VA disability compensation. This is the total monetary amount that you would receive as Veterans benefits. There are several factors that determine this compensation.

When a single Veteran with no dependents has only one service-connected disability, it’s fairly easy to figure out the appropriate amount of benefits according to the VA’s Compensation Benefits Rate Tables. However, the numbers may not always make sense.

For instance, a Veteran with no dependents who is 100% disabled currently receives $2,673 according to the Rate Tables (at the time of this writing). A Veteran with a 50% disability rating, however, receives only $770. So, even though the Veteran with a 50% disability rating is presumed to suffer from about half of the impairment, he does not receive half of the amount of money that the 100% disabled Veteran receives—in fact, he receives only about a third.

Have VA Compensation Rates Changed?

Another issue with the current Compensation Benefits Rate Tables is that the amount of compensation benefits don’t always keep up with changes in the economy. While the cost of living continues to rise, the rates for VA benefits haven’t changed since 2009.

Again, when a Veteran suffers from two or more service-connected disabilities, they must be combined according to the VA Combined Ratings Table. Using what many Veterans refer to as “VA Math,” under the Combined Ratings Table, two 50% disability ratings do not add up to a 100% rating as most people would expect. Rather, two 50% disabilities are combined to give a Veteran a 75% disability rating ( which would then be rounded up to an 80% disability rating).

As another example, a Veteran who has two service-connected disabilities with a 50% disability rating for each is entitled only to an 80% disability rating which pays $1,427. Again, here, $1,427 is not 80% of the $2673.00 that the Veteran with a 100% disability rating receives. The Veteran with the 80% disability rating receives just over half the amount that the Veteran with the 100% VA disability rating receives.

There are several other factors that can affect total compensation, including the number of surviving family members. Veterans can receive additional benefits where they have dependent children, surviving spouses or parents. In addition, increases may be made to a Veteran’s rating if he has a disability which affects both arms or both legs. Finally, a Veteran may be eligible for additional compensation benefits called Special Monthly Compensation where he has certain types of disabilities which include the loss or loss of use of a part of the body.

Many factors affect the VA benefits that a Veteran receives, so it’s important to seek help with your disability claim. An experienced law firm can help you navigate your disability rating and compensation, so you can secure as many benefits as possible.

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Once the Department of Veterans Affairs determines that a Veteran does have service connection on a disability that resulted from their military service, the VA considers the severity of that disability and assigns a disability rating. If the Veteran is not satisfied with that disability rating, he or she can appeal the rating by filing an appeal within one year of the rating decision. But what happens if the Veteran decides that the rating is fair and does not appeal and then the disability worsens? Is it ever too late to ask for a higher disability rating?

The answer to that question is “no.” At any time after a disability rating is assigned, a Veteran may file a claim for an increased rating of their VA disability benefits. Filing that claim is easy. All that is required to initiate an increased rating claim is the Veteran’s good-faith belief that his or her disability has worsened.

What Evidence Is Helpful for A VA Rating Increase?

To support a claim for an increased rating, the Veteran needs to submit medical records which demonstrate that the condition is worse. Those records can be private medical records or VA medical records. Even though VA has access to VA electronic medical records, it is important that the Veteran also submits the relevant medical evidence separately. This is the Veteran’s opportunity to make sure that VA is looking at the evidence we want them to see.

It is common for the VA to send the Veteran out for a new compensation and pension (C&P) examination once a claim for increased rating has been filed in order to assess the extent of the Veteran’s disability for VA disability compensation. The Veteran must attend this examination if scheduled so that VA can evaluate for itself whether the Veteran’s medical condition has worsened. The Veteran may also, at this point, get a private medical examination to demonstrate that the disability has worsened.

Is it difficult to increase your VA Benefits Rating?

VA Disability Claims for increased ratings can be tricky. It is important, for instance, to know what the requirements are for a higher rating under the applicable VA diagnostic codes. For example, many orthopedic disabilities, such as disabilities of the spine or knee, are rated on how much the disability limits the Veteran’s range of motion. While pain is one of the symptoms which affects the Veteran’s quality of life the most dramatically, VA does not consider whether the Veteran’s pain is worse when determining whether the Veteran is entitled to a higher disability rating for a spinal disability. Because of that, if a Veteran bases his claim for increased rating solely on the fact that his pain has increased, he will probably not receive a higher rating. It is important, then, to know how to ask for a disability rating increase on your VA claims.

Considering the circumstances, I have described above, where a Veteran’s low back pain or knee pain has worsened dramatically but he is still able to bend just as much as he was before the pain increased, there may still be a way to ask for an increased rating. Under those facts, we might ask for an increased rating based on the fact that the Veteran’s knee is now unstable and causes him to fall so that he is entitled to a separate rating for instability of the knee. Alternatively, we might ask for an increased rating for the Veteran’s low back disability where the pain now causes him to miss so much work that he is now unemployable and entitled to a total rating based on his back disability. Veterans should familiarize themselves with the VA diagnostic codes governing their specific service-connected disabilities so that they know whether they are even entitled to an increased rating as well as how to ask for one. If you need help navigating the diagnostic codes, we can help.

How Can I Get a 100% VA Disability Rating?

Often, simply receiving an increased disability rating isn’t enough. Some Veterans are unable to obtain or hold gainful employment due to their service-connected disability. In this case, the disabled Veteran may be eligible for a 100% VA disability rating.

There are two main ways that a Veteran can obtain this rating: by meeting the criteria for a 100% rating or qualifying for individual unemployability.

Simply meeting the criteria for a 100% disability rating on the VA’s schedule for rating disabilities can be challenging. Veterans will either need to meet the criteria for one disability or obtain a combined rating of 100% for multiple disabilities. However, reaching a combined rating of 100%, even when you’re close, is difficult. You can see how the ratings add up using our disability calculator.

This is why obtaining individual unemployability can be a smart decision for many Veterans.

Individual Unemployability

If a Veteran is unable to secure and hold what the VA calls “substantially gainful employment” due to a service-connected disability (or disabilities), they may be eligible for a total disability rating based on individual unemployability (TDIU or IU). According to the VA, Veterans are eligible for IU if they have:

• at least one service-connected disability rated at 60% or more disabling, or 2 or more service-connected disabilities—with at least 1 rated at 40% or more disabling and a combined rating of 70% or more, AND
• can’t hold down a steady job that supports you financially (known as substantially gainful employment) because of your service-connected disability. Odd jobs (marginal employment) don’t count.

Veterans can apply for IU through VA Form 21-8940.

Veterans can be eligible for a total disability rating regardless of the initial rating that the VA previously assigned them.

Effective Dates & Increased Ratings

One final note regarding claims for increased ratings–the VA regulations only allow VA to assign an effective date for the increase as far back as one year prior to filing the claim. In other words, once the Veteran files the claim for increase, VA can look back at the evidence for the year prior to the claim to determine when the disability worsened and pay the Veteran for that time. Don’t wait to file your claim, as you could be losing valuable benefits to which you are entitled.

Have Questions About Increasing Your Disability Rating?

Pursuing an increased rating for disability compensation benefits can be challenging. If the VA is denying your claim for benefits or IU, the team at Hill & Ponton can help. Our law firm values attorney-client relationships and is committed to helping Veterans obtain the benefits to which they’re entitled.

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Once the Department of Veterans Affairs determines that a Veteran does have service connection on a disability that resulted from their military service, the VA considers the severity of that disability and assigns a disability rating. If the Veteran is not satisfied with that disability rating, he or she can appeal the rating by filing an appeal within one year of the rating decision. But what happens if the Veteran decides that the rating is fair and does not appeal and then the disability worsens? Is it ever too late to ask for a higher disability rating?

The answer to that question is “no.” At any time after a disability rating is assigned, a Veteran may file a claim for an increased rating of their VA disability benefits. Filing that claim is easy. All that is required to initiate an increased rating claim is the Veteran’s good-faith belief that his or her disability has worsened.

What Evidence Is Helpful for A VA Rating Increase?

To support a claim for an increased rating, the Veteran needs to submit medical records which demonstrate that the condition is worse. Those records can be private medical records or VA medical records. Even though VA has access to VA electronic medical records, it is important that the Veteran also submits the relevant medical evidence separately. This is the Veteran’s opportunity to make sure that VA is looking at the evidence we want them to see.

It is common for the VA to send the Veteran out for a new compensation and pension (C&P) examination once a claim for increased rating has been filed in order to assess the extent of the Veteran’s disability for VA disability compensation. The Veteran must attend this examination if scheduled so that VA can evaluate for itself whether the Veteran’s medical condition has worsened. The Veteran may also, at this point, get a private medical examination to demonstrate that the disability has worsened.

Is it difficult to increase your VA Benefits Rating?

VA Disability Claims for increased ratings can be tricky. It is important, for instance, to know what the requirements are for a higher rating under the applicable VA diagnostic codes. For example, many orthopedic disabilities, such as disabilities of the spine or knee, are rated on how much the disability limits the Veteran’s range of motion. While pain is one of the symptoms which affects the Veteran’s quality of life the most dramatically, VA does not consider whether the Veteran’s pain is worse when determining whether the Veteran is entitled to a higher disability rating for a spinal disability. Because of that, if a Veteran bases his claim for increased rating solely on the fact that his pain has increased, he will probably not receive a higher rating. It is important, then, to know how to ask for a disability rating increase on your VA claims.

Considering the circumstances, I have described above, where a Veteran’s low back pain or knee pain has worsened dramatically but he is still able to bend just as much as he was before the pain increased, there may still be a way to ask for an increased rating. Under those facts, we might ask for an increased rating based on the fact that the Veteran’s knee is now unstable and causes him to fall so that he is entitled to a separate rating for instability of the knee. Alternatively, we might ask for an increased rating for the Veteran’s low back disability where the pain now causes him to miss so much work that he is now unemployable and entitled to a total rating based on his back disability. Veterans should familiarize themselves with the VA diagnostic codes governing their specific service-connected disabilities so that they know whether they are even entitled to an increased rating as well as how to ask for one. If you need help navigating the diagnostic codes, we can help.

How Can I Get a 100% VA Disability Rating?

Often, simply receiving an increased disability rating isn’t enough. Some Veterans are unable to obtain or hold gainful employment due to their service-connected disability. In this case, the disabled Veteran may be eligible for a 100% VA disability rating.

There are two main ways that a Veteran can obtain this rating: by meeting the criteria for a 100% rating or qualifying for individual unemployability.

Simply meeting the criteria for a 100% disability rating on the VA’s schedule for rating disabilities can be challenging. Veterans will either need to meet the criteria for one disability or obtain a combined rating of 100% for multiple disabilities. However, reaching a combined rating of 100%, even when you’re close, is difficult. You can see how the ratings add up using our disability calculator.

This is why obtaining individual unemployability can be a smart decision for many Veterans.

Individual Unemployability

If a Veteran is unable to secure and hold what the VA calls “substantially gainful employment” due to a service-connected disability (or disabilities), they may be eligible for a total disability rating based on individual unemployability (TDIU or IU). According to the VA, Veterans are eligible for IU if they have:

• at least one service-connected disability rated at 60% or more disabling, or 2 or more service-connected disabilities—with at least 1 rated at 40% or more disabling and a combined rating of 70% or more, AND
• can’t hold down a steady job that supports you financially (known as substantially gainful employment) because of your service-connected disability. Odd jobs (marginal employment) don’t count.

Veterans can apply for IU through VA Form 21-8940.

Veterans can be eligible for a total disability rating regardless of the initial rating that the VA previously assigned them.

Effective Dates & Increased Ratings

One final note regarding claims for increased ratings–the VA regulations only allow VA to assign an effective date for the increase as far back as one year prior to filing the claim. In other words, once the Veteran files the claim for increase, VA can look back at the evidence for the year prior to the claim to determine when the disability worsened and pay the Veteran for that time. Don’t wait to file your claim, as you could be losing valuable benefits to which you are entitled.

Have Questions About Increasing Your Disability Rating?

Pursuing an increased rating for disability compensation benefits can be challenging. If the VA is denying your claim for benefits or IU, the team at Hill & Ponton can help. Our law firm values attorney-client relationships and is committed to helping Veterans obtain the benefits to which they’re entitled. Contact us today for a case evaluation.

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A lot of Veterans think that not being able to get or hold a job is enough for them to prove to the VA that they are unemployable. Unfortunately, this is just a myth. The reality is much more complicated. Another myth is that having a statement from a doctor, especially a VA doctor, saying that you cannot work, should be proof of unemployability. But again, this is not the reality. When it comes to proving unemployability, there is a certain level that the VA looks at to determine if a Veteran is eligible for this benefit, regardless of their disability rating. This level of eligibility is functional impairment.

Functional Impairment

Functional impairment means that the Veteran’s functional capacity is so impaired by his or her disabilities that he or she is unable to secure or maintain substantial employment. There are a few parts to this definition we need to explore to get the entire picture.

First is the functioning. Functioning is not based on what the Veteran did before as a job. So, if a Veteran was a painter or a construction worker, having a back injury may not make him unemployable if he is found able to work at a sedentary job such as sitting at a desk. Unfortunately, for many Veterans who have worked in a specific field for most of their lives, changing careers means new training if they are to transition from a physical to a sedentary position. While Vocational Rehab offers training programs and college education for those who qualify, it is often not a viable option for many Veterans because they are not able to make that transition due to other factors that the VA does not take into account when looking at unemployability. Factors such as concentration, ability to retain and follow instructions, adaptability to change, dealing with people, dealing with pain, absenteeism due to sick days and medical appointments, etc. should all be taken into account when the VA is looking at a claim for unemployability.

Securing and Maintaining Employment

Second is being unable to secure or maintain employment. This means that the Veteran may not only be able to get a job but may not be able to maintain employment either. Therefore, if a Veteran gets hired but then loses his jobs often, this may make him eligible for unemployability if the reasons the Veteran loses his jobs are related to his disability. Often employers have been known to shy away from hiring Veterans due to the perception that they may be disabled. This, unfortunately, is not a case for unemployability. If a Veteran is not hired simply because he has a disability, this is again, not a case for unemployability. If, however, a Veteran is not hired or is terminated, because his disability keeps him from doing the job, then it becomes a case for unemployability. For example, Joe is rated as 70% disabled due to back and knee problems. He works as an engineer and is on his feet all day. His workplace allows him a redesigned space where he is able to sit and work. He is still able to do his job so he is employable. If his workplace did not make the accommodation, he would still be able to do his job just not in that environment, and he is still considered employable. But what if Joe is unable to sit to do his job? After physical therapy and surgery, it is determined that Joe has to lay down several times a day and take strong painkillers that inhibit his concentration. Now Joe has possibly become unemployable.

Sustainable Employment

The last part is sustainable employment. Sustainable employment means that it pays above the poverty threshold for a single person with no dependents. This figure fluctuates each year, but for 2017 is $12,060. If a Veteran is working but makes less than $12,060 in the year 2017 or less than the threshold for previous years, they may be eligible for unemployability.

Employment Rates for Disabled Veterans

According to the ADA Website that tracks employment data for the disabled, Veterans are employed at a very low rate. Veterans with no service-connected disabilities are only employed at a rate of 72%; 68% for those with a 0-40% rating; 58% for those rated 50-60%; and only 25% of those with a 70% or higher rating are employed. Ensuring that these unemployed Veterans have the income to sustain them is imperative and the least they deserve after giving so much to their country. While there are many programs out there designed to hire disabled Veterans, there are not enough to employ every unemployed Veteran who wants to work. Working with local employers to help make accommodations, educate them on how to work with disabled Veterans, and designing work programs that work around disabilities is needed to ensure the vast growing number of disabled Veterans will have a place in our workforce in the future.

You may also want to review our VA Unemployability Guide.

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The Department of Veterans Affairs (VA) is on a mission to end Veteran homelessness.

It is making great strides in this effort, helping to house 40,401 Veterans experiencing homelessness in 2022, with 1,301 of those Veterans finding a place to call home in the greater Los Angeles area, the most of any city in America.

The total number of Veterans experiencing homelessness nationwide has decreased by 11% since January 2020 and by 55.3% since 2010.

So how is this progress being accomplished?

VA has several tools at its disposal. One is to provide housing right on VA land through VA’s unique public-private partnership program called the Enhanced-Use Lease (EUL) program.

The EUL program allows VA to partner with private developers, leasing underutilized or vacant properties to development entities that finance, design, develop, construct, operate and maintain the property. The entities assume all financial obligations and risks associated with the development. These developers (lessees) utilize various sources of financing, including tax credits for low-income housing, grants, philanthropy, private and commercial loans, and public issue bonds.

Title 38, U.S.C. Section 8161-8169, Enhanced-Use Leases (EULs) of Real Property (as amended), authorizes VA to lease real property under VA’s control or jurisdiction to other public and private entities on a long-term basis (up to 99 years for most properties) for the provision of supportive housing or projects that directly or indirectly benefit Veterans. The majority of VA EUL projects serve to provide safe, affordable housing for Veterans and their families.

The EUL program serves as the backbone of the West LA Master Plan, a framework for transforming the West LA VA into a fully supportive and connected community of and for Veterans with a minimum of 1,200 housing units.

The first permanent supportive housing project at West LA VA, made possible by the EUL program, was Building 209, which opened in 2017 and provides 54 Veteran units.

Building 207, which opened in February 2023, offers 59 units of permanent supportive housing for formerly homeless Veterans aged 62 and up.

“We are excited about this critical step forward, but there is still much work to be done. No Veteran should experience homelessness – in Los Angeles or anywhere else in America – and we won’t rest until every Veteran has a home in this country they fought to defend,” said Tanya Bradsher, VA Chief of Staff, during a ribbon-cutting ceremony for Building 207.

Two more permanent supportive housing developments in the EUL program, Buildings 205 and 208, with a combined 120 Veteran units, opened in May 2023.

More land is being cleared and made shovel ready. To expedite housing delivery, VA and its EUL partners are prioritizing new construction on vacant land for the next phase of Veteran supportive housing. The three latest pieces of land under lease in December 2022 will result in 264 Veteran units and are scheduled to open in late 2024. This means nearly 500 permanent supportive housing units on the West LA VA Campus in 2025, in addition to the hundreds of Veterans residing on the property in transitional housing, community living centers, and the CalVet State Home.

VA contributes to these Veteran housing construction efforts through investments in utility infrastructure, site preparation, abatement, and other pre-construction costs. In fiscal years 2021 and 2022, VA invested over $70 million for infrastructure and land preparation to support EUL housing at West LA. VA has plans to invest roughly $70 million more in 2023. Starting in FY2023, EUL-related projects at the West LA VA campus will be funded through Sec 705 of the PACT Act through 2036 with more than $350 million envisioned for use in supporting the housing development at West LA.

More Ways to Help Veterans

VA has a host of other programs to help Veterans who are experiencing homelessness or at risk of falling into homelessness. These include paying portions of a Veteran’s rent through a partnership with the Department of Housing and Urban Development, or HUD. The HUD-VASH voucher program combines rental housing assistance with active case management and support from VA staff.

There are two forms of vouchers: tenant-based and project-based.

With tenant-based vouchers, the local public housing authority issues an eligible Veteran a voucher and the Veteran selects an apartment of their choice. If the Veteran moves out of the unit, the contract with the apartment owner ends and the Veteran can move with continued assistance to another unit. Property owners are offered many incentives to participate in the program. Read more about those incentives HERE.

Under the project-based voucher program, a public housing authority enters into an assistance contract with the owner for specified units and for a specified term. The housing authority refers Veterans from its waiting list to the project owner to fill vacancies. Because the assistance is tied to the unit, a Veteran who moves from the project-based unit does not have any right to continued housing assistance.

VA also works to prevent low-income Veterans and their families from falling into homelessness through the Supportive Services for Veteran Families program. This program provides grants to local nonprofits that are experts in various fields that support those who are financially strapped. These organizations help Veterans apply for and receive benefits, fund move-in expenses, provide additional rental assistance that's offered through HUD-VASH, enroll Veterans in job training and education programs, provide subsidized childcare, and connect Veterans to free legal services.

There is also a rapid re-housing component of SSVF, placing Veterans into immediate transitional housing until something more permanent can be found.

As the needs of Veterans evolved, so has VA, adapting to better serve those who have served their country in our time of need. Given that Veteran homelessness is a significant concern and the need for more affordable housing is great, Congress and VA have taken significant steps to provide for Veterans.

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How Long Do VA Appeals Take to Process?

Hurry up and wait. Every current and prior service member knows this famous motto, no matter what branch they served in. Unfortunately, this way of life does not end after separation from the military if you plan on filing a disability claim through the Department of Veterans Affairs. When filing a claim, the process to show service connection and submit the right VA forms can be complicated. And after this process, Veterans are met with long wait times.

Wait times for receiving an initial decision on your claim can take about a year or more, and if you need to appeal the decision, it can be multiple years before you begin receiving monetary VA disability benefits.

While appealing to the Board of Veterans’ Appeals is an opportunity to present new evidence for your VA claim, the wait time can make it seem like your VA disability compensation is out of reach. However, knowing the details of how the appeals process works can help to alleviate some of the frustrations when it comes to the waiting game with the VA.

Where Does My Claim Go?

First, it is important to know where your documents are going when begin to file a VA claim. Within the VA system, there are 59 VA Regional Offices (RO) that receive the documents pertaining to a claim. Basically, there is roughly one RO in each state that is handling the claim for every Veteran living within that state. Therefore, it can be easy to imagine that they experience a bit of a backlog.

I Filed My Claim, Now What?

After you file your initial claim on a VA-526EZ, the RO corresponding to your area will issue a VCAA (Veterans Claims Assistance Act) Notice. This notice informs you that the VA is working on your claim and will mention any other evidence that they may need you to submit. Once you receive this notice, you have 30 days to submit any other documents that you want reviewed with your claim.

Now, the major waiting process begins. After the VCAA Notice, the next thing you should receive from the VA is your rating decision (RD), which can take over 500 days depending on your specific RO. This decision could be a grant of the disabilities that you claimed, with a disability rating percentage and the benefits you will receive, or it could be a denial of your claim. If you wish to appeal the RD, whether it was a grant or denial, you have up to one year to submit a notice of disagreement (NOD). Along with the NOD, you can also submit any further evidence that you feel counteracts the VA’s reasoning for their decision. You can also state whether you want a decision review officer (DRO) to review your claim.

Once you disagree with your first RD, the VA will then issue another decision, either a granted RD or a statement of the case (SOC), which is another denial of your claim. Unfortunately, it can take the VA another year to a few years to issue a second RD or an SOC.

If you wish to further appeal your claim, you are required to submit a VA Form 9 (Appeal to Board of Veteran’s Appeals) within 60 days of receiving your RD or SOC. This form will act as your substantive appeal. By this point, it should be easy to see the fundamentals of hurry up and wait; Veterans filing a claim are only give 30 days, one year, and 60 day deadlines at the various points in the claims process, but the VA has no deadline to issue a RD. It is important, though, to keep in mind the number of ROs versus the number of Veterans making a claim.

After you submit your VA Form 9 appealing the RO’s second decision or SOC, the RO will issue you a 90 day letter stating that the Board of Veterans Appeals (BVA) has received your case. With the 90 day letter, you have 90 days to submit any additional evidence for the BVA to consider in reviewing your claim. From that point, it becomes another waiting game waiting for the BVA to issue their decision, which may take up to, or even exceed, three years.

Keep in mind that the Veterans Appeals Improvement and Modernization Act of 2017 simplified this process. The new system allows Veterans to choose either a higher-level review, supplemental claim, or board review lane when making an appeal. While the new claims may take less time to appeal than those before, the above wait times are likely to apply.

So, Why Should I bother?

Unfortunately, the process to appeal a VA disability claim decision can become a long circle of decisions and appeals until you receive the benefits that you are entitled to. These long wait times can become extremely frustrating and may even deter you from filing a claim, or appealing the decision, but in the end, the outcome can be worth the wait. The effective date for which you will start receiving benefits for your granted disabilities will go back to the date of the original claim on your first VA-526EZ. For example, if you filed your original claim in 1998 and after the entire appeals process you received your rightful decision in 2004, you would receive six years of back pay, plus recurrent monthly benefits!

Is there any way to expedite my claim?

Sure, there are a few ways to help speed up the process and move your claim at a faster pace.

• Filing a Fully Developed Claim (FDC)
  • When you originally file, you can file your claim using the fully developed claim process. This means that you would submit all evidence and service records pertaining to your disabilities with your VA-526EZ. If the VA feels that you provided all of the evidence they need, your claim will be processed as an FDC. Visit the VA’s website to learn more about submitting a fully developed claim.
• Certain personal circumstances, which are explained in more detail in Hill & Ponton’s blog Is it Possible to Speed Up the VA Appeals Process?
  • Advanced age
  • Chronic illness
  • Severe financial hardship

Have Questions About the Appeals Process? Our Veterans Law Firm Is Here to Help

If you want to appeal the VA’s rating decision for your disability claim, the team at Hill and Ponton is here to help. Our Veteran’s disability attorneys put client relationships at the center of our practice, supporting disabled Veterans and their families as they seek Veterans’ benefits. Contact us today for a free case evaluation.

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A bill to expand coverage for Vets affected by toxic exposure doesn’t cover some of the illnesses that women get

Lacy Hollings watched the billowing black smoke rise a hundred feet from her door and sensed a disaster waiting to happen. It was 2006, and she had been deployed to the Ghazi province in Afghanistan as an interrogator and linguist with the United States army. Every day, the dark cloud lingered, stinging her eyes, charring her lungs, and making it difficult to breathe.

What Hollings was seeing was a burn pit, an area roughly the size of a basketball court where all the waste from the base – human sewage, food, tires and metal – was discarded, doused in fuel, and then set on fire with a match. It had a pungently chemical smell and would sizzle and crackle.

The smoke lingered for months, making Hollings’s one-mile runs around the base increasingly unpleasant. She knew there was no way she could live so close to the burn pit and not go home sick, referring to it among friends as “a ticking timebomb”. Dark soot would spray into her tissue whenever she blew her nose, an ominous sign that the smoke had entered her body. And indeed, only a year after she returned home she discovered her first of five cancerous tumors.

Congress has finally recognized the dangers of burn pit exposure in the form of the Honoring Our Pact Act, a sweeping bipartisan bill that passed the House on 3 March 2022. The bill extends healthcare to 3.5 million Veterans affected by burn pit exposure, but it has yet to become law and will only protect Veterans with 23 registered conditions.

For female Veterans like Hollings, who make up about 17% of the US military, their exposure symptoms are often outside this list. And even in cases when they are included – like that of Catherine O’Connors, who deployed to Iraq with the marines in 2005 – it can take female Veterans years to access the benefits they deserve.

“This is just another instance where women Veterans are not acknowledged for their specific needs within the system,” said Jennifer Pacanowski, founder of the non-profit Women Veterans Empowered and Thriving. “Or, where their service-connected disabilities are not associated with where they were stationed.”

Rosie Torres, the founder of BurnPits360, an organization that supports Veterans suffering from toxic exposure and who worked for the Department of Veterans Affairs for 23 years, says that even though the VA is a government administration, it could do more to help.

“I can’t even imagine what Veterans outside the system are going through against the bureaucracy within,” Torres said. “Even if they pass the Honor Our Pact, we will be adding illnesses to our list and calling on Congress to make these changes.”

When Hollings was told in the Bay Pines VA medical center in March 2021 that she needed yet another surgery, she felt nothing. A frank, unemotive voice in her head intoned, “OK, great, another tumor, where’s it at this time?” as her collected, outward self agreed to have the operation on 4 April.

This was the fifth serious health problem Hollings had since returning from Afghanistan in 2007 at the age of 27. The first was an ovarian cyst, the size of a softball, which was removed during her pregnancy. The next was a melanoma on her back, then came a parathyroid tumor, a rare growth in the four glands located around her neck. And finally, two blood clots the size of golf balls, the most recent of which Hollings was treated for last year.

“I know I am going to keep on finding tumors,” she said. “It’s just a matter of time until I find one too late.”

When Hollings graduated from the Defense Language Institute in Monterey, California, at 21, she was excited to join the army and put her years of linguistic training to good use. Although frustrated at being assigned to Afghanistan, where she couldn’t practice Arabic, she quickly fell in love with the place and the people.

Her optimism waned, however, when it was time to return to Indiana and deal with the arduous VA disability services.

As advised, Hollings claimed everything she could, noting the mental health problems she suffered as well as her exposure to burn pits, which she thought would lead to later health complications. She heard nothing for a year. Then she received a denial for the burn pit-related problems. She was given no chance to talk to anybody or get an explanation for her case.

Several times, she tried arguing on the phone, saying: “Look, these burn pits have caused these issues, caused my fibromyalgia. Here is the documentation, and here is why.”

Yet Hollings remembers the disability services responding, “Absolutely, you have these conditions; absolutely, they are disabling and terrifying. But there is no connection between these illnesses and burn pit exposure.”

Hollings does receive medical compensation for depressive disorder and chronic hip pain but says the VA still refuses to consider or acknowledge the causes of her other conditions. Now that her tumors have been removed, she says it is no longer considered a problem to the VA. But if she could get one more chance to talk to them again, she would say, “Quit dodging the bullet; it happened, do the right thing and pay for our injuries.”

On 12 March 2022, Catherine O’Connor left the Memorial Sloan Kettering cancer hospital on New York’s Upper East Side and walked into Central Park with her yellow labrador. Her clothes were her usual, old, even – boots, sweatpants and a waterproof green jacket – but the scar that ran along her neck, visible still under the shadow of her chin, was new. As was the swelling of her right cheek caused by the operation she had just undergone.

O’Connor deployed to Iraq aged 20 as a cyber networks operator in the Marine Corps. Those days, the military seemed unconcerned about the toxicity of setting carcinogens on fire. Her job was to make sure that no one was stealing from the burn pits at the Al Asad airbase in which she was living, and where sensitive documents were destroyed. For 12 hours a day, O’Connor would drive around the vicinity, making sure no one stole from the dump. To the best of her memory, she remembers thinking this couldn’t be good for her.

“At 20, though,” she said, “everyone feels invincible.”

It wasn’t until O’Connor returned home in 2006 to continue her studies that she began to think about the consequences of living near the burn pits.

Fourteen years later, there were repercussions. In November 2021, O’Connor started feeling pain in her ear, as if she had been punched. When she went to a doctor, he said her ears were fine, but there was a lump in the back of her mouth that needed attention. A biopsy revealed salivary gland cancer, common only in people above 60. O’Connor was 38. “This is incredibly surprising,” said the oral surgeon.

O’Connor spent entire days on hold with the VA, trying to figure out whom to talk to or how to move forward. Luckily, as she worked as a lawyer at Wilson Sonsini Goodrich & Rosati, the firm covered her medical bills.

When she checked in for treatment at Memorial Sloan Kettering, one of the best cancer hospitals in the world, O’Connor asked her surgeon about the burn pit connection. The Honor Our Pact legislation had been in the media frequently, and she wanted an expert opinion. “Environmental exposure may entirely be the cause,” he responded. “There is no hereditary explanation for your cancer.”

Surprisingly, his answer helped O’Connor cope with her condition. “There’s a feeling of ‘what did I do wrong?’ that comes with getting cancer,” she said. “The randomness of my diagnoses seemed so unfair, but knowing there could be a cause made me feel better.”

While O’Connor’s cancer was slow-growing, she often wishes she had found it earlier. The surgery took 12 hours, with the surgeon taking grafts from her hip and arm. “This could have been avoided” is a thought that often tortures her.

“While I know the science is just not there yet to confirm, I think if I could turn back time, and you could tell me that conclusively and absolutely that my condition was linked to my exposure, I would not have deployed.”

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Audits and interviews reveal failures to examine medical histories and perform tests before prescribing Veterans opioids. The results are disastrous.

David Parker, whose 12-year military career included deployments as a Marine to Iraq and Afghanistan, was getting out of his car last July at the Veterans Health Administration outpatient clinic in Fort Collins, Colorado, to seek treatment for his injured back when it suddenly gave out.

His body below his waist went numb. His face hit the pavement, and he lost control of his bowels.

As a former military service member, he is one of more than nine million Americans who get medical care from the VA system, the federal government’s sprawling array of 170 hospitals and more than 1,000 clinics. Parker, who is 34, was transported to the hospital in an ambulance and was given a week’s worth of the opiate codeine as part of his treatment.

He regretted what happened next.

“You were supposed to take, like, two a day, max, and I was taking—I think, like, by the fifth day, I was taking four. Four or five a day,” he told The Daily Beast. “I was popping them like Skittles.”

Parker worried about becoming addicted. That’s why, the next month, after a cross-country move—when he went to an East Coast VA hospital for a pancreatic cancer screening and complained about his aching back—he was adamant that he not be given opiates. Staff gave him a pill that they said was ibuprofen, he claimed. In 20 minutes, his back felt great.

“Whatever that ibuprofen was, I need to get that prescribed,” Parker said he told the doctor.

“Well, it’s codeine,” the doctor replied, according to Parker.

He was stunned. He did not want opiates, for fear of addiction, and he said he had informed the nurse of that very concern. Yet he said he was given them anyway.

Although officials at the VA could not speak to Parker’s individual case due to privacy concerns, a spokesperson did tell The Daily Beast that the facility in question “follows standard guidelines for the safe prescribing of opioids and routinely monitors facility and provider level prescribing patterns.” They added that the facility was well below national targets for prescribing opioids.

But among former military members, Parker’s experience is far from unique, interviews and a review of recent audits of VA care show. And even as the coronavirus pandemic continues to dominate the public-health conversation in America, Veterans and their advocates say the agency needs to do more to rein in opioids before it’s too late.

The Veterans Administration has come under withering criticism in recent years for contributing to the nation’s opioid epidemic. A decade ago, the VA prescribed opioids to one out of every four Veterans in its care, according to government statistics. Due to injuries endured in combat, Veterans are more likely than civilians to be dealing with serious pain. But the staggering number of prescriptions caused grave concerns.

Critics included the American Legion, one of the nation’s largest Veterans’ groups, which in 2015 reported, “Overuse of opiate prescriptions clearly creates problems for Veterans within the VA health-care system.”

Floyd Meshad, a Vietnam War Veteran who runs the nonprofit National Veterans Foundation based in Los Angeles, California, opposes long-term opioid therapy for Veterans in general. “If you get opioids and you stay on or get hooked, you don’t know if you’re better or not. You don’t feel anything,” he told The Daily Beast.

Meshad asserted the VA has a history of not examining other treatment options: “The VA’s primary treatment is chemical treatment,” he said.

It should be noted that the VA has succeeded in reducing opioid use among Veterans as the opioid crisis gained national consciousness. In the past eight years, the agency has cut opioid prescriptions by 64 percent, from more than 679,000 in 2012 to 247,000 in 2020. It reduced the number of patients receiving opioids and benzodiazepines together, a combination that has often led to death, by 87 percent in the same timeframe. Officials credit the expanded use of alternative therapies and treatments, like acupuncture and cognitive behavioral therapy; the VA has also benefited from “aggressively emphasizing the safe and responsible use of prescription opioids,” according to a report issued by the VA’s Office of Public and Intergovernmental Affairs.

In 2013, the VA launched its Opioid Safety Initiative, and in 2018, according to Dr. Friedhelm Sandbrink, the Acting National Program Director for Pain Management, it hired pharmacists trained to educate doctors who may be overprescribing opioids on best practices. It also instituted revised procedures that are supposed to reduce the chance for addiction. The procedures include doing a behavioral assessment of Veterans to check for a family or personal history of addiction before prescribing opioids, conducting urinalysis tests for illicit use, obtaining documented informed consent from Veterans in which they are warned that opioid use could kill them, and following up with patients prescribed opioids for long amounts of time.

The changes reflected a shift in the VA’s thinking around opioids, according to Dr. Sandbrink. “I think we realized even more that the risks of opioid medications probably outweigh the benefits for many patients,” he told The Daily Beast.

But Inspector General reports over the past year show VA facilities nationwide are still putting scores of Veterans on opioids without first following their own safeguards.

According to a Daily Beast review of dozens of audits, VA staffers are failing to assess Veteran patients for risks like a family or personal history of addiction prior to prescribing opioids. They aren’t consistently obtaining documented informed consent from Veterans in which they are warned that their opioid use could kill them. They often aren’t obtaining urinalysis tests to check for illicit use, or conducting follow-ups with patients on opioids for long terms. All of these procedures were outlined in the VA’s own updated clinical practical guidelines in 2017, and some also appeared in internal directives issued in 2009 and 2020.

VA officials painted a different picture of the status quo.

“The VA has been recognized by many as a leader in the pain management field for the responsible use of opioids as well as in the treatment of Opioid Use Disorder, and the department is sharing its knowledge and experience with federal and local governments and across the nation’s health-care networks,” a spokesperson told The Daily Beast in response to the audit findings.

Yet the audits indicate that the VA is still falling short. Most of the reports, published in the second half of 2020 and the beginning of 2021, documented dramatic shortcomings in checking Veterans for whether they were at risk to become addicted to opioids. In the 28 audits released with the new procedures, only five medical centers—including Tomah, Wisconsin, Dayton, Ohio, and Saginaw, Michigan—were found to have assessed all of their patients for risks like a history of addiction prior to prescribing opioids. Only three consistently obtained documented informed consent from Veterans to confirm they knew that opioid therapy can carry deadly risks. And only eight audits found VA facilities that conducted routine follow-ups with all of their patients on opioids.

A spokesman for the VA Inspector General declined to comment on the patterns in the audits or on individual cases. The VA’s Office of Public Affairs also said it would not comment on specific cases, citing patient confidentiality concerns. Sandbrink argued that the VA’s national levels for obtaining documented informed consent and testing Veterans’ urine are much higher than the levels found in the audits, though the study he referred to was conducted exclusively by employees of the VA.

The VA facilities in Montgomery and Tuskegee, Alabama, performed as poorly as anywhere in the country, according to the audits. Practitioners at two clinics and a hospital failed to screen over two-thirds of Veterans for a family or personal history of substance abuse. Only 45 percent were checked for addiction behaviors that suggest out-of-control drug use. And 79 percent were not given a form that confirms they understand that their opioid prescriptions pose deadly risks.

“The [Office of the Inspector General] observed significant concerns with medication management of long-term opioid therapy,” the inspectors reported.

Officials cited a shortage of providers and recruiting challenges due to their rural location as reasons they did not comply with behavioral assessments. They said they were not aware that requirements were in place to obtain Veterans’ documented informed consent acknowledging that opioid therapy could kill them.

At a Kansas City, Missouri, VA hospital, the Inspector General reported, staff failed to check 64 percent of patients for histories of drug abuse.

” Deficiencies with aberrant behavior risk assessment, urine drug testing, informed consent, patient follow-up, and quality measure oversight… may have resulted in providers prescribing opioids for patients at high risk for misuse,” auditors wrote.

Hospital officials told auditors, according to the report, that “because [opioid] risk assessments were often documented by other clinicians during varied episodes of care, providers believed requirements were met.” Nevertheless, the Inspector General recommended that the hospital revise its procedures and ensure patients are checked for increased chances of addiction.

Many facilities were found to have failed to check the urine of a significant number of patients on long-term opioid therapy for illicit use. Auditors found that Madison, Wisconsin’s VA hospital failed to test 55 percent of patients. Officials told auditors that they were unaware of the requirement. This was not unusual: only seven of the 28 audits found hospitals consistently obtained urine drug tests, and many cited a lack of awareness or inattention to detail as the reasons for their failings.

A few VA facilities, like in Chicago, Illinois, and Birmingham, Alabama, failed to document justifications for prescribing anti-anxiety benzodiazepines at the same time as opioids—a combination that exponentially increases the chances of fatal overdose. Officials in Chicago told auditors that they trusted that clinicians who prescribed opioids reviewed the notes of clinicians who had prescribed the same Veterans benzodiazepines, but acknowledged there was no evidence they had discussed the risks and benefits with patients, or provided justification for it. Birmingham officials stated that clinicians did not pay attention to the requirements.

Other VA medical centers around the country responded to the auditors with different reasons for their failures. Officials at the Madison and North Chicago facilities claimed they were unaware that monitoring requirements were in place to check for things like a history of substance abuse and adherence to long-term opioid therapy through urine drug testing. An official at the Danville, Illinois, center said that all of their long-term opioid therapy oversight stopped in general because medical staff had higher priorities. An official in Wichita, Kansas, stated that filling out separate progress notes was tedious, resulting in providers not consistently obtaining documented informed consent from Veterans in which they are warned that their opioid use could kill them.

The Inspector General does not review every hospital each year, and has only begun publishing checks on these opioid prescription protocols in the past 11 months. But they offer a rare snapshot into whether VA medical staff have been examining patients for their risk of addiction.

Despite the extensive failures found by inspectors, the agency may be shifting resources. As of last fall, it was moving on from questioning opioid therapy to another major concern: medication prescribed to treat COVID, according to a VA official. The public may never know how other VA facilities perform on checking for a history of addiction or obtaining documented informed consent from Veterans about the fatal risks of opioid treatment.

After Corey Troyer’s dad died of an opioid overdose in June 2011, Troyer went to his father’s house and found four different bottles of opioids. He checked the dates and discovered that they were all prescribed within three months of each other by the VA near his home in Tacoma, Washington, he said. Troyer’s dad John had a history of opioid addiction, for which he was in rehab from 2006 to 2008, he added.

Troyer is unsure whether the VA asked about his father’s history of addiction prior to prescribing him opioids, but he believes that regardless, the institution is to blame for his death.

“The VA just likes to throw medication at people to try to make them better instead of finding the root cause of what is actually wrong,” he said. The VA Puget Sound Healthcare System did not respond to requests for comment for this story.

Merrie Brundage has a similar beef. Her late husband, Paul, who served in Vietnam, turned to the Augusta, Georgia, VA in 2009 to treat his neck pain, back pain, and PTSD. He was prescribed the opioids hydrocodone and tramadol, as well as muscle relaxants and antidepressants, she recalled. Brundage’s husband had a history of substance abuse, and progress notes issued by the VA—and reviewed by The Daily Beast—reflect that they knew he had one and that “his drug of choice [was] Opiates.” That didn’t prevent doctors from dispensing them to him anyway, according to Brundage.

Brundage’s husband started abusing his medications, especially his opiates, and getting extra pills from coworkers, which Brundage said she told the VA many times. The doctors still didn’t change anything about his regimen, she claims.

After gashing his head one morning in the fall of 2011 after taking an excessive amount of his antidepressant and his daughter’s muscle relaxants, Paul Brundage walked outside, fell into a retention pond, and drowned. The death certificate prepared by the Georgia Department of Human Resources said that the combination of pills was deadly.

“Everything went south when he started going to the VA,” Brundage said. Even though her husband died in part from taking pills he was not prescribed, she still blames the agency for reawakening and enabling his addictive behavior. “As far as I’m concerned, they killed him.”

The Augusta VA declined to comment on Brundage’s story, citing patient privacy concerns.

Alex S. Bennett, a principal investigator at New York University’s School of Global Health who is conducting a four-year study on opioid use and misuse in the Veteran community, said that making an array of resources and services accessible is key to reducing the risk of overdoses.

Because many Veterans have been injured in the line of duty and experience chronic, long-term pain, they are more susceptible to suffer from opioid dependence and overdose, he said, adding that he believes the VA has made improvements in curbing addiction.

Veterans facing difficulties adjusting back to civilian life can encounter homelessness, unemployment, and post-traumatic stress disorder—all factors associated with a heightened risk of opioid overdose.

“Oftentimes we look at the drug as the root of evil or good… and really it’s everything else. It’s the housing, it’s the mental health, it’s the physical health. So I think rather than focusing on the drugs as much, we need to focus on the whole person, the whole Veteran,” Bennett said.

Getting Veterans off opioids after they’ve been prescribed them is difficult and risky. In a study of over a million Veterans who received opioid prescriptions from the VA in fiscal years 2013 and 2014, Veterans were found to die in greater numbers from overdose or suicide after stopping treatment, with heightened risk the longer patients were treated before stopping.

Meanwhile, the VA Office of the Inspector General continues to publish audits that examine VA oversight of opioid treatment. The most recent report was published on May 27. And Veterans are continuing to speak out, enraged at what they see as an institutional failure.

Todd Doyle was in the Air Force from 1989 to 2013. He was prescribed sleeping pills, muscle relaxants, antidepressants, antihistamines, opioids, and opiates by the Reno, Nevada, VA, after his service to treat post-traumatic stress disorder, as well as disk degeneration in his back, he said.

Doyle became concerned about the combination of medications he was on, noting he was on so many different ones that he stored them in a tote bag. He finally believed he needed to see a non-VA doctor when, while under the influence of the cocktail of medications prescribed to him, he passed out in the middle of the aisle of a Safeway drug store, he recalled. His wife and son had to carry him to the car.

A spokesperson for the Reno VA declined to comment, as did Doyle’s doctor from the VA, both citing patient confidentiality.

Doyle has since switched to a civilian doctor and weaned himself off opioids, but remains stunned at the hole he found himself in.

“I mean, literally, I felt like they were just gonna prescribe stuff until I was dead,” he said.

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What IS the VA Rating for Migraines?

Migraines are a common condition that can be debilitating. Veterans suffering from migraines may be experiencing this ailment due to an in-service incident. In this case, you may be eligible for VA disability compensation for your migraines. By proving service connection and gathering enough medical evidence, former service members can take steps to obtain veterans benefits.

Migraine Statistics in the US

One of the most debilitating medical conditions of our modern age is migraine headaches. From a medical standpoint, migraines are described as moderate-to-severe headache pain that can last a few hours to a few days, accompanied by physiological symptoms, such as nausea, vomiting, and sensitivity to light and sound. Functionally, migraines can be crippling and completely debilitating. Often people who suffer from migraine headaches must lie down in a dark, quiet room for the duration of the attack, and are unable to work or tend to the needs of their families. The veteran population is no stranger to migraine headaches. In fact, a recent study found that 36% percent of veterans who had completed a 12-month deployment to Iraq were either diagnosed with or exhibited symptoms of migraine. Notice that the study only discussed deployments to Iraq. One can imagine that those statistics, if true for Iraq deployments, must also hold true for military service and deployments to other areas as well.

The Migraine Research Foundation provides surprising statistics on the prevalence and implications of migraine headaches in the United States and worldwide:

• Migraine is the 3rd most prevalent illness in the world and the 6th most disabling illness in the world.
• Nearly 1 in 4 U.S. households includes someone with migraines.
• 12% of the population – including children – suffers from migraines.
• 18% of American women, 6% of men, and 10% of children experience migraines.
• 85% of chronic migraine sufferers are women.
• About half of female sufferers have more than one attack each month, and a quarter experience 4 or more severe attacks per month.
• Migraine is most common between the ages of 18 and 44.
• More than 90% of sufferers are unable to work or function normally during their migraine.
• More than 157 million workdays are lost each year in the US due to migraines.
• More than 4 million adults experience chronic daily migraines – with at least 15 migraine days per month.
• Migraine sufferers, like those who suffer from other chronic illnesses, experience the high costs of medical services, too little support, and limited access to quality care.
• Having migraines increases the risk of other physical and psychiatric conditions.
• The vast majority of migraine sufferers do not seek medical care for their pain.
• Only 4% of migraine sufferers who seek medical care consult headache and pain specialists.

VA Disability Ratings for Migraines

In spite of its acutely disabling effects, migraines take up a very small section in the VA diagnostic code for ratings and have a maximum schedular rating of 50%. VA ratings for migraines are principally rated according to the frequency of the migraine attacks. Here are the ratings according to the Department of Veterans Affairs:

• 0% – With less frequent attacks
• 10% – With characteristic prostrating attacks averaging one in 2 months over the last several months
• 30% – With characteristic prostrating attacks occurring on an average once a month over the last several months
• 50% – With very frequent completely prostrating and prolonged attacks productive of severe economic inadaptability

The magic word for an increased rating, therefore, would appear to be “prostrating.” We find that this is exactly the case for VA disability claims relating to migraines and it is key to obtaining VA benefits. The Disability Benefits Questionnaire for headaches, which the Compensation and Pension examiners use to conduct their exams, includes a whole section on “prostrating attacks.” The questionnaire prompts the examiner to ask the veteran if the migraine attacks occur:

• Less than once every two months
• Once in two months
• Once every month
• More frequently than once a month
• Very frequent prostrating and prolonged attacks of migraine headache pain

While a 50% schedular rating is the highest rating most veterans will receive for migraines, it may be possible to receive extra-schedular individual unemployability. We cover total disability ratings in a past blog post.

What are Prostrating Migraines and What Are Their Ratings?

The VA uses diagnostic code 8100 to rate headaches, including migraine headaches. While the rating code itself is vague, the VA’s internal adjudication manual, the M21-1, provides clarification for these terms for the decision-makers:

Prostrating: causing extreme exhaustion, powerlessness, debilitation or incapacitation with substantial inability to engage in ordinary activities.

Completely prostrating: means extreme exhaustion or powerlessness with essentially total inability to engage in ordinary activities.

Severe economic inadaptability: denotes a degree of substantial work impairment. It does not mean the individual is incapable of any substantially gainful employment. Evidence of work impairment includes, but is not necessarily limited to, the use of sick leave or unpaid absence.

Very frequent: Duration of characteristic prostrating attacks, on average, are less than one month apart over the last several months

Less frequent: Duration of characteristic prostrating attacks, on average, are more than two months apart over the last several months.

When you add the adjudication manual definitions to the rating criteria language, you will find that the Disability Benefits Questionnaire questions translate to this:

• Less than once every two months = 0%
• Once in two months = 10%
• Once every month = 30%
• More frequently than once a month = 50% AND
• Very frequent prostrating and prolonged attacks of migraine headache pain = 50%

The magic word “prostrating” holds even more weight, as the adjudicators tend to look only at Section IV – Prostrating Attacks of Headache Pain (as shown below) in making their determination. The examiner does not check the “Yes” box under 4A or 4C, the adjudicators will not award a higher rating.

However, the adjudication manual cautions adjudicators that even if the term “prostrating” does not appear in the veteran’s medical record—or in the C&P examination, for that matter—equivalent symptomology would warrant that rating. For example, the manual states that if a veteran provides testimony that he/she 1) experiences severe headaches and vomiting when exposed to light; 2) does not engage in any activities when this occurs; and 3) must rest or sleep during these episodes; and if there is medical evidence that the claimant’s description of symptoms is in fact symptoms of migraine headaches, a determination that the headaches cause prostration can be made.

How do I get a proper rating on my Migraines VA Disability Claim?

With the fate of your migraines percent rating essentially in the hands of the C&P examiners, there are a few things you can do to boost your case for an increased rating:

• Complain, complain, complain!

As with most other medical conditions, documentation is key for your VA claim for an increased rating. Tell your doctor about your migraine headaches, even if you do not take prescription medication for them. Let them know your symptomology, limitations, frequency of headaches, and precautions you must take during migraine attacks. That way, even if the C&P examiner does not accurately represent the severity of your migraine headaches, the medical record will support the criteria for a higher rating.

• Don’t downplay your symptoms.

This goes hand-in-hand with the first point. A good rule of thumb, especially for C&P exams, is to describe the symptoms of your most severe migraine attacks. The headaches might not always be that severe, but the point is for the VA to compensate you for functionality that you lose due to your service-connected conditions. However, this is not to say that you should exaggerate your symptoms, as this could cause problems later on.

• Write a statement.

You are your own best historian. You know your migraine condition better than anyone else—so write about it. As with the first point, describe your symptomology, limitations, frequency of headaches, and precautions you must take during migraine attacks. Statements from family members, friends, and/or coworkers who witness you during migraine attacks are also very beneficial. Statements are a strong piece of evidence, especially if you do not see your doctor very often.

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What is sleep apnea? Sleep Apnea is a common, potentially serious sleep disorder in which a person’s breathing is repeatedly interrupted, or ceases, during the course of a night’s sleep. These sleep disturbances can occur from tens to hundreds of times per night. The causes of these disturbances may vary depending on which form of the condition you have: obstructive, central, or a mixed form of both.

Obstructive sleep apnea is one of the more common forms which occurs when the upper airway repeatedly becomes blocked throughout the night. This blockage is caused when the soft tissue in the back of the throat relaxes, impairing the airflow. Central sleep apnea occurs when the brain either does not send signals to the muscles that control breathing or those signals are interrupted. The VA refers to mixed sleep apnea is a combination of the obstructive and central forms of the condition.

How Does the VA Rate Sleep Apnea

Sleep apnea is rated under 38 CFR § 4.97, Diagnostic Code 6847. This diagnostic code falls under the Sleep Apnea Syndromes. The VA assigns the following ratings for Veterans based on the severity of their sleep apnea:

• 100 percent: chronic respiratory failure with carbon dioxide retention, the need for a tracheostomy or the enlargement or failure of the right side of the heart due to lung disease. This is the most severe and the highest rating available.
• 50 percent: the Veteran requires the use of a breathing device, such as a CPAP machine.
• 30 percent: the Veteran is experiencing hypersomnolence, or excessive daytime sleepiness, that does not improve with sufficient sleep or even with naps during the day.
• 0 percent: the Veteran’s condition does not produce any symptoms but has a documented sleep disorder. This rating is a non-compensable rating, however, a Veteran may be entitled to other benefits, such as VA health care.

Establishing Service Connection

In order to establish direct service connection for sleep apnea, a Veteran must show that they have a current, diagnosis of sleep apnea, an in-service event or illness/injury, and a medical nexus or link that shows the Veteran’s sleep apnea is related to their in-service event, injury/illness.

A Veteran can also establish service connection for sleep apnea on a secondary basis. This means that a Veteran has an already service-connected disability that caused the Veteran to have sleep apnea. In this case, there must be a medical nexus to link the sleep apnea to their already service-connected disability. Some conditions that can be secondary to sleep apnea may include but are not limited to heart conditions, mental health conditions, and diabetes. If you have a service-connected condition that you believe is causing your sleep apnea, it may be a good idea to start to talk to your doctors about it.

How Does the VA Diagnose Sleep Apnea?

The VA will usually order a sleep study to be performed in order to confirm a diagnosis of sleep apnea. As a part of the VA’s duty to assist Veterans in obtaining evidence to help prove their claim, the VA has a duty to assist Veterans in scheduling the examination for a sleep study. For Veterans who have already been diagnosed with sleep apnea without a sleep study by the VA, the Veteran may have to undergo a sleep study done by the VA in order to confirm the diagnosis for benefit purposes.

Denied for Benefits?

If you have a previous denial for sleep apnea, please give us a call to see how one of our experienced attorneys can help you! Get started here!

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Understanding The VA Disability Ratings for Sleep Apnea

Sleep apnea is a common condition that affects about 22 million people nationwide. If you are among these individuals living with sleep apnea, you may be eligible for Veterans’ disability compensation. This guide will outline the basics of sleep apnea, how the VA disability rating works for this condition, and how you can prove service connection.

What Is Sleep Apnea?

Sleep Apnea is a potentially serious sleep disorder in which a person’s breathing is repeatedly interrupted, or ceases, during the course of a night’s sleep. These sleep disturbances can occur from tens to hundreds of times per night. The causes of these disturbances may vary depending on which form of the condition you have: obstructive, central, or a mixed form of both.

Obstructive sleep apnea is one of the more common forms which occurs when the upper airway repeatedly becomes blocked throughout the night. This blockage is caused when the soft tissue in the back of the throat relaxes, impairing the airflow. Central sleep apnea occurs when the brain either does not send signals to the muscles that control breathing or those signals are interrupted. The VA refers to mixed sleep apnea as a combination of the obstructive and central forms of the condition.

Some of the most common symptoms of sleep apnea include:

• Episodes in which you stop breathing during sleep — which another person would notice and report
• Gasping for air while sleeping
• Loud snoring
• Waking up with a dry mouth
• Headaches in the morning
• Difficulty staying asleep (insomnia)
• Excessive daytime sleepiness (hypersomnia)
• Difficulty paying attention while awake
• Irritability

Veterans who are experiencing the above symptoms should consider seeking a diagnosis and pursuing sleep apnea disability benefits. This generally requires a sleep study. If left untreated, sleep apnea can lead to conditions like:

• High blood pressure
• Stroke
• Heart failure, irregular heartbeats, and heart attacks
• Diabetes
• Depression
• Worsening of ADHD
• Headaches

How Does the VA Rate Sleep Apnea?

The VA sleep apnea ratings are based on the severity of the Veteran’s Obstructive Sleep Apnea.

Sleep apnea is rated under 38 CFR § 4.97, Diagnostic Code 6847. This diagnostic code falls under the Sleep Apnea Syndromes. The VA assigns the following ratings for Veterans based on the severity of their sleep apnea:

• 100 percent: chronic respiratory failure with carbon dioxide retention, the need for a tracheostomy or the enlargement or failure of the right side of the heart due to lung disease. This is the most severe and the highest rating available.
• 50 percent: the Veteran requires the use of a breathing device, such as a CPAP machine.
• 30 percent: the Veteran is experiencing hypersomnolence, or excessive daytime sleepiness, that does not improve with sufficient sleep or even with naps during the day.
• 0 percent: the Veteran’s condition does not produce any symptoms but has a documented sleep disorder. This rating is a non-compensable rating, however, a Veteran may be entitled to other benefits, such as VA health care.

How Can You Establish Service Connection For VA Disability?

In order to establish direct service connection for sleep apnea, a Veteran must show that they have a current, diagnosis of sleep apnea, an in-service event or illness/injury, and a medical nexus or link that shows the Veteran’s sleep apnea is related to their in-service event, injury/illness.

A Veteran can also establish service connection for sleep apnea on a secondary basis. This means that a Veteran has an already service-connected disability that caused the Veteran to have sleep apnea. In this case, there must be a medical nexus to link the sleep apnea to their already service-connected disability. Some conditions that can be secondary to sleep apnea may include but are not limited to heart conditions, mental health conditions, and diabetes. If you have a service-connected condition that you believe is causing your sleep apnea, it may be a good idea to start to talk to your doctors about it.

How Does the VA Diagnose Sleep Apnea?

The VA will usually order a sleep study to be performed in order to confirm a current diagnosis of sleep apnea. As a part of the VA’s duty to assist Veterans in obtaining evidence to help prove their claim, the VA has a duty to assist Veterans in scheduling the examination for a sleep study. This study will serve as medical evidence for the Veteran’s case.

For Veterans who have already been diagnosed with sleep apnea without a sleep study by the VA, the Veteran may have to undergo a sleep study done by the VA in order to confirm the diagnosis for benefit purposes.

Is There a Connection Between PTSD & Sleep Apnea?

Research has shown that their Veterans with post-traumatic stress disorder, also known as PTSD, may be at risk for sleep apnea. There are factors that overlap in both disorders which affect and aggravate each other. Some of these factors are issues that Veterans may have experienced in active duty, such as disturbed sleep in combat, excessive sleep deprivation, fragmented sleep, hyperarousal, and chronic stress.

Although all of these symptoms contribute to the interaction between sleep apnea and PTSD, the main culprits seem to be sleep deprivation and chronic stress. Studies have shown that patients exhibiting these symptoms tend to have increased frequency and length of apneic events.

Research has also shown that as the severity of PTSD increases in a person, the chances of developing sleep apnea increases as well because of the interplay between the shared factors of the two disorders. Sleep apnea and other mental illness are also associated with each other. Click here to learn more about that topic.

The important takeaway message is that if you are a Veteran suffering from PTSD, it is important to get a screening for sleep apnea. You may be eligible for additional VA disability benefits based on that diagnosis.

What If You’re Denied for Benefits?

If your obstructive sleep apnea VA claim, or other sleep apnea claim, was originally denied, you may be able to appeal the rating and receive VA disability compensation. The law professionals at Hill & Ponton are available to help. You can call our law firm at 1-888-373-9436 to discuss your VA disability claim. You can also click the red button in the corner free case evaluation.

see how one of our experienced attorneys can help you! Get started here!

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How Can You Receive VA Disability for Sleep Apnea?

Sleep apnea is a common condition that affects about 22 million people nationwide. If you are among the former military service members living with sleep apnea, you may be eligible for Veterans disability compensation. This guide will outline the basics of sleep apnea, how the VA disability rating works for this condition, and how qualifying Veterans can prove service connection.

What Is Sleep Apnea?

Sleep Apnea is a potentially serious sleep disorder in which a person’s breathing is repeatedly interrupted, or ceases, during the course of a night’s sleep. These sleep disturbances can occur from tens to hundreds of times per night. The causes of these disturbances may vary depending on which form of the condition you have: obstructive, central, or a mixed form of both.

Obstructive sleep apnea is one of the more common types of sleep apnea, which occurs when the upper airway repeatedly becomes blocked throughout the night. This blockage is caused when the back throat muscles relax, impairing the airflow. Central sleep apnea occurs when the brain either does not send signals to the muscles that control breathing or those signals are interrupted. The VA refers to mixed sleep apnea as a combination of the obstructive and central forms of the condition.

Some of the most common symptoms of sleep apnea include:

• Episodes in which you stop breathing during sleep — which another person would notice and report
• Gasping for air while sleeping
• Loud snoring
• Waking up with a dry mouth
• Morning headaches
• Difficulty staying asleep (insomnia)
• Excessive daytime sleepiness (hypersomnia)
• Difficulty paying attention while awake
• Irritability

Veterans who are experiencing the above symptoms should consider seeking a diagnosis and pursuing sleep apnea disability benefits. This generally requires a sleep study. If left untreated, sleep apnea can lead to conditions like:

• High blood pressure (hypertension)
• Stroke
• Heart failure, irregular heartbeats, and heart attacks
• Diabetes
• Depression
• Worsening of ADHD
• Headaches

Since sleep apnea can correlate with conditions like heart disease and obesity, it’s important to seek treatment. Physicians will treat sleep apnea depending on the type and severity of the condition. Some individuals with breathing disorders will show improvement from lifestyle changes. However, a breathing assistance device called a cpap machine is among the most common treatments. This machine creates airway pressure to help the individual breathe throughout the night.

How Does the VA Rate Sleep Apnea?

The VA disability ratings for sleep apnea are based on the severity of the Veteran’s Obstructive Sleep Apnea. Sleep apnea is rated under 38 CFR § 4.97, Diagnostic Code 6847. This diagnostic code falls under the Sleep Apnea Syndromes. The VA assigns the following ratings for Veterans based on the severity of their sleep apnea:

• 100 percent: chronic respiratory failure with carbon dioxide retention, the need for a tracheostomy or the enlargement or failure of the right side of the heart due to lung disease. This is the most severe and the highest rating available.
• 50 percent: the Veteran requires the use of a breathing device, such as a CPAP machine.
• 30 percent: the Veteran is experiencing hypersomnolence, or excessive daytime sleepiness, that does not improve with sufficient sleep or even with naps during the day.
• 0 percent: the Veteran’s condition does not produce any symptoms but has a documented sleep disorder. This rating is a non-compensable rating, however, a Veteran may be entitled to other benefits, such as VA health care.
• Common issues associated with Sleep Apnea include increased risk of stroke, high blood pressure, memory problems, and more.

How Can You Establish Service Connection For VA Disability?

Eligibility for Veterans benefits depends on proving service connection. In order to establish direct service connection for sleep apnea, a claimant must show that they have a current, diagnosis of sleep apnea, an in-service event or illness/injury, and a medical nexus or link that shows the Veteran’s sleep apnea is related to their in-service event, injury/illness.

A Veteran can also establish service connection for sleep apnea on a secondary basis. This means that a Veteran has an already service-connected disability that caused the Veteran to have sleep apnea. In this case, there must be a medical nexus to link the sleep apnea to their already service-connected disability. Some conditions that can be secondary to sleep apnea may include but are not limited to heart conditions, mental health conditions, and diabetes. If you have a service-connected condition that you believe is causing your sleep apnea, it may be a good idea to start to talk to your doctors about it.

How Does the VA Diagnose Sleep Apnea?

The VA will usually order a sleep study to be performed in order to confirm a current diagnosis of sleep apnea. As a part of the VA’s duty to assist Veterans in obtaining evidence to help prove their claim, the VA has a duty to assist Veterans in scheduling the examination for a sleep study. This study will serve as medical evidence for the Veteran’s case.

For Veterans who have already been diagnosed with sleep apnea without a sleep study by the VA, the Veteran may have to undergo a sleep study done by the VA in order to confirm the diagnosis for benefit purposes.

Is There a Connection Between PTSD & Sleep Apnea?

Research has shown that their Veterans with post-traumatic stress disorder, also known as PTSD, may be at risk for sleep apnea. There are factors that overlap in both disorders which affect and aggravate each other. Some of these factors are issues that Veterans may have experienced in active duty, such as disturbed sleep in combat, excessive sleep deprivation, fragmented sleep, hyperarousal, and chronic stress.

Although all of these symptoms contribute to the interaction between sleep apnea and PTSD, the main culprits seem to be sleep deprivation and chronic stress. Studies have shown that patients exhibiting these symptoms tend to have increased frequency and length of apneic events.

Research has also shown that as the severity of PTSD increases in a person, the chances of developing sleep apnea increases as well because of the interplay between the shared factors of the two disorders. Sleep apnea and other mental illness are also associated with each other. Click here to learn more about that topic.

The important takeaway message is that if you are a Veteran suffering from PTSD, it is important to get a screening for sleep apnea. You may be eligible for additional VA disability benefits based on that diagnosis.

What If You’re Denied for Benefits?

If your obstructive sleep apnea VA claim, or other sleep apnea claim, was originally denied, you may be able to appeal the rating and receive VA disability compensation. The law professionals at Hill & Ponton are available to help. Our disability attorneys focus on Veterans disability and social security disability law, helping your family obtain the benefits you’re entitled to. You can call our law firm at 1-888-373-9436 to discuss your VA disability claim.

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More than 26 million Americans are living with some form of disability, and 1 in 4 Americans struggle with mental health challenges. The Americans with Disabilities Act (ADA) protects the rights of Americans living with disabilities, including the right to have a Service Dog or Emotional Support Animal.

There are more than 500,000 Service Dogs and countless more Emotional Support Animals helping Americans with physical and emotional challenges. The ADA gives Service Dogs access to almost all the same spaces at people, allowing Americans with disabilities or mental health challenges to have the support they need with them at all times.

Benefits of Canine Companionship

There are so many benefits to having dogs in our lives; from keeping us active and healthy to supporting our mental health and social lives, our dogs provide all kinds of support.

Dogs are good for us – they keep us active and healthy, help us be calmer and more mindful, and make us more social and less isolated. For those living with a disability or mental health challenge, canine companionship can be truly lifesaving.

Service Dogs and Emotional Support Animals can perform a wide range of impressive tasks to support their human. Dogs can be trained to alert their handler to a medical alert, like low blood sugar or a seizure. Dogs can also support people struggling with PTSD, anxiety and other mental health challenges by increasing self-esteem and reducing isolation, and even providing tactile support during panic attacks.

There are no nation-wide standards for registering your dog as a Service Dog or Emotional Support Animal, but there are some basic guidelines to follow to determine if you qualify for a Service Dog or Emotional Support Animal, properly train your dog to support you, and obtain the necessary documentation.

Service Dog vs. Emotional Support Animal

Although the terms are often used interchangeably, there is a difference between a Service Dog and an Emotional Support Animal.

There is a difference between Service Dogs and Emotional Support Animals.

The ADA defines a Service Dog as any dog trained to perform a task for the benefit of a person with a disability. You must have a qualifying disability to be able to register your dog as a Service Dog. If you don’t have a qualifying disability, you may still be able to register your dog (or other pet) as an Emotional Support Animal if you struggle with a mental health challenge (a doctor’s note might be required).

If you’re not sure whether you qualify for a Service Dog or Emotional Support Animal, read on to learn more about the difference between the two classifications of support animals.

Service Dog

Service Dogs help people with disabilities perform tasks that they can’t do on their own.

Under the ADA, Service Dogs are allowed to accompany their handlers anywhere the general public is allowed to go, including government buildings, nonprofits and businesses. The ADA also protects the individual with a disability from discrimination, and forbids staff from asking about the individual’s disability. They are only allowed to ask limited questions to confirm that the dog is a Service Dog – like if the dog is a Service Dog, and what task the dog has been trained to perform.

To qualify for a Service Dog, an individual must have a qualifying disability that causes significant difficulty with at least one life-task, such as walking, seeing, or hearing. The Service Dog must be trained specifically to do something the individual with the disability cannot do themselves. Common tasks performed by Service Dogs include assisting vision or hearing impaired individuals in navigating, or alerting a diabetic to low blood sugar or an epileptic to an oncoming seizure.

Emotional Support Animal (ESA)

Emotional Support Animals help people with mental health challenges feel more comfortable and less isolated.

If an individual does not have a qualifying disability, they may still be able to register their dog as an Emotional Support Animal (ESA). Emotional Support Animals do not have the full access to public spaces that Service Dogs do, but they do have some legal protection under the ADA. ESAs are allowed in pet-free housing, and can fly with their handlers. Many businesses and other public spaces, and even some workplaces, have flexible policies for Emotional Support Animals.

To qualify for an Emotional Support Animal, an individual needs to have a mental health challenge which has been documented by a doctor or mental health professional. Emotional Support Animals can provide comfort and support to individuals dealing with PTSD, anxiety, depression, or cognitive disorders.

Training a Service Dog

There are no training standards for Service Dogs, but experts estimate that is takes up to 120 hours to properly train your dog to act as a Service Dog. At least 30 of those training hours should be done in public areas with distractions.

You have many options when it comes to training your dog to be a Service Dog or Emotional Support Animal.

You have many options when it comes to training your dog to become a Service Dog. If you are looking for a dog specifically to be a Service Dog, you can purchase a puppy that has already been trained through a Service Dog organization.

If you already have a dog in your life, you can still turn them into a Service Dog with some focused training. You can find trainers who specialize in Service Dog training, and will either work with you and your dog, or train your dog for you. Working together helps you bond with your dog, which will make it easier for them to perform their job.

You can also train your dog to be a Service Dog yourself. If you have the time and patience, do some research and follow a goal-focused program, you can successfully train your dog to perform Service Dog jobs yourself. There are countless resources available to help you with your training program, like the expert-recommended book “Training Your Own Full Potential Service Dog”.

http://www.amazon.com/dp/B015SJ32AM/?tag=jenrev-20

Before you embark on your Service Dog training, you should ensure that your dog is fit and healthy enough to perform the job. Take them for a Vet check up to ensure they are in good shape and up to date on all the vaccines they’ll need to accompany you everywhere. Older dogs especially should be in good shape before becoming a Service Dog.

Best Breeds for Service Dogs

Labs are a popular breed for Service Dogs, bu any breed can make a good Service Dog with proper training.

Any breed can make a great Service Dog, and any animal can be an Emotional Support Animal (there are even Emotional Support Snakes!).

Shepherds, Retrievers and Labs are popular breeds for Service Dogs due to their trainability and temperament. Larger dogs are best for individuals with mobility issues, but small dogs can perform Medical Alert tasks and may be more convenient as Emotional Support Animals.

Commands & Tasks

Service Dogs can be trained to perform a wide variety of tasks. The specific tasks that you’ll train your dog to perform will depend on the support that you need.

In addition to specific support tasks, Service Dogs should be well-behaved and follow basic commands.

That said, there are some general commands and tasks that all Service Dogs and Emotional Support Animals should be able to perform with ease.

• Heel: All Service Dogs should always maintain their relative position to their handler.
• Proofing: A Service Dog should always be alert for commands, not distracted or sniffing around.
• Calmness: Service Dogs must always been calm in public and focused on performing their job. They should be able to avoid getting overexcited by other dogs or people.

Once your aspiring Service Dog can Heel and show proofing behaviour even when facing distractions, it’s time to move on to Tasking. Tasking refers to the specific assistance tasks that the Service Dog will perform. There are many different tasks that Service Dogs can do, but the specific tasks that you’ll train your dog to perform will depend on your support needs.

Some common Service Dog tasks include:

• Medical Alert: Alert a person to a medical issues, like low blood sugar or a seizure
• Tactile Support: Provide deep pressure therapy
• Blocking, Mobility and Guidance: Guiding vision or hearing impaired people or protecting a person’s space
• Emotional Support: Calming people during panic attacks or over stimulation

The list of tasks that Service Dogs can perform is truly endless, but you can customize your training program to meet your needs.

Certifications

Although by law you only need to verbally confirm that your dog is a Service Dog, having documentation or a Service Dog vest can make explanations easier.

There is no standardized certification process for Service Dogs in the US – if fact, you aren’t even required to register your Service Dog. There are some general guidelines and best practices to follow to ensure your Service Dog is well-trained and to avoid possible issues in public.

Once you’ve trained your dog to perform tasks for you, you can complete a Public Access Test to prove that they are fit to be in public spaces with people. During this test your dog will need to show that they can remain calm and not get overexcited, beg for food or attention, or show any aggression.

Although certification is not required, and the ADA protects individuals from being questioned about or discriminated against due to a disability, some businesses and employers may request documentation to prove that your dog is a trained Service Dog.

Once you’ve confirmed that your dog is a service dog, either verbally or with documentation, accommodations must legally be made for you and your Service Dog. Obtaining a certificate or registration card or having your dog wear a Service Dog vest can make these conversations easier, but you also have the right to stand your ground and provide only verbal confirmation that your dog is a Service Dog.

Making Your Dog a Service Dog

Canine companionship is good for us, especially for those of us with a disability or mental health challenge.

More than a quarter of Americans suffer from a disability or mental health challenge, and more than 500,000 Service Dogs and countless more Emotional Support Animals help those individuals every day.

The ADA protects people with disabilities and gives legal protection to Service Dogs and, to a lesser extent, Emotional Support Animals. However, Service Dogs are fairly unregulated and there is no requirement to certify or register your Service Dog.

A Service Dog needs to be calm and able to avoid getting overexcited around people and other dogs. Service Dogs can be trained to perform countless tasks, including mobility-related assistance, guidance, medical alert and emotional support.

You can purchase a trained puppy from a Service Dog organization, pay a trainer to work with your dog or both of you together, or train your dog yourself. The important thing is that your dog remains focused while working, behaves in public and ignores distractions, and can assist you with tasks that you struggle with.

The benefits of canine companionship are huge for all dog owners, but individuals with physical or emotional challenges can benefit even more so from the love and support that dogs can provide.

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The U.S. military says it has plenty of coronavirus tests ready to meet demand. But not everyone meets requirements to get tested.

Military family members and retirees covered under Tricare and Veterans using the Department of Veterans Affairs health system can receive a test for the novel coronavirus, formally known as COVID-19, but only if they meet certain conditions, officials said.

Who Can Be Tested for COVID-19 and Have the Fee Waived?

The VA and Tricare have instituted similar rules around who qualifies for testing:

• The patient has COVID-19 symptoms, such as fever, cough and shortness of breath.
• The patient has traveled to one of the affected areas, like China or Italy.
• Or they have been in close contact with someone infected with COVID-19.

The VA also requires that the patient live in an area where there has been community spread of COVID-19.

Tricare announced via Facebook Tuesday COVID-19 testing is free for all beneficiaries. While it will still be no-cost if the test was prescribed by a network or non-provider, the usual copay or cost-share for the doctor visit will apply.

The VA is offering free testing to enrolled Veterans, a VA spokeswoman said via email Monday. This extends to Civilian Health and Medical Program (CHAMPVA) beneficiaries.

"VA currently has capacity to meet the demand for increased testing," the spokeswoman said.

What Should I Do If I Think I Have the Virus?

Tricare and VA both are asking patients not to go directly to a medical center without first calling.

The VA is urging Veterans to receive care virtually by downloading its VA Telehealth App; Tricare wants beneficiaries to call into the Military Health System Nurse Advice Line and chat with a registered nurse to assess their symptoms.

"If needed, they can coordinate a virtual visit with a health care provider," a Tricare official said via email.

What Happens If I Need to Be Tested?

If a patient needs to be tested, he or she will be given more information on next steps through the nurse advice line or VA app.

Officials said 14 Defense Department laboratories are performing COVID-19 testing, and they expect more to come online. Military clinics can also utilize state public health labs, officials said.

Where Can I Find Additional Information?

The VA is providing information updates via its coronavirus page here and has offered guidance for facility visits here.

Tricare beneficiaries can stay up-to-date on the latest information here.

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Like many industries, the business world made significant changes to adapt and transition operations.

Many large and small businesses took major hits; however, VA’s Office of Small and Disadvantaged Business Utilization (OSDBU) is working diligently to ensure small, Veteran-owned businesses maintain the resources needed to keep their businesses afloat during these unprecedented times.

In its most recent newsletter, OSDBU highlighted many of the virtual resources available to Veterans, as well as new initiatives on the horizon.

In fiscal year 2019, VA awarded over $12.8 billion to Service Disabled Veteran-Owned Small Businesses and Veteran-Owned Small Businesses, with more than $8 billion awarded to date for fiscal 2020.

“We have a dedicated mission centering around the broadening of access for Veteran-owned small businesses to Federal procurement opportunities throughout the government,” said Chanel Carter-Bankston, Director of Strategic Outreach and Communications for VA’s Office of Small and Disadvantage Business Utilization.

What online resources are available?

The Small Business Administration (SBA) and VA’s Office of Small and Disadvantage Business Utilization work to ensure valuable resources are available online for Veteran entrepreneurs. Some of those training resources include a vast library of interactive tools, webinars, videos, best practices and other information:

• VA Resources
• Learning Sessions
• Other Federal Agency Resources

Veteran entrepreneurs can also visit SBA’s Veterans Business Outreach Centers (VBOC) locally. VBOCs serve as a one-stop shop for counseling, mentorship and more. Find a local VBOC here.

Veterans Helping Veterans

The bond between Veterans is unmatched. VA’s Office of Small and Disadvantaged Business Utilization recognizes this special camaraderie when it announced an initiative highlighting Veteran-Owned businesses doing their part to give back to the Veteran community.

The Veterans Helping Veterans Initiative spotlights businesses that give back to the Veteran community through its hiring practices, the services it offers, how it works with VA, and more. The nominated businesses will be featured in future publications. To nominate, email: 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..

Sign up for notifications from VA’s Office of Small and Disadvantaged Business Utilization for awareness and understanding of VA small business programs.

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Traumatic Brain Injury (TBI) is one of the most common injuries found in former combat Veterans. In fact, health officials have noticed an uptick in TBIs in military service members who served in Iraq and Afghanistan in the past decade. This guide will break down the basics of TBIs and how the VA rates them, as well as the requirements for proving secondary service connection. It will also look at TBI trends in Veterans who served in Afghanistan and Iraq.

Understanding Traumatic Brain Injury & VA Ratings

A Traumatic Brain Injury (TBI) is a disruption of brain function resulting from a blow or jolt to the head or penetrating head injury. A closed head injury occurs when the brain is not exposed, also called non-penetrating or blunt injury. A penetrating head injury, or open head injury, occurs when an object pierces the skull and breaches the dura mater, the outermost membrane of surrounding the brain.

There are several signs and symptoms of TBI to be aware of after a head injury. These include:

• any loss of consciousness
• attention issues
• headaches
• change in vision
• dizziness
• loss of balance
• sleep disturbances
• nausea
• irritability
• word-finding difficulties
• confusion

Memory loss is the most common cognitive impairment. Some people seek treatment for a TBI when they find themselves having difficulty walking a straight line. Others look for help when they have speech issues caused by muscle weakness that causes disordered speech. TBI commonly has neurobehavioral effects like depression and personality changes, as well as chronic pain and substance abuse disorder. A neurologist can link these symptoms to a TBI, ruling out other causes.

In addition to these generalized symptoms, TBI patients commonly suffer functional vision problems. These symptoms include:

• difficulty focusing
• double vision
• difficulty reading
• sensitivity to light
• aching eyes
• loss of visual field

It’s important to note that TBI symptoms can be different in every individual. The level of severity will depend on the nature of the injury, such as whether they experienced a closed or penetrating head injury. The VA takes several factors into account when a Veteran makes a claim for a traumatic brain injury.

How Does The VA Review TBI Claims?

If you make a claim for disability compensation, it’s important to understand the VA disability rating criteria for TBI, as well as the medical evidence and symptoms that they review to arrive at the rating.

What symptoms does the VA review?

The VA evaluates TBI residual effects on current level of mental or cognitive function, emotional and behavioral function, and physical function. Through this full body review, the VA can assign a disability impairment rating.

To start, it’s important to note that the VA defines cognitive functions as memory, concentration, attention, and executive functions of the brain.

• Executive functions include abilities for goal setting, speed of information, judgment, and decision making.
• VA evaluates emotional and behavioral functions based on a diagnosis of a mental disorder.
• These may include inability to control anger, impulsiveness, and lack of initiative, inappropriate sexual activity, and poor social judgment.
• VA evaluates physical functions under the appropriate diagnosis, which may include a neurological disorder.

The severity of symptoms may fluctuate from day to day and from person to person. A TBI impairs brain function temporarily or permanently. Structural damage may or may not be detectable with current technology. Therefore, the VA has the duty to evaluate subjective symptoms as well.

You may have received a diagnosis with mild, moderate, or severe TBI close to the time of injury in service. The VA will not rate your disability based on those classifications while you were in service. Keep in mind that your disability rating is based on the current level of functioning at the time the claim is filed.

How Does The VA Rating For TBI Work?

The VA recognized the old schedule for rating brain disease due to trauma needed to be updated. In 2008, VA revised the rating schedule criteria. Where VA rated the Veteran’s TBI residuals under the old version the Veteran may request review under the new code. This is irrespective of whether his or her disability has worsened since the last review.

The VA reviews that Veteran’s rating under the new codes to see if it should give the Veteran a higher rating. In this instance, the VA will treat the claim as a claim for an increased rating. It is important to note that the VA will not assign an effective date before October 23, 2008.

To break down the numerical system of the rating, the VA evaluates TBI at 0, 10, 40, 70, and 100 percent. They recognize that there are certain cases so severe that warrant a rating higher than 100%, such as when the Veteran cannot work due to the injury. The VA would then have to consider unemployability. These ratings are called special monthly compensation (SMC). There is a specific one just for TBI called SMC-T.

In order to be eligible for SMC-T, a Veteran must show several factors:

1. The Veteran needs aid and attendance
2. Without in-home aid and attendance, the Veteran would require hospitalization, nursing home care, or another type of residential institutionalized care.
3. The Veteran doesn’t otherwise qualify for a higher level of Aid & Attendance under 38 U.S.C.S. § 1114 (R-2).

To break this down further, the VA has a special definition for “aid and attendance.” A Veteran must show that they are in need of aid and attendance by proving that they have the inability to perform specific daily functions. This includes:

• Inability to dress and undress without assistance
• Inability to stay clean and presentable without assistance
• Inability to feed themselves without assistance
• Inability to attend to the wants of nature
• Exposure to hazards and dangers incident to daily environment

If a Veteran can prove all of the above factors to be true, they may be eligible for a 100% rating or more through unemployability. This then makes them eligible for special monthly compensation for their injuries.

What About Secondary Service Connection?

When a Veteran seeks disability benefits for a TBI, it’s possible that they may also qualify for benefits for secondary service connection. This means that the Veteran has other conditions that developed as a secondary result of TBI.

Officials actually adjusted the secondary service connection regulations for TBI in 2013, connecting several illnesses to this condition. These conditions include:

• Parkinsonism (including Parkinson’s Disease) following moderate or severe TBI
• Dementias (presenile dementia of the Alzheimer’s type, frontotemporal dementia, and dementia with Lewy bodies) that develops within 15 years of moderate or severe TBI
• Unprovoked seizures following moderate or severe TBI
• Depression that manifests within three years of moderate or severe TBI or within 12 months of mild TBI
• Disease of Hormone Deficiency (resulting from hypothalamo-pituitary changes) that manifests with 12 months of moderate or severe TBI

These all can apply toward a secondary service connection claim, unless there is clear evidence to demonstrate the contrary. Since the above conditions can potentially inhibit your ability to work and perform daily functions, you might decide to seek VA evaluation for the disability.

How Does VA Determine Secondary Service Connection?

The VA determines a Veteran’s eligibility for secondary service connection based on the severity of the TBI, as well as the time between the original injury and the onset of the associated medical condition. If a Veteran meets the qualifications, meaning that the TBI was severe enough and fit within the listed time frame, they don’t need to seek a medical opinion to be eligible for benefits.

As for determining the severity of a TBI, there are several factors that the VA considers. These include structural imaging, loss of consciousness, alteration of consciousness/mental state, and post-traumatic amnesia. They also use the Glasgow coma scale in their assessment if the Veteran’s TBI resulted in a coma. Depending on the severity and combination of these factors, the VA classifies the TBI as mild, moderate, or severe. However, it’s important to note that a Veteran doesn’t need to demonstrate all of these factors to fit into one level of severity. The Veteran also would qualify for the highest level of severity if they meet the criteria for multiple levels.

Again, if the TBI is severe enough and the secondary condition appeared within the listed time frame, a private medical opinion is not necessary. However, keep in mind that it can still be helpful to gather evidence when applying for secondary service connection. And this can include past medical reports. By collecting this evidence, you are helping to ensure a more accurate VA evaluation. You can also avoid seeking a medical opinion while the evaluation is ongoing.

Acceptable Evidence for VA TBI Claim

Examples of acceptable evidence may include medical reports from past exams, statements from the Veteran, service treatment records that followed the TBI, and witness statements regarding the original injury. All of these pieces of evidence should be from the time of the TBI or shortly after.

To summarize, some Veterans may be eligible for benefits based on the original TBI and secondary service condition. Since the combination of these qualifications can be complicated, it’s important to gather as much evidence as possible and work with a reputable lawyer to put together a case. Doing so will create a stronger claim and for disability benefits.

Traumatic Brain Injury Increases inIraq &Afghanistan Veterans

More than 19,000 service members were diagnosed with mild traumatic brain injury, or concussion, in 2010, according to the Defense Centers of Excellence website. The signature injury of the war in Iraq and Afghanistan is residuals of TBI. The increase is linked to the common use of roadside improvised explosive devices or IEDs, and the resulting blasts.

The VA has made brain injuries a leadership priority. They recognize the critical challenge of TBI and concussion as signature injuries of modern combat and one of the leading combat injuries in recent years [American Forces Press Service, March 14, 2011]. Studies have estimated that about 20% of soldiers returning from Iraq and Afghanistan have suffered at least a mild traumatic brain injury while deployed. Of those, anywhere between 5% to nearly 50% may suffer both post traumatic stress disorder (PTSD) and lingering problems from traumatic brain injuries as well [ProPublica, and Daniel Zwerdling, NPR March 13, 2012].

What Has Caused These TBIs?

Common causes of TBI or concussion in active duty include blasts, vehicle collisions, or blows to the head. There are four categories of TBI including mild, moderate, severe and penetrating. A mild TBI, which is also known as a concussion, is the most common form of TBI. Although most people recover from mild TBI, the outcome of mild-penetrating TBIs can range from complete recovery to permanent disability or death.

Scientists at the National Institute of Neurological Disorders and Stroke (NINDS), part of the National Institutes of Health, are studying the effects of TBIs on the brain and the brain’s response to injury. There is more than meets the eye following even a mild traumatic brain injury. Oftentimes, initial scans do not reveal any physical damage to the brain tissue. However, recent studies by NINDS have shown that there may be therapeutic modalities to decrease the brain damage of TBI if treatment is rendered within hours after the injury. Unfortunately, a service member in the battlefield is not afforded immediate medical treatment. More often than not, a Veteran may not seek treatment for TBI symptoms until discharge from service. This may be in part due to lack of comprehension about the signs and symptoms of TBI not only by the Veteran but oftentimes the VA medical community.

Veterans may be entitled to disability benefits if they can prove that the injury occurred during service, and that they have a current disability linked to the injury. They may also be eligible based on secondary service connection regulations. If you are interested in pursuing benefits based on your injury or medical condition, a Veterans disability law firm can work with you to interpret the VA’s TBI rating system and requirements. They can also work with you to collect medical evidence, make a claim, and appeal your case if necessary.

Source

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Traumatic Brain Injury (TBI) is one of the most common injuries found in former combat Veterans. In fact, health officials have noticed an uptick in TBIs in military service members who served in Iraq and Afghanistan in the past decade. This guide will break down the basics of TBIs and how the VA rates them, as well as the requirements for proving secondary service connection. It will also look at TBI trends in Veterans who served in Afghanistan and Iraq.

Understanding Traumatic Brain Injury & VA Ratings

A Traumatic Brain Injury (TBI) is a disruption of brain function resulting from a blow or jolt to the head or penetrating head injury. A closed head injury occurs when the brain is not exposed, also called non-penetrating or blunt injury. A penetrating head injury, or open head injury, occurs when an object pierces the skull and breaches the dura mater, the outermost membrane of surrounding the brain.

There are several signs and symptoms of TBI to be aware of after a head injury. These include:

• any loss of consciousness
• attention issues
• headaches
• change in vision
• dizziness
• loss of balance
• sleep disturbances
• nausea
• irritability
• word-finding difficulties
• confusion

Memory loss is the most common cognitive impairment. Some people seek treatment for a TBI when they find themselves having difficulty walking a straight line. Others look for help when they have speech issues caused by muscle weakness that causes disordered speech. TBI commonly has neurobehavioral effects like depression and personality changes, as well as chronic pain and substance abuse disorder. A neurologist can link these symptoms to a TBI, ruling out other causes.

In addition to these generalized symptoms, TBI patients commonly suffer functional vision problems. These symptoms include:

• difficulty focusing
• double vision
• difficulty reading
• sensitivity to light
• aching eyes
• loss of visual field

It’s important to note that TBI symptoms can be different in every individual. The level of severity will depend on the nature of the injury, such as whether they experienced a closed or penetrating head injury. The VA takes several factors into account when a Veteran makes a claim for a traumatic brain injury.

How Does The VA Review TBI Claims?

If you make a claim for disability compensation, it’s important to understand the VA disability rating criteria for TBI, as well as the medical evidence and symptoms that they review to arrive at the rating.

What TBI symptoms does the VA review?

The VA evaluates TBI symptoms as residual effects on current level of mental or cognitive function, emotional and behavioral function, and physical function. Through this full-body review, the VA can assign a disability impairment rating.

To start, it’s important to note that the VA defines cognitive functions as memory, concentration, attention, and executive functions of the brain.

• Executive functions include abilities for goal setting, speed of information, judgment, and decision making.
• VA evaluates emotional and behavioral functions based on a diagnosis of a mental disorder.
  • These may include inability to control anger, impulsiveness, and lack of initiative, inappropriate sexual activity, and poor social judgment.
• VA evaluates physical functions under the appropriate diagnosis, which may include a neurological disorder.

The severity of TBI symptoms may fluctuate from day to day and from person to person. A TBI impairs brain function temporarily or permanently. Structural damage may or may not be detectable with current technology. Therefore, the VA has the duty to evaluate subjective symptoms as well.

You may have received a diagnosis with mild, moderate, or severe TBI close to the time of injury in service. The VA will not rate your disability based on those classifications while you were in service. Keep in mind that your disability rating is based on the current level of functioning at the time the claim is filed.

How Does the VA Rating for TBI Work?

The VA recognized the old schedule for rating brain disease due to trauma needed to be updated. In 2008, VA revised the rating schedule criteria. Where VA rated the Veteran’s TBI residuals under the old version the Veteran may request review under the new code. This is irrespective of whether his or her disability has worsened since the last review.

The VA reviews that Veteran’s rating under the new codes to see if it should give the Veteran a higher rating. In this instance, the VA will treat the claim as a claim for an increased rating. It is important to note that the VA will not assign an effective date before October 23, 2008.

To break down the numerical system of the rating, the VA evaluates TBI at 0, 10, 40, 70, and 100 percent. They recognize that there are certain cases so severe that warrant a rating higher than 100%, such as when the Veteran cannot work due to the injury. The VA would then have to consider unemployability. These ratings are called special monthly compensation (SMC). There is a specific one just for TBI called SMC-T.

In order to be eligible for SMC-T, a Veteran must show several factors:

• The Veteran needs aid and attendance
• Without in-home aid and attendance, the Veteran would require hospitalization, nursing home care, or another type of residential institutionalized care.
• The Veteran doesn’t otherwise qualify for a higher level of Aid & Attendance under 38 U.S.C.S. § 1114 (R-2).

To break this down further, the VA has a special definition for “aid and attendance.” A Veteran must show that they are in need of aid and attendance by proving that they have the inability to perform specific daily functions. This includes:

• Inability to dress and undress without assistance
• Inability to stay clean and presentable without assistance
• Inability to feed themselves without assistance
• Inability to attend to the wants of nature
• Exposure to hazards and dangers incident to daily environment

If a Veteran can prove all of the above factors to be true, they may be eligible for a 100% rating or more through unemployability. This then makes them eligible for special monthly compensation for their injuries.

What About Secondary Service Connection?

When a Veteran seeks disability benefits for a TBI, it’s possible that they may also qualify for benefits for secondary service connection. This means that the Veteran has other conditions that developed as a secondary result of TBI.

Officials actually adjusted the secondary service connection regulations for TBI in 2013, connecting several illnesses to this condition. These conditions include:

• Parkinsonism (including Parkinson’s Disease) following moderate or severe TBI
• Dementias (presenile dementia of the Alzheimer’s type, frontotemporal dementia, and dementia with Lewy bodies) that develops within 15 years of moderate or severe TBI
• Unprovoked seizures following moderate or severe TBI
• Depression that manifests within three years of moderate or severe TBI or within 12 months of mild TBI
• Disease of Hormone Deficiency (resulting from hypothalamo-pituitary changes) that manifests with 12 months of moderate or severe TBI

These all can apply toward a secondary service connection claim, unless there is clear evidence to demonstrate the contrary. Since the above conditions can potentially inhibit your ability to work and perform daily functions, you might decide to seek VA evaluation for the disability.

How Does VA Determine Secondary Service Connection?

The VA determines a Veteran’s eligibility for secondary service connection based on the severity of the TBI, as well as the time between the original injury and the onset of the associated medical condition. If a Veteran meets the qualifications, meaning that the TBI was severe enough and fit within the listed time frame, they don’t need to seek a medical opinion to be eligible for benefits.

As for determining the severity of a TBI, there are several factors that the VA considers. These include structural imaging, loss of consciousness, alteration of consciousness/mental state, and post-traumatic amnesia. They also use the Glasgow coma scale in their assessment if the Veteran’s TBI resulted in a coma. Depending on the severity and combination of these factors, the VA classifies the TBI as mild, moderate, or severe. However, it’s important to note that a Veteran doesn’t need to demonstrate all of these factors to fit into one level of severity. The Veteran also would qualify for the highest level of severity if they meet the criteria for multiple levels.

Again, if the TBI is severe enough and the secondary condition appeared within the listed time frame, a private medical opinion is not necessary. However, keep in mind that it can still be helpful to gather evidence when applying for secondary service connection. And this can include past medical reports. By collecting this evidence, you are helping to ensure a more accurate VA evaluation. You can also avoid seeking a medical opinion while the evaluation is ongoing.

Acceptable Evidence for VA TBI Claim

Examples of acceptable evidence may include medical reports from past exams, statements from the Veteran, service treatment records that followed the TBI, and witness statements regarding the original injury. All of these pieces of evidence should be from the time of the TBI or shortly after.

To summarize, some Veterans may be eligible for benefits based on the original TBI and secondary service condition. Since the combination of these qualifications can be complicated, it’s important to gather as much evidence as possible and work with a reputable lawyer to put together a case. Doing so will create a stronger claim and for disability benefits.

Traumatic Brain Injury Increases in Iraq & Afghanistan Veterans

More than 19,000 service members were diagnosed with mild traumatic brain injury, or concussion, in 2010, according to the Defense Centers of Excellence website. The signature injury of the war in Iraq and Afghanistan is residuals of TBI. The increase is linked to the common use of roadside improvised explosive devices or IEDs, and the resulting blasts.

The VA has made brain injuries a leadership priority. They recognize the critical challenge of TBI and concussion as signature injuries of modern combat and one of the leading combat injuries in recent years [American Forces Press Service, March 14, 2011]. Studies have estimated that about 20% of soldiers returning from Iraq and Afghanistan have suffered at least a mild traumatic brain injury while deployed. Of those, anywhere between 5% to nearly 50% may suffer both post-traumatic stress disorder (PTSD) and lingering problems from traumatic brain injuries as well [ProPublica, and Daniel Zwerdling, NPR March 13, 2012].

What Has Caused These TBIs?

Common causes of TBI or concussion in active duty include blasts, vehicle collisions, or blows to the head. There are four categories of TBI including mild, moderate, severe and penetrating. A mild TBI, which is also known as a concussion, is the most common form of TBI. Although most people recover from mild TBI, the outcome of mild-penetrating TBIs can range from complete recovery to permanent disability or death.

Scientists at the National Institute of Neurological Disorders and Stroke (NINDS), part of the National Institutes of Health, are studying the effects of TBIs on the brain and the brain’s response to injury. There is more than meets the eye following even a mild traumatic brain injury. Oftentimes, initial scans do not reveal any physical damage to the brain tissue. However, recent studies by NINDS have shown that there may be therapeutic modalities to decrease the brain damage of TBI if treatment is rendered within hours after the injury. Unfortunately, a service member in the battlefield is not afforded immediate medical treatment. More often than not, a Veteran may not seek treatment for TBI symptoms until discharge from service. This may be in part due to lack of comprehension about the signs and symptoms of TBI not only by the Veteran but oftentimes the VA medical community.

Veterans may be entitled to disability benefits if they can prove that the injury occurred during service, and that they have a current disability linked to the injury. They may also be eligible based on secondary service connection regulations. If you are interested in pursuing benefits based on your injury or medical condition, a Veteran’s disability law firm can work with you to interpret the VA’s TBI rating system and requirements. They can also work with you to collect medical evidence, make a claim, and appeal your case if necessary.

Source

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These are people who put their bodies and minds in harm’s way for their country.

In April, John Rios stood in the Veterans Affairs hospital in Newington, Conn., seeking treatment. For more than 20 years, he had struggled with the effects of post-traumatic stress disorder. For the past eight of them, he had fought to have the Defense Department recognize his military service as honorable. Having finally prevailed, he went to VA seeking health care, his official paperwork in hand.

The hospital turned him away, refusing to recognize him as a Veteran.

Rios had enlisted in the Navy in 1994, when he was 18 years old. He became a seaman on an aircraft carrier and deployed to support operations in Bosnia. But the weight of war took its toll on him. After witnessing injuries and death at sea, Rios developed symptoms of PTSD. When his ship returned to Virginia in 1997, the trauma of war manifested itself in misconduct. After a series of unauthorized absences by Rios, the Navy gave him an “other than honorable” (OTH) discharge six months shy of his end of active obligated service. Though he served in combat, his trauma-related breaches left him — in the eyes of VA — “not a Veteran.”

Rios is one of more than 500,000 former service members who bear the OTH label. The military issues OTH discharges when troops engage in behavior that constitutes a “significant departure” from the conduct expected of service members, and it generally dispenses them without formal due process. This malfeasance can encompass major violations, such as theft or illegal drug use, as well as more minor infractions like arriving late for work, being out of uniform or being disrespectful to a superior officer. Administrative separations free the commanding officer of a struggling service member and can be imposed as a way of avoiding the burdens of the court-martial process.

But OTH separations carry great costs. These former service members are often excluded from VA health care, from VA housing if they are homeless, from VA benefits payments even if they’re disabled by their service and from the educational supports provided to other Veterans. Veterans with the OTH label experience a higher risk of homelessness and are twice as likely to commit suicide. They also face the shaming effects of hearing from federal VA employees that they are “not a Veteran.”

[Five myths about VA health care]

For many OTH Veterans like Rios, traumatic episodes from their service led to early separation from the military. In 2017, the Government Accountability Office found that 62 percent of the 92,000 service members discharged for misconduct between 2011 and 2015 were diagnosed with PTSD, traumatic brain injury or other conditions that affect mental health and can manifest in ways that trigger disciplinary problems. Many of them remain without health care this Veterans Day.

The federal government excludes these Veterans from health care under a complex and opaque system. The military characterizes most discharges occurring after a service member’s first six months of enlistment in five ways: honorable, general (under honorable conditions), other than honorable, bad conduct and dishonorable. Since Congress passed the G.I. Bill of Rights, the eligibility standard for most VA benefits and services includes a requirement that the former service member was “discharged or released under conditions other than dishonorable.”

This is where VA takes matters into its own hands. Instead of simply providing care to all Veterans who pass statutory muster, VA creates its own set of regulations that further excludes former service members. It assumes that those who received honorable or general (under honorable conditions) discharges qualify as Veterans and thus can receive services. For the rest, VA theoretically makes a case-by-case determination about whether a Veteran is “honorable for VA purposes.” In practice, this often means that Veterans with OTH or bad-conduct discharges are excluded from health care unless they can show that the criteria that would exclude them do not apply.

Congress has tried to address this problem by expanding coverage for some of these excluded Veterans. The Honor Our Commitment Act of 2018 extended behavioral and mental health care to Veterans who survived combat and military sexual trauma, even if they have an OTH discharge. But VA has not always followed the law. Although Congress directed the agency to notify newly eligible Veterans within 180 days, it took about a year for VA to publicize the new benefits, and when it finally did, it did no more than mail letters (to people who are disproportionately homeless) and write a blog post, triggering a strong rebuke from members of Congress.

[When it comes to helping our soldiers, talk is cheap]

More troubling, VA staffers routinely misapply the law, misread military records and reject evidence that Veterans qualify for treatment. Across the country, VA administrative staff members have failed to give Veterans accurate information about their rights to mental health care, failed to properly recognize prior honorable terms of service when a Veteran is ultimately discharged with an OTH and failed to serve Veterans like Rios who have had their discharges upgraded. The result: VA staffers often tell survivors of combat or military sexual assault that they are “not Veterans” and ineligible for mental health care, disability benefits and housing services.

The problem has grown in recent years. The wars in Iraq and Afghanistan have seen the highest rates of OTH discharges in history; currently, the rate of such discharges is four times what it was during World War II. These decades-long conflicts have left survivors with invisible wounds that require treatment, but too many of those who suffer under those burdens have been denied means to get help. While only 1.7 percent of Veterans were excluded from VA health care in the World War II era, today 6.5 percent are denied care. They turned their mental and physical well-being over to their country, and the federal government turned its back on them.

For his part, Rios spent years fighting his PTSD on his own — struggling with depression, sporadic employment and bouts of homelessness. After finding mental health treatment, he obtained a legal aid attorney from the Connecticut Veterans Legal Center, where I am executive director, who helped make his case that he deserved to be upgraded to an honorable discharge. So, when VA turned him away, even after his discharge was upgraded, he had a lawyer to turn to for guidance. Many Veterans don’t have those resources.

VA health care can save lives, but the systemic barriers erected by administrators are unconscionable. Rather than a cold shoulder and a shaming dismissal, Veterans like Rios should be greeted with an open door. These are people who put their bodies and minds in harm’s way for their country. VA should recognize them for what they are: already honorable.

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Links to reschedule appointments cancelled due to COVID-19

What should you do if you need to reschedule a VA health appointment that was cancelled due to COVID-19?

If you need help rescheduling an appointment that was cancelled due to COVID-19, we’re here to help.

Do not delay getting in-person care. Make sure you’re taking care of the medical needs you would have addressed before COVID-19, like renewing prescriptions and having regular check-ins with your care team. If you feel like something is not quite right and you would normally see a doctor during non-COVID-19 times, call your care team. It is far better to have someone on your care team review your symptoms than wait until it’s harder to treat them.

Ways to make an appointment

If you or VA canceled an appointment due to COVID-19, you can contact us anytime to reschedule. The fastest way to schedule an appointment is to contact your VA health care provider directly. Here’s how you can do that:

Send a secure message to your care team. https://www.va.gov/health-care/secure-messaging/

Call your care team. Find your VA health facility’s phone number. https://www.va.gov/find-locations

You can also request some types of appointments — such as primary care and mental health — online through our VA appointments tool: https://www.va.gov/health-care/schedule-view-va-appointments/

We encourage you to consider a phone or video appointment for routine needs. Once you make a telehealth appointment, you will receive further instructions about how to join. Learn about VA Video Connect: https://mobile.va.gov/app/va-video-connect

Concerned about coming in?

As our facilities expand in-person services that were paused due to the coronavirus pandemic, we want you to feel confident knowing your safety and wellbeing remain our number one priority at VA.

At VA, safety is more than a checklist. It’s part of our culture and the foundation of everything we do. This video tells that story.

No substitute for in-person care for severely ill

We continue to maximize virtual care services as we know these services have been valuable to you.

However, for those who are severely ill or require intervention for life-threatening conditions, there is no substitute for in-person care. VA is ready, and we’re able to handle your immediate health care needs right now.

A virtual appointment — phone, video, secure message — is a great way to check in with your care team to review your symptoms and discuss appropriate care plans.

Masks and screening when you check in

If you go to a VA health facility for an in-person appointment, you’ll need to wear a mask that covers your mouth and nose. You’ll also need to complete our COVID-19 symptom screening when you arrive.

These measures are only a few ways in which we are working to keep you safe. We earned a trust score above 90% in a recent Veteran survey. We will continue to earn your trust by providing safe care, always. Please ask facility staff if you have questions about your safety or your care.

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Four decades ago, the U.S. Department of Veterans Affairs launched the National Veterans Wheelchair Games with only seven events. Now, video gaming, or esports, will become the newest medal event at this summer’s games.

But Jamie Kaplan, a recreational therapist at the James A. Haley Veterans’ Hospital in Tampa, Florida, has been on the forefront of video game therapy for a decade. In the facility’s gaming room, he has every system from Atari to Xbox One – all modified for disabled Veterans.

“Video gaming was a way for us to bring [Veterans] in – because it was something they are familiar with, something they enjoy doing,” Kaplan said.

Accessible gaming has become the focus of an ongoing partnership between the VA and Microsoft, which debuted their Xbox Adaptive Controller (XAC) in 2018. The device utilizes external buttons, switches and joysticks “to make gaming accessible to players with limited mobility.” Without it, many former service members would be unable to play video games at all.

The XAC, which is available at 24 VA facilities across the country, was the product of years of research and development.

Ken Jones, a mechanical engineer, began rigging gaming devices for injured Veterans on a case-by-case basis after visiting Walter Reed National Military Medical Center Bethesda, Maryland, in 2012. At first, the modifications were simple, but they quickly became more complex as Veterans with more challenging injuries expressed their desire for custom arrangements.

Jones founded the nonprofit Warfighter Engaged to supply the modified devices. It was Jones who created the rigged controller that Sgt. Josh Price used during a hackathon at Microsoft’s Ability Summit in 2015, catching the attention of the tech giant’s executives. Price had lost part of his right arm in a service-related injury.

Working with Jones, end-users and other disability advocates, Microsoft began developing an all-in-one accessible controller as part of their Gaming for Everyone initiative, further enhancing the product at the 2016 hackathon.

Bryce Johnson, inclusive lead at Microsoft Devices, worked extensively on the XAC since its inception. To him, the accessible controller is part of Microsoft’s larger goal of empowering all gamers worldwide. For the first time, the device standardizes a cost-effective, “plug-and-play" custom gaming rig for users and caretakers.

“At Xbox, we believe that when everybody plays, we all win,” he said. “With the Xbox Adaptive Controller, we are making it easier for these gamers to play and connect with the games and people they love.”

“The response from the community has been overwhelmingly incredible and positive, and we are so thankful to those who contributed to the creation of this controller,” Johnson added.

“It’s really good to see. It vindicates what we’ve been saying for years that this is something people need,” Jones said. “Just seeing Veterans now able to interact with their teammates that they played with for years in the military and were basically shut out. Now, to be a part of that community again is really good.”

For troops, "this population definitely has a very strong interest in gaming, in esports, and that world was taken away from a lot of folks...due to physical disabilities,” said Dr. Leif Nelson, VA national director of adaptive sports. “This controller really opened up the door to make gaming accessible to everyone.”

In 2019, Kaplan hosted the first Veterans’ esports tournament in Tampa with good results, and he is planning a Madden NFL 20 tournament on Jan. 31 to celebrate Super Bowl weekend. He hopes to expand similar events to include active-duty service members from nearby MacDill Air Force Base — home of U.S. Central Command, U.S. Special Operations Command, two Air Force wings and dozens of other mission partners — and even local professional athletes.

Kaplan ran video gaming lounges at two nationwide VA accessible events in the last year to introduce esports to the wider Veteran community.

It was at one of these events that Roger Brannon first encountered adaptive esports. Brannon medically retired as a Marine Master Gunnery Sgt. in 2017 after being diagnosed with Lou Gehrig’s disease, also called amyotrophic lateral sclerosis, or ALS, in 2016. Veterans, specifically post-9/11 Veterans, have a higher likelihood of developing ALS than civilians, according to a 2019 research study.

“Before, I couldn’t last 15 minutes with the regular joysticks. When I saw the XAC, I thought, ‘Wow, that could help a lot,'” Brannon said. “I am able to play video games with my son — Star Wars, race car games. We are spending more time together playing video games. It’s now something we can both do.”

Brannon also noted that video gaming with other Veterans at nationwide events provides a welcomed community.

“We’ve gone from just talking online to bringing Veterans in face-to-face with other peers, so they could start to develop relationships with people with similar backgrounds, similar interests and similar situations,” Kaplan said. “It’s not just a way for them to participate within the VA community, but to actually feel a part of their local community.”

To Nelson, the partnership naturally complements the VA’s ongoing adaptive athletics and therapy programs.

“It’s an incredibly crucial part of the rehab continuum,” said Nelson. “After folks go through an in-patient rehab program, then some sort of out-patient rehab, what’s after that? That’s where adaptive sports fit in for us.”

Microsoft’s introduction of the adaptive platform coincided with a 2018 research study that found video game play helps Veterans manage stress levels, cope with ongoing symptoms and enjoy higher levels of self-confidence and camaraderie.

“Adaptive sports can be the springboard to better health, to employment, to getting back to school. Once you know you can achieve something, it raises the bar for all aspects of life,” Nelson added.

As part of the agreement, the VA provides Microsoft with direct feedback from Veteran end-users to be integrated into the next generation of devices.

Jones said the current XAC, however, is remarkable for a first-generation device.

One of the most critical components to the Adaptive Controller is the “Copilot” feature. This 2017 software update allows a gamer to simultaneously use two controllers — one traditional Xbox controller and one XAC — to control a single player. Before, this feature would not have been possible.

This year’s National Veterans Wheelchair Games takes place in Portland, Oregon, from July 3-8 and is cosponsored by the VA and Paralyzed Veterans of America. The video gaming tournament — one of 20+ events — will be the “first-ever fully adaptive esports competition,” according to Nelson. The change signifies the VA’s commitment to fully integrate esports therapy.

“With the Adaptive Controller, it makes everybody equal. It allows these Veterans to feel some sense of normalcy, or how they felt prior to their injury,” Kaplan added. “We don’t want them being their injury. We want them being their individual.”

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America’s post-9/11 wounded Veterans are facing significant financial challenges. According to the latest Annual Warrior Survey from Wounded Warrior Project®, 42% of warriors registered with the nonprofit reported in summer 2021 not having enough money to make ends meet in the past 12 months. In addition, 13% of WWP warriors reported being unemployed at this time, compared to 5% of the U.S. general population.

Thankfully, many Veterans have financial support through their benefits obtained via the Department of Veterans Affairs. America’s wounded Veterans have earned their benefits through their sacrifice and service. However, the current process of applying for disability, rating changes, or pensions with VA can be confusing and daunting. Veterans often rely on trained specialists who help them navigate this claims process.

That is why organizations like WWP and the Veterans of Foreign Wars provide VA-accredited professionals to ensure that benefits claims are filed properly and efficiently — and Veterans never pay a penny for this expert assistance.

Sadly, some non-accredited businesses seek to prey on our most vulnerable Veterans and take advantage of this complicated process to make a quick buck. Some firms charge excessively for assistance in filing VA claims, even promising to increase disability ratings or to get Veterans disability in the first place. This is especially bad if warriors are tricked into signing a contract.

COVID-19 only exacerbated these challenges through appointment cancellations and isolation. In this uncertainty, some Veterans turned to the internet for answers, only to quickly be targeted by aggressive online ads and predatory tactics. Veterans, their family members, and the public need to be aware of these methods and tricks so we can combat this issue together.

Veterans should look out for some of the following tactics:

• Promises or guarantees to increase disability ratings and secure “X” amount percentage increases.
• Companies advertising services that are done faster or better than a Veterans service organization or accredited agents.
• Requesting sensitive login credentials to access the Veteran’s info through secure VA websites like eBenefits or VA.gov.
• Using confusing tactics or ambiguous language in contracts designed to mislead the Veteran.
• Offering health consultation within their own network of doctors and telling Veterans to forego VA exams for a faster decision.

If a Veteran sees any of these red flags, they should immediately ask, “are these organizations accredited with VA?” If the answer is no or somehow ambiguous, or if an organization offers to help warriors with their claim but refuses to go on record with VA as their representative, Veterans should work with someone else.

Legally, only VA-accredited individuals and organizations should assist Veterans and their families with benefits claims. When accredited organizations like VFW and WWP work with Veterans, benefits specialists will never ask warriors to sign confusing contracts.

The only “contract” organizations will ask for is VA Form 21-22, which not only puts us on record with VA as the advocate for a Veteran, but also binds that organization to laws and regulations that protect warriors from predatory fees and contracts.

VA provides a searchable database of free, accredited VSO representatives, attorneys, and agents to help Veterans navigate the benefits process and avoid unscrupulous tactics. That list updates constantly and is one of the best ways that Veterans and families can ensure they’re not getting scammed or preyed upon.

Outside of the Veterans service organization and military service organization community, the American people can also be there for these warriors by helping spread the word about predatory practices and the numerous resources for reputable benefits claims assistance.

We all want to ensure warriors get the benefits they’ve earned in a manner that honors their service. If you need assistance with your benefits claims, reach out to VFW, WWP, or another VA-accredited organization. You’re not alone, and it takes strength to ask for help.

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Ah, super glue — the greatest-of-all-time fast-acting adhesive for all of your stuck-together needs.

Chances are, you have a tube of this in that kitchen drawer, you know, the one with all the takeout menus, rubber bands and random keys to who knows what doors (you should probably clean that out by the way), because it’s an undeniable necessity.

But before it occupied space in our junk drawers, and our hearts, it was accidentally developed for the U.S. military.

Too sticky for Army weapons

In 1942, companies across the country were looking to support the war effort, including the Eastman Kodak Company. One if its inventors, Dr. Harry Wesley Coover, accidentally created a new compound while attempting to make clear plastic gun sights for Allied soldiers.

The compound, cyanoacrylate, was incredibly durable but way too sticky to use. (Imagine getting Krazy Glue anywhere near your eye. No thanks!) So Coover and his team abandoned the substance, not wanting to get stuck, literally or figuratively, on it.

Over a decade later, Coover, who would become known as “Mr. Super Glue,” rediscovered the adhesive compound while researching heat-resistant polymers for jet canopies. Cyanoacrylate adhesives required no heat or pressure to stick items together and hold them permanently. Thus, in 1956, the patent for “Alcohol-Catalyzed Cyanoacrylate Adhesive Compositions/Superglue” was born. How’s that for a name?

Coover and the Eastman team took the patent and repackaged it for commercial sale as “Eastman 910″ – which was later changed to “Super Glue.” This name stuck and still is used for a number of similarly adhesive products today.

A savior for soldiers in sticky situations

Even though the glue was discovered during World War II, military doctors during the Vietnam War capitalized on the product’s adhesive properties to save lives.

Many soldiers suffered injuries off-base, often bleeding out before getting proper care. Thanks to Coover’s invention, medics were able to spray super glue directly on skin to stop bleeding until the patient could make it to a hospital for treatment.

“This was very powerful. That’s something I’m very proud of – the number of lives that were saved,” Coover said in an interview with the Kingsport Times-News.

At this time, the chemical was not yet approved by the Food and Drug Administration because it had the potential to cause skin irritation. A derivative from the same chemical (2-octyl-cyanoacrylate) was approved in 1998 and functioned as a liquid bandage. Marketed under the names Dermabond and Traumaseal, these products pose less danger of irritation and bacterial infection and are available for civilian use.

So the next time you break your mom’s favorite vase and need to glue it back together, give thanks to Mr. Super Glue for finding something that was too sticky for the Army to use.

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The Food and Drug Administration has raised the recommended age to receive the vaccine for human papillomavirus, or HPV to 45. Health care experts say that's good news for women and men who did not receive the anti-cancer vaccine in childhood.

"There are hundreds of different strains of HPV," said Navy Cmdr. Shannon Lamb, a urogynecologist and the U.S. Navy Bureau of Medicine and Surgery's Women's Health Branch chief. "The vaccine doesn't protect from all of them, but it does protect from the most common ones that cause different types of cancers as well as genital warts."

HPV spreads through intimate skin-on-skin contact. Typically, the vaccine is recommended for girls and boys as young as age 9, and women and men up to age 26.

“It's recommended for young people so they're protected before they're ever exposed to the virus," Lamb said. "HPV is a very common infection. Over 80 percent of people will be infected in their lifetime."

In 2018, the FDA approved the vaccine for women and men up to age 45. While many adults have been exposed to some strains of HPV, most have not been exposed to all nine types covered by the vaccine.

"Therefore, expanding the age range for vaccination can help prevent HPV-related diseases in more individuals," she said.

Usually, people don't exhibit any signs or symptoms of an HPV infection, and most won't develop health problems related to HPV. The virus typically goes away on its own after a couple of years. But there's no way to predict who will clear the virus and who won't. And for those who don't, the consequences can be deadly.

According to the Centers for Disease Control and Prevention, HPV is responsible for more than 90 percent of all cervical and anal cancers, 70 percent of vaginal and vulvar cancers, and more than 60 percent of penile cancers. Every year, approximately 25,000 women and 19,000 men are affected by cancers caused by HPV.

For HPV vaccination of service members, the Department of Defense follows guidelines published by the Advisory Committee on Immunization Practices. ACIP recommends shared clinical decision-making regarding HPV vaccination for some adults ages 27-45 who aren't adequately vaccinated. Lamb notes the vaccine isn't mandatory, but it's strongly recommended for eligible service members.

"The vaccine creates a lot of benefit for men and women," Lamb said, "and we know it works." The number of cases of genital warts in the United States has dramatically declined in the military as well as civilian populations since the vaccine was introduced, she said.

"The HPV vaccine is definitely making an impact," Lamb said. "But we're still missing a good chunk of the population that could benefit."

The vaccine is administered as a two-dose series for those under age 15, and a three-dose series for older people. According to data from the Armed Forces Health Surveillance Branch's Medical Surveillance Monthly Report, only 26.6 percent of eligible servicewomen ages 17-26 initiated the vaccine during 2007-2017. During the same time period, only 5.8 percent of eligible servicemen in the same age group did so.

Further, for those who did initiate the vaccine and then remained in service for at least six months, only 46.6 percent of servicewomen and 35.1 percent of servicemen completed the recommended three doses.

"I think there's a lot of misinformation about the HPV vaccine," Lamb said. "Parents may think their kids don’t need it because they're not yet sexually active, for example, and older people may not understand they may be at risk."

Lamb is hopeful that with awareness people will make it a priority to talk to their health care providers about their risk for new HPV infections and the possible benefits of vaccination.

She notes that cancers caused by HPV may take years to develop after a person contracts the virus. Further, while there are cervical HPV screening tests available for women for high risk strains, there are no routine screening tests for men or tests that include all strains of HPV. Over 12,000 women living in the United States will be diagnosed with cervical cancer, and over 4,000 women die from cervical cancer annually. Women at highest risk are those who don’t undergo recommended screening and are not vaccinated, as well as women who smoke or have lowered immune systems.

TRICARE covers the HPV vaccine as recommended by the CDC. More information about the HPV vaccine can be found on the TRICARE website.

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HR 105, TBI and PTSD Treatment Act, will direct the Secretary of Veterans Affairs to establish a pilot program to furnish hyperbaric oxygen therapy (HBOT) to a veteran who has a traumatic brain injury (TBI) or post-traumatic stress disorder (PTS). MVA has reviewed several studies concerning HBOT treatment for PTS and TBI and there are positive indications associated with this treatment. Our interviews with MVA members who served in combat or in Special Operations also point to an affirmative correlation between HBOT and PTS/TBI. We believe that HBOT could potentially allow for a more successful treatment pathway for these invisible wounds.

Please contact your elected officials and ask for their support.

TAKE ACTION

Contact your elected officials and ask them to co-sponsor these TWO bills to help our Veterans

This week, we have two Bills of the Week. HR 1355 and S 454. These companion bills will provide health care and benefits to veterans who were exposed to toxic substances while serving as members of the Armed Forces at Karshi Khanabad Air Base, Uzbekistan. Troops stationed at "K2" were exposed to high levels of radiation from yellowcake uranium residue at the Uzbek base. It is estimated that the radiation levels were 7-9 times the normal background radiation. We estimate that 10,000 military members were exposed, many of whom have developed rare cancers associated with radiation exposure. Please ask your Member of Congress and Senators to co-sponsor these bills.

HR 1355

S 454

TAKE ACTION

HR 1476, PFC Joseph P. Dwyer Peer Support Program Act, will authorize the Secretary of Veterans Affairs to make grants to State and local entities and Non-Governmental Organizations (NGO) to carry out peer-to-peer mental health programs. As you know veteran suicide has reached epidemic level. We are losing thousands of veterans to suicide every year. In most cases mental health plays a role in these tragic deaths. The VA is not able to provide needed services on the local level to arrest this trend. They lack both the expertise and the resources to expand into local communities and tribal areas. This bill will make State and local governments and NGOs allies in the battle against veteran suicide.

TAKE ACTION

HR 1585 and S 565 are companion bills that will provide for the treatment of veterans who participated in the cleanup of Enewetak Atoll as radiation-exposed veterans for purposes of the presumption of service-connection of certain disabilities by the Secretary of Veterans Affairs.

MVA has supported similar bills in previous Congress'. It is time to move this bill off dead center and provide these veterans their earned benefits while they are still alive.

Please ask your Member of Congress and Senators to co-sponsor these bills.

TAKE ACTION

HR 1656, TREAT PTSD Act, will require the Department of Veterans Affairs and the Department of Defense to furnish enrolled members and veterans of the Armed Forces who have been diagnosed with Post Traumatic Stress Disorder with stellate ganglion blocks, should they elect to have them. Serving our nation in the Armed Forces is an incredibly taxing job both physically and psychologically. As such, we strongly believe that active duty members and veterans deserve the best quality of care that our country can provide. The stellate ganglion block treatment is a new but effective method for treatment of PTSD. This bill is a step towards the more complete care that our military and veterans deserve for whatever ailments they have incurred in service to our country.

Please contact your Member of Congress and Senators and ask them to co-sponsor this bill.

TAKE ACTION

Help get support for the TEAM bills HR 2127 and S 927, the TEAM bills, will improve the provision of health care and other benefits from the Department of Veterans Affairs for Veterans who were exposed to toxic substances. The TEAM bills are essential to providing needed medical coverage for victims of military toxic exposure.

TAKE ACTION

HR 2269 and S 657 cover herbicide exposure in Thailand. These bills will modify the presumption of service connection for veterans who were exposed to herbicide agents while serving in the Armed Forces in Thailand during the Vietnam era. Given the 500 meter wind drift buffer zone required for ground spraying of herbicide, the VA's refusal to expand the area of coverage is simply ludicrous. Please contact your Member of Congress and Senators and ask them to co-sponsor these bills.

TAKE ACTION

The Warfighter bills are essential to provide needed medical coverage and compensation for victims of military toxic exposure. For far too long our veterans have suffered and died while awaiting medical care because of the bureaucratic intransigence of the VA. We need a comprehensive toxic exposure plan, and these bills are a good first step. Please ask your Member of Congress and Senators to co-sponsor these bills.

TAKE ACTION

HR 2447 will provide for a presumption of service connection for illnesses associated with service in the Armed Forces in the Panama Canal Zone. It will close certain loopholes for those service members who have been previously denied VA benefits for illnesses connected with their service in the Panama Canal Zone. The PACT Act left these individuals out under the assumption that there was not Agent Orange used in this location. However, there is evidence to the contrary, and we are glad that it is being recognized. These veterans have been suffering and should be taken care of and fairly compensated for their exposure.

Please contact your elected officials and ask for their support.

TAKE ACTION

HR 2526, S.O.S. Veterans Caregivers Act, will merely change the semantics regarding the satisfaction that caregivers and veterans experience. With the subtle adjustment in language, it will clear up gaps in any idiosyncrasies which may be interpreted differently and cause confusion within the Caregivers and Veterans Omnibus Health Services Act of 2010.

Please contact your elected officials and ask for their support.

TAKE ACTION

HR 2601 and S 1188, SFC Heath Robinson Burn Pit Transparency Act, will direct the Secretary of Veterans Affairs to notify Congress regularly of reported cases of burn pit exposure by Veterans. This will address an issue affecting an immense number of service members and veterans. Establishing reporting requirements for Veterans and military members affected by open burn pits is important to ensure they receive adequate benefits and compensation. The first phase in addressing a problem is to understand it. These bills will deepen the knowledge and data surrounding Veterans affected by burn pit related illnesses. We believe requiring the Secretary of Veterans Affairs to regularly notify Congress of reported burn pit exposure will improve the treatment of these Veterans.

Contact your Member of Congress and Senators and ask them to support these bills.

TAKE ACTION

HR 2800, the WINGMAN Act, will permit veterans to grant access to their records in the databases of the Veterans Benefits Administration to certain designated congressional employees. Unfortunately, Congressional assistance is sometimes stymied by a lack of access to VA records. Once a release is signed, these records should be disclosed without further delay. It seems that the VA only moves fast when their representatives do not have access to the records. The Wingman Act will help to cure this problem.

TAKE ACTION

HR 3368 will provide for a presumption of service-connection for certain veterans exposed to herbicides while serving in the Armed Forces on Guam, American Samoa, and Johnston Island. MVA has long supported benefits for these exposed veterans. We worked with the Environmental Protection Agency to confirm the presence of dioxin on Guam, 39 years after the last known spraying.

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HR 3400, VA Emergency Transportation Act, will reimburse Veterans for the cost of emergency medical transportation to a federal facility. Veterans should not have to pay for their emergency transport. This common-sense bill will help ensure our heroes receive quality care quickly.

Contact your Member of Congress and Senators and ask them to support this bill.

TAKE ACTION

HR 3537 and S 1813, Accelerating Access to Critical Therapies for ALS Act, will direct the Secretary of Health and Human Services to support research on, and expanded access to, investigational drugs for amyotrophic lateral sclerosis. A large percentage of ALS sufferers are veterans and we believe that there may well be a nexus between ALS and exposure to military toxic substances. These bills will not only help veterans but all Americans who suffer from this debilitating disease.

Contact your Member of Congress and Senators and ask them to support these bills.

TAKE ACTION

HR 3596, the Lawrence J. Hackett, Jr. Vietnam Veterans Agent Orange Fairness Act, will direct the Secretary of Veterans Affairs to establish a task force on Agent Orange exposure. Over a half century since this toxic herbicide was first used, we still do not understand its effects or even where it was used. Contrived controversies such as whether the herbicide was used for tactical or commercial purposes have only muddied the waters. We need a full baseline review concentrating on the science and not the rationalizations to finally turn the corner of cornering this deadly substance. Too many have died already. Let's fix the problem now!

TAKE ACTION

HR 41, the VA Same-Day Scheduling Act of 2023, will direct the Secretary of Veterans Affairs to ensure the timely scheduling of appointments for health care at medical facilities of the Department of Veterans Affairs. This is very important to veterans. The VHA is still plagued with delays and wait lists. This bill will force the VA to act and schedule in one phone call.

TAKE ACTION

HR 4601 and S 2405, Commitment to Veteran Support and Outreach Act, will authorize the Secretary of Veterans Affairs to award grants to states to improve outreach to veterans. These grants will enable State, County, and tribal officers to tailor their programs to the needs of local veterans. We have reviewed and support the evaluation metrics included in the bills and feel that this program will help support veterans throughout the country.

TAKE ACTION

HR 5026, The Panama Canal Zone Veterans Act of 2021 will grant federal benefits to veterans who served in or near the Panama Canal Zone, all of whom were potentially exposed to deadly tactical herbicides such as Agent Orange.

Under this act, Veterans who served in or near the Panama Canal Zone would be granted presumptive herbicide exposure status, meaning they could receive federal benefits and disability compensation from the VA.

Please support this important bill and show our Panama Veterans that they have not been forgotten. Our Panama Canal Zone Veterans deserve access to the same treatment and benefits as others who served in similar conditions. It is long past time we recognize the sacrifices of those who defended this strategic position when our nation called upon them.

Ask your Member of Congress and Senators to support the Panama Canal Zone Veterans Act of 2021.

TAKE ACTION

HR 6260, the Casualty Assistance Reform Act of 2021, will direct the Secretary of Defense to establish a working group for the reform of the casualty assistance officer program. The casualty assistance officer provides critical aid to the survivors of those who have made the ultimate sacrifice. Unfortunately, this is often collateral duty and personnel are detailed with little or no preparation. Better training and a comprehensive approach to this important duty will help assuage some of the pain of a grieving family. We owe it to our survivors to ensure that they are provided caring assistance by a knowledgeable and trained representative.

TAKE ACTION

HR 6402 and S 1725, will grant a Federal charter to the National American Indian Veterans, Incorporated. Veteran services for tribal areas have been spotty at best. Native American Veterans often do not have access to either service officers or medical clinics. Chartering this group will help to correct these deficiencies. Native Americans are participating in military service in ever increasing numbers. We need to ensure that the VA serves their needs. Please contact your elected officials and ask them to support our Native American Veterans.

TAKE ACTION

HR 6659 and S 3541, the Health Care for Burn Pit Veterans Acts, will provide health care and benefits to Veterans suffering from the effects of toxic exposure. It is a cost of war that must be paid, and it is past time for Congress to deliver on this promise. It is consistent with the pending COST of War Act, won’t negatively impact VA’s delivery of care or benefits to Veterans, and can garner enough bipartisan support to get it all the way to the President’s desk— making it our best chance at ensuring all past, present, and future generations get the care and benefits they earned.

TAKE ACTION

HR 7048, Protect Lifesaving Anesthesia Care for Veterans Act of 2022. This bill will prohibit the Secretary of Veterans Affairs from replacing physician anesthesiologists with certified registered nurse anesthetists, or other health professionals in the health care system of the Department of Veterans Affairs. The administration of anesthesia by other than a licensed physician is a dangerous practice that can result in injury or death to veterans during surgical procedures. Our veterans deserve the very best health care dispensed by the best qualified professionals.

TAKE ACTION

HR 7050, Ernest Peltz Accrued Veterans Benefits Act, will make certain improvements in the laws relating to the administration of benefits payable to survivors of deceased Veterans. Specifically, the bill will expand the class of eligible survivors to include dependent children and dependent parents. Additionally, it will better define the accrued benefits due to these eligible survivors. We owe it to these deceased Veterans to take care of their survivors. This bill will help do that.

TAKE ACTION

HR 7158 and S 2852, Long-Term Care Veterans Choice Act, will authorize the Secretary of Veterans Affairs to enter into contracts and agreements for the payment of care in non-Department of Veterans Affairs medical foster homes for certain veterans who are unable to live independently. These foster homes will result in more individualized care and closer attention to the needs of the severely disabled veteran. This will also reduce the burden on the state and federal veterans nursing homes. Please contact your elected officials and ask them to support these bills.

TAKE ACTION

HR 7337, Access for Veterans to Records Act, will require the Archivist of the United States to submit a plan to Congress to eliminate the records backlog at the National Personnel Records Center. While we understand that the pandemic required a number of employees to work remotely, the medical situation has stabilized in this country. In order to obtain records to support the claims for sick and dying veterans, the National Archives must become more responsive.

TAKE ACTION

HR 7589, Remove Copays Act, will prohibit the imposition or collection of copayments for certain mental health outpatient care visits of Veterans. Our Veterans who are struggling with mental health issues face enough problems without having to scrape together money for a co-pay. Being forced to choose between food and treatment is a choice no Veteran should have to make. This bill will help reduce the pressure on these challenged Veterans and perhaps save the lives of those who are giving into pressures. This bill is a good step to help Veterans embrace treatment with a corresponding decline in the tragic suicide rate.

Please contact your elected officials and ask for their support.

TAKE ACTION

Will direct the Secretary of Defense to carry out a grant program to increase cooperation on Post-Traumatic Stress Disorder research between the United States and Israel. No other nation has had the combat experience as the State of Israel. Joint collaboration on Post-Traumatic Stress and its effect is a force multiplier.

TAKE ACTION

A BILL

To provide PreCheck to certain severely injured or disabled veterans, and for other purposes.

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the “Veterans Expedited TSA Screening Safe Travel Act” or the “VETS Safe Travel Act”.

SEC. 2. AVAILABILITY OF PRECHECK PROGRAM TO CERTAIN SEVERELY INJURED OR DISABLED VETERANS.

(a) In General.—Section 44927 of title 49, United States Code, is amended by adding at the end the following:

“(g) Availability Of PreCheck Program To Certain Severely Injured Or Disabled Veterans.—

“(1) IN GENERAL.—A veteran described in paragraph (2) is eligible for security screening under the PreCheck Program under section 44919 at no cost to the veteran if the veteran is able to meet the background check and other security requirements for participation in the program.

“(2) VETERANS DESCRIBED.—A veteran described in this paragraph is a veteran who—

“(A) is enrolled in the patient enrollment system of the Department of Veterans Affairs established and operated under section 1705 of title 38, United States Code;

“(B) has—

“(i) lost, or lost use of, a limb;

“(ii) become paralyzed or partially paralyzed; or

“(iii) incurred permanent blindness; and

“(C) as a result of a loss, paralyzation or partial paralyzation, or blindness described in subparagraph (B), requires the use of a wheelchair, prosthetic limb, or other assistive device to aid with mobility.”.

(b) Coordination On Implementation.—The Administrator of the Transportation Security Administration and the Secretary of Veterans Affairs shall jointly—

(1) develop and implement a process under which a veteran described in paragraph (2) of subsection (g) of section 44927 of title 49, United States Code, as added by subsection (a), can receive the benefits under such subsection by not later than one year after the date of enactment of this Act; and

(2) provide to Congress a briefing on the status of implementing the process required by paragraph (1) by not later than one year after the date of the enactment of this Act.

SEC. 3. OUTREACH FOR DISABLED VETERANS ON AVAILABILITY OF TRANSPORTATION SECURITY ADMINISTRATION PROGRAMS.

(a) Coordination.—The Secretary of Veterans Affairs and the Administrator of the Transportation Security Administration shall develop and implement a process under which the Secretary provides to disabled veterans effective outreach about Transportation Security Administration programs designed to improve the screening process for passengers with disabilities.

(b) Further Enhancements To Ease Air Travel For Wounded Warriors And Other Disabled Veterans.—Notwithstanding section 3501 et seq. of title 44, United States Code (commonly referred to as the “Paperwork Reduction Act”), or any other provision of law, the Secretary of Veterans Affairs, in coordination with the Administrator of the Transportation Security Administration, shall—

(1) engage appropriate veterans service organizations and other relevant organizations, as appropriate, to assess the awareness of veterans of relevant Transportation Security Administration programs; and

(2) examine the need and feasibility of other measures to improve travel security procedures for disabled veterans.

(c) Briefing Requirement.—Not later than 180 days after the date of the enactment of this Act, the Secretary of Veterans Affairs and the Administrator of Transportation Security Administration shall jointly provide to Congress a briefing on the status of the implementation of subsections (a) and (b).

TAKE ACTION

HR 8736, the GUARD Act, will reinstate criminal penalties for unaccredited claim representatives who charge unauthorized fees while assisting veterans with filing a claim for Department of Veterans Affairs (VA) disability compensation benefits. As documented in a DAMA Subcommittee hearing earlier this year, veterans are being preyed upon by unregulated for-profit corporations. This is unacceptable. Restoring criminal penalties will help deter this type of predaceous behavior.

TAKE ACTION

Humana is joining forces with USAA to launch a new plan that aims to complement the care Veterans receive through the Deparment of Veterans Affairs (VA).

The co-branded Humana USAA Honor plan will be available in eight states for Medicare beneficiaries and aims to make it easier for Veterans to access prescriptions and pharmacies closer to home and outside the VA system if they choose. The plan is available across Pennsylvania and in select markets in Texas, Michigan, Ohio, Indiana, Arizona, California and Hawaii.

Humana first launched its Honor plans for Veterans in 2020, and the new co-branded plan is the first to include prescription coverage, the insurer said.

“While available to anyone eligible for Medicare, the Humana Honor plans are made to serve those who served,” said Jim Van Valin, segment vice president for Humana MarketPoint, the company’s Medicare sales organization, in the release. “Humana and USAA together are committed to the military community, and we are proud to deliver this opportunity for convenience, savings and personalized support. Those who gave so much to our nation deserve a health plan that gives back to them.”

The new plan also includes a $0 monthly premium as well as a monthly Part B premium "giveback" into the members' Social Security checks. Enrollees will not have to pay a copayment for prescriptions in tier 1 and will pay fewer copays for tier 2 drugs at in-network facilities for a one-month supply, with no deductible.

The plans also include a USAA Flex Card that can be applied to hearing, vision and dental services in certain markets along with preventive dental coverage for two annual cleanings and $1,000 to cover other dental bills, Humana said.

“Choosing the right health coverage is an important element of financial security,” said Mary Forey, assistant vice president and senior experience owner for health insurance at USAA. “With this plan Veterans continue to have access to their VA care—which they rightfully deserve and earned—but for $0 premium they can have access to additional services, more convenient prescription drug refills, backup coverage or even a second opinion. We chose Humana because of their dedication to the military community and our long-time partnership.”

Medicare's annual enrollment begins Saturday and runs through Dec. 7.

Source

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MANHATTAN, Kan. (WIBW) - Hundreds of Veterans and community members answered the call to honor a Veteran who passed away with no known family.

Tuesday’s service was held at the Kansas Veterans’ Cemetery at Manhattan.

Veterans from all over showed up in Manhattan to pay their respects for Sergeant David Lofton.

“One of the things that the VFW supports is ‘We support our living by honoring the dead.’” Lee Pierson VFW Post 1786-Manhattan, post commander, Daniel Watkins says.

Sergeant Lofton served in the Army during the Vietnam War, and retired in Junction City.

When he passed away, Johnson Funeral homes could not find any living family members. So local Veterans groups put out the call on social media - asking people to honor him at his funeral.

“To honor an outstanding human being like this today, soldier, Veteran, comrade…and brother… It was truly an honor.” Watkins says.

Mahlon Lofton was among the crowd. A genealogist found him just days ago and reached out to tell him Sergeant Lofton was his third cousin.

“You always see and hear about this stuff happening on the news, elsewhere and you never think that you’re going to be a part of that, so it’s … it’s just a great, great experience.” Sergeant David Lofton’s third cousin, Mahlon Lofton says.

Active duty military, retired Veterans, members of the Kansas Highway Patrol, and community members filled the crowd - honoring a man most never knew - but who lived to serve them all.

“Seeing everyone from this community, the military family, just complete strangers, taking time out of their busy days, is just a truly sobering and amazing experience.” Sgt. Lofton’s third cousin, Mahlon Lofton says.

Sergeant Lofton’s remains were laid to rest at the cemetery’s Columbarium Walls.

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“How could this be, what came of my service?”

Hundreds of Veterans and service-affiliated personnel have drafted a letter to members of Congress and the Biden administration calling for action in the continued efforts of evacuating and resettling Afghan allies.

The letter — which was sponsored by #AfghanEvac, a non-partisan, all-volunteer coalition of more than 100 organizations and service-affiliated personnel — addressed President Joe Biden, Speaker of the House Nancy Pelosi, D-Calif., Senate Majority Leader Chuck Schumer, D-N.Y., House Minority Leader Kevin McCarthy, R-Calif., and Senate Minority Leader Mitch McConnell, R-K.Y., directly, outlining their requests for aid.

“As the United States government continues to navigate the conclusion of its military mission in Afghanistan, we the undersigned, having seen firsthand the heartbreaking uncertainties that our Afghan allies, American citizens, lawful permanent residents, and their families face in their attempts to flee life-threatening circumstances, submit the following letter urging our country’s leadership to act,” the letter reads.

“The withdrawal of the American presence from Afghanistan has prompted unprecedented action by a coalition of Veterans, active duty military, frontline civilians, non-profit, private sector, academic, and other entirely volunteer organizations working hand-in-hand with willing partners within the Departments of State and Defense to assist in the evacuation and resettlement of the aforementioned individuals.”

Kicking off the requests made throughout the letter were those directed at the Biden administration.

The coalition requested that the Biden administration formally appoints “an interagency leader with tasking authority, oversight responsibility, and a dedicated staff to develop and implement a multi-year, actionable plan for evacuating our Afghan allies, including qualified P1/P2 referrals, and bringing them to safety,” no later than Feb. 22, 2022.

The group also called on Congress to help Biden achieve their goals, acknowledging that the effort to help refugees would be bilateral.

Also included in the coalition’s requests for Congress was the passing of an Afghan Adjustment Act, ensuring evacuees have a “full pathway to citizenship.”

Funds were also requested for the State Department and other U.S. agencies such as USAID to help with this process. Furthermore, #AfghanEvac wanted specific changes made to the Special Immigrant Visa eligibility criteria to include Afghan Special Operations Forces (and graduates of ASOSE courses) and the families of those otherwise eligible, mirroring the process for Iraqi applicants.

In the same breath, they also asked that the National Defense Authorization Act (NDAA) appropriate funds for mental health and moral injuries suffered Veterans and others who participated in the 20-year war and the ensuing evacuations.

“As you well know,” the coalition wrote as an explanation for that specific request, “there was a related surge in requests for assistance at the Veterans crisis phone line in the days following our withdrawal and the ongoing mental health impact on Veterans and Afghans alike cannot be overstated.”

Requests were also made that the State Department facilitate the approval and immigration of allied Afghan refugees by approving virtual visa interviews and medical waivers in addition to providing support in the processing of SIVs.

Additionally suggested was that the Defense Department create and maintain “lily pads” in multiple countries that would allow evacuees to be safely and comfortably processed in their journey to the U.S.

Any current plans to close existing safe havens for evacuees should be stopped, the letter read. Instead, the coalition wanted an expansion of those locations to facilitate the resettlement process.

Of the 286 original signatories were 168 Veterans and 77 “frontline civilians,” with some signing as individuals and others representing groups such as Afghan Refugee Relief and Aid, U.S. Committee for Refugees and Immigrants, Task Force Pineapple, Human First Coalition and Truman National Security Project.

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Miami, Florida – A federal district judge in Fort Lauderdale yesterday sentenced the last of 16 defendants for their roles in a large-scale kickback and bribery scheme involving employees and vendors of the U.S. Department of Veterans Affairs (VA) Medical Centers located in West Palm Beach and Miami.

Earron Starks, 51, was sentenced to 30 months’ imprisonment, followed by three years of supervised release, and ordered to pay $2,451,000 in restitution. His wife, Carlicha Starks, 42, was sentenced to three years of supervised release, including one year of home confinement, and ordered to pay $501,000 in restitution.

Earron and Carlicha Starks, both from Hallandale Beach, Florida, were vendors who sold supplies to the VA. They, as did other vendors, paid kickbacks to VA employees in exchange for getting the VA’s business. Court filings describe how in exchange for cash bribes, medical center employees used government credit cards to order medical and other hospital supplies from these corrupt vendors. In some cases, the prices of the supplies were grossly inflated. In other cases, the orders were only partially fulfilled or not fulfilled at all. Ultimately, the fraud scheme enabled the Starks couple and other corrupt vendors to receive over $20 million in purchase orders with VA Medical Centers in West Palm Beach and Miami.

“There is no place for kickbacks in our veterans’ healthcare system,” said Juan Antonio Gonzalez, Acting U.S. Attorney for the Southern District of Florida. “These crimes not only violate the public’s trust, they also compromise the integrity of programs intended to help those who have made great sacrifices for our country. The United States Attorney’s Office will hold accountable anyone who tarnishes the VA through fraud, bribes, or other crimes.”

“These crimes were a gross violation of public trust and a threat to the resources used to care for our nation’s veterans and their families. The act of soliciting and accepting bribes undermines the vital work that honest VA employees do every day,” said David Spilker, Special Agent in Charge, U.S. Department of Veterans Affairs, Office of Inspector General, Criminal Investigations Division (VA-OIG, CI), Southeast Field Office. “The VA OIG is grateful for the United States Attorney’s Office’s partnership in holding these defendants accountable.”

Fourteen additional defendants were charged for their roles in this scheme. They pleaded guilty and received the following sentences:

Defendants who worked at West Palm Beach VA Medical Center (Case Number 19-80223-CR-KAM).

• Clinton Purvis, 54, of West Palm Beach, who pleaded guilty to one count of conspiracy to commit healthcare fraud, was sentenced to 27 months’ incarceration followed by 24 months of supervised release and ordered to pay $1.4 million in restitution.
• Christopher Young, 46, of West Palm Beach, who pleaded guilty to one count of conspiracy to commit healthcare fraud, was sentenced to 24 months’ probation.
• Kenneth Scott, 61, of Riviera Beach, who pleaded guilty to one count of conspiracy to commit healthcare fraud, was sentenced to 24 months’ probation and ordered to pay $295,511 in restitution.
• Robert “Bob” Johnson, 64, of West Palm Beach, who pleaded guilty to one count of conspiracy to commit healthcare fraud, was sentenced to 24 months’ imprisonment followed by 24 months of supervised release and ordered to pay $800,000 in restitution.

Defendants who worked at Miami VA Medical Center.

• Waymon Melvon Woods, 60, of Miami, pleaded guilty to one count of receiving a bribe as a public official and was sentenced to nine months’ incarceration, 36 months of supervised release and ordered to pay $120,505 in restitution (case number 19-20743-CR-FAM).
• Don Anderson, 61, of Port St. Lucie, Fl., pleaded guilty to one count of receiving a bribe as a public official and was sentenced to 10 days of incarceration, 36 months of supervised release, and ordered to pay $31,579 in restitution (case number 19-20746-CR-FAM).
• Jose Eugenio Cuervo, 55, of Miramar, Fl., pleaded guilty to one count of receiving a bribe as a public official and was sentenced to six months of home confinement, 36 months of supervised release, and ordered to pay $8,596 in restitution (case number 19-20748-CR-DPG).
• Donnie Shatek Hawes, 37, of Cutler Bay, Fl., who pleaded guilty to one count of receiving a bribe as a public official, was sentenced to 5 days of incarceration, 24 months of probation, and ordered to pay $2,900 in restitution (case number 19-20745-CR-RNS).
• Robert Lee James Harris, 46, of Miami Gardens, Fl., who pleaded guilty to one count of receiving a bribe as a public official, was sentenced to 6 months of home confinement, 36 months of probation and ordered to pay $7,775 (case number 19-20747-CR-RNS).
• Emir Gilberto Reyes,55, of Homestead, Fl., who pleaded guilty to one count of receiving a bribe as a public official, was sentenced to 60 months of probation and ordered to pay $18,380 (case number 20-20098-CR-FAM).
• Eugene Campbell, 62, of Miami Gardens, Fl., who pleaded guilty to one count of receiving a bribe as a public official, was sentenced to 36 months’ incarceration, 36 months of supervised release, and ordered to pay $592,717 in restitution (case number 19-20744-CR-UU).

Defendants who were VA supply vendors.

• Jorge Flores, 47, of Delray Beach, pleaded guilty to one count of conspiracy to commit healthcare fraud was sentenced to 18 months’ incarceration, 36 months of supervised release, and ordered to pay $2.1 million in restitution (case number 19-80200-CR-RS).
• Robert Kozak, 75, of Boca Raton FL, pleaded guilty to one count of conspiracy to commit healthcare fraud and was sentenced to 6 months’ incarceration, 36 months of supervised release, and ordered to pay $850,000 in restitution (case number 19-80201-CR-RS).
• Vincent Bellafiore, 47, of Palm Beach Gardens, FL, pleaded guilty to one count of conspiracy to commit healthcare fraud and was sentenced to 36 months’ probation and ordered to pay a $10,000 fine (case number 20-80077-CR-RS).

All VA employees were either terminated or resigned.

The convictions were the result of a lengthy investigation by Special Agents of VA-OIG CI, who uncovered the extensive scheme after receiving an anonymous tip. A related case in the Eastern District of Pennsylvania resulted in another VA employee being charged with bribery. VA OIG, Criminal Investigations Division, is responsible for conducting independent investigations of VA’s expansive programs and operations, which includes the largest healthcare system in the country.

Assistant U.S. Attorney Amanda Perwin is prosecuting the case.

Source

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Miami, Florida – A federal district judge in Fort Lauderdale yesterday sentenced the last of 16 defendants for their roles in a large-scale kickback and bribery scheme involving employees and vendors of the U.S. Department of Veterans Affairs (VA) Medical Centers located in West Palm Beach and Miami.

Earron Starks, 51, was sentenced to 30 months’ imprisonment, followed by three years of supervised release, and ordered to pay $2,451,000 in restitution. His wife, Carlicha Starks, 42, was sentenced to three years of supervised release, including one year of home confinement, and ordered to pay $501,000 in restitution.

Earron and Carlicha Starks, both from Hallandale Beach, Florida, were vendors who sold supplies to the VA. They, as did other vendors, paid kickbacks to VA employees in exchange for getting the VA’s business. Court filings describe how in exchange for cash bribes, medical center employees used government credit cards to order medical and other hospital supplies from these corrupt vendors. In some cases, the prices of the supplies were grossly inflated. In other cases, the orders were only partially fulfilled or not fulfilled at all. Ultimately, the fraud scheme enabled the Starks couple and other corrupt vendors to receive over $20 million in purchase orders with VA Medical Centers in West Palm Beach and Miami.

“There is no place for kickbacks in our Veterans’ healthcare system,” said Juan Antonio Gonzalez, Acting U.S. Attorney for the Southern District of Florida. “These crimes not only violate the public’s trust, they also compromise the integrity of programs intended to help those who have made great sacrifices for our country. The United States Attorney’s Office will hold accountable anyone who tarnishes the VA through fraud, bribes, or other crimes.”

“These crimes were a gross violation of public trust and a threat to the resources used to care for our nation’s Veterans and their families. The act of soliciting and accepting bribes undermines the vital work that honest VA employees do every day,” said David Spilker, Special Agent in Charge, U.S. Department of Veterans Affairs, Office of Inspector General, Criminal Investigations Division (VA-OIG, CI), Southeast Field Office. “The VA OIG is grateful for the United States Attorney’s Office’s partnership in holding these defendants accountable.”

Fourteen additional defendants were charged for their roles in this scheme. They pleaded guilty and received the following sentences:

Defendants who worked at West Palm Beach VA Medical Center (Case Number 19-80223-CR-KAM).

1. Clinton Purvis, 54, of West Palm Beach, who pleaded guilty to one count of conspiracy to commit healthcare fraud, was sentenced to 27 months’ incarceration followed by 24 months of supervised release and ordered to pay $1.4 million in restitution.
2. Christopher Young, 46, of West Palm Beach, who pleaded guilty to one count of conspiracy to commit healthcare fraud, was sentenced to 24 months’ probation.
3. Kenneth Scott, 61, of Riviera Beach, who pleaded guilty to one count of conspiracy to commit healthcare fraud, was sentenced to 24 months’ probation and ordered to pay $295,511 in restitution.
4. Robert “Bob” Johnson, 64, of West Palm Beach, who pleaded guilty to one count of conspiracy to commit healthcare fraud, was sentenced to 24 months’ imprisonment followed by 24 months of supervised release and ordered to pay $800,000 in restitution.

Defendants who worked at Miami VA Medical Center.

1. Waymon Melvon Woods, 60, of Miami, pleaded guilty to one count of receiving a bribe as a public official and was sentenced to nine months’ incarceration, 36 months of supervised release and ordered to pay $120,505 in restitution (case number 19-20743-CR-FAM).
2. Don Anderson, 61, of Port St. Lucie, Fl., pleaded guilty to one count of receiving a bribe as a public official and was sentenced to 10 days of incarceration, 36 months of supervised release, and ordered to pay $31,579 in restitution (case number 19-20746-CR-FAM).
3. Jose Eugenio Cuervo, 55, of Miramar, Fl., pleaded guilty to one count of receiving a bribe as a public official and was sentenced to six months of home confinement, 36 months of supervised release, and ordered to pay $8,596 in restitution (case number 19-20748-CR-DPG).
4. Donnie Shatek Hawes, 37, of Cutler Bay, Fl., who pleaded guilty to one count of receiving a bribe as a public official, was sentenced to 5 days of incarceration, 24 months of probation, and ordered to pay $2,900 in restitution (case number 19-20745-CR-RNS).
5. Robert Lee James Harris, 46, of Miami Gardens, Fl., who pleaded guilty to one count of receiving a bribe as a public official, was sentenced to 6 months of home confinement, 36 months of probation and ordered to pay $7,775 (case number 19-20747-CR-RNS).
6. Emir Gilberto Reyes,55, of Homestead, Fl., who pleaded guilty to one count of receiving a bribe as a public official, was sentenced to 60 months of probation and ordered to pay $18,380 (case number 20-20098-CR-FAM).
7. Eugene Campbell, 62, of Miami Gardens, Fl., who pleaded guilty to one count of receiving a bribe as a public official, was sentenced to 36 months’ incarceration, 36 months of supervised release, and ordered to pay $592,717 in restitution (case number 19-20744-CR-UU).

Defendants who were VA supply vendors.

1. Jorge Flores, 47, of Delray Beach, pleaded guilty to one count of conspiracy to commit healthcare fraud was sentenced to 18 months’ incarceration, 36 months of supervised release, and ordered to pay $2.1 million in restitution (case number 19-80200-CR-RS).
2. Robert Kozak, 75, of Boca Raton FL, pleaded guilty to one count of conspiracy to commit healthcare fraud and was sentenced to 6 months’ incarceration, 36 months of supervised release, and ordered to pay $850,000 in restitution (case number 19-80201-CR-RS).
3. Vincent Bellafiore, 47, of Palm Beach Gardens, FL, pleaded guilty to one count of conspiracy to commit healthcare fraud and was sentenced to 36 months’ probation and ordered to pay a $10,000 fine (case number 20-80077-CR-RS).

All VA employees were either terminated or resigned.

The convictions were the result of a lengthy investigation by Special Agents of VA-OIG CI, who uncovered the extensive scheme after receiving an anonymous tip. A related case in the Eastern District of Pennsylvania resulted in another VA employee being charged with bribery. VA OIG, Criminal Investigations Division, is responsible for conducting independent investigations of VA’s expansive programs and operations, which includes the largest healthcare system in the country.

Assistant U.S. Attorney Amanda Perwin is prosecuting the case.

Source

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Getting Results in Transition, or better known as GRIT, was developed in response to the growing concern about the rate of suicide among Veterans, especially during the transition from activity duty to civilian life.

Social determinants, like health, employment, housing, social connectedness, and finance all play a large role in Veterans’ mental and physical health. Active Duty service members report that finding a job once leaving military service is their number one concern.

IBM designed the GRIT mobile solution to help service members, National Guard members, reservists, Veterans, care givers and their families gain personal insight into their emotional well-being. It provides resources to improve their individual situations, and serve as a tool to build resiliency and overall well-being. The first-use case incorporated into the GRIT app today is Employment, with a feature that provides personalized job matching.

"According to Nextgov, Total Brain CEO Louis Gagnon said the app uses neuro-scientific tests that can be done in less than 20 minutes to assess brain function and evaluate how users are doing across their emotions, feelings, cognition and self control. It offers gamified exercises to boost memory, focus, planning and positivity. These exercises are custom-tailored to improve individual users’ specific weak areas, and includes built in scientific screening tests for depression, anxiety, attention deficit disorder, addiction, post-traumatic stress disorder, social phobia and sleep apnea."

GRIT is conducting a field test to give service members, reservists, and Veterans early access to the app. In this real life setting, users evaluate the experience, the usefulness of the app, and collect feedback for improvements. It is looking to find between 500-1000 Active Duty, Active Reservist or National Guard members, or recently transitioned Veterans who would like to participate in the field test. It also encourages family members and care givers to participate. GRIT has identified the following characteristics for the participants:

Lives within one of the following geographic locations –

• California
• Florida
• New York
• Washington D.C.
• Texas
• Pennsylvania
• Ohio

• Currently in need of a job, looking for a job change, under-employed, or about to transition out of military service and looking for a job.
• Interested in any employment or specifically in one of the five Industries: IT, Engineering, Business Management, Construction, Logistics.
• Owns iOS or Android phone.

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Last week, many Americans were shocked and appalled at the contents of the Afghanistan Papers, a series of shocking assessments on our continued involvement in a long, costly war collected by the special inspector general for Afghanistan reconstruction (SIGAR).

The documents were mostly comprised of a series of interviews with top officials that many never thought would go public and were obtained by the Washington Post after a lengthy court battle that ultimately found the documents subject to the Freedom of Information Act.

Although less discussed than the overall lack of honesty regarding our ongoing war in Afghanistan is the impact of involvement in this type of conflict on the Veterans who served there.

According to Jason Dempsey, a retired Army officer who served two tours of duty in Afghanistan and a senior fellow at the Center for a New American Security, “overall, it's largely been a failure. And that applies to almost every dimension of our effort in Afghanistan.”

He elaborated: “realizing that we were essentially on a treadmill, that very little progress [was] being made and that every single rotation was repeating the efforts of the rotation before that . . . without considering whether or not what they did added up to anything that was sustainable or contributed to a meaningful long-term goal for the sustainability of Afghanistan.”

Unfortunately for our nation, this sentiment is not new. Still, it deserves more considerable attention in that it can inform our treatment of the Veterans who served there, particularly those who struggle with mental health conditions and thoughts of suicide. Both Congress and the VA have declared suicide prevention to be a top national priority, yet thus far, both have been unable to make significant progress.

To this end, a brief history of our nation’s collective response to the Vietnam War and the impact this collective response had on the Veterans who served there, proves instructive.

In July 1978, Jeffrey A. Jay, a postdoctoral fellow at the Center for Family Research at George Washington University, wrote an article for Harper’s Magazine entitled “After Vietnam: In Pursuit of Scapegoats.”

In discussing some of the challenges he faced in treating Vietnam Veterans diagnosed with post-traumatic stress disorder (PTSD), Jay observed:

“My talks with Veterans convince me that their problems are not so simple, nor so easily addressed. The Veteran's conflicts are not his alone but are bound to the trauma and guilt of the nation. And our failure to deal with our guilt renders the Veteran the symptom-carrier for society and increases his moral and emotional burden. This burden isolates the Veteran and will freeze him in an attitude of perpetual combat until the issues of the war are confronted in the national conscience.”

Many historians and academics who have studied the Vietnam War, including Jerry Lembcke, a Vietnam Veteran, sociologist and author of "The Spitting Image: Myth, Memory, and the Legacy of Vietnam" (and who this author had the honor of learning from while a student at the College of the Holy Cross), agree that, collectively, society did an abysmal job dealing with the guilt and emotional burdens associated with the Vietnam War, the longest and costliest war the United States was involved in before Afghanistan.

To paraphrase Lembcke, as the Vietnam War became increasingly hopeless, the service members and Veterans put through the revolving door of deployments required to maintain our presence there came to represent something that many American civilians did not want to accept: defeat.

The acceptance of defeat has been hard for our current national conscience to accept in Afghanistan as well. If this were not the case, then indeed, the senior Department of Defense officials interviewed in the Afghanistan Papers would not have had any incentive to lie to the American people about the status of our progress there. Emphasis was repeatedly placed on winning rather than transparency.

Nowhere are the detrimental effects of this dishonesty more apparent than in the Veterans' suicide epidemic that continues to sweep the nation. Just as those returning from Vietnam struggled with feelings of social isolation concerning their inability to justify their war experiences in society, those returning from Afghanistan are suffering the same fate.

Lawmakers have made some progress toward addressing this issue. They recently approved the use of the three-digit number 988 as a suicide prevention number to assist those in crisis. They also introduced legislation to study the link between Veteran suicide deaths and other factors such as prescription drugs and traumatic brain injury (TBI), for example, they are missing the more significant issue of dealing with the collective impact of the Afghan War.

In other words, healing the nation may go a long way toward improving our Veterans.

The first step for government leaders is to accept and acknowledge that our efforts in Afghanistan have failed and that America is no longer brave in military conflicts abroad. As the Alcoholics Anonymous adage goes — admitting that there is a problem is the first step to recovery, and “only be admitting defeat are we able to take our first steps toward liberation and strength.”

As Jay concluded in 1978, “it may well be that isolation, the burden of conflicted feelings, and not being heard makes people crazy” — not just the horrors of war. We must all do our part to deal with the unease of defeat in the Afghanistan conflict, most notably by listening more to the Veterans who served there, and acknowledging that they are not individually responsible for two decades of failed foreign policy. Doing so may very well save numerous lives and prevent entanglement in unwinnable future conflicts as well.

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Los Angeles County, with a population of more than 66,000 people, is at the forefront of a national homelessness crisis. But LA faces an additional, urgent challenge: more than 3,900 Veterans are living on the streets, nearly 1 in 10 of all homeless Veterans nationwide.

Fortunately, Los Angeles is also home to the West Los Angeles VA Campus, a 388-acre site dedicated to serving the needs of Veterans that has enormous potential to create more supportive housing units.

The land was deeded to the federal government in 1888 and for decades thousands of Veterans lived there. Unfortunately, following damage from the 1971 Sylmar Earthquake, the VA began transitioning the land away from housing. While the VA hospital remained, much of the rest of the land was used for other, non-Veteran focused purposes.

In 2016, we joined former Senator Barbara Boxer in securing passage of the West Los Angeles Leasing Act. This law led to the end of most non-Veteran related leases on campus and helped spur the redevelopment of the property into a true home for Veterans.

The VA is now implementing a plan to build at least 1,200 new subsidized apartments, which is composed of 23 projects that range from renovating existing structures to developing and building new units.

The challenge now is to secure the funding necessary to build housing units and get Veterans off the streets as soon as possible.

That’s why we introduced the West Los Angeles VA Campus Improvement Act. The bill would allow the VA to spend revenue generated through land-use agreements on campus to help fund housing, services and infrastructure upgrades. It’s a simple but necessary fix to current law, which only allows that money to be spent on maintenance.

Both the House and Senate have now passed slightly different versions of this bill. We’re both hopeful that the recently passed Senate version of the bill will receive a final vote in the House in coming weeks and the bill can be signed into law by President Biden.

We’re also exploring other ways the VA can contribute more to the cost of retrofitting buildings to make them suitable for housing. Congress directed millions of dollars to bring historic buildings on campus up to today’s seismic standards, and we have encouraged the Biden administration to use those funds for necessary seismic retrofits.

VA Secretary Denis McDonough pledged during his confirmation process to be personally involved in solving the Veteran homelessness crisis. Following his confirmation, we called on him to put West LA VA at the top of his priorities and have asked him to visit the campus soon and lend his support.

As important as housing is to address this crisis, we know that housing alone is not enough.

As new housing units are built on the West LA VA campus, more low-barrier and wraparound support services such as job training, counseling and health care will be vital to help Veterans transition out of homelessness – whether they’re residents on the campus or elsewhere in the community.

The anchor of these services is the VA hospital at the southern part of the campus. Among the 23 planned projects for the campus are efforts to build more outpatient clinics and a research center, solidifying the campus as a center for Veteran medical care in Southern California.

Plans also include a hub for community engagement and reintegration services that are tailored to Veterans’ specific needs, including employment counseling and programs directed toward those battling PTSD, substance abuse and other mental health conditions.

Congress and the new administration can certainly do more to support these efforts by providing resources to programs that pair housing with supportive services, such as the successful HUD-VASH program. This joint program between the VA and the Department of Housing and Urban Development provides Veterans with vouchers to help them find permanent housing. HUD-VASH, which began in 2008, has helped reduce the number of Veterans experiencing homelessness in the United States by half.

With the Sylmar Earthquake now 50 years behind us, it’s long past time to restore this campus as a home and community for Veterans.

The West LA VA campus has the potential to serve as a model for the nation on how to address Veteran homelessness. We just need to push these plans over the finish line. Final passage of the West Los Angeles VA Campus Improvement Act is the next logical step.

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Using surveys and feedback to improve patient experience

Since 2017, more than 4 million Veterans have given VA feedback on their customer experience. These surveys are usually sent to VA customers within a few days of their appointment. Recently, 88.5% of Veterans have responded that they agree or strongly agree with the statement, “I trust VA for my health care needs.” That trust question is what VA’s trust rating is based on, but the other questions in the Veterans Signals program survey helps VA pin point opportunities for improvement.

Check-in process problems

In 2018, the Lexington, Ky., VA Medical Center (VAMC) noticed a key customer experience falling short of expectations. When Veterans were asked “After I checked in for my appointment, I knew what to expect,” the satisfaction score was 82%. This alerted the Lexington VA’s Veterans Experience Officer that their patients did not understand what to expect next when checking in to appointments.

After a deep dive look at the check-in process and using a few secret shoppers (sending a few Veterans or VA employees through the process who would document their experience), the Lexington VA saw the problem. The check-in process was not the same in every office and that was confusing patients.

Creating a solution

The Lexington VA then developed standard scripts and other communication aid materials to help VA employees standardize the check-in process and expectation. Also, employing a Lean Six Sigma technique called GEMBA (Japanese term meaning “the real place”) identified some key meeting places such as clinic lobbies or hallways. It then placed display boards and signs in these high traffic spots between the check-in and provider appointment locations to help patients navigate.

The results

The results pointed to an 8-point increase from 82% to 90% from the end of fiscal 2018 to the end of fiscal 2019 for the same patient satisfaction question, “After I checked in for my appointment, I knew what to expect.”

These results aren’t isolated to the Lexington VA. Improvements based on customer experience feedback are underway across the country. Customer feedback data and patient experience programs pair perfectly to improve VA’s effectiveness, ease, and empathy for Veterans, their families, caregivers and survivors.

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An Air Force Veteran who served in Vietnam and was living his final days at a US Department of Veterans Affairs assisted-living facility was twice found covered in ants and photos show scores of bites on his body, his daughter said Thursday.

Laquana Ross said her father, Joel Marrable, died Saturday at the Eagles' Nest Community Living Center in the Atlanta VA Medical Center.

Ross said she is not upset with the VA over the ants, but wants her father's story to prompt change.

"Maybe this can move the needle and improve the process," she said. "The VA is busy. They have a lot of patients and huge needs they have to address."

The Atlanta VA Health Care System said it "always strives to provide Veterans with the very best health care available. When we don't meet that standard, we hold ourselves accountable," in a statement to CNN.

"That's why we have initiated a top-to-bottom review of this situation to ensure it never happens again. We have apologized to the Marrable family and taken immediate action to correct this issue and ensure no other Veterans will be affected in the future."

What happened

Ross said she was told by the staff last week that workers at the facility visited Marrable in his bed.

She said they told her, "We thought Mr. Marrable was dead. We didn't know what had happened. Everyone jumped in and grabbed him and made sure we did whatever we could to get the ants off of him."

Marrable, 73, had a feeding tube, was weak from cancer and his ability to talk was limited. He was still alive.

Ross said the staff said they stripped the bed and bathed her father, cleaned the room, put new sheets on the bed and put him back in the same room.

The next day he was covered in ants again — on his stomach, feeding tube, diaper, everywhere.

Ross said she reached out to the administrator on duty and they said her father would be moved and they would check on every 15 minutes.

An hour after being in the new room, he died.

"I felt very small in the world Saturday when my dad died," she said. Now I am able to share his story and my dad matters to someone beyond me and my family. Now the world knows and the world cares that this happened."

In a statement to CNN affiliate WSB, the VA said the bedrooms at the facility have been stripped, cleaned and inspected for ants. Other measures taken include the removal of open containers and food in the open being removed, staff making more room visits, daily pest control, a third-party exterminator visit and a future visit by a pest specialist from the VA.

Republican Sen. Johnny Isakson of Georgia said he had contacted the Veterans Affairs Department to "demand answers."

"I am shocked, horrified and downright maddened by the news that a Veteran under the care of the VA was treated so poorly and without any regard for his wellbeing," Isakson said. "This patient, at the end of his life, was clearly not being monitored closely enough, and I am so sad for his family who had to discover his insect-infested conditions before anything was reportedly done."

Ross told WSB her father has served in Vietnam in the Air Force and had cancer. She told the station she had asked the staff about bumps on her father and was told it was ants.

She told CNN her father should be remembered as a good person who loved God.

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Veterans Affairs Secretary Denis McDonough said he is “frustrated” by his department’s slow pace of expanding benefits for military burn pit victims but insists that federal rules limit his ability to move quicker on the issue.

In an interview on “The Problem with Jon Stewart” hosted by comedian Jon Stewart, McDonough said he wants to expand the list of burn-pit-related illnesses eligible for presumptive benefits soon, but is facing internal obstacles to do that.

“The biggest hurdle is establishing a scientific link, and I will be damned if I don’t establish that,” he said. “We do operate within the context of a series of requirements, and we have not yet been able to meet the requirements.”

In August, VA officials announced for the first time that Veterans suffering asthma, rhinitis and sinusitis who were exposed to toxic smoke while serving in Iraq, Afghanistan and other recent conflict locations will be granted presumptive benefit status.

That allows them to more quickly receive medical and financial assistance from the department, without having to prove specific injury details.

Veterans groups have called the action a small first step in helping the estimated 3.5 million exposed to toxic smoke from burn pits during overseas deployments over the last 20 years. But they have also emphasized that the department needs to move quicker to recognize rare cancers and other illnesses caused by the toxic exposures, to assist Veterans suffering now.

Stewart has been a vocal champion of the issue in recent years, appearing at multiple Capitol Hill rallies alongside Veterans advocates to push for legislation to speed up the process.

He dedicated the first episode of his new show to the topic, featuring interviews with Veterans suffering from the health effects of their deployments and the sit-down in McDonough’s office to push for a quicker response from VA.

“From what I’ve seen, [researchers] have done a ton of National Academy of Science studies, and people waive those all the time and say that no links have been established [between burn pits and Vet’s illnesses],” Stewart told McDonough.

“But unfortunately, those studies all say there is insufficient data, and that data is not going to be getting any better because it’s provided by the Defense Department. And if it’s insufficient in 2008, it’s going to be insufficient in 2020.”

Lawmakers have proposed legislation to get around those federal rules and award benefits to burn pit victims quicker. Senate Veterans’ Affairs Committee Chairman Jon Tester, D-Mont., and ranking member Jerry Moran, R-Kansas, spoke with Stewart on a podcast accompanying the episode and said they are still hopeful that work can be completed soon.

“I think the science is very important, but I think that the review of some of these problems sometimes takes a lot longer than anybody is comfortable with,” Tester said. “We need to continue to push the agency and we need to continue to push the people who are doing the research to get it done in a timely way.”

The two senators said the biggest stumbling block for the bill now is getting a potential cost estimate from VA, so lawmakers can adequately budget for a flood of new cases.

Stewart’s show is the latest push from advocates in recent months to emphasize the long-term problem from burn pits outside the military community, in the hopes of making meaningful reforms this year.

Tester said he thinks that is possible, but vowed to continue the legislative push in 2022 if need be.

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Current events are weighing heavily on all of us. Maybe you have less hope than you once did. Maybe you’re feeling more anger. But despite the uncertainty, there are some things we do know: Veterans are resilient and we can get through tough times – together.

Turning to our families, fellow Veterans, friends and communities for support in such times can help get us through this. But sometimes, even that isn’t enough.

Please, whenever the weight is too much, take advantage of the mental health resources that you earned by serving your country. No matter where you are, VA can help protect your well-being – right now – by providing mental health appointments, telehealth, mobile apps, self-help trainings and more.

In these times of heightened stress, anxiety and unrest, a community of support is here for you. Whatever challenge you might be facing, VA will support you, and we encourage you to be there for your fellow Veterans who may also be experiencing intense emotions.

Please explore the many mental health resources highlighted below to learn more. And as always, know that you can always call on VA when you need us. Stay safe and stay well.

Sincerely,

David Carroll, Ph.D.

Executive Director, Office of Mental Health and Suicide Prevention

Veterans’ Health Administration

Looking for VA Mental Health resources?

Mental Health Providers

VA mental health providers will work with you to cope with the challenges you’re facing.

• If you’re already using VA medical services, ask your primary care provider to help you make an appointment with a VA mental health provider.
• If you’re not already using VA medical services, contact your nearest VA medical center or Vet Center to talk about your needs and how to enroll.

Telehealth

You can connect with a VA mental health provider through a computer or mobile device in your home, other preferred location, or at your nearest VA health facility. To set up telephone or video appointments, Veterans can send their health care provider a secure message on My HealtheVet by visiting myhealth.va.gov. Learn more about telehealth options at mobile.va.gov/app/va-video-connect. If you don’t have a telehealth capable device or sufficient internet connectivity and are interested in VA telehealth services, VA may be able to help; contact your local VA medical center.

Mobile Apps

You can access mental health support wherever you are, whenever you need it. VA’s mental health apps can help you manage PTSD-related symptoms and stress, learn to practice mindfulness, cope with depression and more.

Online Self-Help

VA offers many in-depth mental health resources online.

• VA’s mental health page features self-help tips, guidance for Veterans and their loved ones, and information about specific mental health topics and conditions.
• Make the Connection offers Veterans, their family members and friends, and other supporters information about issues affecting their lives. On the website, visitors can watch videos of hundreds of Veterans sharing their stories of strength and recovery, read about a variety of life events and mental health topics, and locate nearby resources.
• Veteran Training is a self-help portal that provides tools for overcoming everyday challenges. The portal has tools to help Veterans work on problem-solving skills, manage anger, develop parenting skills and more, in an entirely anonymous environment. The free tools are based on mental health practices that have proven successful with Veterans and their families.

Help in a Time of Crisis

If you are a Veteran in crisis or are concerned about one, VA is here for you. Free, confidential support from caring VA responders is available 24/7. Call the Veterans Crisis Line at 1-800-273-8255 and press 1, text to 838255 or chat online.

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MACON, Ga. – A civil settlement has been reached with Infectious Disease Consultants of Georgia (IDC), an infusion clinic with six out-patient locations in the greater Atlanta area.

IDC agreed to pay $325,000 to the United States to resolve allegations that it violated the False Claims Act by submitting bills to the Medicare program for infusion services provided by unlicensed or otherwise unapproved individuals. The settlement marks the end of a years-long investigation into IDC’s billing practices that began with a qui tam case filed in the Middle District of Georgia.

“We are committed to protecting the public trust and will carefully investigate allegations of fraud in pursuit of this mission,” said Acting U.S. Attorney Peter D. Leary. “I want to thank the U.S. Department of Health and Human Services for their work investigating these allegations, and also want to thank IDC for cooperating fully during the investigation and resolution of these claims.”

“To ensure patients receive quality care and taxpayer-funded federal healthcare programs are properly billed, Medicare only pays for medical services provided by licensed, credentialed and approved professionals. Therefore, we will continue to investigate allegations of unapproved providers billing federal healthcare programs,” said Derrick L. Jackson, Special Agent in Charge for the Office of Inspector General of the U.S. Department of Health and Human Services. “We are proud to work with the U.S. Attorney’s Office staff to investigate this case and also acknowledge IDC for fully cooperating during the investigation and resolution of this matter.”

Federal health care programs, such as Medicare, allow infusion services to be provided and billed only when they are provided by certain licensed and approved providers. The alleged scheme in this case concerned IDC’s submission of claims to Medicare for infusion services improperly rendered by unlicensed or otherwise unapproved individuals. IDC fully cooperated during the investigation, after which the parties agreed to resolve the allegations described herein. The claims covered by the settlement are allegations only, and there has been no determination of liability.

The case was investigated by Special Agent Shawn McAleer of the U.S. Department of Health and Human Services—Office of Inspector General and Investigator Shaketia Morgan, formerly of the U.S. Attorney’s Office for the Middle District of Georgia. The Government’s civil settlement was reached by Assistant U.S. Attorney Bowen Reichert Shoemaker.

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On October 17, the President signed into law S. 785, the Commander John Scott Hannon Veterans Mental Health Care Improvement Act.  Public Law 116-171

This comprehensive bipartisan bill, in line with DAV Resolution No. 370, will help increase outreach and services to Veterans at risk for suicide and improve VA mental health services by:

• Strengthening VA’s mental health workforce to serve more Veterans by offering scholarships to mental health professionals to work at Vet Centers, and placing at least one Suicide Prevention Coordinator in every VA hospital;
• Directing the department to develop a staffing plan for increasing the number of mental health counselors and region-specific incentives needed to hiring them;
  Improving rural Veterans’ access to mental health care by increasing the number of locations at which Veterans can access VA telehealth services;
• Implementing a pilot program to expand Veterans access to complementary and integrative health programs through animal therapy, agriculture therapy, sports and recreation therapy, art therapy and post-traumatic growth programs;
• Studying the health benefits of providing integrative health treatments such as yoga, meditation, acupuncture, chiropractic care;
• Establishing a grant program that allows VA to better collaborate with community organizations already serving Veterans with a goal of early identification and supportive prevention services for Veterans at risk of suicide;
• Studying the impact of living at high altitude and associated suicide risk factors for Veterans and implementing a precision medicine initiative to identify and validate brain and mental health biomarkers among Veterans to better identify and treat depression, anxiety, PTSD, and traumatic stress disorder.
   

The bill also includes provisions, supported by DAV Resolution No. 020, to improve services to women Veterans by:

• Expanding the capabilities of the VA women Veterans call center, to include text messaging; and
• Creating a centralized website that includes information about all the benefits and services available to women Veterans, the name and contact information for each women's health coordinator, and specific services available for women Veterans at each medical center and community-based outpatient clinic throughout a designated VISN—Veterans Integrated Service Network.

On October 20, the President signed into law H.R. 6168, the Veterans’ Compensation Cost-of-Living Adjustment Act of 2020, which authorizes a cost-of-living adjustment (COLA) for Veterans receiving Department of Veterans Affairs (VA) disability compensation, clothing allowance, and survivors receiving dependency indemnity compensation or DIC payments.

This bill, now Public Law 116-178, will increase the amount paid to Veterans and their survivors by 1.3%, effective December 2020, and be reflected in their January 2021 compensation payment.

VA adjusts Veterans’ monthly disability compensation amounts based on the yearly change in the cost of living as determined by the Social Security Administration (final COLA adjustment of 1.3% in 2021 was based on the Bureau of Labor Statistics (BLS) report of September 2020 inflation data). While this increase is slightly less than the 1.6% increase from last year—it is in line with the historical increases over the last 10 years. The new rates are not yet posted, but click here to view VA’s website, where they should be posted soon.

Source: DAV

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DENVER — An injured Veteran was denied service at a credit union because he was not wearing a mask, something he is physically unable to.

Officials with the ENT Credit Union have apologized to retired Master Sgt. Israel Del Toro, KCNC reported.

Del Toro tried walking into a branch but because he was not wearing a mask he was told to use the drive thru. Del Toro is unable to wear a mask because he lost his ears in an explosion while serving in Afghanistan. A medical condition also makes it difficult for him to breath. He also is unable to drive because he lost his fingers.

“I felt, almost defeated,” Del Toro said. “Because I can’t believe this is really happening. Do people not have common sense anymore?”

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MANCHESTER, N.H. — The Manchester Veterans Affairs Medical Center has been told to make improvements after an unannounced visit by the office of the inspector general.

The visit was conducted in June as part of a routine review done at facilities about every three years. It came two years after concerns of substandard care plagued the Manchester VA.

>> Find the full report here

A 78-page report detailing what the inspection revealed after reviews of eight areas, finding deficiencies in seven of them. The inspector general produced a list of 17 recommendations, ranging from documentation concerns to noncompliance with Veteran health administration protocols.

Staffing is one concern.

At the urgent care center, the report said, “The OIG identified deficiencies with nurse staffing, backup call scheduled for urgent care center providers and availability of support services.

In response to those staffing concerns the Manchester VA reduced its urgent care operating hours on Aug. 30, before that it had been open around the clock.

Construction work is underway on a new urgent care and mental health care addition. Sixteen-thousand square feet that will allow for expanded mental health service.

Communication was another area the report said needed to be fixed when it came to military sexual trauma (MST).

Seventy-seven percent of the patients at the facility who tested positive for MST were not referred for MST-related services, which is VA protocol. The inspector general recommended that change and that providers to get the necessary training.

The report said the OIG, “Identified noncompliance with the environment of care cleanliness, infection prevention and safety.”

The Manchester VA released a statement that said in part, “The facility concurs with all of the OIG’s recommendations and has a comprehensive plan in place to implement them in less than a year’s time.”

Manchester VA officials and the inspector general agreed on dates to complete each of those recommendations.

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DAYTON — An inspector general reported that in 2017 the Dayton VA failed to properly care for a patient who died after being admitted to the VA’s emergency department.

An inspection that began as an anonymous complaint to the Veterans Affairs Office of the Inspector General resulted in a debate on whether to suspend a physician and a list of problems for the Dayton VA Medical Center to fix.

Dayton VA spokesman Ted Froats said the report released Thursday focuses on events that occurred more than two years ago. Since then, the Dayton VA Medical Center has started implementing each of the inspector general’s recommendations, which are expected to be complete this year.

For example, he said the Dayton VA has:

• developed a new policy to ensure timely emergency department transfers and provided clear guidance to staff;

• increased oversight by lowering the threshold that triggers management reviews of our medical providers;

• and standardized all code carts and installed an automated medication dispenser in the resuscitation room, helping ensure patient experiences are consistent.

“The processes we have developed since the OIG’s visit have helped ensure we continue to provide safe, compassionate, comprehensive care to all Veterans,” he said.

The inspector general report said that the office first received the complaint in December 2017.

While investigating the complaint, the inspection team found a number of problems in the emergency department, with a physician who was not named in the report, and with the facility’s operations.

When the patient was admitted to the emergency department, according to inspectors, the physician: ordered a medicine that the patient’s notes said to avoid, significantly delayed in ordering diagnostic tests, didn’t give the patient reasonable medications and treatments for the situationand incorrectly documented that the patient had been moved into another department’s care when the emergency department was still waiting for diagnostic tests.

The investigation found that a CT scan was eventually conducted, but as staff waited for the results a “code blue” was called for the patient, as they went into cardiopulmonary arrest. The responding medical staff couldn’t resuscitate the patient, who died.

Inspectors brought these findings to the facility director, who suspended the physician while facility leadership reviewed the cases.

After consultation with the chief of medicine and the Veterans Integrated Service Network, the facility’s executive board voted to remove the physician. After appeal, this decision was overturned, but the physician ultimately did not return to the VA, resigning in November 2019.

The investigative team also found a number of problems with the operations of the facility, including: problems with its peer review system, problems with the staff following ordered procedures like using bar codes to track medications and problems communicating between different medical teams that potentially led to harming patients or using unnecessary treatments.

Ultimately, the team 13 recommendations on the problems it found, and the leadership of the Dayton VA Medical Center agreed to follow them, presenting action plans and timelines for the goals to be accomplished.

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Disabled Veterans will see a dramatic increase in their life insurance coverage, and new protections in how traumatic injury insurance claims are paid out, under reforms included in a massive Veterans bill passed by Congress this week.

The changes are just two of dozens of new initiatives in the bill, which was unanimously approved by both chambers and is expected to be signed into law by President Donald Trump in coming days.

The legislation — named for former Senate Veterans’ Affairs Committee Chairman Johnny Isakson, R-Ga., and outgoing House Veterans’ Affairs Committee ranking member Phil Roe, R-Tenn. — lifts cap for the Service-Disabled Veterans Insurance program from $10,000 to $40,000 in a move that advocates say is long overdue.

“The program was adopted in the 1950s to help address the growing population of Veterans left without insurance due to an inability to pass a life insurance physical,” said Derek Fronabarger, a legislative director with Wounded Warrior Project.

“The pay-out amount has not changed since the program was established, and the benefit was significantly attrited over the years by inflation. This change will greatly improve life insurance benefits for service-disabled Veterans.”

The S-DVI program is designed to give access to low-cost life insurance to individuals who likely otherwise would not qualify because of their medical status. By raising the cap, lawmakers hope to provide more financial assurances to their families, and better match the program with current Veterans’ needs.

Similarly, provisions related to the Traumatic Injury Protection Servicemembers’ Group Life Insurance program included in the bill are designed to provide more clarity to families when claims are rejected. The provision was inspired by the case of Sgt. 1st Class Cameron Corder, who spent four years fighting with Army bureaucracy for TSGLI payouts after his back injury in Afghanistan.

The new legislation requires that troops or Veterans denied the benefits — which can total up to $100,000 for some injuries — get a detailed explanation of the reasons for the denial, and that those same criteria be used in subsequent appeals of the claims.

In Corder’s case, Army officials gave multiple, sometimes contradictory, reasons for denying his claim. The money was ultimately approved only after intervention from his congressman, Rep. Dan Kildee, D-Mich.

Kildee, who was one of the authors of the new language, called the changes necessary to make sure troops are receiving the benefits they have earned.

“An injured servicemember should never have to go through a difficult and lengthy bureaucratic ordeal to get the benefits they deserve,” he said in a statement. “Our men and women in uniform, who defend our freedoms, represent the best of this country, and we owe them our full support when they return home.”

Both of the insurance changes are set to go into effect early next year, pending the president’s signature on the legislation.

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Interface Rehab (Interface), headquartered and operating in California, has agreed to pay $2 million to resolve allegations that it violated the False Claims Act by causing the submission of claims to Medicare for rehabilitation therapy services that were not reasonable or necessary.

The settlement resolves allegations that, from Jan. 1, 2006, through Oct. 10, 2014, Interface knowingly submitted or caused the submission of false claims for medically unreasonable and unnecessary “Ultra High” levels of rehabilitation therapy for Medicare Part A residents at 11 Skilled Nursing Facilities. These facilities include Colonial Care Center, Covina Rehabilitation Center, Crenshaw Nursing Home, Green Acres Lodge, Imperial Care Center, Laurel Convalescent Hospital, Live Oak Rehabilitation Center, Longwood Manor Convalescent Hospital, Monterey Care Center, San Gabriel Convalescent Center, and Whittier Pacific Care Center. In July 2020, the Department of Justice announced that Longwood Management Corporation and 27 affiliated skilled nursing facilities agreed to pay $16.7 million to the United States to resolve allegations that they violated the False Claims Act by submitting false claims to Medicare for rehabilitation therapy services that were not reasonable or necessary. The settlement announced today resolves Interface’s role in that alleged conduct.

During the relevant time period, Medicare reimbursed skilled nursing facilities at a daily rate that reflected the skilled therapy and nursing needs of qualifying patients. The greater the patient’s needs, the higher the level of Medicare reimbursement. The highest level of Medicare reimbursement for skilled nursing facilities was for “Ultra High” therapy patients, who required a minimum of 720 minutes of skilled therapy from two therapy disciplines (e.g., physical, occupational or speech therapy), one of which had to be provided five days a week.

The United States contends that Interface pressured therapists to increase the amount of therapy provided to patients in order to meet pre-planned targets for Medicare revenue. These alleged targets could only be achieved by billing for a high percentage of patients at the “Ultra High” level without regard to patients’ individualized needs.

“This settlement reflects our continuing efforts to protect patients and taxpayers by ensuring that the care provided to beneficiaries of government-funded health care programs is dictated by clinical needs, not a provider’s fiscal interests,” said Acting Assistant Attorney General Brian M. Boynton for the Department of Justice’s Civil Division. “Rehabilitation therapy companies provide important services to our vulnerable elderly population, but they will be held to account if they provide therapy services based on maximizing revenue rather than the interests of their patients.”

“The claims that patients required ultra-high levels of care appear to be driven solely by a desire to send ultra-high bills to Medicare,” said Acting U.S. Attorney Tracy L. Wilkison for the Central District of California. “This case is further proof that the government will vigorously pursue those who attempt to cheat the taxpayer-funded system that pays for medical care for millions of Americans, sometimes with the help of whistleblowers who shine a light on fraud.”

“Our agency will continue to aggressively investigate health care providers that attempt to boost their profits by falsely billing federal health care programs for medically unnecessary services,” said Special Agent in Charge Timothy B. DeFrancesca of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG). “We will not tolerate such fraud schemes, which undermine medical decision-making and the public's trust in the health profession.”

“This multimillion-dollar settlement agreement signifies an important conclusion to the government’s investigation into Interface Rehab’s dubious business practices that tainted the integrity of federal healthcare programs, including the Department of Defense's TRICARE program, by unnecessarily inflating costs,” said Paul K. Sternal, Deputy Director of the Defense Criminal Investigative Service (DCIS). “DCIS is committed to working with its law enforcement partners to protect the healthcare interests of our military service members, their families and American taxpayers.”

This civil settlement includes the resolution of claims brought under the qui tam or whistleblower provisions of the False Claims Act by Keith Pennetti, a former Director of Rehab at Interface. Under those provisions, a private party can file an action on behalf of the United States and receive a portion of any recovery. Mr. Pennetti will receive $360,000 of the settlement proceeds. The qui tam case is captioned United States ex rel. Pennetti v. Interface Rehab, et al., No. CV-14-4133 (C.D. Cal.).

The resolution obtained in this matter was the result of a coordinated effort between the Civil Division’s Commercial Litigation Branch, Fraud Section, and the U.S. Attorney’s Office for the Central District of California, with assistance from the HHS-OIG and DCIS.

The investigation and resolution of this matter illustrate the government’s emphasis on combating health care fraud. One of the most powerful tools in this effort is the False Claims Act. Tips and complaints from all sources about potential fraud, waste, abuse and mismanagement can be reported to the Department of Health and Human Services at 800-HHS-TIPS (800-447-8477).

The matter was investigated by Trial Attorney Amy Likoff and Assistant U.S. Attorney John Lee of the U.S. Attorney’s Office for the Central District of California.

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With the new coronavirus outbreak on the mind, it’s a good time to make sure you’re well-stocked with emergency supplies.

No one really knows how all this will play out. But in the worst case scenario, if you were stuck in your house for a 14-day quarantine, or if you felt you needed to stay away from others for a few days, would you have enough supplies? Consider whether you’d have the supplies you need if you tested positive for coronavirus and had to stay home until you were clear, or if someone in your household tested positive and you needed to care for that person.

Military commissary and exchange officials advise those in the military community to be ready for any emergency all year long, wherever you live. As of this writing, some military stores have been seeing shortages of items like masks and hand sanitizers, but they were working to replenish the shelves. There’s a shortage nationwide.

Do some research about what is actually effective in preventing sickness. For example, the Centers for Disease Control and Prevention doesn’t recommend face masks for those who are well; they should be used by people who show symptoms of coronavirus to help prevent the spread of the disease to others. And CDC recommends washing your hands often with soap and water for at least 20 seconds, especially after going to the bathroom, before eating, and after blowing your nose, coughing, or sneezing. If soap and water aren’t available at the moment, use an alcohol-based hand sanitizer that’s at least 60-percent alcohol. That’s a good practice year round.

Early data suggests that older people, and those with underlying chronic medical conditions might be at risk for more serious complications from the virus.

So consider the list of emergency supplies, and think about your family’s needs. For example, if you have a family member with special needs, make sure you have plenty of the supplies they need.

Find out now how your local installation officials and local government officials will keep people informed about precautions and restrictions, closings and other actions. Check with your children’s school, child care center, family child care home, about how they will handle a possible outbreak, and create a contingency plan in the event of closings.

Here are some tips for emergency supplies that could apply particularly to a 14-day quarantine, from the American Red Cross and the Defense Commissary Agency:

*A minimum 30-day supply of your prescription medications.

*Other non-prescription health supplies that your family uses, such as pain relievers; cough and cold medicines; , fluids with electrolytes, like Gatorade.

*Thermometer.

*Hand soap, and soap for bathing.

*Household supplies like bleach, household cleaners and wipes, laundry detergents. Check out this list of products from the Center of Biocide Chemistries of more than 100 ready-to-use biocidal products that have been approved by the Environmental Protection Agency as effective at killing viruses like coronavirus: https://www.americanchemistry.com/Novel-Coronavirus-Fighting-Products-List.pdf.

*Paper products like tissues, toilet paper, paper towels.

*Diapers, formula and other items for young children.

*Feminine supplies.

* Food staples, such as dried, canned or frozen fruit and vegetables, because fresh fruits and veggies may not last for 14 days. Consider adding some frozen and/or canned meats to your supply.

*Any specialty foods needed.

*Extra cash.

*Plenty of books, toys and games to keep young children happy.

*Pet food and pet care supplies.

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In less than five months, the war in Afghanistan will wind down as the remaining troops return home. Yet, for countless scores of U.S. service members — as it was for generations of Veterans before, their next battles are likely just beginning.

September marks 20 years of our nation’s longest conflict, the global war on terrorism. Millions of men and women have borne the visible and invisible burdens of war for the past two decades. Unfortunately, far too many are likely carrying undiagnosed illnesses caused by toxic exposure during their service at home and abroad. As a nation, we cannot leave these Veterans behind.

According to the VA, as many as 3.5 million post-9/11 Veterans suffered prolonged and pervasive exposure to burn pits and other toxic chemicals they could not avoid. Now, thousands afflicted with rare and life-threatening cancers, autoimmune disorders, skin diseases, respiratory illnesses, and other conditions continue to struggle to access the basic health care and benefits they desperately need. To fully honor their sacrifice, our country must acknowledge the devastating reality of toxic wounds and commit to treating them with the same urgency as we treat the physical and mental wounds of war. Struggles with toxic exposures are not unique to the current generation of Veterans; instead, they continue a pattern experienced by Veterans of every major conflict in recent history. In World War I, troops were exposed to gas; in WWII, radiation; in Vietnam, Agent Orange; in the Gulf War, oil fires; and in Iraq and Afghanistan, burn pits and other environmental hazards. Toxic exposure for our troops has been synonymous with service for more than 100 years. However, when today’s Veterans become sick from toxic exposures, too often our government is slow to react. It seeks definitive answers about the cause of the illnesses before offering Veterans all the support they need. A comprehensive system for taking care of troops exposed to toxic hazards of military service is long past due.

Hope for Veterans exposed to toxic exposures is on the horizon. Multiple congressional legislative solutions have been introduced in the House and Senate to address toxic exposure reform. To some, it may appear that these bills are competing or duplicative; instead, we believe they are complementary. Each addresses a different piece of the larger toxic exposure puzzle. Beginning this week, the Senate and House Veterans’ Affairs Committees will begin building a comprehensive solution drawing upon several widely supported bills.

The Presumptive Benefits for War Fighters Exposed to Burn Pits and Other Toxins Act would extend presumptive service connection for more than 20 serious respiratory conditions and cancers that may be linked to exposure to burn pits and other chemicals. While VA has yet to affirm that existing data is sufficient to prove associations for these conditions, they must acknowledge that due to the nature of military deployments, requisite data might never have been collected in the first place. After two decades, it is unreasonable to ask critically ill Veterans to continue to wait for more data that might never come, when we can help them today.

The Veterans Burn Pits Exposure Recognition Act would concede exposure to dozens of chemicals for all Veterans who served in areas where burn pits are known to have been widely used, meaning those seeking health care and benefits for illnesses not yet considered presumptive would no longer have to provide specific evidence of such exposures.

The TEAM Act would provide permanent health care enrollment eligibility for all Veterans who were exposed, regardless of their disability claim status. Under this legislation, Veterans who become ill will not have to wait for their VA disability claims to be decided before they receive care. Those who were exposed but may not yet be ill would be able to receive preventive care to catch potential illnesses before they become life-threatening. It would also create a framework with an independent commission charged with establishing additional presumptive conditions that stem from all toxic exposures, foreign and domestic, now and in the future.

No single bill will address all the challenges Veterans exposed to toxic hazards must overcome. But together, these and other complementary bills form the pieces of a larger puzzle that would provide care and benefits for all Veterans, past, present, and future. Veterans should never again have to wait decades — like our Vietnam Veteran brothers and sisters in arms — to receive earned health care and benefits at VA. Congress needs to act quickly, setting aside partisanship and political differences, and send the president a comprehensive bill this year to help our Veterans by addressing exposures to toxic hazards while in service.

Our organizations have different histories and sometimes different approaches to advocating for our nation’s Veterans and their families. However, we are united in our belief that our nation’s heroes have suffered for too long and it is time to pass toxic exposure legislation. The men and women harmed by toxic or environmental exposures while in service need health care and benefits now.

Stephen “Butch” Whitehead, a combat-disabled Army Veteran of the Iraq War, was elected national commander for the more than 1 million-member Disabled American Veterans in 2019. He has completed two overseas deployments, receiving the Bronze Star in 2007 for combat service in Iraq, during his 30-year career. Whitehead also currently serves as command sergeant major of the Army National Guard’s 34th Infantry Division.

Hal Roesch II is the 112th commander in chief of the Veterans of Foreign Wars of the U.S. A 20-year U.S. Air Force retiree, Hal is a Veteran of the Gulf War, with service during Operations Desert Shield, Desert Storm, and Southern Watch.

Lt. Gen. (Ret.) Michael Linnington serves as chief executive officer of Wounded Warrior Project®, leading the team in fulfillment of their mission to honor and empower wounded warriors. Michael served 35 years in the Army, where he held key command and staff positions worldwide, including command of the 3rd Brigade Combat Team, 101st Airborne Division, which included combat operations both in Iraq and Afghanistan.

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RAVENSWOOD, W.Va. (WCHS) — A Jackson County teen was recognized Sunday for his work to honor Veterans and fallen soldiers.

For 17-year-old Philip Lyons, this Memorial Day has an even deeper meaning.

More than 680 American flags line the graves at Ravenswood Cemetery for the men and women who died during or after serving our country. Those graves were counted, tracked and mapped out as part of Lyons' Eagle Scout project.

Lyons received the Eagle Scout Medal Sunday at his church, First Baptist Church in Ravenswood. He was surrounded by family, friends, Scout Masters and mentors.

"It's meant the world to me," Lyons said. "It's meant more than the world. It's like the universe, kind of."

The Jackson County VFW gave Lyons the assignment to log all the Veteran graves at Ravenswood Cemetery.

"I assigned a scout every five rows at the cemetery per section," Lyons said. "They'd sweep across it. They'd take a little sample, a photo of it. Then we'd come back, actually here to the church, and they wrote down their name, their rank and what wars they fought in."

Lyons chose his mentor and Veteran, John Stephenson, to receive a pin during his ceremony.

"I been through Scouts myself, and I know what an accomplishment it is for Philip," Stephenson said. "It takes so much hard work, and I'm so proud of Philip for what all he's accomplished."

Another mentor and Veteran, Richard Massey was beaming with pride.

"It was a blessing to me to get to see Philip reach his potential," Massey said.

Lyons said he won't forget the lessons he's learned as he takes on the next chapter in his life.

"I will keep the memories, the somber thoughts and the pride for my country which I felt when I looked at the headstones," Lyons said.

Lyons has enlisted in the Army National Guard where he intends to become an electrician.

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We knew when he checked his watch as our heroes returned in coffins, Biden doesn’t care about Veterans

Rep. Brian Mast By Rep. Brian Mast

In 2014, I was completing my degree at Harvard University when anti-Israel protests broke out on campus. Soon after, the anger of some in the crowd turned away from our ally and toward me and others who put our lives on the line for the United States of America, for democracy, for their freedom.

While it doesn’t come close, it is the closest I’ve ever gotten to understanding how it must’ve felt for my brothers-in-arms to return home from Vietnam, only to have cowards greet them by literally spitting on them. It’s hard to describe how it feels to know that your neighbors – the people you fought for – hate you and everything you stand for. It makes you sad for them, and it makes you want to retaliate against them at the same time.

It’s just as broken when the commander in chief doesn’t have your back. And President Joe Biden does not have the backs of Veterans.

But it's worse than that; it’s not that he just doesn’t have our six, it’s that he views us as political pawns. The latest example is his shameless attempt to turn folks against House Republicans’ bill to responsibly address out-of-control spending and the debt ceiling – the Limit, Save and Grow Act – by lying about its impact on Veterans’ benefits.

As a Veteran, and as a member of Congress who has read and voted on the bill, hear me when I say this: there are zero cuts to the Department of Veterans’ Affairs (VA) or to Veterans’ benefits. What the bill does is cap discretionary spending at the same level the federal government was operating under in December 2022, a level that Biden then praised for providing "world-class healthcare" for Veterans.

But that doesn’t fit his narrative, so instead, he’s going to lie to the American people and use Veterans as pawns in his politicking. Unfortunately, that’s not out of character for Biden. He’s been in elected office longer than I’ve been alive, and throughout those 52 years, he’s only faked respect for those who’ve worn the uniform when it served him.

Hell, as vice president, he even went so far as to extend an invitation to my wife and myself for Thanksgiving dinner after I was injured in action. It’s hard to imagine that I would’ve made the guest list had I not just lost both of my legs in combat.

Compare that Biden with the Vice President Joe Biden who, alongside President Barack Obama, was responsible for the complete failure and subsequent coverup at the VA in 2014 that left roughly 120,000 Veterans on a waitlist and resulted in the deaths of at least 40 who were still waiting for care.

Or U.S. Sen. Joe Biden, who voted against legislation to increase funding for Veterans’ benefits on at least three different occasions. Or President Joe Biden, who was caught checking his watch as 13 flag-draped coffins were unloaded at Dover Air Force Base following his botched withdrawal from Afghanistan. Actions speak louder than dinner party invitations.

This is not a man who appreciates the sacrifices of our military. This is a man who cares only about his own political career, and who has no trouble lying to Veterans when it serves him. Don’t believe it.

The Limit, Save and Grow Act is a good piece of legislation that limits runaway spending while preserving vital programs at the VA, Social Security Administration, and Medicare; saves taxpayer dollars by undoing stupid policies like the student loan bailout, and grows the economy by unleashing domestic energy and strengthening the American workforce.

The president should spend less time lying and more time working with Speaker Kevin McCarthy to sign it into law before our country faces its first-ever national debt default. That’s what Veterans, and all Americans, deserve.

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There wasn’t a dry eye in the house during the early evening of August 7, when “Eight on Seven,” a Purple Heart Day event, was hosted at the New York City Fire Museum on Spring Street in Manhattan. Decades after the deaths of eight servicemen (one who fought in Vietnam and others who fought in WWII,) the Purple Heart Medals they had earned that somehow had been lost were “brought home” to their families.

Most family members who attended the event did not know the entire story behind each loved one receiving a Purple Heart. Joyce Bailey and her brother David Algranti, who live in California, did not know that Private First Class John M. Efstis, had even received this high honor for his military service. They had never met their uncle, from New Jersey, who died in 1943. They had, however, grown up knowing about the absence his loss had left in their mother and grandmother’s hearts. “They were always waiting for him to come home,” said Ms. Bailey. Wartime news was classified, and it took decades before the public knew over 1,000 troops lost their lives when the British troop transport ship HMT Rohna was attacked and destroyed by German aircraft. PFC Efstis was among those tragically lost.

Although the family eventually learned in the 1940’s about how Efstis had died, the story about his Purple Heart medal only emerged in the months after March 2019 when the medal was found outside Overton Brooks VA Medical Center in Shreveport, La, and handed over to a volunteer at the information desk. Once turned over to the medical center, the medal was shared with a member of the public affairs staff.

The Purple Heart was discussed with Associate Director Zachary Sage, who immediately understood the prominence of this discovery. “I placed the medal for safekeeping in the medical center safe,” and thus the journey home.

Sage and others consulted with Purple Hearts Reunited after a discussion with the commander of Louisiana’s Military Order of the Purple Heart. Major Zachary Fike, founder of Purple Hearts Reunited, shared emotional information about the medal.

Fike is a 21-year Army Veteran who served in Iraq and Afghanistan. Fike is untiring in his commitment to locating families of Purple Heart recipients and reuniting lost Purple Heart medals to families. He said he receives about 300 medals a year that are found in storage boxes, in police raids, and antique shops and delivered to his organization. Mr. Algranti received a message that Major Fike had called him regarding his uncle’s medal, and although concerned that “this might be a scam,” he was reassured by Major Fike that indeed his uncle’s Purple Heart medal had been found. Plans then were made to come to the NYC event. American Airlines donated the plane tickets for relatives involved in the Purple Hearts Reunited event. The stories of the Purple Heart recipients were read as if the Veteran had come back to tell their story.

Johnny would be proud today, and so would be the seven other Veterans recognized during the evening ceremony. Johnny knows he is not forgotten.

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Former “The Daily Show” host Jon Stewart on Tuesday accused the Department of Veterans Affairs (VA) of being “an obstacle” to providing medical coverage and care to service members who have developed illnesses from burn pits in Iraq and Afghanistan.

In an interview on Fox News’ “The Story with Martha MacCallum,” Stewart, who has in recent years become increasingly involved in advocacy on behalf of Veterans and 9/11 first responders, brought attention to the open-air piles of burning trash and fuel that the VA estimates that more than three million service members have been exposed to.

“The damage was extensive,” Stewart explained. “I think anybody who served in Iraq and Afghanistan had experience with them.”

“They use jet fuel to ignite all the waste that may be on a base. And that includes human waste, hazardous waste, munitions, hazardous, you know, radiation like— it’s this toxic brew and this thick black smoke that would pour over 24/7 the soldiers that lived there, slept there, ate there and were exposed,” he added.

Stewart, who played an active role in pushing to make permanent the September 11th Victim Compensation Fund, said that the health issues faced by Veterans exposed to burn pits runs similar to the long-term health problems seen among first responders in the 9/11 attacks.

“You have constrictive bronchiolitis, you have pulmonary issues, you’ve got really rare cancers like Glioblastomas and pancreatic cancer in very young, healthy individuals,” Stewart said. “You’ve got permanent nodules and lung damage, neuromuscular immune, you know, the whole gambit.”

The comedian turned activist said, however, that the VA is not providing adequate medical care for these Veterans.

The VA currently requires Veterans to pay for tests to prove that their illness was a result of exposure to the burn pits, with advocates saying that many of the claims are denied.

“The VA exists to advocate for the Veterans’ care,” Stewart said Tuesday. “They shouldn’t be operating as an obstacle or as some sort of insurance company that has a barrier of entry to deny service-related diseases.”

Stewart argued that, instead, Veterans “need presumption of exposure, and they need to immediately be placed into a program that mirrors the 9/11 program, which has medical screenings that tend towards, what are the illnesses that come from these sorts of toxic exposures? And then they need the healthcare and benefits that come from the diseases.”

“It’s a simple program,” he continued. “We already have the blueprint. It’s going to come down to money. And my feeling about the money is, this is the cost of war. This is the total cost of war.”

“You don’t get to pay for one aspect of the war and not the other. You don’t get to leave people hanging,” he added.

Sens. Marco Rubio (R-Fla.) and Kirsten Gillibrand (D-N.Y.) late last month unveiled bipartisan legislation that would give “presumptive” VA benefits “to servicemembers who have deployed and have illnesses due to exposure to burn pits and other toxins,” thus removing the requirement for Veterans to prove a link.

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VA uses human centered design to capture what matters most

VA is listening to customer feedback. But with more than 20 million potential customers from thousands of different points of view, making that feedback actionable and accessible can be a challenge.

After consulting industry leaders and best practices, VA conducted a broad qualitative research project to gain a picture of Veterans’ life journeys. Using a new-to-VA methodology known as Human Centered Design (HCD), VA created what is now known as the Veteran Journey Map. HCD encourages empathy and understanding. It begins with observation and qualitative research from countless interviews to ensure all perspectives are represented.

The Veterans Journey Map examines Veterans’ situations, needs, behaviors and dreams. It marks a shift in the VA viewpoint from system-centered to user-centered, allowing VA to put the Veteran at the center of policy, program and process decisions.

Since then, VA has created dozens of Journey Maps, examining a variety of Veteran interactions with VA, looking for opportunities of improvement in the services and experience provided.

For example, the VA Patient Experience Journey Map (PX Journey Map) was created to focus efforts on what customers said they cared the most about. VA calls these “the moments that matter.” After completing ethnographic field research, the PX Journey Map team collaborated with research participants and VA stakeholders to synthesize the findings. The results lead to a shared understanding of health care experiences of Veterans across the country. This map represents a common set of moments Veterans experience before, during, and after a health care appointment visit. Instead of the narrow view a single service provider might have into a small part of the patient’s experience, this map examines the full breadth of the patient interactions–both the bright spots and pain points. This Journey Map was a catalyst for the Veterans Health Administration (VHA) to launch innovative patient experience improvements.

Those improvements include:

Own the Moment (OTM)

OTM training empowers VA employees to deliver a positive customer service experience by connecting emotionally with Veterans. OTM helps employees deliver the best experience for Veterans and their families. More than 86,000 VA employees have completed the OTM customer experience workshop.

Red Coat Ambassador Program

The Red Coat Ambassador program outfits volunteers and employees with recognizable red coats or vests to greet and assist Veterans and caregivers when they enter a medical center. The Red Coat Ambassador program is in nearly all VA Medical Centers.

Walking the Post (WECARE Rounding)

Purposeful rounding for VA leadership allows patients and employees to build relationships, verify consistency of care, gather feedback, and follow up on opportunities for improvement. The Veterans Experience Office creates tool kits for this and many other programs to make it easy for VA facilities to implement patient experience programs.

The PX Journey Map also plays a significant role in VA’s ability to measure–in real-time–customer trust in VA and gather additional insights for immediate service recovery and continued experience improvements. Insights from the PX Journey map influence the development of survey questions used in VA’s Veterans Signals (VSignals) customer feedback program. Survey questions are carefully developed based on what matters to the customer, so VA is asking relevant questions to collect meaningful insights.

A Veteran’s journey is ever-evolving, and VA has made listening a priority to ensure those needs are met.

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A federal jury convicted a former Delaware doctor Wednesday for unlawfully distributing and dispensing controlled substances and for maintaining a drug-involved premises.

According to court documents and evidence presented at trial, Patrick Titus, former M.D., 58, of Milford, unlawfully distributed or dispensed a variety of powerful opioids, including fentanyl, morphine, methadone, OxyContin and oxycodone, outside the usual scope of professional practice and not for a legitimate medical purpose. Titus operated an internal medicine practice whereby he would frequently prescribe hundreds of these dangerous controlled substances in high dosages, sometimes in combination with each other or in other dangerous combinations, mostly in exchange for cash. Although these Schedule II drugs are approved for pain management treatment, Titus provided no meaningful medical care and, instead, prescribed these controlled substances to patients he knew were suffering from substance use disorder and/or who demonstrated clear signs that the prescribed drugs were being abused, diverted or sold on the street.

“Doctors who illegitimately prescribe opioid medications are fueling the country’s opioid crisis,” said Assistant Attorney General Kenneth A. Polite Jr. of the Justice Department’s Criminal Division. “Not only does unlawfully prescribing opioids facilitate their diversion and misuse by patients, but it also allows doctors who commit these unlawful acts to exploit their roles as stewards of their patient’s care for their own personal profit. This verdict serves as a reminder that such abuse will be not be tolerated and that we will be resolute in our pursuit of justice.”

“Dr. Titus was convicted of illegally distributing powerful prescription painkillers such as fentanyl, oxycodone, methadone and morphine for profit,” said Assistant Special Agent in Charge Shawn R. Ellerman of the Drug Enforcement Administration’s (DEA) Philadelphia Field Division and head of the DEA’s operations across the state of Delaware. “His conviction is an appropriate resolution for his utter and total disregard for his ethical and legal obligations as a medical doctor, especially due to the fact that he distributed these drugs knowingly to people suffering from substance use disorder.”

“This verdict holds Dr. Titus accountable for his actions and should serve as a warning to others that the illegal prescribing of dangerous narcotics will not be tolerated,” said Special Agent in Charge Maureen Dixon of the Department of Health and Human Services Office of Inspector General (HHS-OIG). “HHS-OIG will continue to work with our partners at the DEA, FDA and the U.S. Department of Justice to investigate allegations of drug diversion and keep our communities safe from illegal prescription drugs.”

Titus was convicted of 13 counts of unlawful distribution and dispensing of controlled substances and one count of maintaining a drug-involved premises. He is scheduled to be sentenced on Nov. 9, and faces a statutory maximum of 20 years in prison per count. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.

The DEA and HHS-OIG investigated the case.

Assistant Deputy Chief Aleza Remis and Trial Attorneys Justin Woodard and Claire Sobczak of the Criminal Division’s Fraud Section are prosecuting the case. Assistant U.S. Attorney Edmond Falgowski of the District of Delaware assisted with the case.

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For Thomas Casados, joining the Navy at the age of 18 was the only alternative to serving time in jail.

Growing up in El Sereno, a working-class neighborhood in east Los Angeles with strong Latin roots and rough streets, Casados would occasionally get picked up by police for fighting. His mischievous ways finally caught up to him shortly before graduating high school.

“The judge told me I could either go to jail or sign up for the service and clean up my act,” Casados, now 67, said. “So, of course I signed up.”

As it would turn out, serving his country would ultimately provide him with a way to avoid serving a lengthy prison sentence, and possibly dying from a drug overdose.

Casados is now a peer support specialist for the Department of Veterans Affairs, helping Veterans struggling with substance abuse and homelessness. But before he ventured down this career path he had his own bouts with addiction, a sickness that resulted in several criminal convictions for drug possession and burglary. He believes his abusive relationship with drugs and alcohol was partially the result of a traumatic incident he experienced while in the service.

“What I finally came to realize is that [abusing drugs and alcohol] was my way of escaping my reality,” he said. “I wanted to be out of the norm.”

When he was in his early 40s, Casados once again found himself facing time in prison. While awaiting trial he learned of a diversion program for Veterans who suffer from PTSD, Traumatic Brain Injury (TBI), or other injuries sustained during their enlistment. He was approached by a VA social worker, Gregory Cain, who presented him with a choice: either go through court-ordered treatment and stay sober with help from VA, or go back behind bars.

“I was sick and tired of going in and out of prison, all because of drugs,” said Casados, who now lives near Prescott, Ariz. “It’s like I tell the Veterans I work with now, all you’re doing is killing yourself slowly. With help, you can be so much more.”

Casados, who recently celebrated 22 years of sobriety, is a beneficiary of the Veterans Justice Outreach Program in which VA social workers like Cain make regular visits to local jails and courts in search of Veterans going through the legal system. Social workers review a Veteran’s legal and medical history to determine if the Veteran’s legal troubles stem from injuries suffered while in the service.

The goal is to help Veterans heal; a secondary purpose is to reduce recidivism rates.

Research has shown that more than half of the Veterans involved with the criminal justice system have either substance-abuse disorders or mental health problems like PTSD, depression, anxiety, according to the US Department of Veterans Affairs. Suffering from one of these conditions can lead to violent behavior, an inability to maintain stable relationships, and depression, all of which can make someone more likely to end up on the wrong side of the law.

One third of Veterans report having been arrested and booked into jail at least once, compared to fewer than one fifth of civilians. There are more than 181,500 Veterans in U.S. prisons and jails, reports the Council on Criminal Justice (CCJ). (The CCJ has formed a commission to study why so many Veterans end up in jail or prison and make recommendations for evidence-based policy changes.)

Data from the 2011–2012 US National Inmate Survey shows that 62 percent of Veterans in jails report four or more prior arrests and 68 percent of Veterans in prison report at least one prior episode of incarceration.

Clearly, action must be taken to rehabilitate Veterans charged with crimes rather than place them in prison, a system that cannot adequately treat and may only exacerbate mental illnesses or substance abuse disorders. The outreach and diversion program begins to address this urgent issue by focusing on rehabilitation, not retribution, for Veterans who commit non-violent offenses.

“Once you are exposed more to the system you see how one slip up or mistake caused by some of the trauma you’ve suffered can lead you to lose your freedom, your job, your home, or your family,” said Sergio Antoniuk, LCSW, supervisor of the Veterans Justice Outreach Program for the VA Greater Los Angeles Healthcare System. “I don’t think the average person understands that amount of trauma and stress that some of these Veterans are going through. The system can be cruel, and Veterans who are vulnerable need support to get back into the real world.”

Veterans who are granted military diversion typically spend up to two years in the program. There are periodic reports to the court, with the Veteran having to prove they are making progress in their journey, which can include completion of rehabilitation or anger management courses. Once they finish, their charges are dismissed by the court.

Veteran David Valles completed the diversion program and is now a peer support specialist helping other Veterans in Los Angeles County. Like Casados, he too abused drugs and alcohol, something he attributes to a traumatic incident he experienced during live-fire exercises as a cadet in the Army. He was offered diversion and spent several months living at the West LA VA in the Domiciliary Program, where he got clean and learned of better ways to cope with his PTSD.

He would eventually earn an associate degree in drug and alcohol abuse counseling. He credits Cain, the same social worker who help helped Casados, with guiding him through some challenging times. He finds purpose in being able to do the same for others.

“It’s been good to be able to help the guys going through what I went through,” said Valles, 61. “I can show them that you don’t have to lose your place in life. You can get back on solid ground.”

Valles admits it can be difficult. He stumbled the first time out, but has been sober for 12 years.

“I’m proof that it’s never too late to turn your life around.”

And it’s not just the Veteran who benefits from military diversion programs. The impact is felt throughout their family. Valles is grateful that he got sober before his mother died so that he could free her from the stress of worrying whether he would end up in prison or in the morgue.

For Cain, the peace he can provide to the families of Veterans is what makes his challenging job rewarding.

“Sometimes we’re the only connection that a mother has to her son,” Cain said. “When you can relieve that stress and they can go to bed knowing that possibilities exist, that someone is looking out for their child, you can go home that night feeling good, knowing that you’re making a difference.”

Those who are interested in learning more about the Veteran Justice Outreach Program can call 213-253-2677 Ext. 24793.

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K9s for Warriors is a non-profit organization that provides trained service dogs for Veterans suffering from post-traumatic stress disorder, traumatic brain injury and/or military sexual trauma related to their service. The group helps to end Veteran suicide and to restore dignity and independence to those who have served in the military.

K9s for Warriors matches Veterans with a service dog and guides them through three weeks of training with their new dog free of charge. Service dogs are scientifically proven to lower symptoms of post-traumatic stress disorder, depression, and social isolation while increasing life satisfaction and overall psychological well-being.

Eligibility

If you are a service-connected disabled Veteran with military service after Sept. 11, 2001, then you are eligible to apply. The disability does not have to be physical and can include psychological diagnoses to qualify for the program. Currently, the program does not apply to Veterans who are legally blind or hearing impaired.

You can begin your application for a service dog on the K9s for Warriors website. The application process takes approximately 1-4 weeks. You must include a letter from your doctor that confirms your service-connected disability and states that you are physically and mentally capable of undergoing the 21-day training program. A Mental Health Verification form, four copies of your DD214, a full-length photo for identification, and an agreement to support form from two individuals must also be included in your application.

If you are accepted, you will be put on a wait list which averages approximately 16 to 18 months. Then, you will be paired with a dog based on your personality and activity level. At that point, you would attend the training program in either Ponte Vedra or Gainesville, Florida. Veterans are provided with housing and meals during the training program. Transportation to Florida is not included; however, there is a list of organizations that will assist with travel costs on the K9 for Warriors website.

Click here to visit the K9s for Warriors website, where you can find more information and read testimonials. You can click here to begin your application.

The sharing of any non-VA information does not constitute an endorsement of products and services on the part of the VA.

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TOPEKA — Last week, 140 flags were on display at the National World War I Museum and Memorial, representing the number of Veterans who take their lives each week.

Addressing and ensuring access to care for the more than 175,000 Kansas Veterans benefits the community at large, not just those struggling with trauma from war, said Matt Naylor, president of the museum and memorial. Health care providers and Veteran services advocates such as Naylor say public awareness of the mental and physical effects that linger after the battles are fought is becoming more common. That means a growing focus on this area.

“We know around about 20 Veterans or active-duty personnel take their lives each day, and that was true during World War I as well, when we didn’t really understand how to treat shellshock,” Naylor said, adding that now providers understand shellshock to be post-traumatic stress disorder. “The impact though, on families, on communities, on economies, is enormous.”

Naylor was joined Monday by representatives of a Veteran’s healing group and the University of Kansas Health System to discuss how the state responds to the needs of its warfighters. One major issue discussed is finding access to providers who understand the issues that Veterans face in their day-to-day lives.

Only about 50% of the roughly 18 million Veterans nationwide receive care through a Veterans’ hospital. The rest depend on the same health systems and networks as anyone else, said Nicole Yedlinsky, a family physician for KU Health System and a Veteran.

Yedlinsky, who was on active duty for seven years, followed by eight years working in the military medical system, said progress is being made in filling gaps that Veterans’ hospitals cannot fill.

“There’s a much bigger awareness of those mental health issues that Veterans face, especially as they transition out of the service, and also that connectedness and the importance of community involvement,” Yedlinsky said.

One aid available to all Veterans working in the health system is the Veteran’s Resource Group. It has worked to repair homes for Veterans and provide needed medical equipment to Veteran’s organizations that need it.

The Battle Within, an Olathe-based organization created by more than 100 Veterans, first responders and other community members, is also working to break down barriers to care and ensure Veterans have a chance to heal. A primary focus is reducing the stigma of mental health, said Adam Magers, the clinical director for The Battle Within. This includes connecting Veterans with therapists and other mental health care providers.

Magers said psychotherapy is effective for the treatment of PTSD and encouraged Veterans to seek the help they need. He also told anyone hoping to help a Veteran should approach them with openness and authenticity.

“Having a traumatic reaction to something like war is normal,” Magers said. He added that “the best thing that we can do when we’re speaking with somebody who’s experienced something traumatic is just make it safe for them to share their experience, and to be honest about how they’re feeling, without having anybody shame them.”

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