VA Creates Red Tape to Deny Care to Iraq War Veterans

Jounal Gazette (Fort Wayne, Indiana)

Not Supporting Our Troops: VA essentially creating red tape to deny care to veterans

Sean Johnson broke three vertebrae in his back when he fell off a truck in Tikrit, Iraq. He ended up having surgery on his own after the military effectively refused to treat him. It took mounds of red tape and calls to Sen. Evan Bayh’s office to resolve the medical bills and disability status.

One Sunday in January 2005, Spc. Sean Johnson fell off a truck. He had been working on a construction project near the Iraqi city of Tikrit with his unit of the Ohio National Guard when he slipped and fell hard, landing on his back.

Because it was Sunday and the troop clinic wasn’t open for non-emergency injuries, Johnson waited until Monday to see a doctor for the intense pain in his back. The doctor prescribed ibuprofen and sent him back to duty.

Over the next few days, the pain got worse, and Johnson returned again and again to the clinic, where he was given more ibuprofen and sent back to duty. He said the other members of his unit accused him of malingering. Still in severe pain a month later, Johnson returned home on regular leave and saw his family doctor. The doctor ordered an MRI, which revealed three fractured vertebrae in Johnson’s lower back. Johnson called his Guard unit and told the commander that a specialist recommended immediate surgery to stabilize his spine.

That single phone call would plunge Johnson into a bureaucratic swamp created by the Department of Defense and the Department of Veterans Affairs. It would take him nearly two years to reach the other side.

Roughly 1.4 million men and women have served in the armed forces in Iraq or Afghanistan since the fall of 2001, some career military and some who were inspired to join after the Sept. 11, 2001 terrorist attacks. About 4,000 have died, and thousands more have been injured, many – like Johnson – in non-combat situations.

This isn’t a story about bureaucratic bumbling – or even about overwhelmed caseworkers trying to fight their way through mounds of files. Such stories are common. This also isn’t a story about whether the war in Iraq is right or wrong.

As Americans prepare to observe Memorial Day, this is a story about how our government sometimes treats soldiers who come back alive. The government doesn’t let them get well.

Instead of doing whatever they have to do to make sure that soldiers and vets receive the care and benefits they were promised, the federal government is wielding red tape to effectively deny care and compensation and hold down costs. At the same time:

•The VA is cutting back the ranks of disability claims adjusters and giving performance bonuses to top VA officials.

•A backlog of disability cases and appeals wait for decisions – 1,800 in northern Indiana alone and an estimated 800,000 nationwide.

•Soldiers and others in the military who appeal disability decisions wait years for their cases to be heard.

All of this is apart from the scandal at Walter Reed Army Medical Center. The Washington Post revealed in February that wounded soldiers recuperating at Walter Reed often become mired in red tape as they seek further treatment or decisions about whether they will stay in the military. The Post also discovered poor living conditions – including vermin, mold, filth and leaking roofs – in an Army building that houses recovering soldiers.

“They’re not incompetent,” said Paul Sullivan, a former VA official who resigned two years ago in a policy dispute and now heads Veterans for Common Sense. “This is intentional. This is the policy.”  [Note: Sullivan resigned in March 2006.]

And the swamp that tried to swallow Sean Johnson is about to get far larger.

Troop shortages have forced the military to redeploy units to war zones over and over, keeping most on active duty. Veterans activist groups are warning that a tidal wave of veterans with complex brain injuries and mental health problems will descend on the VA when the Iraq war finally ends and vets apply for health and disability benefits they were promised. They fear that the VA health system doesn’t have the resources available to be ready.

How can a government ask a group of its citizens to bleed and die on behalf of their country and then nickel and dime the injured survivors to death when they come back? The government not only doesn’t support the troops, it doesn’t even respect them.

Political analysts are fond of pointing out parallels between the war in Vietnam and the Iraq war, but the comparisons are strictly political. The Vietnam War was fought primarily by young male draftees, many of them poor and black. This war is being fought by men and women with spouses and children. National Guard members – whose average age is 33 – leave families and careers to fight in Iraq and Afghanistan.

They’re fighting a different war with different weapons. Improvised explosive devices – the weapon of choice among insurgents in Iraq – often cause devastating brain injuries.

Unless they volunteered, most soldiers in Vietnam did a single tour of duty. In a war fought using volunteers, many soldiers serving in Iraq and Afghanistan have been deployed to war zones three or four times during their tenure, and for many others, their tours were extended. The multiple tours have led psychiatric experts to fear that as many as one-third of returning vets will develop post-traumatic stress disorder sometime after they return.

When Sean Johnson picked up the phone and told his commander he needed back surgery, he was ordered to report to the Army’s medical holding company in Fort Knox, Ky. He obeyed, taking his medical records with him. He never saw a doctor, but a medical assistant who evaluated him decided he didn’t need surgery after all and recommended epidural injections instead.

Three months and two injections later, Johnson demanded to be allowed to seek civilian health care. It was granted, and he finally had surgery in Fort Wayne to implant steel rods and screws in his back and fuse his vertebrae in December 2005, nearly a year after he was injured.

Then the bill arrived.

Even though he was injured in a war zone, the Army demanded that Johnson pay $6,000 of the $140,000 medical bill. Still recovering from surgery and the father of an infant son, Johnson didn’t have $6,000. After three months of haggling and a call from Sen. Evan Bayh’s office, the military eventually agreed to forget the bill.

Then Johnson set out to apply for disability payments, but when he applied, his unit said his records didn’t exist, even after nine requests from a county veterans’ service officer. Frustrated, Johnson contacted Bayh’s office again.

Lots of frustrated vets have contacted Bayh’s office lately. In the past year, VA cases have surpassed even the Social Security office as the government agency Bayh’s constituents complain most about, said Eric Kleiman, communications director in Bayh’s Washington office. Kleiman said the office currently has dozens of open cases involving veterans’ health benefits.

Complaints and news stories about the failure of the Department of Defense and the VA to care properly for injured vets prompted Bayh and other senators to offer several bills designed to improve conditions at military hospitals and reduce red tape in delivery of services to vets.

Much of the frustration arises because vets must wait six to eight months after they file disability requests for caseworkers to return with a decision, said George Jarboe, who runs the Allen County Veterans Service office. And unless they’re eligible for some other reason, most vets can’t use the VA health care system until their case is decided, he added.

If a disability claim is denied, said John Hickey, director of rehabilitation for the American Legion in Indiana, it can take three to four years for an appeal to be heard.

“I think the VA is swamped with claims,” Hickey said. “What they really need is more help.”

Hickey said the most telling indication that the VA’s disability staff is overwhelmed is the large number of appeals that his organization wins on behalf of vets.

“We win a lot of claims through the appeals process,” he said. “That tells you that something isn’t being done up-front. More than half of the claims we file are either remanded for more information or granted.”

Claims backlogs aren’t a natural consequence of war, Paul Sullivan argues. The VA created the backlog to discourage vets from filing. He cites a decision to cut the number of claims caseworkers as proof. And he added that it’s appalling that top VA officials would give themselves bonuses during wartime with benefits backlogs running at six months or more.

[Note: Paul Sullivan told the Journal Gazette that in 2005: 1) VA failed to hire additional claims processors even after VA knew more claims were being filed;  2) VA assigned many claims processors to review 72,000 PTSD claims approved previously; and 3) VA required a second claims processor to approve PTSD claims.  The last two policies slowed down processing, increased the claims backlog, and sent a message to veterans, VA employees, and veterans groups that VA would fight PTSD claims.]

Moreover, vets claiming disability must start by completing a 23-page claim form and obtain their own military discharge records and medical records from the Department of Defense.

“We’re five years into war and the VA and DOD aren’t sharing records,” Sullivan said. “They’ve just started to do it for the most seriously wounded soldiers.”

Congress recently shot down one of the VA’s plans to limit the number of veterans diagnosed with PTSD – and forbade the VA from reviewing 72,000 PTSD claims that had been previously approved. The VA bowed to public pressure and suspended a requirement that vets obtain a second signature for a PTSD claim.

Intervention from Bayh’s office got instant results. After months of claiming that his records didn’t exist, Johnson received a letter from his unit that said the records had been found in a box on the floor.

Last year, the VA finally granted Johnson a 40 percent disability, which entitles him to payments each month. Though his back injury left him unable to return to Iraq, Johnson is still under contract with the Guard. He is resisting reassignment to his original unit, arguing that the members of his unit harassed him after he was hurt.

Now 32, he lives near Avilla, shares custody of his 2-year-old son with his former wife, and has returned to work building houses for Redmond Homes. He still has back pain but says it’s bearable.

“I really thought this would be something that would make me proud,” he said of his time in the service. “It’s something I regret now. I even won two awards for the construction projects I worked on.”

In 1924, a grateful Congress voted a bonus to World War I veterans but decided not to pay it until 1945. In the meantime, the country slipped into the Great Depression, and in May 1932, some 15,000 destitute veterans descended on Washington, many with families in tow, set up camp near the Capitol and demanded their bonuses.

A month later, Congress voted down a bill that would have paid them. The attorney general ordered the “Bonus Army” to disperse, and when they refused, President Hoover ordered the army to clear them out. Led by Chief of Staff Gen. Douglas MacArthur in a detachment that included Maj. Dwight D. Eisenhower and Maj. George Patton, the men, women and children were driven out of the city. Their camp was burned, two babies died, and hospitals were swamped with casualties.

Seventy-five years later, America’s long, tormented history with its military veterans marches on.

Julie Creek is an editorial writer for The Journal Gazette. She joined the newspaper in 1990 and was an education reporter and assistant metro editor. You can reach her at 260-461-8609 or by email at jcreek@jg.net

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