Adding Insult to Injuries: Ill-equipped VA Only Adds to the Pain

Chicago Tribune

Sgt. Garrett Anderson never expected this feeling of betrayal. He loves his country. He supports this war. He believes in his president. He would fight again in Iraq, if he were able.

But coming home has been hell for this injured National Guardsman from Illinois, whose battle to secure medical care and government benefits has undermined his faith in his government.

The latest affront came in mid-March, when the U.S. Department of Veterans Affairs sent a letter denying Anderson 100 percent disability, which confers extra pay and benefits, largely because his medical records didn’t document that “shrapnel wounds, all over body” were “related to your military service.”

“You feel, you give everything you can, and then they turn around and slap you in the face,” said Anderson, who also suffered a shattered jaw, smashed eye socket, severed tongue and below-the-elbow amputation of his right arm after an explosion in Iraq. A VA spokesman declined to comment.

Getting help on the home front is a disheartening struggle for growing numbers of wounded soldiers, whose difficulties extend well beyond the conditions at Walter Reed Army Medical Center that made headlines this year.

In cities large and small, the wounded struggle to find adequate follow-up medical care and rehabilitation services, in part because the VA has been slow to adapt to this new generation of soldiers, observers say. Meanwhile, applying for disability benefits is nightmarishly complex, and long administrative delays leave many injured veterans with little income during a crucial period.

Victor Rojas, a National Guardsman from Aurora, is among hundreds of Illinois soldiers who have found themselves battling bureaucratic obstacles.

Rojas said he has “no complaints” about his care at Walter Reed, where he awoke from a five-week coma in early 2005 after suffering a traumatic brain injury during a rocket-propelled grenade attack in Iraq. The onslaught also shattered his right knee and severed the femoral artery in that leg.

But when he applied for VA disability benefits, the government’s way of compensating retired soldiers for injuries, after returning to Illinois, “it took months and months and months,” said Rojas, 22. “I felt, like, forgotten.”

The agency lost his paperwork at least twice and required Rojas to show up at numerous appointments, even though his memory problems made it difficult, according to Eric Schuller, a senior adviser to Lt. Gov. Pat Quinn. A VA official in the Chicago office said he couldn’t comment on the case.

Open claims mounting

Nationally, the backlog of claims for VA disability benefits has swelled to about 400,000. Pending claims in Illinois soared to 14,263 through March, up 30 percent from a year ago, while new applications now take an average of 238 days to process.

The VA says it is “aggressively pursuing measures to decrease the pending inventory of disability claims and shorten the time veterans must wait for decisions.” Steps include hiring new staff and expanding outreach.

But advocates say the changes don’t go far enough. And they worry especially about young soldiers with moderate brain injuries whose condition impairs their ability to navigate a mazelike bureaucracy.

“It’s the guys who are slightly wounded but still disabled, the guys who can’t focus at work and who lose their jobs, that I’m really worried about. No one’s reaching out to find them and to make sure they’re taken care of,” said Tammy Duckworth, director of the Illinois Department of Veterans’ Affairs.

Rojas finally received a 100 percent disability rating in June 2006, a full year after applying. “It gives you a bad feeling, but what I really worry about is people with bigger injuries than mine,” he said.

Yuriy Zmysly, 22, is one of those people. Inspired by the Sept. 11 attacks, the Lake Zurich man enlisted in the Marines soon after graduating from high school in 2002. Zmysly later served almost two years in Afghanistan and Iraq.

He suffered a devastating brain injury not in the theater of combat but during an emergency appendix operation on a Marine base in January 2006. In fact, many war-related medical crises arise when personnel are training on base or undergoing demobilization.

When Zmysly awoke at a private hospital in Hinsdale after lying in a coma for 2 1/2 months, he was unable to talk, walk or use his hands.

His wife, Aimee, 21, angrily dismissed the hospital staff’s suggestion he go to a nursing home and arranged for him to be admitted to the Rehabilitation Institute of Chicago, where he received hours of therapy daily. After 17 weeks, Zmysly was beginning to stand and try to walk. The military’s health-care plan covered the stay.

But after Zmysly was discharged from the Marines in July, his case shifted to the VA, which provides care almost exclusively at its own enormous network of hospitals and medical clinics across the U.S.

Zmysly moved to Hines VA Hospital just outside Chicago, where therapists quickly concluded he had reached his maximum level of recovery. His wife thought their expectations were too low and their efforts to help him inadequate.

“It was so frustrating to see the gains Yuriy had made at the Rehab Institute being lost,” she said.

Now home in Oak Lawn, Zmysly is getting five hours of physical and speech therapy at Hines weekly — barely enough to improve his state. His wife has tried to schedule more therapy, to no avail.

“They mean well, but they’re overworked and underfunded,” she said.

A Hines spokeswoman said the hospital was committed to providing excellent care but declined to comment on the case, citing patient confidentiality.

Gap in treatment

Dr. Joanne Smith, head of the Rehabilitation Institute, said such stories reveal a troubling gap in services: Military hospitals are great at treating trauma but don’t focus on helping patients learn to live with disabilities. And while the VA is trying to expand rehab services, it doesn’t have the resources or expertise needed for optimal results.

“It’s obvious some of these men and women are not getting the care they need,” said Kathleen Yosko, president of the American Rehabilitation Providers Association and Marianjoy Physical Rehabilitation Hospital in Wheaton.

The VA strongly disputes that assertion, saying it has invested enormous resources and is well-prepared to handle soldiers with challenging injuries through 21 new “polytrauma” centers of excellence, including one established last year at Hines.

Anderson, the National Guardsman, credits the Army with saving his life after an improvised explosive device detonated under his Humvee in Iraq in October 2005.

But he said he encountered extraordinary bureaucratic hassles and sheer nastiness after leaving Walter Reed’s famed amputation ward and entering “medical hold,” the period when the Army decides whether soldiers receiving outpatient care will return to active duty or be discharged.

The hospital gave him a gray backpack to carry his prosthetic arms to therapy. But because it wasn’t Army-issue black, soldiers would yell insults at Anderson as he crossed the 15-acre campus, he said.

“This happened repeatedly,” said Anderson’s wife, Sami, who left law school to stay at his side at Walter Reed. “It’s military first, healing second everywhere you turn.”

In a prepared statement, the Defense Department said it takes pride in “the highest survival rate for the wounded in the history of American military operations” but acknowledged deficiencies.

“In several areas relating to service members recuperating from injury, or seeking to move forward with their lives, we have fallen short,” it said.

System of rigidity

The couple moved back to Champaign in June 2006, where they waited for the VA’s disability determination. The decision, when it finally came last month, was a shock.

Because Anderson’s medical records from Iraq weren’t available — like many soldiers, he returned to the U.S. without them — and the source of his shrapnel went undocumented at Walter Reed, the agency awarded him a disability rating of only 90 percent.

That meant Anderson would have to pay property taxes and would receive an income of about $1,000 less each month.

“I’m really disappointed,” said Anderson, 30. He has filed an appeal and has a new appointment with VA medical reviewers later this month. But nationwide, appeals are currently taking close to two years.

Meanwhile, the family has been unable to find a local specialist, either at the nearest VA or in Champaign, to treat Anderson’s amputated right arm. As a result, Anderson hasn’t received follow-up medical attention for constant nerve pain and potential bone spurs since returning to Illinois.

“You’ve got soldiers with a new breed of injury who, like Garrett, don’t know where to turn,” Sami Anderson said. “I don’t think anyone was prepared for the issues they’re bringing home.”

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