Marty Schram notes one anecdotal but perhaps telling incident. In an upscale bar near the White House, a VA administrator bragged that he’d spent the afternoon immersed in medical books, extracting enough information to cast doubt on the validity of one veteran’s claim, declaring his day’s triumph: “De-nied! De-nied! De-nied!”
BOOK Review: “VETS UNDER SIEGE: How America Deceives and Dishonors Those Who Fight Our Battles,” By Martin Schram, published by Thomas Dunne/St. Martin’s. 306 pp. $25.95
July 27, 2008, Government agencies suffer all too often from mind-bogglingly abstruse procedures and bureaucratic malaise, but Martin Schram’s exposé of the Department of Veterans Affairs makes the agency appear downright Kafkaesque, particularly in its handling of claims filed by disabled veterans.
There’s Garrett Anderson, a national guardsman whose 2005 claim was denied after the VA determined that his extensive shrapnel wounds from a roadside bomb in Iraq were “not service connected.” There’s Bill Florey, whose exposure to sarin gas during Gulf War I entitled him to zero benefits when he developed brain cancer a decade later because he hadn’t shown any symptoms within one year of discharge — even though the VA knew of an ongoing study linking brain cancer to sarin gas exposure. Florey subsequently died. And then there’s the $3.8 million in performance bonuses awarded to senior officials in the VA in 2006, just a few months after many of those same officials had overseen a $1 billion budget shortfall, resulting in the loss of benefits to wounded vets returning from Iraq and Afghanistan.
Schram depicts an understaffed, incompetent VA defending itself in baffling legalese against those who care enough to question it: the occasional Congressional committee, a turf-conscious Department of Defense and, of course, the veterans themselves, who are still waiting for 390,000 of their claims to be processed. Although the Government Accountability Office, that Cassandra of government agencies, issues scathing reports of VA ineffectiveness year after year, Schram argues that the real problem goes unchallenged. Undertrained VA adjudicators, most of whom never meet their claimants, have developed a mind-set that most veterans are hangers-on who present invalid claims in order to rip off the government. The fundamental problem isn’t financial, he says. It’s cultural. The VA, out of some skewed rewards system, has instilled a relentless determination to stall or avoid payments to veterans.
Schram tends to force his point when the facts would suffice. And he might have condensed the numerical data into tables rather than subjecting the reader to numerous GAO excerpts. But despite its flaws, the book asks a compelling question: When the VA has established several state-of-the-art hospitals and can provide high-quality medical care, why does it still fail to consistently offer even the most basic services to all disabled vets?
Schram offers some interesting solutions to the VA’s problems, such as offering a “Vet-med” card, similar to a Medicare card, that would enable a vet to get help at any local medical facility. He asks the VA to give veterans the benefit of the doubt in filing claims rather than leaving the burden of proof on men and women who are often struggling with severe health and financial challenges. And he would rename the organization the “Department of Veterans’ Advocacy.”
While the VA has made some recent improvements — converting to an electronic application process and offering five years of free health care immediately following active service — it seems far from adopting the kind of systemic changes that Schram suggests. Last year the VA effectively killed two congressional bills that would have altered the adversarial attitude toward veterans. Those bills would have required the VA to pay $500 per month to vets whose claims appeals extend more than 180 days and to adopt an auditing system similar to the IRS rather than investigate every claim. In congressional testimony, the VA argued that the first bill would “unjustly enrich” many claimants and the second would give vets “excellent odds” of cheating the government. So much for cultural change.
Schram’s book lacks the dramatic appeal of great investigative journalism, but he should be commended for presenting a fairly cohesive exploration of the VA’s numerous faults. He notes one anecdotal but perhaps telling incident. In an upscale bar near the White House, a VA administrator bragged that he’d spent the afternoon immersed in medical books, extracting enough information to cast doubt on the validity of one veteran’s claim, declaring his day’s triumph: “De-nied! De-nied! De-nied!”
Until the VA is forced out of its cultural entrenchment, such denials will remain commonplace. The question is: Who will do the forcing?