Veterans for Common Sense

March 3, 2008, San Francisco, California (AP) – Lawyers for two veterans groups asked a judge Monday to order the U.S. Department of Veterans Affairs to overhaul its health system, especially its mental health treatment, to meet growing demand from soldiers returning home from Iraq and Afghanistan.

Two veteran advocacy groups sued the Bush administration last year, claiming that the VA failed to provide prompt disability benefits, add staff to reduce wait times for medical care and boost services for post-traumatic stress disorder. A weeklong hearing on the lawsuit began Monday in U.S. District Court.

The lawsuit comes amid intense political and public scrutiny of the VA and Pentagon after reports of shoddy outpatient care of injured soldiers at Walter Reed Army Medical Center and elsewhere. Suicides and suicide attempts continue to rise, the Pentagon reports.

The groups suing are Veterans for Common Sense in Washington, which claims 11,500 members, and Santa Barbara-based Veterans United for Truth with 500 members.

U.S. District Judge Samuel Conti is scheduled to hear from dueling mental health experts this week to determine whether he should order the VA to immediately spend about $60 million to provide care to hundreds of thousands of veterans they say have pending health claims.

“The VA has repeatedly failed to implement programs,” veterans’ lawyer Gordon Erspamer told the judge. “Mental health funding is not being spent on mental health.”

Erspamer urged the judge to act soon to fix a health care system he says is plagued by staffing shortages, high turnover and a crushing need to treat about 56,000 patients with post-traumatic stress disorder. Erspamer argued the demand is expected to increase as more soldiers return from combat zones.

“What is going to happen to the health care system when they all return?” he asked the judge.

The judge responded that he was concerned he had scant authority to tell the VA how to spend its budget, even if he does determine there are problems.

“I have very limited jurisdiction,” Conti said.

U.S. Department of Justice lawyer Daniel Bensing echoed that by telling Conti that issuing such an order had the practical effect of putting the judge in charge of patient care. The veterans’ demands are “unwarranted, unworkable and would do more harm than good.”

The VA has made “massive changes,” Bensing said, adding new resources and mental health workers since 2005 in response to veterans returning from Iraq and Afghanistan.

“It is not the policy of the VA to turn away veterans when they need emergency care,” he said. “They get emergency care.”

March 3, 2008 – A piece of legislation sits on the desk of President Bush today, awaiting his signature. Every expectation is that he will veto it. Another mistake.

more stories like thisThe bill is the Intelligence Authorization Act for fiscal 2008, with a provision tying CIA interrogation techniques to the US Army Field Manual, which is explicit in prohibiting “acts of violence or intimidation, including physical or mental torture, or exposure to inhumane treatment.” The CIA would henceforth be forbidden to engage in any kind of torture, but so would any “instrumentality thereof, regardless of nationality or physical location.” The legacy of Abu Ghraib, Guantanamo, renditions, and black sites would finally be sealed. The United States would bind itself to one standard of interrogation, completely prohibiting any form of torture. The nation would be back in line with standards of the Geneva Convention, and, as a group of retired admirals and generals put it recently, with “the moral principles on which this country was founded.”

Dozens of former military leaders, in a campaign orchestrated by the human rights organization Human Rights First, have been actively working to get all forms of inhumane interrogation outlawed, including those practiced by the CIA. The three points the military leaders make are that information obtained through brutality is unreliable, American soldiers will be subject to similar mistreatment, and that procedures in violation of internationally recognized norms are dishonorable. Their advocacy was part of what led to the passage of the legislation that is now before Bush. Unfortunately, the number of congressional votes in favor of the bill fell short of the margin needed to override a presidential veto.

No one’s vote meant more than Senator John McCain’s, and here is where the first shock is felt. After leading the charge against torture in all its forms – McCain has been vigorous in denouncing the Bush administration’s refusal to outlaw waterboarding – the Arizona senator voted against extending his own firmly stated standard to the CIA.

“What we need,” he said in explaining his vote against the Intelligence Authorization Act, “is not to tie the CIA to the Army Field Manual, but rather to have a good faith interpretation of the statutes that guide what is permissible in the CIA program.” Because McCain, a torture survivor, has such credibility on the question, his negative vote provided cover for many others, which is why Bush’s expected veto can be upheld.

But what is this appeal to “good faith”? Firmly rebutting McCain’s assertion, Lieutenant General Harry Soyster, former director of the Defense Intelligence Agency and one of the most active of the Human Rights First cadre of military leaders, said, “But as Senator McCain well knows, the Bush administration has never provided a good faith interpretation of laws prohibiting torture; instead it has produced – and continues to produce – legal opinions that downgrade the definition of torture to the point where the term becomes virtually meaningless and any conduct at all is permissible.”

Waterboarding is the prime example here, making it the flash point of debate. Last week, the current head of the Defense Intelligence Agency, Lieutenant General Michael D. Maples, told the Senate Armed Services Committee that such simulated drowning is inhumane and in violation of the Geneva Conventions. His agency’s interrogation methods conform to the Army Field Manual.

The Defense Intelligence Agency and CIA are alike in being global intelligence agencies, but they have been at odds with each other before. The issue is personal to me because my father, Lieutenant General Joseph Carroll, was founding director of the Defense Intelligence Agency. General Soyster was its head when my father died, and at dad’s funeral at Arlington, he presented the flag to my mother.

My father was of that World War II generation of American military figures whose sense of moral purpose was firm. I arrived at different conclusions on large questions of war and peace, but the basic values of decency and honor embodied in my father’s career remain ideals against which I measure everything.

That torture is even a subject of debate in this country is a flabbergasting development. That dozens of America’s most admired military leaders find themselves openly opposing the commander in chief on such a question is equally surprising. Another astonishment is that McCain, avatar of military honor, finds it necessary, according to his perceptions of what politics requires, to trim his opposition to torture. It may be just that unthinkable now that Bush will sign the bill before him. But who knows? On torture, the shocks abound.

March 5, 2008, San Francisco, California – The class action lawsuit brought by Veterans for Common Sense (VCS) and Veterans United for Truth (VUFT) against the Department of Veterans Affairs forced VA to confirm two important facts: the number of Iraq and Afghanistan war veteran patients continues rising quickly, and the new law mandating five years of free healthcare is an entitlement.

In the first major revelation, VA’s Dr. Gerald Cross testified that 300,000 Iraq and Afghanistan War veterans were already treated at VA hospitals after returning home from combat.  Of those, VA reported more than 120,000 were diagnosed with mental health condition, including nearly 68,000 diagnosed with post-traumatic stress disorder.

VA also reversed their prior position, and now says the five years of free medical care Congress mandated in the “Dignity for Wounded Warriors Act,” is, in fact, an entitlement.   In court papers filed in January 2008, VA said the five years of free medical care was discretionary, which means spending for new war veterans would be limited to available funds at the option of VA’s secretary.

Arturo Gonzalez, an attorney with Morrison & Foerster, the law firm representing VCS and VUFT, asked VA’s Dr. Cross, “… if a veteran from Iraq returns tomorrow and needs medical care from tomorrow to the next five years, that person would be entitled to care from VA, correct?” 

And Dr. Cross replied, “Yes.” He clarified his comments by adding, “…anything that’s remotely related to their combat service is not only free, there is no copay.” 

VCS encourages veterans with war-related medical conditions, especially mental health conditions or suicide, to seek treatment at VA.  One set of goals VCS is for veterans to know about VA, to want to go to VA for care, and for VA to be fully prepared with prompt and high-quality treatment.

VCS will be supplying this information to reporters and legislators so they know what VA has said under oath.

One of our goals in the current hearing in Federal District Court in San Francisco is to prevent VA from turning away suicidal veterans seeking treatment at VA.   Of the 1.7 million service members deployed to the war zones, 800,000 are veterans, and 900,000 remain in the military.  Of those still in the military, approximately 300,000 are deployed to the combat zones.  Action by the court now could improve services for both our veterans and our soon-to-be veterans.

As of this morning, the court hearing appears to be heading for two or three days of additional testimony.

March 1, 2008 – Washington, DC –  Sen. Patty Murray, D-Wash., is expected to announce legislation next week aimed at increasing the focus on female veterans at Department of Veterans Affairs facilities.

Since the wars in Iraq and Afghanistan began, Murray has spent many hearings questioning VA officials about female veterans with histories of sexual trauma, whether research has been done to determine their health needs and whether VA hospitals are so focused on men’s health issues that women get left behind.

Though VA officials say they are conducting a survey on women’s experiences at their facilities, as well as offering programs specifically for women, proponents of the proposed bill say it would target areas VA has not addressed. It follows a similar House bill proposed by Stephanie Herseth Sandlin, D-S.D., and Ginny Brown-Waite, R-Fla.

Murray’s bill will ask for:

* Assessment and treatment of women who have suffered sexual trauma in the military.

* More use of evidence-based treatment for women — particularly in areas such as post-traumatic stress disorder, where responses may be different or involve different issues than it does for men.

* A long-term study on gender-specific health issues of female veterans.

“One of the things we started to see early on is that there’s a lot we don’t know,” said Joy Ilem, assistant national legislative director for Disabled American Veterans.

Ilem said she uses the Washington, D.C., VA hospital herself and called the care “top-notch.” But she’s worried that as more female veterans enter the VA system, it will be hard to “ramp up” to their needs if VA doesn’t figure out what those needs are early. Also, only 5 percent of the people who use VA’s health care system are women.

Ilem said more research must be done to look into female veterans’ physical and mental health issues, especially those associated with women returning from combat zones.

She said the legislation will call for a copy of the VA’s ongoing study of women’s issues; an outside, independent review of women’s programs; an Institute of Medicine study of female vets’ health issues; and a certification program for clinicians working with victims — male and female — of sexual trauma.

As many as 19 percent of female combat veterans say they have been sexually assaulted, which may put them at higher risk for PTSD.

Plenty of good, evidence-based treatments are available now for women, “but they don’t always make it out to the field,” Ilem said.

Female veterans also face different issues when they return home from combat, Ilem said. Often, they serve as primary caregivers to their children or are expected to fall back into the role of a wife without any time to readjust. For that reason, the legislation will call for women’s retreats for female veterans that could help them reconnect with their husbands and children, as well as learn about VA benefits.

And, as primary caregivers, it may be more difficult for them to make it to VA facilities for health care, so the legislation will call calls for childcare services.

It also asks that Women Veterans Coordinator at VA hospitals be full-time positions without additional duties.

“I think it will be very helpful if we can get this moving” in Congress, Ilem said.

March 1, 2008 – Virginia officials are preparing for a sharp increase in requests for community mental health services from troops returning from Iraq and Afghanistan, and they are concerned that the system will be overwhelmed.

Mental health experts and officials said they are seeing a growing number of recently returned military personnel with post-traumatic stress disorder, depression and other ailments seeking services from behavioral health clinics.

But with a waiting list of about 5,700 for community mental health services, many officials are concerned that the state will not be able to adequately serve the veterans and family members going to these clinics, operated by what are known as community services boards.

State officials said they are preparing for a 15 percent increase over the next decade in people seeking services from the state’s mental health network, especially in emergency situations. That does not include family members who might need counseling. The issue is of particular concern in Virginia because the state has the third highest number of military service members in the country, behind California and Texas.

“This is a population that we’re going to have to think about for some time,” said James Reinhard, commissioner of the state Department of Mental Health, Mental Retardation and Substance Abuse Services. “We’re concerned and believe that [the population] is going to clearly have an impact on our services.”

Paul, a reservist with the 890th Transportation Company, said the flashbacks and nightmares started a month after he returned from Iraq’s Sunni Triangle. Violent images woke him at night and sometimes jolted him during the day. He knew he needed help.

There was a veterans hospital outside of Roanoke, 100 miles from his Shenandoah Valley home, but he had heard stories of long waits and lots of paperwork. He was given the number of a mental health clinic a short drive from his home, so he showed up one afternoon.

“The only thing I could think about was getting to someone close and fast because I was in such pain,” said the 39-year old reservist, who asked that his last name not be used to spare his family media attention. He receives weekly treatment at a Charlottesville clinic that serves veterans. He said he has continued to go to the clinic because, during a long stretch last year, he had difficulty accessing his military insurance coverage.

“I didn’t think about anything else” but getting help, he said.

Veterans who serve less than 20 years, including those who served in the reserves and National Guard, are eligible for mental health care after discharge through the Veterans Affairs Department’s system of hospitals, clinics and drop-in centers. Because of recent changes by Congress, combat veterans are guaranteed mental health evaluations within 30 days of a request, and the period during which they may seek care from the VA has been increased from two to five years.

But Virginia officials said there are signs that many returning soldiers and their families are not accessing services immediately after discharge, and the delay can worsen their conditions. A national study released in November found that mental health problems showed up in higher levels in military screenings three to six months after returning from Iraq than in screenings done immediately upon returning home.

“We’re already seeing people come in, but I think, over time, this is just the beginning,” said Charles A. Hall, director of the Hampton-Newport News Community Services Board, which is near several military bases from which troops have been deployed to Iraq and Afghanistan. “We’ve had a few veterans who have come in two years after being home and say they’ve been struggling all that time and never went anywhere for help.”

In addition, mental health officials in Hampton Roads said they are treating dozens of active duty soldiers and family members who have quietly sought services away from the military’s programs.

The reasons veterans choose community services over military services vary. Some don’t want to be seen in VA facilities out of concern of being perceived as weak by their comrades. They see the community centers as more private. Others say it’s a matter of familiarity and convenience.

“The issue for me is that I wanted someone nearby . . . and I wasn’t trying to see the inside of a vet hospital, ” said Wesley Hull, 25, a Marine who served two tours in Iraq before returning home to Nelson County, just north of Charlottesville.

To address the issue, the state Senate and House of Delegates have passed legislation that could allocate up to $2 million a year for tracking the mental health needs of combat veterans who do not engage with the VA system or private health care. The bills are subject to revision and must be signed by Gov. Timothy M. Kaine (D). The state also is seeking grants from the federal government to help coordinate services between veteran’s hospitals and state mental health agencies.

The issue is not confined to Virginia. Several states, including Kentucky and Missouri, also have established programs to help returning veterans. “The VA isn’t the bad guy here, but they can’t be responsible for the mental health needs of all 1.7 million soldiers deployed,” said Pat Kerr, director of Operation Outreach for the Missouri Veterans Commission.

VA officials said they think they have the structure in place — 152 VA hospitals across the country and 740 mental health agencies they contract with — to meet the needs of returning veterans. Virginia has three VA hospitals and four counseling centers and contracts with 29 outpatient facilities across the state. But the officials acknowledge that there is more work to do.

“We know we have to make access easier in some areas,” said Ira Katz, head of the VA’s mental health services. “We’re not sure we know what the best mechanism is to do that yet. But the important thing is for the VA and mental health providers to work together in the community.”

February 28, 2008 – San Francisco, CA – U.S. veterans of the wars in Iraq and Afghanistan are planning to descend on Washington from Mar. 13-16 to testify about war crimes they committed or personally witnessed in those countries.

“The war in Iraq is not covered to its potential because of how dangerous it is for reporters to cover it,” said Liam Madden, a former Marine and member of the group Iraq Veterans Against the War. “That’s left a lot of misconceptions in the minds of the American public about what the true nature of military occupation looks like.”

Iraq Veterans Against the War argues that well-publicised incidents of U.S. brutality like the Abu Ghraib prison scandal and the massacre of an entire family of Iraqis in the town of Haditha are not the isolated incidents perpetrated by “a few bad apples”, as many politicians and military leaders have claimed. They are part of a pattern, the group says, of “an increasingly bloody occupation”.

“The problem that we face in Iraq is that policymakers in leadership have set a precedent of lawlessness where we don’t abide by the rule of law, we don’t respect international treaties, so when that atmosphere exists it lends itself to criminal activity,” argues former U.S. Army Sergeant Logan Laituri, who served a tour in Iraq from 2004 to 2005 before being discharged as a conscientious objector.

Laituri told IPS that precedent of lawlessness makes itself felt in the rules of engagement handed down by commanders to soldiers on the front lines. When he was stationed in Samarra, for example, he said one of his fellow soldiers shot an unarmed man while he walked down the street.

“The problem is that that soldier was not committing a crime as you might call it because the rules of engagement were very clear that no one was supposed to be walking down the street,” he said. “But I have a problem with that. You can’t tell a family to leave everything they know so you can bomb the shit out of their house or their city. So while he definitely has protection under the law, I don’t think that legitimates that type of violence.”

Iraq Veterans Against the War is calling the gathering “Winter Soldier,” after a quote from the U.S. revolutionary Thomas Paine, who wrote in 1776: “These are the times that try men’s souls. The summer soldier and sunshine patriot will, in this crisis, shrink from the service of his country; but he that stands it now, deserves the love and thanks of man and woman.”

Organisers say video and photographic evidence will also be presented, and the testimony and panels will be broadcast live on Satellite TV and streaming video on ivaw.org.

Winter Soldier is modeled on a similar event held by Vietnam Veterans 37 years ago.

In 1971, over 100 members of Vietnam Veterans Against the War gathered in Detroit to share their stories with fellow citizens. Atrocities like the My Lai massacre had ignited popular opposition to the war, but political and military leaders insisted that such crimes were isolated exceptions.

“Initially even the My Lai massacre was denied,” notes Gerald Nicosia, whose book “Home to War” provides the most exhaustive history of the Vietnam veterans’ movement.

“The U.S. military has traditionally denied these accusations based on the fact that ‘this is a crazy soldier’ or ‘this is a malcontent’ — that you can’t trust this person. And that is the reason that Vietnam Veterans Against the War did this unified presentation in Detriot in 1971.”

“They brought together their bona fides and wore their medals and showed it was more than one or two or three malcontents. It was medal-winning, honored soldiers — veterans in a group verifying what each other said to try to convince people that these charges cannot be denied. That people are doing these things as a matter of policy.”

Nicosia says the 1971 Winter Soldier was roundly ignored by the mainstream media, but that it made an indelible imprint on those who were there.

Among those in attendance was 27-year-old Navy Lieutenant John Kerry, who had served on a Swift Boat in Vietnam. Three months after the hearings, Nicosia notes, Kerry took his case to Congress and spoke before a jammed Senate Foreign Relations Committee. Television cameras lined the walls, and veterans packed the seats.

“Many very highly decorated veterans testified to war crimes committed in Southeast Asia,” Kerry told the committee, describing the events of the Winter Soldier gathering.

“It is impossible to describe to you exactly what did happen in Detroit — the emotions in the room, and the feelings of the men who were reliving their experiences in Vietnam. They relived the absolute horror of what this country, in a sense, made them do.”

In one of the most famous antiwar speeches of the era, Kerry concluded: “Someone has to die so that President Nixon won’t be — and these are his words — ‘the first president to lose a war’. We are asking Americans to think about that, because how do you ask a man to be the last man to die in Vietnam? How do you ask a man to be the last man to die for a mistake?”

Nicosia says U.S. citizens and veterans find themselves in a similar situation today.

“The majority of the American people are very dissatisfied with the Iraq war now and would be happy to get out of it. But Americans are bred deep into their psyches to think of America as a good country and, I think, much harder than just the hurdle of getting troops out of Iraq is to get Americans to realise the terrible things we do in the name of the United States.”

*Aaron Glantz has reported extensively from Iraq and on the treatment of U.S. soldiers when they return home. He is editor of the website www.warcomeshome.org and will be co-hosting Pacifica Radio’s live broadcast of the Winter Soldier hearings from Mar. 14-16.

February 27, 2008 – Washington, DC – An investigation into allegations the Marine Corps delayed sending blast-resistant trucks to Iraq also will examine whether the Marines were negligent in delivering a laser to divert drivers and people from checkpoints and convoys, according to a memo obtained by The Associated Press.

Marines on the front lines sought the tool, known as a Compact High Power Laser Dazzler, but stateside acquisition officials did not deliver it, a civilian Marine Corps official said. A less capable laser was eventually sent, but delays of nearly 18 months may have led to an untold number of Iraqi civilian casualties, according to allegations by the official, an internal critic whose claims are being investigated.

The deaths and injuries occurred when civilians mistaken as the enemy got too close to guarded areas and U.S. troops lacked a nondeadly way of forcing them away, according to the official. The Iraqi government has complained about such incidents in the past.

The dazzler emits a powerful stream of green light that stops or redirects oncoming traffic by temporarily impairing the driver’s vision. Without it, troops have to open fire when warning signals are ignored or not seen.

The Marine Corps has stressed that the allegations made by the official, Franz Gayl, reflect his personal views. Gayl’s conclusions stem from a series of case studies he was conducting for the Marine Corps plans, policies and operations department about the wartime acquisition system.

Gayl has been ordered to terminate the project, however, according to Adam Miles of the Government Accountability Project in Washington. Gayl filed for whistleblower protection last year.

The AP reported Monday that the Marine Corps had asked the Pentagon inspector general to look into Gayl’s charges that a nearly two-year lag in the fielding of mine-resistant, ambush-protected trucks (MRAPs) resulted in hundreds of Marines being killed or injured by roadside bombs.

A Feb. 20 memo from Gen. Robert Magnus, assistant commandant of the Marine Corps, to the Pentagon inspector general requests that the dazzler allegations also be investigated.

The memo, obtained Tuesday evening by AP, notes that a Naval Audit Service review of the system for rapidly shipping needed gear to be deployed was recently completed. The Marine Corps has said that audit found shortcomings and fixes are being made.

Gayl’s charges are related to “human interaction and motivation” within the acquisition system, Magnus said.

After the Naval Audit Service began its review, “allegations surfaced that the Marine Corps had not acted with alacrity in responding to the needs of deployed units, and specifically that mismanagement on the part of Marine officials cost Marine lives by not acquiring (MRAP) vehicles or laser dazzlers in a timely fashion,” Magnus wrote.

Lt. Gen. John Castellaw, the deputy commandant for programs and resources, told the AP on Wednesday that the Marine Corps’ top priority is to get the best gear to troops in combat as quickly as possible. The Marine leadership takes Gayl’s allegations seriously, he said.

“We want to know the truth,” Castellaw said, speaking ahead of a hearing on the Marine Corps’ budget for the fiscal year that begins Oct. 1.

“We will cooperate fully (and) openly,” Castellaw told members of the House Armed Services subcommittee on seapower and expeditionary forces when asked about the IG investigation.

Castellaw said he and Magnus have read Gayl’s studies “cover to cover.”

“The Marine Corps has not muzzled this individual,” Castellaw said.

Gayl is free to produce further studies, the general told the panel, but his work on the MRAP project has ended.

Also Wednesday, four senators called on Defense Secretary Robert Gates to open a wider investigation that examines the wartime procurement practices of all the military branches.

“It is difficult to reform while engaged in the fight, but we believe we must if we are going to win the fight,” wrote Sens. Joseph Biden, D-Del., Kit Bond, R-Mo., Jay Rockefeller, D-W.Va., and Ted Kennedy, D-Mass.

Gayl, a retired Marine officer, is the science and technology adviser to Lt. Gen. Richard Natonski, who heads the plans, policies and operations department.

Gayl completed a case study on the Compact High Power Laser Dazzler on Feb. 14. In it, he notes that Marines stationed in western Iraq filed an urgent request for the tool in June 2005. And he said that the 2005 request and subsequent calls for the dazzler were not met.

“The urgency of the operational need for dazzlers was not debatable, since the tragedies it was designed to mitigate had already been experienced,” Gayl wrote.

Marines in Iraq became so frustrated at the delays they bypassed normal acquisition procedures and used money from their own budget to buy 28 of the dazzlers directly from LE Systems, a small company in Hartford, Conn., according to Gayl. The dazzlers cost about $8,000 each.

But because the lasers had not passed a safety review process, stateside authorities barred the Marines from using them, his report states. There were also questions raised about whether the LE Systems could build sufficient numbers of the dazzlers. LE Systems has said it could meet the demand.

In January 2007, nearly 18 months after the first request, Gayl said the Marines received a less capable laser warning device built by a different company, B.E. Meyers of Redmond, Wash.

Gen. James Conway, the Marine Corps commandant, told members of Congress in July 2007 that a “great deal of effort was made” to meet the specific request for the dazzler from LE Systems. The B.E. Meyers laser, he added, has been well received by troops in Iraq.

As for the blast-resistant trucks, Gayl’s Jan. 22 report on the MRAP accused the Marine Corps of “gross mismanagement.” Cost was a driving factor in the decision to turn down a February 2005 “urgent” request from battlefield commanders for the so-called MRAPs, he said. Depending on the size of the vehicle and how it is equipped, the trucks can cost between $450,000 and $1 million.

Senior Marine Corps officers have said the defense industry lacked the capacity to build MRAPs in large numbers when the 2005 request was made. The best answer to the deadly roadside bombs planted by insurgents was to produce more heavily armored Humvees, they said.

Lt. Gen. James Amos, head of the Marine Corps Combat Development Command at Quantico, Va., said young Marines in Iraq had more confidence in the bolstered Humvee, known as the M1114, than any other vehicle.

“There was not one word spoken. Not a backward glance. Not a raised eyebrow for any other reason,” Amos said of a meeting of Marine generals in 2005 when the decision was made. “The threat dictated at that time that we buy the (M1114).”

When it became clear that a heavier vehicle was needed to deal with increasingly powerful bombs, the Marines pursued the MRAP.

The Humvee is smaller and lacks the MRAP’s special V-shaped hull, which deflects a blast out and away from the vehicle. MRAPs also ride three feet off the ground, allowing more room for the explosion to dissipate.

February 26, 2008 – VA Disability Rating System in Need of Comprehensive and Immediate Repair House Veterans’ Affairs Subcommittee Holds Third Hearing in a Series to Address Necessary Improvements to the VA’s Claims Processing System

Washington, D.C. – On Tuesday, the House Veterans’ Affairs Disability Assistance and Memorial Affairs Subcommittee, led by Chairman John Hall (D-NY), conducted the third in a series of hearings on the benefits claims backlog at the Department of Veterans Affairs (VA). The hearing examined the issues surrounding the VA Schedule for Rating Disabilities (VARSD), which is used to determine compensation for veterans who experienced injuries and disabilities as a result of their military service.

The basis for the current VARSD has not been significantly updated since its development in 1945. Ratings range from 0 to 100 percent and are in increments of 10. The VASRD is divided into fourteen body systems, which incorporate approximately 700 codes that describe illness or injury symptoms and levels of severity. The VA uses a completely different system for rating disabilities than standard diagnostic codes and tools that are currently used by non-military governmental agencies, private sector disability plans, and medical providers. The VARSD, however, is not only used by the VA to determine a veteran’s disability benefits, but also by the Department of Defense (DoD) to determine whether a service member is fit or unfit to perform their military duties.

“Our nation’s service members and disabled veterans deserve to have a system that is based on the most available and relevant medical knowledge,” said Chairman Hall. “It is imperative that out-of-date and archaic criteria are replaced with current medical and psychiatric evaluation instruments for determining and understanding disabilities. The current system is simply not in sync with modern disability concepts.”

Panel discussions focused on a series of recent studies that have been conducted examining various aspects of the VA disability claims rating system, including the comprehensive report from the Veterans’ Disability Benefits Commission, a study on post-traumatic stress disorder from the Institute of Medicine, and research from the Center for Naval Analyses Corporation on compensation for loss of average earning and degradation of quality of life resulting from service-connected disabilities. A second panel comprised of representatives from the medical community provided testimony on standards and guides published by the American Medical and Psychiatric Associations and used by states and the private sector to evaluate levels of impairment and determine compensation. They advocated for VA to apply those same models and internationally recognized tools in evaluating veterans for disability.

Recommendations to improve the VASRD included updating and modernizing the ratings schedule, implementing technology to evaluate disabilities, and including criteria for quality of life loss issues that arise with experiencing disability. It was also recommended that VA raters use vocational assessments, not simply medical evaluations, when granting Individual Unemployability (IU) benefits to those unable to work due to their service-connected disabilities. Panelists proposed improving criteria for traumatic brain injury and expanding criteria for psychiatric disabilities including post-traumatic stress disorder.

“We must learn the lessons of past wars and prepare for the long-term health implications faced by current service members and veterans of today’s and yesterday’s wars,” stated Bob Filner (D-CA), Chairman of the House Committee on Veterans’ Affairs. “We can never adequately repay our veterans for their service and sacrifice, but we owe them our best efforts to provide for their future needs – and we must do better.”

Witness testimony also focused on how best to approach presumptive decisions for veterans who experience health conditions that arise long after completion of military service when specific evidence is unavailable or incomplete. The Institute of Medicine issued a report that called for a more evidentiary based approach to evaluating presumptive conditions. However, Ronald Abrams, Joint Executive Director of the National Veterans Legal Service Program responded, “Any move away from the ‘benefit of the doubt’ standard would have a negative impact on all veterans. If we send our troops into dangerous places, and if we put our service members into dangerous situations, our nation must make certain to at least maintain the non adversarial nature of the VA claims process and protect the ‘benefit of the doubt’ standard. The cost of compensating veterans who suffer from disabilities that are presumptive in nature is a cost of war.”

Brad Mayes, Director of the VA Compensation and Pension Service, provided testimony on a VA plan to improve the current rating schedule and compensate for quality of life losses, which should be completed by August 2008.
“I know there is a lot to be done to improve the VA claims processing system, but after review of the Rating Schedule, it seems that the centerpiece is in need of immediate comprehensive repair,” concluded Chairman Hall. “VA needs the correct tools to do the right thing, so our nation’s disabled veterans get the right assistance.”

Witnesses:

Panel 1
* Dennis Vincent McGinn, VADM, USN (RET.), Member, Veterans’ Disability Benefits Commission
* Lonnie Bristow, MD, Chair, Committee on Medical Evaluation of Veterans for Disability Compensation, Institute of Medicine
* Dean Kilpatrick, PhD, Member, Committee on Veterans’ Compensation for Posttraumatic Stress Disorder, Institute of Medicine
* Jonathan Samet, MD, Chair, Committee on Evaluation of the Presumptive Disability, Decision-Making Process for Veterans, Institute of Medicine
* Joyce McMahon, PhD, Health Care Operations and Policy Research Center, Center for Naval Analyses Corporation

Panel 2
* Mark Hyman, MD, American Academy of Disability Evaluating Physicians
* Sidney Weissman, MD, Member, American Psychiatric Association
* Ronald Abrams, Joint Executive Director, National Veterans Legal Service Program

Panel 3
* Dean Stoline, Assistant Director, National Legislative Commission, The American Legion
* Kerry Baker, Associate National Legislative Director, Disabled American Veterans
* Gerald T. Manar, Deputy Director, National Veterans Service, Veterans of Foreign Wars

Panel 4
* Brad Mayes, Director, Compensation and Pension Service, Veterans Benefits Administration, U.S. Department of Veterans Affairs
Accompanied by Tom Pamprin, Deputy Director for Policy and Procedures, Veterans Benefits Administration, U.S. Department of Veterans Affairs, Steven H. Brown, MD, MS, Director, Compensation and Pension Exam Program (CPEP), Veterans Health Administration, U.S. Department of Veterans Affairs, Patrick Joyce, MD, Chief Occupational Health Clinic, Veterans Health Administration, U.S. Department of Veterans Affairs, Richard Hipolit, Assistant General Counsel, U.S. Department of Veterans Affairs

* Joseph Kelley, MD, Deputy Assistant Secretary of Defense for Clinical and Program Policy (Health Affairs), U.S. Department of Defense
Accompanied by Horace Carson, MD, Senior Medical Advisor, Air Force Review Boards Agency, (SAF/MRB), U.S. Department of Defense

Prepared testimony for the hearing and an audio recording of the hearing is available on the internet at this link: http://veterans.house.gov/hearings/hearing.aspx?newsid=197.

February 26, 2008 – Imagine you are a young soldier wounded in Iraq. Your physical injuries heal, but your mind remains tormented. You are flooded with memories of the bloody firefight you survived, you can’t concentrate, and sudden noise makes you jump out of your skin. At 23 years old, you are about to be discharged from the military, afraid you’ll never again be able to hold a job or fully function in society.

For the thousands of young men and women who apply for disability benefits upon return from Iraq and Afghanistan, these fears are becoming a reality.

When a veteran files a psychiatric disability claim with the Department of Veterans Affairs (VA), an examiner is assigned to determine the extent of incapacitation. As part of the assessment, the examiner requests a psychiatric evaluation to obtain the veteran’s diagnosis. Once the veteran is diagnosed with a service-related mental condition (typically depression, post-traumatic stress disorder or another anxiety disorder) the claims examiner assigns a disability rating.

The most severe level for a veteran leaving service is 100{cd9ac3671b356cd86fdb96f1eda7eb3bb1367f54cff58cc36abbd73c33c82e1d}. But even a 50{cd9ac3671b356cd86fdb96f1eda7eb3bb1367f54cff58cc36abbd73c33c82e1d} rating denotes significant impairment (e.g., “difficulty in understanding complex commands”), according to the Veterans Benefits Administration.

Remarkably, something essential is missing from the claims process: treatment. Veterans can go straight to a claims examiner and be granted psychiatric benefits without ever being treated for their mental illness. Some even do so as soldiers, just prior to discharge from the service. Judging an individual to be doomed to a life of invalidism before he has even had a course of therapy and rehabilitation is drastically premature, even reckless.

In the short term, yes, a monthly check of about $2,500 for full disability, tax-free, is a great relief to the struggling veteran and his family. But serious consequences can accompany a rush to judgment about a veteran’s rehabilitative potential.

First, a veteran told he is disabled may think: Why bother with treatment? But this would be a terrible mistake. The postdischarge period is when symptoms are most responsive to interventions such as behavioral techniques, medication, psychotherapy, family counseling or a combination. And full disability status may actually undermine the possibility of recovery. A veteran who thinks of himself as beyond recovery — the message carried by a high disability rating — risks fulfilling that prophecy.

By abandoning work, the veteran deprives himself of its therapeutic value: a sense of purpose, distraction from depressive rumination, a structure to each day, and the opportunity for friendships. The longer he sits at home, the more his confidence in his abilities erodes and his skills atrophy.

Last year the Government Accountability Office, the President’s Commission on Care for America’s Returning Wounded Warriors, and the Veterans’ Disability Benefits Commission all urged that the disability, compensation and rehabilitation benefits systems be reformed and updated. And last month, Sen. Richard Burr (R., N.C.), ranking member of the Senate Veterans’ Affairs Committee, introduced the Veterans’ Mental Health Treatment First Act.

The purpose of this bill is to induce new veterans to embark upon a path to recovery. Any veteran diagnosed with major depression, post-traumatic stress disorder or other anxiety disorder stemming from military activity would be eligible for a new program that provides a financial incentive of $11,000 distributed over the course of a year (or completion of recommended treatment, whichever comes first).

The compensation is offered in exchange for two commitments. First, the veteran must adhere to an individualized course of treatment. Second, he must agree to a pause in claims action for at least a year or until completion of treatment, whichever comes first. Should he fail to improve — and, sadly, this will happen to some — the veteran remains eligible for 100{cd9ac3671b356cd86fdb96f1eda7eb3bb1367f54cff58cc36abbd73c33c82e1d} long-term disability.

The great virtue of the Treatment First Bill is that it offers an opportunity to receive payment as a condition of trying to get better. Mr. Burr calls it a “wellness stipend” to distinguish it from a “disability benefit.” As it stands now, the only way a veteran can receive payment is to be disabled.

There are practical considerations, of course. For example, is $11,000 enough? For patients needing intensive treatment and still too fragile to work, the stipend falls short as income replacement. The constant stress of financial insecurity will not only impede the veteran’s clinical progress, it makes the formal disability option — the very alternative that Treatment First seeks to avert — look very attractive.

Nonetheless, the proposal delivers a bracing dose of clinical wisdom. Imagine giving young men and women permission to surrender to their psychological wounds without first urging them to pursue recovery. For many young veterans, a “treatment first” approach could be their road to recovery and a rich civilian life.

On February 14, 2008, Veterans for Common Sense testified before Congress and demanded accountability for VA’s catastrophic inability to provide timely and accurate claims decisions to disabled veterans.   VCS specifically called for the removal of Daniel Cooper, VA’s Under Secretary for Benefits, as the top person responsible for VA’s claims fiasco.  

On February 28, 2008, Cooper unexpectedly resigned.  VCS wishes him well.

In light of Cooper’s decision to cut and run, VCS believes today presents a rare opportunity for President George W. Bush to appoint an aggressive veterans’ advocate to overhaul VA’s broken and obsolete claims system.   Now is the right time for Congress to implement the sound and reasonable recommendations made by the Veterans Disability Benefits Commission.

COOPER AND NICHOLSON – A TRAGIC LEGACY OF FAILURE 

Not only is massive reform vital, so, too, is a history lesson in how the wheels came off at VBA.  Here is a chronology showing how Daniel Cooper was fully aware of VBA’s claims crisis well before he became Under Secretary.  However, Cooper failed to use this knowledge and deliver for veterans, even after six years as the top VA official responsible for disability compensation claims:

 • In early 2001, then-Secretary Anthony Principi recognized challenges at VBA, and he created the “Claims Processing Task Force,” naming Cooper to lead it, even though he had no experience with VA.  Cooper was a retired Navy Vice Admiral who served on the board of directors for Exelon, a nuclear power company, and USAA, an insurance and banking company.

 • In October 2001, Cooper issued his Task Force report, which made dozens of thoughtful incremental recommendations, including holding VBA employees accountable.  In November 2001, the full House Veterans’ Affairs Committee held a hearing to discuss the work of the Task Force.  After 9/11 and after the invasion of Afghanistan, Cooper told the full Committee, “In my opinion, today, there are enough resources in VBA to do the job that has to be done,” a disturbing mantra repeated until the Walter Reed scandal blew the cover the shabby way this Administration treats our veterans.

 • In December 2001, with more troops pouring into Afghanistan and with plans on the table to invade Iraq, Cooper provided additional written answers to the questions from Congress about VA staffing resources.  Cooper wrote, “At the hearing, I specifically stated that new resources (i.e., FTE) should not be provided.”  Given that there were hundreds of thousands of claims from half of our Gulf War veterans, everyone wants to know why did Cooper not plan for nor act on the needs of a new generation of war veterans when he became Under Secretary in 2002?

This disgraceful pattern of under staffing and under funding VA continued from 2001 through 2008.

 •  In February 2007, former VA Secretary Jim Nicholson told Congress, “The President’s 2008 budget request provides the resources necessary to ensure that service members’ transition from active duty military status to civilian life continues to be as smooth and seamless as possible.”  Nicholson, who relied on Cooper to run VA’s benefits programs, told Congress, “We expect to improve the timeliness of processing these claims to 145 days in 2008…. In addition, we anticipate that our pending inventory of disability claims will fall to about 330,000 by the end of 2008…”

 • In VA’s press release dated February 4, 2008, VA once again promised to cut the backlog to 300,000 claims and process claims in an average of 145 days. However, VA’s most recent reports confirm the claims backlog of unfinished work stands at more than 400,000, and veterans wait an average of 183 days.  Cooper and Nicholson were repeatedly and catastrophically wrong, and our veterans and their families paid a very steep price. 

COOPER’S EXIT LONG PAST DUE 

Veterans for Common Sense believes Under Secretary Daniel Cooper’s departure was long overdue, just as Nicholson’s was.  Cooper’s tenure was identical to disgraced former VA Secretary Jim Nicholson: both were incompetent and forced out of office because they failed to provide timely and quality assistance to our nation’s veterans.  Their failures reflect on the string of poor choices made by President George W. Bush, who appointed unqualified VA leaders and who chronically under funded VA for years.

In 2006, as the VA claims crisis worsened, Cooper and Nicholson quietly handed out millions of dollars in cash bonuses, up to $33,000 in some cases, to top VA executives – during a time when more and more veterans waited longer and longer for VA benefits.  That’s right, while veterans couldn’t feed their families and pay their bills due to disabilities, top VA executives got huge cash rewards.  A reasonble person would conclude VA leaders were rewarded for failure.  The bonuses should have gone to hard-working and over-burdened claims processors and other VA staff.  Or the bonus cash could have been used to hire more employees.

In another strike against Cooper, in 2007, Veterans for Common Sense and the Military Religious Freedom Foundation filed an ethics complaint about Cooper because he appeared on a video, using his name and government title, to raise money and promote his personal views of religion, which violates our Consitution.

As reported by Aaron Glantz at Inter Press Service, “Cooper has been under fire for using his office to proselytise for evangelical Christianity ever since he appeared in a 2004 fundraising video for Christian Embassy, which carries out missionary work among the Washington elite as part of the Campus Crusade for Christ.  In the video, Cooper says of his Bible study, ‘It’s not really about carving out time, it really is a matter of saying what is important. And since that’s more important than doing the job — the job’s going to be there, whether I’m there or not.'” 

STARK LESSONS 

The lessons from the Nicholson and Cooper resignations are stark and tragic: the Bush Administration failed to monitor and then to plan for the massive tidal wave of hundreds of thousands of unexpected patients and disability claims as a result of the Iraq War fiasco.   The end result of Cooper’s and Nicholson’s catastrophic failure is that 400,000 veterans wait an average of more than six months for a VA disability claim decision.

No veteran should ever have to wait more than 30 days for a VA decision.  We must put veterans first.  As World War II General Omar Bradley said while leading VA, “We are dealing with veterans, not procedures – with their problems, not ours.” 

VCS believes Cooper’s departure represents an opportunity for the President and Congress to honor our nation’s commitment to those who protect and defend our Constitution.  It is also an opportunity to let more than 200,000 hard-working dedicated VA employees know that desperatey needed help is on the way.

The future looks tough.  VA is expected to spend up to $700 billion dollars providing disability payments and healthcare to 700,000 or more Iraq and Afghanistan war veterans over the next 40 years, according to a Harvard University report. 

In 2009, VA expects to treat 333,000 – yes, a third of a million – Iraq and Afghanistan war veteran patients.  Older veterans continue pouring into VA as our domestic economy worsens.  Plus hundreds of thousands of Vietnam War veterans are flooding into an already overburdened VA with PTSD and serious illnesses related to Agent Orange dioxin poisoning.

WHAT NEXT?

These facts present President Bush and Congress with two simple choices for VA:

 • They can either ignore VA’s claims crisis and the urgent need for substantial overhaul, and then watch helplessly as hundreds of thousands more veterans slip through the cracks into despair.

 • Or, they can name an aggressive veterans’ advocate who will reform and modernize VA’s broken and obsolete claims system following the recommendations of the Veterans Disability Benefits Commission, VA union employees, veterans’ groups, and veterans’ advocates.

One of the first reforms that would have an immediate impact is automatically approving Iraq and Afghanistan war veterans’ claims for traumatic brain injury (TBI) and post traumatic stress disorder (PTSD), as VCS recommended in our Congressional testimony in July 2007 and again this month.  Real reform begins by listening to the veterans forced to wait and the veterans living on meager benefits, veterans so far ignored by this Administration.  Real reform means listening to VA rank-and-file employees with experience and ideas who were ignored for the past seven years.

With 11 months remaining in Bush’s lame duck term, now is the right time for VA reform.  Let’s hope the President finally fights for veterans by naming a high-quality replacement for Cooper and by treating VA’s fiasco with the urgency it deserves.