Veterans for Common Sense

Trauma Disorder Claims at New High

June 20, 2006 — More than 30 years after their war ended, thousands of Vietnam veterans are seeking help for post-traumatic stress disorder, and experts say one reason appears to be harrowing images of combat in Iraq.

Figures from the Department of Veterans Affairs show that PTSD disability-compensation cases have nearly doubled since 2000, to an all-time high of more than 260,000. The biggest bulge has come since 2003, when war started in Iraq.

Experts say that, although several factors may be at work in the burgeoning caseload, many veterans of past wars reexperience their own trauma as they watch televised images of U.S. troops in combat and read each new accounting of the dead.

“It so directly parallels what happened to Vietnam veterans,” said Raymond M. Scurfield of the University of Southern Mississippi’s Gulf Coast campus, who worked with the disorder at VA for more than 20 years and has written two books on the subject. “The war has to be triggering their issues. They’re almost the same issues.”

At VA, officials said the Iraq war is probably a contributing factor in the rise in cases, although they said they have conducted no formal studies.

PTSD researcher John P. Wilson, who oversaw a small recent survey of 70 veterans — nearly all from Vietnam — at Cleveland State University, said 57 percent reported flashbacks after watching reports about the war on television, and almost 46 percent said their sleep was disrupted. Nearly 44 percent said they had fallen into a depression since the war began, and nearly 30 percent said they had sought counseling since combat started in Iraq.

“Clearly the current Iraq war, and their exposure to it, created significantly increased distress for them,” said Wilson, who has done extensive research on Vietnam veterans since the 1970s. “We found very high levels of intensification of their symptoms. . . . It’s like a fever that has gone from 99 to 104.”

Vietnam veterans are the vast majority of VA’s PTSD disability cases — more than 73 percent. Veterans of more recent wars — Iraq, Afghanistan and the 1991 Persian Gulf War — together made up less than 8 percent in 2005.

VA officials said other reasons for the surge in cases may include a lessening of the stigma associated with PTSD and the aging of the Vietnam generation — explanations that veterans groups also suggest.

PTSD is better understood than it once was, said Paul Sullivan, director of programs for the group Veterans for America. “The veterans are more willing to accept a diagnosis of PTSD,” he said, “and the VA is more willing to make it.”

In addition, as Vietnam veterans near retirement age, “they have more time to think, instead of focusing on making a living all the time, and for some this is not necessarily a good thing,” said Rick Weidman, executive director for policy and government affairs at Vietnam Veterans of America.

Max Cleland, a former U.S. senator from Georgia and onetime head of the VA who was left a triple amputee by the Vietnam War, said the convergence of age and the Iraq war has created problems for many of his fellow veterans — as well as for himself.

“As we Vietnam veterans get older, we are more vulnerable,” he said. When the war started in 2003, he said, “it was like going back in time — it was like 1968 again.”

Now he goes for therapy at Walter Reed Army Medical Center and is wary of news from Iraq. “I don’t read a newspaper,” he said. “I don’t watch television. It’s all a trigger. . . . This war has triggered me, and it has triggered Vietnam veterans all over America.”

PTSD has become a volatile topic lately, with some skeptics questioning whether the rise in claims is driven by overdiagnosis or by financial motives. A report last week from the Institute of Medicine, part of the National Academies, concluded that “PTSD is a well characterized medical disorder” for which “all veterans deployed to a war zone are at risk.”

VA’s growing PTSD caseload became an issue last August, when the agency announced a new review of 72,000 PTSD compensation cases, expressing concerns about errors and a lack of evidence. That probe was dropped after a sample of 2,100 cases turned up no instances of fraud.

Still, some experts are not convinced that the Iraq war has driven up the caseload. “I’m skeptical that it accounts for a broad swath of this phenomenon,” said psychiatrist Sally Satel, a resident scholar at the American Enterprise Institute. “These men have had deaths in their families, they had all kinds of tragedies over 30 years that surely affected them emotionally but they coped with.”

Although a small percentage of veterans might be deeply affected, she said, she doubts “they have become chronically disabled because of it.”

Around the country, many veterans dwell on the similarities between the wars in Vietnam and Iraq: guerrilla tactics, deadly explosives, fallen comrades, divisive politics. The way they see it, “Iraq is Vietnam without water,” Weidman said.

“We have people who have symptoms that they haven’t had in a long time,” said Randy Barnes, 65, who works in the Kansas City offices of Vietnam Veterans of America. For some, “the nightmares and flashbacks have been very hard to deal with,” he said. Group therapy sessions are “much more crowded,” he said, “with Vietnam veterans particularly, but now also with the Iraq and Afghanistan veterans.”

Barnes served as a combat medic in Vietnam from 1968 to 1969 and went into treatment only in the late 1990s. By the time the Iraq war started, he said, he felt steadier — but then his symptoms ramped up again.

“Depending on what I saw or heard that day or read, I would have night problems — nightmares, night sweats,” he said. Sometimes, he said, he would roll out of bed and wake up crawling on the floor, “seeking safety, I guess.”

A study published in February by VA experts showed that veterans under VA care experienced notable mental distress after the war started and as it intensified. While younger veterans, ages 18 to 44, showed the greatest reactions to the war, “Vietnam era VA patients reported particularly high levels” of distress consistently, the study reported.

Powerful images of war have revived combat trauma in the past. “Traumatized people overreact to things that remind them of their original trauma,” said Scurfield, the PTSD expert in Mississippi.

When the movie “Saving Private Ryan” was released, World War II veterans sought mental health help in great numbers, said Wilson of Cleveland State. “It rekindled it all,” he said.

May 19, 2007 – Should veterans enjoy the same legal rights as Social Security claimants, or even undocumented workers?

This question was addressed by the Veterans Benefits, Health Care and Information Technology Improvement Act of 2006 (Public Law No. 109-461), discussed in the excellent May 13 article “Law that opens door for lawyers divides veterans.”

The constraint on legal representation for veterans dates back to the Civil War. In 1862, Congress enacted a statute imposing a $5 limit — two years later doubled to $10 — on fees to attorneys or other agents assisting veterans in applying for pensions, allowances and other benefits.

In 1988, Congress recognized that the cap was ana- chronistic and eliminated it. The same statute, however, prohibited veterans from retaining a lawyer prior to completion of a complex Department of Veterans Affairs administrative process culminating in a final decision by the Board of Veterans’ Appeals. Many a viable case is lost long before that stage.

Veterans’ service organizations — most notably the Disabled American Veterans and Veterans of Foreign Wars — are doing an excellent job representing claimants. But their resources are limited, and the annual number of VA claims has risen to around 800,000, with a backlog of approximately 400,000. The VA itself has a small army of lawyers to keep up, but claims will surge with increasing numbers of Iraq war veterans.

Veterans are still not entitled to legal representation from the outset, but only following their first adverse ruling (filing of a “notice of disagreement”).

The ultimate issue is freedom of choice. The decision on representation by counsel in a particular case should reside with the claimant, and veterans should not be precluded by the government from enjoying the same rights as others in this regard.

Jan Schneider
Attorney

Harold Schneider
World War II veteran and Jan Schneider’s father. They reside in Sarasota.

May 18, 2007 – A freshman congressman is trying to keep a veterans hospital open by arguing that its placid grounds can provide the perfect setting for treating soldiers with post-traumatic stress disorder.

The Veterans Administration is considering closing the 115-acre Livermore VA Medical Center campus, which includes a hospital and nursing home, as well as an outpatient clinic called French Camp.

It is also weighing an expansion of the facility, and a decision by agency Secretary Jim Nicholson is expected by late spring or early summer.

Rep. Jerry McNerney, D-Calif., pressed Nicholson on the subject in a letter sent Thursday.

McNerney said he believes a decision to shutter the facility is “imminent,” based on his conversations with patients who have been directed toward other VA clinics.

“I believe one of the ways we can meet the needs of our veterans is to maintain and perhaps expand services offered at the Livermore VAMC,” McNerney wrote.

“With the creation of a new generation of veterans increasingly afflicted with post-traumatic stress disorder, I believe we must not only maintain services at the Livermore VAMC and French Camp Outpatient Clinic, but also expand the services offered to meet the need for PTSD-specific treatment,” he wrote.

“The Livermore facility, with its tranquil and relaxing setting, provides the perfect location for the type of treatment PTSD sufferers require,” he said.

Earlier this month, a panel of medical experts reported a surge in the number of veterans suffering post-traumatic stress disorder. Claims increased from 120,265 in 1999 to 215,871 in 2004 and payments jumped from $1.72 billion to $4.28 billion in the same period, a combined committee from the Institute of Medicine and National Research Council said.

The largest share of claims is still coming from Vietnam War veterans, but there are expected to be many more claims in the future from personnel who served in the first Gulf War and in the current conflicts in Iraq and Afghanistan, the panel said.

PTSD is an anxiety disorder some people develop as a result of experiencing or witnessing a traumatic event, such as military violence.

Kerri Childress, spokeswoman for the VA Palo Alto Health Care System which includes the Livermore campus, said there is no hard timeline for when Nicholson may make a decision.

VA spokeswoman Laurie Tranter said Friday she could not predict what Nicholson will do.

“The secretary is aware of the strong feelings regarding the Livermore campus and issues of access to long-term care and outpatient services,” Tranter said. The agency seeks “to ensure that all aspects of concern to veterans are considered prior to making a decision,” she said.

PALMYRA — Raymond Everlith Jr. served his country for 22 years and in two wars in the Middle East, but when it came time for him to get his teeth fixed, his nation demanded $250.

When he retired from the U.S. Army Reserves as a master sergeant last September, after serving in both the Gulf War and Operation Iraqi Freedom, Everlith believed the Veterans Administration would provide his health care for the rest of his life.

But when he went to the Togus VA Medical Center in Augusta on Wednesday to have repairs made on the false teeth that were wired in during his mobilization to Iraq four years ago, Everlith was shocked to learn that not only would the hospital not fix his teeth, but would provide no free health care of any kind.

“Everybody always tells you, if you ever have a problem, and you’re a veteran, just go to the VA,” Everlith said. “That’s all I’ve heard for 20 years. And the one time I need help, I go to the VA, and they say, ‘We can’t help you.’ “

Everlith, 40, would typically qualify for VA health benefits, said Rene Deschene, service officer for the Veterans of Foreign Wars of Maine. Soldiers who served 24 months of continuous active duty and meet certain financial criteria, and those who served in Iraq, are eligible for VA health care.

Soldiers returning from Iraq who have not served 24 months of continuous active duty, however, must sign up for health coverage within two years or returning to the United States to maintain the benefits.

“If they fail to sign up with the two years, they have to meet the 24 months continuous service and the means test,” Deschene said.

Everlith said he had never heard of the policy until Thursday.

“Nobody ever said a word to me about it,” Everlith said. “There was nothing set up for us. Nobody told me I needed to go anywhere or do anything. They put me on a plane, processed me and sent me home.”

Deschene said the situation is not common, but has been known to happen.

“If he wasn’t (told), whoever was in charge of that transportation unit wasn’t doing their job,” Deschene said.

Everlith’s experience is not unheard of, particularly among those who serve in the reserves, Deschene said. The National Guard, which has very local command, does a good job of informing troops of benefits and how to secure them, Deschene said. And those exiting the military from active duty are automatically processed for benefits upon their departure. But reservist soldiers can have commands in different states and be attached to nearly any unit. Everlith, for example, served with the 11th Bravo Infantry, but was activated to serve in Iraq with the 3rd Personnel Command out of Mississippi. Sometimes the information that is supposed to be given to soldiers gets lost in the shuffle, Deschene explained.

“The major command for reserves have got to step up and make sure their people get the briefing,” Deschene said.

Jim Doherty, staff assistant for the center director at Togus, said the VA is constantly doing outreach and meeting with returning soldiers to brief them on securing their benefits.

“I’m beating the bushes and trying to tell people, ‘You need to sign up,’ ” Doherty said.

Getting the information to reserve units is sometimes difficult, he said.

“We cannot get into a unit unless we’re invited in,” Doherty said. “Sometimes their next echelon is in another state. It’s harder to have that single point of contact.”

Doherty said he was unsure when the two-year sign-up policy began, but believes it was 2003. It is possible, Doherty agreed, that the policy had not yet been announced at the time Everlith left Iraq.

Regardless of why he never signed up for the benefits, Everlith’s inability to receive VA health benefits now is, at least in part, due to his good health. The only option Everlith now has to receive benefits is to connect his injury or malady to his time in the service. The only other way Everlith, who drives an oil truck for a living and does have health insurance through the company, could qualify for VA health benefits is if he falls into a certain income category, which currently is about $24,000 or less per year.

“He has to become service connected for something,” Deschene said. “That’s his only option.”

Even though Everlith’s teeth were repaired by the Army during his mobilization, because it was a preexisting condition he was forced to sign a paper promising to pay the bill in order to have VA personnel fix his teeth.

“Because I was able to do my job and come out unscathed after 22 years with no lingering effect, I’m on my own,” Everlith said.

His father, Raymond Everlith Sr. of Fairfield, who was permanently disabled by injuries he received during the Korean War, has relied on the VA to provide his health care for more than 50 years. He said he is incensed that his son is not allowed the same benefit.

“This is no way to treat a veteran,” Everlith Sr. said. “He’s not looking for sympathy. He just wants to get work done on his mouth.”

Everlith said he wonders how many other veterans are in his position — he would like to hear from those who are at olesoldier2003@yahoo.com. He said he is not angry at his inability to receive benefits, but he is disappointed.

A spokesman for U.S. Sen. Susan Collins, R-Maine, said Collins would look into Everlith’s case.

Everlith believes Congress should make VA health benefits for soldiers automatic after 20 years of service.

“To say, ‘Thanks for your service; you’re on your own now,’ which is what they told me (Wednesday), I was just shocked,” he said. “It’s just not right. The United States pays for health care for illegal immigrants, but they won’t pay for me. That’s the least they could do for somebody who gives 20 years for their country.”

Craig Crosby — 861-9253    ccrosby@centralmaine.com

May 18, 2007 – PHOENIX — Incensed by the sale of anti-war T-shirts and other paraphernalia emblazoned with the names and pictures of America’s military dead, some states are outlawing the commercial use of the fallen without the permission of their families.

Despite serious questions of constitutionality, Oklahoma and Louisiana enacted such laws last year, and the governors of Texas and Florida have legislation waiting on their desks. Arizona lawmakers are on the verge of approving a similar measure.

“You should have some rights to your own name and your own legacy, particularly if you’re a deceased veteran,” said state Sen. Jim Waring, a Republican who sponsored the Arizona bill. “Celebrities have that. Why shouldn’t our soldiers have that?”

The bills were prompted largely by pleas from military families upset that their loved ones’ names and photos were being used on phone cards, body armor and other products.

In many cases, the target of their ire is Dan Frazier, a Flagstaff man who sells T-shirts online that list the names of 3,155 U.S. military personnel killed in Iraq. The shirts bear slogans such as “Bush Lied – They Died” and “Support Our Remaining Troops – Bring the Rest Home Alive.”

Margy Bons, a Phoenix-area woman whose Marine reservist son, Sgt. Michael A. Marzano, was killed by an insurgent bomb in Iraq in 2005, said he believed in his mission.

“My son was not duped into going to war,” she said. “I’m angry that somebody can use somebody else’s name for their political beliefs without permission.”

Frazier, 41, said he will not retreat. “I’m providing a valuable service to people to help show the enormity of the cost of war,” he said.

Under the Arizona bill, violators could get up to six months in jail and fines of $2,500 for an individual and $20,000 for an enterprise. A spokeswoman for Gov. Janet Napolitano declined to say whether she would sign the bill if it reached her desk.

The Florida bill would impose a $1,000 penalty per violation for using a military member’s name or photo commercially without permission.

Law enforcement officials in Oklahoma and Louisiana said they were unaware of any prosecutions under their laws. But the Arizona legislation also authorizes families to sue, and Bons said she will see Frazier in court.

Frazier said he has sold a couple of thousand shirts through his Web site, www.carryabigsticker.com, since 2005 and regards it as more of a political statement than a moneymaker. He said the shirts, which sell for $20 to $22, are expensive to produce.

Frazier said the various state bills and laws infringe on his First Amendment right to free speech.

Waring said Frazier is selling a commercial product, and that opens the door to state regulation.

“This is clearly commercial speech. He’s not giving the shirts away,” Waring said. “I don’t dispute that if he was giving the shirts away to make a political statement, we probably couldn’t do anything about that.”

However, a constitutional law expert said the facts that the dead soldiers’ names are public record and that the Arizona legislation grants exceptions for plays, articles and certain other uses could undermine its constitutionality.

“You can’t make some irrational distinctions and stop some people and not others without a really good reason,” said Paul Bender, an Arizona State University professor and a top Justice Department official in the Clinton administration.

Bender said the shirts are clearly a political statement: “He’s not advertising anything on the T-shirts.”

May 21, 2007 – Professor Andrew J. Bacevich of Boston University rarely discussed his son’s service in Iraq, where the lieutenant was living a dream as an Army officer charged with the life-and-death responsibilities of a platoon leader.

The younger Andrew J. Bacevich, a 2003 graduate of BU, only sparingly mentioned to classmates and co-workers the well-known professor whom he resembled so closely in appearance and character.

But if they did not draw public attention to their relationship, father and son nonetheless seemed to be mirror images of each other to friends, co-workers, and comrades in the military. The adjectives they use, over and over, to describe the pair create an extraordinary portrait of the two: intelligent, confident, thoughtful, courageous, determined, and patriotic.

Now, First Lieutenant Andrew J. Bacevich, 27, is dead, mortally wounded by a suicide bomber May 13 in Iraq. And his father, who served in Vietnam and later rose to the rank of Army colonel, is left to ponder the searing loss of an only son in a war the professor has bitterly criticized.

“Our kinship is that we, he and I, had a knack for picking the wrong war in which to serve,” Bacevich told WBUR radio after his son’s death.

A professor of history and international relations, Bacevich told the radio station he has been struggling to fathom his own responsibility in his son’s loss. As a citizen, Bacevich said, he felt compelled to assail what he saw as an immoral war and a “catastrophic failure.” And yet, he added, exercising that responsibility does not seem to have made a difference.

“What kind of democracy is this, when the people do speak, and the people’s voice is unambiguous, but nothing happens?” said Bacevich, 59, who lives in Walpole.

Despite his opposition to the war, Bacevich supported his son’s decision to follow him into the Army, said Katy Bacevich, 22, one of young Andrew’s three sisters. According to colleagues, the elder Bacevich has always viewed the Army as a noble calling, which gives citizens the chance to give back to the country but should not exclude independent thought. And in that dynamic, they added, lies the strength of a man to whom patriotism does not preclude dissent. “His view of the military comes from a country he loves and an institution he cherished,” said Michael T. Corgan, a BU professor of international relations, who served two tours as a Navy officer in the Vietnam War. But to Bacevich’s mind, he said, “it’s his patriotic duty to speak out and say what he’s seeing rather than go along because it’s easier. Here’s a man of moral and physical courage.”

Bacevich has also brought that message to the classroom. Larry W. Matthews , a retired Army colonel and Gulf War veteran, encountered Bacevich during a Pentagon-sponsored program in 1997 at Johns Hopkins University, where Bacevich led a seminar. Bacevich’s message, Matthews recalled, was that as long as you could back up an argument, “you can, as an officer, challenge and disagree. . . . That’s a new muscle for some military folks.”

The seeds of Bacevich’s values were planted in Illinois, where he was raised as a deeply religious Catholic before enrolling at the US Military Academy. Shortly after his 1969 graduation from West Point, where he had been class president, was a poetry editor, and a rugby player, “Skip” Bacevich served as a lieutenant in Vietnam.

His 23-year Army career later included command of an armor regiment in 1991 in Kuwait, where Bacevich attracted the attention of another colonel, William Nash, who eventually became a major general in charge of US forces in Bosnia.

“He was a top-notch professional, both on the intellectual side and the practical side of soldiering,” said Nash, who has retired from the Army and is a senior fellow on the Council on Foreign Relations. “I think his analysis of the Iraq war has been extremely thorough, well-reasoned, and sound, and I can’t think of anything he’s said that I disagree with.”

Bacevich, who declined requests for an interview, seems difficult to categorize ideologically. In his writings, he has criticized both what he views as the self-indulgence of the radical left, and a neoconservative philosophy that endorses “preventive war” such as the invasion of Iraq.

The current war, he wrote March 1 in an opinion article in the Globe, has alienated America’s friends, emboldened its enemies, and left the nation in greater danger.

To Nash, Bacevich’s positions are bolstered by academic rigor and should be taken seriously.

“He has been intellectually solid and, I think this is very important, has differed with policy but not with service to the country,” Nash said. “When our chicken hawks of the administration try to argue that if you’re against what they’re doing, you’re unpatriotic, Skip Bacevich is living proof that it’s not true.”

The news of the younger Bacevich’s death hit Nash hard.

“The death of young Andy really makes me mad,” the retired general said. “Why? Well, because here’s a loyal soldier serving his country without regard to the wisdom of his country’s policies.”

Nash paused, then added softly: “Thank God we have people like that. Thank God.”

The younger Bacevich found the path to the Army to be much more difficult than his father’s. After a year in the ROTC program at BU, Bacevich was forced to leave because of a childhood history of asthma. Both Bacevich and his father were distressed at the setback and appealed the decision, said Beri Gilfix, the university’s Army ROTC office manager.

Although the younger Bacevich showed his fitness while a BU student by running the Boston Marathon in 3 hours, 35 minutes, the Army’s tough stance against asthmatics stood. The Army later relaxed its asthma restrictions. And in 2005, determined to join the Army despite almost-certain deployment to Iraq, Bacevich enlisted as a private and was accepted into Officer Candidate School.

“He didn’t have to join the military,” said Alexie Holmberg, 27, an Army veteran of Afghanistan who knew Bacevich in ROTC. “He could have gotten out of college and started making big money and living in places a lot nicer than Iraq. I’ll tell you what, we were lucky to have him in our Army.”

Holmberg, who has left active duty and is an Army captain in the Massachusetts National Guard, had used Professor Bacevich as an academic adviser. To Holmberg, the similarities between father and son were striking.

“They’re very solid characters. They were guys who were built on real solid foundations,” Holmberg said. “His dad was what you think of as an army colonel — very intelligent, very to the point, and very candid.”

Although he tried hard to keep his son in ROTC, the elder Bacevich steered clear of his son’s studies under fellow BU professors of international relations.

“We knew he was proud of his son,” Corgan said. “But Andy wouldn’t dream of asking anybody to do something on behalf of his son. Andy set a standard of behavior and performance, and his son measured up to that.”

Like his father, the younger Bacevich, who graduated from the College of Communication, showed a propensity for history and the benefits of a well-researched argument. Former colleagues at the State House, where Bacevich worked as an aide to Governor Mitt Romney and former state senator Jo Ann Sprague, a Walpole Republican, praised his ability to learn the intricacies of the legislative process.

“We always made the joke that Andrew had the most important job,” said Matthew Grew, who was associate director of Romney’s legislative office when Bacevich worked there in 2004. When a bill would go to the governor’s desk, Grew said, Bacevich would solicit reactions from concerned groups and then prepare a briefing for senior staff. “He was a really dedicated guy, and he exuded confidence,” Grew said.

Doug Shea, who was Sprague’s chief of staff, said Bacevich came to the office as a BU intern with a confidence seldom seen at that age. “Most of them are self-conscious and tread lightly,” he said.

That assessment was echoed by Joe Denneen, who also worked in Sprague’s office and is now chairman of the Walpole Selectmen. “The State House just came natural to him,” Denneen said.

A funeral Mass for Bacevich will be said at 10 a.m. today in St. Timothy’s Church in Norwood, near his Walpole home.

Brian MacQuarrie can be reached at b_macquarrie@globe.com.

May 20, 2007 – Barbara Damon-Day, the mother of a Maine Army National Guard captain who died of unexplained causes while serving in Afghanistan, has been on a mission of her own.

Carrying a thick notebook filled with information about soldiers’ health issues — and pictures of her son, Capt. Patrick Damon — Damon-Day worked the halls of the state House to line up support for legislation inspired by her son’s mysterious death last June.

The father of two collapsed after a recreational run in Bagram, his wife, Hildi Halley, said at the time. Damon-Day believes it was related to the extensive series of vaccinations soldiers undergo before deployment, and perhaps how the vaccinations interacted with each other.

She wants to create a commission to improve health screening for National Guard personnel, particularly for vaccinations.

Her bill has 155 co-sponsors in the 186-member Legislature, and is widely expected to be approved in the House and Senate. Damon had served as chief of staff for a former House speaker before becoming administrative director for the Public Utilities Commission.

The Maine National Guard did not return a call seeking comment. Gov. John Baldacci, who oversees the Guard, has endorsed the bill.

Damon, 41, had taken leave from the utilities commission when he was deployed to Afghanistan in January 2006 with the Maine Guard’s 240th Engineer Group.

While the military lists the death as “sudden unexpected,” Damon-Day believes it was “prolonged and preventable.”

“In the military, you are vaccinated, literally, to death,” she said.

Vaccine Healthcare Center at the Walter Reed Army Medical Center in Washington declined to release any information about Damon because of confidentially laws. Damon-Day said the center was investigating his death as possibly vaccine-related.

Her campaign has made waves outside Maine.

In Congress, an amendment calling for better medical screening of military personnel this month was attached to a federal defense spending bill. Rep. Tom Allen, D-Maine, said the amendment was inspired by Damon-Day, whom he credits for elevating the concern over military vaccinations.

The proposal in Augusta would create a nine-member commission to review all preventive health treatment practices and protocols, vaccinations and other medications administered to members of the Maine National Guard. It would also help propose recommendations for safer health care practices and medications to the U.S. military.

If the VA rules against a veteran, it gets worse: The average time to process an appeal is 657 days.

VA officials have all sorts of excuses for the delays — of course. When have you ever known government not to have an excuse for bureaucratic inefficiency?

According to the VA, one reason it takes longer to process disability claims by veterans is that the agency needs to determine whether the claims are related to service in the military. The VA quite properly doesn’t want to award disability payments to someone whose claim stems from an injury or illness in civilian life.

Compounding the problem is the fact that VA and Defense Department computers apparently are not compatible. Records from the Defense Department actually have to be delivered by hand to the VA, according to the agency.

VA officials say they are taking steps to reduce the waiting time involved in processing disability claims. We hope so — but we, like many veterans who have had to seek VA assistance, will believe it when we see it.

The VA needs to do better — a lot better in a variety of its activities, ranging from processing of claims to operations at its clinics and hospitals. Veterans who have served their country, sometimes sent into overseas combat zones with just a few weeks’ notice, have a right to expect that the VA will put more emphasis on serving them. And we, the Americans served by those veterans, should join in demanding improvements.

May 21, 2007- More local veterans are seeking help for post-traumatic stress disorder, and the numbers are expected to rise as more troops return home from Iraq and Afghanistan.

But, while the military is getting better at addressing mental illness, some doctors say that not enough veterans are seeking help. Psychologists say the stigma attached to mental health is one reason more veterans are not coming in for help, but the sooner they are treated for post-traumatic stress disorder, the better chance they have of overcoming it.

“Of course, there’s no cure for memories, there’s no cure for difficult experiences, but there are many things that can help,” said Bruce Purvis, a psychologist at the VA Medical Center in Asheville.

Post-traumatic stress disorder, or PTSD, is an anxiety disorder that can occur following the experience of a traumatic event. While anyone who witnesses a traumatic event can suffer from PTSD, people who have been in combat are extremely susceptible to developing the disorder.

Andrew Clark, 24, began experiencing symptoms of the disorder about one month after he left the Air Force in 2005, following two deployments to Iraq.

Clark started to have nightmares. He would wake up soaked in sweat and his heart would be racing. He found himself searching the side of the road for trash as if he was looking for roadside bombs. He couldn’t wait in line and would explode if the person behind the counter couldn’t ring him up fast enough. After his unit was deployed back to Iraq and Clark was unable to go, he plunged into depression.

“Adapting back to civilian life is the hardest part of it,” he said.

Clark said when he was in Iraq, it was necessary to put his emotions aside so that he could do his job.

“It took me awhile to understand that I’m not in that environment anymore,” he said.

PTSD numbers increase

The National Center for PTSD estimates that about 30 percent of men and women who served in Vietnam experience PTSD and an additional 20 percent to 25 percent have had partial PTSD at some point in their lives. The center also estimates that between 6 percent and 11 percent of veterans from the war in Afghanistan and about 12 percent to 20 percent of military personnel who served in Iraq have been diagnosed with PTSD.

At the Asheville VA Medical Center, the number of patients being treated for PTSD has increased over the past 10 years.

Like most VA Medical Centers across the country, most of the PTSD claims at the Asheville VA are from Vietnam War veterans, but the number of veterans from recent wars who are being treated for the disorder in Asheville has more than doubled to 170 patients from October through April of this year from 58 patients during the 2006 fiscal year. This number does not reflect veterans who are also getting help at the Veterans Center and other mental health facilities.

“Until we send our robots out to fight their robots, we’ll always have PTSD,” Purvis said.

Returning home

Soldiers returning from World War I experienced shell shock, and veterans from World War II were said to suffer from combat fatigue. But a formal diagnosis for PTSD did not exist until the early 1980s.

According to the National Center for PTSD, people with the disorder have four major types of symptoms: They re-experience the event either while awake or asleep; they stay away from people, places and things that remind them of the trauma; they experience a loss of emotions; and they feel on guard, have trouble sleeping and are irritable.

To receive a formal diagnosis of PTSD, these symptoms must last for more than one month, cause significant distress and affect the person’s ability to function normally.

The combat behaviors veterans learn in the military and the return to civilian life after being in a life and death situation can exacerbate some of these symptoms.

But, Purvis said these are normal responses to an abnormal situation.

“It’s the way we’re put together,” Purvis said. “It’s the way we’re wired.”

Dr. Alan Krueger, a former psychiatrist at the Asheville VA Medical Center, said even if military personnel don’t develop PTSD or other mental health issues, war has some effect on everyone who is involved in it.

“I don’t think anybody who goes into combat comes out unscathed,” Krueger said.

The lessons of Vietnam

But doctors say newer veterans like Clark may have a better chance at recovery than some of the older veterans who fought in Vietnam.

“The symptoms are very much the same but the package is different,” Purvis said.

Lonnie Darr, 60, was in Vietnam for three years. After he left the military in 1980, he couldn’t hold down a job, his wife and kids left him, and he withdrew from the world.

One morning, he woke up in his car under a freeway in Los Angeles, homeless and alone, and decided to seek help.

“I never heard of PTSD until I went to the Vet Center,” he said. “I knew something was horribly wrong, but I couldn’t put my finger on it.”

Although Darr is now getting help, he still struggles with many of the symptoms of PTSD on a daily basis. He is married for the third time, but he hasn’t been able to work for the past three years because of severe anxiety and intrusive thoughts about Vietnam.

Most days, Darr stays in his home office, which his wife has nicknamed “the bunker.” Even a trip to Sam’s Club causes him severe anxiety.

While the number of times he thinks about Vietnam has decreased, a few times a week, Darr will be back in a bunker staring into the face of a teenage North Vietnamese soldier or running through a firefight in Khe Sanh.

“In my day-to-day life, I see Vietnam all the time,” Darr said. “This doesn’t leave you.”

Because PTSD was not formally diagnosed until the 1980s, many Vietnam veterans like Darr went without help for a long time, which made their symptoms worse and harder to overcome.

“When the Vietnam veterans came out we seemed to be pretty unaware of the psychological consequences of combat,” Purvis said.

Krueger said because they are getting treatment at a younger age, veterans of Iraq and Afghanistan might have a better chance of overcoming PTSD than the veterans of previous wars.

Younger veterans have fewer additional health problems, and because they are being treated earlier for PTSD, fewer structural changes take place in the brain that compound the problems, Krueger said.

“The sooner we can intervene, the better,” he said.

The military now also acknowledges the need for mental health services. Families and soldiers are educated about PTSD, and there are more support services both before and after soldiers go to war. The military screens soldiers for mental health problems during combat, and they have critical stress units on the ground in Iraq.

Krueger said doctors and the military today also realize that the methods of individual deployment and lack of time for adjustment back to civilian society during the Vietnam era affected soldiers’ mental health. Veterans of the Vietnam War also came home to an unwelcoming society and felt isolated and rejected, something that contributed to the development of PTSD.

Purvis said he thinks these differences may mean that younger veterans will have an easier time overcoming PTSD.

“I think we’re trying to do a number of things to help the younger veterans because of the lessons learned from Vietnam,” he said.

Problems still exist

But, there is still a stigma associated with mental illness, both in the military and in civilian society, that prevents some veterans from getting help for mental health issues.

Both Clark and Darr said they tried to deny that they had a problem in the first place, a common response in veterans with PTSD, and both men said many of their friends claim there is nothing wrong with them even though they suffer from many of the symptoms of PTSD.

“They often think they’re the only ones who are affected that way,” Krueger said.

Clark said he realizes now that he isn’t alone and the help he has received at the VA has helped him with his symptoms.

He is less irritable with other people and realizes he doesn’t have to constantly be on alert, but Clark said he still suffers from occasional nightmares and anxiety.

“I don’t know if it goes away or not,” he said.

But, Purvis said that if veterans get help soon enough and they receive the proper care, they can overcome PTSD.

“I think you can put a great deal of it behind you,” he said.

What PTSD sufferers can do

How to get help:

People who suffer from PTSD should see a therapist to help them deal with their symptoms. Veterans can call the VA Health Benefits Service Center at (877) 222-VETS to find the closest VA Hospital or Veterans Center.

Help in WNC:

Veterans who want help at the VA Medical Center need to get into the VA system. They can do that by visiting admissions at the VA hospital. For emergencies, veterans should go to the emergency room. Veterans need to prove their eligibility for services by bringing a copy of their DD214. The Asheville VA Medical Center is at 1100 Tunnel Road. Veterans can also call the hospital at 298-7911.

Veterans also can visit the Veterans Center in Greenville, S.C. The Veterans Center does not require any paperwork and accepts walk-ins. For more information, call David Hollingsworth at (864) 271-2711. The Vet Center is at 14 Lavinia Ave., Greenville.

On Wednesdays, Hollingsworth comes to the Pardee Health Center in the Blue Ridge Mall in Hendersonville.

For more information, call 692-4600. There are group sessions at noon and 6 p.m. Individual counseling is available by appointment. There is also a spousal support group that meets once a month.