March 31, VCS in the News: VA Program to Schedule Patient Appointments on Verge of Collapse

March 31, 2009 – An eight-year-old, $167 million project to develop a core computer application to schedule patient appointments at hospitals run by the Veterans Affairs Department has all but collapsed, and senior executives are worried about the repercussions it could cause on the Hill and in the White House, according to an internal memo obtained by Nextgov.

The Replacement Scheduling Application Development Program, which VA began building in 2001, “still has not developed a single scheduling capability it can provide to the field, nor is there any expectation of delivery in the near future,” wrote Dr. Michael Kussman, undersecretary for health at the Veterans Health Administration, in a March 20 memo to Stephen Warren, acting assistant secretary for information and technology.

The scheduling application is a core piece of VA’s new HealtheVet, a vast medical platform that will include patient enrollment and scheduling systems, a data repository, electronic health records, a pharmacy system, a workload management system, and a way for patients to manage their medical records and personal information. VA plans to use the system to replace its aging Veterans Health Information System and Technology Architecture (VistA), the Government Accountability Office reported on June 20, 2008.

The botched effort comes on the heels of another scheduling program — a five-year, $75 million failed project started in 2001. That program, the Scheduling Replacement Project, was started by IT staffs in the VA healthcare regions serving Louisiana, Oklahoma, Mississippi and Texas, but after five years of work they failed to develop a usable product. Top VA management then transferred development in November 2006 to a new centralized VA IT operation. Kussman said the failure of the Scheduling Replacement Project precipitated a decision by then VA Chief Information Officer Robert McFarland to centralize all IT development in the Office of Information and Technology in the department’s headquarters.

A pilot version of the scheduling program was supposed to be installed at the VA Medical Center in Muskogee, Okla., in the summer of 2008, Dr. Paul Tibbits, head of the Office of Enterprise Development at the Office of Information and Technology, told a House Veterans Affairs Committee hearing in 2007. He also said he anticipated the program would be in use in all VA hospitals by January 2011.

But Kussman’s memo detailed a series of “significant test failures” with a beta version of the scheduling system, which had less functionality than originally envisioned. In February, VA terminated its contract with the schedule application developer, Southwest Research Institute, based in San Antonio. A spokeswoman for the organization did not return a call for comment by deadline.

Kussman added his office was not notified until March 18 that the problems with the scheduling applications were so significant that the program has been suspended.

The suspension is “significant and likely to generate intense congressional and Office of Management of Budget interest,” Kussman said. “This is also of concern . . . because of the numerous representations of clear progress we have been making, not only to Congress and OMB, but more importantly to our health care providers, who are eagerly waiting for this capability.”

The patient scheduling project has “floundered under VHA’s leadership since 1998,” Rep. Steve Buyer, R-Ind., the ranking member of the House Veterans Affairs Committee, said in a statement. He added the current failure exemplifies the need for VA to develop a professional cadre of contracting officers and program managers.

Buyer said VA must make significant management changes to improve its effort to centralize IT development. “Stovepiped management within the existing VA organization and hidden pockets of application dollars continue to challenge this consolidation,” he said. “Bureaucratic backroom skirmishes that occur on a regular basis are hamstringing successful and disciplined development of new IT systems and applications and wasting taxpayer dollars.”

VA needs the scheduling application to manage a forecasted sharp increase in the number of veterans seeking care at its medical facilities during the next several years, said Paul Sullivan, executive director of Veterans for Common Sense. He said VA will soon be hit by a “tidal wave” of veterans and predicted the number of Iraq and Afghanistan veterans will jump from 400,000 in September 2008 to 600,000 in September 2010.

“VA has a decade-long history of initiating IT programs, only to experience extensive delays and major cost overruns,” said Gerald Manar, deputy director of the National Veterans Service at the Veterans of Foreign Wars. “The fact that VA has frittered away eight years and millions of dollars in developing the RSA, with no viable results and no end in sight, is extremely disappointing but, based on its track record, not surprising.”

Adrian Atizado, assistant national legislative director for the Disabled American Veterans group, urged VHA to take control of its IT programs to avoid problems such as suspension of the scheduling application. VHA “should regain its authority for planning, programming, operating and budgeting information technology matters that directly affect delivery of health care to enrolled veterans in coordination with the VA chief information officer.”

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Mar 26, VCS in the News: Obama’s Migraine – Torture Policies of Bush Administration

March 26, 2009 – Human rights lawyers are proving to be a major headache for the new administration of President Barack Obama by stepping up their court challenges on issues of prisoner abuse to test the reality of the president’s pledge to create a “an unprecedented level of openness” in government.

A series of current court challenges illustrates the point.

Five years ago, the American Civil Liberties Union filed a Freedom of Information Act request that the Department of Defense release photos showing prisoner abuse by the U.S. military in Iraq and Afghanistan that the public had never seen. The government refused.

Five years later, in September 2008, a unanimous three-judge panel of the U.S. Circuit Court of Appeals ordered the George W. Bush administration to release the photos. But, as of today, the government has not complied with the court’s order. The only record the government has released to date is a set of media talking points used by the State Department.

In early March, the DOD asked for a hearing by the full appeals court. That request was denied. The government then asked for a 30-day stay of the court’s mandate.

That prompted ACLU lawyers to write to the Defense Department, asking the government to reconsider its position and release the photos in light of President Barack Obama’s executive order. The Defense Department has not yet replied.

Jameel Jaffer, Director of the ACLU’s National Security Project, told us, “The Obama administration’s commitment to transparency is commendable. “We want to make sure that this rhetoric becomes reality.”

ACLU attorney Amrit Singh, who argued the case in court, added, “The American public has the right to view these images to know what was done in its name.”

“Release of the photos would send a powerful message that the new administration truly intends to break from the unaccountability of the Bush years,” she said.

The government refusal to disclose these images is based on its attempt to radically expand the exemptions allowed under the FOIA for withholding records. The government also claimed that the public disclosure of such evidence would generate outrage and would violate U.S. obligations towards detainees under the Geneva Conventions.

However, the appeals court panel rejected the government’s attempt to use exemptions to the FOIA as “an all-purpose damper on global controversy” and recognized the “significant public interest in the disclosure of these photographs” in light of government misconduct. The court also recognized that releasing the photographs is likely to prevent “further abuse of prisoners.”

Much of what the public knows about U.S. treatment of prisoners has been learned from the more than 100,000 pages of government documents obtained in response to the ACLU’s FOIA lawsuit.

Attorney General Eric Holder recently issued comprehensive new FOIA guidelines that direct all executive branch departments and agencies to apply a presumption of openness when administering the FOIA.

In another case, in 2003, lawyers from the Center for Constitutional Rights, the ACLU, Physicians for Human Rights, Veterans for Common Sense, and Veterans for Peace, filed a FOIA request to the Departments of Defense, State, Homeland Security, and Justice, as well as the CIA, to immediately process and release all records relating to treatment of prisoners in U.S. custody.

When the government failed to respond, the organizations filed a lawsuit charging that these government agencies illegally withheld records concerning the abuse of detainees in American military custody.

Their complaint noted, “Photographs and videos leaked to the press have established beyond any doubt that detainees held in Iraq have been subjected to humiliating and degrading treatment. The government has conceded that numerous detainees have died in custody; at least sixteen of these deaths have been classified as homicides. There is growing evidence that the abuse of detainees was not aberrational but systemic, that in some cases the abuse amounted to torture and resulted in death, and that senior officials either approved of the abuse or were deliberately indifferent to it.”

In 2005, a federal district court judge ordered the government to release 74 photos and three videos. The DOD and the Army appealed the district court’s decision. A year later, the Court of Appeals upheld the lower court’s decision, dismissing the government’s appeal. But the government still has not released the photos and videos.

In other cases, human rights lawyers have filed two court challenges against the Obama administration’s treatment of Guantanamo detainees and its future plans for the men, most of whom have been held for years without trial.

One motion was filed on behalf of Chinese Uighur, Huzaifat Parhat. He was among 17 Uighurs ordered released by a U.S. court last June, seven years after their arrest, but who remain in detention at Guantanamo Bay.

Lawyers filed a motion of contempt against Secretary of Defense Robert Gates denouncing his “continued refusal to comply with a final order” by the appeals court to release Parhat, the document said.

The lawyers also demanded that a new court ruling should include “a threat of sanctions” in order to ensure Gates complies with the order to release Parhat.

Yet another lawsuit filed by about 15 Guantanamo inmates took issue with new rules laid down by the administration of President Obama earlier this month justifying the state’s right to hold terror suspects.

On March 13, the Justice Department said it was dropping the “enemy combatant” designation for terror suspects and vowed to apply international law to its detention policies. It said only those who “substantially supported” the Al-Qaeda network, Taliban Islamic militants or “associated forces” would be held under such laws.

But the detainees’ lawyers minimized the new policy as only a “partial retreat” from the positions held under the previous administration of former president Bush.

“The conceptual approach they now advance has not greatly changed,” they argued in the court filing.

They also lashed out at the government for justifying detaining suspects without charge or trial solely on the basis of a congressional decision authorizing the U.S.-led “war on terror” after the September 11, 2001 attacks.

The political decision to hold suspects indefinitely without charge because they are deemed too dangerous to be free is a policy choice that under the US Constitution “must be resolved by Congress, not by the executive branch,” they wrote.

In a fourth case, lawyers for 30 Guantanamo detainees filed a motion accusing the Obama administration of violating the Geneva Conventions in its treatment of the estimated 240 prisoners remaining at the controversial prison camp.

Obama has vowed to close the camp within the next 12 months, and has ordered individual reviews of the cases against each of the remaining prisoners.

Civil libertarians are perplexed by some of the early actions the Obama administration has taken in court. In two recent cases, lawyers for the Obama Justice Department have invoked the same “state secrets” defense used by President Bush’s administration.

They are also disappointed by the lack of media interest in issues of prisoner detention and treatment. Based on questions asked of President Obama during many interviews and during his two recent press conferences, the mainstream press appears to have little interest in these issues. So these questions are likely to be resolved in the courtroom.

Since the terrorist attacks of 9/111, the judicial branch has rebuffed many of the policies and practices of the Bush Administration. But with a large proportion of Bush appointees now sitting as federal judges, how their future decisions will impact the Obama Administration remains unclear.

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Mar 24, PTSD News: Veterans Groups Seek Update in Definition of Combat

March 24, 2009, Washington, DC (AP) — Veterans advocates told Congress on Tuesday that a World War II-era law requiring proof of participation in combat in order to receive certain benefits creates an unnecessary hurdle for veterans who served in Iraq and Afghanistan, but not on the front lines.

Note: Please see VCS Statement on re-defining combat: http://www.veteransforcommonsense.org/articleid/12533

There is particular concern, they said, that the rule interferes with disability benefits for veterans with post-traumatic stress disorder whose trauma may not be documented by the military. PTSD can affect people who experience a traumatic event. Symptoms can include flashbacks and anxiety.

The mental disorder has affected service members in noninfantry roles such as truck drivers or cooks, who on today’s battlefields are vulnerable to roadside bombs or mortar attacks. They often lack a combat infantry badge or other documentation to prove their battlefield experience.

The VA has said that about half of all disability claims for PTSD are approved, and the majority of denials come because the veteran lacks evidence of injury related to their time in the service, according to a report last year from the Congressional Budget Office.

Female veterans, who are officially banned from infantry jobs but still experience combat in the current war zones, are among those having difficulty in obtaining the benefits, Carolyn Schapper, an Iraq War veteran, testified.

“The traditional understanding of female servicemembers’ military duties has been the biggest hurdle to getting them adequate compensation for their injury,” said Schapper, a member of the group Iraq and Afghanistan Veterans of America.

Rep. John Hall, D-N.Y., chairman of the House Veterans Affairs subcommittee, which held Tuesday’s hearing, said the law should be updated to define a combat veteran as any veteran who served in a combat theater of operations or in combat against a hostile force.

“There should be a better way for VA to assist veterans suffering from PTSD to adjudicate those claims without being burdensome, stressful and adversarial,” Hall said.

It’s estimated that if the law is changed, thousands more veterans would seek disability compensation for PTSD, potentially costing hundreds of millions of dollars annually. The CBO report said the average disability rating for a veteran with PTSD earned them about $543 a month.

Rep. Doug Lamborn, R-Colo., said he was concerned that changing the combat veteran definition could result in a reduction of benefits overall, and that “too loose” a definition could diminish the sacrifices of those “who actually did engage in battle with the enemy.”

Under the proposed change, a diagnosis of PTSD would still be required to obtain the disability benefits.

Organizations such as the Disabled American Veterans and the American Legion argue that Congress’ original intent was to include all combat veterans, but the VA has interpreted it otherwise over the years.

Bradley Mayes, director of Veterans Benefits Administration’s Compensation and Pension Service, told the subcommittee that changes have been made to make it easier for veterans with PTSD to qualify for disability compensation.

Antonette Zeiss, deputy chief officer for mental health services at the Veterans Health Administration, noted that the VA provides health care for five years for the recent veterans, so some veterans are getting treatment for PTSD even if they are not receiving disability benefits for PTSD.

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Mar 23, Editorial Cartoon: The Economy v. The War

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Burning Toxic Waste is Making U.S. Soldiers and Iraqis Sick, But the Pentagon Refuses to Admit It

Six years into the war, many U.S. bases in Iraq are still without incinerators, leaving open pits spewing toxic plumes over soldiers and civilians.

March 18, 2009 – Acetaldehyde, Acrolien, Arsenic, Benzene, Carbon Monoxide, Ethylbenzene,  Formaldehyde, Hydrogen Cyanide, Hydrogen Fluoride, Phosgene, Sulfur Dioxide, Sulfuric Acid, Toluene, Trichloroethane, Xylene. These are just some of the chemicals detected in smoke from the Balad Burn Pit, one of the many vast open pits spewing toxic plumes over Iraq and Afghanistan.

But not to worry; In “Just the Facts,” an information sheet for troops, the Department of Defense has stated that “the potential short- and long-term risks” from Balad “were estimated to be low.” The VA has just announced it will monitor reports of veterans’ pit-related illness. But the DoD has yet to declassify old air sample reports or issue current findings.

The Pentagon’s fact sheet appeared after VAWatchdog.com linked to a memo showing that, as early as 2006, the DoD had known that the pit was “an acute health hazard.” In the memo, titled “Burn Pit Health Hazards,” Air Force Bioenvironmental Engineering Flight Commander Darrin Curtis wrote to authorities that he found it “amazing that the burn pit has been able to operate without restrictions over the past few years without significant engineering controls being put in place.” In an accompanying memo, James R. Elliott, Chief of Air Force Aeromedical Services, concurred that the pit’s fumes contained “known carcinogens” and “respiratory sensitizers” that posed a “chronic and acute health hazard to our troops and the local population.”

“Iraqi Crud” and “Black Goop”

This week, the same memo was boldly posted on Wikileaks, more widely publicizing toxic exposure and governmental neglect. The evidence is clear. The Balad Burn pit is a Big Bad Burn Pit which burns most anything that comes its way including medical waste, styrofoam, and plastic. Soldiers, contractors, foreign workers, and Iraqis suffer what troops call “Iraqi crud,” whose symptoms include a hacking cough and black phlegm that goes by the name “black goop.” According to Army Times reporter Kelley Kennedy, “Though military officials say there are no known long-term effects from exposure to burn pits in Iraq and Afghanistan, more than 100 service members have come forward to Military Times and Disabled American Veterans with strikingly similar symptoms: chronic bronchitis, asthma, sleep apnea, chronic coughs and allergy-like symptoms. Several also have cited heart problems, lymphoma and leukemia.” Kevin Wilkins, an Air Force reservist, died last year after returning home from a tour of Balad and Qatar; his wife blames the pit. A year after working at Balad as a nurse, Wilkens was admitted to the hospital for a relentless headache and vomiting, symptoms that began in country. He was diagnosed with a brain tumor and died a week later.

Sen. Russ Feingold (D-Wisconsin) has taken up the cause. Six years into the war in Iraq, many bases are still without incinerators. In Afghanistan, U.S. bases have no incinerators. General David Petraeus claims the Pentagon is employing more incinerators, but that burn pits go with the territory: “There is and will continue to be a need for burn pits during contingency operations,” Petraeus wrote to Feingold.

Denial and Obfuscation

Dr. Michael Kilpatrick, a spokesman for the Office of the Assistant Secretary of Defense for Health Affairs, claims the DoD carefully samples air at Balad and other bases with burn pits and all is well. “The bottom line on all of this sampling is that we have not identified anything, where there are troops, where it would have been hazardous to their health,” Kilpatrick said.

Take it from where it comes. Between 1997 and 2002, Michael Kilpatrick directed the Office of the Special Assistant for Gulf War Illness, where his main purpose seemed to be to promote stress — and only stress — as the link between wartime experience and veterans illness. In those five years, he spent $250 million “without publishing any medical research report or offering a single treatment program for ill GW veterans,” according to veterans advocate Steve Robinson. According to the General Accounting Office (GAO), Kilpatrick’s fixed position discouraged scientists from applying for grants for research on Gulf War illness, leaving pioneering work, such as that by Dr. Robert Haley, to rely on private funding. Despite compelling finding as early as 1998, that Gulf War illness was caused by brain damage from neurotoxins,  Kilpatrick insisted that  veterans’ headaches, dizziness, fatigue, bone and joint pain, memory loss, poor concentration, muscle weakness, skin rashes and sores, and gastrointestinal problems, and even  amyotrophic lateral sclerosis (ALS) could be linked only to stress. Since then, Kilpatrick has gone on to use his medical credential to discount the dangers of depleted uranium, hide the DoD’s non-compliance with pre- and post-deployment screening, and obfuscate the facts around distribution of anti-nerve gas pre-treatment pills, a major cause of Gulf War illness. And now he’s whitewashing Balad’s black fumes and “black goop”

The KBR Connection: Will There Be Accountability?

One Georgia man is having none Dr. Kilpatrick’s reassurances. In November, Joshua Eller, a civilian draftman, initiated what he hopes will be a class action suit against contractor KBR and its former parent company, Halliburton, for exposing people at the Balad base to unsafe water, food and hazardous burn pit fumes.

The suit claims that “all across Iraq and … not confined to Balad” KBR provided bathing water that was not disinfected, including according to former KBR employee testimony, water from the Euphrates and Tigris rivers that was polluted with sewage.  Regularly, KBR served soldiers spoiled, expired and rotten food and used dishes that may have been contaminated with shrapnel. The lawsuit claims that the plaintiff suffers from chronic skin lesions, abdominal distress, and nightmares.

KBR dumped medical waste, including needles, bandages, and body parts in the open pit. On one occasion,” the suit states, the plaintiff “witnessed a wild dog running around base with a human arm in its mouth.

Nora Eisenberg is the director of the City University of New York’s fellowship program for emerging scholars. Her short stories, essays and reviews have appeared in such places as The Partisan Review, The Village Voice, The Los Angeles Times and Tikkun. When You Come Home, her new novel, which explores the the 1991 Gulf War and Gulf War illness, will be published this month by Curbstone Press.

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Mar 19: After Six Years of Iraq War, Veteran Hangs Sign from VA HQ in Protest

Protester scales VA building to hang sign

March 19, 2009, Washington, DC (AP) — An Army veteran has been arrested after climbing up the Veterans Affairs Department building in downtown Washington to hang a sign protesting the Iraq war.

Forrest Schmidt was arrested Thursday outside the building, which is less than a block from the White House. Before his arrest, Schmidt had time to hang a large banner over the building entrance that read “Veterans say NO to War and Occupation.”

A group of veterans and anti-war activists is planning to march on the Pentagon on Saturday to mark the sixth anniversary of the Iraq war. The march will continue past the offices of defense contractors, including Boeing Co., Lockheed Martin Corp. and General Dynamics.

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Mar 19, VCS Quoted in Article About Iraq War Soldier’s Suicide: The Long Lonely Road Home for John Fish

Paul Sullivan of Veterans for Common Sense says there is more at stake here than the wishes of one family. “The Army failed to follow their own rules when the Army deployed an unfit soldier,” he said.  “Until there is accountability, the Army will continue to send unfit soldiers back to war with fatal consequences.”

A local recruit’s tragic death illustrates how the military has redeployed soldiers to Iraq and Afghanistan despite mental heath concerns

February 20, 2009, San Luis Obispo, California – On August 26, 2007, U.S. Army Specialist John Fish had already served a tour in Iraq and was training for a second deployment, to Afghanistan, when he walked into the New Mexico desert leaving a suicide note behind. “I have some things to take care of,” the 19-year-old wrote. “I won’t be coming back.”
 
Three days later, an Army search party found his body; a bullet lodged in his skull, service weapon by his side. Fish’s ashes were flown back to the Central Coast, to his mother and stepsister in Paso Robles and a memorial service at Camp Roberts.
 
“The Army was very good about showing up and trying to make arrangements,” Fish’s mother Cathy told New Times.  In addition to the funeral, the military offered the family grief counseling and organized the mailing of hundreds of condolences cards from all over the country. But she hastened to add, “They can never bring my son back.”
 
Today, John Fish’s remains rest in a small, wooden, U.S. military-issued box on a shelf in the family living room, where a photograph of a uniformed, crew-cut soldier graces the modest home’s entryway. John’s mother works the night shift as a licensed vocational nurse at nearby Vineyard Hills Health Center.
 
During a recent interview, she repeatedly shied away from discussing the Army’s investigation into her son’s death (the Army investigates all suspected suicides), preferring instead to remember his life. He loved such slapstick movies as Monty Python’s Search for the Holy Grail, and Spaceballs. “Everybody liked him,” she said. “He had a whole entourage of friends and they would get together and play at LAN parties.”
 
“We’re really proud of John,” she said, choking back tears. “I just feel badly that it ended the way it did. I gave them an all-American boy and they returned a box; and there are a lot of other American families all over the country experiencing the same thing.”
 
Indeed, John Fish is one of an increasing number of American soldiers who’ve committed suicide after fighting in Iraq and Afghanistan. The Army reports 117 active duty Army soldiers killed themselves in 2007, the year Fish took his life. At the time, it was a 26-year high.  But that record was quickly eclipsed by the 2008 Army figure of 128 suicides, with 15 more deaths under investigation. (Suicides for the Marines also have been increasing, with 41 in 2008, up from 33 in 2007 and 25 in 2006.) The longer these wars go on, it seems, the faster soldiers die by their own hand. In January 2009, more American soldiers committed suicide than died in combat in Iraq and Afghanistan combined.

The crisis has gotten so bad, normally taciturn Pentagon officials have begun to speak publicly about what some veterans’ advocates are calling a suicide epidemic. “The uptick, most recently, in suicide—very troubling,” Marine Corps Gen. James Cartwright, vice chairman of the Joint Chiefs of Staff, told a recent Pentagon news conference.

“We’re trying to understand, is this cumulative?” Cartwright said. “Is there something that is a trigger event here? We’re working with several agencies, on the national health side, to try to understand this.”

Veterans groups say the reasons for the rise in soldier suicides are clear. They are the product of a deadly combination: the guerilla nature of the Iraq and Afghanistan wars and the Pentagon’s decision to send the same fighting men and women to war over and over again.
 
“The obvious reason [for the rise in suicides] is the only one they’re not willing to look at,” argues Penny Coleman, author of the book Flashback: Post Traumatic Stress Disorder: Suicide and the Lessons of War. More than 30 years ago, Coleman was widowed when her first husband took his own life after returning home from Vietnam. “Whenever the military talks about suicide, the stressors they talk about are relationship issues, and financial issues, and work issues. They’re ignoring the elephant in the room and it makes me want to scream. It’s combat, and that’s the one thing that they don’t want to talk about because it would undermine the entire war. It’s time for that to be acknowledged.”
 
This time around, the soldiers’ combat experience is even more brutal than thirty years before. Unlike Vietnam, there are no R&R locations in Iraq, where soldiers can blow off steam in bars and clubs. In addition, because of the draft, the vast majority of troops sent to Southeast Asia served only one 12-month tour. This time around, more than 717,000 soldiers have deployed at least twice to the war zones. Some, like John Fish, have been ordered deployed for a second tour even after telling military doctors they’re thinking about committing suicide.
 
John Fish never told his mother about his experiences in Iraq but he was more forthcoming with his best friend C.J. McDougal. Before Fish joined the Army, the two of them would spend hours playing computer games—Fish especially liked first-person shooter games where the player shoots at images on the screen.
 
Fish loved the Pentagon-developed America’s Army, which was introduced as a recruiting tool in July 2002. He saw the game as more realistic, preferring it to other games in which the player shoots Nazis, zombies, or aliens. “He liked guns,” C.J. said. “I don’t know what it was. He was in love with everything that had to do with projectiles. He would say to me, ‘Could you run 3,200 feet per second? You better be able to, because I know your head’s not bulletproof.’”
 
When he turned 17, Fish dropped out of Paso Robles High School, took the GED, and joined the Army. He would become an expert at guns and ammunition, he told his friends and family, and would open up a weapons repair shop when he got out of the military.
 
Shortly thereafter, in December 2005, John Fish deployed to Baghdad with the 41st Fires Brigade. While in Iraq his mood darkened, and on March 11, 2006 Army documents show Fish sought out the military’s mental health practitioners, “complaining of being depressed and lack of motivation because he felt he was not being used effectively.” While he had been trained as an ammunition specialist, he was primarily being used as a radio operator.
 
“Fish preferred to stay busy and had a hard time as a [radio operator],” the Army reported in an investigation published after his death: “While in Iraq, SPC Fish was highly motivated when assigned tasks to accomplish, but was very quiet and reserved and seemed to be depressed more than normal.”
 
His friend C.J. gives another reason for John’s slide into depression. “He’d seen war and wasn’t too thrilled about it anymore,” his friend said. Real war wasn’t like the first-person shooter games he played at home. Mortars exploded regularly on his post, and one—a dud that failed to explode—landed just a few feet away from him.
 
The feeling of killing changed him, too.
 
“On one of the missions he was sent on, he was told to clear a room: to throw a grenade through the window, then knock down the door and open up and fire on anything and everything,” C.J. said.  “After the smoke cleared, he saw he had killed four to six women and children.” It is not unusual for soldiers to be assigned to a temporary combat mission and returned to regular responsibilities when there’s a shortage of troops for the combat task. This has been a major issue in the Iraq and Afghanistan wars. Because of the shortage of available troops, soldiers are being sent out on combat missions regardless of whether or not they are trained to properly carry them out.

Regardless of the reason for Fish’s decline, everybody around him—his mother, friends, and the Army—all noticed his condition improved dramatically after he returned to the United States. After initially being withdrawn and overly quiet, John Fish, a hardened war veteran at age 18, began to relax and be social again.
 
But then, when he learned his unit was being redeployed to the war zone, Fish again began to slip away. On August 17, 2007 he told a psychiatrist at Fort Hood, Texas that he was depressed and had thoughts of suicide “mostly at night when he had nothing to do.”
 
The psychiatrist diagnosed Fish with Dysthymic Disorder (a form of depression) but nonetheless cleared him to train for his second deployment “without limitations.”?

“There was nothing in Fish’s behavior that threw up any immediate red flags,” the Army’s suicide investigation reads.

Less than two weeks later, John Fish walked into the desert and shot himself in the head.
 
“The notice of a second deployment into war can be compared to telling a rape survivor that the victim must walk down a dark alley constantly for one year and be repeatedly raped again and again,” explains Paul Sullivan, a Gulf War veteran who heads up the group Veterans for Common Sense. “Military studies have found that multiple deployments significantly increase the risk of mental health conditions by as much as 50 percent,” he notes. Since the start of the Iraq war, Sullivan’s organization has documented the suicides of many soldiers and Marines who, like Fish, took their own lives after being notified of a second tour.
 
The military’s decision to redeploy John Fish appears to be a direct result of one of President George W. Bush’s least noticed policy changes. With wars raging in both Iraq and Afghanistan, the Bush Administration was so desperate for soldiers that it changed the military’s rules to allow the redeployment of soldiers to Iraq or Afghanistan even after they had been diagnosed with mental illnesses caused by their first tour.
 
In December 2006, the Pentagon released a set of guidelines that allow commanders to redeploy soldiers with a “psychiatric disorder in remission, or whose residual symptoms do not impair duty performance.” The guidelines set out a long list of conditions for when a soldier could and could not be returned for an additional tour in Iraq or Afghanistan. Those on lithium, for example, would not be allowed to deploy while those on another class of medications similar to Prozac were eligible to be sent to the front.
 
In June 2008, nearly a year after Fish’s death, Time magazine published a damning investigative report titled “America’s Medicated Army.”
 
“For the first time in history, a sizable and growing number of U.S. combat troops are taking daily doses of antidepressants to calm nerves strained by repeated and lengthy tours in Iraq and Afghanistan,” wrote reporter Mark Thompson. “Data contained in the Army’s fifth Mental Health Advisory Team report indicate that, according to an anonymous survey of U.S. troops taken last fall, about 12{cd9ac3671b356cd86fdb96f1eda7eb3bb1367f54cff58cc36abbd73c33c82e1d} of combat troops in Iraq and 17{cd9ac3671b356cd86fdb96f1eda7eb3bb1367f54cff58cc36abbd73c33c82e1d} of those in Afghanistan are taking prescription antidepressants or sleeping pills to help them cope.”
 
So far, President Barack Obama has not reversed those policies. His plan for a surge of more than 30,000 troops in Afghanistan (which enjoys bipartisan support in Congress) means he will likely have to continue the controversial policies as a means of supplying enough bodies at the front to keep the war going.

“I’ve been very concerned about Afghanistan,” Congresswoman Lois Capps said during a recent discussion with New Times about the crises facing returning veterans. “I trust our new president understands the nuances and complexities of the situation.”
 
“I’m not a pacifist,” she said, “but we cannot see war as an answer. It creates so many problems and we cannot avoid its enormous cost. These costs need to be counted in ahead of time and even then it’s going to be even more than we expect.”
 
Two weeks before his death, John’s mother flew to Killeen, Texas for a special mother-son weekend outside the gates of Fort Hood. “I snatched him up,” she said. “We rented a room in a Best Western-style hotel with a pool out front and I wouldn’t let him out of my sight.”

She didn’t notice anything wrong. “He had a nice new apartment and a brand new car,” she told me. “He had proposed to a girl. He told me he was excited because he knew when he came back from his second tour he would be done with the Army.”
 
Cathy Fish brought DVDs for them to watch together, including the slapstick film Harold and Kumar Go to White Castle. They watched a mini-marathon of the Discovery Channel series Dirty Jobs, where host Mike Rowe profiles what it’s like to hold some of America’s most disgusting jobs, including garbage collector, oil-rig worker, portable toilet cleaner, sewer inspector, and crab fisherman.
 
“Everything seemed fine,” she said. “We didn’t find out until later, when the Army released its investigation, that he had told them that he was depressed. It was a complete surprise when he died.”
 
Author Penny Coleman said that kind of last, happy interaction is common as suicide victims reach their final days. “Very often when people decide that’s the route they’re going to take it appears to those around them they’ve gotten better,” she explained. “Once they’ve decided that’s the way out it can be a kind of relief. In such a circumstance when they enjoy their time with family and friends, what they’re actually doing is saying goodbye.”

Coleman said her first husband Daniel did that after he came back from Vietnam. “He visited everybody he loved before he killed himself,” she said. “That was something that was really hard on me, that he seemed to come back to life in the weeks before he died.”

On August 20, 2007 John Fish departed Fort Hood with an advanced party of his brigade on route to Doña Ana House Camp in the New Mexico desert. He and other personnel in his section were responsible for setting up the ammunition supply point and ensuring the living quarters were set up for the unit’s pre-deployment training exercises, but he was no longer committed to the task.

“During this time, SPC Fish was counseled several times for his personal hygiene and criticized for his driving abilities,” the Army’s suicide investigator wrote. On August 26, 2007, one of Fish’s noncommissioned officers asked to see his clean laundry and made him empty his laundry bag and show him. “This offended SPC Fish and he stated that he did not want to conform to their rules. Later that night,” the Army report reads, “SPC Fish was seen on his bunk writing in his notebook and when asked what he was writing SPC Fish replied, ‘Nothing.’”
 
The next morning, Fish was reported missing and his assigned weapon was also missing. “A suicide note was found on SPC Fish’s bunk stating that he had something to take care of and would not be back and not to bother looking for him. It also mentioned that he finalized his plan while driving to work” the day before.
 
A search party including more than 1,000 soldiers was formed. As a precaution, all five area schools were placed in lockdown. Two days later, Fish was found dead in the New Mexico desert after an aerial team spotted his remains about 1.5 miles from the camp.
 
John Fish’s family and friends don’t want to dwell on the 19-year-old’s suicide and they haven’t pushed for more detailed investigations or the punishment or prosecution of the officers who ordered Fish redeployed despite his psychiatric diagnosis. “What’s the point?” his mother asked rhetorically. “It wouldn’t change the fact that he’s dead. Besides, since I wasn’t there, I’ll never really know what happened.”

But Paul Sullivan of Veterans for Common Sense says there is more at stake here than the wishes of one family. “The Army failed to follow their own rules when the Army deployed an unfit soldier,” he said.  “Until there is accountability, the Army will continue to send unfit soldiers back to war with fatal consequences.”

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Senator Murray Introduces Bi-Partisan Legislation to Prepare VA for Rapidly Growing Number of Women Veterans

March 17, 2009 – Washington, DC – Today, U.S. Senator Patty Murray (D-WA), a senior member of the Senate Veterans’ Affairs Committee, introduced major bi-partisan legislation to prepare the Department of Veterans Affairs (VA) for the influx of women veterans who will access care there in the coming years. Senator Murray’s bill, the Women Veterans Health Improvement Act of 2009, will address many of the unique needs of female veterans, particularly those women who are returning from Iraq and Afghanistan. U.S. Senator Kay Bailey Hutchison (R-TX) is the lead co-sponsor of the legislation and has also played a vocal role in ensuring the VA meets the unique needs of female veterans.

“Women have stepped up to serve at unprecedented levels,” said Senator Murray. “Which means the VA is now faced with unprecedented challenges in caring for them as they return home. This bill addresses the unique challenges women face by providing specialized care for the visible and invisible wounds of war. As more women begin to transition home, and step back into lives as mothers, wives, and citizens, the VA must be there for them.”

“Women serving in combat in Iraq and Afghanistan and performing dangerous missions throughout the world make up an important and growing segment of our veteran population. The number of women veterans receiving care through the VA is expected to double in less than five years,” said Senator Hutchison. “Our bill will help improve access to quality health care services for women who have bravely served in our armed forces.”

“Generations of women have served honorably in all of this country’s major conflicts.  These women have earned the right to expect the same high quality health care services and benefits as their male counterparts,” said Dave Gorman, Executive Director of Disabled American Veterans (DAV). “While significant progress has been made in recent years to remove institutional barriers that often discourage women veterans from seeking assistance at VA facilities, more needs to be done. The Women Veterans Health Care Improvement Act will help ensure these women have equal access to VA benefits and services. DAV is proud to have worked on this legislation with Senator Murray, who has proven herself time and again to be a steadfast and effective champion for all of America’s veterans.”

Senators Murray and Hutchison’s bill was co-sponsored by Senators Jay Rockefeller (D-WV), Barbara Mikulski (D-MD), Barbara Boxer (D-CA), Olympia Snowe (R-ME), Ron Wyden (D-OR), Tim Johnson (D-SD), Susan Collins (R-ME), Blanche Lincoln (D-AR), Debbie Stabenow (D-MI), Lisa Murkowski (D-AK), Frank Lautenberg (D-NJ) and Sherrod Brown (D-OH).

“The brave women of our military have been fighting side-by-side in Iraq and Afghanistan with our men in uniform so that we may live in freedom – they deserve the same support from the government when they return home,” Senator Mikulski said. “There is currently an unprecedented number of women defending their country at war. We owe them a debt of gratitude, and that means making sure they have a VA health care system that meets their needs.”

“More women are serving in the military today than at any time and this number is only growing. They face unique challenges and the VA must be prepared to meet their needs,” said Senator Boxer.

“With over 10,000 women veterans in Maine, and almost two million across the nation, each are patriots that have answered their nation’s call, and it is essential the nation be there for them when they return to the homefront and their families,” Senator Snowe said.  “I am honored to join with my colleagues to introduce this bill today that rightfully recognizes and addresses issues with which many of these veterans and their families are managing today.” 

“Our women vets have served courageously and selflessly alongside their fellow soldiers, sailors, airmen, and Marines. The time has come that we recognize the unique needs of these veterans by respecting their differences and addressing the inequities that may exist in the system,” said Senator Johnson, Chairman of the Senate Military Construction / VA Appropriations Subcommittee.

“This legislation will help ensure that our women in the military return home to a high quality health care system that they certainly deserve and have earned. I am proud to recognize the invaluable service that our service members have made, and I will continue to assist those who do so much to protect our nation,” said Senator Lincoln.

“For far too long, the VA has operated with a “one size – fits all” culture,” said Senator Murkowski.  “Those days are gone. The physical, mental and reproductive health challenges that face women veterans may require a different menu of services, delivered in a different way than the VA has grown accustomed. This legislation sends a powerful wake-up call that America’s 1.7 million women veterans earned their benefits too and it is time for the VA to step up and meet its needs.”

“American service women need to know that their commitment to this country is both recognized and honored,” said Senator Brown. “We must meet the obligations of every veteran in a way that reflects their bravery and sacrifice. This bill would expand the VA’s resources to address gaps in services and provide women with access to benefits they have earned.”

Among other things, the legislation introduced today will:
– Require the VA to implement a program to train, educate, and certify VA mental health professionals to care for women with sexual trauma
– Require the VA Secretary to conduct a comprehensive assessment of the barriers women are facing in accessing care at the VA.
– Authorize a report to Congress on the effects the wars in Iraq and Afghanistan have had on the physical, mental, and reproductive health of women who have served there.
– Require the VA to begin a pilot program that provides child care to women veterans that seek mental health care services at the VA.
– Require the VA to begin a pilot program that provides readjustment counseling to women veterans in group retreat settings.

Senators Murray and Hutchison introduced similar legislation last year in the 110th Congress which passed the Senate Veterans’ Affairs Committee http://murray.senate.gov/news.cfm?id=299802 before the Senate session ended.

For Detailed Information on the Women Veterans Health Improvement Act of 2009 visit: http://murray.senate.gov/veterans/women-vets-2009.pdf

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President Pledges Help to Vets

March 16, 2009 – President Obama renewed his vow today to uphold the “sacred trust” with those serving in harm’s way abroad.

“They are our best and brightest, and our bravest, enlisting in a time of war,” he said at the Department of Veterans Affairs, whose mission, he said, is more vital now during the “long and difficult conflicts” in Iraq and Afghanistan.

Obama has promised to increase military pay, improve benefits to veterans, and offer more help to military families. Last week, first lady Michelle Obama visited Fort Bragg, the sprawling Army base in North Carolina, to bring that message.

The president noted that his own family — particularly his grandfather, a World War II veteran — benefited from aid to veterans without which, he said, he would not be in the White House.

His full remarks, as provided by the White House, are below:

THE PRESIDENT: Thank you very much. To Jim Benson for helping to organize this; for Mahdee for your service to our country — a Pledge of Allegiance that you’ve shown in your own commitment to protecting this country; and obviously, to Secretary Shinseki. It is an honor to join you and the hardworking public servants here at the Department of Veterans Affairs as we mark a milestone in the distinguished history of this department.

You know, 20 years ago, on the day the Veterans Administration was officially elevated to a Cabinet-level agency and renamed the Department of Veterans Affairs, a ceremony was held to swear in the administrator of the old entity as Secretary of the new one. And in his remarks that day, President George H.W. Bush declared that the mission of this agency is “so vital that there’s only one place for the veterans of America: in the Cabinet Room, at the table with the President of the United States of America.” I could not agree more.

I could not be more pleased that Eric Shinseki has taken a seat at that table. Throughout his long and distinguished career in the Army, Secretary Shinseki won the respect and admiration of our men and women in uniform because they’ve always been his highest priority — and he has clearly brought that same sense of duty and commitment to the work of serving our veterans.

As he knows, it’s no small task. This department has more than a quarter of a million employees across America, and its services range from providing education and training benefits, health care and home loans, to tending those quiet places that remind us of the great debt we owe — and remind me of the heavy responsibility that I bear. It’s a commitment that lasts from the day our veterans retire that uniform to the day that they are put to rest — and that continues on for their families.

Without this commitment, I might not be here today. After all, my grandfather enlisted after Pearl Harbor and went on to march in Patton’s Army. My grandmother worked on a bomber assembly line while he was gone. My mother was born at Fort Leavenworth while he was away. When my grandfather returned, he went to college on the GI Bill; bought his first home with a loan from the FHA; moved his family west, all the way to Hawaii, where he and my grandmother helped to raise me.

And I think about my grandfather whenever I have the privilege of meeting the young men and women who serve in our military today. They are our best and brightest, and they’re our bravest — enlisting in a time of war; enduring tour after tour of duty; serving with honor under the most difficult circumstances; and making sacrifices that many of us cannot begin to imagine. The same can be said of their families. As my wife, Michelle, has seen firsthand during visits to military bases across this country, we don’t just deploy our troops in a time of war — we deploy their families, too.

So while the mission of this department is always vital, it is even more so during long and difficult conflicts like those that we’re engaged in today. Because when the guns finally fall silent and the cameras are turned off and our troops return home, they deserve the same commitment from their government as my grandparents received.

Last month, I announced my strategy for ending the war in Iraq. And I made it very clear that this strategy would not end with military plans and diplomatic agendas, but would endure through my commitment to upholding our sacred trust with every man and woman who has served this country. And the same holds true for our troops serving in Afghanistan.

The homecoming we face over the next year and a half will be the true test of this commitment: whether we will stand with our veterans as they face new challenges — physical, psychological and economic — here at home.

I intend to start that work by making good on my pledge to transform the Department of Veterans Affairs for the 21st century. That’s an effort that, under Secretary Shinseki’s leadership, all of you have already begun — conducting a thorough review of your operations all across this agency. And I intend to support this effort not just with words of encouragement, but with resources. That’s why the budget I sent to Congress increases funding for this department by $25 billion over the next five years.

With this budget, we don’t just fully fund our VA health care program — we expand it to serve an additional 500,000 veterans by 2013; to provide better health care in more places; and to dramatically improve services related to mental health and injuries like Post-Traumatic Stress Disorder and Traumatic Brain Injury. We also invest in the technology to cut red tape and ease the transition from active duty. And we provide new help for homeless veterans, because those heroes have a home — it’s the country they served, the United States of America. And until we reach a day when not a single veteran sleeps on our nation’s streets, our work remains unfinished. (Applause.)

Finally, in this new century, it’s time to heed the lesson of history, that our returning veterans can form the backbone of our middle class — by implementing a GI Bill for the 21st century. I know you’re working hard under a tough deadline, but I am confident that we will be ready for August 1st. And that’s how we’ll show our servicemen and women that when you come home to America, America will be here for you. That’s how we will ensure that those who have “borne the battle” — and their families — will have every chance to live out their dreams.

I’ve had the privilege of meeting so many of these heroes. Some of the most inspiring are those that I’ve met in places like Walter Reed — young men and women who’ve lost a limb or even their ability to take care of themselves, but who never lose the pride they feel for their country. And that is, after all, what led them to wear the uniform in the first place — their unwavering belief in the idea of America; that no matter where you come from, what you look like, who your parents are, this is a place where anything is possible, where anyone can make it, where we take care of each other and look out for each other — especially for those who’ve sacrificed so much for this country.

These are the ideals that generations of Americans have fought for and bled for and died for. These are the ideals at the core of your mission — a mission that dates back before our founding — one taken up by our first President years before he took office, back when he served as Commander-in-Chief of the Continental Army. Then-General Washington fought tirelessly to support the veterans of America’s Revolutionary War. Such support, he argued, should “never be considered as a pension or gratuity…” Rather, “…it was the price of their blood,” and of our independence; “…it is, therefore,” he said, “more than a common debt, it is a debt of honor…” A debt of honor.

Washington understood that caring for our veterans was more than just a way of thanking them for their service. He recognized the obligation is deeper than that — that when our fellow citizens commit themselves to shed blood for us, that binds our fates with theirs in a way that nothing else can. And in the end, caring for those who have given their fullest measure of devotion to us — and for their families — is a matter of honor — as a nation and as a people.

That’s a responsibility you hold, that’s the work that you do — repaying that debt of honor, a debt we can never fully discharge. And I know it’s not always easy. I know there’s much work ahead to transform this agency for the 21st century. But I have the fullest confidence that with Secretary Shinseki’s leadership, and with the hard work of the men and women of this department, we will fulfill our sacred trust and serve our returning heroes as well as they’ve served us.

Thank you. God bless you, and may God bless the United States of America. Thank you, everybody.

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Editorial Column: VA Presumes All Veterans are Dishonorable

March 16, 2009 – Since reconvening in January, Congress has proven surprisingly capable of swift movement to redress some of the worst injustices of the past eight years.

The past two months alone have brought legislation in support of job creation, equal pay for women, and expanded health coverage for children, raising hopes for the relief of other vulnerable groups. Among those most in need of renewed attention are veterans of our all-volunteer military who have come home from war seeking disability benefits for Post-Traumatic Stress Disorder (PTSD).

While the dysfunctional state of the VA claims adjudication system has become a matter of growing public concern, the rhetoric surrounding our obligation to returning troops still falls short of actual legislative priorities.

Meanwhile, recent efforts to reform the VA benefits system through litigation have only affirmed the need for legislative action, with courts repeatedly dismissing the issue as a Congressional matter. The resulting inertia makes the passage of the recently introduced COMBAT PTSD Act especially vital.

Under current VA policy, these disability claims are effectively presumed fraudulent until proven otherwise; beyond establishing their medical condition, claimants must prove through elaborate documentation that their disability stems from their military service.

While the disability claims process imposes a toll on all veterans seeking benefits, its burden falls with particular weight on those with Post-Traumatic Stress Disorder (PTSD), who must identify the specific stressor that triggered their condition, even if they have already been diagnosed and referred to treatment.

In response, Congressman John Hall has introduced legislation to eliminate this added step for all veterans who served in combat and were subsequently diagnosed with PTSD.

Under the existing system, the VA Clinician’s Guide warns examiners that PTSD symptoms are “relatively easy to fabricate,” directing them to supplement treatment records with elaborate documentation from claimants’ family and friends concerning changes from pre- to post-service status. Despite the fact that one of the diagnostic criteria for PTSD is an inability to recall important aspects of a trauma, reviewers routinely deny or remand claims due to incomplete information.

As labor-intensive for reviewers as for claimants themselves, this system has yielded a backlog of over 900,000 claims.

At the same time, the VA continues to measure employee productivity by number of cases processed, offering reviewers an incentive to take any shortcut necessary to clear their desks of pending claims. The resulting combination of too much work and too little time ultimately gives rise to premature — and inaccurate — determinations, setting in motion years of appeals.

Additionally, since the proof requirement calls for the release of extensive military personnel data, it poses a particular disadvantage to claimants with irregular or inaccessible records.

Claimants seeking compensation for Military Sexual Trauma, for example, are inevitably obstructed by the military’s policy of retaining harassment complaint files for only two years, eliminating critical evidence of the stressor that gave rise to their condition. Even in the best of circumstances, the retrieval of military records is a bureaucratic struggle, requiring protracted negotiation with a central archive in Missouri.

In spite of these inequities, the VA defends its current system as a precaution against claimant fraud.

According to VA spokeswoman Kerri Childress, eliminating the proof requirement “would be a travesty for veterans — an assault to the pride of honest soldiers when other vets scammed the system.”

Such cynicism, however, hardly seems justified by actual numbers; not only are 50{cd9ac3671b356cd86fdb96f1eda7eb3bb1367f54cff58cc36abbd73c33c82e1d} of rejected claims reversed at the first level of appeal, but 90{cd9ac3671b356cd86fdb96f1eda7eb3bb1367f54cff58cc36abbd73c33c82e1d} of claims that reach the final stage of review are ultimately approved. Far from ensuring the veracity of claims, the proof requirement serves chiefly to postpone the delivery of benefits, often until too late.

It should also be noted that no other disability insurance system, be it the Social Security Administration or the private medical insurance industry, is designed around a presumption of claimant fraud.

A useful analogy, offered by Kennedy School professor Linda Bilmes, is the approach the IRS uses for taxes: instead of investigating the accuracy of every claim, it handles most transactions with minimal processing, and audits a small subset of the total.

“The expectation” Bilmes explains, “is that the majority of claims received are approximately correct, because making them perfect would cause unacceptable delays.”

In fact, most states require by law that the medical insurance industry pay providers within 30-60 days of receiving the claim, with financial penalties for non-compliance. Federal veteran law, on the other hand, includes neither a timeline for the processing of claims nor penalties for unreasonable delays. Instead of enjoying a privileged status for their service, veterans are in fact subject to requirements unknown to any other disabled population.

Establishing service in combat as the presumptive stressor for the incurrence of PTSD would be a long overdue first step towards fixing a notoriously broken system. As Congressman Hall has emphasized, claimants would still need to be clinically diagnosed with PTSD to be eligible for benefits; they would simply be relieved of the obligation of “proving” the events that caused this diagnosis.

If we trust our troops to represent us honorably in battle, then surely we should afford them the benefit of the doubt when they seek compensation for their losses — suffered on our behalf — upon their return.

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