ptsd Insult To Injury

[allan]

FWD FROM: COLONEL DAN

Who supports the troops? It should be DOD & VA? BUT IT IS NOT!!

Story here... http://www.usnews.com/usnews/health/articles/070408/16va.htm

---------------

Insult to Injury

New data reveal an alarming trend: Vets' disabilities are being downgraded

By Linda Robinson

In the middle of a battle in Fallujah in April 2004, an M80 grenade landed a

foot away from Fred Ball. The blast threw the 26-year-old Marine sergeant 10

feet into the air and sent a piece of hot shrapnel into his right temple.

Once his wound was patched up, Ball insisted on rejoining his men. For the

next three months, he continued to go on raids, then returned to Camp

Pendleton, Calif.

But Ball was not all right. Military doctors concluded that Ball was

suffering from a traumatic brain injury, post-traumatic stress disorder

(PTSD), chronic headaches, and balance problems. Ball, who had a 3.5

grade-point average in high school, was found to have a sixth-grade-level

learning capability. In January of last year, the Marine Corps found him

unfit for duty but not disabled enough to receive full permanent disability

retirement benefits and discharged him.

Ball's situation has taken a dire turn for the worse. The tremors that he

experienced after the blast are back, he can hardly walk, and he has trouble

using a pencil or a fork. Ball's case is being handled by the Department of

Veterans Affairs-he receives $337 a month-but while his case is under

appeal, he receives no medical care. He works 16-hour shifts at a

packing-crate plant near his home in East Wenatchee, Wash., but he has gone

into debt to cover his $1,600 monthly mortgage and support his wife and

2-month-old son. "Life is coming down around me," Ball says. Trained to be

strong and self-sufficient, Ball now speaks in tones of audible pain.

Fred Ball's story is just one of a shocking number of cases where the U.S.

military appears to have dispensed low disability ratings to wounded service

members with serious injuries and thus avoided paying them full military

disabled retirement benefits. While most recent attention has been paid to

substandard conditions and outpatient care at Walter Reed Army Medical

Center, the first stop for many wounded soldiers stateside, veterans'

advocates say that a more grievous problem is an arbitrary and dysfunctional

disability ratings process that is short-changing the nation's newest crop

of veterans. The trouble has existed for years, but now that the country is

at war, tens of thousands of Americans are being caught up in it.

Now an extensive investigation by U.S. News and a new Army inspector

general's report reveal that the system is beset by ambiguity and riddled

with discrepancies. Indeed, Department of Defense data examined by U.S. News

and military experts show that the vast majority-nearly 93 percent-of

disabled troops are receiving low ratings, and more have been graded

similarly in recent years. What's more, ground troops, who suffer the most

combat injuries from the ubiquitous roadside bombs, have received the lowest

ratings.

One counselor who has helped wounded soldiers navigate the process for over

a decade believes that as many as half of them may have received ratings

that are too low. Ron Smith, deputy general counsel for the Disabled

American Veterans, says: "If it is even 10 percent, it is unconscionable."

The DAV is chartered by Congress to represent service members as they go

through the evaluation process. Its national service officers are based at

each rating location, and there is a countrywide network of counselors.

Smith says he recently asked the staff to cull those cases that appeared to

have been incorrectly rated. Within six hours, he says, they had forwarded

him 30 cases. "So far," Smith says, "the review supports the conclusion that

a significant number of soldiers are being fairly dramatically underrated by

the U.S. Army."

Magic number. In an effort to learn how extensive the problem is, U.S. News

spent six weeks talking to wounded service members, their counselors, and

veterans advocacy groups and reviewing Pentagon data. At first glance, the

disability ratings process seems straightforward. Each branch of service has

its own Physical Evaluation Boards, which can comprise military officers,

medical professionals, and civilians. The PEBs determine whether the wounded

or ill service members are fit for duty. If they are, it's back to work.

Those found unfit are assigned a disability rating for the condition that

makes them unable to do their military job. The actual rating is key, and

here's why: Service members who have served less than 20 years-the great

majority of wounded soldiers-who receive a rating under 30 percent are sent

home with a severance check. Those who receive a rating of 30 percent or

higher qualify for a host of lifelong, enviable benefits from the DOD, which

include full military retirement pay (based on rank and tenure), life

insurance, health insurance, and access to military commissaries.

But the system is hideously complicated in practice. The military doctors

who prepare the case for the PEBs pick only one condition for the service

member's rating, even though many of the current injuries are much more

complex. The PEBs use the Department of Veterans Affairs ratings scale,

which grades disabilities in increments of 10-a leg amputation, for example,

puts a soldier at between 40 and 60 percent disabled. The PEBs claim they

have the leeway to rate a soldier 20 percent disabled for pain, say, rather

than 30 percent disabled for a back injury. If rated at 20 percent or below

and discharged, the soldier enters the VA system as a retiree where he is

evaluated again to establish his healthcare benefits. Ball, for example, was

found by the VA to be 50 percent disabled for PTSD.

Since 2000, 92.7 percent of the disability ratings handed out by PEBs have

been 20 percent or lower, according to Pentagon data analyzed by the

Veterans' Disability Benefits Commission, which Congress formed in 2004 to

look into veterans' complaints (Page 47). Moreover, fewer veterans have

received ratings of 30 percent or more since America went to war in

Afghanistan and Iraq, according to the Pentagon's annual actuarial reports.

As of 2006, for example, 87,000 disabled retirees were on the list of those

exceeding the 30 percent threshold; in 2000, there were 102,000 recipients.

Last year, only 1,077 of 19,902 service members made it over the 30 percent

threshold (chart, Page 49).

The total amount paid out for these benefit awards has remained roughly

constant in wartime and peacetime, leading disabled veterans like retired

Lt. Col. Mike Parker, who has become an unofficial spokesperson on this

issue, to allege that a budgetary ceiling has been imposed to contain war

costs. A DOD spokesperson, Maj. Stewart Upton, said that the Pentagon "is

committed to improving the Disability Evaluation System across the board and

to ... a full and fair due process with regard to disability evaluation and

compensation."

Other data reveal glaring discrepancies among the military services. Even

though most of those wounded in Iraq and Afghanistan have been ground

troops, the Army and Marine Corps have granted far fewer members full

disabled benefits than the Air Force. The Pentagon records show that 26.7

percent of disabled airmen have been rated 30 percent or more disabled,

while only 4.3 percent of soldiers and 2.7 percent of marines made the

grade. Services engaged in close combat, experts say, could be expected to

find more members unfit for duty and meriting full retirement benefits.

Instead, the Air Force decided that 2,497 airmen fall into that category

while the much larger Army, with its higher tally of wounded, has accorded

those benefits to only 1,763 soldiers since 2000.

How many of these veterans' cases have been decided incorrectly? Nobody

knows. These statistics show trends that are clearly at odds with what logic

would dictate, but there has been no effort to discover how many of those

low ratings were inaccurately conferred or to ascertain why the number

receiving full benefits has declined during wartime or why there is such a

discrepancy between the Air Force and the other services. But there is

abundant anecdotal evidence of a process cloaked in obscurity and riddled

with anomalies, and of ratings that are inconsistent and often arbitrarily

applied.

DAV lawyer Smith, for example, took on the case of a soldier whose radial

nerve of his dominant hand had been destroyed, the same affliction former

Sen. Bob Dole has. Like Dole, the soldier was unable to write with a pen or

to button his shirt. "There is one and only one rating for that condition,

which is 70 percent disability," says Smith. The PEB gave the soldier 30

percent, the lawyer said, "which I found to be fairly outrageous." Upon

appeal to the Army Physical Disability Agency, the entity that oversees that

service's disability evaluation process, the rating was raised to 60

percent. Smith recently took on another case, that of Sgt. Michael Pinero, a

soldier who developed a degenerative eye condition called keratoconus that

required him to wear contact lenses. Army regulations prohibit wearing

contacts in combat, which should have made him ineligible for deployment and

therefore unfit to perform his specific military duties. But the PEB ignored

the eye condition, which Smith believes merited a 30 percent rating or more,

and rated Pinero 10 percent disabled for shin splints. Smith has asked the

Army to clarify whether it considers the regulation on contact lenses

binding or, as one board member alleged, merely a guideline. Disputes over

such distinctions are common in the Alice in Wonderland world of disability

ratings.

Controversy frequently surrounds decisions on which conditions make a

soldier unfit for duty. Smith took issue with a recent statement made by the

Army Physical Disability Agency's legal adviser, quoted in Army Times

newspaper. The official said that short-term memory loss would not

necessarily render soldiers unfit for duty since they could compensate by

carrying a notepad. "Memory loss is a common sign of TBI," Smith said, using

the abbreviation for traumatic brain injury, which has afflicted many

soldiers hit by the roadside bombs commonly used in Iraq. "The rules of

engagement are a seven-step process.... If a suicide bomber is coming at

you, you cannot stop and consult your notepad," he added. "I find this

demonstrative of the attitude that pervades the Physical Disability Agency,"

which is in charge of reviewing evaluations for accuracy and consistency.

Trying to overturn a low rating can be a full-time job-and an exasperating

one. Take Staff Sgt. Chris Bain, who lost the use of his arms but not his

sense of humor. "They call me T-Rex because I have a big mouth and two hands

and I can't do nothing with them," he jokes. He left the Army in February,

but he still has plenty of fight in him. During an ambush in Taji, Iraq, in

2004, a mortar round exploded 2 feet away from him, ripping through his left

arm and hand. A sniper's bullet passed through his right elbow. His buddies

saved his life, throwing Bain on the hood of a humvee and rushing him to a

combat hospital. Once transferred to Walter Reed, Bain refused to have his

arm amputated and underwent eight surgeries to save it. That choice cost

him. While an amputation would have automatically put him over the 30

percent threshold, the injury to his left arm was rated at 20 percent even

though he cannot use the limb.

Bain was angry. A noncommissioned officer who had planned on 20 or 30 years

in the Army, he knew his career was over, but he wasn't going to go quietly.

"I wanted to be an example to all soldiers," he said. "My job was to take

care of troops." He went to find Danny Soto, the DAV representative at

Walter Reed he'd heard so much about. "Danny is just an awesome guy. He took

great care of me, but he should not have had to," Bain says. Soto is a

patron saint to many soldiers at Walter Reed. He walks the halls, finding

the newly injured and urging them to collect documents for their journey

through the tortuous-and, to many, capricious-system. Many soldiers are

young, and after they have spent months or years recuperating, they just

want to get home and are unwilling to argue for the rating they deserve.

Even though he missed his wife and three children, Bain decided: "I've

already been here two years, another one ain't going to hurt me. Too many

people are getting lowballed."

With Soto's help, Bain gathered detailed medical evidence of his injuries

and went to face the board. They gave him a 70 percent rating for injuries

related to the blast except for his hearing loss, which was not considered

unfitting since he had a hearing aid. Oddly enough, however, the board put

him on the temporary disabled retirement list instead of the permanent list.

"What do they think, that after three years, my arm is going to come back to

life?"

A lifetime of adjusting lies ahead for Bain. "I can't tie my shoes, open

bottles of water, or cut my own food," he says. "I have to ask for help."

The 35-year-old veteran has found a new sense of purpose. He's decided to

run for Congress in 2008, and fixing the veterans' system is his top

priority. "I do not want this s--- to happen again to anyone. No one can

communicate with each other. The paper trail doesn't catch up." It's a tall

order, but the soldier says that he has "100,000 fights" left in him.

A systemic fix doesn't appear to be anywhere in sight. A March 2006 report

by the Government Accountability Office found that Pentagon officials were

not even trying to get a handle on the problem. "While DOD has issued

policies and guidance to promote consistent and timely disability

decisions," the report concluded, "[it] is not monitoring compliance." But

the GAO report did spur Army Secretary Francis Harvey, who was forced to

resign last month in the wake of the Walter Reed scandal, to order the

Army's inspector general to conduct an investigation of the disability

evaluation system. After almost a year of work, the inspector general's

office last month issued a 311-page report that begins to pierce the

confusion and opacity surrounding the process. While it does not determine

how many erroneous ratings were accorded to the nearly 40,000 soldiers rated

20 percent disabled or less since 2000, it does make three critical points:

1) the ambiguity in applying the ratings schedule should end; 2) wide

variance in ratings is indisputable, even among the three Army boards, and

3) the Army's oversight body is not doing its job.

Way overdue. Army officials met with U.S. News to discuss the inspector

general's report. "This is something that has been near and dear to our

hearts for a long time, and it's probably way overdue as far as having

someone go and take a look at it," says a senior Army official. The

inspector general's team found that Army policy was not consistent with the

policies of either the Pentagon or the Department of Veterans Affairs. It

recommended that the Army "align [its] adjudication of disability ratings to

more closely reflect those used by the Department of Veterans Affairs." For

years, the Army has asserted that it has the right to depart from VA

standards on grounds that it is assessing fitness for duty and compensating

for loss of military career, not decreased civilian employability.

Veterans' advocates argue that federal law requires the military to use the

Veterans Affairs Schedule for Rating Disabilities as the standard for

assigning the ratings. But over the years, Pentagon directives on applying

the schedule have opened up a whole new gray area by saying the schedule is

to be used only as a guide. And the services have interpreted them in

different ways, engendering further discrepancies. Soto, the DAV national

service officer at Walter Reed, says that inconsistencies are especially

prevalent in complex cases of traumatic brain injury and post-traumatic

stress disorder. "There is a saying going around the compound here," Soto

says, "that if you are not an amputee, you are going to have to fight for

your rating."

The inspector general's report calls for ending the ambiguities. "What we're

saying is it shouldn't be left to interpretation; it should be clearly

defined," says one Army official. "If there were a way to cut down on that

ambiguity, I think that variance would decrease."

Finally, the report bluntly concludes that the system's internal oversight

mechanism is not functioning. "The Army Physical Disability Agency's quality

assurance program does not conform to DOD and Army policy," it says-the same

conclusion the GAO came to a year ago. The inspector general's report adds

evidence of just how little the watchdog is doing to ensure that cases are

correctly decided. The agency is supposed to send cases to either of two

review boards when soldiers rebut their rating evaluations, but from 2002

through 2005, the agency sent only 45 out of 51,000 cases to one of the

boards. The other review board has not been used at all.

The inspector general's team made 41 recommendations in all, finding among

other things that the Army lacks a formal course for training the liaison

officers who are supposed to guide soldiers through the PEB process, that

the disposition of cases lags badly, that the computerized information

systems are antiquated, and that the two key medical and personnel databases

are not integrated and cannot communicate with each other. The report has

been forwarded to the action team that Army Vice Chief of Staff Richard Cody

convened-one of many official groups formed since the revelations of

substandard conditions and bureaucratic delays at Walter Reed.

Veterans' advocates are skeptical that the administration or the military

bureaucracy will make major changes anytime soon. In testimony to Congress

last month, Veterans for America director of veterans' affairs Steve

Robinson recommended taking the entire ratings process away from the

Pentagon and giving it to the Department of Veterans Affairs. "It's hard to

ignore the fact that in time of war they are giving out less disability," he

says. "Is it policy? I don't know. But it is a fact."

Congress has not responded to this problem. Says Rep. Vic Snyder, the

Arkansas Democrat who chairs the House Armed Services subcommittee on

military personnel: "This whole issue of disability ratings is very complex.

It is not well understood by many people, including many in Congress. That

is why we set up the [ Veterans' Disability Benefits] Commission in 2004. We

are hoping it will help us sort this out."

A lot is riding on the commission. Its chairman is Lt. Gen. Terry Scott, who

retired in 1997 and ran Harvard's Kennedy School of Government's National

Security Program until 2001. After the Pentagon data on the disability

process were presented to the commission last week, Scott said "we still

don't understand the whys and wherefores" of the skewed ratings. The core

problem, he believes, is that "the military was not designed to look after

severely wounded people for a long time." The commission has not yet decided

what changes it will recommend, but he said there is a general sense that

"one physical exam at the end of service should be enough for both agencies,

DOD and VA."

Cash and staff. Any solutions that call for transferring more responsibility

to the Department of Veterans Affairs will have to be matched by enormous

infusions of cash and staff. Already, the VA is reeling under a backlog of

over 600,000 claims from retired veterans, which the agency predicts will

grow by an additional 1.6 million in the next two years. Harvard Prof. Linda

Bilmes, an economist who has published two studies on the costs of the Iraq

war and the associated veterans' costs, projects that as much as $150

billion more will be required to deal with the wounded returning from Iraq

and Afghanistan.

Meanwhile, people like Danny Soto want to know who is going to stop the

military boards from giving out ratings like the 10 percent given to one

soldier for a skull fracture and traumatic brain injury, when the VA later

assigned a 100 percent rating. Soto is also frustrated by a recent case in

which a soldier whose legs had been severely injured in a blast in Iraq was

given only a 20 percent disability rating for pain and by the treatment of a

man who has a bullet hole through his eye and suffers from seizures. As Soto

sat with that soldier in front of the board, he asked why he had been placed

on the temporary list. "At what point do you think he is going to fall below

30 percent?"

Soto is unsparing in his criticism of the bureaucracy. "This system," he

says, " is so broke." Old soldiers say the root of the problem is an Army

culture that preaches a "suck it up" attitude. "If you ask for what you are

due, you are perceived to be whining or trying to pad your pocket," says a

retired command sergeant major. "If you're not bleeding, you're not hurt.

That's what we were taught."

With Edward T. Pound

-----Original Message-----

From: Bill [mailto:w.steimel@comcast.net]

Sent: Monday, April 09, 2007 7:58 AM

To: colonel-dan@sbcglobal.net

Subject: VA Watchdog dot Org - VA NEWS FLASH - 04-09-2007 #8 -- INSULT TO

INJURY: CHEATING OUR VETS - HOW THE PENTAGON IS SHORTCHANGING WOUNDED

SOLDIERS -- The U.S. military appears to have dispensed low disability

ratings to wounded service members with serious i

http://www.vawatchdog.org/07/nf07/nfAPR07/nf040907-8.htm

[Berta]

Allan-I just got this from the Colonel too and I hope everyone here will read it-

I was very surprised and upset at this statement:

"The agency is supposed to send cases to either of two

review boards when soldiers rebut their rating evaluations, but from 2002

through 2005, the agency sent only 45 out of 51,000 cases to one of the

boards. The other review board has not been used at all"

(They mean the Army Disability review agency)

The disparity in those two figures is alarming.Not to mention this whole article-

I often wonder-and have no way to know -unless Gold Star Wives posts this info-and I have missed it-as to whether widows and widowers of deceased Iraq veterans are being properly compensated not only by the death insurance benefit but also are getting proper help in filing SC death DIC claims.

[allan]

My gut feeling?

I think their getting stiffed, just like the rest of us.

These numbers are proof.

I don't suppose Senators like Obama come & hang out at hadit.com? or do they?

No criminal acts? nothing illegal?

Congress & the President need to deal with this now. If treating our wounded like this is not a crime, its time to make it one.

We need mandatory funding for veterans & protection rights making it a federal crime to treat Veterans in such a manor.

Some of these folks need to get the message once & for all, that Mentally, emotionally & physically disable US Veterans, will no longer be "EASY PRAY" for our enemies, foreign or DOMESTIC.

No private, or public agency should be allowed to shirk their responsibility to treat us with respect & dignity, or to provide "due process of the law".

One heck of a job, Nickelson.

[allan]

My gut feeling?

I think they're getting stiffed, just like the rest of us.

These numbers are proof.

I don't suppose Senators like Obama come & hang out at hadit.com? or do they?

No criminal acts? nothing illegal?

Congress & the President need to deal with this now. If treating our wounded like this is not a crime, its time to make it one.

We need mandatory funding for veterans & protection rights making it a federal crime to treat Veterans in such a manor.

Some of these folks need to get the message once & for all, that Mentally, emotionally & physically disable US Veterans, will no longer be "EASY PRAY" for our enemies, foreign or DOMESTIC.

No private, or public agency should be allowed to shirk their responsibility to treat us with respect & dignity, or deny "due process of the law".

One heck of a job, Nickelson.