27 September 2013

Vietnam Veterans of America Enacts Resolution Supporting C-123 Veterans!

Thanks to the Vietnam Veterans of America. the C-123 Veterans Association has even more
momentum towards gaining recognition of our Agent Orange exposure from the VA. The following national resolution was enacted at their 2013 convention, and extends the resolution supporting us first put forward in 2012.

Also, special thanks are due VVA and their president, John Rowan, for assistance in dealing with the USAF School of Aerospace Medicine and the faulty report that unit issued about C-123 dioxin contamination. When the request  went to VVA for help challenging the Air Force report, VVA leadership immediately responded and the benefits of their assistance are still being felt, and will continue to be felt, as the medical and scientific communities conclude their challenge to USAFSAM's C-123 report. We can't detail too much of this controversy until publication of the various scientific reports this fall.


2013 VVA Convention Resolution Proposed by the AGENT ORANGE COMMITTEE ADOPTED by Vietnam Veterans of America

The United States Air Force (USAF) used its fleets of C-123K transport aircraft in more than 9,100 missions, for aerial application of more than twenty million gallons of toxic herbicides between 1961 and 1971 in Vietnam. The aircraft were returned to the United States for continued use in airlift missions by USAF squadrons at Westover Air Force Base, Massachusetts; Pittsburgh Air Reserve Station, Pennsylvania; and, Rickenbacker Air Reserve Base, Ohio between 1972-1982 and were then retired from service and placed in storage. Veterans whose duties brought them into intense contact with these aircraft were exposed to military herbicides.
The United States Air Force (USAF) in 1979, in response to the presence of noxious fumes, conducted scientific tests on unit aircraft and identified and determined that significant levels of military herbicides and insecticides used in Vietnam still contaminated the aircraft; and, additional tests carried out in 1994 by USAF Armstrong Laboratories still showed the presence of herbicides, and in particular, the presence of highly toxic Agent Orange contaminant dioxin. Finding that the contamination was considered sufficient by the USAF, it then required the use of HAZMAT protective equipment when carrying out tests or otherwise entering the aircraft. As late as 2009, further USAF tests conducted at Davis-Monthan AFB, Arizona demonstrated continued contamination of these aircraft. USAF toxicology staff has testified in federal proceedings that toxic levels of contamination due to the herbicides were a danger to public health; and that the levels observed in the aircraft greatly exceed the Department of Defense’s (DoD) own standards for maximum permissible exposure to any dioxin contaminating interior surfaces. Other federal agencies have reviewed the data and concurred that exposures to personnel at levels exceeding DoD recommendations are likely to have occurred. In response to the State of Arizona and US Environmental Protection Agency environmental concerns, the USAF withdrew the aircraft from commercial resale, quarantined them and, in April 2010, ultimately took extraordinary disposal measures and smelted the remaining fleet. It is estimated that approximately 1,500 service members, including aircrews and maintenance personnel were exposed to military herbicide-contaminated conditions on the C-123 aircraft; with many of these personnel, who now having health problems commonly associated with herbicide exposure and have endured lengthy legal struggles to prove these problems are service-related. The Secretary of the Department of Veterans Affairs, under Public Law 102-4, has statutory responsibility to accurately designate situations and locations that caused veterans to have been exposed to military herbicides used in Vietnam, as well as their contaminants.

Resolved, That:
Vietnam Veterans of America, in light of the review of the data and scientific information available currently, has confirmed that post-Vietnam service aboard the C-123 led to dioxin exposure at about the same intensity as with ground troops from the Vietnam War. And, having secured expert scientific opinions as to the length and breadth of that exposure; urges the Department of Veterans Affairs to promptly designate the C-123K aircraft, used after the Vietnam War in the United States during 1972 to 1982, as having been Agent Orange exposure sites to permit the approximately 1,500 veterans who were aircrew or maintenance personnel to be eligible for Agent Orange-related benefits.
Further, in light of the inaction by both the United States Air Force and the Department of Veterans Affairs in ameliorating the present situation encountered by these approximately 1,500 veterans; VVA will also advocate with the United States Congress for the introduction of enabling legislation that would grant presumptive herbicide exposure status to US servicemembers who served in the units cited above.

Adopted by a majority voice vote by Vietnam Veterans of America at its 16th national convention in Jacksonville, Florida on 16 August 2013

25 September 2013

House of Representatives Begins Circulating Congressional Letter to VA About C-123 Veterans

Congresswoman Bonamici (D-OR) and her Republican colleague Congressman Paul Cook have begun circulating their bipartisan letter from the House of Representatives to VA Secretary Erik Shinseki, demanding justice for C-123 aircrew Agent Orange veterans. All veterans are urged to ask their congressional representatives to sign on and join this bipartisan effort! Congresswoman Bonamici has asked all veterans to urge their representatives to contact her office and join this important effort. The Senate, under leadership of Senator Richard Burr and Senator Jeff Merkley, has a similar effort underway.
Call Congress today – urge support for Congresswoman Bonamici and Congressman Cook's letter, shown below:

Veterans Exposed to Agent Orange Deserve VA Benefits

From: The Honorable Suzanne Bonamici
Sent By: carly.katz
Date: 9/25/2013

Veterans Exposed to Agent Orange Deserve VA Benefits

Dear Colleague:

Please join us in a letter to the Veterans Administration (VA) to reexamine its benefits policy for veterans exposed to Agent Orange after the Vietnam War.  Veterans who served on Agent Orange spray aircraft after the Vietnam War are facing serious health issues today due to their exposure to military herbicide residue.  These veterans served our country without knowledge of the risk to their health and they deserve to be treated fairly by the VA.  Despite evidence and support from the country’s top experts on Agent Orange, the VA refuses to provide these veterans with disability benefits. 

From 1972 to 1982, between 1500 and 2500 aircrew, aerial port, and maintenance staff served on C-123 aircraft that had been used during the Vietnam War to spray military herbicides, including Agent Orange.  Many of the country’s top experts on Agent Orange, including the Director of the National Institute of Environmental Health Sciences and the Director of the Agency for Toxic Substances and Disease Registry, have written detailed statements supporting the crewmembers’ likely exposure to Agent Orange.  Despite this overwhelming evidence and support from the scientific community, the VA denies that any level of exposure to dioxin occurred.  As a result, many veterans’ disability claims have been denied by the VA.

After publication of a Washington Post story highlighting the serious health issues facing the C-123 veterans and the VA’s refusal to grant them benefits, the VA reversed its denial of disability benefits for LTCOL Paul Bailey.  This is a positive development, but there are still many other sick veterans waiting for the benefits they have earned.. 

Please join us in writing to Secretary Shinseki urging him to reevaluate previously denied claims and carefully consider pending claims.  To sign this letter, please contact Carly Katz in Rep. Bonamici’s office at carly.katz@mail.house.gov or Claire Cozad in Rep. Cook’s office at claire.cozad@mail.house.gov by COB October 3.


Suzanne Bonamici                                         Paul Cook
Member of Congress                                     Member of Congress


October XX, 2013

Dear Secretary Shinseki:

Thank you for your work on behalf of our nation’s veterans.  We were pleased to hear that the Department of Veterans Affairs recently reversed its denial of disability benefits for LTCOL Paul Bailey, who served on C-123 aircraft in the years after the Vietnam War.  In light of this, we urge you to reevaluate previously-denied claims for other veterans who also served on C-123 aircraft.  In addition, we ask that you expedite review on current pending cases for the veterans who served aboard these planes, many of whom are suffering from multiple illnesses.

From 1972 to 1982, between 1500 and 2500 aircrew, aerial port, and maintenance staff served on C-123 aircraft that had been used during the Vietnam War to spray military herbicides, including Agent Orange.  These men and women served their country without knowledge of the danger posed to them by the dried herbicide residue on the aircraft.  Many of the country’s top experts on Agent Orange, including the Director of the National Institute of Environmental Health Sciences and the Director of the Agency for Toxic Substances and Disease Registry, have written detailed statements supporting the claims of the  crewmembers that they were exposed to Agent Orange.  Despite overwhelming evidence and support from the scientific community, the VA continues to deny that any level of exposure occurred.

As described in a recent Washington Post article, a 2009 recommendation by Hill Air Force Base in Utah stated that “smelting is necessary for these 18 [C-123] aircraft so the Air Force will no longer be liable for ‘presumptive compensation’ claims to any who works around this ‘Agent Orange’ metal.”  This appears to indicate a desire to obscure evidence of Agent Orange exposure in order to deny benefits to those who served; if that is accurate, it is shameful and an affront to many who put their lives on the line for our country.

The C-123 veterans deserve better than this.  Given the vast evidence from the toxicology community, as well as documentation from the military, the VA must seriously reconsider its position on this issue.  Those whose claims were denied deserve to have their files reopened and reevaluated.  And the claims that are still being processed must be given expedited, careful, and thoughtful review.  This attention should be given to all C-123 veterans who, from 1972 to 1982, flew the same aircraft from the same bases and with the same mission.

We will continue to follow this issue closely.  We look forward to a prompt response from you outlining the steps you plan to take to help the C-123 veterans.

      /s/       Susan Bonamici

24 September 2013

C-123 Veterans' Response to Secretary Principi - Wall Street Journal, August 28

 (this is our Association's response to former VA Secretary Anthony Principi's Wall Street Journal editorial, in which he argued for greater restrictions on veterans disability claims)
C-123 Veterans' Response to Secretary Principi:

Mr. Principi's suggestion that one group of veterans (in his editorial, Vietnam veterans) should step away from the VA's benefits application line as the solution to make room for another, more current group of veterans is ridiculous. The solution instead is to move that application line along faster, easier and less expensively than the VA does today. The
solution most definitely is NOT to deny any one group of veterans their earned benefits in favor of another group equally worthy.

Secretary Principi is correct that that veterans may turn to the VA for what could be diseases of age, but as the IOM and studies by researchers like Dr. Mark Garzotto MD (VA Portland OR) continue to show, diseases like highly aggressive prostate cancer are directly linked to doubling the rate among Agent Orange-exposed veterans as they age....clearly a situation deserving of VA attention regardless of a veteran's age when care becomes needed. And there are other similar situations surfacing only in later life.
Very fortunately, the VA and the Department of Defense have recently overhauled the separation of troops who are ill or injured, arranging their disability ratings before separation and also packaging essential care such as years of extended medical care and a wonderfully conceived "wounded warrior" program. Thus, troops leaving active duty don't face the desperate years of VA claims process addressed by the Secretary's article.
The Secretary shows yet another example of the VA mindset determined to resolve budget and other issues on the back of the veterans who earned these protections the hard way..not by being in the line, but by being On The Line!
------Wes Carter

17 September 2013

Please Join Our C-123 Agent Orange Site

Please consider joining our C-123 Agent Orange site...it helps distribute free postings to your email box each morning when there is new copy, and it help show Google their support is appreciated. Unlike most other blogs, Google immediately posts our materials on the Internet, making this resource available to all veterans concerned about herbicide exposure and concerned about how we can work with the Department of Veterans Affairs.

Our current version of C-123 Veterans: VA Illegally Blocks Agent Orange Claims is Edition 3.2, available in PDF format (free!) by downloading the 32MB book. This version is for all computers, smart phones and tables.

If you have an iPad, Apple publishes the book in iTunes, which you can find by searching Wes Carter, or clicking HERE. The Apple version is necessarily a few weeks behind the PDF version due to Apple's editing cycle. Again, the book is free from whichever source you prefer.

14 September 2013

VA Expert Posts Claims Suggestions

Getting Your Claim Processed Favorably and Quickly: Helpful Hints from the VA

Simple Truth #1: Make your claim easy to approve

As a Veterans representative, it was most difficult to move a claim through the process when it was submitted with no evidence to go with it. Sometimes I would get claims for “leg condition” or “back pain,” leaving me with nothing but questions: Which leg? What part of the leg? What is the actual condition causing back pain? Too many times, there were no medical records to show a diagnosis, or worse, nothing that would tell VA where to look for medical records.  When I would talk with the Veteran, I often found that the Veteran did not understand that he or she needed to submit supporting evidence. That’s understandable, because of complex legal requirements for compensation claims. So I often explained that the best way to get a claim granted is to make it easier for VA to grant it, or easier for your representative to help you.

Simple Truth #2: Tell VA where to find evidence

Sometimes I hear people say that VA will develop your claim to the fullest and you just have to file it. But you have to tell VA where to look. If you don’t, it can be like looking for a needle in a haystack of Federal agencies, each with its own set of records. And if Veterans don’t tell VA where their records are, we may not know where to find them. This becomes even more important if you’ve received treatment from a private sector doctor.

Simple Truth #3: Often, you can obtain evidence easier than VA

Usually, Veterans can get evidence about their own history more easily than VA can. Private medical records are a good example of this, since VA cannot compensate private medical providers for records. We have a duty to assist the Veteran in finding evidence, but it can take a lot longer. If you do not at least tell them where the evidence is, it becomes much harder to find and less likely VA will be able to obtain it and grant your claim. To put it another way, if it was hard for me as a Veterans representative, it was hard for VA.

12 September 2013

VA Saves Huge $$ By Denying and Delaying Veterans' Disability Claims (part 2)

VA Saves Big $$$ By Delaying Veterans’ Claims:

Too often folks think a delayed VA claim is merely that...postponement of compensation which will all catch up eventually. That is a terribly wrong impression. 
The truth is so much worse...the awful truth is that the VA saves immense amounts of their budget by denying claims whenever possible, and by postponing approvals as long as possible. While some veterans’ disabilities are minor, other vets are left, or become, totally disabled with military injuries, without funds, without medical care, and with families left destitute until some day a VA clerk gets around to approving their claim after years waiting. (And, yes, we understand that current discharged troops have an extended period of VA medical care, but none of the other disability benefits essential to life after injury.)
The advantages and savings (to the VA) are obvious when you think about it:

      • No medical care at all (VA estimate: $600 per visit) is provided during the application phase or appeal – a two year wait for a claim to be denied followed by a two-three year wait to reach the BVA means five years of VA savings by not providing any care at all
  • All dental, pharmacy, vision, rehabilitation, wheelchairs, crutches, prosthetics, lab, imaging, social services and every other vital care is refused until a claim is finally approved; denied medical care for such things worsens the impact of the veteran's service-connected injury–an untreated dental or other infection can kill a veteran with heart disease or other illness. Cancers (and despair!) can kill a veteran long before the VA finishes considering even the initial claim
  • No travel pay or special clinics, such as the Spinal Cord Injury Centers 
  • No clothing allowances for prosthetic or medication-damaged clothing
  • No federal or state disabled veteran hiring preference
  • No Service-Disabled Veterans Life Insurance, nor provision for the one year of free VGLI
  • No family benefits, such as ChampVA and dependents’ educational allowance (the loss or even delay of these two can be devastating to college-age families, where students waiting for a parent's disability claim can't get the vital Dependents Educational Allowance, placing college beyond the means of most disabled veteran parents!)
  • No military commissary privileges, nor space-available flights
  • No adaptive housing or vehicle allowances
  • No interest paid on retroactive claim settlements; no reimbursement for medical bills paid by veteran for military injuries before claim is approved
  • No state benefits, such as free tuition for veterans or their dependents, property taxes, auto allowances; no disabled veteran hiring preference until claim is approved; no fee-free VA Home Loan until veteran rated "service connected disabled"
  • If the veteran dies without eligible survivors, even the retroactive disability payments are “saved”
  • Adaptive housing and other special housing needs denied until claim awarded means veteran usually pays for such modifications rather than wait
  • No clothing or automobile allowances
  • No aid & attendance allowance, nor nursing home
  • No burial allowance if veteran dies before claim awarded
  • If the veteran dies before claim is decided, in the event of a denial the survivors have a much poorer chance of successful appeals without the veteran's personal knowledge and input to the appeal, thus saving the VA years of DIC, CHAMPVA, etc.

11 September 2013

Don't Tweak the VA's Nose, Part Two

Reading over my recent VA decision, in which 15 separate issues claimed were all denied, I'm convinced I really, really annoyed somebody at 1800 G Street in the District.

Denied were some issues for which I haven't even been examined yet. Maybe they were denied to save postage later??

Denied also were issues for which I submitted a Line of Duty determination, commander's letter, Bethesda Naval Hospital treatment records, all of which the VA summed up as  "no record of injury or treatment during service."

Denied were claims for aid and attendance, although I'm confined to bed or a power chair most of the time and unable to manage my life without help (cleaning, dressing, transportation, cooking, medication, home management, etc.) 

Denied were claims for chronic pain, despite VA referrals to pain clinics for treatment of chronic pain, despite VA steroid injections, despite VA-prescribed morphine, despite clinical diagnosis of chronic pain, despite Social Security legal determination of chronic pain, despite twelve surgeries since Gulf One, all denied without reference in the denial even to the VA's own records for these proofs.

Denied also, all my claims for poor treatment/bad results/failure to diagnose/malpractice associated with years of poorly monitored steroid prescriptions which resulted in a myriad of health problems. Denied even though a surgeon failed to note two years of steroid prescriptions, and instead noted in error the absence of those prescriptions because he didn't bother reading the patient records, important because steroids are a near-universal precursor for problems the VA then failed to treat. And a little CYA from his boss.

It just goes to show you: don't annoy the VA until your claim has been decided and you are safe in the P&T category!

American Legion Decries Poor Quality of VA Rating Decisions before House/Senate Joint Hearing

Sen. Bernie Sanders, (I-Vt.), chairman of the Senate Veterans' Affairs Committee/C-SPANVA Needs to Improve Claims Decisions, vets tell Congress:

By Steve Vogel, Published: September 10 at 12:17 pmE-mail the writer

The commander of the nation’s largest veterans organization warned lawmakers Tuesday that the Department of Veterans Affairs’ progress in reducing the size of the disability claims backlog is threatened by the number of mistakes the department makes on those claims.

The VA reported recently that it has cut the inventory of claims 20 percent from its peak of nearly 900,000 veterans since March.

“We are optimistic that recent efforts to move beyond an outdated, paper-based processing system will help [eliminate] the backlog of undecided claims, but unfortunately, accuracy remains a serious problem,” American Legion national commander Daniel Dellinger told a joint hearing before the House and Senate veterans’ affairs committees.

The VA’s reports place the accuracy rate in the mid-80s, Dellinger noted. But the Legion’s action review teams working with VA regional offices are finding error rates as high as two-thirds, he added.

“That’s unacceptable,” Dellinger said. “And again, we all share in the obligation to correct the problem.”

Legion officials told the lawmakers that the VA work-credit system that rewards claims processors for the number of claims they complete causes some of the accuracy problems.
An employee may not do a thorough job of researching a claim “to make that quota,” said Verna Jones, the Legion’s director of veterans affairs and rehabilitation.

“As is, the work-credit system is counter-productive,” she testified. The Legion recommended overhauling the system.

Sen. Bernie Sanders (I-Vt.), chairman of the Senate Veterans’ Affairs Committee, said he shared “guarded optimism” about the VA’s performance.

“While we’ve seen a steady decline in the backlog, clearly there is much, much more work to do,” Sanders said. “Veterans deserve not only timely but accurate decisions.”

Reporter Steve Vogel
(note: this reporter’s earlier articles detailed the 75% error rate in claims forwarded to the Board of Veterans Appeals, and the three to five year wait for adjudication at that tribunal. Thus presently-denied claims, which took between two and three years to be denied, face another unconscionable delay before the veteran can finally receive necessary medical care and compensation!)

10 September 2013

VA Appeals Process Remains Deadlocked

Veterans face another backlog as a quarter-million appeal disability claims

As the Obama administration touts its recent progress in reducing the enormous backlog of veterans’ disability claims, a second backlog is rarely mentioned.
More than a quarter-million veterans are appealing disability-claim decisions they say are wrong, and in some cases they can wait four years or more for a ruling, figures from the Department of Veterans Affairs show.

The 256,061 veterans appealing decisions represent an approximately 50 percent increase since President Obama took office. And more are coming. The Board of Veterans’ Appeals, which makes the final administrative decisions on appeals, expects its number of pending cases to double over the next four years.
“I’m not looking for any special treatment here,” said Matthew Goldberg, 47, a retired Army Special Forces soldier who served three tours in Iraq and earned three Bronze Star Medals. Since 2008, he has been appealing a VA decision that granted him limited disability compensation for post-traumatic stress disorder and a back injury.
“I just want to be treated with dignity and respect, and a lot of the time I didn’t get that from VA,” said Goldberg, who has sought higher compensation.
The appeals backlog has grown partly because VA has directed resources away from appeals and toward the high-profile disability backlog, according to interviews with VA workers and veterans’ advocates.
“VA is robbing Peter to pay Paul,” said Glenn Bergmann, a former appellate litigator in VA’s Office of the General Counsel who now frequently represents veterans on disability-claim appeals.
VA Secretary Eric K. Shinseki acknowledged in an interview last week that appeals do not get the same emphasis as new claims but said that will change as the backlog shrinks. “Yes, there is a need to focus on appeals,” Shinseki said. “This is an elephant. You have to take bites one at a time.”
In recent months, amid criticism from Congress and the media, the department took dramatic steps to attack the claims backlog. It mandated overtime for new claims and directed that disability cases older than one year be moved to the front of the line.
Gerald Manar, deputy national veterans service director for the Veterans of Foreign Wars, said VA officials at regional offices often make a “calculated decision” to pull workers off appeals and redirect them to new claims.
“Over the last three years or so, every time VA has made a push, they pull almost all of the employees out of appeals and into front-end work,” said Manar, a former VA benefits manager.
Beth McCoy, assistant deputy undersecretary for the Veterans Benefits Administration, said VA headquarters has directed regional offices not to take workers off appeals. “It’s tempting to take those appeals resources,” she said. “But that wasn’t our intent, and we continue to reinforce that.”
A veteran who takes an appeal through all available administrative steps faces an average wait of 1,598 days, according to VA figures for 2012. If the veteran pursues the case outside VA to the U.S. Court of Appeals for Veterans Claims, it takes an additional 321 days on average, according to court documents

VA Rating Officials Do Easy Claims First, Hard Claims Last to earn bonuses

WWhile veterans waited longer than ever in recent years for their wartime disability compensation (added: and access to medical care), the Department of Veterans Affairs gave its workers millions of dollars in bonuses for “excellent” performances that effectively encouraged them to avoid claims that needed extra work to document veterans’ injuries, a Yakima WA News21 investigation has found.

In 2011, a year in which the claims backlog ballooned by 155 percent, more than two-thirds of claims processors shared $5.5 million in bonuses, according to salary data from the Office of Personnel Management.
The more complex claims were often set aside by workers so they could keep their jobs, meet performance standards or, in some cases, collect extra pay, said VA claims processors and union representatives. Those claims now make up much of the VA’s widely scrutinized disability claims backlog, defined by the agency as claims pending more than 125 days.
“At the beginning of the month ... I’d try to work my really easy stuff so I could get my numbers up,” said Renee Cotter, a union steward for the Reno, Nev., local of the American Federation of Government Employees.
Now, claims workers said, they fear the VA’s aggressive new push to finish all one-year-old claims by Oct. 1 — and eliminate the entire backlog by 2015 — could continue the emphasis on quantity over quality in claims processing that has often led to mistakes. VA workers have processed 1 million claims a year for three years in a row.
Beth McCoy, the assistant deputy undersecretary for field operations for the Veterans Benefits Administration, or VBA, said bonuses for claims processors were justified because, even though the number of backlogged claims was rising, workers were processing more claims than ever.
“There are many, many employees who are exceeding their minimum standards, and they deserve to be recognized for that,” she said.
She also said the VBA is improving quality even as it processes more claims.
But documents show that a board of appeals found in 2012 that almost three out of four appealed claims were wrong or based on incomplete information.
Approximately 14,000 veterans had appeals pending for more than two years as of November.
The VA has promised to reduce wait times and improve accuracy by scanning the piles of paper claims into an electronic system for processing with new software, but the expensive transition has been beset with problems.
The workload for VA claims workers also has doubled in the past five years. This included new claims from a quarter-million Vietnam veterans in 2010, when the VA added B-cell leukemias, Parkinson’s disease and ischemic heart disease to the growing list of health conditions that veterans can claim because of exposure to the toxic chemical Agent Orange in Vietnam. In addition, more than 830,000 Iraq and Afghanistan war veterans returning home had filed claims as of March, according to VBA data.
According to 2012 data, the VA employed more than 11,000 claims processors or assistants. Most handle disability claims, while some deal with claims such as those for education and other benefits.
In an attempt to encourage more productivity, the VA changed claims processors’ performance criteria between 2010 and 2012. The changes discouraged them from spending time gathering additional documents that could support complicated claims, according to written performance requirements for claims processors.
McCoy, the VBA official, said she heard from employees in the field that they felt the performance standards were not fair. “Things are changing very quickly, and we’re struggling a little bit to keep up with the pace of change as we update our performance standards,” she said.
A processor must gather medical and military records for each disability and assign disability ratings based on the severity of injury, which then determines the monthly check from the government(added: as well as whether or not VA will even treat the veteran's illness or injury.)
The VA paid $44.3 billion in disability benefits and $5.5 billion to survivors of veterans with a service-connected disability, according to its annual benefits report for fiscal 2012. A veteran who is rated 10 percent disabled receives a standard $129 per month.
Claims for multiple injuries require significant time to gather documentation. Other claims, including for post-traumatic stress disorder, military sexual trauma or traumatic brain injury, can require just as much effort because they can be more difficult to prove than physical injuries.
In April 2010, the VA stopped giving its employees performance credit for “supplemental development,” which included tasks such as calling and sending follow-up letters to veterans and follow-up requests for military documents and medical records.
The change was meant to encourage processors to finish claims. But a complex disability claim could take all day, while a claim for one or two injuries could be completed much faster, said David G. Bump, a national representative of the American Federation of Government Employees and former claims processor at the Milwaukee regional office.
“I think after a couple of years of seeing things piling up, they realized that that didn’t work,” said Bump, a member of the bargaining committee that has met three times with the VBA in 10 months to discuss changing the standards.
Claims workers can be fired or demoted for not meeting standards in Automated Standardized Performance Elements Nationwide, or ASPEN, the VA’s system of awarding a specific number of points daily for each task an employee performs.
Performance evaluations for all claims workers include the elements of “productivity,” “quality” and “customer service.” While “quality” is measured by a random sampling of an employee’s claims and “customer service” is measured by the number of complaints against the employee, “productivity” is judged by ASPEN points, the average work credits the employee must earn per day.
ASPEN points could translate into financial awards at the end of each year if a worker earns an “excellent” or “outstanding” performance.
But News21 found that regional office management gave bonuses to some employees even as their claims backlogs grew. During 2012, Office of Personnel Management records show some of the most troubled offices gave their employees the most extra pay.
The Baltimore office, which has the longest wait times in the country, gave bonuses averaging $1,100 each to 40 percent of its workforce. The Oakland, Calif., office, which shut its doors to retrain underperforming employees, awarded nine out of every 10 workers a total of about $33,000 — almost enough to pay the standard year’s benefit to a veteran who is 100 percent disabled.
In Sioux Falls, S.D., claims workers processed claims four times as fast as those in Oakland and Baltimore but less than one in 10 there received extra pay last year.
In 2008, Congress ordered the VA to review its work-credit system. A 75-page report produced by the Center for Naval Analysis in 2009 recommended the VA address perceptions that quantity receives more emphasis than quality, by changing the tasks that receive points to better reflect the actual work.
“This is one of the reasons why, as some managers noted, the inventory of old claims consists disproportionately of ‘difficult’ cases,” the report said.
A claims processor in Reno told News21 that this “breeds cheating” and that he has seen employees who aren’t making enough points go into “survival mode” and process only easy claims. Shifting performance points to reward backlog-related work would be more effective, said the worker, who, like others, requested anonymity for fear of reprisals.
“Your backlog is over here. But your points are in this direction. How stupid is that?” asked the worker.
Damon Wood’s disability claim for PTSD, ringing in the ear and a bad back and knee has been cycling for 21 months through a fortified federal office building in a corporate park on the outskirts of Reno.
He quit checking its status online because it hadn’t changed for more than 11 months. When he tried calling the Reno regional office for more help, he was diverted to one of the VA’s eight national call centers.
“Your hands are tied by the people who actually have the claim in their hands,” Wood said. “So you can’t do anything more or anything less. It’s up to them.”
Fran Lynch, a former Seattle claims processor and exam consultant, said the VA built a “wall of separation” between the workers and the veterans.
“People form opinions about veterans based on paperwork, and they make decisions based on those opinions without ever really knowing the guys’ circumstance,” he said.
Allison Hickey, VA undersecretary of benefits, promised veterans in April that the more than 65,000 claims two years old or older would get a temporary or permanent decision by June 19, while those waiting more than a year would be considered by October.
For the third consecutive year, the VA mandated 20 hours per month of overtime for employees for part of this year to meet the deadlines, costing the agency approximately $44 million. In June, the VBA processed a record 110,000 claims, officials said.
Darin Selnick, a VA political appointee in the George W. Bush administration, called the quickly finished claims an old “sleight-of-hand trick.” Selnick said regional office directors and central office staffers misled VA leadership during the past decade with similar numbers games that disguised the problem and kicked the can down the road.
“They knew it was coming, and they knew it was going to get worse,” Selnick said. “I think the current leadership, Allison Hickey, they do the same thing to her.”
In addition to a mounting pile of claims filed by the veterans of Iraq and Afghanistan, claims processors struggle with understaffing, an incomplete software system and paper claims that must be shipped around the country in boxes and sorted in mailrooms and that are sometimes forgotten in file cabinets.
The VA has for years tried to alleviate the load on overwhelmed offices by shipping backlogged claims around the country to other offices. Hickey ordered this “brokering” of old claims as a way for some offices to meet her deadlines.
According to internal documents, the VA has shuffled more than 50,000 claims among regional offices since January, including 16,000 in June. But workers say the practice is unfair to local veterans filing claims when their local office has to shoulder the load for poorly managed offices.
Workers in Milwaukee received more than 5,000 old claims from Houston and Los Angeles beginning June 11. Sioux Falls received 2,600 claims from St. Louis, Houston and Portland. Meanwhile, Reno completed just more than 1,000 old claims after shipping off 4,500 claims in its inventory to offices in Louisville, Sioux Falls and elsewhere.
“We’re looking like we’re making progress ... but in ways that aren’t sustainable,” said one claims processor, who declined to be named for fear of reprisals. “We’re not actually doing anything to fix problems that are actually causing the backlog. ... At some point, that overtime’s got to end and you can’t continue to broker out work, and what happens at that point? Nothing’s been fixed, and the same problem persists.”
All of these problems come at a critical time for veterans seeking disability compensation.
Stephen Leon served two tours in Afghanistan and won the Army Commendation Medal for valor after a firefight with three suicide bombers outside a gate in Kabul in 2011. The blast from one of their bombs left him with wrist, neck, knee, back and ankle injuries, as well as traumatic brain injury and PTSD.
When he returned home July 2011, he couldn’t get his mind off Afghanistan, the battles and the friends he lost. “You’re used to a life of being at peace, with yourself and your family and ... when you go over there, all that breaks up,” he said.
Facing financial difficulties and struggling with PTSD, he was forced to move in with his mother. “I couldn’t get a dime for claims, I couldn’t get in touch with anyone, and the ones I could get in touch with, they didn’t want to help me anyway,” he said.
He enlisted the help of an independent advocate, who fought for his claim and connected him with housing and better PTSD treatment. He was rated 70 percent disabled a year ago and now lives in his own apartment in Revere, Mass.
Without the help of an advocate and without the money, Leon said, he is convinced he would be homeless or dead.
• Shinn was a Women & Philanthropy fellow for News21 this summer. Hannah Winston contributed to this report.
• This article is part of the project “Back Home: The Challenges Facing Post-9/11 Veterans Returning from the Wars in Iraq and Afghanistan” produced by News21, a national investigative reporting project involving top college journalism students across the country and headquartered at the Walter Cronkite School of Journalism and Mass Communication at Arizona State University. News21 is funded by the John S. and James L. Knight Foundation and the Carnegie Corp. The Ethics and Excellence in Journalism Foundation, the Hearst Foundations, the Donald W. Reynolds Foundation, Women & Philanthropy at Arizona State and the Peter Kiewit Foundation funded the work of individual fellows. For the complete project, visit backhome.news21.com

09 September 2013

VA Budget Skyrockets Despite Federal Spending Cuts

VA Budget Skyrockets Despite Federal Spending Cuts

Sep 09, 2013
DAYTON -- The Department of Veterans Affairs spends more today in inflation adjusted dollars than it did after World War II and the Vietnam War, when millions of troops returned from the battlefield, according to federal budget figures.
By the next fiscal year, the VA budget is projected to rise 58 percent since 2009 to $152.7 billion, more than double the $70.9 billion spent in 2005, agency figures show.
At the Dayton VA, spending has risen to a projected $285.3 million this year compared to $131.2 million in 2001.
Two factors more than any others have driven health care costs higher at the Dayton VA Medical Center, officials said. Aging Vietnam veterans who have more health needs as they grow older, and the return home of thousands of veterans from the battlegrounds of Iraq and Afghanistan.
"It's the number of veterans returning from the war, but it's also the conditions they are returning with," said Dr. William J. Germann, Dayton VA chief of primary care service and a retired Air Force brigadier general. "There are a number of veterans coming back dysfunctional and as a result may not be able to hold a job."
Straining under the national debt, budget cutters have slashed billions in federal spending and ordered unpaid furloughs of hundreds of thousands of Department of Defense civilian employees, but the VA's spending has more than doubled in little more than a decade and keeps climbing.
"It's a tricky issue because you want to make sure we are keeping our compact with men and women who have served and been in harm's way ... but you also recognize we're not doing those men and women a service if we're not spending that money wisely," said Stephen C. Ellis, vice president of the non-partisan Taxpayers for Common Sense in Washington, D.C., and a former Coast Guard officer.
'Overwhelmed' with new claims
The more than 3 million veterans since the first Gulf War in 1991 who have entered the VA ranks have overwhelmed the system, said Dr. Chrisanne Gordon, a Marysville rehabilitative physician.
"I do feel the system is overwhelmed," Gordon said. "I would say overwhelmed and slow to respond."
She's worked with the Dayton VA to link Iraq and Afghanistan veterans to civilian medical centers. The mostly teaching hospitals have advanced technology to detect traumatic brain injury a normal MRI does not locate, she said.
"I really believe there needs to be collaborative effort between VA and the civilian medical community," she said. "My belief is in the civilian world we are more accountable and we react quicker."
The number of veterans and visits have climbed dramatically at the Dayton VA and community clinics in Springfield, Middletown, Lima and Richmond, Ind.
Both figures show why costs have jumped.
Five years ago, the VA treated 32,858 veterans who accounted for 360,946 visits at a cost of $588 per visit. Under Dayton VA projections, those numbers will rise to 36,691 veterans making 470,151 visits at a cost of $607 per visit.
"This has never happened before so the workload has increased exponentially," said Margaret I. Kruckemeyer, a retired Dayton VA nurse practitioner and former president of the Nurses Organization of the VA, a national advocacy group. "You are going to have issues and all of our people who have served their country especially in war zone, come back with scars. ... You never have a veteran with a pure problem. They have a multitude of problems, and that's costly."
Kruckemeyer said the nation has an obligation to meet the health care needs of veterans who risked their lives in combat.
"If we spend trillions of dollars to send our men and women who volunteer to do whatever Congress tells them to do on behalf of freedom, then they come back wounded and you can't see some of the scars, it just seems like there's a disparity," the former Army nurse said.
Her husband, William C. Kruckemeyer, was a helicopter pilot in Vietnam. Today, the Beavercreek couple said, he lives with the legacy of exposure to the herbicide Agent Orange, which was sprayed by U.S. troops throughout Vietnam.
His health has worsened because of auto-immune related conditions that have affected four major organs. Kruckemeyer, who uses a wheelchair, has had extensive treatments at the VA.
"I was fortunate enough to have my wife as my advocate so I could get in and move around" the VA health system, he said. " ... I could see where a fellow or a gal who has come back and has not had the benefit of somebody that knows the ropes and where to go and how to get there, that can be a real problem."
Christopher P. Wilson, of Bellbrook, is one of the new veterans who has come to the Dayton VA from the battlefield. The 27-year-old served as an Air Force machine gunner on a Humvee at Camp Bucca in Iraq where he lived through mortar and IED attacks.
Since the military police officer left the Air Force last November, he said he's sought treatment at the Dayton VA for PTSD, anxiety and depression. Before he left the Air Force, he was diagnosed with post-traumatic stress. But he had to wait a year for the VA to reach the same conclusion, he said.
"I went to the VA and the doctor basically told me without a diagnosis from them the military diagnosis means nothing," he said. Today, he receives counseling, but expressed frustration over the four months he said it took to schedule a medical appointment to change a prescription.
Like many other veterans, he's also waited months on a VA disability claim filed with the Veterans Benefits Administration regional office in Cleveland. The married father of two young children is enrolled in business college courses and looks for work.
"It puts a lot of stress on the family going just from being in the military and getting out to being on deployment to trying to find work," he said. "It would be nice to have the extra money. My wife is having to work now and I'm trying to find a job and juggle day care."
The homefront cost of war
Despite the rising costs for the VA, U.S. Sen. Sherrod Brown, D-Ohio, said spending on veterans' needs has bipartisan support in Congress.
More veterans today have arrived home with injuries that soldiers died from in past wars, they're receiving more costly and sophisticated care and the rise in veterans' claims for exposure to Agent Orange have pushed costs upward. But the expense is justified as long as the Veterans Benefits Administration makes progress to reduce a claims backlog, he said.
"I think (the cost) can be sustained because I think it needs to be," he said. "... We can't be penny wise pound foolish on this."
While much of the federal government hasn't escaped budget cuts, U.S. Sen. Rob Portman, R-Ohio, said the decision to exempt the VA from the budget sequester was "the right one."
"We need to have every VA employee on deck to serve our veterans," he said in a email in response.
Still, he said, while the priority on veterans' spending was justified, "some of this funding could be spent more efficiently. We need to focus on that as we work to solve the VA's challenges and that effort will only become more critical as the VA's budget continues to feel the pressure of our unsustainable debt and deficit."
U.S. Rep. Mike Turner, R-Dayton, voted against the sequester and also opposes imposing it on the VA. "Exempting the VA from the effects of sequestration is necessary to ensure veterans and their families continue to receive the services, care, and the assistance that they have earned and deserve," he said.
The Dayton VA has hired new staff, bought medical equipment, and expanded programs to treat returning veterans for post-traumatic stress disorder, traumatic brain injury and expand mental health care services, among other priorities. It opened a women's health care center to treat the fastest growing segment of veterans, according to Dayton VA Medical Director Glenn A. Costie.
The Dayton VA plans to open a new multi-million dollar magnetic resonance imaging (MRI) machine to meet demand. They've also focused on housing homeless veterans, another VA priority.
Rising costs peak
In 1947, two years after the end of World War II, the VA spent a post-war high of $87 billion, according to a Congressional Research Service report released last year. VA spending reached a post-Vietnam peak of $76.9 billion in 1976, the research service said. Both budgets were adjusted for inflation and compared to 2011 dollars.
This fiscal year, the VA will spend $138.5 billion. That number includes $66.4 billion in entitlements, such as disability pensions, and housing vouchers, and an expected $61 billion in discretionary spending on health care, among other areas.
"Spending on veterans' benefits and services has certainly grown at a much faster rate than other areas of the budget," Todd Harrison, a senior fellow at the Center for Strategic and Budgetary Assessments in Washington, D.C., said in an email. Congress sets veteran benefits based on formulas that don't require annual appropriations. "These benefits are an entitlement for the people who qualify, and the spending is essentially on autopilot. To change the level of spending, Congress would have to change the criteria for determining who qualifies and what benefits they will receive."
VA spending will keep rising, he predicted. "I don't think it is likely Congress will make substantial reforms in this area of the budget due to the political consequences involved," Harrison wrote. "No one wants to be seen turning their backs on veterans, especially as the military is winding down two protracted wars."
Kimberly Frisco, a Dayton VA spokeswoman, said the VA has a two-year budget, and the agency can't predict what might happen to spending after 2014.
VA accountability on spending
Even so, Congressional critics have demanded more accountability from the VA with the surge of cash.
The VA nationwide has been subjected to congressional criticism for lavish spending on conferences, bonuses given to some VA senior executives a congressional critic contended weren't linked to performance, and a persistent claims backlog that has bedeviled the Veterans Benefits Administration.
"VA doesn't have a money problem," said U.S. Rep. Jeff Miller, chairman of the House Veterans Affairs Committee, said in a statement to this newspaper. "It has a management problem. Whether it's funding, staffing, or information technology tools, Congress has given the VA everything it has asked for to overcome perennial challenges such as its mountain of backlogged disability benefits compensation claims. ... For its part, VA has failed to deliver the backlog results department officials have been promising for years."
Despite record VA spending on medical and mental health care, the agency has struggled to "curb the epidemic of veterans suicides and to stop the emerging pattern of preventable deaths and serious patient safety issues at VA medical centers around the country," Miller said.
"But perhaps there is no better illustration of VA's management failures than the department's ongoing executive bonus scandal which calls into question whether VA leaders even know the meaning of the word accountability," Miller said.
Miller's website pointed to a Dayton VA case involving unsanitary practices at the dental clinic, among other cases across the nation: Former Dayton VA Medical Center Director Guy B. Richardson collected an $11,874 bonus in 2010 while the center's dental clinic was under investigation for unsanitary practices by a former dentist over 18 years, the Dayton Daily News has reported.
Costie, who took over the position when Richardson departed to another VA job, said his bonus was tied to "clear metrics" and approved through "a chain of command" of higher-ranking managers who evaluated his performance. Costie was paid a total of $186,829, including a $10,380 bonus, through late August, according to data released under a Freedom of Information Act request.
The claims backlog has brought focused criticism from Congress, even as the agency has reported progress to reduce the problem.
VA spokeswoman Nicole Alberico noted the agency completed a "record-breaking" 1 million claims in each of the past three years, but the number received continues to exceed what's processed. The VA has a goal reduce the number of claims beyond 125 days to zero by 2015 with a 98 percent accuracy rate.
House Speaker John Boehner, R-West Chester Twp., said "more transparency and more accountability" is needed on the issue.
"While I applaud the renewed efforts to address disability claims in Ohio that have been pending more than two years, I have serious concerns that they will be just another Band-Aid covering the larger problem: the system, is broken and needs to be fixed," Boehner said.


Department of Veteran Affairs Sequestration and the Military