Iraq, Afghanistan VA Patients Exceed 400,000
Thursday 29 January 2009
by: Maya Schenwar, t r u t h o u t | Report
Source:
http://www.truthout.org/012909J
Symptoms of post-traumatic stress disorder (PTSD) bring the horrors of the
battlefield home. Twenty-six percent of Iraq and Afghanistan veterans who seek
care at the VA have PTSD. (Photo: Joe Raedle / Getty Images)
As the number of veterans seeking health care continues to rise, the VA is
straining to meet demands.
Amid talk of a drawdown of troops in Iraq, new statistics from the Department of
Defense (DoD) and the Department of Veterans' Affairs (VA) show that US
casualties are still climbing quickly. Iraq and Afghanistan battlefield injuries
and deaths number 81,361, up from 72,043 last January, according to data
obtained through a Freedom of Information Act request by Veterans for Common
Sense (VCS). Veteran patients - including those who didn't seek care until their
return home - shot up to 400,304 (from 263,909 in December 2007).
For the thousands of soldiers flooding the VA, mental illness tops the list of
ailments. Forty-five percent of VA patients have already been diagnosed with
mental health conditions, including a startling 105,000 diagnosed with
post-traumatic stress disorder (PTSD). These data do not include the
incalculable number of mentally ill veterans who have not received a diagnosis
or haven't sought treatment at the VA.
Health care for veterans has improved substantially in the past year, mostly due
to legislative changes and funding boosts, according to Raymond Kelley,
legislative director of AMVETS. The recently passed Dignity for Wounded Warriors
Act entitles veterans to up to five years of free health care for
military-related medical conditions. Other legislative victories include
improvements to VA facilities, increased mental health care research and a boost
for the claims processing system, which has been vastly understaffed and
overburdened throughout the "war on terror."
However, many barriers to adequate care and compensation remain, particularly
for veterans filing for disability benefits. Delays and denials of those claims
are routine. Among vets with PTSD, 59 percent have not been approved for
benefits, meaning that their claims are pending or rejected - or that, due to
any number of deterrents, they have not filed a claim.
According to Paul Sullivan, executive director of VCS, the average wait-time for
veterans to receive an answer after filing for disability compensation is more
than six months. A recent VCS lawsuit against VA showed that PTSD patients face
even longer delays.
"That's wrong and it needs to get fixed now, especially during the recession
when the veteran may also be out of work due to their disability," Sullivan told
Truthout. "While veterans wait, their homes are foreclosed. Renters are evicted.
Cars are repossessed. Some families often lack food or utilities while VA
dawdles endlessly. Many veterans become homeless waiting for disability
benefits."
More than 809,000 veterans (from all wars and peacetime) are currently waiting
on pending claims.
Sullivan points to the case of Iraq veteran Scott Eiswert, who committed suicide
after the VA rejected his PTSD disability compensation claim for the third time.
After his death, the VA went further, denying Eiswert's life insurance benefits.
Jennifer Pacanowski, an Iraq veteran now living in Pennsylvania, waited two and
a half years to receive a PTSD diagnosis, and nine months for her PTSD claim to
be processed. In the meantime, her mother paid for all her medical care. Most of
Pacanowski's efforts to utilize the VA yielded only frustration.
"Every time I reached out to the VA for help, they tried to have me admitted
into the psych ward, which scared me, since all I needed was to talk to
someone," Pacanowski told Truthout. "My family doctor from childhood tried to
help with meds and treatment but [dealing with] combat veterans was a completely
new thing for him, so it was hit or miss, with months of med changes and severe
depression and anxiety, so I could not function."
Pacanowski still can't get all she needs from the VA. Since receiving her
diagnosis, she has been eligible for full mental health benefits. However, the
VA is overbooked, crowded and understaffed, and can only offer Pacanowski an
appointment once every three weeks. So her family still shoulders much of the
burden, paying for a private psychologist who can fill in the gaps.
According to Kelley, some claims are adjudicated quickly - usually those of
recently discharged vets with very clear medical documentation of their
condition. However, if a veteran doesn't visit the VA soon after returning home,
or can't supply what the VA deems clear documentation, the claim could linger
for years.
Moreover, the VA's intimidating bureaucracy deters some veterans from filing a
claim at all. The process is arduous and sometimes convoluted, and, since a
positive result is never guaranteed, vets sometimes abandon their attempts.
"We understand from speaking with veterans that some veterans are discouraged
from filing claims because the claim form is 23 pages," Sullivan said. "I have
watched veterans turn away in disgust when handed the stack of redundant forms
VA requires."
The current, bulky method for filing claims also leaves a high margin for error,
increasing the chances of denial. VCS suggests shortening the claim form to one
page. According to Kelley, veterans should consult an officer from a veterans'
service organization before filing a claim, to make sure it is correct and
complete.
Pacanowski points to other reasons why veterans - especially those with PTSD -
avoid the VA.
"I know many veterans with PTSD from all wars," she said. "Most are afraid to go
to the VA because of fear of judgment and the constant run-around you get … The
vets I know that don't go to the VA receive most help from fellow veterans. Or
try and forget."
Self-medication, including drugs and alcohol, is also a popular alternative to
the intimidating bureaucracy of VA treatment, according to Pacanowski.
With the advent of the Obama administration, veterans' organizations are hopeful
that many of their long-sought goals will be realized. The House Veterans'
Affairs Committee, too, is looking to make significant headway under the new
president. According to Rep. Bob Filner, chairman of the committee, top
priorities include providing the VA with "sufficient and timely funding,"
expanding access to health care for veterans in rural areas, and rebuilding the
compensation and benefits system.
"We have a remarkable opportunity to make progress this year when it comes to
veterans' issues," Filner told Truthout. "President Obama has laid out an
ambitious agenda and the House Veterans' Affairs Committee is committed to
bringing results to our veterans and their families."
Kelley points to the stabilization of VA funding as a key priority for the
coming years. Under the current system, the VA budget remains uncertain each
year until the annual appropriations bills are passed. This makes it difficult
to plan long-term projects or expand ongoing initiatives.
"There has been a long-running problem with VA receiving a sufficient, timely
and predictable budget," Kelley told Truthout. "AMVETS supports legislation that
will allow Congress to provide advanced appropriations for VA healthcare,
allowing VA to know well in advance of their budget so they can begin hiring
personnel and planning infrastructure projects."
VCS is pushing for another measure to increase efficiency at the VA: automatic
approval of disability claims for Iraq, Afghanistan and Gulf War veterans who
have been diagnosed with PTSD. The extra claim-approval step often means months
or years of painful limbo for ill veterans, and according to Sullivan,
eliminating it would be a legally and scientifically sound move.
Filner confirmed that when it comes to the claims process, the VA has a long way
to go. Moving into the new governmental climate, he stresses the urgency of
addressing the issues keeping patients from receiving proper treatment.
"We must make progress in rebuilding the VA's broken benefits system," Filner
said. "We need to thank veterans for their service by granting their claims and
providing appropriate care."