ATTENTION ARIZONA WOMEN VETERANS

Attention all women who have or are currently serving in the military

2nd annual state-wide Arizona Military Women's Conference

When: Opening ceremonies are 1 p.m. Friday afternoon 5/21/10 (with a welcome reception from 5 - 8 p.m.) and Saturday 5/22/10 from 9 a.m. to 4 p.m.

Where: Sheraton Crescent Hotel, 2620 W. Dunlap Ave., Phoenix, AZ 85021

Why: You have benefits that you earned through honorable service to your country. You owe it yourself to find out more.

This year, we have great exhibitors and an excellent program. If you are interested in receiving updates as information becomes available, please send an email to gforsberg@azdvs.gov.

***** UPDATE - April 26, 2010 *****

The keynote speaker will be LTC Dawn Lake (USA, Retired) and our mistress of ceremonies will be COL Pam Rodriguez (USANG, Retired). MG Irene Trowell-Harris, R.N., Ed. D (USANG, Retired) will also provide information about the VA's Center for Women Veterans since her appointment in 2001. Each presenters is a hero who has a wealth of information to share.

You will also hear from experts on various benefits. These panelists can provide you immediate, accurate answers to your questions on various topic (such as compensation and pension, employment and small business opportunities, education, Women Veteran Coordinators, VA Eligibility and Minority Veterans, Vocational Rehab, Troops to Teachers, Education, Social Security, and medical benefits).

A mobile vets center will be available during the conference so that attendees will have the opportunity to confidentially speak with trained mental health counselors. Attendees who wish to initiate a claim will also have an opportunity to meet with professional Veterans Benefits Counselors.

We are keeping registration costs to a minimum ($30 for the conference includes lunch on Saturday). Please do not let your ability to pay keep you from attending, however. If you are having difficulty paying registration, contact the Registration Chair at (480) 833-9680 to learn about scholarships available.

DEADLINE May 5, 2010: To reserve lodging, please access the link Sheraton Crescent Hotel. The Sheraton Crescent Hotel is a beautiful pet-friendly and family-friendly hotel with great amenities. The rooms are being offered at $69 per night plus tax.

To make certain we have an accurate count on meals to serve on Saturday, we must also receive your registration no later than May 5, 2010 to ensure you will get a meal. Attendees are welcome to register at any time, however, and walk-ins are welcome at the conference.

GO HERE FOR MORE INFORMATION & REGISTRATION FORMS

Win an iPad!!!

UPDATE:  Go HERE for all the details -- time to bid!!! (and support a worthy cause  -- Soldiers' Angels who try to make sure that no soldier goes unloved!)


Here is this juicy little item from our friends at You Served... and how you can win an auction AND receive a brand new iPad...

New Veterans' Caregivers Bill -- A Response to Molly

So Molly Pitcher said to my last post:

WOW. Where to start. Every veteran is entitled to treatment at a VA whether service connected or not. If you are service connected over 50% all treatment is free. Women do not receive adequate care. I would suggest reading recent GAO reports on the matter. What you take for granted in your private physicians office, I thank Congress for. Childcare: women vets are WAY younger than male vets. therefore childcare is a HUGE barrier to care. Its also true for most OIF/OEF vets. However, women are getting the spot light. It will benefit the single dad tho too. so why complain? To answer you question about a admitted vet: way too early to tell, these are pilot programs. Women are a small minority in the VA. We fight extremely hard to get equitable care (and it is not equitable). Please do some reading before writing against what we work hard for. Check out GAO please. I will be interested in what you post then. I mean you no disrespect and have a huge amount of respect for any mother with as many children as you in the service, however how many are daughters? Follow up with me at my email, and I will be happy to send you the different reports.

Different niches of veterans have been fighting for whats best for them since there were veterans groups. Women are finally doing the same. Don't discount that. esp. when they are the smallest minority in the VA.

Wow. Where to start? I was going to respond via email (but I didn't see an addy at her address), but when I thought about it, I realized it was a good opportunity to educate people -- not just on this particular bill, but on the Veterans Administration health care system... although I am far from an expert (Lord, can anyone be an expert on that bureacracy?) but I'll talk a little just on the points Molly makes.

Shall we begin?

First, Molly: I did read the 2009 GAO report; heh. To imagine that you had but I hadn't. Thanks for offering to provide copies, but I have them*:

Exec summary including recommendations: http://www.gao.gov/products/GAO-10-287#recommendations
Full report: http://www.gao.gov/new.items/d10287.pdf

On to the specifics.

Molly: Every veteran is entitled to treatment at a VA whether service connected or not. If you are service connected over 50% all treatment is free.

Molly, you really should have clicked on the link with the big red HERE that took you to the VA eligibility page (my emphasis):

1.VA must determine your eligibility [for VA health care] status as a veteran by reviewing your

◦Character of Discharge from active military service, and your
◦Length of active military service [snip].
2.VA must determine whether you qualify for one of the eight enrollment Priority Groups.
+ Enrollment Restriction:  In order to ensure the availability of quality and timely health care to veterans with service connected conditions, special authority based on military service, low income, and those with special health care needs, in January 2003 VA made the difficult decision to stop enrolling new Priority Group 8 (high income) veterans whose income exceeded VA Income Thresholds.

IF you are enrolled in the VA, care for ALL service-connected conditions is free -- even if it is not rated at or above 50% disabled (you're just in a lower priority group which has its own problems of getting services). The rules for care and medications you receive via the VA for non-service conditions are complex (can you say convoluted?) but the bottom line is that you MAY have to pay a co-pay or fee. Or not. Results may vary.

 

However, here's where I think Molly got the service-connected over 50% is free   (my emphasis)

Certain veterans do not need to be enrolled to receive medical care benefits.
You do not have to be enrolled if you:
•Have been determined by VA to be 50% or more disabled from service-connected (SC) conditions
•Are seeking care for a VA rated service-connected disability only
•It is less than one year since you were discharged for a disability that the military determined was incurred or aggravated by your service, but that VA has not yet rated

yeah. but it's still free. And it is true that any veteran can walk into the VA to seek treatment; whether it's free and how long the wait is a different story.

Molly: Women do not receive adequate care.

Horse hockey.  The 2009 GAO report found that there were varying levels of compliance with privacy configurations of check-in areas, waiting rooms and exam rooms at SOME VA facilities -- but made no finding or recommendation with respect to the SERVICES PROVIDED TO WOMEN VETERANS. Your statement that "women do not receive adequate care" is a talking point and a sensationalist headline, but not substantiated by the "recent GAO report" you so readily refer me.

As a matter of fact, the recommendations in the 2009 GAO report were to improve compliance WITH EXISTING PRIVACY POLICIES and mandates relating to access to information on women veterans services via the VA website and its materials. As the GAO noted, many of the problems with privacy compliance have to do with the lack of space, current [physical] configurations of VA facilities, standardizing reporting of implementation of privacy measures; special note is made that many of the VA facilities were having difficulty meeting the "one-stop care" measure because they could not attract physicians and mental health providers with gender-specific (i.e., women's health) training to satisfy the mandate -- especially at facilities that treat few women veterans.

The GAO report does enumerate many gender-specific services provided to women veterans:

The VA facilities GAO visited provided basic gender-specific and outpatient mental health services to women veterans on site, and some facilities also provided specialized services for women. Seventeen of the 19 medical facilities GAO visited offered basic gender-specific services including pelvic examinations and cervical cancer screening on site, and 15 offered access to one or more female providers for gender-specific care. The availability of specialized gender-specific services--such as treatment of reproductive cancers--and mental health services for women varied by service and facility. While some VAMCs offered a broad array of specialized gender-specific care on site, smaller CBOCs referred women to other VA or non-VA facilities for many or most of these services. Nationally, 9 VAMCs have residential mental health programs that are for women only or have dedicated cohorts for women.

One of the GAO's recommendations is for the VA to improve the information about these services and to make the information highly visible on the VA website. (see Summary, para. 2, and recommendations, generally). In their report (p. 10), the GAO said, "VA Facilities Provided Basic and Specialized Gender-Specific Services and Mental Health Services to Women Veterans, though Not All Services Were Provided On Site at Each VA Facility." They go on to note that those facilities that did not provide every female-specific service referred female veterans to other [VA] facilities for such care (same practice as for all veterans when services required are not offered at the closest VA facility). The GAO also reports that all facilities planned to offer all female-specific services in the future. In not one case did the GAO cite inadequacy of care or a disparity in care given to male v. /female veterans.

Is that a justification for the VA facilities for not having implemented the privacy measures that were noted all the way back in 1982 (and '92 and '94...)? Hell no. Should have been done LONG ago. But inadequate privacy is not the same as inadequate or inequitable care.

Now, if you were referring to the VA's Report of the Under Secretary for Health Workgroup, Provision of Primary Care to Women Veterans and the discussions of women veterans' dissatisfaction (performance) ratings for VA services... or the mismatch in utilization of services (immunizations, colo-rectal screenings, etc.) between male and female veterans, the assumption being that these services are not being offered or communicated as well to female veterans? OK. I get that. Something that needs attention. However, utilization of care is not the same as adequacy or equity of care. I heard no such allegations of inequity by the female veterans appearing before the Committee on Veterans Affairs (see discussion a bit later) nor did I read or hear examples of services provided to male veterans that women veterans did not also receive. Does that mean there aren't any disparities? No, but no one has recently spoken to some disparity or a level of disparity that exists and requires attention. Do service levels and quality differ from facility to facility? Yes, they do. But those measures are across the board and not explicit to women veterans. Poor (and exceptional) service affect men veterans at those facilities as well.

Molly: childcare is a HUGE barrier to care.

The GAO report (in addressing the "one-stop care" model mandated to better meet the needs of female veterans) states [at p.2]  (my emphasis),

Because many of these women work or have child care responsibilities, multiple visits can be problematic, especially when services are not available in the evenings or on weekends.

[Note that the footnote to this entry states that under current law, the VA cannot provide child care nor operate childcare facilities.]

Even in facilities that have "one-stop" providers, the GAO notes [p. 26, para. 2] that many of the women veterans themselves have opted to have their gynecological care from a VA provider separate from their VA PCP.  The GAO report does not say or even intimate that child care is a significant problem or bar to access and offers no facts, figures, suggestions or recommendation for such.

In fact, since the GAO report is silent on the issue, I was curious where the impetus had come from. Seems the child care "thing" resulted from testimony from two of five [hand-selected] female veteran panelists representing various veterans' organizations that appeared before the  July 2009 Senate Committee on Veterans Affairs Hearing on "Women Veterans: Bridging the Gaps in Care".

According to the summary of the panel's testimony provided by Women's Rights/Change.org, the panelists "spoke about the vital need for child care at VA facilities, as well [as] the importance of making VA clinics and hospitals more child-friendly."  I watched the video of the hearing to ascertain who said what and the basis of this dire need. Ms Olds of the VFW listed child care among the needs of women veterans on par with hiring more physicians and mental healthcare providers, access to service, and outreach to women veterans, etc. It was a big issue for panelist Ms Williams, as well (she sits on the Board of a women's veterans organization whose name was not in her written testimony and I could not understand the organization's name from viewing her testimony.)

Ms Williams regales the Committee and guests with shocking stories of a woman veteran who had to change her child's diaper on the floor at a VAMC while waiting for appointments and of another who was told emphatically that if she couldn't find child care for her child, she should just not show up. I don't doubt for a second these stories are true -- who would make such things up?  I find no study, no data, no survey -- nothing in sworn testimony or reports or news stories -- to indicate whether, in fact, lack of childcare impacts in any way access to health care for veterans (male or female); there are just anecdotal accounts that it's a problem for two veterans.

In her testimony before the Committee, Ms Olds referred to the VA's  Report of the Under Secretary for Health Workgroup, Provision of Primary Care to Women Veterans and pointed to their findings generally -- which led me to think it contained facts or a discussion or study or recommendation on child care, but I could find no such information in that report on the need for child care. I did find (my emphasis): 

While no-show rates for general primary care have a target of 13 percent, the no-show rates for women’s gender-specific prevention clinics have ranged from 14 percent to well over 28 percent at most facilities. (f/n 70)   Factors related to no-show rates for women’s clinics differ from those for men, e.g., not missing work and childcare and eldercare responsibilities.

Don't get me wrong. I was a working mother with young children before most of the women on that panel were born; my former DIL is a working mother; we have a daughter who expects to be a working mother in a few years; and six nieces -- four of whom are currently mothers of very young children. I fully -- and I mean FULLY -- understand the problems of balancing work, family and all our other commitments as women -- including to our own health -- and the child care issue. It all just leads me to ask how all the mothers of young children in America who are NOT veterans get to medical appointments and what do they do with their children... and makes me wonder where all the child care facilities are in non-government hospitals and medical facilities around the country?

I am ok if the VA provides a stipend to cover child care costs the same way mileage is reimbursed, but not OK with using funds to create and staff child care facilities. Of course they should outfit restroom facilities with changing tables -- but childcare? I'd also be OK with the VA partnering with child care providers or day care centers to provide occasional care for veterans' children while they are at the VA. [Side note to Molly: My son would not really benefit from childcare at the VAMC since he and his child's mother -- also an enrolled veteran, fwiw -- provide child care for their child for ALL of their personal commitments.] 

Frankly, while it may be a problem for SOME women veterans -- and I empathize, I sincerely do -- is it a "HUGE" impediment in access to care? No.

Since both the GAO report and the VA Report also found that having a job could also be a factor that prevented female veterans from accessing care, is it proposed the VA pay them, too? Perhaps the Congress that is so willing to pass inane and often over-reaching laws should MAKE employers give veterans time off for medical appointments? Maybe it can be illegal to fire or suspend a veteran-employee for attending medical appointments? (Sure... one more reason not to hire a vet.) Besides, every attempt at legislating decency throughout history has failed.  Not sure what will have to be done about elder care responsibilities... (well, if Obamacare comes to pass, we won't have to worry about us elders. ok. /snark)

WHY should the VA provide newborn services? OK. I do get that the VA offers obstetrical care -- but not at its facilities. They do cover it... so I see where the whole newborn services got there... but that's not mentioned in the GAO report or the VA's report either!  Maternity and neo-natal care is available through private providers or community health care providers -- at facilities far better equipped to provide such services. In fact, the GAO notes that veterans requiring obstetrical care are routinely referred to non-VA facilities for such care and the report contains no note nor offers a recommendation to provide newborn services or provides a justification.

The use of resources to provide these services to the very small number of female veterans that might require them is a misplacement of resources. Could it be nominal in the scheme of things? Sure. But where does it end?

Molly: Women are a small minority in the VA.

You make my very point: if women veterans are such a small percentage of the overall veteran population (8% of 23,067,000) -- and child-bearing female veterans an even smaller percentage -- why siphon off dollars, resources (space and staff) and create programs for that small group of veterans when there are so many other needs to be met that could serve ALL veterans?

The original VA medical system's mission was quite explicit: "to provide care to veterans with service-connected disabilities. In addition, to the extent that staff and facilities are available, VA facilities can provide care for non-service disabilities to veterans who are unable to defray the cost of care elsewhere."

It seems that the purpose of the VA is now to be everything it can be to every single veteran -- that qualifies. The money earmarked (and I use that term deliberately) for these new expanded women-only services (some of which are not detailed) could well be used to expand the eligibility to veterans -- including women veterans -- who remain excluded from all VA medical services because they are above the even newly-revised financial threshold and do not have combat- or service-connected conditions.

I am not against providing services to female veterans. On the contrary: female veterans -- like male veterans -- have earned every service at the highest level. Where there are deficiencies -- in either male or female care -- they should be addressed. However, I am opposed to creating special programs that apply to a very tiny minority of veterans when the needs of ALL veterans -- male & female -- are better served by the use of those funds and facilities... especially when no need has been empirically established for things like childcare and newborn services. In fact, the money being spent on these measures could easily have been used to bolster and expand the class of providers caring for the wounded or increase the comepnsation level.

Molly: What you take for granted in your private physicians office

I take nothing for granted.

Molly: I mean you no disrespect
sure you do... if even a little or you wouldn't have admonished me as you did.

have a huge amount of respect for any mother with as many children as you in the service, however how many are daughters?
Jeez. I'm surprised you didn't pull the race card... or the chickenhawk argument... and you didn't mention that in addition to the three sons (two are veterans and one is active), my father was a disabled veteran, my husband is a veteran (note: 25 years, 2 combat tours, and not eligible to enroll for VA medical services!), one sister is a veteran of the USMC in the 70's, and we have a nephew also serving (AF). As for the daughter? She went to medical school. Aren't my husband and three sons enough?

Molly: I will be interested in what you post then.
Well, now you know.

_______________________

* Here's the links to the 1982 GAO Report , 1992 Report , the (limited scope) 1994 Testimony (report) and of course, the GAO's and VA's 2009 Report is linked above.

New Veterans Caregivers Bill: A Small Rant (I Don't get it.)

Well, I do get the principle parts of the bill -- and good that the approximately 2,000 family members who care for the severely wounded in their homes day in and day out. Yeoman's work... and long overdue for recognition and compensation.

But this I don't get.

From Many Angles to Caregiver Bill

Expand VA services for 1.8 million women veterans currently receiving VA care or expected to enroll in the system. VA for the first time will cover up to seven days of newborn care for enrolled female veterans. Other initiatives will force changes to the VA health system to make it respectful of privacy and other needs of female veterans. VA is directed to launch a pilot for providing patient childcare services too.

OK, I know I'll take heat for this... but can someone explain this to me?? EXPAND services???  Do women veterans not get the same services as male veterans?? Is there some service (besides GYN) that doesn't apply EQUALLY to men? What do they want to expand?? I don't get it.

The VA is now going to provide childbirth services?? NURSERIES? Is childbirth now a combat- or service-related medical condition? The VA has a hard enough time attracting physicians and medical professionals to treat the GENERAL veterans' community and now they'll have to hire OBs???

Do women veterans have some additional privacy concerns that aren't being extended and/or that don't apply to men?? In every treatment area in our VA there are curtains and private examining rooms... it's not a shower room atmosphere. If there was a problem at selected facilities, did that require a piece of legislation -- and funding??

"Other needs of female veterans??" That's a rather nebulous phrase. WHAT other needs?? I'd like to know.

Filner said other parts of S. 1963 focus on VA health care “access for people who don’t normally have access. Like women. It’s time to think about childcare, privacy curtains, to think about respect, basically.”

"Access for people who don't normally have access... Like women??" Since when? Every veteran -- male or female -- has access to the VA if they meet the eligibility requirements. If the intent is to grant women veterans access under conditions that men cannot qualify -- well I object. STRONGLY object. If they want to expand access, then they should open the VA health care eligibility to ALL veterans and not just the combat- and service-connected disabled or the very poor. (Oh, you didn't know that access to VA health care is limited to certain classes of veterans?? Go HERE.) They certainly shouldn't be granting special privileges to veterans who just happen to be women.

Childcare services? The VA is going to provide babysitters?? (This from a woman with a VA-enrolled son who has a child.) Will the VA be taking charge of the child/children when the veteran has to be admitted?

Older veterans will find it refreshing, he said, to see children of women veterans, from time to time, in waiting areas of VA medical facilities.

“It changes the whole ambiance of the place,” Filner said. “It’s no longer a bunch of dying people. There’s life! And so… childcare not only helps the families with kids but the whole atmosphere.”

Ambiance??? Atmosphere??? Atmosphere???  Are you kidding me??? If you want children's ambiance go to the play areas at McDonalds or to Chuck E Cheeze or volunteer at a day care center. Jeez. What happened to finding your own childcare and being responsible for your child/children? 

This is nuts! I'm damn sure this isn't what the VA was set up to do. YES I know there are women veterans... and I know that there are areas of "special" in that topic, but the VA as a Nanny?? FFS.

It is high time that we accept that there is no way to meet every single need of every single veteran for things NOT connected to their service. If it's service-connected, we should spare no effort or funds. However, given the demands -- practically and financially -- on the VA for medical and psychological care for SERVICE-CONNECTED conditions, is this really the best use of the money?? Birthing and childcare?? Turning this esteemed veterans medical provider into a new welfare program is a tragedy. What other needs common to ALL veterans will be shortchanged or not be attended while these new women-only mandates are established and funded?? It's just plain crazy, I tell you.

Next they'll be mandating sex-change operations for transgender veterans. These new women-only measures are plain pandering and electioneering. I'm sure I could come up with a list of services to ALL veterans that should be expanded or improved rather than adding obstetrics, newborn care and babysitting services.

OK. rant end.

Vigilance: The Good Kind

Over at PBS - Point of View, I blog about the necessity of being vigilant in protecting the warrior legacy:

It is important for all of us — citizens who truly support the troops and who honor our veterans — to become active and remain engaged in protecting the warrior legacy. As we head into a new year, I implore everyone in the military, veterans, their families and the general public to learn about proposed and pending legislation and to be energetic in communicating their opinions to their Senators and Representatives. This is important not just at the federal level, but at the state levels as well. 

As state and federal legislators look to reduce spending or find funding for pet (read: pork) projects, military and veterans programs will be looked at as likely sources for cuts, because of their relative size to other budget commitments. Our watchfulness will be vitally important to the roughly 1.4 million personnel on active duty, the additional 900,000 members of the Reserve and National Guard and the 23.2 million military veterans in the United States.

Please go over and read all of it and bookmark some of the links to military and veterans organizations -- and to your legislators -- that are provided.

You should also take the time to read the contributions by the other bloggers at the PBS/Conversations - On Coming Home blog... and leave your comments!

Do You Know A Veteran in Need of Health Care?

From the Military Officers Association of America:

Fallen on Hard Times? VA May Help With Health Care

2009/01/27 00:00:00

The VA offers an assortment of programs that can relieve health care costs or provide care at no cost to veterans who are struggling financially because of a job loss or decreased income.

Veterans whose previous income was ruled too high for VA health care may be able to enter the VA system based on hardship if their current year's income is projected to fall below federal income thresholds. The fall must be caused by job loss, separation from service, or some other financial setback.

Veterans determined eligible because of hardship can avoid copayments applied to higher-income veterans. Qualifying veterans may be eligible for enrollment and receive health care at no cost.

"With the downturn in the economy, VA recognizes that many veterans will feel the effects," says VA Secretary Dr. James B. Peake. "Therefore, it is important that eligible veterans learn of the many ways VA has to help them afford the health care they have earned."

Also eligible for no-cost VA care are most veterans who recently returned from a combat zone. These veterans are entitled to five years of free VA care. The five-year "clock" begins with their discharge from the military, not their departure from a combat zone.

Enrollment coordinators at each VA medical center across the country can provide veterans with information about these programs. Veterans also may contact the VA's Health Benefits Service Center at (877) 222-VETS (8387), or visit the VA’s Health Care Eligibility and Enrollment Web site at www.va.gov/healtheligibility.

National Resource Directory For Wounded Warriors

When my son was wounded -- and then when he was being medically discharged -- I spent a hundred hours or more researching what treatments and benefits were available, how to access care and benefits, the process of who, what, where, when, how... So I was pretty thrilled to see the email below announcing a single resource guide for Wounded Warriors and their families. I haven't reviewed this new resource directory yet, and I hope it is everything they say it is, but something is always better than nothing! And it's about time!!

Department of Defense Launches National Resource Directory For Wounded Warriors, Families And Caregivers

The Department of Defense today launched the National Resource Directory, a collaborative effort between the departments of Defense, Labor and Veterans Affairs.

The directory is a Web-based network of care coordinators, providers and support partners with resources for wounded, ill and injured service members, veterans, their families, families of the fallen and those who support them.

"The directory is the visible demonstration of our national will and commitment to As new links are added each day by providers and partners, coverage from coast to coast will grow even greater ensuring that no part of that journey will ever be made alone," said Lynda C. Davis, Ph.D., deputy under secretary of defense for military community and family policy.

Located at http://www.nationalresourcedirectory.org, the directory offers more than 10,000 medical and non-medical services and resources to help service members and veterans achieve personal and professional goals along their journey from recovery through rehabilitation to community reintegration.

"The VA is extremely proud to be a partner in this innovative resource. This combination of federal, state, and community-based resources will serve as a tremendous asset for all service members, veterans, their families and those who care for them. The community is essential to the successful reintegration of our veterans, and these groups greatly enhance the directory's scope," said Karen S. Guice, M.D., executive director, federal recovery care coordination program at the Department of Veterans Affairs.

"The National Resource Directory will prove to be a valuable tool for wounded, ill, and injured service members and their families as they wind their way through the maze of benefits and services available to them in their transition to civilian life. The Department of Labor is pleased to have the opportunity to work with our partners at DoD," said Charles S. Ciccolella, the assistant secretary of labor for the veterans' employment and training service.

The National Resource Directory is organized into six major categories: Benefits and Compensation; Education, Training and Employment; Family and Caregiver Support; Health; Housing and Transportation; and Services and Resources. It also provides helpful checklists, Frequently Asked Questions, and connections to peer support groups. All information on the Web site can be found through a general or state and local search tool.

The National Resource Directory's launch in November is a key feature of Warrior Care Month.

x-posted at Milblogs and Parents Zone.

Veterans Day 2008

I have written before about the members of my family that have served honorably in the Armed Forces of the United States and how proud I am of them. I have also stood as personal witness to the terrible cost of Freedom (start with the picture of my father at left... notice he has lost his left arm above the elbow) and HERE HERE HERE HERE HERE HERE HERE

Thanks to my mother, our family learned early to honor those that serve. We attended Memorial Day, Independence Day and Veterans' Day parades in our town...

some years we sat and cheered from the curbs as we waved our American flags, while in other years we participated as Girl Scouts, pep squad members, cheerleaders. After the Vietnam War, honoring our service people was not particularly celebrated and, in many towns, the parades were discontinued because no one came to cheer the Veterans.

When we had children of our own, we took them to the parades... we cheered the vets, we saluted the flag. We waved at ships arriving home with fathers and sons on deck and mothers and wives smiling and crying on the pier.

We attended many wreath laying ceremonies at our war memorial on the grounds of our county court house in New York and cheered from the court house lawn on Main Street (really) as the Veterans' paraded by. The large court house square, the large military community and the community's patriotism were key factors in our choice of the town we now live in. Paying homage to those that serve is the least we can do... a few minutes from a whole day set aside to honor our Veterans.

I sometimes think that even without the influence of DH's career (he had finished his 25 years and started his second career by the time the oldest was entering high school), our patriotism and our respect for our service members might have influenced our three sons' choices to serve in the military. We could not be any prouder of them.

This year we will be at the closest Veterans Hospital where our town, and the surrounding communities come to honor our Veterans... this year there are eight Grand Marshals... all Veterans wounded in the service of their country.

So on Veteran's Day, we each have the opportunity -- the obligation -- to thank all the Soldiers, the Marines, the Sailors, the Airmen, and the members of the Coast Guard who have served and are serving to protect us -- whether they fought or just stood on the Wall.

To all those who raised their hand, swore the oath and said, "This we'll defend", from the bottom of our hearts, we thank you.

And don't forget, Veterans: WEAR YOUR MEDALS ON VETERANS DAY. (Info on that HERE)

and remember, HIRE A WOUNDED VETERAN when you have the need or the chance...

The Annual Inter-Military Branch Campaign for Project Valour-IT -- which gives laptop computers to wounded military members (including voice-activated software to those that need it) IS ON!! Go HERE for more information on this incredible program. This year in honor of the three Navy guys I love (two veterans and one still serving), I am raising money as part of the NAVY team! Click below to donate NOW! The campaign runs through Thanksgiving!

The Soldier

It is the soldier, not the reporter,
who has given us freedom of the press.

It is the soldier, not the poet,
who has given us freedom of speech.

It is the soldier, not the campus organizer,
who has given us the freedom to demonstrate.

It is the soldier, not the lawyer,
who has given us the right to a fair trial.

It is the soldier,
who salutes the flag,
who serves under the flag,
and whose coffin is draped by the flag,
who allows the protester to burn the flag.

-- Father Dennis Edward O'Brien, USMC

VA to Raise TBI Benefits

VA to Raise Traumatic Brain Injury ( TBI) Benefits

The Dept. of Veterans Affairs announced last week changes to its schedule for rating disabilities for Traumatic Brain Injury (TBI), the "signature wound" of Iraq and Afghanistan.

A VA press release noted, "Traumatic brain injuries result in immediate effects such as loss or alteration of consciousness, amnesia and sometimes neurological impairments." In some cases "prolonged or even permanent problems with a wide range of impairment in such areas as physical, mental and emotional/behavioral functioning may occur." People with TBI may experience headache, sleep difficulties, decreased memory and attention, slower thinking, irritability, and depression.

22,000 veterans presently are being compensated for TBI, including 5,800 Iraq and Afghanistan veterans. Those already receiving compensation for TBI injuries can be reevaluated under the new rating schedule criteria. The VA stressed, however, that veterans with the "most severe" forms of TBI would not receive much, if any, extra compensation because the current rating schedule provides adequate compensation in such cases. The rating schedule change mainly has the potential to affect those with mild or relatively moderate TBI who may have been assigned low or modest ratings in the past.

Under the new rules, TBI ratings will be based on the degree of "cognitive impairment" and other "residuals" of TBI. These may include mild to severe loss of memory, attention, concentration, judgment, motor activity, visual spatial orientation, ability to communicate and other functions. The rating schedule goes into effect in late October. Because of the complexity of each individual evaluation, it's not possible to assert that a particular person or particular condition would receive a particular rating increase.

Courtesy of MOAA
and the Veterans Administration

Note: Some news coverage indicates that all veterans presently being compensated for mild/moderate TBI will automatically receive increased compensation (my combat-wounded veteran said, "Mom, the VA doesn't give you anything without you having to ask for it in double triplicate first.") He's right.

According to the Final Rule published in Federal Register* the amendment applies to all applications [for benefits] received by the VA on or after the effective date of the new rule, and the old criteria will apply to applications received prior.

However, a veteran whose residuals of TBI were rated by the VA under a prior version of the rule will be permitted to request a review under the new criteria, irrespective of whether his or her disability has worsened since the last review or whether the VA receives any additional evidence.

Note, however, that the effective date of any increase in disability compensation based solely on the new criteria will not be retroactive to the original disability but no earlier than the date of the new criteria (estimated to be late October 2008). Also note that the rate of compensation will not be reduced based solely on the new rating criteria [see pp 1-2]. However, note that in response to many comments on the effective date of the new criteria and suggestions that making veterans apply for a review is burdensome and suggestions that the VA conduct its own reviews for (at least) all post 9/11/01 TBIs, the VA declined to make changes to those provisions and said, "however, consistent with 38 U.S.C. 1155, any review under the new criteria will not result in a reduction in a veteran's disability rating unless the veteran's disability is shown to have improved." [p. 52] So, yes, there is apparently a risk of reduction of disability compensation on some other grounds if you apply for a review.


* pages 1-60 of the document is a discussion of comments and change/no change to the draft rule published back in August; pages 61-71 contain rating criteria, discussion and notes for evaluators.

Finally, I spent a career reading the Federal Register and the United States Code and the Code of Federal Regulations (along with a myriad of states' laws and rules and regulations), and it never ceases to amaze me: 71 pages (OK, double spaced, I'll grant) for a mere AMENDMENT to a diagnostic code. The entire "Unanimous Declaration of the Thirteen United States of America" (also known as the Declaration of Independence) is less than 6 pages (double spaced)... 1,317 words including the title. No wonder people give up trying to get benefits they've earned.

Publish Post

Summary of FY09 Defense Authorization Act

Summary of FY09 Defense Authorization Act


Active Duty Issues

- Pay Raise: 3.9% pay raise effective Jan 1, 2009

- End Strength: Army +7K USMC +5K Navy -2.8K USAF -12.5K (did not restore previously proposed cut for USAF, even though SecDef has stated that the planned USAF cut will not be imposed)

- Paternity leave: 10 days authorized for new military fathers, in addition to normal leave

- Maximum reenlistment period: Raised to 8 years vs. 6

- Warrant Officer mandatory retirement: Change to 30 years as WO vs 30 yrs (applies to Army WOs only)

- Sabbatical Program: Authorizes 20 officers and 20 enlisted members per service per year to take up to 3 years off from active duty to pursue personal/professional goals (participants to be paid 2 days’ basic pay per month and keep TRICARE eligibility, but will receive no retirement credit for sabbatical time and will owe 2 months’ active duty upon return for every month of sabbatical)

- Increase in Service Academy Enrollment: Authorizes up to 4,400/yr per academy starting 2008/09 academic year

- Meal Charges in Hospitals: Permanently bans charging hospitalized troops

- Temporary Lodging Expense Allowance: Raises maximum daily amt per family on CONUS PCS from $180 to $290

- Family Separation Allowance: Authorizes payment to both member spouses with dependents if both are assigned remotely

Military Family Issues

- Spouse PCS Weight Allowance: Authorizes 500 lbs for professional items

- Spouse Education: Authorizes programs to help spouses with degrees/credentials/licenses to pursue portable careers

- Impact Aid: Authorizes $35M to assist schools with high proportion of military children, with additional $15M for schools in BRAC/unit movement areas and $5M for schools attended by severely disabled military children

Guard/Reserve Issues

- Education: Requires honorable discharge for Guard/Reserve members to use education benefits resulting from active duty (effective 1/28/08 for members who haven't used any of their entitlement)

- TRICARE Reserve Select Premiums: DoD must recalculate (and presumably reduce) premiums for 2009 and beyond and base them on actual costs for previous year (2009 costs to be based on costs for 2006 + 2007) (GAO previously estimated that Guard/Reserve participants were overcharged by 45%-72%)

- G/R Medical/Dental Readiness: Services may provide free health/dental care to any SelRes/IRR (if subject to involuntary recall) they deem appropriate and may waive dental copays for Guard/Reserve personnel to facilitate/ensure readiness

- Transition TRICARE: DoD may temporarily continue active duty TRICARE coverage for separatees who enter SelRes (continue for 60 days if less than 6YOS; 120 days if 6+YOS)

Health Care Issues

- TRICARE Fees: Bar increases in pharmacy copays or retiree fees for FY09

- Preventive Care:
(1) Waive TRICARE copays/deductibles for beneficiaries under 65 for colorectal/prostate/breast/cervical screening, annual physical, vaccinations and other services authorized by SecDef (those over age 65 to be reimbursed for copays rather than waived due to budget technicality);
(2) establish TRICARE Prime pilot project in three geographic areas to test monetary and nonmonetary incentives to encourage healthy behaviors;
(3) Establish smoking cessation program for all under-65s (refund copays for over-65s);
(4) Test a “preventive health services allowance” payable to up to 1500 active duty members in each service ($500/yr single, $1000 family to purchase preventive services); (5) Authorize SecDef discretion to pursue other innovative programs (e.g., G/R medical/dental readiness and/or stipend for G/R families to continue employer care for families when activated)

- ECHO Payments: Raise TRICARE payment cap for active duty children with special needs from $2500/mo to $36K per year, allowing carryover month-to-month

- ECHO for Retiree Children: Require Sec Def report on providing limited temporary transition coverage upon retirement

Retiree/Survivor Issues

- Concurrent receipt: No provisions

- SBP: Authorize inclusion survivors of members who died on active duty among eligibles for modest new special survivor allowance

Wounded Warrior Issues

- DoD/VA Senior Oversight Committee (SOC): Extend SOC authority for 1 yr, with SecDef report by Aug 31 with recommendation on continuation

- Disability Determinations: Disqualifying condition is to be deemed service-connected unless there is "clear and unmistakable" evidence it existed before service entry and wasn't aggravated by service

- Centers of Excellence: Establish centers for hearing loss/auditory injuries and for traumatic extremity injuries/amputations

- Bonus Treatment: Bars recoupment of any paid amount and requires full repayment of unpaid balance within 90 days for member who dies or is separated/retired for combat-related injury/illness

Other Issues

- Decorations: Requires SecDef to replace decorations on one-time basis upon request by recipient or next of kin

- Salute: Authorizes military/vets not in uniform to salute flag during national anthem

Answering Email

I received this via email from a kindly Congressional staffer who wanted to make sure I had seen it. I do not know this staffer personally, but he read my post trashing the proposed Veterans Mental Health Treatment First Act. I appreciate that he sent this along, given that I have also written on Veterans Suicide Prevention (for which I took a lot of drubbing from those who think this is a "bash the military" meme… but who need to be reminded that Veterans – like non-Veterans -- commit suicide – most not because of their service, but in spite of it… and are worth saving one person at a time.) I think I might have scared the staffer off as I haven't had a response… yet.

Hi Carla –

I read your blog post on veterans' mental health, and thought you might be interested in this story.

Best,
K

FOR IMMEDIATE RELEASE

Contact: (Veterans' Affairs)

May 15, 2008

AKAKA USES OVERSIGHT AUTHORITY TO FORMALLY REQUEST SUICIDE DATA FROM DEPARTMENT OF VETERANS AFFAIRS

WASHINGTON, D.C. – Today U.S. Senator Daniel K. Akaka (D-HI) invoked his oversight authority as Chairman of the Veterans' Affairs Committee to formally request data from VA on veterans' suicides that is not otherwise available to the Congress. In a letter to Veterans Affairs Secretary James Peake, Akaka stressed the need for full and accurate data on the issue.

"We will not know the true cost of war until we know the true rate of suicides among veterans," said Akaka. "Until the VA mental health care system meets the needs of those who have served, we will continue to see the tragic consequence of veteran suicides."

In his letter, Akaka specifically requested the following from Secretary Peake:

• The total number of veterans who have committed suicide or attempted to commit suicide

• The number of veterans who have committed suicide or attempted to commit suicide while receiving care from VA
• Information on VA's efforts to improve outreach and assistance for veterans between the ages of 30 and 64
• All of VA's health care quality assurance reviews related to suicides and suicide attempts over the past three years

As Chairman of the Senate Veterans' Affairs Committee, Akaka is empowered by federal law to review medical quality assurance records that are otherwise not provided outside of the Department.

Akaka's request follows heightened concerns from Congress and others regarding veteran suicides. Last week, Secretary Peake testified that both male and female veterans are more likely than non-veterans to commit suicide. In recent weeks Akaka has sought action on veteran mental health issues, meeting with Secretary Peake, and working with the Senate Majority Leader to bring up S. 2162, the bipartisan Veterans' Mental Health and Other Improvements Act of 2008. According to a recent RAND study, nearly one in five Iraq and Afghanistan veterans – roughly 300,000 so far – report symptoms of PTSD or major depression, and fewer than half receive mental health care. [ed. Emphasis added.]

-END-

K,

Thank you for thinking of me. I admire and am deeply appreciative of the [legislator]'s work on behalf of Veterans. However, I have concerns about straight statistics and the twisting (the magic of bad statistics) that occurs when released (and used inappropriately as in the past.) By that I mean that data is used to promote political bashing rather than reflecting a true and sincere attempt to analyze why and how [fill in the blank] is occurring -- including how to "fix" the problem -- if, in fact, there is a problem and if it is fixable at all.

For example, I'd note that previously released data on the number of suicides within the active military (including Reserve and Guard) looked shocking; however, when compared historically and compared to the rate of suicide within the general populace (soldiers coming from the general population), the rates in every age, gender and ethnicity were the same as or lower than the general population (see, here for just one discussion and quasi-analysis). I suspect that the same might be evidenced in the veterans' suicide numbers.

The last statement of [this] press release also illustrates the "magic of poor statistics": the Rand study actually says (page 1 of the Rand Press Release; more on p. 3 of the Research Highlights) that "slightly more than half seek treatment"... and, we assume, all received treatment. Therefore, slightly more than half (53%) actually sought and received treatment. So it is not true that "fewer than half received treatment"; the correct statement is that just less than half did not seek treatment -- they never asked for it. Of course, the assumption being that if the 47% who also had "symptoms" had sought or would seek treatment, they, too, would receive it. I know these don't spin well into shocking headlines, but it is a disservice [to connect suicides and misquoted statistics] and undermines legitimate arguments for meeting the needs of the military and veterans' communities.

You can understand my reservation that data (on veterans' suicides) served up in a vacuum is not particularly relevant unless it is also tested in a broader sense. In order to determine whether the suicides are "relevant" to the Veterans' Affairs Committee's work, the focus should not be simply on the empirical number of suicides by veterans (and its use as evidence of some "failure" on the part of the VA) but the legitimate investigation must also include whether the suicides have some connection to the veteran's military service (for instance had service-connected PTSD), whether the veteran served in combat, whether they suffered some detectable mental health condition prior to their suicide, and whether they sought or were offered treatment, etc.

This same slant is evident in the headlines about homeless veterans: are they homeless for some reason unrelated to their military service and just happen to be veterans, or are they homeless because they are veterans?? That there are homeless veterans is not in dispute. WHY they are homeless and SHOULD that be a concern are the questions that should also be asked and answered. Military service is not always the cause of veterans' misfortune-- homelessness or suicide. Tragic and sad? Absolutely. Of course, if all the relevant data indicates that the VA could be doing something (or should be doing something) in this regard, we should all stand on our chairs and DEMAND that it be done (and demand appropriate funding with reasonable timetables!) But we all know that resources are finite and that there are things that can and should be "fixed" in the DoD and VA systems (see my posts HERE and HERE).

As for the "Veterans' Mental Health and Other Improvements Act of 2008", it certainly is terrific on its face (and in its intent certainly), but some of its provisions are so over broad -- requiring treatment for substance abuse, etc. whether or not such abuse/addiction is a result of or connected in any way to military service and extending to individuals who have been out of the military for decades?? I reiterate that resources are finite and question whether this is the best use of those resources to serve the largest group of veterans with needs (in other words, will veterans get the biggest bang for the bucks?) Has there been an identified need for such services (I have seen no such study or conclusions)? Is there a larger population of veterans with a need that will not be met by diverting such funding? I also might question the paternal attitude of trying to "fix" every problem of every veteran (or every citizen).

Finally, I find it notable that Senator Akaka is also seeking information on "outreach" efforts to older veterans, but know it's a hollow pursuit unless funding is restored to open up enrollment again in ALL VA health care priority groups that would permit such services to be offered to ALL veterans. And, it goes without saying that Congress must be willing to FUND and commit resources to the VA in order to do something about anything. There certainly is enough legislation [already] languishing in various Defense and Veterans Committees (e.g., legislation addressing the comprehensive Dole/Shalala recommendations) that sits simply because these proposed bills have become partisan in an election year -- Democrats hesitant to support a Republican-sponsored bill (and vice versa) for fear the "credit" for such legislation will inure to the "other" party -- all while Veterans and service members suffer and die while waiting for services and compensation. No one asked them what political party they were when they took their oaths and party shouldn't matter to do what's right on their behalf.

Thank you again for forwarding this. Please don't think this a rant against [the legislator] -- it isn't and it isn't meant to be. It's the result of frustration with a system that puts election year politics (hell, any year politics) ahead of the needs of those who protect and defend. As the wife a retired career Navy officer, and the mom to a serving US Sailor, a Navy vet and a disabled Army veteran, I know of what I speak.

Best regards,

Carla

Some Soldier's Mom

Pure Crap: Veterans' Mental Health Treatment First Act

Updated with additional links 2/27/08

My friend Maggie pointed me to this Opinion Piece (thanks Maggie!)

Sally Satel, a resident scholar at the American Enterprise Institute (just what is a resident scholar?? Do they LIVE there?) wrote this opinion piece for the Wall Street Journal in which she (once again) posits that veterans who receive disability compensation for the VA have no incentive to receive treatment... that, in effect, if you compensate an individual for his mental health disability, you are paying him to be ill.

And don't be fooled by this statement in the OpEd: "Last year the Government Accountability Office, the President's Commission on Care for America's Returning Wounded Warriors, and the Veterans' Disability Benefits Commission all urged that the disability, compensation and rehabilitation benefits systems be reformed and updated." While it's true that the GAO and these two commissions recommended many reforms, THIS legislation is not in response to those recommendations to come out of the reports and studies. This is just one of Dr. Satel's little pet theories she's willing to try out on Veterans. I watched her testimony before the House Veterans' Affairs Committee last May and pointed out Dr. Satel's (and others') clueless testimony then.

This scholar (how do you get to be designated a "scholar" and I'm not clear exactly what subject she is actually a "scholar"... Does a 5-year medical residency -- where PTSD may have been one of any number of neuropsychiatric disorders afflicting her patients make you a scholar on the many manifestations of combat-induced PTSD?? I digress.) Dr. Satel -- whose admirers love to cast her as the maverick challenging the establishment (how terribly '60's!) -- has been carping ("that posttraumatic stress disorder is a straightforward diagnosis... She questions... and speculates on why they are perpetuated. The case of combat veterans will be discussed with emphasis on the implications for failing to consider alternative explanations (and treatments) for post event phenomena." Yah.) and whining about PTSD in veterans for many years. This latest pronouncement in the WSJ is nothing more than a position she (and the Senator) have been promoting for a number of years (see the VA Watchdog site; see also, this Vietnam Veterans of America article.) Only this time they're disguising it as the Veterans' Mental Health Treatment First Act (Search S.2573 at www.thomas.gov for brief text.)

They like to characterize this latest proposed legislation as "helping wounded veterans" -- but that is far from the truth. For a person who has decried the "victimization" mentality, she and the Senator are doing a damn fine job of victimizing veterans with PTSD.

It is clear that this woman DOES NOT GET IT. Her AEI biography says she worked as "Staff psychiatrist, West Haven (CT) VA Medical Center, 1988-1993" although the Wiki bio says, "She completed her residency in psychiatry at Yale University between 1988 and 1993" so I assume she conducted her residency at the VA (that means she graduated from medical school and got to "practice" at the VA. Other than her political appointments and testimony before government agencies, it appears her only other work as a psychiatrist (per the NYTimes) is a sum of "12 hours a week as a psychiatrist at Dr. Clark's [Oasis] methadone clinic in northeast Washington." Oh... and she was a professor and is now a lecturer. Oh. Author. Although in her testimony before various Congressional Committees she says she "formerly worked with disabled Vietnam veterans", it is apparent she never listened to those vets. And it's clear she has no clue about patients coming directly or near-directly from the military to the VA.

While I find something rational in her reservations about veterans who 25 or 40 years after their military service suddenly develop PTSD) she has certainly never worked in a military setting when she says, "Judging an individual to be doomed to a life of invalidism before he has even had a course of therapy and rehabilitation is drastically premature, even reckless." [emphasis added]

I don't challenge the portion of her latest (2005) tome, "One Nation Under Therapy: How the Helping Culture Is Eroding Self-Reliance" which she posits that a diagnosis of PTSD is too often assigned to people who just can't seem to deal with life's little annoyances (like minor auto accidents and moviegoers who have seen The Exorcist), but I can hardly imagine that anyone the VA has found to be disabled to a significant degree by PTSD is lounging around on that stipend and refusing to work.

First off, Dr. Satel, no one who has been found to be suffering from PTSD (or sought treatment for it) while in the service has simply been handed a ticket out of their commitment and then handed a check. There are evaluations, counseling and treatment requirements -- in both the military and the VA. If someone has been found unfit for duty as a result of his or her PTSD, they have been through more evaluations, counselings and reports than are ever required of anyone in the civilian sector. And, if they have been judged to be 100% disabled as a result of PTSD or some other mental impairment -- trust me, THEY ARE NON-FUNCTIONING. They are not just sitting around waiting for the check to come in... and they are most definitely not sitting around thinking, "Well I must be an invalid for the rest of my life because the government is paying me to be an invalid."

In her most recent OpEd, Satel says that $2,500 a month is nice for a struggling vet... and then goes on to say how detrimental this disability payment is, "By abandoning work, the veteran deprives himself of its therapeutic value: a sense of purpose, distraction from depressive rumination, a structure to each day, and the opportunity for friendships." You're kidding, right? Lady, you frick'n need to visit the real world on occasion. Other than the 100% disabled veteran, you assume that a veteran with PTSD is just sitting at home and NOT working. I have news for you, Doctor: Few veterans receive a 100% disability rating for their PTSD and few get even a 50% rating (which would translate to less than $750 per month)... for a 30% disability they would receive $348 per month. And you think they can afford to sit home and ruminate depressively? I also posit that if an OIF/OEF veteran has received a 100% disability, it was/is most likely as a result of a combination of his/her physical conditions and less for [claimed] mental impairments [if any]. The VA Compensation tables are here. See for yourself.

The people with whom I am personally familiar that have PTSD (whether mild or chronic and officially diagnosed or not) want principally to get on with their lives... but above all, they want to NOT have the symptoms of PTSD. All find their own ways to cope: counseling... medications... drinking... hard physical activity... sleeping with the light on... a combination of things. But I can assure the good doctor that these vets are not sitting around watching the soaps, eating bonbons and waiting on the direct deposit. Are there exceptions? Sure.

Dr. Satel in this current OpEd says, "Remarkably, something essential is missing from the claims process: treatment." No, it's not. Treatment is available for every Veteran who wishes it. And veterans who claim a service-connected disability for PTSD have to be evaluated by a clinician -- they have to have real symptoms and credible evidence that their service was a cause. Does the criteria for long-delayed claims (25 or 30 years later?) need to be revised? Probably. But this legislation doesn't address that problem.

I am highly uncomfortable not only with with Dr. Satel's 2005 pronouncement that "...the VA must beware of the disability trap: Veterans should not be urged to obtain long-term disability payments for at least two years after their return from overseas. In most circumstances, psychiatric conditions will be temporary. Moreover, generous disability payments provide an economic incentive to remain ill. In fact, work is often good therapy, providing structure, a sense of purpose and social opportunities" but also with her continued 2006 assault, "With a new generation of soldiers returning from Iraq and Afghanistan, the Veterans Affairs Department needs to look at post-traumatic stress disorder in a new way: the department must regard it as an acute but treatable condition." [emphasis added.] Treatable? Yes... although not always successfully and not always completely. And.Not.Curable.

And back in 2006 Satel proclaimed that, "Only in rare instances should veterans be eligible for lifetime disability..." So, let's follow Dr. Satel's logic: if a veteran loses a leg, the military or the VA provides a prosthetic and the Veteran learns to walk again, should we also end their disability compensation because they have been treated although not cured??

Dr. Satel and the Senator forget the principle of Veterans' Disability Compensation: The purpose of VA disability compensation benefits is to compensate veterans who suffer from disability related to service for an average impairment of earning capacity related to their disability. 38 U.S.C.A. § 1155 (West 1991); 38 C.F.R. Part 4 (2002). [emphasis supplied]

Is the VA a perfect system? Hell no. But there are much more meaningful changes and modifications that have been recommended that will help it improve.

Are there those who take advantage of the system? Well yes. As with any system, once you know the rules you can beat it... but there are few (and Dr. Satel is one) who believe the fraud is widespread. Do we need to be sure that benefits are paid to those who truly need them? Of course. But this legislation does nothing of the sort.

Do we need a whole 'nother system of applying, certifying and paying? Hell No. Veterans already complete reams of paper work and forms for everything they do: getting into the services, seeking medical treatment in the services, leaving the services, getting into the VA system, and receiving care in the VA system. Veterans do not need one more layer of bureaucracy and paper work. The VA is not a welfare organization -- it is a system to reward (as in GI Bill, VA loans, small business incentives...) and to care for and compensate VETERANS when they need it. They have earned it.

Will this program actually encourage Veterans to get treatment and reduce the stigma of seeking treatment? Highly unlikely and No.

This proposed legislation should be sh*tcanned. The Senator would better spend his time trying to get legislation that is tied up in committee that actually responds to recommendations OUT of committee and before the Congress. And the money that would go to fund this useless piece of feel-good-does-nothing legislation would be better spent paying back the poor veterans who have had to REPAY the military branches for their medical severance payments or continue health insurance for medically discharged veterans.