"Shh!": wrote VA mental health services director Dr Ira Katz disregarding 12,000 veterans per year attempt suicide while under departmental treatment!

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Jonathan Melle
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"Shh!"

Dr. Ira Katz, head of mental-health services for Veterans Affairs, in an internal e-mail about data showing that 12,000 veterans per year attempt suicide while under departmental treatment. The e-mail has been submitted as evidence in a lawsuit alleging that the VA deliberately concealed the risk of suicide among veterans.

Source: May 5, 2008, NEWSWEEK, Page 27, "Perspectives"

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5/3/2008

PLEASE PUBLISH!

The VA is a terrible bureaucracy that gives government a bad name!

The VA's motive in treating veterans is not science, but financial. The more Veterans with disabilities incurred or aggravated by military service receive substandard medical service and that are outprocessed and screwed out of their veterans benefits (like me), the more money the VA saves and can otherwise waste with excessive executive salaries & bonus schemes and also credit card fraud activities by VA bureaucrats--all of which has been recently reported in the news. The bottom-line is that the VA believes they should behave like a greedy insurance company instead of a service provider for Veterans.

In this week's "Newsweek" publication, one of the highlighted quotes is:

"Shh!"

-Dr. Ira Katz, head of mental-health services for Veterans Affairs, in an internal e-mail about data showing that 12,000 veterans per year attempt suicide while under departmental treatment. The e-mail has been submitted as evidence in a lawsuit alleging that the VA deliberately concealed the risk of suicide among veterans.

Source: May 5, 2008, NEWSWEEK, Page 27, "Perspectives".

That pisses me off! We send our young troops off to combat zones and then do NOT provide them with the proper medical treatment when they return home. Instead of saying "Shh!", the VA bureaucracy should be reprimanded by the U.S. President & Congress! What is wrong with our nation!?

In Dissent!
Jonathan A. Melle
Veteran

www.jonathanmelleonpolitics.blogspot.com/2008/04/veterans-affairs-employees-charged-26.html

&

www.jonathanmelleonpolitics.blogspot.com/2007/11/us-army-to-va.html

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The Berkshire Eagle, Op-Ed
The treasonous letter
By Michelle Gillett, STOCKBRIDGE, Massachusetts
Tuesday, May 06, 2008

Everyone writes letters to the editor, if not in practice, at least in theory. The letters page of every national and local publication is a forum for citizens with something on their minds. Everyone reads the letters section. Although sometimes, the response can be more than the writer bargained for.

Laura Berg wrote the following to the editor of her local paper, the Alibi in Albuquerque, New Mexico in September, 2005: "As a VA nurse working with returning . . . vets, I know the public has no sense of the additional devastating human and financial costs of post-traumatic stress disorder; now we will have hundreds of thousands of our civilian citizens with PTSD as well as far too many young soldiers, maimed physically or psychologically — or both — spreading their pain, anger and isolation through family and communities for generations. And most of this natural disaster and war tragedy has been preventable . . . how very, very sad! We need to wake up and get real here, and act forcefully to remove a government administration playing games of smoke and mirrors and vicious deceit."

A few weeks after her letter was published, Berg's office computer with all her case files on the veterans she treats was confiscated and VA Secretary James Nicholson requested a thorough investigation of the letter-writing nurse. Berg was shaken and angry even after Mel Hooker, chief of human resource management service at the VA, admitted that no evidence was found implicating the use of Berg's work computer with her letter.

However, in a memo to Berg, he justified the investigation by saying "the agency is bound by law to investigate and pursue any act which potentially represents sedition."

Sedition is a plot or conspiracy to use force to overthrow the government and can result in 20 years in jail. The Alien and Sedition Acts were passed in 1798 by the Federalists and signed into law by John Adams. The acts were designed "to protect the United States from alien citizens of enemy powers and to stop seditious attacks from weakening the government."

But Thomas Jefferson said the Federalists had overstepped their bounds. He declared the Sedition Act invalid not only because it was a violation of the First Amendment to the United States Constitution but because it violated the Tenth Amendment to the Constitution: "The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people."

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More than 200 years later, a woman who speaks her mind, speaks from her heart and her experience in a letter to the editor is investigated. What is happening to our country when a letter to the editor is construed as an act of treason? Where is Thomas Jefferson when we need him? Even though the VA admitted it was wrong, Berg has been told that it would be preferable if she not mention she works for the VA in future correspondence with editors.

In March, 2006, Amy Goodman interviewed Laura Berg on Democracy Now. Berg told her, "I did not sign away my First Amendment rights as a citizen, by choosing to serve in the federal government and choosing to serve veterans and care for people that have been wounded . . . I have a right to speak my opinion. I have a right to say I'm a V.A. nurse. I do not speak for the V.A. I speak as a public citizen. . . we really need to speak out about this. This is really, really frightening."

A few weeks ago, Laura Berg received the new PEN/Katherine Anne Porter First Amendment Award, which honors a United States citizen or resident who has fought courageously to safeguard the First Amendment's right to freedom of expression as it applies to the written word. PEN Freedom to Write Program Director Larry Siems praised Berg's "determination to express her views in print and courage in the face of the most heavy-handed and overbearing official reaction."

"When Laura Berg sat down to write her letter to the editor, she was enacting her most basic constitutional right and affirming our national faith that exercising this right is an act of patriotism and civic engagement. That her letter was greeted instead as a threat to overthrow the government shows just how far we deviated from our national values in the years following 9/11. Berg's experience is a reminder of how quickly our most basic values can fall victim to exaggerated fears for national security. And her story is a reminder of how much one individual voice can mean in such a time."

The truth of Laura Berg's words is even more resonant three years after she wrote her letter to the Alibi. We are all too aware of the "devastating human and financial costs of post-traumatic stress disorder," and the physical and financial costs of the war. Let's hope we can take her advice and "wake up and get real."

We need not only to remove this government that relies on deceit and fear-mongering, we need to vote for a new one that restores our civility and sense of justice.
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Michelle Gillett is a regular Eagle contributor.
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The Boston Globe, Page A4, Nation/World, Monday, May 12, 2008

“Pool of disabled veterans grows: Costs are soaring as wars’ toll rises”
By Jennifer C Kerr, Associated Press

WASHINGTON—Increasing numbers of US troops have left the military with damaged bodies & minds, an ever-larger pool of disabled veterans that will cost the nation billions for decades to come – even as the total population of America’s veterans shrinks.

Despite the decline in veterans – as soldiers from World War II & Korea die – the government expects to be spending $59 billion a year to compensate injured warriors in 25 years, up from today’s $29 billion, according to internal documents obtained by the Associated Press. And the Veterans Affairs Department concedes that the bill could be much higher.

Veterans now have worse wounds & more disabilities. In addition, more veterans are aware of the benefits & are quicker to file for them.

Another reason for the higher costs is advanced medical care. Troops come home with severe injuries that might have killed them in earlier wars.

Time is also a factor when it comes to disability compensation costs. Payments tend to go up as veterans age, and an increasing numbers of soldiers from the Vietnam War will be getting bigger payments as they age and are less able to work around their disabilities.

The number of disabled veterans has jumped by 25 percent since 2001 – to 2.9 million – and the cause is no mystery.

“This is a cost of war,” said Steve Smithson, a deputy director at the American Legion. “We’re still producing veterans. We’ve been in a war in Iraq for 5 years now, and the war on terror since 9/11.”

VA & Census Bureau figures show the previous 6-year period, before hostilities in Afghanistan & Iraq, saw a more modest increase of 4 percent in the number of disabled veterans. Veterans can make claims for disability benefits long after their military service has ended.

Today’s veterans – disabled or not – number nearly 24 million. That population is projected by the VA to fall under 15 million by 2033, mostly because of dying World War II & Korean War vets, but costs are expected to rise.

Inflation accounts for a big chunk of the increase. But even when the VA factors out inflation, the compensation for disabled veterans would still grow from $29 billion to $33 billion in today’s dollars.

VA officials declined several requests for interviews. In a written response to handful of questions, the agency noted a few factors at play in the rising costs, such as the aging veterans population, an increase in the number of disabilities claimed, & the severity of injuries sustained.

Smithson said today’s veterans also are filing claims for more disabilities. “It’s not like the WWII generation & the Korean War generation where they weren’t aware of what they could file for,” he said.

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The Boston Globe, Page A2, Friday, May 16, 2008, “Daily Briefing”

“VA repudiates disability e-mail”

An internal e-mail written by a Veterans Affairs Department employee suggested avoiding a diagnosis of post-traumatic stress disorder for veterans & instead considering a diagnosis that might result in a lower disability payment. The March 20 e-mail had been forwarded to VoteVets.org, a veterans lobbying group, and was distributed yesterday by the group & Citizens for Responsibility & Ethics in Washington. VA Secretary James Peake issued a statement calling the e-mail sender’s suggestions inappropriate & said the employee had been repudiated & was apologetic. The VA did not release the name of the employee. (AP)

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"VA denies money was a factor in stress disorder diagnoses: Staff psychologist to testify before Senate panel"
By Hope Yen, Associated Press, June 4, 2008

WASHINGTON - A Veterans Affairs psychologist denies that she was trying to save money when she suggested that counselors make fewer diagnoses of post-traumatic stress disorder in injured soldiers.

Norma Perez, who helps coordinate a post-traumatic stress disorder clinical team in central Texas, indicated she might have been out of line to cite growing disability claims in her March 20 e-mail titled "Suggestion." She said her intent was simply to remind staff members that stress symptoms could also be adjustment disorder. The less severe diagnosis could save the VA millions of dollars in disability payouts.

"In retrospect, I realize I did not adequately convey my message appropriately, but my intent was unequivocally to improve the quality of care our veterans received," Perez said in testimony prepared for delivery today before a Senate panel.

The Senate Veterans' Affairs Committee and the VA inspector general are investigating whether there were broader VA policy motives behind the e-mail, which was obtained and disclosed last month by two watchdog groups. The VA has strenuously denied that cost-cutting is a factor in its treatment decisions.

"One question that was raised repeatedly about this latest e-mail was, 'Why would a clinician be so concerned about the compensation rolls?' " said Senator Daniel K. Akaka, Democrat of Hawaii, who chairs the Senate panel. "As an oversight body, we must know whether the actions of these VA employees point to a systemic indifference to invisible wounds."

VA Secretary James B. Peake has called Perez's e-mail suggestion "inappropriate." VA officials this week said her e-mail was taken out of context.

"The e-mail, as characterized by others, does not reflect the policies or conduct of our healthcare system," said Michael Kussman, VA's undersecretary for health, in testimony prepared for the Senate hearing. "We certainly agree that it could have been more artfully drafted."

In her e-mail to staff members at the VA medical center in Temple, Texas, Perez wrote, "Given that we are having more and more compensation-seeking veterans, I'd like to suggest that you refrain from giving a diagnosis of PTSD straight out. . . . We really don't have time to do the extensive testing that should be done to determine PTSD."

Many veterans and injured troops have long alleged that the government might seek to reduce disability costs by assigning a lower benefits rating. Last year, retired Lieutenant General James Terry Scott, chairman of the Veterans' Disability Benefits Commission, said he believed the Army might at least subconsciously consider cost. A lawsuit filed in San Francisco accuses the VA of misclassifying PTSD claims.

In her testimony, Perez said symptoms for PTSD and adjustment disorder are often similar, as are the treatments for them. She said by making an initial diagnosis of a lesser disorder, VA staff can begin treatment right away without going through the arduous process of deeming it PTSD.

Perez also noted that awarding disability benefits is not part of her staff's work, but she did not say why she chose to cite that as a factor in urging fewer PTSD diagnoses. Veterans diagnosed with PTSD are eligible to receive up to $2,527 a month in government benefits.

A recent Rand Corp. study found that about 300,000 US military personnel who served in Iraq or Afghanistan are suffering from PTSD or major depression. Lesser diagnoses in benefits decisions could save the government millions of dollars.

"Although our clinic is a treatment clinic, we all fully support the compensation process and the department's policy of erring in the best interest of the veteran whenever there is any doubt," Perez wrote.

Perez's testimony was made after Peake was called to Capitol Hill last month to answer questions about internal e-mails suggesting that VA officials were hiding the number of veterans who tried to kill themselves. One of the e-mails started with "Shh!" Some lawmakers have said the VA's top mental health official who wrote it, Dr. Ira Katz, should be fired, but Peake has said he has no plans to do so.

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Colonel Elspeth Ritchie discussed efforts to understand suicide among US soldiers in Iraq and Afghanistan yesterday. (J. Scott Applewhite/associated press)
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"Soldier suicide rate hits record high: 115 dead in '07; Army says toll climbing in '08"
By Pauline Jelinek, Associated Press, May 30, 2008

WASHINGTON - Army soldiers committed suicide in 2007 at the highest rate on record, and the toll is climbing ever higher this year as long war deployments stretch on.

At least 115 soldiers killed themselves last year, up from 102 the previous year, the Army said yesterday.

Nearly a third of them died at the battlefront, 32 in Iraq and four in Afghanistan. But 26 percent had never been deployed to either conflict.

"We see a lot of things that are going on in the war which do contribute - mainly the longtime and multiple deployments away from home, exposure to really terrifying and horrifying things, the easy availability of loaded weapons, and a force that's very, very busy right now," said Colonel Elspeth Ritchie, psychiatric consultant to the Army surgeon general.

"And so all of those together we think are part of what may contribute, especially if somebody's having difficulties already," she said at a Pentagon news conference.

Some common factors among those who took their own lives were troubled relationships, work problems, and legal or financial difficulties, officials said.

More US troops also died overall in hostilities in 2007 than in any of the previous years in Iraq and Afghanistan. Violence increased in Afghanistan with a Taliban resurgence, and the rate of deaths of US personnel increased in Iraq even as violence there declined in the second half of the year.

Increasing the strain on the force last year was the extension of deployments from 12 months to 15 months, a practice ending this year.

The 115 confirmed suicides among active-duty soldiers and National Guard and Reserve troops who had been activated amounted to a rate of 18.8 per 100,000 troops - the highest since the Army began keeping records in 1980.

Two other deaths are suspected suicides but are still under investigation.

So far this year, the trend is comparable to last year, said Lieutenant Colonel Thomas E. Languirand, head of command policies and programs.

As of Monday, there had been 38 confirmed suicides in 2008 and 12 more deaths that are suspected suicides under investigation, he said.

The suicide rate continues to rise despite a host of efforts the Army has made to improve the mental health of a force under unprecedented stress from the longer-than-expected war in Iraq and the long and repeated tours of duty it has prompted.

The efforts include more training and education programs for troops and their families. Officials also have hired more mental health workers, increased screening to measure the psychological health of soldiers, and worked to reduce any stigma that keeps them from going for treatment when they have symptoms of depression, anxiety, post-traumatic stress, or other emotional problems.

"More than any time in history, our soldiers and their commanders are armed with information about combat and its impact on psychological health," said Brigadier General Rhonda L. Cornum, assistant surgeon general for force protection.

"We still believe there is more to be done, and we are committed to maximizing prevention" and treating those who need help, she said.

Suicides have been rising nearly each year of the five-year-old war in Iraq and the nearly seven years of war in Afghanistan. The 115 deaths last year and 102 in 2006 followed 85 in 2005 and 67 in 2004. The rate of 18.8 per 100,000 last year compared with a rate of 17.5 in 2006 and 9.8 in 2002 - the first full year after the start of the war in Afghanistan.

The Centers for Disease Control and Prevention said the overall suicide rate in the United States was about 11 per 100,000 in 2004, the latest year for which the agency has figures. The Army said that when civilian rates are adjusted to cover the same age and gender mix that exists in the Army, the civilian rate is more like 19.5 per 100,000.

The Army, which is the largest force serving in both wars, is the only service to release annual figures on suicides it gathers every year by polling troops at the war fronts on mental health issues.
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www.boston.com/news/nation/washington/articles/2008/05/30/soldier_suicide_rate_hits_record_high/
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"Other suicide findings"
May 30, 2008

93 of the 115 suicides were active duty troops; 22 were members of the Army National Guard or Reserve who had been mobilized.

Five were women.

There were 166 attempted suicides among troops in Iraq and Afghanistan and 935 in the whole Army.

Young, white, unmarried junior enlisted troops were the most likely to attempt suicide.

Firearms were the most common method for those who killed themselves. Overdoses and cutting were the most common for all attempts.

30 percent of all cases reportedly involved drugs and/or alcohol.

The majority of people who committed suicide did not have known histories of mental disorders.

Seven percent of those who killed or attempted to kill themselves had served multiple tours of duty in the wars.

The highest number of attempts occurred among soldiers who were in the second quarter of their tour.
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SOURCE: Associated Press
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www.boston.com/news/nation/articles/2008/05/30/other_suicide_findings/
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(A Boston) GLOBE EDITORIAL
"The psychological fog of war"
June 11, 2008

THE HARSH emotional and mental costs of sending troops to frequent and long deployments in wars without clear battle lines became apparent last month, when the Pentagon released data on suicides and cases of post-traumatic stress disorder. In 2007, there were 115 suicides among active duty service members, an increase over a total of 102 in 2006 and the highest figure since the Pentagon began keeping data on suicides in 1980. Last year, the services also registered their highest number of post-traumatic stress disorder cases - 14,000, an increase of 46 percent over 2006.

As one step to reduce the pressure on its ranks, the Department of Defense has already announced it would end the 15-month deployments in Iraq required by the surge of 2007. For the longer term, a drawdown in US forces in Iraq would reduce the need for the frequent deployments that are so harmful to service members' family relationships.

Other preventive steps have included recruiting more mental-health professionals and a new Department of Veterans Affairs practice of checking on the condition of every discharged service member, including those who have not reported any health problems. Such calls are aimed at getting care to those who are suffering from the depression, anxiety, emotional numbness, intrusive thoughts, sleeplessness, and nightmares of the stress disorder without reaching out for help.

Between 2003 and 2007, the services have reported a total of 40,000 post-traumatic stress disorder cases. As high as that number is, military officials say it represents just a fraction of the total. One reason troubled service members shrink from seeking help is their fear of hurting their careers. Recently, Secretary of Defense Robert Gates took the laudable step of dropping a requirement that troops list counseling for problems related to combat service in filling out a questionnaire for national security positions.

Last month, two nonprofit organizations, Give an Hour and the American Psychiatric Foundation, announced that they will use a $1 million grant from the Lilly Foundation to recruit and educate volunteer mental health professionals to work with returning service members and their families. While this is a commendable effort to close a gap in services caused by the government's failure to staff up for the mental-health problems that two simultaneous wars inevitably create, troops should not be dependent on volunteers for these services. When it comes to troops and their families reaching out for help, the old expression associated with life in the armed forces - "hurry up and wait" - cannot be tolerated.

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"America is failing returning veterans"
The Berkshire Eagle - Letters
Monday, June 16, 2008

Imagine, risking your life fighting for the freedom of your country, only to come home and discover that the battle has just begun. This is what happens to many soldiers who come back to America and end up living on the street. These men and women are our guardians, selflessly risking there lives to protect us, only to find themselves eating out of dumpsters, sleeping in abandoned warehouses, and living in worse conditions then they did when they were fighting in the Middle East. I think that it is appalling. The number of homeless soldiers in America is massive. They are also treated with such disrespect. Why aren't we helping the people who risk their lives for us?

Think about this number: 275,000. Now think about this ratio: 1:4. The first statistic, 275,000, represents how many soldiers are on the streets at one time. This doesn't include the wives and children that many of them have. If we counted them, the numbers would skyrocket to over a million. The other statistic, the ratio of 1:4, represents the percentage of homeless soldiers compared to the percentage of other homeless Americans. That means that 25 percent of all homeless people in America are soldiers and war veterans. However, when people hear these numbers, many of them are not surprised, and do not seem to care. What does this say about America as a whole?

"Coming home can be harder than fighting war," states Private First Class, Herald Noel, one of these unfortunate heroes. This statement is too true. Many say that soldiers are rapidly becoming the next generation of homeless people in America. One source stated, "in the next couple of decades, we could be looking at an epidemic of homeless veterans, and much as 1:2 compared to other homeless individual."

Why are we sending the young men and women who fight for us onto the streets? Ask the people who took away their homes and put them there. We should become more aware of this issue. We should be embracing them, starting fundraisers, opening up homeless veterans shelters, donating supplies to help them. Soldiers are just like us, and they should be given the same rights as us. Why are so many neglected? They have earned the right to have a roof over their head, and a warm bed to sleep in. War veterans have seen more tragedy, more bloodshed, and more violence than most Americans could witness in a hundred lifetimes. We need to help the people who risked their lives for us.

JASMINE BECKER
Pittsfield, Massachusetts

This letter to the editor was written as part of an eighth grade, English Language Arts class project at Herberg Middle School.

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The Boston Globe, Op-Ed, JAMES CARROLL
"A blind eye on soldiers' suicides"
By James Carroll, June 30, 2008

'SUPPORT THE troops" is an American lie. This nation is grievously and knowingly failing the young men and women who wear the uniform of its military services, and nothing demonstrates that more powerfully than the suicides of soldiers. According to the Army's own figures, the rate of suicide among active duty personnel nearly doubled between 2001 and 2006. The number then grew even higher in 2007, when suicide ranked third as the cause of death among members of the National Guard. Even if proximate causes vary from war zones to home fronts, such data are anomalous, since suicide rates among soldiers historically go down during wartime, not up.

Veterans, too, are in trouble. In May, the head of the National Institute of Mental Health warned of "a gathering storm." Thomas Insel told the American Psychiatric Association that one in five of the 1.6 million soldiers who have been deployed in Iraq or Afghanistan (or more than 300,000) suffer from post-traumatic stress syndrome or depression. Potentially life-threatening mental disorders, including self-destructive behavior like addiction, raise the prospect, in Insel's words, of "suicides and psychological mortality trumping combat deaths."

As America has steadily averted its gaze from the actualities of its wars in Iraq and Afghanistan, so, too, has the nation refused to look at what is happening to those it sends to fight. Repeated deployments to war zones, combined with meager support upon returning home, are leaving many soldiers adrift. Each one who commits suicide, or attempts to (more than 2,000 last year), shows this. It would be presumptuous to draw conclusions from any single instance of such despair, but taken as a whole, these acts of self-destruction lay bare some difficult truths.

The war in Iraq, in particular, is an exercise in the obliteration of meaning. The war's essence is its lack of essence. The war's catch-22 is that its stated goal is social order, while the American presence itself creates disorder. Our troops know this. They arrive in the war zone with every intention of protecting an innocent population from the enemy, only to discover that the enemy and the population are indistinguishable. "Insurgents" often turn out to be, not ideologues, much less "terrorists," but only cousins of those already killed. Victims and victimizers are alike. Suspicion is ubiquitous. No one trusts Americans. Such contradictions make the war controversial in the United States, but in Iraq they make the soldiers' situation intolerable.

These particular problems exist within a larger context of collapsing sources of meaning. The myths on which the military ethos depend have been broken.

Whatever ethnic fevers grip Iraqis, for example, American soldiers know, if only unconsciously, that the passion for nationhood on which 19th- and 20th-century wars depended is being undercut by the global citizenship of the 21st century. Not since Earth was seen whole from the moon is nationalism what it was. Even more transforming, faith in technological violence as an instrument of justice is being undercut by the catastrophic planetary outcome that can already be anticipated if technological violence is not curbed. The human naiveté that uses violence in the name of ending violence can no longer be sustained. For Americans plunged into the heart of this contradiction, the unbridled violence of their own nation points to the suicide of the very species.

But for American soldiers, it is more personal even than that. For meaning's sake, their purpose has been defined around loyalty. Unit cohesion is the absolute virtue. Thus our soldiers prepare to die not for Iraq, nor even for America, but for one another. "I've got your back," they promise. In combat, such commitment is often heroically fulfilled, but, alas, once the bureaucracy replaces the buddy, loyalty, too, is found to be a lie. Harsh to say, but the American military cares nothing for the individuals who comprise it, only for the mission those individuals, in formation, can accomplish. Hence the shameful exploitation of troops in disabling redeployments, and the resulting abuse of their families. Hence the nation's abandonment of those, who, upon discharge, find no unit, no cohesion, and their backs against the wall. Support the troops? On your bumper.

Suicide is always a tragedy, and, whether accompanied by a note, always a message - one that survivors must read. In the case of soldier suicides, we Americans are all their next of kin. Their despair demands our attention. What are they telling us?
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James Carroll's column appears regulary in the Globe.
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"Many veterans may be owed cash: Errors made in clearing claims"
By Anne Flaherty, Associated Press, July 16, 2008

WASHINGTON - Tens of thousands of veterans may not have been paid money owed them by the government because of hasty efforts to clear a massive backlog of claims, House Democrats said yesterday.

In a new report, Democrats found that at least 28,283 veterans had their claims denied at a time when the government had stopped doing quality assurance checks. The Defense Finance and Accounting Service and contractor Lockheed Martin were working feverishly to clear a backlog of claims resulting from changes in the law that made veterans eligible to receive disability and military retirement pay simultaneously.

"Most guys who get a letter saying they get zero money would never challenge it. They wouldn't know how," retired Army Command Sergeant Major Harold Lewis is quoted as saying in the report.

Lewis, who was disabled during the Vietnam War, fought the rejection of his claim and was eventually awarded $15,000.

The assessment was conducted by the House Oversight and Government Reform's domestic policy subcommittee, led by Representative Dennis Kucinich, Democrat of Ohio.

Officials at the defense accounting service and Lockheed Martin said they planned to address the concerns at a hearing today.

Spokesman Tom LaRock said the accounting service has processed more than 229,000 claims and paid out more than $149 million in entitlements. The office has established "a reliable and repeatable process enabling us to adjudicate incoming claims within 30 days of receipt," he said.

In mid-2006, the defense accounting service had hired Lockheed Martin to help it work through the long list of cases. The government identified some 133,000 veterans who were eligible for money through its "VA Retro" program. The list quickly grew by 84,000 more names because newly retired veterans or those with a changed disability status were being added.

Officials finally cleared the backlog this summer.

According to the House investigation, officials reached their goal only after lowering their standards. The defense accounting service was concerned about the number of errors in Lockheed Martin's work, but eventually suspended quality control procedures to prevent further program delays, Democrats said.

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"Veterans groups focus on unclaimed remains"
By Associated Press, August 25, 2008

ROCHESTER, N.H. - Now that four forgotten servicemen have been laid to rest, veterans groups are working to make sure others aren't being overlooked.

The veterans, whose cremated remains were abandoned years ago at a Manchester funeral home, were buried with military honors Friday after attempts to contact their survivors failed. Following the efforts by funeral director Arthur Phaneuf and Roger Desjardins, director of the state veterans cemetery, other groups are coming forward to ensure other veterans also are honored.

Dan Meehan of Rochester is state coordinator for the Missing in America Veterans Recovery Program, a national project to find, identify, and properly inter unclaimed cremated remains of forgotten veterans. He plans to contact all funeral homes in New Hampshire to determine whether any have unclaimed remains of service members. Anyone honorably discharged is entitled to free burial in the veterans cemetery.

"We don't want anybody left behind," he said.

Russ Armstrong of Guilford, who serves on the veterans subcommittee for the state Council on Aging, said he wants to recruit representatives from each county to contact their local funeral homes. The group then will work with the veterans cemetery.

"Our approach is one veteran at a time," Armstrong said.

Charles Hafner, president of the New Hampshire Funeral Directors Association, said he believes most funeral directors would support a movement to inter unclaimed remains of veterans "as long as we're fairly certain no family members are going to come forward and object to it."

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(A Boston) GLOBE EDITORIAL
"This does not compute for vets"
September 15, 2008

CONGRESS ACTED wisely this year when it pushed through - over the objections of President Bush - a major expansion of the GI Bill's education benefits for veterans. At long last, benefits will be more in line with the cost of public and private higher education.

But the Department of Veterans Affairs has set off alarm bells in Congress and among veterans' organizations by proposing to privatize the administration of the new GI Bill. Congress should block any move by the department that will give an outsourced computer program any voice in determining the eligibility and benefits of veterans.

Currently, VA offices in the states administer the education benefits, a system that veterans' organizations say has worked well. VA employees call veterans to fill in gaps in the applications and, if necessary, help applicants by tracking down information from the Defense Department.

The American Legion veterans organization says it is not against an update in the VA's information technology, but that the 250,000-employee department has the capability already. In particular, the legion says, the VA should draw on the skills of younger veterans who have both IT training and an awareness of the problems veterans face in resuming their lives and pursuing careers and education.

At a congressional hearing Thursday on the VA proposal, the national commander of the American Legion, David K. Rehbein, said the "VA was created to fulfill obligations like this, not to hire someone else to do it."

As advocates for veterans are only too aware, the VA has tried before to privatize an important function, and the results were abysmal. In 2003, the VA paid a defense contractor nearly $300 million for a new system to track hospital supplies. It never worked and ended up endangering patients' health.

At Thursday's hearing, VA official Keith Predigo said the use of a computer program for "minimizing human intervention" is in line with a government-wide goal of Bush's. "Claims that are rejected by the automated process and require a manual eligibility determination will remain the responsibility of trained VA personnel," he said.

But members of Congress are properly skeptical of the plan, not least because the department has no back-up. The new benefits go into effect Aug. 1, 2009, but the department will not require its contractor to prove "functionality" of its system until June 1. That leaves little time to fix snafus. Congress should not let a private contractor spin a telephone-menu tangle around one of its proudest recent achievements.

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"Mortgage help for U.S. veterans"
The Berkshire Eagle/The North Adams Transcript - Letters
Tuesday, November 04, 2008

The Veterans' Benefits Improvement Act of 2008 will allow the Veterans Administration to help a substantial number of veterans with sub-prime mortgages refinance into a safer, more affordable VA-guaranteed loan.

Veterans who wish to refinance their sub-prime or conventional mortgage may now do so for up to 100 percent of the value of the property. These types of loans were previously limited to 90 percent of the value. Additionally, Congress raised the VA's maximum loan amount for these types of loans. Previously, these refinancing loans were capped at $144,000. With the new legislation, such loans may be made up to $729,750 depending on where the property is located. These changes will allow more veterans to refinance through VA, allowing for savings on interest and potentially avoiding foreclosure.

For more information, or to obtain help from a VA loan specialist, veterans may call 1-877-827-3702 or visit www.homeloans.va.gov

WILLIAM T. BRADLEY
Adams, Massachusetts
The writer is director of Veterans' Services for Adams.

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"Employers, veterans look to fill thousands of jobs"
Updated: 11/13/2008, 6:10 PM, Capital News 9, By: Steve Ference

ALBANY, N.Y. -- For some, it's the beginning of their new life.

"It's a little scary. A bit nervous. Hopefully places like this will help me out," said Eugene Alston, a soon to be veteran of the Navy.

The beginning of their new life, being, of course, the move from the military to the civilian world.

"I served three years on the USS Toledo, United States Submarine," said Alston, holding a folder of resumes. "So, I've been pretty much around the world."

Alston was one of scores to attend a veteran’s job fair in Albany, looking to take his Navy experience and turn it into a solid career.

"I was doing this since I was 18. Transitioning to the civilian world I think is going to be the hardest thing to do," Alston said.

"What you see is a reflection of the economy, number one. You see a lot of veterans looking for jobs," said James McDonough, the State Director of Veterans Affairs.

Little wonder why so many showed up to talk with more than 30 employers, arguing it just makes sense to hire those who have been willing to give all for their country.

Steve Toomey, CSX Military and Diversity Recruitment Manager, said, "Veterans that walk in here are definitely job ready from day one because of their training."

And there are actually a number of job fairs like this happening around the state at the same time. Crucial, because it comes at a time when state jobs are being frozen. State jobs being where veterans have typically looked for employment.

"The employment situation is much more difficult and this is one group of individuals we want to pay special attention to," said State Labor Commissioner M. Patricia Smith.

It may not make it past all the bad economic news we hear so much about, but at least at the job fairs taking place in Buffalo, Syracuse, Albany and New York City, even in the tough economy, there are still jobs out there.

"I'm down to my last resume," said Alston. "I wasn't prepared. I didn't think we'd be that wanted here, but I'm glad.”

This, as some employers look to give veterans a fighting chance, especially with more and more expected to return home in the coming months.
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"Vets Groups Sue VA Over Claims Delays"
(Military.com) Week of November 17, 2008

Two veterans groups, the Vietnam Veterans of America and the Veterans of Modern Warfare, are suing the Department of Veterans Affairs (VA) over what they call "unacceptable delays" in veteran's claims. The lawsuit demands that the VA provide an initial decision on every veteran's claim for disability benefits within 90 days and resolve appeals within 180 days, and seeks relief to provide a lifeline of interim benefits if the VA delays last beyond the limit. For more information, visit the Veterans of Modern Warfare website and the Vietnam Veterans of America website.

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"Dept. of Veterans Affairs says it can handle strain of new GI Bill"
By Hope Yen, Associated Press, November 19, 2008

WASHINGTON - The government sought yesterday to dismiss concerns that it might try to delay rollout of the new GI Bill, pledging to be ready to handle growing claims in veterans education benefits after abandoning plans to hire a contractor.

Testifying before a House panel, officials with the Department of Veterans Affairs acknowledged the potential for glitches as they scramble to upgrade government IT systems before the new legislation providing millions of dollars in new GI benefits takes effect next August.

But the VA contended it was on track to implement an IT system "in-house" just one month after abruptly scrapping plans to hire an IT contractor that the government previously contended was critical to get a system up and running on time.

"We have the resources. We have the working functionality," said Keith Wilson, the VA's director of the Office of Education Service, reversing course from earlier comments made by the VA. "We have a full pool of people to do the testing and manage all the efforts under way."

Congress voted in June to dramatically expand the GI Bill, which was first signed into law by President Franklin D. Roosevelt in 1944 for returning World War II veterans but hasn't been updated much since then.

Under the old measure, veterans can receive $1,321 monthly to cover all college expenses. Now, the new GI Bill will cover tuition and fees of any in-state public university. It also provides a monthly housing allowance and a $1,000 yearly stipend for books and supplies.

At least 520,000 veterans are expected to take advantage come next fall, up from about 250,000 who are currently attending colleges and universities on the GI Bill, drawing concern that the VA might not be able to keep up. In September the VA said it would hire an IT contractor due to inadequate staffing and "skill sets" to handle the education benefits at its agency. But amid criticism from veterans advocacy groups and then-Democratic presidential candidate Barack Obama, the VA abandoned those plans in October.

Yesterday, Wilson told the House Veterans subcommittee on economic opportunity that the VA would build on existing government systems to help deliver VA benefits for about two years beginning in August 2009. That process is fully under way with a timetable that will meet the August deadline, he said.

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Former senator Robert J. Dole greets retired Army Gen. Eric K. Shinseki, right, at Shinseki's Senate confirmation hearing. (By Brendan Hoffman -- Getty Images)
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"Shinseki Says He Would Modernize VA"
By Ann Scott Tyson, Washington Post Staff Writer, Thursday, January 15, 2009; A06

Retired Army Gen. Eric K. Shinseki pledged yesterday to transform the Department of Veterans Affairs into a proactive, "21st-century organization" to meet the needs of a growing population of wounded veterans.

Shinseki, the former Army chief of staff who put his career on the line in 2003 by challenging then-Defense Secretary Donald H. Rumsfeld's estimate of troop numbers required in Iraq, received bipartisan praise as a man of candor and integrity in a Senate confirmation hearing on Shinseki's nomination as VA secretary in the incoming Obama administration.

Sen. Daniel K. Inouye (D-Hawaii) recalled Shinseki's controversial prewar testimony that several hundred thousand troops would be needed to occupy and stabilize Iraq. "He told the truth, and in doing so took a position contrary to the administration," Inouye said. "His honest assessment that more troops would be needed cost him his job, but it is the surest measure of his fitness to serve as a Cabinet member."

Several senators expressed gratitude for Shinseki's willingness to take on the challenges at VA, which is struggling to meet the needs of a growing population of more than 25 million veterans, more of whom are likely to seek benefits as the economy deteriorates. In the hearing before the Senate Committee on Veterans' Affairs, Shinseki pledged to speed up the sluggish process for approving claims, which takes an average of six months; to streamline the transfer of medical and other records from the Defense Department to VA; to better meet the needs of veterans living in rural areas; and to modernize the delivery of benefits.

"We are somewhere back in the 19th century" in terms of the VA claims system, said Sen. Bernard Sanders (I-Vt.). Shinseki agreed, saying one of his top goals is to update VA's information technology network and move toward an electronic records system. "Asking [veterans] to take a number and wait or put up with records that are lost or take six months to adjudicate is not part of the culture I expect," Shinseki said.

"My message would be this: Treat our veterans with respect and dignity," the nominee said. "They're not here begging for a handout."

Shinseki, a native Hawaiian, graduated from West Point in 1965, served two combat tours in Vietnam as an artillery forward observer and cavalry troop commander and, after being wounded twice, "pleaded to stay on active duty," Inouye said. The Army agreed, and Shinseki served as an instructor in the English department of West Point and then rose through the ranks in Army command and staff positions. He commanded the 1st Cavalry Division in 1994 and 1995 and led NATO forces in Bosnia from 1997 to 1998. The following year, he took office as the 34th chief of staff of the U.S. Army.

Forced from that post by Rumsfeld, Shinseki also proved prophetic in warning at his June 2003 retirement ceremony that the Pentagon should "beware a 12-division strategy for a 10-division Army," suggesting that the Army was too small for its current missions. Such caution was vindicated by a decision in early 2007 by Rumsfeld's successor, Robert M. Gates, to permanently expand the Army by 65,000 soldiers over five years.

If confirmed, Shinseki said, he will confront the immediate tasks of formulating a "credible and adequate" 2010 budget request and implementing the new GI bill by August. "The overriding challenge, which I will begin to address on my first day in office, will be to make the Department of Veterans Affairs a 21st-century organization focused on the nation's veterans as its clients."

Sen. Daniel K. Akaka (D-Hawaii), the committee chairman, said that Shinseki's nomination would be scheduled for a vote by the Senate on Jan. 20 and that he anticipated Shinseki's confirmation on Inauguration Day.

The nomination of Shinseki, himself an amputee, will inspire confidence in military veterans, said former Republican senator Robert J. Dole. "Here's a man who's been through it; here's a man who understands it," Dole said at the hearing.

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"VA still underbudgeting for vets' healthcare, GAO says: New secretary vows to provide honest figures"
By Hope Yen, Associated Press, January 24, 2009

WASHINGTON - Two years after a politically embarrassing $1 billion shortfall that imperiled veterans healthcare, the Veterans Affairs Department is still lowballing budget estimates to Congress to keep its spending down, government investigators say.

The report by the Government Accountability Office highlights the Bush administration's problems in planning for the treatment of veterans, which President Obama has pledged to fix. It found the VA's long-term budget plan for the rehabilitation of veterans in nursing homes, hospices, and community centers to be flawed, failing to account for tens of thousands of patients and understating costs by millions of dollars.

In its strategic plan covering 2007 to 2013, the VA inflated the number of veterans it would be financially able to treat at hospices and community centers with the budget planned, investigators concluded. At the same time, they said, the VA didn't account for roughly 25,000 - or nearly three-quarters - of its patients who receive treatment at nursing homes operated by the VA and state governments each year.

"VA's use, without explanation, of cost assumptions and a workload projection that appear unrealistic raises questions about both the reliability of VA's spending estimates and the extent to which VA is closing previously identified gaps in noninstitutional long-term care services," according to the 34-page draft report obtained by the Associated Press.

Lawmakers expressed anger, saying they will be watching for new VA Secretary Eric Shinseki to provide a more honest accounting.

"The problems at the VA have been caused by years of mismanagement and putting the bottom line above the needs of our veterans," said Senator Patty Murray, Democrat of Washington. "While we won't fix everything overnight, Secretary Shinseki has pledged honesty and accurate accounting, which are key to realistic budgets and providing the services our veterans have earned."

The VA did not immediately respond to a request for comment.

In the report, the VA acknowledged problems in its plan for long-term care, which accounts annually for more than $4 billion, or 12 percent, of its total healthcare spending. In many cases, officials told the GAO they put in lower estimates to be "conservative" in their appropriations requests to Congress and to "stay within anticipated budgetary constraints."

As to the 25,000 nursing home patients unaccounted for, the VA explained it was usual clinical practice to provide short-term care of 90 days or less following hospitalization in a VA medical center, such as for those who had a stroke, to ensure patients are medically stable. But the VA had chosen not to budget for them because the government is not legally required to provide the care except in serious cases.

"VA supports GAO's overarching conclusion that the long-term care strategic planning and budgeting justification process should be clarified," wrote outgoing VA Secretary James Peake in a response dated Jan. 5. He said the department would put together an action plan within 60 days of the report's release.

In 2005, the VA stunned Congress by suddenly announcing it faced a $1 billion shortfall after failing to take into account the additional cost of caring for veterans injured in Iraq and Afghanistan. The admission, which came months after the department insisted it did not need additional money, drew harsh criticism from both parties.

The GAO later determined the VA repeatedly miscalculated - if not deliberately misled taxpayers - to justify Bush administration cuts to healthcare amid the burgeoning Iraq war.

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"Fix veterans' benefits"
The Berkshire Eagle - Letters - Saturday, February 07, 2009

Governor Patrick, with his close ties to President Obama, has an opportunity to be a champion for veterans in Massachusetts and the country at large.

Due to the fact that federal veterans' benefits are so paltry the commonwealth, to keep at least some veterans out of financial distress and off the streets, augments these benefits with a program called Chapter 115.

In this time of renewed civic responsibility and with the new administration sworn to begin to take care of the neglected in America, Governor Patrick should strongly push for total reform of the VA disability system.

As we approach the 200th birthday of Lincoln who swore to care for those who shall have borne the battle, our new president could emulate the Great Emancipator in this regard as he has in so many other symbolic ways.

If federal veterans' benefits truly reflected the costs of living in 2009 and not 1949, Chapter 115 would not be necessary, freeing up these resources for other uses. Most importantly, Massachusetts would be leading the rest of the nation in finally meeting the unpaid obligations this country owes to its veterans.

JIM NORCHI
Pittsfield, Massachusetts

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"VA clinic warns of possible contamination"
By Bill Poovey, Associated Press, February 14, 2009

CHATTANOOGA, Tenn. - Thousands of patients at a Veterans Administration clinic in Tennessee may have been exposed to infectious body fluids of other patients when they had colonoscopies in recent years, and VA medical facilities all over the United States are reviewing procedures.

VA officials also said a problem was found with equipment at an ear, nose, and throat clinic at the VA medical center in Augusta, Ga., and 1,800 veterans have been notified they may have been exposed to infection there.

A spokesman at Alvin C. York VA Medical Center in Murfreesboro, Tenn., said the clinic is offering free blood tests and care to all patients whose records show they had colonoscopies between April 23, 2003, and Dec. 1, 2008.

Christopher Conklin said notification letters were sent this week by registered mail to 6,378 patients of the Murfreesboro facility. He said no related health problems have been reported, and every measure is being taken to assure affected veterans are screened. One veteran who received notification, Gary Simpson, 57, said, "The fact that it took five years for them to catch a mistake like that - it seems like somebody should have caught an incorrect valve and incorrect cleaning of the equipment during that time." His wife, Janice, called the discovery "sickening."

Conklin said a valve on equipment used in the colonoscopies was discovered wrongly connected Dec. 1 and the mistake was traced back to April 23, 2003.

A VA statement said that in response to the discovery at Murfreesboro and an inspection that found a problem with endoscopic equipment at the VA medical center in Augusta, Ga., all VA medical centers and outpatient clinics are reviewing procedures.

A VA statement said 1,800 veterans who were treated in Augusta, Ga., from January through November last year in the ear, nose, and throat clinic at the Charlie Norwood VA Medical Center are being notified "that they may have been exposed to infection because the instrument used in the procedure was improperly disinfected." The statement described the risk of infection as "extremely small."

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"Army reports more suspected suicides"
By Associated Press, boston.com, March 6, 2009

WASHINGTON - After a sharp spike in soldier suicides in January, the Army said yesterday that there were another 18 suspected suicides last month.

The increase continues a four-year rise in an Army under stress from two wars.

"It's a very high number; it's very disturbing," Colonel Thomas Languirand, head of the Army suicide prevention program, said of February's toll. "We're taking every effort we can think of" to try to bring it down.

The Army usually releases figures on self-inflicted deaths only once a year. But due to the large number of suspected suicides in January - 24 - officials decided to announce monthly figures to focus attention on the problem and on prevention programs available.

Army Vice Chief of Staff General Peter Chiarelli said there were two confirmed suicides in February and 16 suspected but still being investigated - compared with 11 confirmed deaths in the same month of 2008.

Usually the vast majority of suspected suicides are eventually confirmed, but the investigations can take months. When January figures were released last month, officials said there were seven confirmed and 17 pending, a figure updated yesterday to 12 confirmed and 12 pending.

Speaking by telephone to a group of bloggers, Chiarelli noted that officials already have bolstered suicide prevention programs and are having special training sessions this month and next, but he said no one thing can solve the problem.

The military has added mental health staff, operates hotlines for soldiers to call, and has programs to counter stress on the battlefields in Iraq and Afghanistan. There was no breakdown on how many of the suicides happened at the warfront.

Amid stress on the military in fighting the wars, troops are having difficulty keeping their marriages and personal relationships intact and are suffering financial, legal and work problems. Chiarelli said yesterday that unemployment also seemed to be a factor in February suicides among National Guard and Reserve members.

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(Barrie Maguire Illustration)
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The Boston Globe, Op-Ed, TYLER E. BOUDREAU
"The military's post-traumatic stress dilemma"
By Tyler E. Boudreau, March 9, 2009

WITH ARMY and Marine Corps suicide rates climbing dramatically, surpassing even those killed in Iraq and Afghanistan last month, the nation is increasingly disturbed and demanding treatment for veterans. But these suicide reports highlight an important distinction: A significant portion of those returning from war are not yet veterans; they are still active or reserve service members, which means, above all, that they probably will be going back to one of our theaters of operations. And that means that any treatment for post-traumatic stress will be positioned in direct conflict with the mission itself. As a former Marine captain and rifle company commander, I witnessed this conflict firsthand.

In response to the stigma surrounding post-traumatic stress in the military, Admiral Michael Mullen, chairman of the Joint Chiefs of Staff, said in May 2008, "It's time we made everyone in uniform aware that the act of reaching out for help is, in fact, one of the most courageous acts and one of the first big steps to reclaiming your career, your life, and your future." It is heartening to hear the man at the top speaking so forcefully on this issue. And while Mullen is, no doubt, genuinely concerned for these men and women in uniform, I suspect this issue may not be as simply resolved as he makes it sound.

I was in Iraq in 2004. From the day we had arrived home to the day we were scheduled to return to Iraq was exactly nine months. The pressure to prepare ourselves quickly was intense. When the first Marine came to my office and asked to see the psychiatrist about some troubling issues from our time in Iraq, I was sympathetic. I said, "No problem." When another half dozen or so Marines approached me with the same request, I was only somewhat concerned.

But when all of them and several more returned from their appointments with recommendations for discharge, I'll admit I was alarmed. Suddenly I was not as concerned about their mental health as I was about my company's troop strength. Manpower is not an endless spigot. There are always recruitment strains and so there are limits to how many men are available. My company would be allocated only so many Marines for our deployment. Whatever we lost before embarkation, for whatever reasons, we just went without.

As all those Marines in my company began filtering out, some from essential positions, I started to worry about the welfare of those remaining. I worried, quite naturally, that if the exodus continued, we might not have enough to accomplish our mission or to survive on the battlefield. My sympathies for those individuals claiming post-traumatic stress began to wane. A commander cannot serve in earnest both the mission and the psychologically wounded. When the two come in conflict, as they routinely do as a result of repeated deployments, the commander will feel an internal and institutional pressure to maintain the integrity of his unit. I did. And there begins a grassroots, albeit subconscious, resistance to Mullen's plan to destigmatize the people who seek help. Because as much as I cared about my Marines, it was difficult to look upon those who sought to leave without suspicion or even mild contempt.

In the spring of 2008, RAND released its well-known report in which it estimated that one in five service members returning from war will contend with symptoms of post-traumatic stress or depression. In a typical rifle company, those estimates would represent a loss of at least 30 men. I knew I couldn't afford that. Commanders at every level know it. The military knows it, too; it knows it can't afford a 20 percent reduction in forces and it can be counted on to prevent that from ever happening - even Admiral Mullen. One can only imagine the military's dismay if, through its own rigorous efforts to screen and encourage soldiers to report their invisible wounds, commanders were suddenly faced with hundreds of thousands of troops demanding treatment and discharge.

Where psychological and traumatic brain injuries can still, to some extent, be doubted and debated, and when their treatment stands in opposition to troop strength and to mission accomplishment, the needs of those wounded service members will be subordinated.

The result by necessity, which we are already witnessing today, will be dubious treatment protocols within the military aimed at retention, diagnosed soldiers returning to the battlefield, and a slowly diminished emphasis on screening. It will happen. It has begun already. There will be no policy shift. There will be no change in the language we hear from our leaders. But we will know all too well that our soldiers are still not being properly treated by the ever-increasing number of suicides that occur.
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Tyler E. Boudreau, a former Marine captain, is the author of "Packing Inferno: The Unmaking of a Marine."
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''I am no longer shamed by lack of hair and scar,'' says Judy Szczeblowski, who suffered a brain injury during surgery for a tumor. (Suzanne Kreiter/ Globe Staff)
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"Instant images, enduring frustrations: Exhibit exposes brain injury woes"
By Irene Sege, Boston Globe Staff, March 12, 2009

When Judy Szczeblowski enrolled in a photography project for survivors of brain injury in 2006, her chin-length hair hid the scar and bald spot that dominate the back of her head, artifacts of the surgery and radiation used to treat a life-threatening brain tumor in 1990. By the time the project ended 10 weeks later, Szczeblowski had cut her hair short enough to expose the entire bald spot.

The photograph Szczeblowski asked her mother to take of the back of her head is on display this week at the State House, part of an exhibit called "Brain Injury X-posed" that features the work of Szczeblowski and seven other long-term survivors.

"I am no longer shamed by lack of hair and scar," Szczeblowski wrote in her caption. "It represents a new freedom, pride in what I have overcome."

At a time when as many as one of every five US service members returning from Iraq and Afghanistan has suffered a traumatic brain injury, the exhibit provides a glimpse of what could lie ahead for some of them. It highlights not only the photographers' new limitations, but also the resilience of their spirits and the brain itself. It offers personal testimony to scientists' emerging understanding that the brain can rebuild cognitive and motor function much longer after the original insult than once believed.

Szczeblowski, who lives in Medfield, was the executive chef at Boston's Algonquin Club when doctors found her brain tumor. Today she works part time at the Sherborn Library. Scott Davis of Natick was a Babson College freshman when he lost control of his car in 1978 and slammed into a tree. He didn't understand his lingering brain injury until 2003, when he lost his job of 18 years at a financial firm for mistakes that could have proved costly if not caught. Today he's a part-time supermarket cashier. Peggi Robart of Newton was a respiratory therapist and clinical educator when a sign on a rental car shuttle bus hit her on the head in 2002. Today she's a volunteer.

Kathleen Donovan, 51, of Natick was assistant manager at a camera store when she suffered a stroke while doctors probed an inoperable brain tumor in 1999. After awakening from a three-month coma needing to relearn how to walk and talk, and spending a year and a half in a wheelchair, she now works part time taking tickets in a movie theater.

Their disabilities are not immediately apparent. Davis, 49, didn't discover until almost two decades after his accident that he has a mild seizure disorder, which he controls with medication. Robart still has trouble reading. Szczeblowski battles daily headaches. They all developed strategies to organize their thinking and master new tasks. They tire easily.

"We don't have crutches or wheelchairs," Davis says. "You can't necessarily look at us and say this person's disabled."

"It's a daily challenge," Robart says, "to push your own envelope but not so much you get a horrible headache or get overwhelmed."

The participants belong to a larger support group sponsored by the Brain Injury Association of Massachusetts. In PhotoVoice, they got disposable cameras, then talked and wrote about the images they made. "We ended up communicating much deeper emotions," says Szczeblowski, 53.

"Not only did we become closer as a group, but we could do more," says Robart, 50. "I could organize better."

In an act of triumph, Robart wore a dress to the exhibit Tuesday. The wounded left side of her brain no longer transmits impulses to her right foot, so for years Robart wore a brace to keep her foot in place and clunky walking shoes, hardly the footwear for dresses. In November, Robart got an electrical device that she straps below her right knee. Whenever she steps with her left foot, the device signals her lamed foot. Robart hopes it will eventually retrain her brain so she will be able to walk without it or her cane.

"In the past we thought people only recovered in the first three to six months. Now we believe people can recover for the first 18 months to two years," says Dr. Ross Zafonte, vice president of medical affairs at Boston's Spaulding Rehabilitation Hospital. "We're finding that isn't even the limit. What if you intervene for a specific deficit? We're showing some of that can be improved."

Robart photographed a ladder resting beyond a patch of mud. "It's a muddy, rutty, hands-and-knees crawl up to the first rung of the ladder that begins to make some semblance of sense - and then you get to begin to really struggle," she wrote.

The group has displayed pieces of their work in a few libraries. In November, 200 people attended a PhotoVoice program at the Newton Free Library that focused on veterans. The State House exhibit marks the first showing of the entire project.

Davis's photo of ducks is the first picture the group discussed, and he likes to think it set the tone for the project. Ducks, Davis wrote, "likely don't have things they can't do that they could do before, and, if they do, they probably don't have near-constant thoughts about them."

Photographs of people who helped her and correspondence with legislators document Donovan's 2 1/2-year struggle to get the one-bedroom apartment she shares with her two cats after living in a nursing home. "I'm tenacious," Donovan says. Her next goal is to become a physical therapy assistant. "Make my life count," she says.

Szczeblowski snapped a picture of her shelf of cookbooks to illustrate what she's lost. A photograph of a perennial garden she's planted outside her apartment captures what she's found.

"Judy the chef. Those words were always together. With PhotoVoice I really cut that cord," Szczeblowski says. "I was happy and content and had built a life as good as the one I'd had."
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The Miami Veterans Affairs hospital reported it was in the clear, only to discover during a more thorough review in March that endoscopic equipment was not being sanitized as the manufacturer recommended. WFOR-CBS 4.
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The Miami VA, which this week said it may have exposed thousands to HIV and hepatitis by using improperly sterilized equipment, gave itself a clean bill of health in January.
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"HIV risk at Miami VA hospital not found until 2nd review"
BY LESLEY CLARK AND FRED TASKER, MiamiHerald.com, Posted on Thursday, March 26, 2009

The Miami Veterans Affairs hospital, which may have exposed thousands of veterans to HIV and hepatitis by using improperly sterilized colonoscopy equipment, gave itself a clean bill of health in January, only to discover problems two months later after a more intensive review, VA officials told U.S. House members in a closed-door briefing Thursday.

The green light came weeks after the Department of Veterans Affairs, in a Dec. 22 alert, warned veterans hospitals nationwide to check for problems associated with colonoscopy equipment. The alert followed similar reported problems at a Tennessee VA clinic that also could have exposed thousands of veterans to hepatitis and HIV.

The Miami hospital reported it was in the clear, only to discover during a more thorough review in March that endoscopic equipment was not being sanitized as the manufacturer recommended. The VA had asked all medical centers to perform a more comprehensive review in mid-March, said Katie Roberts, VA spokeswoman in Washington.

That finding prompted the hospital to send out a letter Monday, alerting about 3,260 people who may have had colonoscopies at the center between May 2004 and March 12, 2009.

Miami VA spokeswoman Susan Ward declined to comment Thursday, and Dr. John Vara, the Miami VA's chief of staff, could not be reached. Roberts confirmed the timeline.

'When the Dec. 22 patient safety alert came out with its questions about processes, there was just this initial response by Miami that `we're OK,' '' Roberts said.

She said the department was conducting an internal investigation and that employees could face disciplinary action if there was cause. ''We don't take this lightly,'' she said.

Members of Congress on Thursday promised hearings into the matter and said they still had questions after the hourlong briefing.

''The more you know, the more you worry about,'' said Rep. Ileana Ros-Lehtinen, R-Miami, who provided details of the meeting. She was one of several South Florida members to attend the briefing convened by U.S. Rep. Steve Buyer, R-Ind., the top Republican on the House Committee on Veterans' Affairs. She was particularly troubled about the timeline that VA officials provided.

Buyer said he is concerned that the Miami case comes on the heels of problems at VA hospitals in Georgia and Tennessee.

''I want the VA to tell us why routine procedures were not in place,'' Buyer said.

William E. Duncan, M.D., associate deputy under secretary for health quality and safety, said in a statement, "We feel that the risk of cross-contamination among patients is small, and many patients are at no risk whatsoever."

"Our proactive monitoring program caught this problem. It's part of our efforts to ensure that veterans who get their care from VA receive the best care available anywhere,'' he added.

U.S. Rep. Kendrick Meek, D-Miami, whose district includes the hospital, said the VA has said it plans to send a team to the Miami hospital to ensure it is complying with proper protocol.

Meek sent out a news release about the problem Monday, after he was alerted to it by the VA. He plans to tour the hospital Friday morning. ''There's only a small likelihood that anyone could be infected, but there is a possibility,'' Meek said. ``The veterans are very concerned, for themselves and their families.''

The Miami problem arose when the tubing, pump and reservoir used in the colonoscopy procedure were rinsed after use but not disinfected as required by the manufacturer. It created a slight chance that back-flow from the pump could carry tiny amounts of virus into the patient.

As of Wednesday, the Miami VA had received 4,300 calls, and about 912 patients had undergone testing, though only 500 were in the at-risk pool of those receiving colonoscopies between May 2004 and March 12. Also, 55 VA employees are in the risk pool of 3,260 people.

As many as half the people in the risk pool may have zero risk because the flushing system identified as the problem was not used or attached during their procedure, but the VA doesn't know which people that includes, so it is offering testing to everyone.

Asked whether anyone in the risk pool carried any infectious disease, the VA suggested that as many as 100 had previously been diagnosed with HIV before getting VA colonoscopies -- creating a slight chance that they could have inadvertently infected others..

Since December, the VA has revealed similar problems with colonoscopy equipment at VA clinics in Murfreesboro, Tenn., and Augusta, Ga. On Thursday, it said 10 of the 6,400 veterans exposed in Murfreesboro and six of the 1,100 veterans exposed in Augusta have since tested positive for viral infection. The 10 who tested positive in Murfreesboro were infected with hepatitis B or C -- none with HIV, a VA spokeswoman said. She didn't have the breakdown for veterans in Augusta.

''There is no way to determine if the positive test results are directly related to the endoscopies at each facility,'' said VA southeast regional spokeswoman Jan Northstar, noting they may have been infected before the procedures or by other means. She said the VA received 4,300 phone calls requesting screening from veterans in Murfreesboro and 675 from Augusta.

''In both Murfreesboro and Augusta, some veterans have declined tests or gotten tested in private healthcare facilities, so we cannot specify the overall number of veterans who were tested,'' Northstar said. ``VA clinicians and infectious-disease experts are working with each veteran to create a plan of care based on their individual results.''

Miami VA officials have assigned additional staff to the Special Care Call Center for Veterans to ask questions or schedule testing. Veterans should call 305-575-7256 or 877-575-7256.

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"VA patient contracts HIV after error"
By Associated Press, April 7, 2009

CHATTANOOGA, Tenn. - A Veterans Affairs patient who was among thousands treated with unsterilized equipment has tested positive for HIV, the first such case reported since the department warned veterans they could have been exposed to infectious diseases.

The VA previously reported that hepatitis had been found in 16 patients, but the agency cautioned there was no way to prove that the patients contracted the illnesses because of treatment at their facilities.

In an e-mail late Friday, the agency said it was investigating "the possibility of such a relationship."

The VA earlier this year warned more than 10,000 veterans to get blood tests because they could have been exposed to contamination while getting colonoscopies in Murfreesboro, Tenn., and Miami.

The endoscopic equipment in question was also used at an ear, nose, and throat facility in Augusta, Ga. All three sites failed to properly sterilize the equipment between treatments.

The VA has said it does not yet know whether veterans who were treated with the same kind of equipment at its other 150 hospitals may have been exposed to the same mistake before the department had a nationwide safety training campaign. An agency spokeswoman has said the VA is certain the mistake with the equipment was corrected nationwide by March 14.

The statement Friday did not say where the patient who tested positive for HIV was treated, and the agency did not return telephone and e-mail messages yesterday.

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"Obama Pledges New Data System for Veterans"
By David Brown, Washington Post Staff Writer, Friday, April 10, 2009; A02

President Obama said yesterday that his administration will create an electronic record for veterans that will "contain their administrative and medical information from the day they first enlist to the day that they are laid to rest."

Research has shown that the handoff of medical information -- between individuals and hospital systems -- can be dangerous. Incomplete, incomprehensible or misunderstood data can contribute to medical error or substandard care.

While the Defense Department's hospitals and the Veterans Affairs medical system have electronic records, they are not seamlessly connected -- a problem Obama said he is determined to solve.

"Currently, there is no comprehensive system in place that allows for a streamlined transition of health records between DOD and the VA," the president said during a briefing at the Eisenhower Executive Office Building that was attended by the secretaries of those two departments as well as patients and practitioners from Washington area hospitals and military and VA facilities.

"I can't tell you how many stories that I heard during the course of the last several years . . . about veterans who were finding it almost impossible to get the benefits that they had earned despite the fact that their disabilities or their needs were evident for all to see," he said.

Obama has made electronic record-keeping a key feature of his health-care reform effort. There is evidence that electronic medical records reduce errors and waste.

A problem, however, is how the military and VA hospital systems, which use different software, will be able to communicate with each other. While the White House gave no details about how that will be accomplished, integration is the goal.

"I'm asking both departments to work together to define and build a seamless system . . . with a simple goal: When a member of the armed forces separates from the military, he or she will no longer have to walk paperwork from a DOD duty station to a local VA health center. Their electronic records will transition with them," Obama said.

The VA has a highly regarded system that allows a practitioner in any veterans hospital to retrieve data, look at X-rays and even review diagnostic videos. VA hospitals are officially "paperless." Military hospitals, however, use paper and electronic records.

"This new approach incorporates a transition strategy by maintaining a seamless access to all clinically relevant data from both systems, while concurrently building 'common services' between the two," said Cynthia Smith, a Pentagon spokeswoman.

In his remarks, Obama noted the toll of traumatic brain injury and post-traumatic stress disorder on veterans of the wars in Iraq and Afghanistan. He said his 2010 budget contained the largest single-year increase in VA funding in 30 years, with substantial increases for mental health screening and treatment.

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The Alvin C. York Campus of the Veterans Affairs Department in Murfreesboro, Tenn. is seen April 23, 2009. The VA first shocked veterans when it warned thousands of its patients to get blood tests for HIV and hepatitis because they might have been treated with dirty equipment at facilities including the one in Murfreesboro. Now it's frustrating veterans by not providing more information.
(AP Photo/Mark Humphrey)
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"Magnitude of dirty VA hospital equipment unknown"
By Bill Poovey, Associated Press Writer, Saturday, April 25, 2009

CHATTANOOGA, Tenn. – Thousands of veterans were at first shocked to learn they should get blood tests for HIV and hepatitis because three hospitals might have treated them with unsterile equipment. Now, just a couple of months after the Department of Veterans Affairs issued the dire warnings, veterans are growing frustrated by the lack of information from the tightlipped federal agency.

Nearly 11,000 former sailors, soldiers, airmen and Marines could have been exposed to infectious diseases because three VA hospitals in the Southeast did not properly clean endoscopic equipment between patients. On Friday, the VA revealed that another patient had tested positive for HIV, bringing the total to four such cases among patients who got endoscope procedures at hospitals in Miami, Murfreesboro, Tenn., and Augusta, Ga.

The agency also said a new hepatitis case had been discovered, increasing the number of positive tests to 26. More than 4,270 veterans still have yet to get test results.

Beyond those skimpy facts, the VA has said little else, citing an ongoing investigation.

It hasn't answered questions from The Associated Press about why problems with cleaning the equipment — and possibly co-mingling infectious body fluids — went on for five years at the Miami and Murfreesboro hospitals and about a year in Augusta. The VA also refuses to say if it found similar problems at its other 150 hospitals or if more patients should get blood tests.

The VA has stressed that the positive tests are "not necessarily linked" to medical treatment at its hospitals, and infections don't always cause symptoms and can go undetected for years.

Still, veterans are calling on the agency to release more information.

"This effort must involve continual updates on what the VA is learning about the extent of this situation," Vietnam Veterans of America President John Rowan said in a statement Thursday.

More facts are little comfort, though, to those who are already infected — and those that don't know.

A 60-year-old Navy veteran who had a colonoscopy at a VA hospital last year got an unimaginable phone call recently — a blood test showed he had HIV. A second test by the VA was negative, and now, the Tennessee man doesn't know what to think.

"I screamed out loud, `No' and went over and held my wife and told her what happened," said the veteran, who spoke to The Associated Press on the condition of anonymity because he was afraid of repercussions against himself and his employer. "We had a nice, good cry. The things that go through your mind. You think your whole world is going to end. Her world could end, too."

It was not clear whether the Tennessee man was counted as a positive HIV test by the VA.

The VA said the problems with the endoscopic equipment had gone on for years, but were discovered in December when it learned the Murfreesboro facility wasn't following cleaning procedures the manufacturer recommended. It issued an internal alert for hospitals to check their procedures, and the problem at Augusta was discovered in January.

On Feb. 9, the VA announced a nationwide safety check of endoscopic equipment used in colonoscopies and ear, nose and throat treatments. The procedure involves a narrow, flexible tube fitted with a fiber-optic device such as a telescope or magnifying lens that is inserted into the body.

Some veterans were warned in February to get tested, and more were alerted in March when the Miami hospital backtracked on its previous conclusion that it didn't have a problem.

The day after the first HIV infection became public April 6, the VA announced that its top medical official, Dr. Michael Kussman, was retiring. Kussman still works at the VA but could not be reached for comment. VA spokeswoman Katie Roberts said there was "no connection whatsoever."

The endoscopic equipment is made by Center Valley, Pa.-based Olympus American Inc., and the company has said its recommended cleaning procedures are clear.

The VA and its inspector general have started investigations, and congressional members of the Veterans Affairs Committee have asked for a hearing in late May to discuss how the VA has been handling the problem.

U.S. Rep. Steve Buyer, R-Ind. and ranking member of the committee, said in a statement he and his staff have been briefed weekly by senior VA officials. His office declined to release more information.

Private hospitals have also spread infectious diseases with unsterile equipment, but requirements to report such problems vary by state and there's no national regulation requiring disclosure, according to Barbara Rudolph, director of The Leapfrog Group, which advocates for quality health care.

The VA is providing a hot line for veterans and their families and posts the information it is releasing on its Web site. Because the VA hasn't ruled out other hospitals having had problems, some veterans are wondering if its more widespread.

In Cedar Rapids, Iowa, former Marine Allen Lusk had several colonoscopies at the VA hospital in Iowa City and tested positive for hepatitis B in December.

"I never had it till I started going to the VA," said Lusk, 51.

He started using the VA in 2006 after he was injured when a car fell on him and he didn't have health insurance. After seeing news reports about the contaminated equipment problems elsewhere, Lusk went to his county health department for an HIV test. He tested negative.

"To be honest, I'd like to see them come out and be honest about how big this really is," he said. "It might be embarrassing, but in the long run it might be better for them."

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A BOSTON GLOBE EDITORIAL
"When combat stress kills"
May 15, 2009

AMERICANS received a grim reminder this week that, as the wars in Iraq and Afghanistan drag on, death doesn't always come at the hands of an enemy. On Monday, Sergeant John M. Russell shot and killed five fellow servicemen at a mental health clinic at Camp Liberty in Iraq after his commanding officer recommended that he receive psychological counseling and confiscated his weapon.

Russell directed violence at others, but more and more often service members aim weapons at themselves. In 2008, over 140 service members committed suicide, far more than in any year since the statistic has been tracked. This internal wave of violence is a signal that the emotional and mental costs of war are taking a severe toll on American soldiers.

To reduce effects of combat stress, Admiral Michael Mullen, chairman of the Joint Chiefs of Staff, said he would consider increasing time between deployments. This must be tied with an effort to decrease the number of deployments, particularly since the Army's mental health assessment found that soldiers on a third deployment were at much higher risk of mental health issues.

But the stigma of mental health problems prevents too many soldiers from getting help. According to his father, Russell was concerned that by sending him to the clinic, his commanding officer was "setting him up" for discharge. Accessing mental health services must not be seen as a reason for demotion. Already, some leaders are taking initiative to change this. General Carter Ham, the commanding general for the Army in Europe, admitted that he sought counseling after his return from Iraq and told soldiers that he believed he was "a better general because I got some help." These messages from leaders signal that vulnerability to combat stress is part of the job.

Combating stigma must also involve better access to resources. All soldiers get a health assessment after their deployment, but most soldiers only fill out questionnaires. An experimental model at Fort Lewis in Washington called the Soldier Wellness Assessment Pilot Program gives returning soldiers a minimum of a 15-minute face-to-face mental health interview. Doctoral-level medical providers and other services are immediately available for those with symptoms of stress. However, this program is funded not by the Department of Defense, but by a grant from the surgeon general's office. The Pentagon ought to adopt the model more widely.

Until regular care becomes part of the regimen, the burden of identifying service members in mental distress falls on their colleagues and loved ones. This just isn't enough. The profound psychic wounds of those we send to war must be identified and treated in a systematic way.

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"Court rules sick veterans can sue UK"
By Associated Press, June 6, 2009

LONDON - Military veterans who participated in Cold War-era nuclear weapons tests won the right to sue the British Ministry of Defense yesterday for on-the-job hazards.

Britain's High Court ruled that about a thousand veterans and their survivors can pursue their claim for compensation because of exposure to radiation, which has been linked to cancer and other health problems.

The veterans participated in nuclear testing in Australia and on Pacific Ocean islands in the 1950s. They argue the defense ministry was aware of the health risks but failed to adequately protect them.

The British military has said it took the precautions that were acceptable at the time.

Most of the claimants are from Britain, though some are from Fiji and New Zealand.

Other countries have taken steps to compensate nuclear weapons workers. In the United States, workers or their survivors can receive compensation through a program established by Congress nearly a decade ago.

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Rep. John Hall (D-N.Y.), chairman of a House Veterans' Affairs subcommittee, said the VA needs "a cultural and management sea change." (Dennis Cook - AP)
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"Groups Urge VA to Reform Disability Claim Procedures"
By Steve Vogel, Washington Post Staff Writer, Thursday, June 25, 2009

Citing a fast-growing backlog of unresolved disability claims, veterans groups and members of Congress are calling for an overhaul of Department of Veterans Affairs procedures for handling cases.

The number of unprocessed disability claims has grown by nearly 100,000 since the beginning of the year and totaled 916,625 as of Saturday, a rise driven in part by increasing numbers of veterans from the Iraq and Afghanistan wars.

Rep. John Hall (D-N.Y.), who last week chaired a House Veterans' Affairs subcommittee meeting titled "Can VA Manage One Million Claims?," said the department needs "a cultural and management sea change."

Veterans "are waiting to have their claims and appeals processed," Hall said at the hearing last Thursday. "They are waiting for compensation. They are waiting for medical assistance and rehabilitation."

The American Legion, the nation's largest veterans service organization, says immediate reform is needed. "As the backlog of claims approaches 1 million, and the needs of deserving veterans go unmet, VA can wait no longer to institute new and workable policies and procedures," said David K. Rehbein, the national commander.

But the VA contends that the 1 million figure is misleading and that, in any event, it is incorrect to refer to it as backlog.

About 234,000 of the unresolved cases involve claims that are awaiting adjustment. An additional 195,000 are on appeal, and about 79,000 are considered miscellaneous. The remaining 410,000 cases are original or reopened claims for disability compensation and represent the "core" of the VA claims inventory, said Michael Walcoff, deputy undersecretary for benefits.

"While we currently have approximately 400,000 claims in our inventory, the majority of these claims are not 'backlogged,' " Walcoff told the subcommittee in prepared testimony. "The inventory is dynamic rather than static. It includes all claims received, whether pending for just a few hours or as long as six months."

Critics accuse the VA of resorting to semantics. "It seems like they're looking at ways to minimize the significance of it," said Steve Smithson, deputy director of veterans affairs and rehabilitation at the American Legion.

"At the end of the day, these are still individual veterans waiting for benefits they were promised," said Meaghan Smith, a spokeswoman for Hall. "If you asked the veteran waiting, he or she would call it a backlog."

For Army veteran David Bohan, who fought with the 1st Infantry Division during the Persian Gulf War, the bottom line is that it takes veterans too long to navigate the system. "This is very frustrating and very time-consuming," Bohan told the subcommittee. "I understand why so many people just give up."

But the VA said veterans have shorter waits, despite the 13.5 percent increase in the number of claims since last year. The average amount of time to resolve disability claims is 162 days, compared with 179 the previous year, according to the VA. About 20 percent of the cases have been pending for more than half a year.

"They have made some progress, but it's still unacceptable," Smithson said. "They need to move forward and not try to explain it away."

The National Veterans Foundation said in a news release that it receives hundreds of calls each month from veterans stuck in the VA claims process.

"This isn't a problem that was created overnight," said Shad Meshad, president of the group. "It's been building for decades. It's bad enough that these young veterans are being held up, but the men and women who served in Vietnam are still getting the short end of the stick, 40 years later."

Some of the delay results from congressionally mandated reforms that force the VA to be less arbitrary about how it reaches decisions, according to testimony at the hearing.

The VA has hired nearly 4,200 additional employees since January 2007, but it takes at least two years to fully train them to process claims, Walcoff said. "We're only now beginning to see the full impact of those employees hired at the outset of this initiative," he said.

Subcommittee members expressed frustration at the rate of progress. "VA seems to be overwhelmed, and it is well past time for frank assessment of what is going on," said Rep. Doug Lamborn (R-Colo.), the ranking member.

Walcoff said VA officials are "not satisfied with current performance and strive for new methods of improvement."

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Angela Peacock spent years with no home after serving in Iraq.
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"More female veterans are winding up homeless: VA resources strained; many are single parents"
By Bryan Bender, Boston Globe Staff, July 6, 2009

WASHINGTON - The number of female service members who have become homeless after leaving the military has jumped dramatically in recent years, according to new government estimates, presenting the Veterans Administration with a challenge as it struggles to accommodate the hundreds of thousands of returning veterans from Iraq and Afghanistan.

As more women serve in combat zones, the share of female veterans who end up homeless, while still relatively small at an estimated 6,500, has nearly doubled over the last decade, according to the Department of Veterans Affairs.

For younger veterans, it is even more pronounced: One out of every 10 homeless vets under the age of 45 is now a woman, the statistics show.

And unlike their male counterparts, many have the added burden of being single parents.

“Some of the first homeless vets that walked into our office were single moms,’’ said Paul Rieckhoff, executive director and founder of Iraq and Afghanistan Veterans of America. “When people think of homeless vets, they don’t think of a Hispanic mother and her kids. The new generation of veterans is made up of far more women.’’

Overall, female veterans are now between two and four times more likely to end up homeless than their civilian counterparts, according to the VA, most as a result of the same factors that contribute to homelessness among male veterans: mental trauma related to their military service and difficulty transitioning into the civilian economy.

But while veterans’ services have been successfully reaching out to male veterans through shelters and intervention programs, women are more likely to fall through the cracks.

“While the overall numbers [of homeless vets] have been going down, the number of women veterans who are homeless is going up,’’ Peter Dougherty, director of homeless veterans programs at the Department of Veterans Affairs, said in a telephone interview.

The trend has alarmed top lawmakers and veterans groups, who fear that the federal government - which is already straining to care for new veterans suffering from post-traumatic stress disorder, brain injuries, and other physical ailments - is ill-prepared to deal with the special needs of female veterans who find themselves on the street.

Many of them are like Angela Peacock, a former Army sergeant who was diagnosed with PTSD when she returned from Iraq in 2004 and became addicted to pain-killers.

Later evicted from her apartment in Texas, she spent more than two years “couch-hopping’’ between friends and family before moving in as a squatter in an empty house in St. Louis.

“They could kick me out anytime they want,’’ Peacock said in an interview. “I have been clean for two and a half years and am working on getting my life back, but it doesn’t happen overnight.’’

According to the National Coalition for Homeless Veterans, a nonpartisan advocacy group in Washington, about 23 percent of the homeless population in the United States are veterans. Nearly half are from the Vietnam era and three-fourths experience some type of alcohol, drug, or mental heath problem.

Most of the homeless vets, who are estimated by the Veteran’s Administration to number at least 130,000 on any given night nationwide, are men older than 50.

With a new generation of veterans from Iraq and Afghanistan leaving the armed forces, however, the demographics are swiftly changing. And with more women serving on active duty - a full 15 percent of the military is now female - the share of female homeless veterans has grown from about 3 percent a decade ago to 5 percent, according to the VA.

Among younger veterans, meanwhile, the share of women is nearly double, making up 9 percent of homeless veterans under the age of 45.

“There are twice as many under 45 than above,’’ said Dougherty, who is also the executive director of the Interagency Council on Homelessness, which coordinates the federal government’s efforts to combat homelessness.

In recent days, senior members of Congress have called for an expansion of some of the VA’s programs to ensure they are properly suited to meeting the needs of the growing female population.

“Women veterans and veterans with children often have different needs and require specialized services,’’ Senator Patty Murray, a Democrat of Washington and a member of the Senate Veterans Affairs Committee, said in a statement.

Senator Jack Reed, Democrat of Rhode Island and a former Army officer, also believes more women-focused veterans services are needed.

“We need to adapt services for our veterans to reflect this shift and provide more gender-specific resources, such as housing and counseling to prevent female veterans from becoming homeless,’’ Reed said.

For example, Rieckhoff, who served in Iraq before founding the Iraq and Afghanistan veterans group, said female veterans often face unique homelessness risk factors, including sexual assault while in the military and diminished earning potential in civilian life.

But he also believes that the culture of the VA is mostly geared toward meeting the needs of men.

“They are having a tough time evolving to meet the demands of women, who are at a higher risk for homelessness to begin with,’’ Rieckhoff said.

The Obama administration has taken some steps toward combating homelessness among all veterans, including allocating $75 million to public housing authorities in the 50 states, Puerto Rico, and Guam to provide permanent housing and dedicated case managers for an estimated 10,000 veterans.

“For a woman veteran in particular, this is a way for them to have a place to live and not have to ditch the child while they take care of other needs that they have,’’ said Dougherty.

But Murray, Reed, and others say far more needs to be done, especially for homeless veterans with children.

They have sponsored legislation that calls for $50 million in extra funding over the next five years to allow the Veterans Affairs and Labor departments to make special grants to homeless veterans with children, including for transitional housing.

The legislation would also allow the Labor Department to fund facilities that provide job training and child care for female veterans.
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Bryan Bender can be reached at bender@globe.com.
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"Women veterans fall through cracks in system"
The Boston Globe, Letters, July 8, 2009

KUDOS TO The Boston Globe for educating the public about the rising numbers of homeless women veterans (Page A1, July 6).

Women veterans often fall through the cracks of a system that has not been built to recognize servicewomen’s accomplishments, sacrifices, or specific needs. The Department of Veterans Affairs has much progress to make in recognizing women’s physical and psychological wounds and awarding women veterans equal disability compensation for their trauma.

Similarly, the epidemic of military sexual trauma - sexual harassment, sexual assault, and rape - has yet to be adequately addressed by the armed forces, the VA, or mainstream veterans’ groups, leading to untreated post-traumatic stress disorder, alcohol and drug abuse, homelessness, and suicide among female and male vets.

But another point needs to be made: One of the reasons women veterans fall through the cracks is that they are rarely given the authority to represent their own issues or advocate for themselves. It’s a shame that reporter Bryan Bender relied heavily on the voices of male veterans who can hardly be considered experts on the needs of women in uniform.

Anuradha Bhagwati
Brooklyn, N.Y.
The writer, a former Marine captain, is executive director of Service Women’s Action Network.

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MIT, VA Medical Centers
"Northeastern, VA engineer healthcare collaboration"
Posted by Elizabeth Cooney, boston.com/news/health/blog - July 8, 2009

Boston engineers are joining forces with the nation's largest healthcare system to incorporate lessons learned from other industries into daily patient care, including ways to prevent the kind of safety lapses that could expose patients to potential infection.

Northeastern University will lead one of four collaborations with the Veterans Affairs healthcare systems designed to make care more safe, effective, efficient, and reliable. Through the New England Healthcare Engineering Partnership, engineers from Northeastern will work with the eight hospitals and 37 outpatient clinics that make up the New England Veterans Affairs healthcare system. Grants and matching funds of $3.4 million per year from the VA will support the New England effort, which is based in Boston, for an initial three-year period. MIT and Worcester Polytechnic Institute will also participate.

"Industrial engineers work on improving processes," partnership executive director James Benneyan said. He is a professor of industrial and mechanical engineering at Northeastern and a fellow at the Institute for Healthcare Improvement in Cambridge. "We're the guys doing Six Sigma at GE and the Toyota Production System. The VA already has one of the best healthcare systems and certainly the best information and electronic medical records systems. This is a huge opportunity."

Six Sigma is the name of a famous quality effort to make near-perfect goods by eliminating defects in the production process. Toyota's system eliminates the need for car-parts warehouses by running factories so efficiently that parts are immediately put into cars. Benneyan said in healthcare, waiting rooms could disappear, just like Toyota warehouses, if access and flow were improved so that all patients were seen right away.

Patient safety is a more immediate concern as a team from the new partnership looks into recent problems at three VA hospitals. Colonoscopy equipment was not properly sterilized, putting thousands of veterans in Georgia and Tennessee at risk. Benneyan said the errors -- which may in Tennessee may have stemmed from valves that looked alike but performed differently -- have implications for reusable equipment throughout healthcare. Ideally a solution would make such errors impossible, he said, using as an example fixtures near intensive care unit beds that allow only oxygen and not other gases to be hooked up to the patient because only the oxygen tube will fit.

"We look at potential failures and design processes and systems such that potential failure can never happen," he said. "It's what the airlines and nuclear power do."

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"U.S. infidelity to our defenders"
The Berkshire Eagle, Letters to the Editor, Friday, July 10, 2009

The media amply covered the following news items: Governor Sanford's infidelity to his wife, John Edwards' infidelity to his wife, and John Ensign's infidelity to his wife.

Hidden in the folds were two examples of a country's infidelity to those who also took a sacred oath: The Veteran Administration's claims backlog hit 915,000 on May 4, 2009, a 14 percent increase in four months.

In January and February, for the first time in military history, the number of battlefield suicides was higher than the number of combat deaths in the war zones.

JIM NORCHI
Pittsfield, Massachusetts

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"Report: VA putting patients at risk of overdose"
By Kimberly Hefling, Associated Press Writer, Friday July 10, 2009

WASHINGTON – Two years after an Iraq war veteran overdosed on medication at a Veterans Affairs facility, the problems blamed in his death have not been corrected at many of the VA's residential treatment sites, a government study found.

The VA's inspector general ordered the review as part of legislation passed to fix problems after the 2007 death of 27-year-old Justin Bailey in a Los Angeles residential facility.

Bailey, a Marine, had surgeries for a groin injury he sustained during the first part of the Iraq war and was diagnosed with post-traumatic stress disorder.

His father, Tony Bailey, later testified before Congress that the day before his son died, he was given five different prescriptions in doses covering 14, 15 and 30 days. The father also said that his son had been in the treatment facility for six weeks, but had yet to see a psychiatrist. He said his son was known to abuse prescription medications and had used illegal drugs.

The inspector general's review says less than half of sites visited had appropriate policies to screen patients. It also says more than 10 percent of patients allowed to give themselves narcotics received more than a week's supply.

"This report indicates what we and the Bailey family feared," said Sen. Daniel Akaka, D-Hawaii, chairman of the Senate Veterans Affairs committee.

Akaka, however, said he was pleased the administration has said it will implement improvements, and he will work to make sure that happens. The IG review said the VA agreed to changes it recommended.

The review was dated June 25, but was released this week.
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On the Net: Veterans Affairs Department review: http://www.va.gov/oig/54/reports/VAOIG-08-00038-152.pdf
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"Veterans’ disability claims go neglected: Agency struggles as demand rises"
By James Dao, New York Times, July 13, 2009

He jumped at loud noises, had unpredictable flashes of anger, and was constantly replaying battle scenes in his head. When Damian J. Todd, who served two tours in Iraq with the Marine Corps, described those symptoms to a psychiatrist in January 2008, the diagnosis was quick: He was suffering from post-traumatic stress disorder.

Less swift was the government’s response when Todd submitted, a month later, a disability claim that would entitle him to a monthly benefit check. Nearly 18 months went by before the Department of Veterans Affairs granted it last month, Todd said.

Todd, 33, is part of a flood of veterans, young and old, seeking disability compensation from the department for psychological and physical injuries connected to their military service. The backlog of unprocessed claims for those disabilities is now above 400,000, up from 253,000 six years ago, the agency said.

The department says its average time for processing those claims, 162 days, is better than in at least eight years. But it does not deny that it has a major problem, with some claims languishing for many months in the overtaxed bureaucracy.

“There are some positive signs in terms of what we’re doing,’’ said Michael Walcoff, deputy undersecretary for benefits in the Veterans Benefits Administration. “But we know that veterans deserve better.’’

Walcoff said the department recently finished hiring 4,200 claims processors, but many will not be fully trained for months. The Government Accountability Office reported last year that the Veterans Affairs Department had about 13,000 people processing disability claims.

The larger significance of the backlog, veterans groups and officials said, is that resources for veterans are being stretched perilously thin by a confluence of factors beyond the influx of veterans from Iraq and Afghanistan.

Aging Vietnam veterans with new or worsening ailments are requesting care. Layoffs are driving unemployed veterans into the department’s sprawling health system for the first time. Congress has expanded certain benefits. And improved outreach efforts by the department have encouraged more veterans to seek compensation or care.

Walcoff said most of the 82,000 claims the department received each month were not from veterans returning from the current wars. “We’re still getting a lot of Vietnam vets,’’ he said.

Advocates say the actual backlog is nearing 1 million, if minor claims, educational programs, and appeals of denied claims are considered. They point to the discovery of benefits applications in disposal bins at several department offices last year as evidence of shoddy claims handling. And they assert that they routinely see frustratingly long delays on what seem like straightforward claims.

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"VA clinics lack privacy for women, report says"
By ASSOCIATED PRESS, July 15, 2009

WASHINGTON - Veterans Affairs Department hospitals and clinics are not always ensuring that female veterans have privacy when they bathe and receive exams, government auditors said yesterday.

As thousands of female veterans return from Iraq and Afghanistan and enter the VA’s health system, the Government Accountability Office reported that no VA hospital or outpatient clinic under review is complying fully with federal privacy requirements.

GAO investigators found that many VA facilities had gynecological tables that faced the door, including one door that opened to a waiting room. It also found instances where women had to walk through a waiting area to use the restroom, instead of it being next to an exam room as required by VA policy.

At four hospitals investigators visited, women were not guaranteed access to a private bathing facility. In two of those cases, there wasn’t a lock on the door.

Female veterans told the Senate Veterans’ Affairs committee that VA workers need to be better educated about combat situations that women face in the two ongoing wars. Beyond privacy concerns, there are other issues as well, they said, such as a lack of child care at VA hospitals and difficulty in finding diaper-changing tables.

“Many VA facilities are not prepared to accommodate the presence of children,’’ said Kayla Williams, an Iraq veteran and author. “Several friends have described having to change babies’ diapers on the floors of VA hospitals.’’

A majority of the female veterans who have turned up at VA facilities are between the ages of 20 and 29, and on average are much younger than the average male veteran, the GAO survey found. Nearly 20 percent have been diagnosed with post-traumatic stress disorder, and many experienced sexual trauma while serving.

Randall Williamson, director of health care issues at GAO, said although top VA officials are committed to improvements in women’s care, hospitals and clinics were not always taking simple steps to make women more comfortable, such as repositioning exam tables.

Patricia Hayes, chief consultant of the veterans strategic health care group at the VA, said the agency recognizes the care given to women is not as good as what’s offered to men, but it has made changes and will continue to do so.

She said space constraints and the layout of buildings pose challenges, but the VA is putting together long-term plans for construction improvements.

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"Rise Seen in Veterans’ Mental Health Diagnoses"
By JAMES DAO, nytimes.com - July 17, 2009

A new study has found that more than one-third of Iraq and Afghanistan war veterans who enrolled in the veterans health system after 2001 received a diagnosis of a mental health problem, most often post-traumatic stress syndrome or depression.

The study by researchers at the San Francisco Department of Veterans Affairs Medical Center and the University of California, San Francisco, also found that the number of veterans found to have mental health problems rose steadily the longer they were out of the service.

The study, released Thursday, was based on the department health records of 289,328 veterans involved in the two wars who used the veterans health system for the first time from April 1, 2002, to April 1, 2008.

The researchers found that 37 percent of those people received mental health diagnoses. Of those, the diagnosis for 22 percent was post-traumatic stress syndrome, or PTSD, for 17 percent it was depression and for 7 percent it was alcohol abuse. One-third of the people with mental health diagnoses had three or more problems, the study found.

The increase in diagnoses accelerated after the invasion of Iraq in 2003, the researchers found. Among the group of veterans who enrolled in veterans health services during the first three months of 2004, 14.6 percent received mental health diagnoses after one year. But after four years, the number had nearly doubled, to 27.5 percent.

The study’s principal author, Dr. Karen H. Seal, attributed the rising number of diagnoses to several factors: repeat deployments; the perilous and confusing nature of war in Iraq and Afghanistan, where there are no defined front lines; growing public awareness of PTSD; unsteady public support for the wars; and reduced troop morale.

Dr. Seal said the study also underscored that it can take years for PTSD to develop. “The longer we can work with a veteran in the system, the more likely there will be more diagnoses over time,” said Dr. Seal, who is co-director of the mental health clinic for Iraq and Afghanistan veterans at the San Francisco veterans medical center.

The new report joins a growing body of research showing that the prolonged conflicts, where many troops experience long and repeat deployments, are taking an accumulating psychological toll.

A telephone survey by the RAND Corporation last year of 1,965 people who had been deployed to Iraq or Afghanistan found that 14 percent screened positive for PTSD and 14 percent for major depression. Those rates are considerably higher than for the general public.

“The study provides more insight as to just how stressed our force and families are after years of war and multiple deployments,” said René A. Campos, deputy director of government relations for the Military Officers Association of America. “Our troops and families need more time at home — more dwell time, fewer and less frequent deployments.”

The study was posted Thursday on the Web site of The American Journal of Public Health.

Dr. Seal cautioned that, unlike the RAND study, the results from her research could not be extrapolated to the roughly 1.6 million veterans who have served in Iraq or Afghanistan because about 60 percent of them were not receiving health care through the veterans system.

But she noted that the number of Iraq and Afghanistan war veterans receiving care through the veterans system was at a historic high, 40 percent, potentially making the study’s results more universal.

The study also found that veterans older than 40 with the National Guard or the Reserves were more likely to develop PTSD and substance abuse disorders than those under 25. A possible reason, Dr. Seal said, is that older reservists go to war from established civilian lives, with families and full-time jobs, making combat trauma potentially more difficult to absorb.

“It’s the disparity between their lives at home, which they are settled in, and suddenly, without much training, being dropped into this situation,” she said.

In contrast, the study found that among active-duty troops, veterans under 25 were more likely to develop PTSD and substance abuse problems than those over 40, possibly because those younger troops were more likely to have been involved in front-line combat, Dr. Seal said.

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Iraq war veteran Carlton Duncan receives treatment from the Soldier On center in Northampton. (Essdras M Suarez/ Globe Staff)
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"For returning vets, a tragic toll on the roads: Devastating death rate from crashes sounds the alarm at Veterans Affairs"
By Brian MacQuarrie, Boston Globe Staff, July 26, 2009

NORTHAMPTON - For Dominic Taverna, a two-tour Army scout who prowled Iraq for insurgents, the dream of peace and quiet lost some of its appeal when he returned to Revere in 2007.

“I was looking for that rush, and you just couldn’t find it,’’ said Taverna, 28, staring past his folded hands. “You’re driving 90 all the time. You’re hauling ass under overpasses. You just can’t flip a switch.’’

Former Army sergeant Carlton Duncan, 26, nodded knowingly. He would drink too much, Duncan said, before grasping the wheel of his car and driving without any memory of where he went or how he got there.

Dominick Sondrini, 28, a former Marine officer, raced his car for the pure thrill of driving 90 miles per hour, “because I knew I wasn’t going to get in trouble.’’ Police nearly always allowed Sondrini, who would flash his military ID after a traffic stop, to drive away without a ticket, he said.

Dangerous driving is often a byproduct of military bravado, the three veterans said. But among survivors of the wars in Iraq and Afghanistan, the practice is now seen as a deadly crisis, prompting the Department of Veterans Affairs to take unprecedented preventive action.

In the first years after returning from deployment, veterans of the two wars are 75 percent more likely to die in motor vehicle accidents than civilians of comparable age, race, and sex, according to a 2008 VA study. The rate for motorcycle deaths is an astounding 148 percent higher.

The tragic result is that motor vehicle crashes - which already are the top killer of Americans ages 16 to 34, according to the latest federal safety data - are killing newly returned veterans at a devastating rate. The 2008 study, which has yet to be released, analyzed fatalities through 2006.

“You have to look at the situation they’ve been in,’’ said Mel Tapper, who manages the Center for Returning Veterans, based at the VA Medical Center in Jamaica Plain. “They’ve been in an extremely tense, life-threatening situation, where there’s adrenaline that goes through people constantly.’’

Once veterans return to the safety of home and loved ones, that tension - sometimes life-saving in war, but often debilitating in peace - can continue for months or years.

In Massachusetts, car crashes have taken the lives of at least two returning veterans in the past nine months.

On July 10, an Iraq veteran from East Longmeadow was killed in Andover when the driver lost control of the car in which he was riding. Mark Ecker II, 23, who lost both legs after an explosion in Ramadi, had not been wearing a seat belt. On Oct. 21, Boston firefighter Paul Loring, another Iraq veteran, died in a one-car accident when the vehicle he was driving struck a tree in Quincy.

These motor vehicle tragedies have not been linked to reckless behavior. But the deaths are part of the overall fatality rate for men and women returning from combat zones that has alarmed government officials. As a result, the VA has launched a safe-driving initiative in which home-bound veterans are counseled about the risks of careless driving and encouraged to be screened for risky behavior.

Such screening, however, is more easily promoted than practiced. For veterans who have recently left a war zone, making a comfortable readjustment to home life can be maddeningly elusive.

“There’s no violence, no threat, no immediate danger,’’ said Kevin Lambert, a former Marine who counsels veterans at risk of suicide for the state Department of Veterans’ Services, comparing ordinary life to deployment in a war zone.

Lambert, 26, a wounded Iraq veteran, knows the challenges firsthand. The most difficult hurdle, he said, was the unfamiliar “peacefulness’’ he encountered in the United States. “It was very hard to transition to that, because I felt there was something wrong,’’ Lambert said.

Taverna, the former Army scout, said the desk job he took back home became so boring that he would pick bar room fistfights to replace the dangerous excitement of Iraq.

“I was used to that rush,’’ Taverna said. “Fighting is the closest thing to combat.’’

After too much fighting and too much drinking, Taverna sought help from Soldier On, a nonprofit organization that leases space at the VA Medical Center in Northampton to provide shelter, therapy, and medication, if needed, to the physically and emotionally scarred. Duncan, the once-chronic drunk driver, also receives treatment there, where Sondrini, the former Marine, wears a jacket and tie as a case manager.

The personality-altering effects of war service, such as post-traumatic stress disorder and traumatic brain injuries, are known to many recent veterans at Northampton. Trying to suppress those symptoms can encourage alcohol abuse, drug use, and recurrent, self-destructive behavior like speeding.

“Think about it,’’ said Michael Hagmaier, executive vice president of Soldier On. “Many of these veterans had their drivers’ licenses for maybe a year when they went in, so the only real training they’ve had is driving in the desert at 80 miles per hour.’’

Coleman Nee, undersecretary of the state veterans department, concurred that a problem exists. “It’s the bulletproof theory,’’ Nee said. “If I didn’t get killed over there, nothing’s going to happen to me here.’’

The SAVE program, where Lambert works, reaches out to veterans who often have a difficult time seeking help for PTSD and other injuries. In the two years since the program began, Lambert said, SAVE has contacted 7,000 Massachusetts veterans or relatives of service members.

Despite a historic reluctance to seek help, an increasing number of veterans and active-duty personnel appear willing to acknowledge their vulnerabilities.

Dr. Douglas Jacobs, the president of a Wellesley nonprofit that has contracted with the Defense Department for mental health and alcohol-use screening, said the effort has recorded a huge increase in anonymous self-assessments this year. Through the first six months of 2009, the number of screenings through the service, called Military Pathways, has doubled to 31,000.

If respondents score positive on tests for a variety of issues - depression, PTSD, anxiety, and alcohol abuse, for example - they are referred to the appropriate services.

Resources exist in Massachusetts to address reentry issues, said state Representative Harold Naughton Jr., a Clinton Democrat who is House chairman of the Committee on Veterans and Federal Affairs. But questions remain as to whether they are being used as efficiently and effectively as possible, said Naughton, a captain in the Army Reserve.

To that end, Naughton said, an oversight hearing will be held this fall in which outreach programs funded through the state will be asked to justify continued funding of their work.

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"6 more cases of botched cancer treatment at Pa. VA"
AP - August 18, 2009

PHILADELPHIA – Six more cases have been found of cancer patients being given incorrect radiation doses at the Veterans Affairs Medical Center in Philadelphia.

The errors happened in a common surgical procedure to treat prostate cancer.

That brings the total to 98 veterans who were given incorrect radiation doses over a six-year period at the hospital.

The program had treated 114 cancer patients before it was halted when the problem surfaced in 2008.

The cases involved brachytherapy, in which implanted radioactive metal seeds are used to kill cancer cells. Most veterans got far less than the prescribed dose while others received too much.

The newly reported cases have been forwarded to the U.S. Nuclear Regulatory Commission from The Department of Veterans Affairs.

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Information from: The Philadelphia Inquirer, www.philly.com

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"Report: Too many vets wait a year for claim"
By Kimberly Hefling, Associated Press Writer, September 23, 2009

WASHINGTON --Too many veterans' disability claims take more than a year to process, the Veterans Affairs Department's inspector general said Wednesday.

An audit released by the VA showed that a year ago, 11,000 veterans had claims pending more than a year. It says the agency awarded retroactive payments totaling about $43 million for about a third of them. Of that total, it says about $14 million was unnecessarily delayed because of deficient claims processing.

Among the worst cases, one veteran was owed nearly $65,000 for a delayed claim, and another veteran waited more than two years for payment, the IG said.

"These delayed benefit payments have the potential to adversely affect the economic status and quality of life for veterans who are eligible for benefits," the IG said.

The report said the VA has made progress in reducing lingering claims, but it's still creating too much of a financial burden for veterans. The VA has hired more claims processors but is struggling with a growing number of claims approaching one million as more veterans file claims who served in the Iraq and Afghanistan wars.

It recommended changes such as improving its workload management.

The VA agreed with most of the IG findings and recommendations, the IG said.
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On the Net: IG audit on veterans claims:
www.va.gov/oig/52/reports/2009/VAOIG-08-03156-227.pdf
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Patrick W. Dunne, under secretary of veterans affairs in charge of benefits administration, will resign early next year. (Alex Wong/Getty Images).
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"Troubled V.A. Agency Will Get a New Chief"
By JAMES DAO, The New York Times (Online), November 21, 2009

WASHINGTON — The official responsible for the problem-plagued disability compensation system at the Department of Veterans Affairs will resign early next year, the department announced Friday.

The official, Under Secretary Patrick W. Dunne, has run the Veterans Benefits Administration since 2006, a period in which the agency has been swamped by claims not only from wounded Iraq and Afghanistan veterans but also from aging Vietnam veterans. The rise in the backlog of unprocessed claims has fueled bitter complaints from members of Congress and veterans’ advocates.

The benefits administration also came under fire this year when it was late issuing payments to colleges and students under the new G.I. Bill. In response, Eric Shinseki, the secretary of veterans affairs, ordered offices to open on a Saturday to make emergency payments to students.

In announcing Mr. Dunne’s resignation, Mr. Shinseki said: “Pat Dunne has guided the Veterans Benefits Administration through a number of challenges during his tenure as under secretary. I applaud his service and loyalty to our team and thank him for his unfailing commitment to our nation’s veterans.”

A spokeswoman for Mr. Shinseki, Katie Roberts, denied suggestions by veterans’ advocates that Mr. Dunne, a retired Navy rear admiral, had been forced out. “He served the department well,” Ms. Roberts said.

Veterans’ advocates say the benefits administration has been slow to modernize. Revamping the department’s outdated computer technology, along with reducing the claims backlog, is one of Mr. Shinseki’s top priorities.

“Veterans wait an average of six months for an initial answer on a disability claim and another four to five years while they wait for appeals,” said Paul Sullivan, executive director of Veterans for Common Sense.

Mr. Sullivan’s group estimates that the backlog is close to one million claims, though the department says a more accurate measure places it at closer to half a million.

The benefits administration has headquarters separate from those of the Department of Veterans Affairs, and Mr. Sullivan said Mr. Shinseki should require the new under secretary to have offices under the same roof so they can work more closely.

“They need a battle plan to overhaul the V.B.A. and bring them out of 19th-century paper processes,” Mr. Sullivan said.

Ms. Roberts, the secretary’s spokeswoman, said a commission would be assigned the task of recommending a list of potential successors to Mr. Dunne. The post requires Senate confirmation.

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