Finding a job biggest challenge for veterans, survey finds
DEFENSE & NATIONAL SECURITY
Marines hang-out in the recreation area at the Wounded Warriors barracks aboard Camp Pendleton January 12, 2011.
By: Hope Hodge
7/17/2012 12:35 PM
Within five to seven years, the Department of Veterans Affairs estimates that more than one million new veterans will enter their system, in need of disability claims processing, health care, and more.
The influx is both enormous (the VA reports it served 1.3 million veterans in total during 2011) and inevitable: with combat ending and the ranks narrowing after a decade and a half of war, many troops will begin the natural process of transitioning out of the military and returning to civilian life.
The VA that will receive them is already overburdened, battling a veterans’ claims backlog of over a decade that swept past 600,000 overdue claims just last week and shows no clear signs of improvement.
“This is disgraceful. This is an insult to our veterans. And you guys just recycle old programs and put new names on them,” House Veterans Affairs committee ranking member Rep. Bob Filner (D-Calif.) exploded at a June 19 hearing, before testimony was even under way. “We just keep announcing new names, new pilot programs, on and on. If it wasn’t tragic, it would be ridiculous.”
By Fiscal Year 2013, federal funding for veterans, at $140 billion, could surpass total federal funding for education. The VA, including all claims centers and hospitals, employs about 300,000 workers, and 3,300 of those employees have been hired since the start of FY 2010 just to augment the staff processing disability claims. But money and manpower has not been enough to stem the worsening problem of connecting veterans to healthcare and benefits in a timely fashion.
l Backlogged claims: The VA defines a backlogged claim as one not processed within the department’s goal timeframe of 125 days. The claim is the first step in the disability process, and a granted claim, awarded by percentages according to the severity of a service-connected illness or injury, results in a set cash benefit. The backlog dates back to the 1990s and has grown rapidly in recent months. From January 2011 to the week ended July 9, the backlog roughly doubled, from 300,000 claims to just over 600,000. More than two-thirds of all pending claims, each representing an ailing or injured veteran, are now dragging months behind schedule.
l Long waits: The average claim adjudication wait time is as few as 183 days or as many as 300, depending on who you ask. Claims processed in Oakland, Calif., the second-worst backlogged region in the nation according to a May Inspector General’s report, take nearly a year to get approved or denied. The backlog worsened in 2010 when VA Secretary Eric Shinseki added a handful of new medical conditions to the list of ailments presumed connected with exposure to the Vietnam-era herbicide Agent Orange, a move that was lauded by veterans’ groups. But this month the VA officials announced they were nearing the end of processing about 230,000 retroactive Agent Orange claims. And the majority of the nearly 920,000 total claims still pending before the department remain overdue.
l Paper-based system: Lacking technology also slows the process: the VA and Department of Defense use largely incompatible information technology systems, unable to easily communicate regarding veterans’ health records. And, the claims system remains largely paper-based, a decade into the 21st century. House Veterans Affairs Committee Chairman Jeff Miller (R-Fla.) said he was most frustrated with the outdated mechanics of the system, making it taxing on veterans and susceptible to human error.
“What you have now is World War II veterans relegated to carrying boxes of papers down the hallways of (the Veterans Benefits Administration) or regional offices in an attempt to get their claims adjudicated,” he said. “And that’s not right.”
VA knows it has problems
VA officials are amply aware of the problem. On June 19, VA undersecretary for benefits Allison Hickey testified before the House Veterans Affairs Committee that a new electronic Veterans’ Benefits Management System would break the back of the backlog by 2015, processing claims on time with 98 percent accuracy, in spite of the new wave of veterans entering the system. More recently, Hickey told reporters the department plans to fast-track certain claims to regional offices to speed the process of resolution.
But the announcements are the last in a long series of shiny promises, all trumpeting dynamic changes expected to cut through layers of bureaucracy and clear the wait list—and all failing to deliver. As early as 2001, according to archives kept by the blog VAWatchdog.org, the VA was touting a new 120-day task force aimed at making the claims system current. A decade ago, those 120 days came and went.
To hear some lawmakers describe it, the entrenched bureaucracy of the VA is like Pilgrim’s Progress author John Bunyan’s Slough of Despond, in that “here have been swallowed up at least twenty thousand cart-loads, yea, millions of wholesome instructions”—all unsuccessful at providing a clear way above the mire.
But former House Speaker Newt Gingrich, who discussed improving care available for military brain injuries and making healthcare vouchers available for veterans while he was on the presidential campaign trail earlier this year, told Human Events in an interview that the answer lies not in more money or more people, but in a fundamental rethinking of the Department of Veterans Affairs. One such effort he proposed: inviting a brain trust of successful business leaders to tackle the VA in a way that could inject the department with market urgency and efficiency.
“If McDonald’s can report worldwide (store sales) at five o’clock every evening,” Gingrich said, with a wry grin. “I suspect, by the way, that one White House dinner that had the right 40 people, all of whom had to have at least a billion dollars in assets, would have so much talent devoted to reforming the VA the following morning, so many resources made available to the VA the following morning, that it would be startling.” Gingrich said choosing those with experience as industry leaders to head the VA could also help to put systems back on track.
“You end up with retired people, academics, what have you, people for whom it’s a good job,” he said.
“These are jobs that are so big you don’t want somebody for whom it’s a good job; you want somebody who has already done a job this size.”
Miller also saw hope in a free market opportunity.
“I have often said if the federal government would offer some young group of software developers a million dollars to develop a patch that would allow the DoD and VA systems to communicate, they’d do it in 24 hours,” he said, during an interview with Human Events in his office. “But people, being the humans that they are, like staying with what they know. Unfortunately, it isn’t serving the veterans who are trying to get their disability ratings decided.”
Take a page from the IRS
At the June 19 hearing, Filner pointed out that not all government bureaucracies function with the seeming lack of urgency for which people fault the VA. The Internal Revenue Service, for example, speedily processed millions of tax returns annually by assuming information submitted was accurate, then auditing periodically to encourage honesty and root out fraud.
“Grant the claim, subject to audit,” Filner said. “Send out the check, do something.”
Two relatively junior members of the committee, both physicians who previously served in private practices, offered a more nuanced option: establish a fast-track system for claims of tinnitus, or hearing loss. Touted as the number-one service-connected disability each year by the American Tinnitus Association—over 840,000 veterans received compensation for tinnitus in FY 2011—the condition is also easy to diagnose with a simple examination.
“Hearing, you can test it pretty easily, make those determinations,” Rep Phil Roe (R-Tenn.) told Human Events. “Many veterans have been in combat; It just happens. Those are simple things they should get off the table.”
Rep. Dan Benishek (R-Mich.) said he planned to introduce a bill, in this legislative session or the next, to make tinnitus a presumptive temporary assignment.
“Audiology, it’s a simple determination: a guy has hearing loss or he doesn’t. Why does that take 18 months then to make a determination that a guy has a hearing loss?” Benishek told Human Events. “Why can’t we make a temporary disability for hearing loss, get him his benefits immediately? Why can’t we eliminate that 30 percent from the backlog and speed up the process.”
According to worksheets provided by the VA, a hearing loss claim grant now requires completion of five steps, included review of a veteran’s medical records and history, before diagnosis and claim adjudication can be made.
Challenge veterans service organizations
Gingrich laid much of the onus for sparking change within the VA at the feet of veterans service organizations, the congressionally charted, independent advocates for veterans.
“With very bold and dramatic change, for that the veterans’ organizations would have to decide that they are prepared to see change at the VA. I think today they’re not prepared to say that,” he said.
“Their job is to represent the veterans, and they ought to be clear and aggressive about whether they think this generation of veterans is getting the care they need in the way they need it, in a timely manner and a convenient manner. I think it’s very hard to answer yes to that.”
Gingrich said he suspected many organizations calculated it was safer to work within the bureaucracy than to anger decision makers and risk losing valuable access and clout.
Filner’s June 19 rant did not spare the organizations either.
“Why are you so afraid of blowing up the whole system? Why are you guys playing their game?” he asked. “You represent the veterans. Do something real.”
Human Events reached out to two of the highest-profile organizations, Disabled American Veterans and Veterans of Foreign Wars, for comment.
VFW Public Affairs director Joe Davis said more attention should be paid to the positive work of the VA in adjudicating thousands of new Agent Orange claims from those who served in the Vietnam era, welcoming large numbers of veterans into an already overburdened system, and taking steps to provide ample care for veterans of the current conflict immediately following their years of service. In spite of speed bumps, the department, he said, was on the right track.
“You’ve got to look at the big picture instead of just banging,” Davis said.
David Autry, deputy national director of Communications for DAV, said veterans’ organizations were working hard to assist the VA’s efforts to implement an electronic system and to challenge poor performance.
“We have to work within the system that we have, but we are continually urging the VA to straighten up and fly right,” he said.
Jim Strickland, a Vietnam veteran and manager of VAWatchdog.org, is tired of watching veterans struggle to play by outmoded rules.
“The Department of Veterans Affairs is hopelessly broken and the really big problem is until Congress acts decisively, VA will not repair itself,” he told Human Events. They need to remodel the Department of Veterans Affairs. They need to reorganize the VA and give them a new mandate.”
Strickland said that despite ample funding, the system was often arcane, operating by laws and disability schedules created decades ago.
As the system stands, he said, “the VA is at war with veterans.”
In Congress, some are beginning to acknowledge that the department is at a tipping point.
“The VA is well intended as it is, and it still moves at glacial speed,” Roe said. “If it continues to get worse, you do have to think outside the box.”
Gingrich said a fundamental re-conception of the VA was in order to make the system convenient for veterans rather than bureaucrats and give more attention to post-traumatic stress and traumatic brain injury, the signature wound of the wars in Iraq and Afghanistan. The issue was so important, he said, that he would like to see it a part of the Republican presidential platform.
“We’re faced with a new generation of veterans’ problems vastly different than earlier ones,” he said.
Miller suggested his committee might be able to pursue more aggressive solutions for reforming the VA after the end of combat activity in Afghanistan, and said he was willing to countenance a more radical change.
“We do know that throwing money and people at the problem hasn’t solved it,” he said.
Invited to comment on this story, VA spokesman Josh Taylor referred to the electronic management system for claims, reiterating the department’s goal of resolving the backlog by 2015.
“This administration has shown unwavering commitment to serve Veterans,” the spokesman said in a statement. “VA has completed a record-breaking 1 million claims per year the last two fiscal years, and we are on target to complete another 1 million claims in FY2012. But too many veterans have to wait too long to get the benefits they have earned and deserve.”
Military suicides rising, even as combat eases
By ASSOCIATED PRESS | 6/7/12 6:08 PM EDT
WASHINGTON (AP) — Suicides are surging among America’s troops, averaging nearly one a day this year — the fastest pace in the nation’s decade of war.
The 154 suicides for active-duty troops in the first 155 days of the year far outdistance the U.S. forces killed in action in Afghanistan — about 50 percent more — according to Pentagon statistics obtained by The Associated Press.
The numbers reflect a military burdened with wartime demands from Iraq and Afghanistan that have taken a greater toll than foreseen a decade ago.
The military also is struggling with increased sexual assaults, alcohol abuse, domestic violence and other misbehavior.
Because suicides had leveled off in 2010 and 2011, this year’s upswing has caught some officials by surprise.
The reasons for the increase are not fully understood. Among explanations, studies have pointed to combat exposure, post-traumatic stress, misuse of prescription medications and personal financial problems. Army data suggest soldiers with multiple combat tours are at greater risk of committing suicide, although a substantial proportion of Army suicides are committed by soldiers who never deployed.
The unpopular war in Afghanistan is winding down with the last combat troops scheduled to leave at the end of 2014. But this year has seen record numbers of soldiers being killed by Afghan troops, and there also have been several scandals involving U.S. troop misconduct.
The 2012 active-duty suicide total of 154 through June 3 compares to 130 in the same period last year, an 18 percent increase. And it’s more than the 136.2 suicides that the Pentagon had projected for this period based on the trend from 2001-2011. This year’s January-May total is up 25 percent from two years ago, and it is 16 percent ahead of the pace for 2009, which ended with the highest yearly total thus far.
Suicide totals have exceeded U.S. combat deaths in Afghanistan in earlier periods, including for the full years 2008 and 2009.
The suicide pattern varies over the course of a year, but in each of the past five years the trend through May was a reliable predictor for the full year, according to a chart based on figures provided by the Armed Forces Medical Examiner.
The numbers are rising among the 1.4 million active-duty military personnel despite years of effort to encourage troops to seek help with mental health problems. Many in the military believe that going for help is seen as a sign of weakness and thus a potential threat to advancement.
Kim Ruocco, widow of Marine Maj. John Ruocco, a helicopter pilot who hanged himself in 2005 between Iraq deployments, said he was unable to bring himself to go for help.
“He was so afraid of how people would view him once he went for help,” she said in an interview at her home in suburban Boston. “He thought that people would think he was weak, that people would think he was just trying to get out of redeploying or trying to get out of service, or that he just couldn’t hack it – when, in reality, he was sick. He had suffered injury in combat and he had also suffered from depression and let it go untreated for years. And because of that, he’s dead today.”
Jackie Garrick, head of a newly established Defense Suicide Prevention Office at the Pentagon, said in an interview Thursday that the suicide numbers this year are troubling.
“We are very concerned at this point that we are seeing a high number of suicides at a point in time where we were expecting to see a lower number of suicides,” she said, adding that the weak U.S. economy may be confounding preventive efforts even as the pace of militarydeployments eases.
Garrick said experts are still struggling to understand suicidal behavior.
“What makes one person become suicidal and another not is truly an unknown,” she said.
Dr. Stephen N. Xenakis, a retired Army brigadier general and a practicing psychiatrist, said the suicides reflect the level of tension as the U.S. eases out of Afghanistan though violence continues.
“It’s a sign in general of the stress the Army has been under over the 10 years of war,” he said in an interview. “We’ve seen before that these signs show up even more dramatically when the fighting seems to go down and the Army is returning to garrison.”
But Xenakis said he worries that many senior military officers do not grasp the nature of the suicide problem.
A glaring example of that became public when a senior Army general recently told soldiers considering suicide to “act like an adult.”
Maj. Gen. Dana Pittard, commander of the 1st Armored Division, last month retracted — but did not apologize for — a statement in his Army blog in January. He had written, “I have now come to the conclusion that suicide is an absolutely selfish act.” He also wrote, “”I am personally fed up with soldiers who are choosing to take their own lives so that others can clean up their mess. Be an adult, act like an adult, and deal with your real-life problems like the rest of us.” He did also counsel soldiers to seek help.
His remarks drew a public rebuke from the Army, which has the highest number of suicides and called his assertions “clearly wrong.” Last week the chairman of the Joint Chiefs of Staff, Army Gen. Martin Dempsey, said he disagrees with Pittard “in the strongest possible terms.”
The military services have set up confidential telephone hotlines, placed more mental health specialists on the battlefield, added training in stress management, invested more in research on mental health risk and taken other measures.
The Marines established a counseling service dubbed “DStress line,” a toll-free number that troubled Marines can call anonymously. They also can use a Marine website to chat online anonymously with a counselor.
The Marines arguably have had the most success recently in lowering their suicide numbers, which are up slightly this year but are roughly in line with levels of the past four years. The Army’s numbers also are up slightly. The Air Force has seen a spike, to 32 through June 3 compared to 23 at the same point last year. The Navy is slightly above its 10-year trend line but down a bit from 2011.
As part of its prevention strategy, the Navy has published a list of “truths” about suicide.
“Most suicidal people are not psychotic or insane,” it says. “They might be upset, grief-stricken, depressed or despairing.”
In a report published in January the Army said the true impact of its prevention programs is unknown.
“What is known is that all Army populations … are under increased stress after a decade of war,” it said, adding that if not for prevention efforts the Army’s suicide totals might have been as much as four times as high.
Marine Sgt. Maj. Bryan Battaglia, the senior enlisted adviser to the chairman of the Joint Chiefs of Staff, recently issued a video message to all military members in which he noted that suicides “are sadly on the rise.”
“From private to general, we shoulder an obligation to look and listen for signs and we stand ready to intervene and assist our follow service member or battle buddy in time of need,” Battaglia said.
The suicide numbers began surging in 2006. They soared in 2009 and then leveled off before climbing again this year. The statistics include only active-duty troops, not veterans who returned to civilian life after fighting in Iraq or Afghanistan. Nor does the Pentagon’s tally include non-mobilized National Guard or Reserve members.
The renewed surge in suicides has caught the attention of Defense Secretary Leon Panetta. Last month he sent an internal memo to the Pentagon’s top civilian and military leaders in which he called suicide “one of the most complex and urgent problems” facing the Defense Department, according to a copy provided to the AP.
Panetta touched on one of the most sensitive aspects of the problem: the stigma associated seeking help for mental distress. This is particularly acute in the military.
“We must continue to fight to eliminate the stigma from those with post-traumatic stress and other mental health issues,” Panetta wrote, adding that commanders “cannot tolerate any actions that belittle, haze, humiliate or ostracize any individual, especially those who require or are responsibly seeking professional services.”
Looking After the Soldier, Back Home and Damaged
Marijuana study of traumatized veterans stuck in regulatory limbo
Various issues, including high unemployment and loss of limbs, afflict the lives of America’s combat veterans trying to make a new life on “Civvy Street.” Advanced medical care has preserved the lives of badly wounded, who would have died in previous wars. These articles are posted to inform the general public about the issues that confront men and women who have served in the armed forces.
Vets like Lawrence Booth are frustrated by the civilian job hunt
Published: Friday, September 02, 2011, 8:46 PM Updated: Saturday, September 03, 2011, 8:01 AM
By Mike Francis, The Oregonian
While in Iraq in 2006 and 2007, Lawrence Booth of Hillsboro wired buildings at LSA Anaconda – known widely as “Mortaritaville” — and drove his crew’s Armored Security Vehicle through some dangerous parts of the country. He’s been shot at, had his truck blown up once by a roadside bomb and had his back damaged by the wear and tear of his deployment.
But in Oregon, he’s out of money and almost out of time.
At 26, Booth is a victim of a sluggish economy and a frustrating inability to make his military certifications translate into the civilian certifications necessary to work as an electrician or heavy equipment operator.
“I can’t see why I can’t run a yellow piece of equipment but I can run a green one,” he said Thursday. “I can’t see why I can wire an outlet in Iraq, but I can’t wire an outlet in Hillsboro.”
Booth is part of a particularly troubled component of the employment statistics — young veterans who have recently left the service. Post-9-11 veterans have a harder time finding jobs than older veterans and the general population, according to a May report to Congress. And the contrast is starkest for young male veterans between 18 and 24, whose unemployment rate was almost 27 percent in April.
Booth has looked for work for several years, as he had to forfeit his spot with Axis Crane when it moved his facility while he was deployed from Oregon City to Albany. He’s since sold his car and “everything of value” to keep food on the table for his family — wife Jennifer, 5-year-old Hailey and 2-week-old Kevin. He spent his last $150 getting his OSHA 30 safety certification in hopes that he could get hired, then get an upgraded certification that would help him get promoted.
He’s posted his qualifications on Craigslist and sent out about 80 resumes, he estimates. The only nibbles he’s gotten are a couple of phone calls from staffing agencies, with no solid results.
Meanwhile, the $850 rent on the family’s Hillsboro’s house is due today — during the weekend America celebrates the labor movement — and the Booths are on the verge, he fears, of losing everything.
More veterans, more efforts to help
At the same time, a new group of about 600 Oregon National Guard soldiers is in transit this week between Iraq and their homes, mostly in eastern Oregon and Idaho. Earlier in the deployment of the troops of the 3rd Battalion, 116th Brigade, commander Lt. Col. Phil Appleton of Silverton said 218 of them weren’t in school and didn’t have jobs waiting. The battalion has strongly emphasized preparing those troops to get a job or go to school when they got home. Many are returning to counties like Malheur, which has an unemployment rate of 11.1 percent, 1.6 percentage points higher than the statewide rate.
The Guard has arranged job fairs and other post-deployment services for returning troops, but it’s a challenge to stay in contact with people who serve one weekend a month and live in communities scattered around the state.
Later this month, Central City Concern is putting on its annual Portland Veterans Stand Downand Job Fair at the Oregon Convention Center. It’s meant to be a one-stop shop for veterans who need to connect with the Department of Veterans Affairs, get dental care, or find a job. The centerpiece of the Sept. 20 event will be the presence of dozens of private- and public-sector employers who want to talk to veterans about job openings.
Daava Mills, a recruiter for Vigor Industrial in Portland, with locations in Bremerton, Seattle, Everett, Tacoma and elsewhere, says she’s found some “very good” workers through Central City Concern’s veterans programs.
“They are taught to ask questions. They are taught to make suggestions,” she said, describing a recent hire of Desert Storm veteran with higher-than-typical analytical skills for a general laborer.
“They are ready to take direction and they take a lot of initiative,” added Rachel Post, director of supportive housing and employment at Central City Concern, the Portland-based nonprofit. “They are used to working as part of a team. You’re probably not going to find it to such a high degree in the general population.”
The report to Congress called for continuing investment in reintegration programs, like the Oregon Guard’s, and applauded the public sector practice of giving preference to veterans for jobs.
But what Lawrence Booth needs is the answer to a problem that still hasn’t been solved — a practical way to translate military skill into their civilian-world equivalents. Booth has nine years of military experience, only to have his qualifications treated as if he’s just starting out.
“You get educated,” he said, “just to be uneducated at the end.”
Sept. 20, 9 a.m.-4 p.m.
Oregon Convention Center, 777 N.E. Martin Luther King Jr. Blvd.
Sponsored by Central City Concern, the Department of Veterans Affairs, Oregon Paralyzed Veterans of America, WorkSource Oregon and others.
Rare lung disease diagnosed in soldiers
Nashville doctors try to pinpoint cause
5:32 AM, Jul. 21, 2011
Jimmy Williams didn’t realize his military service might be the reason for his breathing problems when he retired from the U.S. Army in 2007 after two tours in Iraq.
He thought he was simply out of shape. “I was really tired all the time, wore out,” he said. “I was just feeling run down, gasping for air. I could hardly mow my yard.”
Williams now knows he suffers from constrictive bronchiolitis, a rare condition that cannot be diagnosed with X-rays or pulmonary function tests. A team of Tennessee researchers discovered scarring inside the small airways of his lungs and those of other soldiers who served in Iraq and Afghanistan.
Their findings, published today in The New England Journal of Medicine, could help veterans prove disabilities stemming from their war service.
“These guys had very believable stories,” said Dr. Robert F. Miller of Vanderbilt University Medical Center. “In a large majority of cases, they were elite athletes at the time of deployment. Now, they can’t run two miles.”
Although many of the soldiers were exposed to a 2003 sulfur-mine fire near Mosul, Iraq, not all were, so the exact cause of the lung damage remains a mystery. Another big question is how many undiagnosed veterans are suffering from the ailment.
Although Williams had brief exposure to the mine fire, he believes a burn pit at Balad, Iraq, to dispose of garbage, debris and military equipment caused his condition.
“I would wake up at night choking,” he said. “I had black soot on everything I owned, but we didn’t think about it. We just did our jobs.”
Miller first noticed the illness in 2004 when perplexed doctors at Blanchfield Army Community Hospital in Fort Campbell referred some soldiers to Vanderbilt. He and colleague Dr. Matthew S. King, who is now at Meharry Medical College, started looking for the cause along with other lung specialists.
It took surgery — open lung biopsies — for the physicians to make the diagnoses.
“I think the whole situation was kind of surprising because this constrictive bronchiolitis is a very uncommon disease in people who are otherwise healthy,” said King, the lead author of the study. “It is common in people who have had lung or bone marrow transplants. It is common in people who have lupus. It is common in people who haveautoimmune disease. But it is not at all common in fit, young military personnel or other healthy people.”
The disorder, however, can result from inhaling irritants. Workers in factories where diacetyl is used to make microwavable popcorn have been diagnosed with the condition.
The study was conducted from February 2004 through December 2009.
It began with 80 soldiers. Forty-nine of them agreed to undergo the open lung biopsies. Of that number, 38 were diagnosed with constrictive bronchiolitis. Twenty-eight of those soldiers had been exposed to the sulfur-mine fire.
Other exposures included dust storms, burn pits and combat smoke.
“I don’t think our study links this disorder to burn pits,” Miller said. “Burn pits may be a problem that contributes to this disorder. I think what we can say is that this disorder is linked to service in the Middle East. We haven’t been able to definitively link what the cause is for this.”
The patients who have been treated have not shown improvement, King said, but their conditions have not worsened since they have been stateside.
Vanderbilt is shipping 45 slides to National Jewish Hospital in Denver, where a researcher has received a U.S. Department of Defense grant to try to determine what substances are lodged in the tissues of the lung samples.
Miller is urging the U.S. Department of Veterans Affairs to recognize this disorder in making decisions about disability.
Williams went to a VA center to apply for disability assistance, but the representative told him the request probably would be denied because of the lack of medical data about the condition.
“It’s not just me,” he said. “It’s the other soldiers out there that have the same problem but are afraid to come forward. … They are fathers with families. What do they have for the future to look for?
Head wounds boost risk of dementia, study finds
Tuesday, July 19, 2011 03:07 AM
BY ALBERTINA TORSOLI
PARIS – Head injuries may more than double the risk of dementia in military veterans, a study found.
The dementia risk was 15.3 percent among U.S. veterans who had sustained a traumatic brain injury, compared with 6.8 percent for those who didn’t suffer head trauma, over a seven- year period. The risk was significant for all forms of traumatic brain injury, or TBI, said researchers, who reviewed medical records of 281,540 veterans ages 55 and older.
The findings, presented at the Alzheimer’s Association International Conference in Paris yesterday, highlight another hazard of war.
Traumatic brain injury accounts for 22 percent of casualties overall and 59 percent of blast-related injuries in Iraq and Afghanistan, said Kristine Yaffe, director of the Memory Disorders Program at the San Francisco Veterans Affairs Medical Center and a professor of psychiatry at the University of California, San Francisco, who led the research.
“This issue is important because TBI is very common,” Yaffe said in a statement.
Brad Eifert was in Iraq during two of the war’s most violent years. When he returned home, he knew that something was wrong.
Coming Together to Fight for a Troubled Veteran
By ERICA GOODE Published: July 17, 2011
OKEMOS, Mich. — When the standoff began on a humid August night, it seemed destined to become one more case of a returned soldier pulled down by a war he could not leave behind.
Staff Sgt. Brad Eifert circled through the woods behind his house here, holding a .45-caliber pistol. The police were out there somewhere and, one way or the other, he was ready to die.
He raised the gun to his head and then lowered it. Then he fired nine rounds.
“They’re going to take me down, they’re going to finish me off, so,” he remembers thinking, “finish me off.”
Leaving his weapon, he ran into the driveway, shouting, “Shoot me! Shoot me! Shoot me!” The police officers subdued him with a Taser and arrested him. A few hours later, he sat in a cell at the Ingham County Jail, charged with five counts of assault with intent to murder the officers, each carrying a potential life sentence.
In daring the police to kill him, Mr. Eifert, who had served in Iraq and was working as an Army recruiter, joined an increasing number of deployed veterans who, after returning home, plunge into a downward spiral, propelled by post-traumatic stress disorder or other emotional problems.
Their descent is chronicled in suicide attempts or destructive actions that bring them into conflict with the law — drunken driving, bar fights, domestic violence and, in extreme instances, armed confrontations with the police of the kind that are known as “suicide by cop.”
Such stories often end in death or prison, the veteran in either case lost to the abyss.
But something different happened in Mr. Eifert’s case. Headed for disaster, he was spared through a novel court program and an unusual coming together of a group of individuals — including a compassionate judge, a flexible prosecutor, a tenacious lawyer and an amenable police officer — who made exceptions and negotiated compromises to help him.
If he takes advantage of the chance to recover his life, he is likely to avoid incarceration and receive the care he needs to move forward.
How this came about — it evolved over more than seven months, during which Mr. Eifert remained in jail — says much about what is required to pull a psychically wounded soldier back to safety and raises questions about the limitations of the systems in place to deal with troubled veterans, whose trespasses can in many cases be traced to a lack of adequate help earlier on.
Some officials believe that war trauma should not qualify veterans for special treatment in the criminal justice system, especially in cases where public safety is endangered. “P.T.S.D. is not a get out of jail free card,” said a prosecutor in a Missouri case involving a veteran who had a faceoff with the police.
Yet a growing number of legal and law enforcement experts argue that when a veteran’s criminal actions appear to stem from the stresses of war, a better solution than traditional prosecution and punishment is called for. The society that trained them and sent them into harm’s way, they say, bears some responsibility for their rehabilitation. And they point to other exceptions in the legal system like diversion programs for drug offenders and the mentally ill.
“I don’t interpret it as excusing behavior, but as addressing what the behavior is,” said Judge Robert T. Russell Jr. of Buffalo City Court, who founded the first special court for veterans there in 2008. It can provide an alternative to punishment, mandating treatment and close supervision and holding them to strict requirements.
“The benefit is, you increase public safety, you don’t have a person reoffending and, hopefully, that person can become functioning and not suffer the invisible wounds of war,” Judge Russell said.
Mr. Eifert, 36, was fortunate that, just months before, his county had become one of 80 jurisdictions around the country that have adopted the veterans court model. But the resolution of his case took more than that.
The judge had to take an interest in his case and accept him in the court, which did not normally hear serious cases involving the use of a firearm.
The prosecutor had to ultimately decide that Mr. Eifert’s emotional difficulties warranted leniency.
Army suicides set record in July
By Greg Jaffe, Published: August 12
The U.S. Army suffered a record 32 suicides in July, the most since it began releasing monthly figures in 2009.
The high number of deaths represents a setback for the Army, which has put a heavy focus on reducing suicides in recent years. The number includes 22 active-duty soldiers and 10 reservists. The previous record was 31, from June 2010.
Army officials cautioned that investigations are underway in most of the deaths to confirm the exact cause.
“Every suicide represents a tragic loss,” Gen. Peter W. Chiarelli, the vice chief of staff of the Army, said in a written statement. “While the high number of potential suicides in July is discouraging, we are confident our efforts . . . are having a positive impact.”
Over the past several years, the Army has launched a major effort to institute new training to improve soldiers’ ability to bounce back from stress, and setbacks in combat and in their personal lives. It has hired hundreds of mental health and substance abuse counselors and has launched a push to convince soldiers that seeking help for mental health problems will not have a negative impact on their careers.
The service also has tapped the National Institute of Mental Health to conduct a five-year, $50 million study and statistical analysis of suicide in the Army, an effort that includes surveys, data mining and medical testing.
Chiarelli, meanwhile, has devoted hundreds of hours to studying the suicide problem and its possible links to post traumatic stress disorder and traumatic brain injuries caused by battlefield explosions.
So far, the efforts have not resulted in a significant change in the suicide rate in the Army. Over the first seven months of 2011, about 160 active-duty and reserve soldiers have committed suicide, which is about on par with the number of troops taking their own lives during the same months in 2009 and 2010.
The Marine Corps, which reports information on suicides by corps members online, also has posted annual suicide rates similar to the Army’s.
Senior Army officials had hoped that the slowing pace of combat deployments to Iraq and Afghanistan might reduce the overall strain on the force and help drive down the rate of soldier suicides. The extra time at home, however, does not appear to have had a significant impact on the suicide rate.
In recent years, the Army’s suicide rate has surpassed the rate for the overall population. Comparing suicide rates among soldiers is difficult because the latest national suicide statistics, which are compiled by the Centers for Disease Control and Prevention, are about three years old.
If the suicide rate among troops is compared to a population that is similar to the military in terms of age, race and sex, the rate in the Army and Marine Corps appears to be about the same or slightly lower than the population at large, according to the Rand Corp., a government-funded think tank.
Oklahoma veteran receives prosthetic leg with computerized knee
Brian Wofford, a McLoud native who lost his leg in Iraq, has received a new prosthetic leg with a waterproof, computerized knee from Scott Sabolich Prosthetics and Research in Oklahoma City.
BY SONYA COLBERG email@example.com
Published: August 30, 2011
Brian Wofford lost his leg fighting for others’ freedom.
Now he’s stepping into a renewed sense of freedom of his own.
“It’s always exciting getting a new leg,” he said.
This makes Wofford’s seventh leg. This one sports a high-tech, microprocessor-studded prosthetic knee, the first of its kind fitted on a veteran at Scott Sabolich Prosthetics and Research in Oklahoma City and one of about 125 worldwide. Thanks to the new Genium prosthetic that “thinks,” he doesn’t worry about incidents like the time a former knee buckled and laid him flat four times as he crossed a sloping, busy street in Washington, D.C.
As he spoke, the 28-year-old McLoud native touched the arching scar on his left jaw that toughens his boyish features. He recalled noticing how kids in Baghdad waded barefoot through backed-up sewage water while other people carefully placed stones over sewage flooded streets to reach the open-air fruit stands. So in his first peacekeeping mission in September 2004, the truck commander cheerfully packed up after the grand opening of a sewage pump station that troops had rebuilt.
He glanced back to check the blind spot when his driver started to pull away. That moment, a suicide bomber swerved, almost hit them head-on and detonated a bomb. Their Humvee took most of the damage, jamming a piece of metal into Wofford’s jaw, spewing shrapnel into the faces of Wofford’s gunner and driver, cramming the windshield into the driver’s forehead.
“I took the windshield out of my driver’s head. Threw it on the hood,” Wofford said.
Before they could help other wounded soldiers get to the medics, another car turned a corner and exploded another bomb. Wofford was blown 10 feet away. He hobbled six or seven steps until his left leg collapsed. His left foot was on backward, and shrapnel peppered football-size and fist-size holes in his body. Bullets from snipers pinged past the soldiers as Wofford struggled with a jammed gun.
“I’m laying in the middle of Baghdad with a useless rifle,” he said.
An Iraqi guardsman died when he tried to stop a third suicide bomber nearby. There were no American fatalities, but about 200 Iraqis were injured and 49 Iraqi children were killed, he said, changing the feeling toward terrorist organizations in Baghdad.
That attack also changed Wofford and the other 10 injured American soldiers.
It can ‘think for you’
The most obvious sign on Wofford is the amputated leg. Below his shorts, the polished steel limb is set off by a new, gray computerized knee especially designed for the military with U.S. Department of Defense funding. Though just becoming available to civilians, the design allows soldiers to return to field operations, said Scott Sabolich, owner and clinical director of Scott SabolichProsthetics and Research.
The knee contains hydraulics that slow it down when the patient activates it. Unlike others, this waterproof, computerized knee can create different walking patterns. It has an accelerometer in it that detects when the knee is moving forward or backward, as well as points on the top and bottom of it that detect torque.
“It can basically think for you,” Sabolich said. “It’s basically an intelligent knee.”
Wofford, a 6-foot, 2-inch and 230-poundUniversity of Wisconsin-Whitewater student studying secondary math education and coaching, is a little different from many Scott Sabolich patients who are older or weaker and have lost limbs to diabetes or other types of accidents.
Wofford could overpower some of the stability and comfort shortfalls of his earlier knee.
“We could put him in a door hinge, and it would work,” said Scott Williams, prosthetic practitioner with Scott Sabolich.
He said the new knee will reduce a lot of the work Wofford had to put into remaining stable on stairs, rocks and steep inclines. Wofford doesn’t feel like he’s tipping over on inclines because of the flexion in the knee.
“It opens up a lot more doors of freedom of movement,” Williams said.
When Sabolich joined the 64-year-old family business two decades ago, prosthetics had just gone from wooden to aluminum knees and stainless steel ones with hydraulic units. About 10 years ago, prosthetic knees became computerized with the advent of C-leg and the Rheo for above-knee amputees.
“They were phenomenal. But they can’t do what this can do,” Sabolich said.
Suitable for most patients under 50, the knee likely will become the standard in the next decade, he said.
Boulders are no longer mountains to owners of this new knee because it actually picks up the foot and steps for the wearer. It knows when to bend the knee as the patient walks.
“It’s the most amazing thing in the world,” Sabolich said.
Wofford said he plans to return to Oklahoma when he gets his degree. And he’s prepared for the most frequent question he’s heard with all his other prosthetic knees.
“People ask me, ‘How do you walk on that?’”
“I walk. How do you walk?” he says.
“It’s still walking. It’s natural, but it’s different.”
Widespread mental health conditions reported in returning war vets
By DAVID GOLDSTEIN
The Star’s Washington Correspondent
WASHINGTON | Nearly one of every five of the more than 2 million troops who have served in Iraq and Afghanistan suffer a mental health condition, according to a new report.
Faced with this wave of new and damaged veterans, federal agencies are in danger of being overwhelmed.
In a related development this week, an internal Department of Veterans Affairs survey found that staffers do not believe they have the resources to handle the rise in cases.
“A large number of people serving overseas have mental health impacts, and more and more are coming home,” said Democratic Sen. Patty Murray of Washington, chairwoman of the Senate Committee on Veterans’ Affairs, which conducted the survey. “I am deeply concerned that we are not ready.”
Some of the findings of the Veterans for Common Sense:
•712,000 have sought medical treatment of some kind since leaving military service.
•368,000 suffer a mental health condition.
•212,000 suffer from post-traumatic stress disorder, a signature injury of the wars.
Paul Sullivan, executive director of Veterans for Common Sense, said that in 2003, estimates were that the VA would see about 50,000 new patients. But with nearly three-quarters of a million Iraq and Afghanistan veterans already in the VA system, he called the long-term estimate “ominous,” hitting a million before 2014.
The nonprofit, nonpartisan activist group compiled the statistics from a raft of federal reports.
Of the 109,000 casualties since combat in Iraq and Afghanistan began, 6,200 troops have been killed.
Among those were 298 war-zone suicides, according to the study. Overall, it reported 2,300 active-duty suicides since 2001.
Underscoring the stress of 10 years of war, suicides exceeded deaths in combat in 2009.
The study said that nearly 1 million troops — 42 percent of all service members sent to the combat zones — have been deployed at least twice.