Written by: Kathleen Zaratzian

On September 24, 2014, Disabled American Veterans (DAV) released a comprehensive report assessing the distinct needs of female veterans and the sufficiency of programs available to them when they leave military service.  The report, titled Women Veterans: The Long Journey Home, urges the expansion of female specific programs and outlines ways in which federal agencies and community service providers do not adequately meet the unique needs of female veterans.  The number of female military service members and transitioning female veterans is increasing, which makes it essential that veterans’ services are restructured to close the gender gap in health care, job training, finance, housing, social issues and combating sexual assault.

Women constitute a growing number of U.S. military service members.  Female roles are expanding to previously “men-only” positions including roles in infantry and armor divisions and special operations.  More than ever before, women are directly exposed to combat and other violence, increasing the likelihood of common combat related injuries such as PTSD and Traumatic Brain Injury.  Last year, the VA cared for approximately 390,000 female veterans at its hospitals and clinics, as compared to the 5.3 million male veterans who used the VA system.  Despite the sizeable difference across gender, this is more than double the number of women who received care in 2000.  And the number of female veterans is expected to increase, while the number of male veterans is expected to decrease by 2020.

Despite the growing prominence of women in the military, the report found that “[w]hen women talk about their military service, a large number will report that they feel invisible, that their ‘non-combat’ role was less valued than those of the men who served and that they do not identify themselves as veterans. There remains a misperception on the part of the American public and women who serve that they are not eligible for full veterans’ benefits.”  The DAV proposes changes to the culture of veterans’ services to broaden services that currently tailor to male veterans and to close the gender gap in veterans’ services that currently leave female veterans feeling devalued and undeserving of the benefits that they earned during service.

Some of the ways in which the needs of female veterans differ from their male counterparts in terms of disability benefits include: higher rates of PTSD symptoms, depression and other co-morbid conditions; different responses to prosthesis and complications with fittings during pregnancy; preferences for female physicians and increased privacy; different types of treatment such as gender-specific group counseling, residential treatment and specialty inpatient programs; and women specific health services.

Evidence that female veterans are not receiving adequate services can be seen in the VA’s finding “that almost one in five women veterans has delayed or gone without needed care in the prior 12 months.”  One third of VA medical centers do not have a gynecologist on staff.  Additionally, reports of military sexual trauma (MST) are growing and one in five women enrolled in VA health care screen positive for MST.  However, a third of VA medical centers and community clinics were unable to provide full MST services as recently as 2013.

DAV recommends expansion of gender-specific programs and a shift in military culture that honors, respects, and fully understands the unique needs of female veterans.  Fortunately, the VA appears receptive to these recommendations.  Dr. Carolyn Clancy, VA’s acting undersecretary, told a group of female veterans and supporters that the report will serve “as our road map for improvements.”  The VA is best situated to provide the best health care to female veterans because VA health care combines social, economic, psychological and physical services specialized for veterans.  However, the differences between men and women in the ways that they experience military service and gender-specific health needs must not be ignored.

Sources:

  1. Matthew Daly, Report: Services for female veterans fall short, Federal News Radio (September 25, 2014), http://www.federalnewsradio.com/538/3708509/Report-Services-for-female-veterans-fall-short.
  2. New Report Reveals Nation Still Not Fully Equipped to Support Women Veterans, DAV (September 24, 2014), http://www.dav.org/learn-more/news/2014/new-report-reveals-nation-still-fully-equipped-support-women-veterans/.
  3. Women Veterans: The Long Journey Home, DAV, (2014), http://www.dav.org/wp-content/uploads/women-veterans-study.pdf.

Written by: Katie Ashley

The Department of Veteran’s Affairs (VA) has recently announced its intention to “recruit [the] best and brightest” health care practitioners through increases in pay in order to better serve our nation’s veterans.  The proposed plan will raise the pay ceiling for prospective Veterans Health Administration (VHA) medical professionals.  Namely, there will be an annual pay bump of $20,000 to $35,000 for future physicians.  In addition to the salary boost, the VA plans to take additional measures such as partnering with local nursing programs as well as the Department of Defense Health Affairs, and developing a program to enlist more corpsmen and combat medics to join the ranks of VHA clinicians, among others.  Moreover, the VA boasts that it is the largest employer of medical practitioners and that more than 70% of all doctors in the United States have received training through the VA.

That being said, a 2014 survey by The Medicus Firm indicated that physicians continue to rank government employment as their last choice.  Health care providers from all over the country consistently show a lack of interest in working for the government, which includes working for the VA.  This disinterest among physicians in VA work, especially in long-term employment, has resulted in “[a] revolving door of short-term physicians,” which ultimately hurts our veterans.  This high degree of turnover explains how the VA can claim to be the largest employer of practitioners.  Having temporary medical professionals, and more notably, professionals who are less than interested in working in these positions, results in a lack of continuity of medical care, lack of attentive medical care, and an overall indifference towards the “noble and inspiring mission” of serving those who served us.

Although this proposed increase in pay may entice physicians to stay longer—ameliorating the continuity problem—I cannot see how dangling money in front of physicians to work in a position that the majority of all medical practitioners do not want is going to improve the care that our veterans receive.  The practitioners should not be in it for the money, they should not be in it as a stepping stool to obtain a bigger and better job, they should not be in it because there are no other jobs to choose from, but rather they should be in it to help those who put their lives on the line to keep us safe.  Even though more practitioners are needed, and the additional money may attract more prominent physicians than in the past, I cannot say that I would want a physician who is more motivated by money than my well-being.  At the end of the day, quality is better than quantity.

If this proposed pay raise results in improved care for our veterans, then I am all for it.  It is baffling to me why working in these positions is so undesired.  Our veterans watched out for our backs, and now it is time for us to better care for theirs.

Sources:

http://www.forbes.com/sites/brucejapsen/2014/06/15/though-veterans-need-physicians-va-isnt-popular-employer/

http://www.va.gov/opa/pressrel/pressrelease.cfm?id=2632

Written by: Chelsea King

On September 10, news broke of another VA records doctoring scandal: this time, at the Board of Veterans Appeals (BVA), the appellate court that handles benefit claims appeals.  Whistleblower Kelli Kordich testified before Congress and exposed the BVA’s manipulation of records in order to keep long delays under wraps.  She also testified that BVA decisions sat on board heads’ desks for hundreds of days only needing a mere signature.  BVA leaders, however, denied the allegations, saying that the delay is a result of overwork.

Two Senators on the Senate Armed Services Committee specifically called out the VA regarding this in a letter to Secretary McDonald on September 17.  One of their proposed solutions is to “make better use of [the] Decision Review Officers” at the Regional Offices.  This statement is a good example of how Congress does not understand the VA.  While it would be great to have more Decision Review Officers (DROs), the priority at the Regional Office level should be to employ competent DROs who are able to handle the intellectual and time rigors of the job.  Without good DROs, the BVA’s backlog will just be increased, leading to more “overwork.”

The BVA news hits close to home here at the Puller Clinic.  Many veterans who had claims decided against them at the Regional Office level have been waiting for many years to hear back from the BVA.  The average wait time for a veteran’s appeal is three years, even before news of the records doctoring broke.  The news is especially disheartening given how much veterans rely on the BVA to provide a more thorough review of their cases and to correct inaccuracies that exist from Regional Office review.

Hopefully Ms. Kordich’s testimony will ignite change in the VA at the appellate level.  While it is important for the Regional Offices to improve, it is just—if not more—important that the BVA runs smoothly and efficiently, since the appellate court reviews appeals from the entire nation’s veterans and is able to overturn Regional Office rulings on benefits claims.

 

Sources:

  1. Travis Tritten, Whistleblower Claims Records Manipulation by VA Appeals Board, Stars And Stripes (Sept. 10, 2014), http://www.stripes.com/news/whistleblower-claims-records-manipulation-by-va-appeals-board-1.302377.
  2. Leo Shane, Mismanagement Alleges at VA Appeals Board, Military Times (Sept. 10, 2014), http://www.militarytimes.com/article/20140910/NEWS05/309100060/Mismanagement-alleged-VA-appeals-board.
  3. Shaheen, Ayotte Call for Investigation Into Board of Veterans Appeals Backlog, Press Release (Sept. 17, 2014), http://www.shaheen.senate.gov/news/press/release/?id=3fdf8d20-7358-4462-8cff-1adf804b4850.

Burn Pit Registry

September 17, 2014

Written by: Stephen Beaty

Anywhere you find people these days, you will find trash.  And somehow, someone must dispose of that trash.  Over the last 24 years of conflict in southwest Asia, the United States Military has burned a tremendous amount of trash.  As recently as mid-2008, officials at Joint Base Balad (also known colloquially as Camp Anaconda), near Balad, Iraq, acknowledged that approximately 147 tons of waste were being burned in open pits each day.  At that time, the military had installed 3 incinerators burning an additional 120 tons of waste.  The logical assumption is that prior to the incinerators, the entire daily trash supply was being burned in the open pits.  Every major military base in southwest Asia had burn pits.

Various opinions rage back and forth regarding the danger this smoke created for the inhabitants of the various military posts.  The debate centers around whether breathing the smoke from these burn pits was simply a hazard while it was being inhaled or whether it might create chronic disability in the years to come for the Servicemembers caught in the smog.

The Veterans Administration (VA) has set up a place for Servicemembers and veterans to register if they were exposed to smoke from the burn pits.  According to the VA website, the Airborne Hazards and Open Burn Pit Registry is designed to aid Veterans and Servicemembers “to become more aware of their health, to receive information about ongoing health studies and VA services, and to create a ‘snapshot’ of their health to assist discussing their health concerns with a health care provider.”  Veterans who are not currently receiving VA medical care are eligible for a free VA medical evaluation.  By registering and answering the online questionnaire, veterans and Servicemembers also help the VA to “monitor certain diseases and health conditions.”

To be eligible for the registry, people must either be an active duty Servicemember or a Veteran.  Like other VA benefits, dishonorably discharged Servicemembers are not eligible.  In addition, the Servicemember must meet certain time and location qualifications.  Personnel must have served with the United States Military in Afghanistan or Djibouti in support of OEF after 11 September 2001 or in the Southwest Asia theater of operations (as defined in 38 CFR 3.317 (e)(2)) region after 2 August 1990.  This theater includes the following countries, bodies of water, and the air space above these locations: Iraq, Kuwait, Saudi Arabia, Bahrain, Gulf of Aden, Gulf of Oman, Oman, Qatar, United Arab Emirates, and waters of the Persian Gulf, Arabian Sea, and Red Sea.

For more information please visit: https://veteran.mobilehealth.va.gov/AHBurnPitRegistry.