Waste in Afghanistan: How U.S. trashed troops’ health and squandered millions (Fast Company)
When the United States military began leaving Afghanistan, they left a nasty surprise for departing American soldiers: health risks from open-air burn pits. A damning report released late last week by SIGAR, the Special Inspector General for Afghan Reconstruction, says the incinerators and burn pits were “indefensible” and led to thousands of troops, contractors, and Afghan civilians unnecessarily inhaling toxic fumes. “Given the fact that DOD has been aware for many years of the significant health risks associated with open-air burn pits, it is indefensible that U.S. military personnel, who are already at risk of serious injury and death when fighting the enemy, were put at further risk from the potentially harmful emissions from the use of open-air burn pits,” said SIGAR’s inspector general, John F. Sopko. He called the persistent use of burn pits in spite of ongoing concerns “disturbing.” In a separate class-action lawsuit, now moving closer to trial in U.S. district court in Maryland, hundreds of veterans allege sickness due to exposure to the burn pits. Veterans participating in the suit, filed against contractor KBR and its former parent company Halliburton, claim to have lung damage caused by exposure to the burn pits, which were operated by the contractors. The veterans contend that their proximity to the pits also resulted in long-term medical issues, including asthma, acute respiratory illness, immunity disorders, and even cancer. A dozen veterans have also been diagnosed with a rare condition called constrictive bronchiolitis, a scarring and inflammation of the lung’s smallest passageways that develops with exposure to environmental toxins or in lung-transplant patients.
See our section on burn pit exposure
Oakland VA office botched benefits, forgot about claims going back to the 1990s (SFGate.com)
The U.S. Department of Veterans Affairs’ regional office in Oakland shoved thousands of compensation and disability claims into a filing cabinet without processing them, leaving many veterans or their surviving family members without needed benefits, the agency’s inspector general said in a report issued Wednesday. The claims, which dated back as far as the mid-1990s, were discovered in 2012 as a national scandal erupted over the VA’s sloppy and slow handling of benefits, which outraged veterans. The report said the office in 2012 counted 13,184 informal claims for benefits that had been found in the cabinet, with 2,155 requiring “review or action.” Those files were assigned to a special team, the report said, but later, in spring 2014, office workers found a cart of the claims that the team had reviewed but failed to act upon. “Management determined staff had not taken action on these informal claims as required,” the report stated. Inspectors quoted staffers as saying that processing the claims discovered in the cabinet “was not a priority” in the office. When the inspector general’s office visited for a two-week probe in July, it learned the office had created a spreadsheet after 537 unprocessed claims were found in the cart. But the office had created no paper trail for the larger cache of claims. Inspectors couldn’t verify they had been taken care of due to “management’s poor record-keeping practices,” the report said. The Oakland office, which reviews claims for Northern California veterans, “did not maintain adequate records and provide the oversight needed to ensure timely processing and storage of these informal claims,” the report said. “As a result, veterans did not receive consideration for benefits to which they may have been entitled.”
Chris Kyle’s killer still gets $2,800 monthly in benefits from the VA (IJReview.com)
During the trial of Eddie Ray Routh, a surprising fact came to light while Routh’s mother testified: the VA has classified him as disabled, and he is still getting $2,800 in monthly benefits. That he had been treated by the VA and released, despite being diagnosed with schizophrenia and PTSD, was not new information. Routh’s parents have been managing an account that contains the money he’s received over the two years he’s been in custody. If convicted of murder, the benefits will be reduced by 90% and Routh will receive $280 a month. It is unclear how much Kyle knew about Routh’s treatment at the VA or if he was aware of the diagnosis.
Disability insurance for veterans: not working (The Economist)
In the 1990s American veterans were more likely to be in the labor force than non-veterans. By 2013, things had really changed. Three-quarters of male veterans aged between 18 and 64 were in the labor force, compared to four-fifths of male non-veterans of the same age. The difference in their employment rates was equally striking. A new NBER paper looks at what happened, and why. It suggests that the Veterans’ Affairs Disability Compensation (VADC) program, which pays benefits to veterans with disabilities, has a role to play. The three authors look at trends over time in the labor-force participation of veterans, and compare those to what non-veterans are doing. They then see whether the VADC program can explain the differences. Over time the American government has relaxed eligibility criteria for VADC (as they have for federal disability insurance). For instance, in 2001 scientists found evidence of a link between exposure to Agent Orange, a herbicide used during the Vietnam war, and diabetes. As a result, those with type-II diabetes became eligible for VADC. The rapid rise in VADC enrollment coincided with a big increase in the inflation-adjusted benefit: it grew by 46 percent from 2001 to 2013. By 2014 some veterans could get tax-free benefits of nearly $3,000 a month (which is roughly the same post-tax income as that of the second-poorest quintile of American households). No wonder, then, that VADC expenditures (in inflation-adjusted dollars) boomed, from $20 billion in 2000 to $54 billion in 2013. As the Economic Report of the President shows, that’s roughly the amount of money that the Treasury gets from estate and gift taxes, as well as customs duties.
Long-acting opioids related to unintentional overdose risk (Medscape.com)
Long-acting opioids were associated with a greater than 2-fold risk for unintentional overdose compared with short-acting formulations, according to a cohort study published online February 16 in JAMA Internal Medicine. Moreover, the risk was more than 5-fold greater in the first 2 weeks of using a long-acting opioid. “If replicated in other cohorts, our findings suggest that clinicians weighing the benefits and risks of initiating different opioid regimens should consider not only the daily dose prescribed but also the duration of opioid action, favoring short-acting agents whenever possible, especially during the first 2 weeks of therapy,” write Matthew Miller, MD, ScD, from the Department of Health Sciences and Epidemiology at Northeastern University in Boston, Massachusetts, and colleagues. The study population was made up of veterans who were largely men older than 50 years. Previous studies had found that higher doses of opioids were associated with greater risk for overdose, but few studies have considered the duration of action in overdose risk, the authors note. The current study involved 840,606 veterans with chronic pain diagnoses who began opioid therapy between January 1, 2000, and December 31, 2009, who had not taken opioids in the previous 6 months. The researchers reviewed diagnostic and procedural codes as well as pharmacy data from the Veterans Health Administration. They note that they were not able to track the actual amount of medication taken, but considered patients to be using the opioids on the basis of filled and refilled prescriptions.
House veterans panel to meet in Wisconsin on overprescribing drug concerns (Milwaukee Journal Sentinel)
A congressional field hearing that will look into allegations of overprescribing of opioid painkillers to veterans at the Tomah VA Medical Center will be held in Tomah, according to the chairman of the House Committee on Veterans’ Affairs. The medical center already is being investigated by the VA’s Office of the Inspector General and the Veterans Affairs secretary of health. The state Department of Safety and Professional Services is conducting its own review of the Tomah facility’s chief of staff, a nurse and a pharmacist. The medical center came under scrutiny last month when whistleblowers alleged that a physician was handing out prescriptions like candy. Several Wisconsin members of Congress had asked for the congressional hearing. In a letter to Rep. Sean Duffy and three other Wisconsin congressmen, Veterans’ Affairs Committee Chairman Jeff Miller (R-Fla.) said the Tomah field hearing would be held. No date has been set.
Florida representative introduces Veterans Education Training Act (Tallahassee.com)
U.S. Rep. Gwen Graham’s first piece of legislation as a member of Congress would train and hire more recovery coordinators to help badly injured post-9/11 veterans. Graham hopes the VETS Act — Veterans, Education, Training Act — will improve veterans’ ability to recover from war injuries by helping them better navigate government red tape to receive benefits. Recovery coordinators with the U.S. Department of Veterans Affairs assist seriously injured military members from active duty to veteran status. The coordinators help veterans find health care, housing and employment. Graham, who announced the legislation Wednesday afternoon while standing with North Florida veterans at Gulf Coast State College in Panama City, said it was “the least we can do for those who have served our country so admirably.” Part of the legislation would require the VA work to establish recovery coordinator training curriculum in existing nursing schools like Florida State University, Tallahassee Community College and Florida A&M University. It would also allow the VA to increase the number of recovery coordinators and create a better system so that service members don’t “fall through the cracks.”
Texas Chief Justice presses lawmakers on legal aid for veterans (Texas Tribune)
Texas Supreme Court Chief Justice Nathan Hecht on Wednesday called on state lawmakers to continue their support for legal aid to the poor and military veterans and to complete unfinished work on truancy reform for students. “For the past six years, at the judiciary’s urging, the Legislature has provided critical financial support for the legal system’s efforts to provide basic civil legal services to the poor,” Hecht told a joint meeting of the Texas House and Senate in his State of the Judiciary address, which the chief justice delivers at the beginning of every legislative session. He urged lawmakers to extend that support and to look harder at programs that help military veterans in the legal system. “Too often, servicemen and women return from duty to find benefits delayed, families struggling, jobs scarce, homes in foreclosure and debt collectors at the door. These enemies at home can be as real a threat to a veteran’s survival as the enemies faced in the field,” Hecht said, pushing for a $4 million request to help provide legal aid to veterans.
What’s the state of veterans in Orange County, Calif.? (The Orange County Register)
Military veterans in Orange County – especially those who served after the 9/11 terror attacks – face significant challenges transitioning to civilian life. Veterans here also need more targeted support as they struggle with employment, housing and physical and mental health issues, according to the newly released “The State of the American Veteran: The Orange County Veterans Study.” The report, which surveyed 1,227 former service members, is among the most in-depth looks at local veterans. The report can be found at oc-cf.org/veterans. “I’m not here to say veterans are broken,” said Anthony Hassan, a USC researcher who co-authored the study. “But I am here to tell you this transition is not easy.” The report will be made public Thursday in Costa Mesa. Retired U.S. Navy Adm. Michael Mullen, former chairman of the Joint Chiefs of Staff, is among those expected to attend an event hosted by the Orange County Community Foundation. The report didn’t focus on veterans with specific problems. Instead, it explored the more typical adjustments faced by veterans who return to civilian life following years spent in the insulated and regimented world of the military.
Bush Institute focuses on veterans’ struggles to re-enter daily life (The Dallas Morning News)
Marine veteran David Smith said he wasn’t sure what to do with himself after coming home from the Iraq War. Without a bachelor’s degree, the only work he could find was a minimum-wage job doing construction. In time, though, things stabilized. Smith landed a better job, attended community college and eventually enrolled at the University of California, Berkeley. “The story you just told sounds like everything was going great,” former President George W. Bush, who got to know Smith during a Wounded Warrior bicycle ride, said Wednesday during a panel discussion at the Bush Institute’s second Military Service Initiative Summit. “But that wasn’t the way it was, as I recall,” Bush said. Smith, who now lives in Norway, then opened up. Before an audience at a summit forum on how to help veterans re-enter civilian life, he acknowledged that he had had such difficulty dealing with post-traumatic stress disorder after his time in Iraq that he one day found himself standing in his college bedroom with a shotgun in his mouth. But instead of pulling the trigger, he locked the gun away in his roommate’s room, listened to messages from family and friends, and decided to seek help. “I knew I couldn’t do this anymore, and I knew I had to really, really make a committed decision to fix this, or it was going to take me out,” he said. Smith, who was deployed twice, said that he was reluctant to seek help after his 2007 discharge because resources were lacking and he felt stigmatized by having PTSD.
Veterans become a protected class: a double-edged sword (Huffington Post)
Opinion: “Did you ever think a career choice could determine whether or not you are legally defined as a protected class? On March 24, this becomes fact as changes are made to the Vietnam Era Veterans’ Readjustment Assistance Act (VEVRAA). This act requires covered federal government contractors and subcontractors to take affirmative action to employ and promote veterans protected by the Act and prohibits discrimination against veterans. The new mandate becomes enforceable as part of a company’s 2015 Affirmative Action plan and established a hiring benchmark commensurate with the national veteran population, or 7.2 percent. For me, this news is a double-edged sword. My work centers around inspiring and convincing companies to hire veterans. Too many companies falsely believe veterans will be a liability, and so they tend to shy away from us. The new law puts some muscle behind the need to hire veterans, yet there is a real problem when veterans need the government to force companies to act. VEVRAA and its new mandate cannot educate employers, though. What will make a difference is when companies understand and accept that military service does not equate a “resume gap.”
Failing to clean up the VA (CATO Institute)
Opinion: “The Department of Veterans Affairs (VA) has a long history of mismanagement. Last year, the public became aware of a wait-time scandal at the VA hospital in Phoenix. Veterans were forced to wait months for appointments, even as the hospital was reporting no delays in service and allowing its management to receive performance bonuses. Over 1,700 veterans were not placed on the official wait lists to hide the length of actual waits. The VA Inspector General suggested that the Phoenix VA was not the only center to modify its wait lists in this fashion. In response to the crisis, Congress passed a law that allowed veterans who were waiting for treatment to access non-VA providers. At the time, I cautioned about the risk of a possible large, unfunded entitlement program being created. Now it seems that there are other issues with the way that the VA is implementing the expanded program. Veterans continue to be shut out of service and providers are uncertain how to utilize the benefits. … The VA hospital system is a mess, showing the downsides of socialized health care. During last year’s scandal, Congress simply put a bandage on the problem by allowing some veterans to use outside providers. Congress should revisit the issue and institute more fundamental reforms to the Veterans Health Administration.
Chronic stress may put TBI caregivers at risk for illness (Reuters)
Women caring for partners with traumatic brain injury (TBI) experience enough grief and stress to put their own health at risk, according to a small study of U.S. veterans’ wives and girlfriends. Anger, blame and grief for the loss of the man they once knew were linked to elevated inflammation levels that raise the women’s risk for chronic disease, researchers say, and not being able to turn to their loved one for support only makes things worse. “You think about your spouse or significant other and that is such a meaningful relationship and usually the person you go to when you are under stress,” said Karen Saban, of the Loyola University Chicago Marcella Niehoff School of Nursing, who led the study. “Here they are going through this very stressful situation but they’ve kind of lost their main person to get support from.” Saban, who is also a research health scientist at the Edward Hines Jr. Veteran’s Administration Hospital in Hines, Illinois, noted that the women could be finding it particularly difficult to cope because they are relatively young, still working and raising children. Past research shows a link between grief and physical health problems like high blood pressure and coronary artery disease, Saban and her colleagues write in Biological Research for Nursing. Chronic stress and depression also puts caregivers at increased risk of inflammation-related illnesses, they note. Since the year 2000, Saban’s team writes, 244,217 veterans have been diagnosed with the TBI, considered moderate or severe in 43,000 of those cases. The injury can cause seizures, lack of coordination, weakness and cognitive problems.
Illinois governor halts veterans’ eviction from state VA facility (Breitbart News)
A Vietnam War vet is back at a state Veterans Home facility in Quincy, Illinois. For now. On Monday, the home hired a private transportation company, enlisted the services of a state trooper, and tried to forcibly evict vet Eugene Zalazinski. The plan was to deposit Mr. Zalazinski at his brother’s house in Chicago, although the facility had not informed the vet’s brother of this plan. Within an hour of the eviction, Governor Bruce Rauner intervened and temporarily reversed the move. According to Doug Wilson, who has covered this saga extensively for the Quincy Herald Whig newspaper, the care facility, which provides long-term care to about 450 Illinois veterans, began evictions proceedings against Zalazinski last week. The vet’s family and attorney were able to win temporarily reprieves. Last Wednesday, Zalazinki’s brother Robert tried to meet with Veterans Home officials to work out a solution. Wilson reported that Dawn Whitcomb, adjutant of the facility, told the family Mr. Zalazinski could stay in the facility while he searched for alternative living arrangements. On Friday, Ms. Whitcomb apparently had a change of heart and visited Mr. Zalazinski’s room, accompanied by a state trooper, and told him to pack his bags to leave. She told the vet he may have to be taken to a Salvation Army shelter for the homeless if he didn’t have other living arrangements. That push for eviction seems to have simply evaporated and Zalazinksi remained in the home over the weekend. The facility’s decision to evict Mr. Zalazinski seems to rest on his tendency to “hoard” newspapers, magazines and mail. The Illinois Department of Veterans Affairs has cited the “condition your room is kept in” as a reason for the involuntary eviction. Zalazinski’s room has been cleaned out several times over his 11 years at the home. His family has offered to help clean out the room again and suggested counseling to address his “hoarding” tendencies.