Backlog of claims dips below 100,000 cases (Military Times)
The number of backlogged veterans disability claims fell under 100,000 cases this weekend, a figure that officials with the Department of Veterans Affairs are hailing as proof that years of effort into modernizing their systems are paying dividends. But VA officials Monday also indicated that they may never fully eliminate that backlog because doing so could unnecessarily rush some veterans’ claims through the system. About 98,500 of the almost 363,000 pending claims in the Veterans Benefits Administration now are backlogged, defined as pending for more than 125 days. VA officials six years ago set a self-imposed deadline of getting that total down to zero by the end of 2015. In a conference call with reporters Monday, VA Under Secretary for Benefits Allison Hickey called the drop below 100,000 cases “an historic milestone” and a level of processing achievement “that we have never experienced before.” “Today is a new day for VA, and we are focused on delivering for our veterans … like no time ever before,” Hickey said. The claims backlog became a national scandal for the department two years ago when it peaked at around 613,000 cases, despite years of promises from the White House and VA leaders that they were working on the overdue cases. VA officials have used a combination of new paperless processing techniques, mandatory overtime by claims raters and upgraded software systems to pull the numbers down. Since the peak, the backlog total has dropped 84 percent, with the average processing time for a case plunging from 282 days to around 105 today. Outside advocates have offered cautious praise of the work so far, with veterans organizations lauding the effort but also warily reminding of past promises to end the backlog. The progress also has drawn criticism from groups mistrustful of any VA data in the wake of its 2014 records manipulation scandals, and for a corresponding 27 percent increase in the total pending disability appeals cases in the last two years.
VA hosting head injury conference in Washington (Military Times)
Investing in research and treatment of traumatic brain injury can ward off future problems for veterans, including unemployment, homelessness and suicide, Veterans Affairs Secretary Bob McDonald said Monday during opening remarks of a two-day conference on head injury in Washington, D.C. Drawing more than 300 of the country’s top TBI researchers, the VA’s State of the Art Conference on traumatic brain injury aims to share cutting-edge approaches to detecting head injuries, treating them and solving related problems. Since 2001, more than 327,000 troops have been diagnosed with mild, moderate and serious head injuries, according to the Congressional Research Service. But that number is likely much higher since service members often don’t report mild concussions or exposure to circumstances such as blasts that cause head injury, health officials believe. Often diagnosed side-by-side with traumatic brain injuries are mental health conditions such as depression, substance abuse and post-traumatic stress disorder. According to the CRS, 138,197 post-9/11 veterans have been diagnosed with PTSD alone. The challenge for researchers is developing new methods to detect brain injuries, understand their scope and treat them, and the VA, with its unique patient population, is poised to be a “national leader” in the field, according to McDonald, “Our vision is VA can, should and must be the national leaders. … We owe veterans more than ‘a couple of beers, a six pack or a Darvon’ to help with their pain,” McDonald said, quoting lyrics from the 1984 Jerry Jeff Walker song, “Rodeo Cowboy.” To ward off a future crisis similar to the scandals that rocked the VA in 2014, McDonald said, the department must solve the puzzle to help veterans now and as they age. “The cost of war endures far longer than the wars themselves. … What created the crisis at VA was not the wars in Afghanistan and Iraq. It was the aging of the Vietnam veteran. … We need the best estimates to secure resources and provide care. We need to do a really good job to forecast the challenges as we move forward,” McDonald said. VA spent $36,222,000 on research in 2014. McDonald said science is as important to VA health care as education and clinical care, the three pillars of the Veterans Health Administration. “We have an obligation to get this right, otherwise, there’s another axis problem lying in wait. Let’s not leave another unresolved problem as our legacy. … We owe it to all of our veterans,” he implored researchers.
Jeb Bush wins endorsement of 75 more military veterans (Fox News)
A 75-member group of military veterans, including Medal of Honor recipients and former Navy SEALs, will announce their endorsements of former Florida Gov. Jeb Bush for president at an event in the swing state of Colorado Tuesday. The endorsements constitute the largest group of military veteran supporters for any candidate in the 2016 election, according to the Bush campaign. “It’s an incredible honor to have the support of these heroic individuals.” Bush said in a statement to Fox News. “I am committed to a safe America through a strong military, and having a strong military includes having policies that will keep our country’s commitment to our veterans.” Bush’s so-called veterans coalition includes four members of Congress, eleven Medal of Honor recipients, and ten former Navy SEALs or Army Special Forces soldiers. At Tuesday’s town hall in Englewood, Colo., Bush is also set to announce more details about his plan to overhaul the Department of Veterans Affairs, which has been plagued by scandals and criticism over the last two years. “The entire system needs to be simplified, reformed and refocused on its most important mission—to ‘care for those who shall have borne the battle,” Bush wrote in a National Review editorial earlier this month. Recent polls of Republican primary voters have shown Bush coming in a distant second to billionaire businessman and reality TV star Donald Trump. In addition to veterans’ issues, the two contenders have sparred over immigration and other issues.
Academic accommodations can aid troubled veterans (Military.com)
Relocated to an empty clinic in the Phoenix Veterans Affairs Health Care System after going public about dangerous patient care problems, Dr. Katherine Mitchell needed a project to stay busy. With the rate of suicides increasing within the Phoenix system, she started studying victims’ case files and found a pattern that seemed tragically easy to address: Of four who reported struggling in college, three had not received widely available but little-known academic accommodations for mental health issues, such as post-traumatic stress disorder and traumatic brain injuries. The fourth was already failing before he received any information. “There’s a lot of myths and a hesitation to use academic accommodation because all the soldiers come from a very strong warrior background where asking for accommodation can be a sign of weakness,” she said. “It’s not a sign of weakness; it’s a strategy to use to make it through school.” From her research and collaboration with veterans, Mitchell has drafted a first: a veterans’ guide to reasonable academic accommodation for mental health issues, for use by doctors, VA caseworkers and veterans. With so many returning veterans of the Iraq and Afghanistan wars poised to begin using their GI Bill money for college, Mitchell hopes the next step will be for the VA and veterans service organizations to use the guidelines to educate veterans on their options and help them formulate academic plans. Academic accommodations are available for a range of disabilities. Students dealing with mental issues from post-traumatic stress and traumatic brain injuries commonly are given additional time to take tests, note-taking assistance, breaks during lectures and tutoring. Mitchell has submitted the guidelines to Federal Practitioner, a professional journal of the VA, the Department of Defense and U.S. Public Health Service health care workers. She said that there likely were a number of factors in the Phoenix suicides, but failure in college can compound problems associated with post-traumatic stress and depression. “Whenever you have academic failure, it helps snowball other stresses in your life,” she said.
Pentagon debunks DOD-VA interoperability myth (NextGov)
For years, the Pentagon and the Department of Veterans Affairs struggled to integrate their electronic health records systems, spending upward of a billion dollars on an effort that was ultimately scrapped, raising red flags in Congress and among government watchdogs. At one point in 2014, VA attempted to convince the Pentagon to use its proprietary VistA records system as a replacement for DOD’s aging legacy system, but that effort fizzled. Instead, the Pentagon bid out and awarded a massive contract valued at up to $9 billion to Leidos to upgrade its health records system. Much of the build-up during the bid time frame centered on the Pentagon’s wish for interoperability between health systems. Yet, Pentagon officials, briefing reporters July 30 before the Leidos award, contended that interoperability between VA and the Defense Department was actually far less of an issue than it was made out to be. “There is not a big interoperability problem with the VA and DOD today,” Frank Kendall, DOD undersecretary for acquisition, technology and logistics, told reporters. Kendall said it was a “misconception” DOD was buying commercial electronic health records software to solve interoperability. Chris Miller, program executive officer for DOD’s healthcare management systems modernization, was even more adamant about the two departments’ capability to share. DOD has continued its work on interoperability and standards with VA and the Office of the National Coordinator for Health IT, he said. Miller added that interoperability was an important requirement in the Defense Healthcare Management System Modernization award given how often DOD shares health records with VA and private providers. DOD and VA each have close to 10 million beneficiaries, on par with the largest private sector providers. “I offer this to anybody,” Miller said. “We share more information between DOD and VA than any two large health systems in the world. I can take any provider today, put them in front of a computer anywhere and I can pull up the entire longitudinal health record between [a DOD beneficiary] and a veteran. I’ve done this on the Hill, I’ve done this with a number of senior people in government because they don’t believe me.”
Veterans may face poorer oral, throat cancer outcomes (CancerTherapyAdvisor.com)
In veterans, oropharyngeal squamous cell carcinoma (SCC) is associated with traditional carcinogens and poor clinical outcomes, according to a study published in Head & Neck. Vlad C. Sandulache, M.D., Ph.D., from the Baylor College of Medicine in Houston, and colleagues evaluated patient, tumor, and treatment characteristics for 200 veterans treated for oropharyngeal SCC between 2000 and 2012. The researchers found that most patients (77 percent) were white and heavy smokers. During treatment, 27 patients required tracheostomy and 63 required gastrostomy placement. At five years, overall survival (OS) was 40 percent. Completion of a treatment regimen consistent with National Comprehensive Cancer Network guidelines was unattainable by almost 30 percent of patients. “Oropharyngeal SCC in veterans is associated with traditional carcinogens and poor clinical outcomes,” the authors write. “Careful consideration must be given to improving treatment paradigms for this cohort given their limited tolerance for treatment escalation.”
Alaska veterans say reformed VA hurting, not helping (The Washington Times)
A 2014 law to reform the Veterans Administration health care system has only made things worse in Alaska, according to veterans testifying Monday at a congressional listening session in Fairbanks.A group of about two dozen veterans at the Fairbanks North Star Borough Assembly chambers told David Shulkin, the third-in-command at the Veterans Administration, that the Veterans Choice Act hasn’t delivered the improved care that it promised. Last year’s law called for creation of a temporary program that allows veterans across the nation to seek treatment at clinics and hospitals outside of the VA system if they face waits of more than 30 days or live more than 40 miles away from a VA facility. But the frustrated veterans who testified said they’ve been met with denials of service, long delays for the VA to pay claims and confusing, automated telephone calls when they want answers. “I had surgery on March 23. I had a bill sitting on my desk for 90 grand up until August. You tell me what hospital is going to sit and wait for their money to be paid when services have been rendered?” said Darrell Walker, Alaska commander of the nonprofit organization Disabled American Veterans. “And then you call Choice (the Choice program) … every time you call you don’t get the same service center.”
Remains of 2 Arizona vets headed to Arlington National Cemetery (AZFamily.com)
Veterans from Arizona gathered in Mesa Monday morning to begin their journey to Arlington National Cemetery where they will deliver the cremated remains of two Arizona veterans. The bike ride is part of the Missing in America Project, a nationwide organization whose mission is to locate and identify war veterans and provide a final resting place in a military cemetery for those who have served our country. Clyde “Tex” Taylor, the project’s coordinator in Arizona, said the two from Arizona include a World War II veteran, Mildred Kennedy who served in the Navy, and Jim Fuller, who served in the Marine Corps in Vietnam. The group of about 20 motorcyclists and veterans are on their way to Limon, Colorado. The group has stops in St. Louis, Grayville, Illinois, and then Arlington, Virginia.