May 26 Veterans News

May 26 Veterans News

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VA restored benefits to 4,200 veterans wrongly declared dead (Military.com)
A Florida congressman says the Veterans Administration cut off the benefits of more 4,200 people nationwide after they were wrongly declared dead. Rep. David Jolly says these people were “very much alive” and their benefits were resumed after the VA looked into their cases, which happened between 2011 and 2015. The Florida Republican raised the issue with the VA in November on behalf of a group of veterans in the Tampa Bay area. He told The Associated Press early Wednesday that agency has since acknowledged mistakes in 4,200 cases in the previous five years, and that it has changed its protocols for confirming deaths. “We simply cannot have men and women who have sacrificed for this country see their rightful benefits wrongfully terminated because the VA mistakenly declares them dead,” Jolly wrote in a statement. Danny Pummill, the acting undersecretary for benefits at the VA, acknowledged mistakenly declaring the 4,200 veterans dead in a May 6 letter to Jolly. The agency’s computer systems don’t track the causes of each error, but Pummill wrote that they could have resulted from incorrect data provided by another agency, human error or computer issues. The VA tightened its protocols for confirming deaths in December. Now, when officials think a veteran is dead, the department will send a letter to his or her address and request confirmation of the death from a surviving family member, according to a Dec. 10 letter from the VA to Jolly’s office. If the VA doesn’t hear from the family — or from a veteran erroneously believed dead — only then will the department terminate payments, that letter said. The VA also verifies each beneficiary’s entitlement through an automated match with the Social Security Administration’s Death Master File. “It’s a problem that should have been addressed years ago, as it has caused needless hardships for thousands of people who had their benefits terminated and their world turned upside down,” said Jolly, who is running for the U.S. Senate.

Unqualified VA doctors performed 25K TBI exams (NWCN)
A nationwide investigation has exposed the Department of Veterans Affairs for using doctors who were not qualified to diagnose traumatic brain injuries. Now the VA is offering nearly 25,000 veterans, including some in Spokane, a chance to make it right. Records show many VA facilities failed to fully implement their own policy, denying thousands of veterans a fair chance at the right treatment and the right benefits. This decision to offer new brain scans to 25,000 veterans could lead to retroactive benefits dating back to 2007. Traumatic brain injuries can be difficult to recognize. So the VA’s own policy states only four types of highly-trained specialists are allowed to diagnose them. But it turns out, that is not always what happened. “We didn’t get it right the 1st time we need to get it right now,” said VA Deputy Undersecretary for Disability Assistance David McLenachen. This investigation started with KREM 2’s sister station, KARE 11 News, in Minneapolis, Minnesota, with documented cases of veterans who were not even diagnosed by medical doctors. The cases in Minnesota then prompted the VA to launch a nationwide review, now saying there are nearly 25,000 veterans who were seen by unqualified doctors at 40 different VA facilities in 25 states. This includes nearly two dozen patients seen at the Spokane VA Hospital. Department of Veterans Affairs leaders said they are still finalizing exactly how many individuals qualify for a new TBI scan. But a list shows there are at least 20 in Spokane, so far. “It was a systemic national problem that we’ve identified that we are working to fix now,” said McLenachen. “We’re going back and taking a look and providing them all an opportunity to have this. It’s the only fair and right thing to do.” The VA is now announcing plans to offer new TBI exams and reopen benefits claims for the 25,000 veterans. KREM 2 reached out to local VA officials Thursday. No one was available to talk. But KREM 2 will continue to track this for you, and will let you know as the situation develops. In the meantime, VA leaders said it will begin the process of notifying the affected veterans soon. It will send out letters, letting them know to come back in for diagnosis and possible treatment.

Study looks at veterans most at risk for suicide attempts (ABC News)
Suicide remains a substantial problem among veterans with rising rates in the past decade and higher rates than the general population, according to researchers. A new study, published today in the Journal of the American Medical Association Psychiatry, looks at a large group of veterans and active service members to help determine timing and other factors that put them at higher risk and ways to help combat the problem. “Deployment context is important in identifying SA [suicide attempt] risk among Army-enlisted soldiers,” the authors wrote in the study. “A life/career history perspective can assist in identifying high-risk segments of a population based on factors such as timing, environmental context and individual characteristics.” Researchers from several institutions including the Uniformed Services University of Health Sciences, Harvard Medical School, and the University of California-San Diego examined data from 163,178 enlisted soldiers. Of those, 9,650 had attempted suicide during the study period between 2004 to 2009. The authors found some surprising results including the fact that enlisted soldiers, who had never been deployed, accounted for 61.1 percent of the enlisted soldiers who attempted suicide. Among these soldiers, the risk for suicide attempt was highest when they reached their second month of service. Those who were deployed were at highest risk six months into deployment. For those who had previously deployed and returned home, five months after getting back home was their highest risk time. The most likely soldiers to attempt suicide were women, who had received a mental health diagnosis in the past month. Those who screen positive for depression or post-traumatic stress disorder (PTSD), were also at high risk for a suicide attempt if they had been deployed previously. Dr. David Rudd, a clinical psychologist focused on veteran issues and the President of the University of Memphis, told ABC News said the findings showed how soldiers often show signs of distress early into their service. “Individuals who have difficulty have it early in their service,” said Rudd. “It speaks to significant vulnerability when they come into service.” Rudd said the fact that suicides rates are at high levels even in people who have not seen combat suggests that officials should focus on improving screening measures before service to identify people unable to cope with the stressors of a military job. “It raises a tougher question,” Rudd said. “Are they really suited for military experience?” “We need better screening, the question is how do you do it effectively for numbers that large. Clearly self report screening is not doing that effectively.”

Groups oppose plan to steer more vets to private health care providers (Military.com)
Several of the country’s largest veterans’ service organizations say Sen. John McCain’s plan to reform VA health care has merit but aren’t on board with expanding a program to steer vets to private health care providers. Under the so-called Veterans Choice Program, those who live more than 40 miles from a VA facility or who face long wait times for care can go to community health care providers. While advocates see expanding the program as a way to provide veterans with more options, the groups — including The American Legion, the Veterans of Foreign Wars, the Disabled American Veterans and Paralyzed Veterans of America — say it would lead to a fraying and shrinking of an integrated managed care system they say serves veterans best. “The American Legion appreciates Senator McCain’s efforts to improve the provision of health care for America’s veterans. However, one of the central, core elements of the bill expands care in the community in a way that is concerning,” Lou Celli, veterans affairs and rehabilitation division director for the Legion, said Tuesday during a hearing of the Senate Veterans Affairs Committee. Celli said the Legion supported the Choice Program when it was proposed and passed but not as a broad replacement for VA health care. “Veterans should be provided with the option of receiving care in the community as a supplement to VA health care and not to supplant VA care,” he said. Celli also said Legion members surveying veterans’ care across the country since the program was passed in 2014 found that many ran into some of the same problems with private sector providers, including long wait times for appointments. He said the Legion would not support McCain’s bill. Some veterans groups offered qualified or partial support for the legislation. Carlos Fuentes, senior legislative associate for the VFW, had the same concerns about expanding the program to all enrolled veterans, warning it would result in veterans “receiving disparate and uncoordinated care” instead of the “integrated and managed health care” that medical researchers claim provides better outcomes. He urged the committee to amend the bill to ensure that program eligibility applies to veterans unable to be served at a VA facility by a clinically necessary date or when the distance to the facility makes a community option reasonable to the veteran and the provider. Fuentes said his group does support several other sections of McCain’s bill, including one requiring the VA to provide veterans access to private sector urgent care clinics; one authorizing some providers to practice telemedicine across state lines; and the extension of VA pharmacy operating hours, including authorizing VA to contract with health care providers, such as temps, to operate clinics on nights and weekends. Adrian Atizado, deputy national legislative director for the Disabled American Veterans, said his organization is on board with the provision expanding pharmacy hours, including bringing in temporary providers to staff the facilities. Beyond that, however, the organization will not endorse the legislation, he said. Atizado testified that McCain’s plan to allow all vets enrolled in VA health care to go to community providers “only addresses demand by expanding it into the private sector. The group, however, opposes any legislative proposal that would have the effect of privatizing VA health care and diminishing the VA health care system, he said. Similarly, Atizado said his organization cannot back the provision requiring VA to contract with a national chain of walk-in clinics to service veterans enrolled in VA health care. He said the legislation does not define a walk-in clinic — something the committee would have to clarify and spell out the costs and the implications for veterans. If by walk-in the legislation means “urgent care,” then Disabled American Veterans would support the intent of the bill, he said. But the group’s greatest concern with that provision is that it could lead to a fragmentation of veterans’ health care unless the services are coordinated with VA primary care providers. Carl Blake, associate executive director of government relations for Paralyzed Veterans of America, argued in his prepared testimony that a Choice program enabling countless number of veterans to go into the private sector would undermine the care that serves all veterans, in particular those who require specialized services.

Opinion: VA chief Robert McDonald is mired in denial (The Denver Post)
The Denver Post Editorial Board: Veterans Affairs Secretary Robert McDonald’s retreat this week from his foolish comparison between wait times at VA hospitals and waiting for a Disney ride was entirely predictable and would be forgettable too if it wasn’t typical of the secretary’s approach. But it is unfortunately all too typical. McDonald has repeatedly downplayed, dismissed or misrepresented the depth of problems at his agency and even the nature of the attempted fixes. And he has belittled critical reports as “recycled and embellished” even though the media highlighted scandals that otherwise would have failed to come to light. Just last month at a United Veterans Committee of Colorado banquet, McDonald suggested the VA had led the way in reforming “how we design, bid and construct facilities.” In fact, as members of Colorado’s congressional delegation were quick to point out, Congress “stripped the VA of construction authority” — in the words of U.S. Sen. Michael Bennet — because of incompetence. And as Rep. Mike Coffman noted, it was absurd for McDonald to suggest the waiting-list scandal that surfaced first in Phoenix was due to a lack of training, when it was so clearly rooted in outright corruption. Meanwhile, it isn’t clear that wait times in many places have improved despite VA claims. Just last week “PBS NewsHour” reported that the VA has botched the Veterans Choice program that Congress created in the wake of the wait-time scandal to give veterans an option in private practice. The punch line: “We found that some veterans are actually trying the Choice program, and then it takes so long that thousands and thousands of them are returning to the VA and just saying, well, the appointment I would get here would be faster. Overall, wait times at the VA are worse than they were when this program started.” And yet this week McDonald was at it again. “What really counts is how does the veteran feel about their encounter with the VA,” McDonald told reporters. “When you go to Disney, do they measure the number of hours you wait in line? Or what’s important? What’s important is what’s your satisfaction with the experience.” Besides trivializing delays in access to life-and-death health services by comparing them to lines, say, for Cinderella Castle, McDonald also happened to be spectacularly wrong. As Scott Shackford at Reason’s Hit & Run blog pointed out, “Disney has invested incredible sums of money in its efforts to reducing the amount of time people spend in lines and the friction caused by these waits” — from a FastPass to “micro-chipped wristbands designed to ease guests’ planning and wait times while in the park.” McDonald has been VA chief two years, and apparently has been co-opted utterly by the bureaucracy. His resignation should be the first one the next president accepts.

Phoenix VA blocks local doctor from giving lecture on marijuana study (KTAR)
A Phoenix doctor is conducting a study this summer focusing on how marijuana affects veterans with post-traumatic stress disorder. Dr. Sue Sisley wants to give a lecture on her cannabis study to medical staff at the Phoenix Veterans Affairs Medical Center. She said the hospital is blocking her from making a presentation, even though her study has been approved by the Food and Drug Administration. “The notion that the Phoenix VA hospital refuses to allow that information to be shared with their medical staff is really shameful,” Sisley said. She added if the VA medical staff gets the information, they could recommend vets that might be good fits for the study. “The highest density of veterans who meet those criteria are at the Phoenix VA hospital,” Sisley said. She said the VA has a duty to support science that might uncover new treatments for vets with PTSD. “If they refuse to do that, I think that is negligent and it’s an abomination,” Sisley said. Even though medical marijuana is legal in Arizona, it is still a federal crime to possess pot. Dr. Samuel Aguayo, associate chief of staff for research at the Phoenix VA medical center, said they are not permitted to promote or recruit veterans for marijuana research. “VA medical staff are not authorized to make a decision on whether marijuana and marijuana research is appropriate for veterans,” Aguayo said. Both houses of Congress passed legislation last week that would allow VA doctors to talk with veterans about medical marijuana as a treatment option. If that ends up being signed into law, Aguayo said they may reconsider allowing Sisley’s lecture at the VA. “We will examine what the law allows and doesn’t allow,” Aguayo said. “It may have an impact on our decision to permit this activity here at the Phoenix VA or not,” Aguayo said. Aguayo said until VA doctors are legally allowed to talk with patients about medical marijuana, having medical staff recommend vets for Sisley’s marijuana study would be inappropriate.

Combat dreams haunting veterans could be a new disorder (Huffington Post)
A 39-year-old man with no significant medical history sleepwalks, sleep-talks, and snores loudly.  He kicks and punches the air during the night — and sometimes hits at his wife, one time bruising her face. What’s the diagnosis? Wait, one more thing: all this started after he returned from a 12-month deployment during the Iraq War in 2007. Now, what’s the diagnosis? It’s not any sleep disorder that’s currently in the books, according to one military sleep doctor. Col. Vincent Mysliwiec, a sleep-medicine specialist for the U.S. Army, thinks that cases like the one described comprise a new syndrome, which he calls Trauma-Associated Sleep Disorder, or TSD. “This disorder has some similarities with both Post-Traumatic Stress Disorder (PTSD) and REM Behavior Disorder (RBD), in which people act out their dreams, but it does not respond to the characteristic treatment for either of those,” he told The Huffington Post. “Most importantly, it’s observed among young veterans who were deployed in active combat.” Mysliwiec, who is based at Brooke Army Medical Center in San Antonio, began observing hard-to-classify sleep disturbances among veterans returning from Operation Iraqi Freedom in Iraq and Operation Enduring Freedom in Afghanistan around 2008. He outlined the diagnostic criteria for TSD in a 2014 article in the Journal of Clinical Sleep Medicine. Most TSD sufferers don’t experience daytime symptoms, like flashbacks, which are a hallmark of PTSD. The drug Clonazepam, which treats PTSD, is ineffective on TSD symptoms. And unlike in RBD, the nightmares in this syndrome are usually replays of a traumatic combat experience, rather than generalized scary dreams. Mysliwiec hopes that if the American Academy of Sleep Medicine accepts this diagnosis, more resources can be directed towards its study and treatment. … Mysliwiec has observed about 20 cases firsthand so far, but he estimates there are thousands more who are undiagnosed nationwide. TSD sufferers have responded well to a drug called Prazosin, which treats hypertension. They have also seen improvements with cognitive behavioral therapy and sleep hygiene interventions, like instituting regular sleep and wake times. After combing through the historical record, Mysliwiec suspects that veterans he served in earlier wars had the same condition. “A Civil War veteran was observed to exhibit ‘dream-enacting behavior’ and scrounging for food in his sleep, and there are similar reports of sleepwalking among World War II veterans,” he said. If TSD is accepted as a standalone condition, its diagnosis would still be complicated. Veterans suffer from a host of sleep disorders, so it can be tough to disentangle the symptoms of one from the other. For instance, they’re four times as likely as other Americans to suffer from obstructive sleep apnea. Plus, many patients never realize they have TSD, since it happens during sleep, Mysliwiec said. Spouses have generated a lot of his referrals. So single veterans may never realize they have a problem. The study Mysliwiec conducted is also limited, with just four cases. “This report contains a case series of just four individuals, all of whom are men and all of whom are on the younger side,” said Dr. Raj Dasgupta, a USC professor and Fellow of the American Academy of Sleep Medicine. “We definitely need a broader study.” He pointed out that several of the patients in the cases were on prescription medications and one had a history of alcoholism — all of which complicates their diagnoses. Still, Dasgupta thinks that further study may confirm the idea of a veteran-specific sleep disorder. “We already know that war can literally change the brain, so I would not be surprised if active combat uniquely affects veterans’ sleep,” he said. Mysliwiec is grateful for the extent to which the military supports his research work, thanks to a renewed focus on sleep and wellness within the Army. Soldiers used to view sleep “the enemy of productivity, the enemy of vigilance, the enemy of being able to outlast our adversaries,” Maj. Gen. David Wilmot, the Deputy Surgeon General for Army National Guard told the National Sleep Foundation in 2014.

Study: Less than 10 percent of new VA hires were doctors (Fox News)
A newly released study hammered the Department of Veterans Affairs for spending a fraction of its budget on new doctors while devoting millions to lawyers and public affairs officials – as thousands of veterans were waiting for care. The study from OpentheBooks.com shows that between 2012 and 2015, just one in 11 new hires were “medical officers.” The findings are fueling criticism that the VA’s problems amount to more than just resources. “What’s clear is that money is not the issue – the culture is,” said John Cooper, press secretary for Concerned Veterans for America. OpentheBooks.com, a government watchdog group that publishes spending records from government agencies, found the VA added more than 39,000 positions (a 12.5 percent increase) between 2012 and 2015, while spending on annual salaries increased by 18.7 percent. The 3,591 medical officers hired amounted to less than 10 percent of the new positions. Much of the money that could have been directed to hiring new doctors – including $99.1 billion in salaries and bonuses – flowed to VA employees largely outside of the medical field. The report noted the VA hired 175 lawyers between 2012 and 2015, bringing the total number of lawyers to 1,060 at the cost of $454 million in salaries and bonuses. The VA also directed $99 million to salaries and bonuses for public relations officials, according to the report author. In addition, the report said the VA paid $1.7 million for surveys; $751.1 million for “household” and “office” furniture; and $303 million for non-essential positions such as painters, interior designers and gardeners. The group also found 19 percent of the employees – or 67,609 – were paid more than $100,000 per year, with the top echelon of salaries reaching $400,000. “It’s pretty difficult to argue the VA is suffering from a lack of resources when it spends money like this,” Cooper said. The report was released amid the latest controversy over the VA’s attitude toward its veterans. Secretary Robert McDonald earlier this week dismissed the extensive backlog in the system, saying veteran satisfaction, not wait time, should be the focus – and comparing the issue to lines at a Disney theme park. “When you go to Disney, do they measure the number of hours you wait in line? What’s important is what’s your satisfaction with the experience,” he said. McDonald’s remarks were “shockingly tone deaf” and “calloused,” Adam Andrzejewski, founder and CEO of OpenTheBooks.com, who authored the group’s report, wrote on Forbes.com. Lawmakers on Capitol Hill voiced similar outrage this week, though McDonald issued a statement saying: “On Monday, I made some remarks on how we’re working to improve Veterans’ satisfaction with the care they receive from VA. It was never my intention to suggest that I don’t take our mission of serving Veterans very seriously.” The VA scandal that was exposed two years ago concerned reports that veterans were dying while waiting for care, and that officials were covering up how long the wait-times really were. The latest report noted nearly 500,000 veterans still wait to see a VA doctor. But a separate report also found that VA doctors are not overworked or overbooked. The Independent Assessment of the Veterans Health Administration reported in September that VA doctors only consult with 10 to 12 veterans per day, which is just about half the number of patients private consultants see.

2 combat-amputee U.S. veterans summit Mount Everest (Time)
An Iraq veteran who summited Mount Everest on Tuesday was the second combat amputee in a week to climb the world’s highest mountain. Chad Jukes, 32, lost his leg in a roadside bomb while serving in the Army and climbed Everest wearing a prosthesis, USA Today reported. Thomas Charles “Charlie” Linville, 30, summited the mountain on Thursday. Linville, who had his right foot amputated, was the first combat-wounded veteran to reach the summit of Mount Everest, according to the Heroes Project, an organization that leads veterans and active service members on mountain expeditions. Jukes was part of a climbing group sponsored by U.S. Expeditions and Explorations, aiming to raise awareness about military suicides and post-traumatic stress disorder. His team also included two active-duty Army officers, Army Times reported. As the 2016 climbing season nears its end, climbers also suffered a deadly weekend on the summit as three people died, two went missing and about 30 become sick or contracted frostbite.

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