One more tragic and infuriating mistake of the Bush administration was to prosecute a war with no budget or plan for dealing with the returning soldiers who would be entitled to their Veteran's Administration (VA) benefits. There was little or no consideration or budgeting for the survivors of soldiers who were killed on duty and in combat. There was little or no consideration for the wounded soldiers who would need compensation, pensions and a lifetime of care.
Any soldier who serves honorably for 180 or more contiguous days in any branch of the US armed forces is a veteran. Also a soldier who incurs a service related condition or is killed while serving honorably before the 180 days is also a veteran. His or her dependents are entitled to survivor's benefits.
Soldiers who are discharged under less than honorable or "other" conditions are not entitled to Veteran's benefits. Such soldiers may be able to have their discharges investigated and appealed in order to restore their reputations and become eligible veterans. Many Vietnam era veterans underwent unfair and unlawful determinations and some have had their reputations restored, but only after persevering for years or decades. Many current veterans will engage in processes that may go on for decades.
There are new theaters of war that cause injuries that have not been seen before. From new forms of shrapnel, bullet, explosive force and concussive force, to new or rare diseases and disorders and mental illnesses, the unprecedented and extended combat of the past decade created a need for vast adjustments and improvements to the VA medical care and administrative systems. And those improvements are being made.
How civilian crime and risk taking has helped injured Veterans:
With the vast increase in injuries from thrill seeking stunts and activities that result in everything from concussions to muscular and bone damage comes new medical trauma, treatment, therapy and surgical processes. With the vast increase in drug and gang related shootings, some of which even involve stolen military grade weapons and bullets, has come vastly improved trauma, surgical, rehab and other treatments.
The VA is excellent at reviewing and adopting promising new treatments, procedures and appliances that come from the civilian sector, but with much more scrutiny and review of both efficacy and cost. This can result in delays in getting the latest and greatest, but ensures that all vets can get reliable, quality care and rehabilitation for traumas that are similar between combat, non combat and civilian activities.
How new military grade weapons, exotic locations and unique activities present new medical care challenges:
There are new forms of brain and tissue injury that come from concussive forces that send waves through brain matter and body tissues. There was previously no plan or program for treating these types of injury. There are also all forms of exposures to new toxins, and old, dormant bacteria and viruses when soil is blown up and stirred up in the heat of combat. Shrapnel that is specially designed to introduce more tissue damage, infection, poisons and difficult healing of wounds is another issue that was not foreseen in ways that could allow the VA medical system to prepare.
Problems with processing claims with the VA:
One myth is that, as soon as the wounded soldier is in a US facility, they are in the VA system. That is not true, the soldier spends a certain amount of time in the medical care system for their branch of the Armed services, until they are discharged from duty. Then the soldier must apply for service connected status and be accepted into the VA system of care.
This process can take a year, even for obvious cases of service connected injuries or conditions. The VA simply did and does not have sufficient trained staff to process the mass of applications and to get the wounded soldiers into the system. While any vet can get care at the VA, returning wounded combat soldiers can be placed in the lowest priority for medical care and can get not a penny of service connected compensation and pension for far too long.
The good news is that more staff has been hired. The bad news is that the required training can take a year. Thanks to the service organizations, such as AmVets and Veterans of Foreign Wars, many returning soldiers can get advocacy and aggressive help in getting their benefits. The VA also has excellent telephone benefits advisers as well as a comprehensive website for anyone who needs to get answers.
Another myth is that anything that injures an active duty soldier qualifies them for VA benefits. The term "service connected" does not apply, for example, to ski injuries while on vacation, risky or drunk driving while off duty, and other actions that are the fault of the soldier and that result in injury. This is a major issue for the VA when the cases are borderline, difficult to review and often impossible to make a determination for.
Another myth is that only combat soldiers are exposed to danger. For every combat solder, there may be 10 to 20 support soldiers who are exposed to toxins, poisons, fuels, explosives, heavy equipment and other serious work hazards, many of which have no civilian equivalents.
The final issue with processing claims with the VA involves medical problems that are not discovered until after the Veteran has left service. There are many horror stories of toxic exposures, malpractice cancers and other conditions that do not manifest until a year or more after the service connection is broken. It can be enormously difficult to prove that there ever was a service connection in many cases.
Improvements at the VA:
One thing that can be said for the VA is that, once a veteran is in the system, the system takes excellent care of the veteran for the most part. One major problem with the VA system of medical care was in the over centralization of major facilities. This meant that rural and distant veterans had to travel up to hundreds of miles for care.
Now, rural and distant veterans can get local care, with fewer long distance trips to centralized facilities. There is also better travel compensation that even pays for bridges and toll road fees.
A major overhaul in VA hospitals, clinics and even personnel has been going on for at least 10 years. Where receptionists could once be surly, rude and difficult, they are now the same as in private and civilian practices. There is excellent automation, where practitioners at any VA facility can get access to the full records of a Veteran. Construction has been booming, as clinics, hospitals, equipment and facilities have been upgraded, renovated, procured and built.
The VA works with local medical schools that provide the newest and brightest in medical fellows, residents and specialists as well as collaboration with medical scientists and even some very highly regarded civilian physicians and specialists.
Compensation and Pensions:
There have not been many changes to the basic structure of compensation and pensions (C&P). There are movements to improve the pay structures, which date back to the 1950s, but with no success.
Annual VA C&P increases are tied to Social Security pay increases. Social Security increases are tied to the Consumer Price Index. The major problem with this in 2010 is that the ENTIRE Index was used. This gave the impression that all prices had gone down, so there was no reason for a raise in either social security or VA pensions.
When the parts of the Consumer Price Index that are actually used by people on fixed incomes, such as gas, rental housing, food, cars, medical care and utilities, the costs had actually gone up! The same problem is expected for 2011: increased costs of essential goods and services, but overwhelming decreases in the price of luxury and non essential goods and services that leads to an overall decline in prices.
Overall: The Veterans Administration has done a massive and complex job and has done it well, given the unplanned and poorly led influx of wartime era combat and non combat veterans and their dependents who need to get into the system without any more excessive delays. But there are those in Congress who will let the VA and the veterans languish in order to further political goals, making it difficult to enact budgetary and other improvements to a system that is one of the hot button political issues of our times.