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Sun May 26, 2013
America's Vets: Returning Home To A Broken System
The Department of Veterans Affairs is being criticized for the shortfall in care for almost a million veterans who can't get timely compensation and have been waiting hundreds of days for help, often to no avail.
Frustration with the agency came to a head last Thursday when VA Secretary Eric Shinseki was called before a closed-door meeting of the House Appropriations Committee.
"We are aggressively executing a plan that we have put together to fix this decades-old problem and eliminate the backlog, as we have indicated, in 2015," Shinseki said after the meeting.
That's a long time for people in crisis to wait.
Coming Home Hurt
Glenn Smith, a 28-year-old Army veteran from St. Louis, joined the military in 2004.
"I joined because I loved tanks, believe it or not," Smith tells Jacki Lyden, host of weekends on All Things Considered.
Smith was deployed to Iraq twice between 2006 and 2010; he spent most of four years in combat. He now has an irregular heartbeat, and attributes it to one of the many IED blasts he went through. The irregular heartbeat, discovered during a routine training exercise, led to him being discharged last spring.
Smith described an anxiety attack in March in which "things just [closed] in" on him. It's even happened while he was driving.
"I didn't feel like I had any release or way to break free of it," he says. "I've had memories and nightmares of my experiences while I was in Iraq. Any all that just came rushing to the surface."
Smith also says he has a bad case of PTSD.
His PTSD has been so debilitating, he needs help navigating the VA. He submitted his initial claim about a year ago, but still lacks regular treatment for the disorder.
"Once I got back home to St. Louis, I've been trying to push with the VA here ... [and] trying to get my compensation and also trying to get therapy for my PTSD," he says. "Recently ... I was told my case wouldn't be looked at for another year or so because they're backlogged two years right now."
While he waits, Smith is patching together medical care for his PTSD. His heart condition is getting better, but he's in limbo, waiting for his benefits while he attempts to carry on.
"For the immediate horizon, I'm just trying to find a job so I can feel like I have a sense of moving forward and healing," he says. "And for the fall, I'm actually getting myself into college."
A Backlog Of Assistance
There are almost 900,000 VA benefits claims pending, says Quil Lawrence, NPR's veterans affairs correspondent. He tells Lyden that VA has set a goal that it should only take 125 days to process each claim.
"Currently, almost 600,000 of them are 125 days old or more," Lawrence says. "In some major cities, it's taking 300 days, even 600 days to get your claim taken care of."
The VA is updating its electronic medical software, and says delays are expected when moving from a paper system to one that is digital. But there is still the issue of moving medical information from military records to the VA's system.
"Despite a billion dollars that has been spent to get these two systems to unify, the Pentagon is still deciding to adopt the VA's software model," Lawrence says.
Tales of VA red tape range from the tragic to the comic, Lawrence says, citing one example where a double-amputee veteran was told his condition wasn't "chronic."
Criticism of VA secretary Shinseki's handling of the problem has come from both sides of the aisle, and some question whether his 2015 goal is even possible, Lawrence says.
"There's a strange conflict within the VA's mission," he says. "They're trying to get care to as many deserving veterans as possible, but the more successful they are at finding those veterans and signing them up, the bigger their backlog gets."
One of the people looking for those veterans is Tommy Sowers, the assistant secretary of public and intergovernmental affairs at the VA. He says the battle the agency is fighting is not an easy one.
"Some of the decisions here have been tough decisions, but right decisions," Sowers says.
He says the VA has expanded access to veterans related to Agent Orange, who have waited four decades for justice. The agency did the same thing for PTSD, he says, and expanded the number of people being treated for military sexual trauma.
"This is a challenge [and] we're making tough decisions that make it possible for more people to apply for and receive benefits," he says.
The agency is actively addressing the paperwork issue, Sowers says, and is in the process of implementing a paperless system this year. He stresses it is decades of paperwork that has piled up, and that they are essentially transitioning from a 19th century system to a 21st century system.
"Six months ago, only about 3 percent of our claims were electronic; today, nationwide that's about 18 percent," he says. "The backlog today is less than it was a year ago ... and in the past two months we've seen the backlog reduce by about 50,000 claims. We're all impatient and we're all driven to fix this."
In the meantime, Sowers says the VA does take care of emergency health care, and 56 percent of vets have used it.
JACKI LYDEN, HOST:
It's WEEKENDS on ALL THINGS CONSIDERED from NPR News. I'm Jacki Lyden.
The Veterans Administration finds itself drawing withering fire for the shortfall in care for almost a million veterans, veterans who can't get timely compensation, who've been waiting hundreds and hundreds of days for help, often to no avail.
Imagine a parade, not of bold uniforms and brass bands, but of the battered, battered by the great long grinding fatigue of these wars, people who are missing limbs, chronic conditions, PTSD so profound that normal life is only a dream, where suicide is common and where backlog is the norm. That's our cover story today: Veterans returning home to a broken system.
(SOUNDBITE OF MUSIC)
LYDEN: Last Thursday, frustration with the Veterans Administration came to a head. VA Secretary Eric Shinseki was called before a closed-door meeting of the House Appropriations Committee. After the meeting, he renewed a pledge to eliminate the claims problem by 2015.
SECRETARY ERIC SHINSEKI: We are aggressively executing a plan that we have put together to fix this decades-old problem and eliminate the backlog, as we have indicated, in 2015.
LYDEN: 2015 is a long time for people in crisis to wait.
GLENN SMITH: My name is Glenn Smith. I'm from St. Louis, Missouri. And I'm an Army veteran.
LYDEN: Glenn Smith is 28 years old now. He remembers when he first joined the Army.
SMITH: I was 19 years old when I first went to the Army recruiter back in 2004, and I joined because I love tanks, believe or not.
LYDEN: Smith was deployed to Iraq twice between 2006 and 2010. He spent most of four years in combat.
SMITH: I went through a lot of IED blasts. And I guess one of those IED blasts kind of gave me an irregular heartbeat. Since I've gone home, I've noticed that I really do have a bad case of posttraumatic stress disorder, PTSD. Back in March of this year, I had an experience, like a real bad anxiety attack where I was just - things were just like closing in on me and I had to - I didn't feel like I had any release. I didn't feel like I had any kind of way to break free of it.
I mean, I've had memories and nightmares of my experiences while I was in Iraq, and all that just came rushing to the surface. There were times I'd be driving down the road or I'd be with somebody and they're driving down the road and I get this flash of a bomb going off on the side of the road. And I usually have a panic attack shortly after that and just had to hold my head down, just calm myself down.
LYDEN: When that happens, Glenn Smith has to check himself into the VA emergency room. He's done that twice now. During a routine training exercise, they discovered a heart problem that led to his medical discharge in the spring of last year. Since then, his PTSD is so debilitating, he needs help navigating the VA. Almost a year ago, he submitted his initial claim. He still lacks regular treatment for his PTSD.
SMITH: Once I got back home to St. Louis, I've been trying to push with the VA here in St. Louis. I was trying to get my compensation and also trying to get therapy for my PTSD. My father has experienced dealing with the VA, and he was - he's been a major role in trying to help me get my compensation and get what I need to get done with the VA.
Recently, he went to the VA earlier this week, and I was told that my case wouldn't be looked at for, like, another year or so because they're backlogged two years right now.
QUIL LAWRENCE, BYLINE: The latest figures we have put it at about almost 900,000 claims pending.
LYDEN: That's NPR's veterans affairs correspondent Quil Lawrence. I asked him how the VA's approaching this seemingly insurmountable number.
LAWRENCE: The VA has set a goal that it should only take them 125 days to process each claim. Currently, almost 600,000 of them are 125 days old or more. So that's the backlog, all of those claims. In some major cities, it's taking 300 days, some it's even 600 days to get your claim taken care of. And this backlog has become pretty easy prey for critics. They talk specifically about a VA building in Winston-Salem, North Carolina, which may actually be sinking, structurally unsound because of all the paperwork stacked there.
LYDEN: Why hasn't the VA been able to solve this problem?
LAWRENCE: Well, they're updating their electronic medical software, and they are expecting delays as they go from a paper system to a digital system. But despite Congress making it a law that the Pentagon and the VA have to come up with a seamless electronic medical system that they can share so your health record in the military can just sort of bing, transfer into the VA database. And despite maybe a billion dollars that has been spent to get these two systems to unify, the Pentagon is still deciding whether to adopt the VA software model.
LYDEN: What are the dimensions of the problem when it comes to compromising the backlog - this backlog? How does it compromise vets? What do you hear when you talk to them?
LAWRENCE: Well, it goes from the tragic to the comic. I actually was speaking with a double amputee who lost both legs in Afghanistan. He actually laughed when he told me that the VA had informed him his condition was not chronic. And he sort of said, well, maybe they're going to grow back. That's an example of this sort of inane red tape errors that are driving vets crazy.
I've spoken with other vets who - more often their spouses actually who are trying to push this claim for them because they'll say, well, my Marine husband is waiting to get his claim for PTSD settled, and in the meantime he's tried suicide. And we're just waiting for it to happen again while the VA is still yet to say, you have PTSD from combat.
LYDEN: And the PTSD combined with depression combined with the wait, that certainly has to be one of the gravest dimensions of this problem.
LAWRENCE: Absolutely. Yeah. And many of these conditions make it hard to fill out forms. If you have a mild brain injury, then this sort of red tape that's put before you by the VA is even more maddening.
LYDEN: The military man in charge of this, Eric Shinseki, certainly widely respected, but he has come under a lot of criticism for failing to fix this. Have they given him a job that he's not suited to do? Has this reached a critical political turning point?
LAWRENCE: He may have already weathered the worst of what seemed like a real push for him to be replaced, but it isn't a totally partisan debate. There are people on either side from either party. Even some Democrats have publicly questioned whether his goal of ending this backlog in 2015 is possible.
LYDEN: How realistic is it from your reporting?
LAWRENCE: Well, Shinseki keeps saying it publicly, so he must think it's possible. There's kind of a strange conflict within the VA's mission. They're trying to get care to as many deserving veterans as possible. But the more successful they are at finding those veterans and getting them signed up, the bigger their backlog gets.
I was just up in Alaska with Dr. Tommy Sowers of the VA. He found veterans there at the edge of the earth - over the edge of North America anyhow who had never been in contact with the VA and was able to sign some of them up. The idea is that with more electronic capability and less and less paper coming in, at some point, the tide will turn. But some of the recent measures taken by the VA, like mandatory overtime or some other simple measures, people are wondering why they didn't do that a long time ago.
LYDEN: NPR veterans affairs correspondent Quil Lawrence. He spent time with Assistant Secretary of the VA Tommy Sowers. And we asked him about the conundrum he's in.
TOMMY SOWERS: Look, some of the decisions here have been tough decisions but right decisions. We've expanded access to veterans related to Agent Orange, and they have been waiting four decades really for justice. We did the same thing with posttraumatic stress. We've expanded the number of folks being treated for military sexual trauma. And so this is a challenge. We're making tough decisions that really allow more people to apply for and receive benefits.
LYDEN: And the paper issue that's gotten so much attention, Sowers says the administration is actively addressing it.
SOWERS: This is the year where we're implementing a paperless system. And again, this is decades of paper that has built up over time. And so we're transitioning from a 19th century system to a 21st century system.
And I was just in one of these regional offices and - where six months ago, only about 3 percent of our claims were electronic. Today, nationwide, that's 18 percent. And here in Montana that has adopted this system, it's up to 85 percent. So we've got to tackle this paper issue, and we're doing it this year.
The backlog is less today than it was a year ago. The overall pending number of claims is less today than it was a year ago. And in the last basically two months, we've seen the backlog reduced by about 50,000 claims. We're all impatient, and we're all driven to fix it.
LYDEN: In the meantime, the Assistant VA Secretary Tommy Sowers says the VA does take care of emergency health care and that 56 percent of all vets have used it.
Meanwhile, Army veteran Glenn Smith is patching together medical care for his PTSD. His heart condition is improving, but he's in limbo, waiting for his benefits while he attempts to carry on. I asked him what he thinks his future looks like.
SMITH: On the horizon - well, I'll tell you, for the immediate horizon just trying to find a job so I can feel like I have a sense of moving forward and healing. And for this fall, I'm actually getting myself into college.
LYDEN: But when Glenn Smith looks back on himself at 19, he wonders who he was.
SMITH: I think I was being naive. I really didn't think about it when I joined, but I really wasn't prepared for what I've seen and things I experienced.
LYDEN: Army veteran Glenn Smith served two tours in Iraq. He lives in St. Louis, and he's waiting for help. Transcript provided by NPR, Copyright NPR.