VFW Post 4252 NON-PROFIT ORGANIZATION 3190 North Carl G. Rose Highway U. S. POSTAGE Volume 19 Issue 3 Dulce et decorum est pro patria mori May - June 2017 PAID Hernando, FL 34462 HERNANDO, FLORIDA PERMIT #1 The Grapevine www.veteransgrapevine.com An Award Winning Nonprofit Publication Dedicated to the Heroes of America – Our Veterans and Their Families

Dr. David J. Shulkin sworn in as VA Secretary

Find the Devil – Root Cause Analysis

A closer look at the various causes that have influenced the care delivery and overall efficiency of the Veterans Health System can be summarized in the diagram below (Source: Inefficiencies in Veterans Health System: An Explorative Analysis, healthcarereformmagazine.com, 2014 article by Varun Bahl and J. P. Pattanaik).

Dr. Shulkin, it is time to fix the system!

The Grapevine

Managing Editor – John Stewart S. No Factors Impact Most of the causes which have a impacted Veterans Email: [email protected] 1 Man (Human Resources) High Health System do revolve around Methods and the Hu- 2 Machine (IT, Medical Equipments) Moderate man Resources. Inefficient methods and practices cou- Mailed to Veterans at Home Read Online by Veterans around the World 3 Money (Budget, Funding) Moderate pled with causes related to human resources have com- 4 Methods (Policy, Internal Process) High pletely derailed the Veterans Health System. However, Sponsored by Patriotic Private Citizens 5 Materials (Supplies) Low factors like age old IT systems (MACHINE), VA budget and Local Business Leaders 6 Facilities (Infrastructure) Moderate cut (MONEY) can not be ignored. from our Surrounding Communities

The United States Department of Veterans Affairs (VA) is a government-run military veteran benefit system with Cabinet-level sta- tus. It is the United States government’s fourth largest department, after the United States Department of Defense, the Department of www.veteransgrapevine.com Health and Human Services, and the Department of Education. With a total 2013 budget of about $78.4 billion, VA employs nearly 312,841 people at hundreds of Veterans Affairs medical facilities, clinics and benefits offices and is responsible for administering ...and his Hero programs for veterans, their families and survivors. They currently manage over 1700 healthcare facilities across the country.

A Hero Remembered Presumptive Conditions Veterans with PTSD in the Justice System sell's report, there was a 0% recidivism rate among Veterans who had completed the program. US Marine Corps First Lieutenant Wesley Lee Fox received the A "condition", in the language of the VA, is any disease, ill- In recent years, programs have been developed to avoid unnec- Veterans Justice Outreach Medal of Honor for his actions on February 22, 1969 as a twice ness or injury that occurs during active duty military service. essary incarceration of Veterans who have deployed to war and wounded and the only officer remaining to lead his company, he To be service connected and eligible for a disability subsequently developed mental health problems. The programs To provide direct services to justice-involved Veterans, whether refused medical treatment for his own injuries to supervise the compensation rating, the condition must be caused or contrib- aim to assist Veterans who become involved in the justice sys- or not they live in a community that has a Veterans Treatment preparation of his wounded men for evacuation. uted to by an event that occurred during service. If the condi- tem to get treatment for mental health problems that may exist. Court, VA has developed the Veterans Justice Outreach initia- tion existed prior to service, it must be shown to These programs are especially needed given the numbers of tive (VJO). VA is committed to the principle that when mental Then 1st Lt. Fox was have been aggravated (made worse) by military service. Veterans returning from Afghanistan and Iraq. illness plays a role in non-violent crimes committed by Veter- assigned to Company A, ans, both the Veteran and the community are better served by 1st Battalion, 9th Ma- To achieve a disability compensation rating, the veteran must Veterans Treatment Court treating the Veteran's mental illness rather than incarcerating rines, 3d Marine Division prove that he or she had appropriate military service, that an him or her (5-6). Under VJO, each VA Medical Center has a during the Vietnam War. event that caused the claimed condition occurred In 2008 the Center for Mental Health Service of the US Sub- designated justice outreach specialist. VJO specialists function A veteran of combat in and that a medically diagnosed condition that is disabling stance Abuse and Mental Health Services Administration as a link between VA, Veterans, and the local justice system. Korea and Vietnam, he exists today. (SAMHSA) convened a conference with the goal of looking at They serve both incarcerated Veterans and justice-involved Vet- held every Marine Corps ways to decrease the involvement of Veterans with the justice erans who have not been incarcerated. enlisted rank except Ser- The regulations that govern presumptive conditions only system and to provide them with mental health treatment. The geant Major and every eliminate the requirement to prove that an event caused the conference was attended by representatives from law enforce- VJO staff work with the courts to help eligible justice-involved officer rank except Gen- condition. For example, a Vietnam veteran does not have ment, corrections, the courts, community organizations, Federal Veterans get mental health assessment, treatment planning, and eral. He is one of 75 liv- to prove that agent orange caused the diabetes he has today. It agencies, and Veterans' health and advocacy organizations. Out referrals to VA services. Specialists communicate with officers ing Medal of Honor re- is presumed that he was exposed to agent orange and also of this forum emerged recommendations for a Veterans Treat- of the court about Veterans' compliance with VA treatment pro- cipients. that agent orange is at the root of the diabetes. While agent ment Court (1). grams, and they may also assist in training law enforcement per- orange and the Vietnam veteran are the best known of all sonnel on issues such as PTSD or traumatic brain injury. During Operation Dewey presumptive conditions and ratings, atomic veterans, certain Veterans Treatment Courts are based on the Drug Court and Canyon in Quang Tri Korean veterans and other veterans may also be eligible for Mental Health Court models introduced in the 1990s (2). As in Conclusion Province, 1st Lt. Fox’s presumptive ratings of certain conditions. these models, the goal is to divert those with mental health is- company came under sues from the traditional justice system and to give them treat- Efforts such as Veterans Treatment Courts and the VA's Veter- intense fire from a large The regulations are complex. Some veterans who have a Vi- ment and tools for rehabilitation and readjustment. While each ans Justice Outreach initiative may prove helpful to Veterans and well concealed ene- etnam Service Medal aren't eligible for presumptive ratings Veterans Treatment Court is part of a community's justice sys- who become involved in the justice system. The goal of these my force. He maneuvered to a position from which he could assess because they didn't set their boots on the soil of the coun- tem, treatment courts often form partnerships with VA and with programs is to divert eligible Veterans from the traditional legal the situation and confer with his platoon leaders. As they departed try of Vietnam. Many Korean veterans don't realize that they Veterans' organizations. Since the first Veterans Treatment system and to make sure they get needed treatment and support. to execute the plan he had devised, the enemy attacked. First Lt. may be eligible for service connections due to exposure to the Court was established in 2008, the number of courts has been This is important for all Veterans, including those returning Fox was wounded, as were all of the other members of the com- herbicide agent orange. growing fast. By August, 2010, there were 41 Veterans Treat- from Iraq and Afghanistan, who may be in need of treatment for mand group except the executive officer. ment Courts in the United States (2). PTSD or other mental health problems. If you believe that you may be eligible for any presumptive First Lt. Fox continued to direct the activity of his company, ad- condition and rating, the best wayto find out is to file a VA How does a Veterans Treatment Court work? vancing through heavy enemy fire to personally neutralize one disability claim. The process of adjudication is the only sure enemy position and directing his company to destroy others. He way to know. One example of how a Veterans Treatment Court works is the moved through the hazardous area coordinating aircraft support court in Tulsa, OK (3). When a Veteran is arrested, police offic- with the activities of his men. When his executive officer was mor- ers ask whether the detainee is a Veteran. If so, the Veteran's tally wounded, 1st Lt. Fox reorganized the company and directed eligibility for Veterans Treatment Court and for VA benefits is the fire of his men as they hurled grenades against the enemy and determined. Only Veterans charged with non-violent crimes drove them into retreat. Wounded again in this final assault, he who are in need of mental health or substance abuse treatment refused medical attention, established a defensive posture and su- are eligible for treatment court. pervised the preparation of casualties for medical evacuation. His actions inspired his Marines to overcome the fierce enemy A Veteran's participation in treatment court is voluntary. Veter- resistance and destroy a large bunker complex. ans who choose to participate are assessed by a mental health professional, and their treatment needs are determined. Most He retired from the Marine Corps as a full colonel in September Veterans receive treatment through the Veterans Health Admin- 1993. But he continued to wear the uniform for eight more years as istration (VHA) network. While Veterans Treatment Court al- deputy commandant of cadets for the Virginia Tech Corps of Ca- lows the Veteran to remain in the community, a judge regularly dets in his home state. There, his used his experiences to inspire a checks on progress while the Veteran is in treatment. If the Vet- new generation of military officers, business and civic leaders. eran fails to meet the requirements of the program - for exam- ple, fails drug screens or disobeys court orders - the Court will impose sanctions which may include community service, fines, Corny Time jail time, or re-arrest back through the legal system.

Q: What do you get from a pampered cow? In 2008 the first Veterans Treatment Court was started in Buf- A: Spoiled milk. falo, NY. According to a report by its founder, Judge Robert Russell (4), the Buffalo program provides medical and mental Q: What did the grape say when it was stepped on? health treatment, training and job placement services, as well as A: Nothing, it just let out a little wine. housing, transportation and other supportive services. Veterans are also provided with mentors: other Veteran volunteers who I told my wife I was going to make a bike out of spaghetti. She provide further support for the program participants. Upon couldn't believe it when I rode pasta. completion of the Buffalo program, many participants have had their charges reduced or dismissed. At the time of Judge Rus-

Veterans groups warn against unlimited choice priorities for the department, one of which was to redesign the VA Publishes Final Regulation to Aid Veterans Roe, Wenstrup & Conaway Introduce Bill To for health care Veterans Choice Program into “Choice 2.0.” Exposed to Agent Orange in Korea Protect Veterans’ 2nd Amendment Rights. Passes House, Now Awaits Senate Approval By NIKKI WENTLING | The Choice program, which Congress created in 2014 and funded Will Provide Easier Path to Health Care and Benefits with $10 billion, is set to expire in August with about $1 billion Published: March 1, 2017 House Committee on Veterans’ Affairs Chairman Phil Roe, unspent. Shulkin is looking for Congress to eliminate the expira- Veterans exposed to herbicides while serving along the demili- tion date and reauthorize the program before he works to redesign M.D. (R-TN), along with Reps. Brad Wenstrup, DPM (R- WASHINGTON — Speaking to House and Senate veterans’ tarized zone (DMZ) in Korea will have an easier path to access OH) and Mike Conaway (R-TX), introduced the Veterans affairs committees, the American Legion and Veterans of For- it. quality health care and benefits under a Department of Veter- 2nd Amendment Protection Act. This bill would prohibit VA eign Wars on Wednesday warned against the Department of ans Affairs (VA) final regulation that will expand the dates from considering any beneficiary who is assisted by a fiduci- Veterans Affairs excessively outsourcing medical treatment to Duffy called on Congress to quickly work on a solution to the when illnesses caused by herbicide exposure can be presumed choice program, rather than “waiting until the 11th hour.” ary as “mentally defective” without a magistrate or judicial the private sector. to be related to Agent Orange. authority ruling that the beneficiary is a danger to themselves

Shulkin wants to do away with rules that stipulate veterans could or others. Charles Schmidt, national commander of the American Le- “VA’s primary mission is to be an advocate for Veterans,” gion, spoke out against “all-out privatization or any dissolu- only go outside of the VA for health care if they had to wait more said Secretary of Veterans Affairs Eric K. Shinseki “With this than 30 days for an appointment or live more than 40 miles driving “The freedoms granted by the Constitution should apply to tion of the VA system.” VFW National Commander Brian new regulation VA has cleared a path for more Veterans who all Americans—especially the men and women who have Duffy echoed that message later, saying veterans want to “fix distance from a VA facility. Some veterans and lawmakers have served in the demilitarized zone in Korea to receive access to criticized the 40-mile, 30-day rule for limiting veterans’ choices, been willing to risk their lives to protect those free- – not dismantle – the VA health care system.” our quality health care and disability benefits for exposure to doms,” said Roe. “This commonsense bill would ensure no and Shulkin called the program “extremely complex and bureau- Agent Orange.” cratic.” veteran or beneficiary is declared ‘mentally defective’ simp- Rep. Jack Bergman, R-Mich., asked whether American Le- ly because they utilize a fiduciary.” gion members would rather receive “quality health care or Under the final regulation published today in the Federal Reg- Shulkin has not released plans for which veterans would be al- health care from VA.” The phrasing prompted discussion from ister, VA will presume herbicide exposure for any Veteran who “For the men and women who have worn the uniform of this the crowd of a few hundred veterans. lowed to receive private-sector health care, or in what instances, served between April 1, 1968, and Aug. 31, 1971, in a unit but has said he wants a system with less “red tape.” country to be denied the very constitutional freedoms that determined by VA and the Department of Defense (DoD) to they fought for is unconscionable,” said Wenstrup. “The truth is, the two aren’t mutually exclusive,” answered The DAV, VFW and American Legion have said they want some have operated in an area in or near the Korean DMZ in which private options available to veterans, but not unlimited choice. Louis Celli, an American Legion director. “The VA trains herbicides were applied. “Veterans shouldn’t be forced to choose between utilizing some of the finest doctors in the country, and we want to make The organizations discussed other priorities with lawmakers, in- the resources they’ve earned at the VA and exercising their sure it retains the highest quality physicians. We’ll continue to Previously, VA recognized that Agent Orange exposure could Second Amendment rights. As a veteran myself, I am hon- be a partner with them.” cluding more gender-specific health care for women at VA facili- only be conceded to Veterans who served in certain units along ties, expanded benefits for caregivers and a modernization of the ored to work with my colleagues, Chairman Roe and Con- the Korean DMZ between April 1968 and July 1969. gressman Conaway, to ensure no veteran is denied their con- The comments followed a presentation from VA Secretary process that veterans use to appeal claims for disability and pen- sion compensation. stitutional rights due to bureaucratic overreach.” David Shulkin on Sunday in which he proposed removing In practical terms, eligible Veterans who have specific illnesses rules from the Veterans Choice program that limit the number VA presumes to be associated with herbicide exposure do not The three groups told lawmakers they have not met with President "All too often, government bureaucracies fail the heroic men of veterans allowed to seek non-VA care. have to prove an association between their illness and their and women who have fought for our freedom," said Cona- Donald Trump, though they have tried. The American Legion said military service. This “presumption” simplifies and speeds up it was anticipating a meeting. way. "In this case, the same department that was created to “The bottom line is, if you open up choice to anyone, and they the application process for benefits and ensures that Veterans help our veterans is taking away one of their most important can go anywhere, it will eventually drain resources from the receive the benefits they deserve. During his address Tuesday night, Trump promised to increase constitutional rights: the right to bear arms. I'm glad to have VA,” Disabled American Veterans Director Garry Augustine Chairman Roe and Congressman Wenstrup on board with said Tuesday. “The VA will eventually whither on the vine.” VA funding. VA encourages Veterans with covered service in Korea who this important legislation to ensure that no veteran is wrong- have medical conditions that may be related to Agent Orange ly denied their rights under the very Constitution they served The American Legion, VFW and Disabled American Veterans “Our veterans have delivered for this nation, and now we must to submit their applications for access to VA health care and deliver for them,” Trump said. to protect." were invited to present their legislative priorities to lawmakers compensation as soon as possible so the agency can begin pro- this week. Used with permission from Stars and Stripes. cessing their claims. Background: Under current practice, if a veteran or benefi- Visit their website at www.stripes.com ciary is appointed a fiduciary from the Department of Veter- Republicans on congressional veterans’ affairs committees Individuals can go to website http://www.vba.va.gov/bln/21/ ans Affairs (VA), they are labeled as mentally incompetent have said in recent months that they don’t want to privatize Editor’s Note: Following the U.S. Senate’s passage by unani- AO/claimherbicide.htm to get a more complete understanding in VA’s system, and the department automatically sends the the department. Sen. Thom Tillis, R-N.C., reiterated that mous consent the U.S. House of Representatives passed on April of how to file a claim for presumptive conditions related to veteran’s name to the Federal Bureau of Investigation’s Na- Wednesday. 5th legislation that extends the Veterans Choice Program (VCP) herbicide exposure, as well as what evidence is needed by VA tional Criminal Background Check System (NICS). Inclu- until the funding dedicated to the program is exhausted. The VCP to make a decision about disability compensation or survivors sion on the NICS list may prohibit the beneficiary from le- “We don’t want to privatize the VA, and I want to underscore is a critical program that increases access to care for millions of benefits. gally purchasing or owning a firearm. A beneficiary may that,” Tillis said. “Anyone here who tells you we’re intent on Veterans. Without this legislation, the ability to use VCP funding apply for relief from the firearms prohibitions included in privatizing the VA is not right.” would have ended abruptly on August 7th of this year. I do hope, Additional information about Agent Orange and VA’s services current policy, but that leaves a VA bureaucrat – not a mag- however, past problems with this program will be corrected. We for Veterans exposed to the chemical is available at istrate or other judicial authority – with the power to deter- At the end of Wednesday’s hearing, Sen. Jon Tester, D-Mont., will see. www.publichealth.va.gov/exposures/agentorange. mine whether or not relief is warranted. questioned whether that was true. The regulation is available on the Office of the Federal Regis- “Senator Tillis started out saying nobody wants to privatize ter website at http://www.ofr.gov/. stuff up here, but if you listen to some of the questions, it sounds like they want to privatize stuff up here,” Tester told the American Legion. “So, your input is critically, critically ID Statement: Grapevine important.” Volume 19 Issue 3 Come Join Us! May - June 2017

Bi-Monthly VFW Post 9877 meet- Shulkin also testified to the Senate Committee on Veterans’ rd Affairs last month that he would not let a privatization of the Sponsored in part by ings are held on the 3 VA occur “under my watch.” VFW Post 4252 Tuesday of each month 3190 Carl G. Rose Hwy at the Amherst Library. Speaking to the DAV on Sunday, Shulkin unveiled his 10 Hernando Florida 34442

VA Hospitals Still Struggling With Adding Staff my kids to see me like this; I don't want to put my kids VA Union Issues, Not Claims Backlog, Dominate failure to report information and no instance where infor- Despite Billions From Choice Act through this,' " she said. Debate at Hearing mation reported was inaccurate. Rather, the GAO found simp- ly that DVA failed to collect the data properly," Cox said. Before they get to work on reforming the U.S. Department of His VA records show Grijalva went to one last appointment at by Richard Sisk Veterans Affairs, Congress and the White House might want to the VA in San Diego, scheduled in December. His medication However, Republicans at the hearing cited a finding in the take a closer look at the last time they tried it — a $16 billion arrived just before his death. Around the time of his death, the The partisan lines were quickly drawn in the House last week GAO report that 346 VA employees in 2015 were authorized fix called the Veterans Choice and Accountability Act of 2014, VA was just beginning to implement the Veterans Choice Act. on the perennial issue of union business being conducted dur- to spend 100 percent of their work time on union activities. designed to get veterans medical care more quickly. San Diego seemed like a prime candidate to get extra staff. ing regular hours at the Department of Veterans Affairs. Some of those employees were nurses or other health care But the NPR and local member station analysis of the VA's Rep. Phil Roe, chairman of the House Veterans Affairs Com- providers, the Republicans said. NPR and local member stations have been following that mon- own data show that San Diego got far fewer new staff mem- mittee, spoke of the "frustration that I have" on hearing reports ey, including the $10 billion for vets to get care outside the VA bers than it requested, and also fewer than many other VA that a doctor making $212,000 at a VA facility in Los Angeles "I don't believe the average American would see this as rea- system. The Choice Act also channeled about $2.5 billion for centers that didn't have such bad wait times. and an emergency room doctor making $242,000 at a VA fa- sonable or as necessary," said Rep. Jodey Arrington, a Texas hiring more doctors, nurses and other medical staff at VA medi- cility in Chicago were spending 100 percent of their time on Republican and chairman of the Subcommittee on Economic cal centers. No logical staffing pattern union business. opportunity. "I believe the average American would be out- raged." The goal of the hiring money was to address a simple math The VA data show no logical pattern for distributing the "We certainly understand that there can be a union," said the problem. The number of veterans coming to the VA has shot up 12,000 doctors, nurses and other medical staff hired under the Tennessee Republican, but "how in the world do you explain Other Republicans cited a 2012 Office of Personnel Manage- in recent years, and the number of medical staff has not kept Choice Act. that to people?" ment report, which found that 250,000 VA employees spent pace. The idea was that more caregivers would cut wait times. about 1.1 million hours on union activities. But an investigation by NPR and local member stations found David Shulkin became head of the Veterans Health Admin- Roe said that the VA's budget has risen from $97 billion to that: the VA has about the same number of new hires as the VA istration after that law passed, but has been overseeing the $180 billion since 2009, and its workforce has grown from "Official time certainly is of benefit, but when it's used in ex- would have been projected to hire without the additional $2.5 reform since 2015. Last fall, he told NPR that the Choice hires 260,000 to 370,000 during the same period. The VA's prob- cess, it becomes abusive," said Rep. Mark Meadows, a North billion; the new hires weren't sent to VA hospitals with the long- were based on a survey of VA medical centers. lems are "not for lack of personnel, not for lack of money," he Carolina Republican and chairman of the Subcommittee on est wait times; and the VA medical centers that got new hires said. Government Operations. were not more likely to see improved wait times. "Our goal is to get [the medical centers] the health profession- als that they need. So that's the Choice money. We wanted Rep. Gerry Connolly, a Virginia Democrat, countered that un- Rep. Mark Takano, a California Democrat, agreed that "We San Diego's wait-time dilemma everybody to go out and execute on it, and to use that money ion employees at the VA doing business during regular hours, need to do a better job of accounting for official time," but as quickly as possible because we have a sense of crisis," said referred to as "official time," are vital to the mission of im- noted the relative silence of his Republican colleagues on San Diego's experience is typical. The Southern California city Shulkin, who has been nominated to become secretary of the proving care. He cited "the ability of unions to protect the President Donald Trump's federal hiring freeze that has left is home to one of the largest concentrations of post-9/11 veter- Department of Veterans Affairs. His confirmation hearing is whistleblowers who help prevent waste, fraud and abuse. the VA with 45,000 vacancies, according to Dr. David ans, and when the Veterans Choice Act passed, the San Diego expected this week. Sometimes, I think some of my colleagues forget that whistle- Shulkin, the new VA secretary. VA had some of the country's worst wait times for mental health blowers are federal employees." care in particular. The act was meant to help former soldiers like He also said the VA focused on places where the staff was Shulkin has said he would approve 37,000 exemptions to the Charlie Grijalva, who was diagnosed with PTSD when he was most needed. Thirty-three medical centers were "prioritized" The back and forth came at a joint hearing of two House Veter- hiring freeze for public safety or health reasons, but that still in the Army. among the VA's 168 hospitals. ans Affairs Subcommittees on a Government Accountability would still leave the Veterans Benefits Administration (VBA) Office report released last week, stating that the current VA with 763 positions which would not be exempted, Takano Back in 2014, Grijalva lived with his wife, Gloria, in Imperial But the VA data show that prioritized medical centers didn't systems cannot accurately track the amount of time employees said. Valley — about two hours from the VA hospital in San Diego. always get more resources than others. Los Angeles was prior- spend on union activities. After spending 18 months deployed in Afghanistan, and a year itized and got only about 108 new hires from the Choice mon- The VBA has a backlog of about 100,000 disability claims in Iraq, he started having suicidal thoughts. ey. Dallas, a similarly large center, got almost three times as According to the GAO report, the VA uses two timekeeping cases and another backlog of more than 400,000 disability many (298), even though Dallas was not "prioritized" and systems -- a legacy system, called the Enhanced Time and At- claims cases on appeal, Takano said. Lifting the hiring freeze The VA tried to help him. Early in 2014, the doctors there didn't have particularly bad wait times. tendance System (ETA), which remains in effect at some facil- at the VBA would "help our veterans get benefits faster. Our seemed to get his prescription right. By summer, his psychiatrist ities during a changeover to the VA Time and Attendance Sys- veterans are being hurt because those jobs aren't being filled." had left the VA, but Grijalva was transferred to a nurse practi- Albuquerque, N.M., and Cincinnati have about the same vol- tem (VATAS). tioner. He missed an appointment in September 2014, according ume of appointments. But Albuquerque had among the worst (Source: www.military.com) to records provided by the VA, but the new provider agreed to wait times in the country for mental health, while Cincinnati The former does not have codes for employees and supervisors refill his prescription over the phone. was among the best. The VA's data show both received the to record the local use of official time for union work but the same number of psychiatrists from the Choice money. latter does, the GAO said. Because San Diego's wait times were so long, under the new Choice program, Grijalva qualified to see a private doctor out- Wait times across the board have not come down, though the "As of September 2016, approximately 50 percent of VA facil- side the VA system. He had an initial consultation with the pri- VA says that's because of a continuing surge in demand from ities and about one-third of VA employees (120,000) had tran- vate psychiatrist near his home, but he didn't live to begin treat- patients. And Shulkin stressed that wait times are not the most sitioned to VATAS, with its official time-recording capabili- ment. In December 2014, his medication ran out. important measure of health care. He says efficiency is up and ties. The full VATAS multi-facility rollout is scheduled to be the number of veterans waiting for urgent care has shrunk completed by July 2018," the GAO said. Grijalva had a young family and a new baby on the way. His from tens of thousands to a mere dozen or two. Still, it was the wife said he insisted on giving his kids a magical Christmas. long wait times — and the harm they did to veterans — that In his prepared statement for the hearing, J. David Cox, Na- "He said, you know, 'I want to do what I did as a kid,'" Gloria drove Congress to pass the Choice Act. tional President of the American Federation of Government Grijalva said. "Play some Christmas music. Have the kids deco- Employees, AFL-CIO, said the GAO report "found time and rate the tree, drink hot chocolate. ... Even though he was feeling Slow hiring in a tough market again that elected employee representatives who worked with the way he was, he wanted to have that kind of Christmas for his VA managers on workplace and patient issues brought value kids." Doctors and nurses are scarce nationwide. In the economic because of the deep commitment to veterans care that AFGE Call The VA centers where many vets live, medical professionals often find shares with [the Department of Veterans Affairs.]" It wasn't to be. A few days before Christmas, his wife found better offers at private hospitals. And in rural or remote areas, Benefits: 1-800-827-1000 him. He had hanged himself a few hours after he texted her, "I there often are very few doctors or nurses available to work at "It must be emphasized that nowhere in the GAO report is Health Care: 1-877-222-VETS (8387) love you." either VA or private hospitals. there any suggestion or allegation of union wrongdoing with VA Inspector General: 1-800-488-8244 regard to the use of official time in DVA. GAO found no union Veterans Crisis Line: 1-800-273-8255 Press 1 "He has told me when he was at his lowest that [he] 'didn't want (continued on next page)

(continued from previous page) hiring we were doing," Shulkin told NPR in December. VA Changes Gulf War Veterans Need To Know Your disability appeared either during service in SW Shulkin knows that his hiring process is cumbersome. This sort of budgeting strategy is common in Washington, ac- Asia or before December 31, 2021, to a degree that is cording to Phil Carter, of the Center for New American Security. There have been some changes to the eligibility and claims at least 10% disabling; and "The complexity of hiring puts us at a disadvantage with the "It makes complete sense for a self-interested bureaucracy to hire period for Gulf War Veterans concerning presumptive illness- The illness is classified as either an undiagnosed ill private sector. We are very fortunate that people wait and turn with that money first. I think VA hired staff with this money will es. Because of the mystery of the illnesses Gulf War Veterans ness; diagnosable functional gastrointestinal disorder; down private sector jobs because this is where they want to all intention of improving access and quality. I think the VA lead- have experienced, the rules seem to be ever changing, and we diagnosable chronic fatigue syndrome; or diagnosable work and this is the mission ... but frankly we have to be com- ership found it harder to do that," he said. expect that to possibly continue into the future. Studies on the fibromyalgia. petitive," he told NPR last fall. illnesses many Gulf War Veterans experienced continue to be Carter says that the VA has a difficult time projecting what needs conducted to find causes, treatment, and But for now, here are You may also need either medical evidence or nonmedical Shulkin came to the VA from the private sector, he said, to it will have across a system of 168 hospitals nationwide, and that the changes that Veterans should know about when it comes indications such as verification of lost time from work; chang- get the department in step with best practices. He has succeed- the VA may just have been hiring at its maximum capacity in a to filing for a Gulf War related presumptive illness. es in appearance and/or behaviors; changes in physical abili- ed in getting some salaries up to private-sector levels. But the tough market. ties; and/or changes in mental or emotional attitudes or capaci- roughly $2.5 billion from the Choice Act resulted in a net gain Change in Eligibility: ties. A C&P Exam may be required to verify medical condi- of only a few thousand doctors and nurses, across a system "But I don't see malice here, just the basic inefficacy of American tions. that serves about 9 million veterans. bureaucracy," Carter said. Eligibility rules have changed recently as to who qualifies as a Gulf War Veteran. The definition of Southwest Asia theater And the GOOD NEWS is: The Time Period to File Claims That's partly because the VA's process is so slow that about But some Republicans in Congress do see something more mali- of Military Operations no longer includes Afghanistan. The has been Extended 13 percent of candidates drop out during the months-long lag cious — a shell game to free up money from congressional re- areas included in the definition are: time after they are hired. NPR and local member stations strictions. In December 2016; it was announced that the time to file for spoke with more than half a dozen current VA employees Iraq; presumptive illness claims was extended by 5 years un- about this problem, but none agreed to be quoted. Almetta A spokesman for the House Committee on Veterans Affairs said: Kuwait; til December 31, 2021; extending the original time period from Pitts is a former VA employee who used to work at the VA in "It was a money grab, with no plan on where to put people and Saudi Arabia; December 31, 2016. This extension was based on studies con- Seattle. Waiting to start that job nearly left her broke. VA used the funds to fill existing vacancies for the most part." The neutral zone between Iraq and Saudi Arabia; ducted that showed that many presumptive illnesses may take "It took about six months. And so I had to think about ways to Bahrain; much longer to manifest than original thought. Another factor just put my money together to be able to really be able to pur- (Source: This story is part of a project called "Back at Base," in Qatar; is that the Gulf War has not officially ended, so extending the sue this job," she said. which NPR — along with public radio stations around the coun- The United Arab Emirates (U.A.E.); date was imperative for those who are still serving in the thea- try — is chronicling the lives of America's troops where they Oman; ter of operations. Several past extensions have already been Pitts liked the VA. She interned at the VA in Seattle while live. A live broadcast by STEVE WALSH, KPBS: PATRICIA Gulf of Aden; passed; possibly more will be passed in the future if our mili- pursuing her master's in social work. Her mother, an Army MURPHY, KUOW; STEPHAN BISAHA; and QUIL LAW- Gulf of Oman; tary personnel continue to serve in theater. vet, was already working there as a federal police officer. Af- RENCE on their Jan 31st Morning Edition discussed this subject. Waters of the Persian gulf, the Arabian Sea, and the ter a series of interviews, Pitts was notified she had been NPR's Juan Elosua contributed to this story.. You can find NPR Red Sea; and What Does this Mean for Veterans? hired. online at www.npr.org). The airspace above these locations. If a Veteran has any conditions that fall under the category of a "I received my acceptance letter and it did inform me that I While Veterans of service in Afghanistan are still eligible for qualifying chronic illness, including those undiagnosed illness- started that September and I was like 'Oh my gosh, I'm so certain infectious diseases associated with the SW Asia thea- es such as fatigue, unexplained rashes, headaches, cognitive excited,' but ... 'Wow, it's like May.' " ter, a recent Court of Appeals for Veterans Claims decision issues, muscle and/or joint pain or other multi-symptom ill- has affirmed that Afghanistan is not considered part of the nesses; and certain infectious diseases, your time to file a During the four months of waiting, Pitts moved back in with SW Asia theater when considering presumptive illnesses claim has been extended by another 5 years. This extension her mom to save money until the job started. She ended up (see CAVC decision). It is noted on the VA website that ser- means many Veterans who may not have realized they are working for the VA for 13 months and was laid off. At the vice in Afghanistan on or after September 19, 2001, is consid- eligible for benefits can now apply before the new deadline is time, Human Resources offered to help find another job at a ered qualifying service for disability benefits associated with reached or those who have not started to experience symptoms VA out of state. She loved her work helping traumatized vet- “certain” presumptive diseases; but may after the original deadline, will now be eligible to erans, but Pitts decided she had to move on. apply for benefits. Brucellosis; Budget shuffling Campylobacter jejuni; Coxiella Burnetii (Q Fever); Another reason the $2.5 billion bump didn't seem to raise the Malaria; VA's staffing levels may have more to do with Washington Mycobacterium tuberculosis; bureaucracy than health care. Nontyphoid Salmonella; Shigella; NPR found that the rate of increase in VA staff after the Visceral leishmaniasis; and Choice money was not noticeably different than past years West Nile virus. without it. Check with your local VA representative to review your spe- The Choice hiring money from Congress mostly replaced, cific issues and ensure that you qualify before you file your instead of augmented the VA's normal hiring budget, which claim to ensure you do not experience undue delays in the freed up less restricted money to take care of other needs. claim process. Shulkin defends how the money was spent. Other eligibility requirements to file for Gulf War associated A recent study has found that women who carry a little extra presumptive illnesses are: "When you're given a budget you face a number of new weight live longer than the men who mention it. stresses on those resources. You have increases in pharmaceu- ticals, you have your wage increase, you have your leasing Are an eligible Veteran; I have never understood why women love cats. Cats are inde- cost increases, you have IT increases. So without the Choice It’s True Served in the SW Asia theater of operations between pendent, they don't listen, they don't come in when you call, August 2, 1990, to present; money, we would not have been able to have maintained the Why are there millions of sperm and only one egg? they like to stay out all night, and when they're home they like There is no other cause of your disability or illness type of hiring that we were doing and expanded the type of to be left alone and sleep. In other words, every quality that other than service in the SW Asia theater; Because men never ask for directions! women hate in a man, they love in a cat. Your disability has existed for 6 months or more;

Marine vet volunteers as medic in Mosul cam- The nightmare is far from over. The volunteer medics are plan- paign ning for more work when Iraqi forces cross the Tigris River to Outstanding Citizens Supporting Us With Their Donations liberate the western part of Mosul. By SETH ROBSON Jessie Minnis In Memory of Maj. Ahmed Hussein, an Iraqi special forces officer who over- Dr Jeremiah Hubbard The Late John Hurst MOSUL, Iraq — A “marathon mass casualty” is how Ameri- sees the aid station where the volunteers work, said as many as Amherst, Virginia In Memory of Family Heroes Morrell B. Shorter Amherst, VA Amherst, Virginia can volunteer Pete Reed sums up his work providing medical 100 civilians have been treated there daily during the offensive. care to Iraqi soldiers and civilians in this city. “We receive a lot of women and children with injuries because CMSgt (ret) John Stewart Jack Cunningham Beverly Hills, FL Frank W. Bartram they’re targeted when they try to escape. They shoot them in the Beacon Investigations Dr. Chase back as they run, especially the women,” Hussein said. Forest, VA Madison Heights, VA Reed, 27 of Bordentown, N.J., did two Afghan tours as a non- In Memory of John Hurst commissioned officer in the Marine Corps from 2007 to 2011 CMSgt (ret) Woody Morcom, Jr. Amherst, VA before a four-year stint as an emergency medical technician. Islamic State’s latest tactic is to drop grenades from drones on Madison Heights, VA Mrs. Elsie Morra Ira M. Anderson He’s been in Iraq since 2015. fleeing civilians, he said. Monroe, VA Monroe, VA Sherri Torode In Memory of On Saturday Reed smoked a cigarette amid mortar blast cra- Hussein praised the work of the foreign volunteers and U.S. Frank Turner ters behind a field clinic in Mosul’s battle-scarred Al Karama Special Forces trainers teaching first aid to Iraqi troops. Gary M. Taylor of Edward Jones Your Name or Belongs Here! Amherst, VA neighborhood. His clothes were flecked with the blood of a Amherst, VA child he had tried, in vain, to save. The Iraqi medics will treat anyone, even injured enemy fighters, but they don’t trust the locals, he said.

To Our Readers: If you are not presently a booster and would like to join this The burly former ski instructor estimates he and his small elite Post list of people who care about veterans, email me at team of foreign volunteers have treated 1,500 wounded since “I’m coming here to help these people, but when I was here in Those of you choosing to support our veterans are patriots 2014, I couldn’t leave my base in uniform because there were [email protected], or mail your donation to: the battle to free Mosul began in October. and I wanted to thank you for helping us. If you are also in- many people working with al-Qaida. Now I don’t trust anyone,” terested in helping us with publication costs of this paper and Norman L. Ryan Each day the volunteers treat 50 to 60 patients. The patients’ he said. maintaining our website you now have a wonderful oppor- Quartermaster, VFW Post 9877 injuries range from bullet and shrapnel wounds to amputations Used with permission from Stars and Stripes. tunity to do so. Send a donation and it will appear here in 132 Wedgewood Place and “the worst things imaginable,” Reed said. Visit their website at www.stripes.com Grapevine issues for one year. We ask for at least a donation Madison Heights, VA 24572 of $20 for the one year period. You may submit the donation Donations are exempt from Federal income tax as described in “I’ve dealt with a lot of messed-up kids and put a lot of people in memory of a loved one who served our country, yourself, a section 501(c)(19) of the Internal Revenue Code and as such in body bags — young, old, women, Sunni, Shia,” he said. Smarty Pants friend, anonymously, or anyone you wish. donors may deduct contributions as provided in section 170 of Marine Corps training prepared him to fight, deal with a few A new college graduate gets his first job in a hardware store.

the Code. injured people and treat his buddies and himself, he said. Your contribution will help us offset the significant costs of When he asks his boss what task he is assigned to, the man tells “I don’t think there is any training in the world that can train printing and mailing the Grapevine. Any excess funds will be him to begin by sweeping the aisles. THANK YOU FOR SUPPORTING OUR VETERANS!!! you to treat three-month’s worth of mass casualties. It’s a mar- used by Post accounts established to help our veterans. The athon mass casualty. It is just this endless cycle of pain and "But I'm a college graduate," replies the young man. more contributions we receive, the better quality of the violence and death,” he said. Grapevine and the more information we can provide to you. "Oh," says the boss, "In that case, let me show you how it's Reed came to Iraq with the goal of fighting the Islamic State done! but ended up training Kurdish peshmerga fighters and working as a medic with Iraqi special operations forces.

“My family thought I was nuts at first. They didn’t understand. AMHERST INSURANCE AGENCY, INC. They have always been positive, but they just weren’t sure what I was doing over here,” he said.

Half of the patients Reed treats are soldiers and half are civil- ians. The things he’s seen have left a mark. 5033 S. Amherst Highway Tel: 434-845-3446 His most recent memory is of four boys, ages 10 to 13, who PO Box 688 Fax: 434-847-7518 were playing soccer last week when one kicked an improvised Madison Heights, VA 24572 explosive device. The boy with the most serious injuries had an amputated leg and burns all over his body. [email protected]

“There were fist-sized holes in his abdomen and huge frag- mentation in his thorax and entry wounds from shrapnel be- hind his ear. There was less bleeding than you would imagine because the heat cauterized the wounds,” he said.

The medics stabilized the boy as best they could, and he made it to another aid station before dying. His friend, whose intes- tines hung out of a hole in his stomach after the blast, sur- vived, he said.

“The only way you could see this in an emergency room in the States would be if a propane tank factory exploded,” Reed said. “I’m resilient, but there is no way anyone could make it through this without some emotional impact.”

2 vets win Agent Orange exposure cases from benefits related to Agent Orange exposure on Okinawa. Okinawa An unnamed aircraft crew chief who served at Air Force bases (continued from previous page) chromium have also been discovered on reverted land near Camp Lester. on Okinawa and Moses Lake, Wash., in the mid- to late-1950s By MATTHEW M. BURKE AND CHIYOMI SUMIDA was granted disability after alleging a service connection to his ever actually stored, used, tested, and/or transported in Okina- prostate cancer, which is associated with herbicides like Agent wa, Japan.” In 2015 and again last year, habu snakes captured adjacent to CAMP FOSTER, Okinawa — There have long been rumors Orange. Camp Kinser tested positive for toxic substances. Checkered past that Agent Orange was stored or used on Okinawa, but no one has been able to find proof. The veteran said he was exposed to 2,4-D and 2,4,5-T — later Early last year, local officials announced that high levels of the known as Agent Orange — JP-4 jet fuel, benzene and other Okinawa has a checkered history regarding U.S. military hazardous organic compound perfluorooctane sulfonate were Now two servicemembers who served on the Japanese island chemicals while working on the flight lines for hours at a time chemical storage and contamination. detected in streams running through Kadena Air Base and in adjacent groundwater wells. Air Force officials later admitted during the Vietnam War era have won court cases claiming with no protection. they developed ailments from exposure to the toxic defoliant. A 1993 U.S. government position paper provided to Stars and the use of a banned firefighting foam that contains the com- Judges in the separate lawsuits cited specific diseases that The veteran said the chemicals were used to control vegetation Stripes by the Japan Times described how large amounts of pound. have been linked to Agent Orange and a lack of proof that the on flight lines, runways and around “structures” on Okinawa. hazardous chemicals and waste coming back from Vietnam were stacked in barrels at U.S. bases on the island. They in- Japanese officials maintained there was no cause for alarm. chemical compound wasn’t on Okinawa, based on a two-year “The Veteran explained that, approximately 15 to 16 times a day gap in records and other evidence. for 18 months, he regularly inhaled and ingested 2,4-D; and cluded insect, rodent and plant killers; acids; alkalis; degreas- 2,4,5-T, and dioxin-treated dirt that covered his skin. He was ers; and solvents. “We have been conducting environmental surveys every year The judges were careful to limit their rulings to the specific exposed, inhaled, ingested, and absorbed 2,4-D; and 2,4,5-T, and since 1970s by taking samples of water, bottom sediments and The barrels, which appear to number in the thousands, accord- fish in rivers and ocean in the vicinity of [the] military bases,” cases, likely to avoid opening the door for hundreds of former dioxin-treated dirt about 5,850 to 6,000 times while at Naha Air servicemembers to seek class-action status for physical prob- Force Base in Okinawa,” according to the Oct. 8, 2015, decision ing to photographs from the time, were exposed to the ele- said Satoru Matsuda, former director of the Okinawan prefectur- lems that may be linked to Agent Orange. by Veterans Law Judge Mark Hindin after an appeal from a re- ments for long periods and leaked into the soil, which then al task force investigating pollution claims. “No abnormal gional office in Oakland, Calif. seeped into the sea, the paper said. counts have been detected that lead us to assume that environ- mental contamination is flowing out from military bases.” Pentagon officials referred requests for comment to the De- partment of Veterans Affairs, which declined to answer ques- The veteran provided newspaper articles, testimony and family Cleanup efforts were launched in 1973 and continued through- tions or discuss how many similar cases there have been in research to back his claim. out the years. Nearly 30,000 pounds of highly toxic ferric Vindication? chloride was buried across from the Camp Kinser theater. Pes- recent years. ticides were repackaged and buried in a landfill. Some were With further land givebacks on the horizon, at Camp Kinser and “Given this evidence, the Board accepts that the Veteran was Each case is heard on its own merits, the agency said in a exposed to 2,4-D and 2,4,5-T and other chemicals during his neutralized and flushed away, and in some cases Mother Na- Marine Corps Air Station Futenma, Japanese officials worry statement to Stars and Stripes. active service while in Okinawa,” Hindin’s decision said. ture was left to her own devices to expel the toxins. about pollution that might be lurking below the surface.

But the ruling included a caveat: In 1974, dead fish were reported directly offshore from Camp “When polluted land is returned, it is a huge obstacle for rede- “VA can grant a claim and award disability compensation if there is evidence of a current disability, an in-service expo- “While the Veteran was not exposed to Agent Orange per se, the Kinser. They showed up on the base shoreline in early 1975, velopment, as we’ve seen in Chatan, Okinawa City and Onna,” sure, and a medical nexus or link between the in-service expo- evidence is in equipoise as to whether he was exposed to its the paper said. Pesticides, dioxin (a component of Agent Or- said Kenei Miyagi, chairman of the Urasoe Military Landown- ange) and the cancer-causing chemical compound polychlo- ers’ Association, which leases land to Camp Kinser. Miyagi was sure and the subsequent development of the illness,” the state- chemical components that VA determined cause prostate can- rinated biphenyl, or PCB, were found. referring to dozens of barrels containing tar-like substances and ment said. “VA has no credible evidence of Agent Orange cer.” use, storage, testing, or transportation in Okinawa, and thus waste oil, as well as toxic substances, that have been uncovered no evidence to support claims of exposure to Agent Orange In a second case, an unnamed Army veteran with the 412th “Marks of leaked chemicals meet the eyes at every turn,” the on land returned recently to the Japanese government. report said. during military service in Okinawa.” Transportation Company said he was exposed between October 1968 and May 1970 at Naha Military Port as the defoliant The U.S. military allows sites to be investigated only when they The U.S. military began using plant-killing chemicals called spilled on him numerous times while he was loading and un- “One of our top priorities is the health and safety of our com- are returned to Japanese control. herbicides in the 1950s to defoliate military facilities. loading barrels from cargo ships. The veteran said the barrels munity, both on-base and off-base,” a Marine Corps spokes- woman said in a statement in late 2015 about the report. “It is impossible for us to accurately assess the environmental Agent Orange is a blend of “tactical herbicides,” according to had orange bands around them, a telltale sign of Agent Orange. the VA’s website, that was used in Korea to deprive the ene- situation,” Miyagi said. “However, by piecing together the sto- my of cover and in Vietnam to defoliate jungles and kill The veteran claimed that caused his diabetes mellitus, type 2, “As the author himself noted, further sampling found no sus- ries of former base employees, which we believe are reliable, crops. The toxic mixture has been blamed for a slew of veter- which is associated with herbicide exposure. pected toxins present,” the statement said. “Importantly, U.S. we can assume that a considerable amount of substances and and Okinawa Prefectural Government authorities continued to chemicals had been stored and discharged … We need assur- ans’ health problems, from cancers to heart disease, and has been known to cause birth defects in the offspring of those He collected multiple statements from fellow veterans over the test decades later, with no further environmental action re- ance that the returned land is free of pollutants.” exposed. years that supported his claim. Those veterans said the drums quired. The Marine Corps takes any environmental concerns were shipped to Okinawa, offloaded and loaded onto other boats very seriously, and is committed to exercising due diligence in Veterans claiming Agent Orange-related disabilities on Okina- thoroughly identifying and addressing any environmental is- wa say they feel vindicated by the evidence that keeps being The military discontinued use of Agent Orange in 1970, and heading to Vietnam. They often leaked and reportedly came veterans have battled the VA for benefits regarding exposure back through the port the same way, the veterans said. sues.” unearthed and the cases found in the veterans’ favor, even if ever since. The VA has recognized the claims of some veter- Pentagon officials said the 412th Transportation Company’s unit they are a small portion of the total claims. ans who served in Vietnam, Korea, Thailand, on some ships records from 1968-70 had been lost. Since Okinawa’s reversion back to Japan in 1972, the U.S. has continued to consolidate its forces on the island and return They hope more veterans will receive benefits. and in some aircraft, while denying others. Guam and Japan — most notably Okinawa — have been left off the list despite “Credible evidence sustains a reasonable probability that during large swaths of land to the host nation. While Agent Orange claims. service, while performing regular duties at the Naha Naval Port has not been found, local officials have made some troubling Some say Agent Orange is just another meaningless buzzword, in Okinawa, Japan, the Veteran was exposed to Agent Orange discoveries. and that the bar of contamination and exposure to toxic chemi- cals on Okinawa has been exceeded. In January, Guam Gov. Eddie Calvo ordered the Environmen- from leaking barrels,” said the Sept. 8, 2016, decision by the tal Protection Agency to investigate claims made by U.S. mil- Department of Veterans Affairs, Board of Veterans’ Appeals. In 2013, the first of 108 barrels was unearthed in returned land itary veterans who served there in the 1960s and ’70s that Veterans Law Judge Michelle Kane heard the case on appeal adjacent to Kadena Air Base. Tests revealed they contained Kris Roberts, a former facilities maintenance officer at Marine Agent Orange was sprayed on the island. That investigation is from the Winston-Salem, N.C., regional office. traces of cancer-causing dioxin and toxic ingredients found in Corps Air Station Futenma and a New Hampshire state repre- Agent Orange and other common pesticides and herbicides. sentative, is the first servicemember to receive VA recognition ongoing. Despite ruling in the veteran’s favor, Kane said the determina- Japanese government officials said the barrels and their con- for a condition — prostate cancer — related to hazardous chem- Disability awarded tion was in no way a comment “as to whether Agent Orange was tents did not pose a risk to public safety, but Japanese media ical exposure at Futenma. reports accused them of inaccurately reporting the contamina-

tion levels, eroding some faith in the investigation. The retired lieutenant colonel said he and dozens of men under In October 2015, an unnamed veteran was awarded disability (continued on next page)

Toxic substances like arsenic, asbestos, lead and hexavalent (continued on next page)

(continued from previous page) hurting and need help with their VA compensation claims. US soldiers getting credentials for their special- credential in hand and recognized in all 54 jurisdictions of ties to help with civilian job hunt the United States.” him unearthed more than 100 leaking barrels from the base in This blog is addressed to those who need help, don’t understand, 1981. After loading the barrels for transport off the island, a or who’re trying to help others. The U.S. Army is boosting efforts to help soldiers succeed in The report released at the event said that among steps that typhoon struck and flooded the area. civilian life by giving them more tools and qualifications to can help soldiers succeed in civilian life are identifying cre- First, though, let’s bust those myths. find work after military service. dentials that most closely meet labor market demand, analyz- Roberts said he and some of his men were forced into the neck- ing attainment of credentials and incorporating military and VA is still compiling FY16 data, but in FY15, VA paid more mon- deep water to open a flood-control gate. Acting Army Secretary Robert Speer plans to give a directive veteran interests in credentialing programs. ey to compensate more Veterans—with more claimed medical in the near future that will broaden a transition program to conditions rated at higher average percentages—than ever before. Van Roosen said that about 15 percent of troops retire from Shortly after, the onetime marathon runner said he began suf- As you can see, someone’s getting paid, and that someone is (as of include credentialing soldiers in areas ranging from truck driv- fering from asthma and blackouts. He said he had two strokes ing and mechanics to information technology, according to the military after they have served 20 years. FY15) 4.56 million someones—and those someones are Veterans and damage to his central-nervous system that was stopping his who took home $66.38 billion dollars in FY15 for their service- Military.com. heart. Most leave after five years, Military.com said, meaning that connected disabilities. about 135,000 soldiers transition out each year. In some cases the Army gives soldiers the skills they need, He said he developed thymus cancer, and his daughter was born So, who are these people getting approved, and how do they do it? such as how to drive a truck, but then does not give them the suffering from a multitude of similar conditions. formal credentials, such as a commercial driver's license, that Lynchburg Tire If you read my last blog, you’ll remember that, since VA disability allow them to apply successfully for similar work in the civil- Roberts began fighting for VA disability in 2007. His doctors compensation is taxpayer money, there’s a legal process to claim ian world. Corporation told him in a 2012 medical report provided to Stars and Stripes that money. This means that VA disability compensation is guard- that they believed he had been exposed to Agent Orange. The ed by the laws that your elected lawmakers wrote. Maj. Gen. Hugh Van Roosen said Thursday the Army could 3730 South Amherst Hwy. Phone 434-929-1082 The laws explain who is eligible: those who have separated from Madison Heights, VA 24572 Fax 434-929-1085 records also indicate the Marine Corps could not provide docu- do more to help soldiers be employable, reported Mili- mentation about the barrels. Roberts was awarded disability in active military service with any discharge except dishonorable, as tary.com. 2561 Fort Avenue Phone 434-847-7735 August 2015. well as those still serving in the Reserves/National Guard. That’s Lynchburg, VA24501 Fax 434-847-6164 the first part. The second part is that, if you want to claim an injury "Is there any reason why we couldn't -- without a whole lot of He already gets 100 percent VA disability, so he won’t see an or medical condition, it must have happened to you during the time effort -- include a commercial driver's license in the program?" increase in benefits. To him, it was the principle. you were active (including Reserves/Guard activated, Reserves/ asked Van Roosen, the service's deputy chief of staff for man- Guard drill and/or annual training). (An addition to the second part power and personnel plans, programs and policies. allows one to claim active military service aggravated a pre- Two Locations! “What I’d really like to see out of all of this is stop the blaming, service injury or medical condition). The third part is that, if you stop pointing fingers,” he said. “I have been telling people, I claim an injury or medical condition that occurred/happened to "We're always struggling with hours in the training day. don’t care if it’s Agent Orange.” Dioxin and PCBs “kill people you during active service, then you need to give VA evidence of However, we have to balance that against whatever we can do too.” the injury or medical condition that occurred/happened during the to ensure a soldier who's leaving has as soft a landing as possi- time you were in active service. ble." “We’ve been arguing for years over the name of a hazardous chemical while not dealing with any other hazardous chemi- Note: this does not mean that it had to happen while deployed, and The Army is already doing exactly that in some vocations, he cals.” it doesn’t mean it had to happen in uniform or during the duty day. said. Yes, you can file a claim if you served active duty during peace- Roberts said he feels responsible for the Okinawans and the time, or got injured in a pick-up basketball game off post after the "We're already doing credentialing in our medical fields ... Navy Seabees who worked for him. They may be sick and have duty day, and if the injuries you sustained affect you today, then [but] there's a lot of areas, particularly in our IT fields, that we no idea why. it’s something you could claim. don't do anything like that, and there's not any particularly “To me, there’s no way the U.S. military and government can good reason for it," he said. deny hazardous chemical hot spots on Okinawa,” he said Yeah, I know—I wasn’t a Sick Call Ranger, either. So, what do you do if you don’t have much in your records? My co-worker, Military.com reported that Speer is expected to issue the di- Stars and Stripes staffer Yoo Kyong Chang contributed to this Mark, wrote an excellent blog discussing what you can use for rective within a month. report. evidence. But I’d like to add even more detail to that list: pictures (you, your wound, your clothing and gear, your vehicle, your At the same time, Army Sgt. Major Daniel Dailey has spoken Used with permission from Stars and Stripes. AAR, etc.), receipts, unit citations, award letters, prescriptions, about promoting the benefits of college credits and credential- Visit their website at www.stripes.com news clippings, base hospital records, in-take and discharge logs; post-service private doctor records; and statements from your ing to recruit. spouse, your commander, your platoon sergeant, your roommate, VA Compensation: Who is eligible? any witness who was there or knew you or was affected by your A report titled "The State of Credentialing of Service Mem- injury/medical conditions (“Yeah, after X happened, I remember bers and Veterans: Challenges, Successes and Opportunities,” By: Jason Davis Mikey didn’t go on patrol for a week, and I had to cover down.”). which was funded by Military.com, was released at the Ameri- can Legion event. (Jason Davis served five years in the 101st ABN, including two The last thing you need is actually two things: a current medical combat tours to Iraq. He's currently an M.A. candidate in Writing diagnosis from a medical professional (VA or civilian), and for The report noted that U.S. lawmakers are acknowledging the at Johns Hopkins University and serves as social media adminis- that doctor to give the professional opinion that after reviewing need to give troops certifications and civilian licenses that will trator for the Veterans Benefits Administration). your military medical records your current diagnosis—the injury help them transition in civil life. or condition you suffer from right now—is because of what hap- If you believe the internet, or what the guy sitting across from you pened to you in active service. Yes! Have the doc review your Military.com quoted Sen. Elizabeth Warren, D-Mass., noting at your appointment at the VAMC said—which is what he heard records. at a recent hearing of the Senate Armed Services Committee's from some guy who was sitting next to him at his last appoint- Personnel Subcommittee: "America spends hundreds of mil- ment—then the answer to the questions Who is eligible for VA Recap: active service period, not dishonorable; evidence that lions of dollars each year to train service members to do high- Lynchburg CBOC compensation? and How do you get it? is No one, and You don’t. something happened to you on active service; current medical di- ly skilled jobs ... they should be ready to move into civilian agnosis; and medical professional agreeing the medical condition life with [the help of] certifications.” I read comments like these every week on the VBA Facebook was caused by the thing that happened to you on active service. 1600 Lakeside Dr Lynchburg, VA 24501 page. There are two thoughts I take away from these sentiments: She said that the Senate "wants to work on making it easier for some people commenting on Facebook would rather be cynics So that explains Who is eligible for VA disability compensation Phone: 434-316-5000 Fax: 434-316-7071 than attempt to help others; and some people are really, honestly and What you need to give VA to prove it. our service members when they leave the service to have that

Message from VA Secretary Dr. David Shulkin cluding Chief Medical Officer of the University of Pennsylva- Shulkin proposes eliminating 40-mile, 30-day rule priority. He said he would work to push legislation in Congress nia Health System, Temple University Hospital, and the Medi- for non-VA care that would allow the VA to “make sure bad employees are leav- I am grateful to President Trump and to members of Congress cal College of Pennsylvania Hospital. He has also held aca- ing the system.” for entrusting me with the privilege of serving Veterans and the demic positions including Chairman of Medicine and Vice By NIKKI WENTLING, February 26, 2017 dedicated employees of the Department of Veterans Affairs as Dean at Drexel University School of Medicine. As an entre- Some lawmakers have pushed to make it easier to fire VA em- your secretary. It is my highest professional honor. preneur, Dr. Shulkin founded and served as Chairman and WASHINGTON – Veterans Affairs Secretary David Shulkin on ployees as a way to root out a perceived culture of corruption in CEO of DoctorQuality, one of the first consumer-oriented Sunday proposed eliminating a controversial policy that limits the department. Together, we’ll ensure our nation’s obligation to provide care sources of information on quality and safety in healthcare. veterans from receiving private-sector health care. and benefits to those “who shall have borne the battle” and ful- Speaking to hundreds of people at the Disabled American Veter- The VA will also announce some “bold proposals” regarding fill our institutional I CARE Values: integrity, commitment, A board-certified internist, Dr. Shulkin is also a fellow of the ans annual conference in Arlington, Va., Shulkin laid out his top suicide prevention in coming weeks, Shulkin said. advocacy, respect and excellence. American College of Physicians. He received his medical de- 10 priorities for the Department of Veterans Affairs. It was his gree from the Medical College of Pennsylvania, and he com- first public address since becoming VA secretary. Trump commented during his campaign on the number of vet- That obligation and those values are sacred to me, first, as an pleted his internship at Yale University School of Medicine eran suicides – calling it a “national tragedy” – and said he American – a beneficiary of the service and sacrifices of Veter- and a residency and fellowship in General Medicine at the High on Shulkin’s list was redesigning the Veterans Choice Pro- would improve mental health care at the VA. According to the ans and their families who defend our uniquely American free- University of Pittsburgh Presbyterian Medical Center. He also gram into what he called “Choice 2.0.” latest VA statistics, an average of 20 veterans died from suicide doms and opportunities. They’re also sacred to me because my received advanced training in outcomes research and eco- each day in 2014. father served the nation as an Army psychiatrist, and both my nomics as a Robert Wood Johnson Foundation Clinical Schol- His plan would include removing the rule that allows veterans to grandfathers were Army Veterans. My paternal grandfather ar at the University of Pennsylvania. go outside the VA for health care if they had to wait more than Other priorities Shulkin listed Sunday included improving VA served as chief pharma- 30 days for an appointment or live more than 40 miles driving infrastructure, better coordinating with the Department of De- cist at the VA hospital Dr. Shulkin has been named as one of the “50 Most Influential distance from a VA facility. Some veterans and lawmakers have fense, enhancing information technology and making quicker in Madison, Wisconsin, Physician Executives in the Country” by Modern Healthcare. criticized the 40-mile, 30-day rule for limiting veterans’ health decisions on claims for disability and pension compensation. and as a young doctor, I He has also previously been named among the “One Hundred care choices, and Shulkin called the program “extremely com- trained in VA hospitals. Most Influential People in American Healthcare.” He has plex and bureaucratic.” “Now I’m focused on the future,” Shulkin told Stars and So, serving the nation been married to his wife, Dr. Merle Bari, for 29 years. They Stripes. “I’m focused on how we can make significant advance- and serving Veterans is are the parents of two grown children.). President Donald Trump issued a plan for VA reform during his ments from where we were to make this a better system.” a family tradition. campaign that he said would ensure every veteran could choose Disabled American Veterans and other veterans organizations It was a privilege to between the VA or private-sector care. Shulkin said Sunday that will have opportunities soon to highlight their own priorities for serve as VA’s Under he wanted a system with less “red tape.” VA reform to the Senate and House veterans' affairs commit- Secretary for Health tees. over the past year and a “We want to be thoughtful about how we propose what the new half. Now, I look for- choice program will look like, and do that in conjunction with Disabled American Veterans will present their priorities to law- ward to continuing our Congress, and to make sure we are fulfilling the president’s makers on Tuesday, followed by The American Legion and collective efforts across promise and commitment that he has made to the country’s vet- Veterans of Foreign Wars on Wednesday. the department and our erans,” Shulkin told Stars and Stripes. country to deliver the Used with permission from Stars and Stripes. Visit their website at www.stripes.com care and services our Choice set to expire Veterans need and de- serve. Among many Before he can propose Choice 2.0, Congress first must eliminate critical efforts already the expiration date for the original Veterans Choice Program, underway, we will con- Shulkin said. tinue building on significant progress increasing access for Vet- erans, preventing suicide, addressing unique needs of women “We want to make sure we continue the current program so vet- Veterans, supporting Veterans’ families and caregivers, continu- erans don’t experience any gap in care,” he said. ing to drive down the disability backlog and Veteran homeless- ness, and pursuing necessary legislation to reform the outdated The program was created as a temporary measure in 2014 after appeals process and for other critical legislative priorities. it was discovered veterans were suffering long waits for health With the support of the president, Congress, Veterans, their ser- care at some VA facilities. It was funded with $10 billion and vice organizations, and the American people, we – the dedicated given an expiration date of Aug. 7, 2017. employees of VA – will continue to fulfill President Lincoln’s promise. Sen. John McCain, R-Ariz., and Rep. Phil Roe, R-Tenn., intro- duced legislation last month to do away with the expiration date. Don’t forget to visit your webpage. There is no nobler mission. There is no higher calling for any The lawmakers estimated by August, the choice program would American. I am humbled and proud to serve with you. The link can be found at www.veteranspage.com. still have approximately $1 billion in funding. Congress has yet to taken action on either the House or Senate (Dr. David J. Shulkin is the Secretary of Veterans Affairs. Prior You can read, or download, bill. an online version of this to his confirmation on Feb. 13, 2017, Dr. Shulkin served as Department of Veterans Services paper there or at: VA’s Under Secretary for Health for 18 months, leading the Office of the Commissioner “If Congress doesn’t act, we will see a significant amount of nation’s largest integrated health care system, with over 1,700 resources be removed,” Shulkin said. sites of care serving nearly nine million Veterans 900 E. Main Street www.veteransgrapevine.com Richmond VA 23219 Shulkin has previously attempted to ease concerns that the VA Before he began his service with VA, Dr. Shulkin held numerous would move completely to the private sector. He did so again chief executive roles at Morristown Medical Center, and the (804) 786-0286 (Phone) (804) 786-0302 (Fax) CONTACT VA Sunday, saying the private sector does not have the "military Atlantic Health System Accountable Care Organization. He also cultural competency" that the VA provides. (800) 827-1000 served as President and CEO of Beth Israel Medical Center in I told my doctor that I broke my arm in two places. New York City. CHAMPVA (800) 733-8387 He told me to stop going to those places. Other priorities Home Loan Eligibility Center (888) 244-6711 Dr. Shulkin has held numerous physician leadership roles in- Shulkin on Sunday also listed employee accountability as a top VA life Insurance (800) 669-8477

Shulkin promises ‘major changes’ at Veterans Friday morning and reiterated his feelings during the town hall The Boy Who Became a World War II Veteran brother’s clothes and fedora and practiced “talking deep.” What Affairs event in the afternoon. at 13 Years Old worried him most was not that an enlistment officer would spot the forged signature. It was the dentist who would peer into the By NIKKI WENTLING, February 24, 2017 “I think that it’s time to stop beating us up,” Shulkin said. “I’m In 1942, Seaman Calvin Graham was decorated for valor in mouths of potential recruits. “I knew he’d know how young I disappointed there seems to be an obsession with finding our battle. Then his mother learned where he’d been and revealed was by my teeth,” Graham recalled. He lined up behind a cou- WASHINGTON — Department of Veterans Affairs Secretary failings.” his secret to the Navy. ple of guys he knew who were already 14 or 15, and “when the David Shulkin on Friday promised major changes were com- dentist kept saying I was 12, I said I was 17.” At last, Graham ing to the agency, saying President Donald Trump expects it. That runs contrary to how Trump has spoken about the VA, By Gilbert King played his ace, telling the dentist that he knew for a fact that the which he has called “the most corrupt agency” and “probably SMITHSONIAN.COM boys in front of him weren’t 17 yet, and the dentist had let them the most incompetently run agency” in the government. through. “Finally,” Graham recalled, “he said he didn’t have “We’re going to be looking for some major changes, to really With powerful engines, extensive firepower and heavy armor, time to mess with me and he let me go.” Graham maintained reevaluate how we do things,” Shulkin said during a live, “The constant berating that the VA is filled with unethical peo- the newly christened battleship USS South Dakota steamed out that the Navy knew he and the others on line that day were un- online question-and-answer podcast with veterans. “If you ple is really painting a picture that is… a disservice to our vet- of Philadelphia in August of 1942 spoiling for a fight. The derage, “but we were losing the war then, so they took six of look at the president’s 10-point plan, he’s not looking for mi- erans, because it breaks down their confidence in the system,” crew was made up of “green boys”—new recruits who enlisted us.” nor changes. The reason why I feel I got a 100-0 Shulkin said. “I worry there are people who need help but don’t after the Japanese bombing of Pearl Harbor—who had no [confirmation] vote from the Senate is because there’s one come to us because they hear this narrative.” qualms about either their destination or the action they were It wasn’t uncommon for boys to lie about their age in order to thing the country agrees on -- that our vets deserve better than likely to see. Brash and confident, the crew couldn’t get serve. Ray Jackson, who joined the Marines at 16 during World what they’re getting now.” During Shulkin’s confirmation hearing Feb. 1, Republican and through the Panama Canal fast enough, and their captain, War II, founded the group Veterans of Underage Military Ser- Democratic senators also said they thought there were “good Thomas Gatch, made no secret of the grudge he bore against vice in 1991, and it listed more than 1,200 active members, in- However, he did not offer veterans specifics about how he stories” at the VA, and that the agency was being unfairly criti- the Japanese. “No ship more eager to fight ever entered the cluding 26 women. “Some of these guys came from large fami- would change the department, only calling it a “modernizing cized in some instances. Pacific,” one naval historian wrote. lies and there wasn’t enough food to go around, and this was a of our system.” way out,” Jackson told a reporter. “Others just had family prob- Shulkin, who is a physician, also said Friday he would continue In less than four months, the South Dakota would limp back to lems and wanted to get away.” Part of the change will include the Veterans Choice Program, a practice that he started as undersecretary for health and find port in New York for repairs to extensive damage suffered in which Shulkin said he wanted to “redesign” this year. time to treat VA patients. some of World War II’s most ferocious battles at sea. The ship Calvin Graham told his mother he was going to visit relatives. would become one of the most decorated warships in U.S. Instead, he dropped out of the seventh grade and shipped off to The program allows some veterans to receive care in the pri- On Monday, he saw patients on physician rounds in the VA’s Navy history and acquire a new moniker to reflect the secrets San Diego for basic training. There, he said, the drill instruc- vate sector with the VA paying the bill, but many veterans New York Harbor Healthcare System. it carried. The Japanese, it turned out, were convinced the ves- tors were aware of the underage recruits and often made them have criticized it as complex and confusing. sel had been destroyed at sea, and the Navy was only too hap- run extra miles and lug heavier packs. “I think it’s important for me to make sure I stay connected py to keep the mystery alive—stripping the South Dakota of The Veterans Choice Program is set to expire in August. with the services we deliver,” Shulkin said during the podcast. identifying markings and avoiding any mention of it in com- Shulkin said Friday he’s working with Trump and lawmakers “I get tremendous value from actually being able to take care of munications and even sailors’ diaries. When newspapers later to propose changes to the program, though no details were vets and hear from them and work with staff.” reported on the ship’s remarkable accomplishments in the Pa- offered. cific Theater, they referred to it simply as “Battleship X.” Used with permission from Stars and Stripes. He’s previously deflected claims of “privatization.” Visit their website at www.stripes.com That the vessel was not resting at the bottom of the Pacific was just one of the secrets Battleship X carried through day after In Trump’s 10-point plan for VA reform, which was intro- day of hellish war at sea. Aboard was a gunner from Texas duced during his campaign, the president said he wanted to who would soon become the nation’s youngest decorated war allow all veterans the option to seek care in the private sector. hero. Calvin Graham, the fresh-faced seaman who had set off Some veterans organizations have voiced concerns and con- for battle from the Philadelphia Navy Yard in the summer of tend paying more for veterans to seek outside care could di- 1942, was only 12 years old. minish resources at VA facilities. Graham was just 11 and in the sixth grade in Crockett, Texas, Just months after her christening in 1942, the USS South Scott Blackburn, who was named Friday as Shulkin’s acting when he hatched his plan to lie about his age and join the Na- Dakota was attacked relentlessly in the Pacific. deputy secretary, said the VA would “buckle down” and “get vy. One of seven children living at home with an abusive step- Photo: Wikipedia more disciplined.” Blackburn previously led former VA Secre- father, he and an older brother moved into a cheap rooming tary Bob McDonald’s VA transformation initiative, “MyVA.” house, and Calvin supported himself by selling newspapers By the time the USS South Dakota made it to the Pacific, it had and delivering telegrams on weekends and after school. Even become part of a task force alongside the legendary carrier USS “The president wants to do some really big things,” Blackburn though he moved out, his mother would occasionally visit— Enterprise (the “Big E”). By early October 1942, the two ships, said Friday. “We still have a long way to go.” sometimes to simply sign his report cards at the end of a se- along with their escorting cruisers and destroyers, raced to the mester. The country was at war, however, and being around South Pacific to engage in the fierce fighting in the battle for Shulkin, who previously worked as VA undersecretary of newspapers afforded the boy the opportunity to keep up on Guadalcanal. After they reached the Santa Cruz Islands on Oc- health under McDonald, was confirmed Feb. 13 as the new events overseas. tober 26, the Japanese quickly set their sights on the carrier and VA secretary. The town hall-style event Friday was the first launched an air attack that easily penetrated the Enterprise's time that Shulkin spoke publicly to veterans as VA secretary. “I didn’t like Hitler to start with,” Graham later told a reporter. own air patrol. The carrier USS Hornet was repeatedly torpe- He said he would do more online town halls in the future if When he learned that some of his cousins had died in battles, doed and sank off Santa Cruz, but the South Dakota managed to veterans requested them. On Sunday, Shulkin will address he knew what he wanted to do with his life. He wanted to protect Enterprise, destroying 26 enemy planes with a barrage members of Disabled American Veterans at the organization’s fight. “In those days, you could join up at 16 with your par- from its antiaircraft guns. winter conference in Arlington, Va. ents’ consent, but they preferred 17,” Graham later said. But he had no intention of waiting five more years. He began to Standing on the bridge, Captain Gatch watched as a 500-pound Besides promising major changes, Shulkin on Friday con- shave at age 11, hoping it would somehow make him look bomb struck the South Dakota’s main gun turret. The explosion demned the “berating” of the VA by public officials and the older when he met with military recruiters. Then he lined up injured 50 men, including the skipper, and killed one. The media. with some buddies (who forged his mother’s signature and ship’s armor was so thick, many of the crew were unaware stole a notary stamp from a local hotel) and waited to enlist. they’d been hit. But word quickly spread that Gatch had been He first mentioned the issue during a VA podcast released At 5-foot-2 and just 125 pounds, Graham dressed in an older (continued on next page)

(continued from previous page) in newsreel footage, wrote the Navy, revealing the gunner’s true age. POST 9877 OFFICERS knocked unconscious. Quick-thinking quartermasters managed to save the captain’s life—his jugular vein had been severed, Graham returned to Texas and was thrown in a brig at Corpus Commander Milton Carson and the ligaments in his arms suffered permanent damage—but Christi, Texas, for almost three months. some onboard were aghast that he didn’t hit the deck when he Sr. Vice Commander Steve Poleski Jr. saw the bomb coming. “I consider it beneath the dignity of a Battleship X returned to the Pacific and continued to shoot Japa- captain of an American battleship to flop for a Japanese nese planes out of the sky. Graham, meanwhile, managed to get a Jr. Vice-Commander Adon Jennings bomb,” Gatch later said. message out to his sister Pearl, who complained to the newspa- pers that the Navy was mistreating the “Baby Vet.” The Navy The ship’s young crew continued to fire at anything in the air, eventually ordered Graham’s release, but not before stripping Quartermaster/Adjutant Mickey Ryan including American bombers that were low on fuel and trying him of his medals for lying about his age and revoking his disa- to land on the Enterprise. The South Dakota was quickly get- bility benefits. He was simply tossed from jail with a suit and a Chaplain Ron Tomlin ting a reputation for being wild-eyed and quick to shoot, and few dollars in his pocket—and no honorable discharge. Navy pilots were warned not to fly anywhere near it. Back in Houston, though, he was treated as a celebrity. Reporters Surgeon Ray Showalter were eager to write his story, and when the war film Bom- The South Dakota was fully repaired at Pearl Harbor, and Cap- badier premiered at a local theater, the film’s star, Pat O’Brien, Judge Advocate – Ray Taylor tain Gatch returned to his ship, wearing a sling and bandages. invited Graham to the stage to be saluted by the audience. The Seaman Graham quietly became a teenager, turning 13 on No- attention quickly faded. At age 13, Graham tried to return to 1 Year Trustee – Preston Cunningham vember 6, just as Japanese naval forces began shelling an school, but he couldn’t keep pace with students his age and American airfield on Guadalcanal Island. Steaming south with quickly dropped out. He married at age 14, became a father the the Enterprise, Task Force 64, with the South Dakota and an- following year, and found work as a welder in a Houston ship- 2 Year Trustee – Lester Hamilton other battleship, the USS Washington, took four American yard. Neither his job nor his marriage lasted long. At 17 years destroyers on a night search for the enemy near Savo Island. old and divorced, and with no service record, Graham was about 3 Year Trustee – Jessie Minnis There, on November 14, Japanese ships opened fire, sinking or to be drafted when he enlisted in the Marine Corps. He soon heavily damaging the American destroyers in a four day en- broke his back in a fall, for which he received a 20 percent ser- Sgt. At Arms – Larry Brooks gagement that became known as the Naval Battle of Guadalca- vice-connected disability. The only work he could find after that nal. was selling magazine subscriptions. Service Officer – Bob Crews

Later that evening the South Dakota encountered eight Japa- When President Jimmy Carter was elected, in 1976, Graham Committee Officer – Mike Eams Try to fill in the missing numbers. nese destroyers; with deadly accurate 16-inch guns, the South began writing letters, hoping that Carter, “an old Navy man,” Dakota set fire to three of them. “They never knew what sank might be sympathetic. All Graham had wanted was an honorable ‘em,” Gatch would recall. One Japanese ship set its search- discharge so he could get help with his medical and dental ex- Membership Chairman – John Mason The missing numbers are integers between 0 and 50. lights on the South Dakota, and the ship took 42 enemy hits, penses. “I had already given up fighting” for the discharge, Gra- The numbers in each row add up to totals to the right. temporarily losing power. Graham was manning his gun when ham said at the time. “But then they came along with this dis- The numbers in each column add up to the totals along shrapnel tore through his jaw and mouth; another hit knocked charge program for deserters. I know they had their reasons for the bottom. him down, and he fell through three stories of superstructure. doing what they did, but I figure I damn sure deserved more than The diagonal lines also add up the totals to the right. Still, the 13 year-old made it to his feet, dazed and bleeding, they did.” and helped pull other crew members to safety while others were thrown by the force of the explosions, their bodies In 1977, Texas Senators Lloyd Bentsen and John Tower intro- aflame, into the Pacific. duced a bill to give Graham his discharge, and in 1978, Carter announced that it had been approved and that Graham’s medals “I took belts off the dead and made tourniquets for the living would be restored, with the exception of the Purple Heart. Ten and gave them cigarettes and encouraged them all night,” Gra- years later, President Ronald Reagan signed legislation approv- ham later said. ”It was a long night. It aged me.” The shrapnel ing disability benefits for Graham. had knocked out his front teeth, and he had flash burns from the hot guns, but he was “fixed up with salve and a coupla At the age of 12, Calvin Graham broke the law to serve his coun- stitches,” he recalled. “I didn’t do any complaining because try, at a time when the U.S. military might well be accused of half the ship was dead. It was a while before they worked on having had a “Don’t ask, don’t tell” policy with regard to under- my mouth.” In fact, the ship had casualties of 38 men killed age enlistees. For fear of losing their benefits or their honorable C.W. Abbitt, Jr. Founded in 1957 and 60 wounded. discharges, many “Baby Vets” never came forward to claim the & Sons, Inc by Fletcher (Pat) Cash nation’s gratitude. It wasn’t until 1994, two years after he died, Veteran of WWII Regaining power, and after afflicting heavy damage to the Jap- that the military relented and returned the seaman’s last medal— anese ships, the South Dakota rapidly disappeared in the his Purple Heart—to his family. Bill Abbitt and Employees smoke. Captain Gatch would later remark of his “green” men, (Source: http://www.smithsonianmag.com) “Not one of the ship’s company flinched from his post or (434) 845-5987 showed the least disaffection.” With the Japanese Imperial “Serving the Area for Over 50 Navy under the impression that it had sunk the South Dakota, A Bad Diagnose Years” the legend of Battleship X was born. 171 Wright Shop Road The doctor finished examining the frail husband. The wife took Madison Heights, Virginia 24572 In mid-December, the damaged ship returned to the Brooklyn the doctor aside and asked how she could help her husband. The Navy Yard for major repairs, where Gatch and his crew were doctor said what he needs to keep alive is more sex. If you could profiled for their heroic deeds in the Pacific. Calvin Graham increase your sexual activity to 5 times per day it would work received a Bronze Star for distinguishing himself in combat, as wonders. She returned to her husband who asked her what the When we got married we agreed that I would make the well as a Purple Heart for his injuries. But he couldn’t bask in doctor said. major decisions and my wife the minor decisions. Now glory with his fellow crewmen while their ship was being re- after 50 years of marriage there have been no major paired. Graham’s mother, reportedly having recognized her son She said "you're going to die. decisions.

MOST DECORATED ENLISTED MAN IN NAVY HISTORY ing enemy force. Now virtually dark, and although BM1 Williams Frequently Asked Questions Regarding the Mili- will I still get an annuity? was aware that his boats would become even better targets, he or- tary’s New Blended Retirement System James Elliott Williams, a Native American Cherokee from South dered the patrol boats' search lights turned on to better illuminate the A 7. Yes, for those who retire after at least 20 years of service, Carolina, entered the Navy in July 1947 and before retiring in April area and moved the patrol perilously close to shore to press the at- Q 1. How is the military retirement system going to change? the retirement remains predominantly a defined benefit in which 1967 gained the distinction of becoming the most decorated enlisted tack. Despite a waning supply of ammunition the patrol successfully you will get monthly retired pay. Instead of being calculated at man in Navy history. When he retired from active service he was engaged the enemy ashore and completed the rout of the enemy A 1. -- The military retirement system will change as outlined 2.5% times the average of your highest 36 months of basic pay employed with the Wackenhut Corporation and in 1969 was ap- force. Under the leadership of BM1 Williams, who demonstrated in the current National Defense Authorization Act. Changes (or your last month of basic pay, if you are under the older, final pointed to the U.S. Marshal Service in South Carolina. He also be- unusual professional skill and indomitable courage throughout the 3 will not go into effect until January 2018 Service members who pay system), your monthly retired pay will be calculated with a came an instructor at the Federal Law Enforcement Training Center, hour battle, the patrol accounted for the destruction or loss of 65 joined after 2006 but before January 1, 2018 will have the 2% multiplier. Glynco, Georgia, and also served at the U.S. Marshal Service Head- enemy boats and inflicted numerous casualties on the enemy person- choice of whether to stay with the existing system or opt into quarters in Washington, D.C., until his retirement from Federal nel. His extraordinary heroism and exemplary fighting spirit in the the new “Blended Retirement System.” Those who joined be- Q 8. What education will you be providing and when can Service Government Service. face of grave risks inspired the efforts of his men to defeat a larger fore 2006 will remain in the current system. members opt in? enemy force, and are in keeping with the finest traditions of the U.S. Significant Awards: Q 2. Why is this good thing for Service members? A 8. DoD recognizes that quality financial education is key to Naval Service. making an informed decision as to whether a Service member MEDAL OF HONOR A 2. -- Blended Retirement will benefit the entire force. Cur- should opt-into the blended or remain under the current system. NAVY CROSS Williams died on October 13, 1999, and was buried at Florence Na- rently, approximately 81 percent of those members who join The first opportunity that a Service member will have to opt-into SILVER STAR MEDAL (2) tional Cemetery in Florence, South Carolina. The Master Chief Petty the military leave with no retirement benefit. Under the Blend- the new system is on January 1, 2018. In anticipation of the new LEGION OF MERIT W/COMBAT 'V' Officer of the Navy, speaking at the funeral said, “We will forever ed Retirement System, about 85 percent of Service members system, DoD has begun work on three courses: a leader overview NAVY AND MARINE CORPS MEDAL (2) be grateful for the leadership and commitment he showed his sailors. will receive a retirement benefit, even if they don’t qualify for of the blended retirement system (fielded by June 2016); a course BRONZE STAR MEDAL W/COMBAT 'V' (3) Petty Officer Williams was an amazing sailor.” Following his death full retirement. focused on those Service members with less than 12 years of PURPLE HEART (3) a retired Rear Admiral who commanded Williams in Vietnam re- service as of December 31, 2017 who will be eligible to opt-in NAVY COMMENDATION MEDAL W/COMBAT 'V' (2) marked, “Willie did not seek awards. He did not covet getting them. Q 3. How does the Thrift Savings Plan figure into the new sys- (fielded by January 1, 2017); and a course for our new accessions COMBAT ACTION RIBBON We did not seek to make him a hero. The circumstances of time and tem? who enter the force on January 1, 2018 and beyond – who are NAVY PRESIDENTIAL UNIT CITATION (2) place, and the enemy’s presence did that. I know through personal now under the new blended system (fielded by January 1, 2018). NAVY GOOD CONDUCT MEDAL investigation of each incident that he never placed his crew nor his A 3. -- Blended Retirement will enroll all Service members The courses targeted at those eligible to opt-in as well as the new NAVY EXPEDITIONARY MEDAL patrol boats in danger without first ensuring the risk was calculated joining after January 2018 into the Thrift Savings Plan (TSP), recruits will include calculators so that Service members can NATIONAL DEFENSE SERVICE MEDAL and that surprise was on his side. He always had the presence of with automatic and matching Department of Defense (DoD) make comparisons as well as understanding the impact and need KOREAN SERVICE MEDAL mind not to endanger friendly villages. He inspired us all, junior and contributions. After completion of two years of service, the to make contributions to the TSP under the new system. The VIETNAM SERVICE MEDAL senior alike. It was my greatest honor to have served with the man Service member is vested and that money belongs to them. If courses will also take into account unique aspects for both the REPUBLIC OF VIETNAM CAMPAIGN MEDAL who truly led us all with his example of unselfish devotion to duty.” you leave, it goes with you. active and reserve components. We intend to beta test each of these courses at least three months before delivery. MEDAL OF HONOR CITATION: In December 2004 the USS JAMES E. WILLIAMS (DDG-95) was Q 4. I’m in the new blended retirement system, how long will commissioned in his honor. the DoD match my contributions? Q 9. What should Service members deciding whether to change For conspicuous gallantry and intrepidity at the risk of his life above into the new system be most aware of? and beyond the call of duty. BM1 Williams was serving as Boat A 4. Based on the National Defense Authorization Act passed Captain and Patrol Officer aboard River Patrol Boat (PBR) 105 ac- on November 25, 2015, the DoD will contribute 1% of a Ser- A 9. Because many of our Service members don’t make it to a 20 companied by another patrol boat when the patrol was suddenly vice member’s basic pay to their TSP after 60 days of entering year retirement, this is a new benefit worthy of careful considera- taken under fire by 2 enemy sampans. BM1 Williams immediately service and will begin to match the Service member’s contribu- tion. Early retirement savings and the power of compounding ordered the fire returned, killing the crew of 1 enemy boat and caus- tions (up to an additional 4% when a Service member contrib- interest are important life-long concepts that you will want to pay ing the other sampan to take ref- utes at least 5%) at the start of the third year of service. Both attention to and learn more about. Stay tuned to the conversation uge in a nearby river inlet. Pursu- the DoD automatic 1% and the matching contributions continue – you should be as informed as possible to include having all of ing the fleeing sampan, the U.S. through the end of the Service member’s 26th year of service. your questions answered, before you make your decision. DoD is patrol encountered a heavy vol- committed to getting this right for you. ume of small-arms fire from ene- Q 5. What is the second part of the system, continuation pay? my forces, at close range, occupy- Q 10. Do you think that a lot of Service members will leave the ing well-concealed positions A 5.—The Blended Retirement System also offers a new military with the new system, since they’ll have money in their along the river bank. Maneuver- “continuation pay” – after 12 years of service, members will pocket and no incentive to stay? ing through this fire, the patrol receive a cash payment if they opt to stay in for 4 more years. confronted a numerically superior The payment will be two and half months of basic pay for the A 10. We have done analysis on all of the Services and conclude enemy force aboard 2 enemy active component member and half a month’s basic pay for the the current force profiles will not change when we reduce the junks and 8 sampans augmented reserve component member. retirement multiplier from 2.5% to 2.0% and offer government by heavy automatic weapons fire matching into the TSP. We will however, need a continuation from ashore. In the savage battle Q 6. What about the third part, the annuity? pay. This pay is similar to a retention bonus and targeted at the that ensued, BM1 Williams, with mid-career to ensure the necessary retention that maintains those utter disregard for his safety ex- A 6. -- The third part of the Blended Retirement System is a force profiles. After two years of service, Service members can posed himself to the withering defined benefit or a monthly annuity, which is similar to the 20- keep the DoD contributions to their TSP account. Service mem- hail of enemy fire to direct coun- year retirement system now in place. Members who retire will bers will have the option to leave those contributions in the TSP ter-fire and inspire the actions of his patrol. Recognizing the over still get their monthly annuity pay, but at a reduced amount. or to roll them into another company and/or government 401K whelming strength of the enemy force, BM1 Williams deployed his The annuity’s formula is 2 percent times years served times the retirement plan. The current TSP rules apply for early withdraw- patrol to await the arrival of armed helicopters. In the course of his “high three” or the average of the highest 36 months (three al before age 59 ½, in which the Service member would pay a movement he discovered an even larger concentration of enemy years) of basic pay received. The Blended Retirement System penalty and incur the associated tax liability for taking the funds boats. Not waiting for the arrival of the armed helicopters, he dis- annuity is close to the current retirement formula, which uses 2 out early. played great initiative and boldly led the patrol through the intense and a half percent as the multiplier. enemy fire and damaged or destroyed 50 enemy sampans and 7 (continued on next page) junks. This phase of the action completed, and with the arrival of the Q 7. If I’m in the new blended system and retire after 20 years, armed helicopters, BM1 Williams directed the attack on the remain-

(continued from previous page) tions, likely coming from separate places in the brain. VA: Nurse practitioners nationwide no longer America, said at a press conference about the rule earlier this need physician supervision year. “No one would do that. But that’s what illogical and Q 11. How does this benefit the Defense Department? The researchers emphasize that these effects don’t pinpoint a wasteful practice limitations on highly skilled advanced prac- region in the brain where the disorders differ. Rather, they By NIKKI WENTLING tice nurses do.” A 11. This system allows the member to benefit from the power show a pattern that distinguishes the disorders when the EEG of compounding interest through the government contributions results are averaged among a large group. WASHINGTON — To address staffing shortages across the State laws determine what advanced practice nurses are al- to the TSP. Many more of our Service members will be started country, the Department of Veterans Affairs will allow thou- lowed to do. Nurses at VA hospitals in 22 states already have earlier than before in their long-term retirement savings. From a “When you’re looking at an EEG, you can’t easily tell where sands of advanced practice nurses nationwide to treat patients full-practice authority because their states allow them to evalu- readiness point of view, the Department will have a 401k like in the brain signals associated with TBI and PTSD are coming without physician supervision. ate, diagnose and treat patients and prescribe medications. component to our retirement system when people join our ranks from,” said Laura Manning Franke, Ph.D., the study’s lead Some states require advanced practice nurses to be supervised in critical cyber and medical specialties. researcher and research psychologist at the Hunter Holmes Starting Jan. 13, certified nurse practitioners, clinical nurse spe- while treating, diagnosing and prescribing patients. Others al- McGuire VA Medical Center in Richmond, Virginia. “You cialists and certified nurse-midwives at VA hospitals will be low APNs to treat and diagnose patients alone but require over- get kind of a coarse measure – left, right, anterior, posterior. authorized to “practice to the full extent of their education … sight for prescribing medications. We had a different distribution, which suggests that different without the clinical supervision or mandatory collaboration of parts of the brain are involved. In order to determine what physicians,” the rule states. “For example, the same nurse practitioner is required to have patterns are tracking their TBI and PTSD, you need an aver- more physician oversight in Kansas City, Mo., than across the age to do that,” Franke added. David Shulkin, the VA Undersecretary for Health, said the state line in Kansas City, Kan.,” the American Nurses Associa- change would free up physicians, alleviating challenges the VA tion wrote in a statement. The study linked mTBI with increases in low-frequency has with getting veterans quick access to medical treatment. But waves, especially in the prefrontal and right temporal regions the physician-led American Medical Association said the rule Under the VA’s new rule, advanced practice nurses will be ex- of the brain, and PTSD with decreases in low-frequency would do away with the team-based care that’s been adopted at empted from state laws that restrict their practice. waves, notably in the right temporoparietal region. the VA and revert it back to an “outdated model” of health care delivery. Members of groups such as the American Association of Nurse The differences in the levels of the waves may explain some Practitioners and the ANA reacted happily to the rule’s an- of the symptoms of the two disorders, suggesting a decline in The VA started a system-wide effort to hire additional health nouncement, saying it’s something they’ve lobbied for over responsiveness for someone with mTBI, for example, and care providers and speed up veterans’ access to treatment in several years. more anxiety for someone with PTSD. 2014, when media reports and internal investigations revealed Q 12. What reaction have you received from current Service veterans had long waits for care and managers were manipulat- “This is a win for veterans, as well as the VA nurses who treat members on the new plan? Franke also noted that more low-frequency power has also ing wait-time data. them,” the ANA wrote. been linked to cognitive disorders such as Alzheimer’s disease A 12. Many Service members want to hear more details about and less low-frequency power to problems such as drug addic- Approximately 93,500 nurses are on the payroll at the VA, mak- The rule change has pitted nurses groups against other groups how the new retirement system will work and how it impacts tion. Additionally, spotting distinct patterns of mTBI and ing it the county’s largest employer of nurses. About 5,700 of advocating for physicians, which claim educational gaps make them and their families. That’s why increased financial educa- PTSD in separate parts of the brain is key for two reasons: the them are advanced practice, meaning they have a master’s or advanced practice nurses unqualified to serve as primary care tion and training will be essential to help Service members make possibility these conditions can be confused with each other is doctoral degree in a nursing specialty. providers. wise financial decisions and we in the Department are commit- reduced. That can help improve diagnosis and treatment and ted to getting this right. We expect that the new courses that will the patterns show that electrical activity appears to be affected To meet veterans’ needs, the VA has estimated it needs to hire After a proposal was posted on the Federal Register in May, it include calculators for comparison to be available to our mem- long after combat-related mTBI, suggesting long-term chang- 40,000 more nurses by 2018. received more than 223,000 comments in two months. It gar- bers by January 2017 and that training will occur throughout es in neural communication, the signaling between cells in the nered thousands more when the VA announced this month the that year. nervous system. “That could help, in part, explain the reason Last year, the Government Accountability Office issued a report rule was finalized. The VA will continue to accept comments for persistent problems.” stating it was especially hard for the VA to recruit and retain until Jan. 13, when the change goes into effect. nurses with advanced training. VA study finds EEG can help differentiate be- The study included 147 active-duty service members or Veter- The American Medical Association prompted questions of tween PTSD and mild traumatic brain injury ans who had been exposed to blasts in Iraq and Afghanistan. The rule falls in line with a recommendation from the Commis- whether advanced practice nurses had enough training to treat Of those, 115 had mTBI, which accounts for nearly 80 percent sion on Care this fall that called on the VA to more effectively patients without supervision. A recent VA study points to a possible breakthrough in differ- of all traumatic brain injuries. Forty of the participants had use the health care providers it already has. entiating between post-traumatic stress disorder (PTSD) and PTSD, and 35 had both conditions. The VA responded to those comments, saying advanced prac- mild traumatic brain injury (mTBI), otherwise known as a con- The Commission on Care was established by Congress to make tice nurses would not be altogether replacing physicians or cussion. Despite the new findings, Franke and her team believe more recommendations on VA reform, and its duties concluded earli- providing treatment beyond their training. work is needed to better explain the differences in the patterns er this year when it released its final report. In the report, com- The two disorders often carry similar symptoms, such as irrita- of both conditions in the brain’s electrical activity. Research- missioners wrote the VA was “failing to optimize use of ad- The AMA also argued the change would get away from the bility, restlessness, hypersensitivity to stimulation, memory ers need to analyze the differences in scans from larger num- vanced practice nurses.” VA’s team-based approach to health care, in which a primary loss, fatigue and dizziness. Scientists have tried to distinguish bers of patients. care provider, nurse and others work together to treat veterans. between mTBI and PTSD in hopes of improving treatment op- “In the Navy, we would never train a sailor to use 10 skills and “All patients deserve access to physician expertise,” AMA tions for Veterans, but many symptom-based studies have been Meanwhile, though, she said she hopes the research will play then limit them to three; it makes no sense,” retired Capt. president Andrew Gurman said in a statement. “Providing coor- inconclusive because the chronic effects of the two conditions a role in helping medical professionals better diagnose Kathryn Beasley, with the Military Officers Association of dinated, physician-led, patient-centered, team-based patient are so similar. If someone is rating high on an mTBI scale, for someone’s condition through an individual EEG—whether care is the best approach to improving quality care for our example, that person may also rate high for PTSD symptoms. that person has PTSD, a brain injury, or a combination of the country’s veterans, especially given the highly complex medi- two. cal care that veterans often require.” The researchers used electroencephalogram, or EEG, a test that measures electrical activity in the brain. The size and direction “That’s the holy grail,” said Franke. “We want to use the EEG http://www.stripes.com/ The VA reiterated that it would not do away with its model of of the brain waves can signal abnormalities. to differentiate the problems, but also to predict recovery and Stars and Stripes has one of the widest distribution ranges team-based care. be able to measure how people are doing in a more biological of any newspaper in the world. Between the Pacific and Analyzing a large set of EEGs given to military personnel from way than just measuring symptoms, although those are still European editions, Stars and Stripes services over 50 coun- The rule giving APNs full-practice authority will go into effect the wars in Iraq and Afghanistan, the researchers saw patterns relevant. But symptoms are also problematic because they’re tries where there are bases, posts, service members, ships, Jan. 13. That’s also the last day the public can comment on the of activity at different locations on the scalp for mTBI and influenced by so many things that aren’t the disease that we’re or embassies. I am proud that Stars and Stripes continues change. PTSD. They saw brain waves moving slowly in opposite direc- interested in.” in support of our Grapevine. Used with permission from Stars and Stripes. Visit their website at www.stripes.com

Compensation 101: What exactly is VA while in active military service. N D T M S M T B A A B M L E R Q D F C H A P D O Z F S C Q P Remembering compensation? O E V N F C L E T F Z J Q I U Z I B P L N I U I K O H F G X We Were Forgotten But VA compensation is also an acknowledgement. An acknowl- I N O Y I O I B C R K I A Y O L S A T Q A D R X S O W L W G Word Search By: Jason Davis edgement implies acceptance from the federal government that T I M X O Y U T M U E O E A R U A J J O A I K E I E K W U G what happened to you in service can or may affect you after ser- C A T D L Q G K I R N R L T M B B C X Q B S M C E R A T J B (Jason Davis served five years in the 101st ABN, including vice. And that’s a broad, vague statement. Thus, VA compensa- A L I B D Y S S S L E B G V I D I F I H H Q E S W G S S P Q ACTION POLITICS two combat tours to Iraq. He's currently an M.A. candidate in tion makes up for the potential loss of civilian wages or civilian C X C E J O E S D W O G E M S W L B B T G S A R J W O D E X AGENT PRAYER Writing at Johns Hopkins University and serves as social me- working time you’d miss as a result of, or for tending to Y Q G V K I E V H G M P N L V S I K V X I N D E E Y O H Z G AIRMEN SAILORS dia administrator for the Veterans Benefits Administration). (appointments, etc.), your injuries/medical conditions. It’s basi- T P Q U L L U E R X O U C U I U T B E H F L P H C P L G Z Y BENEFITS SOLDIERS cally the government saying, “Hey, thanks for your service. You Q A Y I E W E S W Q M I N Y H E Y Y W E I B O Z E D X H S L BLOOD UNBELIEVE- As a social media administrator for VA’s Benefits Administra- sacrificed your health for America, so we accept that your re- O R M M P L Y E X I X R W F D N V V A W S D E P Y B R A T Q CHILDREN ABLE tion, I read thousands of comments (yep, all of them) each duced health may impact your ability to live as comfortably as K A O Y C Y J R O Q N C D O A A K E D G P R G N F X L L L V CHOICES VETERANS week from thousands of people scattered across the country. you would had you not gotten hurt/sick.” F H Y H P N G U C Y Z K E P S X H U A Z H W O N E M R I A A CLAIMS WAR It’s no surprise that the most-talked about VA benefit CONGRESS WARFARE N D A H H Q L S L M Y U Z V E R R C F B L T C L Q F B S Z B is VA compensation, but it is sometimes surprising that the Lastly, VA compensation is not income. I’m going to say that DEATH WHEELCHAIR X I U A I I F A I L U R E S N K C M P F L R A W I Z I Y N D words we use to talk about this benefit are different from the again: VA compensation is not income. It is not a replacement or DENIAL R D E A T H E E S O M F T H I V N O U L V E R F Q A X T M R words used by those in our social media community. Even substitution for civilian employment, and it is not a military re- DISABILITY X T L T Z M H M I I P X R V R U P N D H E G W Y T G S C S B Find These more surprising is that many don’t fully understand the intent, tirement. Except in uncommon situations, VA does not pay you DISEASE D B G E K P P E M P I F W K A E T E T E R D D O Z X F N S B purpose or process behind this benefit. to not find or hold civilian employment. Compensation makes up FAILURES Words T K D E R U Q V H L L I Z K M N C Y N E T T O G R O F Z X Z for; it doesn’t replace. FAMILIES S S E R G N O C J N L L G B A O J P E X H W K W U Q L E U E That’s on us, I guess, that we need to reach more of you to FORGOTTEN G Q A Y Y Z E H Q U N E C D U W H V X C O T D W R A B B J M better explain what compensation is, how it works, and who Those are the basics. That’s what it is. GUARD G Y S Q H J U S S R E Z E T A G G S R U S R P S U N P T N S can get it. In general terms, this blog intends to do just that. HOMELESS W Q H K F Q O N O N S R N V Q N N J X S P E R A F R A W Y G Or, more loosely: here’s the skinny, the straight talk, with no HOSPITAL Disclaimer J Q C A O L P P K E S E W S I M P T U N I P T D A I A M Z X PR, no spin, no BS. HOUSING F L X Y D X C E X X G V Z S O U S V U A T C C Y F K L R O F All submissions to The Grapevine are subject to review and approval HUNGER L T Q I O D S R V A L G U X I K D N O R A W E T Y S G E F G Ready? by the Post Commander. Additionally, I as Editor, reserve the right ILLNESS T W E X C P C Z Y H O O U C E W F H N E L R P I M O U W R X to edit those submissions due to space limitations or structural con- MARINES E R C H I L D R E N H Y F A F X W D S T R Y E Z C C O T I D So, what is compensation? tent that is, in my unprofessional opinion, unacceptable. I further MEASURES reserve the right to delay or refuse publication of any submission, S K E C X H O R A N G E J M R C T Y W E T R D A R E V J M L MONEY due to space limitations, or late receipt, that would not meet my nec- F W L J G S B K X I E B Y W S D E U X V G Y L L L E S C J A It’s money, obviously. But there’s more to it than that. People ORANGE essary deadlines. All donations, including those from ads, are non- often say it’s their “monthly check,” their “service-connected POLITICAL refundable, of which 100% of the monies are used to print and mail payment,” “their disability payment,” or even simply their this paper with any excess amount utilized in the support of veterans. “benefits.” These are actual words I often see, but even they Track Your VA Claims Status Online don’t effectively describe what compensation is, nor do they This newsletter may contain copyrighted material the use of which accurately portray which specific benefit—among dozens has not always been specifically authorized by the copyright owner. You will now be able to track the progress of your disability VBA administers—they’re referring to. In most instances that individual is unknown. I am making such compensation claim online at Vets.gov. After you create a material available in an effort to advance understanding of veterans' Vets.gov account, give it a try. There are now less-confusing There are several types of VA compensation, but I’ve learned issues and believe this constitutes a 'fair use' of any such copyrighted steps in the timeline. Where there used to be eight steps in the that most people are most often referring to disability compen- material as provided for in section 107 of the US Copyright Law. In claim process, there are now only five: (1) claim received; (2) sation. When referring to disability compensation, people most accordance with Title 17 U.S.C. Section 107. The material in this initial review; (3) evidence gathering, review and decision; (4) often say “my claim,” “my money,” “my benefits,” or “my newsletter is distributed without profit to those who have expressed preparation for decision notification; and (5) complete. Disabil- check.” Sometimes they even say “my pension,” which is, an interest in receiving the included information for educating them- ity compensation is the only claim status currently available on itself, an entirely different and unrelated VA benefit. selves on veteran issues affecting them. For more information go to: Vets.gov. Other claim types will be added in early 2017. Also, Alright, I’ve dragged you along long enough, What IS VA http://www.law.cornell.edu/uscode/17/107.shtml. If you wish to use soon, you will be able to discover, apply for, track and manage compensation? copyrighted material from this newsletter for purposes of your own all your VA benefits at vets.gov. that go beyond 'fair use', you must obtain permission from the copy- First of all, it’s taxpayer money. Every year, VA makes a right owner. budget request for the following year. In simple terms for just Beware of Veteran Pension Scams VBA, we look at what we’re currently paying to administer Finally, everything herein may be factual or not. It is sourced from VA benefits, including how much we’re paying in compensa- commercial and private enterprises and content is checked for accu- Veterans' benefits, including their pensions, are being targeted tion to the millions of Veterans on the rolls, then we analyze racy as best as possible. However, you have the responsibility to in a new scam. As part of the scam, criminals pose as attorneys how much more we’ll need based on many factors, mostly that check the facts before responding to an article and committing any or financial advisers and extend an offer to assist the veteran there are more Veterans now accessing and receiving and ap- actions based upon any article from this publication. with their pension. The scam involves convincing veterans to plying to more VA benefits. However, VA’s budget does not transfer their assets into a special trust account, then charging limit what we can pay in benefits. them exorbitant fees to help complete lengthy, complicated Military pranking their recruits paperwork associated with the transfer. The veteran is told the Secondly, to safeguard taxpayer money, disability compensa- asset reallocation will allow the person to qualify for aid and tion is a process. There are federal laws that govern how we, • Instructed a private in the mess hall to look for left-handed spat- attendance benefits. But, this is not true. If you are approached the VBA, can administer it. This is a protection to the taxpayer ulas by scammers, contact your local police or sheriff's department. to prevent abuse and fraud. 65 year old Mafia boss is sentenced to 50 years. • Sent a recruit to medical supplies office in search of fallopian Next, maybe most importantly—and the part you care about tubes "But judge, I'm 65 years old! I can't do 50 years!" most: VA disability compensation is a tax-free, monthly pay- Old is when you're on vacation and your energy ment to eligible Veterans for the injuries and medical condi- • Had a new guy conduct a “boom test” on a howitzer by yelling runs out before your money does. The judge sets his gavel down, looks at him and says, "Well, tions they incurred/acquired/caught/received or aggravated “Boom!” down the tube in order to “calibrate” it. OK. Just do the best you can."

Lawmakers try again to accelerate discipline of VA VA study confirms high cure rates with use of new The federation’s concern is mostly centered on a measure in hepatitis C drugs The new drug regimens examined in the study do not contain employees; union fights back the new legislation that goes a step further from the original interferon, which has troublesome side effects such as fever,

and would eliminate VA employees’ option to initiate a fatigue, and low blood counts. The newer drugs are considered By NIKKI WENTLING grievance procedure through their unions. Virus undetectable in high percentage of patients after treatment far more tolerable than the older interferon-based antiviral regi- WASHINGTON — Lawmakers are trying again – this time with mens, although they are far more expensive. Currently, an employee facing discipline who doesn’t want A VA database study shows that new drug regimens for hepatitis support from the Department of Veterans Affairs – to give the C have resulted in “remarkably high” cure rates among patients VA secretary more power to fire, demote or suspend poor- to appeal through the Merit Systems Protection Board can The researchers extracted anonymous data on all patients in issue a complaint with their union, which could be resolved in VA’s national health care system. performing employees and recoup their bonuses. VA care who received HCV antiviral treatments between Janu- through collective bargaining. ary 2014 and June 2015 using the VA Corporate Data Ware- Of the more than 17,000 Veterans in the study, all chronically Complementary bills were introduced in the House and Senate infected with the hepatitis C virus at baseline, 75 percent to 93 house, a national, continually updated repository of data from this week to give VA Secretary David Shulkin those authorities. That process can be lengthy and open-ended, congressional VA’s computerized patient records. aides said. percent had no detectable levels of the disease in their blood for The legislation would also shorten the timeline VA employees 12 or more weeks after the end of treatment. The therapy regi- have to appeal any disciplinary action against them and require The study’s optimistic finding is a source of optimism for Vet- “We have never seen such an aggressive attack on collective mens lasted 8 to 24 weeks, depending on patient characteristics. quicker determinations from the Merit Systems Protection Board, “This promising news comes as VA is dedicating significant erans and others infected with the hepatitis C virus, according which hears the appeals. bargaining rights in the VA,” said Marilyn Park, a legislative to coauthors Dr. Lauren Beste and Dr. George Ioannou, spe- representative with the union. “Right out of the gate they’re funds to help greater numbers of patients with hepatitis C,” said David Shulkin VA Under Secretary for Health. “In March, we cialists in internal medicine and hepatology, respectively, with “[T]here are still too many bad apples within the department. Our saying the right to use a grievance procedure would not ap- the VA Puget Sound Health Care System in Seattle. ply.” announced our ability to fund care for all Veterans with hepatitis veterans deserve better, and the VA employees who fulfill their C for fiscal year 2016 regardless of the stage of the patient’s liver duties deserve better,” Rep. Phil Roe, R-Tenn., said in a written According to the researchers, modern, direct-acting antiviral Law allows federal employees 30 days advance written no- disease. VA has long led the country in screening for and treating statement. “I’m proud to have worked with President [Donald] hepatitis C. As of mid-September 2016 alone, the Department drugs for hepatitis C far outperform our older options in terms Trump and his administration on this legislation to bring long tice before they’re fired or demoted. The new legislation cuts of efficacy and tolerability. With older drugs, most patients that to 10 days. treated more than 100,000 Veterans infected with the virus. More overdue accountability to the Department of Veterans Affairs.” than 68,000 of these patients had been treated with these new could not undergo antiviral treatment because they had contra- indications or medication side effects. With newer options, The bill would also require the appeals board to issue a deci- highly effective antivirals.” The House Committee on Veterans’ Affairs on Tuesday released almost anyone can safely undergo treatment for hepatitis C. text of the VA Accountability First Act of 2017, sponsored by sion on a demotion or termination in 45 days. Data last year from the board showed it took an average of 281 days. The VA researchers analyzed data from four subgroups of pa- Roe. Sen. Marco Rubio, R-Fla., introduced the companion bill tients infected with hepatitis C—genotypes 1, 2, 3, and 4—and VA research continues to expand knowledge of the disease Thursday. After going through those processes, employees could file through scientific studies focused on effective care, screening, another appeal with the board and then seek judicial review found that genotype 1 patients showed the highest cure rates and genotype 3 the lowest. Genotype 1 was by far the most common and health care delivery. Some studies look at particular groups Last year, there was outcry from the veterans community when with the U.S. Federal Circuit. of hepatitis C patients—for example, female Veterans, or those type of infection among the four subgroups. the Merit Systems Protection Board reversed the VA’s attempt to with complicated medical conditions in addition to hepatitis C. fire two executives who were found to have manipulated the hir- Also in the legislation is a change to allow the VA secretary For more information on VA care for hepatitis C, visit to reduce the pension of a VA employee who receives a felo- The study group of more than 17,000 Veterans included more ing system to move to positions of lesser responsibility while than 11,000 patients with confirmed or likely cirrhosis, a liver www.hepatitis.va.gov and www.hepatitis.va.gov/patient/hcv/ maintaining the same salary. Lawmakers and veterans organiza- ny conviction, if it influenced their job performance. The index.asp. Information about the database study may be found secretary could recoup bonuses if employees performed disease that can result from hepatitis C, among other causes. The tions, along with Shulkin and Trump, have pushed for increased study team found “surprisingly high” response rates of around 87 in the September 2016 issue of the journal Gastroenterology. accountability as a way to root out a perceived culture of corrup- poorly on the job and recoup relocation expenses if employ- ees were found to have committed fraud, waste or malfea- percent in this group. tion in the department. sance. The overall results were consistent with those from earlier clini- Congressional aides told Stars and Stripes that they worked with cal trials that led to FDA approval of the three new drug regi- Shulkin and VA’s general counsel to create the legislation, and Park asserted all of the changes would negatively affect re- cruitment and retention at the department. mens in the study: sofosbuvir (SOF), ledipasvir/sofosbuvir they’re anticipating support from White House officials. (LDV/SOF) and paritaprevir/ ritonavir/ ombitasvir and dasabuvir Trump’s 10-point plan for VA reform released during his cam- “Anyone who takes a job in a hard-to-fill area does not need (PrOD). paign included asking Congress to pass legislation giving the VA AUBREY BURKS, AUCTIONEER secretary more disciplinary authority. In presentations to veterans it looming over their head their relocation expenses could be (VAL #2907 003417) taken away,” she said. “It will just make the work environ- The drugs, introduced in 2013 and 2014, have been credited with organizations this week, Shulkin listed accountability as his top revolutionizing hepatitis C treatment, which means a cure is now 131 FAULCONERVILLE DRIVE ment even more depressing. You are going to lose people.” AMHERST, VA 24521 priority. in reach for the vast majority of patients infected with the virus. The union plans to reach out to members of Congress in an Call: (434) 660-4326 attempt to fight against the legislation. Previously, using earlier drug regimens, most patients could ex- Email: [email protected] “If there is evidence that an employee has broken the law, caused pect, at best, only a 50 percent chance of a cure. harm to veterans, or have violated the public trust, they should be Shulkin, in an interview on Fox News this week, said the HAVE AN ITEM YOU WANT TO SELL? For photos, item terminated immediately,” Shulkin wrote in an opinion piece post- “Our results demonstrate that LDV/SOF, PrOD and SOF regi- WANT TO SELL IT AT AUCTION? ed Wednesday on Fox News’ website. “Instead, due to overly unions wouldn’t be able to stop it from passing. listing and terms, or mens can achieve remarkably high SVR [sustained virologic CONTACT US FOR A FREE, directions, visit our cumbersome and lengthy arbitrations as well as extensive bureau- “If the union decides they’re not able to change, we’re going NO-OBLIGATION CONSULTATION! to continue, anyway,” he said. “We hope to work with them, response] rates in real-world clinical practice,” VA researchers website cratic red tape, VA has not been able to remove employees as wrote. quickly as we would have liked.” but they certainly don’t have the ability to stop us from mak- ing the changes we need to.” A similar bill to the ones introduced this week passed the House last September, but never made it to a vote in the Senate. (Editor’s Note: Bill has passed the House and awaits Senate Former VA Secretary Bob McDonald responded to that bill by approval). reiterating the VA “can’t fire its way to excellence.” Aides said the new legislation is a tempered version of the original and in- Used with permission from Stars and Stripes. cludes more time to appeal for employees facing disciplinary Visit their website at www.stripes.com action. Did you hear about the snail that got beat up by two turtles? But the American Federation of Government Employees, a union The police arrived and asked the snail, "so what happened that represents approximately 270,000 VA employees, reacted to hear?" the bill with surprise, calling it “terrible” and saying it would strip employees of their due process rights. Snail says, "I dunno, it all happened so fast!!!”

VA Accountability Watch Fayetteville VA Medical Center Director Elizabeth B. Goolsby (continued from previous page) VA national cemeteries now offering pre-need received a performance bonus of $7,604 in 2012. eligibility determinations The Department of Veterans Affairs provides a wealth of ser- Atlanta, Georgia vices for some 22 million American veterans, but a rash of pre- Dallas, Texas VA announced today that it now provides eligibility determinations ventable veteran deaths, infectious disease outbreaks and bene- Despite four preventable patient deaths, three of which for interment in a VA national cemetery prior to the time of need. fit and construction delays has put the organization under in- Dallas VA Medical Center Director Jeff Milligan and regional VA’s inspector general linked to widespread mismanage- Through the Pre-Need Determination of Eligibility Program, upon tense scrutiny. director Lawrence Biro have received a combined $50,000 in ment, former Atlanta VA Medical Center Director James request, individuals can learn if they are eligible for burial or memo- bonuses since 2011 despite a series of allegations from VA Clark received $65,000 in bonuses over four years. Addi- rialization in a VA national cemetery. Despite the fact that multiple VA Inspector General reports workers, patients and family members regarding poor care at the tionally, the facility’s current director, Leslie Wiggins, have linked many VA patient care problems to widespread mis- facility as well as more than 30 certification agency complaints maintains that no employees responsible for the misman- “MyVA is about looking at VA from the Veterans’ perspective, and management within VA facilities and GAO findings that VA against the medical center in the last three years. agement linked to the deaths should be fired. then doing everything we can to make the Veteran Experience effec- bonus pay has no clear link to performance, the department has tive and seamless,” said VA Secretary Bob McDonald. “This new consistently defended its celebration of executives who presid- Philadelphia, Pennsylvania (Source: House Committee on Veterans Affairs) program reaffirms our commitment to providing a lifetime of bene- ed over these events, while giving them glowing performance fits and services for Veterans and their families.” reviews and cash bonuses of up to $63,000. The director of VA’s Philadelphia regional office, Thomas Refinance or Purchase Lastowka, received a $23,000 bonus in 2011 despite a doubling Interested individuals may submit VA Form 40-10007, Application VA Accountability Watch is dedicated to showing America’s in the backlog of disability compensation claims at the office More than 21 million Veterans and Service persons live in for Pre-Need Determination of Eligibility for Burial in a VA Nation- veterans and American taxpayers how the department’s wide- between 2010 and 2011. the U.S. today, but only about 6% of them bought a home al Cemetery, and supporting documentation, such as a DD Form 214, spread and systemic lack of accountability may actually be using a VA loan in the past five years. Even fewer have if readily available, to the VA National Cemetery Scheduling Office encouraging more veteran suffering instead of preventing it. Phoenix, Arizona refinanced. Those percentages could be much higher. Eligi- by toll-free fax at 1-855-840-8299; Does VA have the proper management and accountability ble Veterans often bypass the VA home loan for more ex- structures in place to stop preventable veteran deaths, serious Phoenix VA Regional Office Director Sandra Flint has received pensive programs. For most, that's a mistake. or email to: patient-safety issues and benefit and construction delays? Con- more than $53,000 in bonuses since 2007 despite a doubling in [email protected]; sider the following recent examples and let us know what you the office’s backlog of disability compensation claims since Refinance. The VA IRRRL program stands for Interest think on Facebook. 2009. Rate Reduction Refinancing Loan. It's meant to reduce the or mail to the National Cemetery Scheduling Office, P.O. Box veteran's VA loan rate quickly and easily. It requires no pay 510543, St. Louis, MO 63151. Washington, DC Columbia, South Carolina stubs, no W2s, no appraisal. No kidding. That reduces the time and effort required for Veterans to get into today's VA will review applications and provide written notice of its deter- Diana Rubens, the VA executive in charge of the nearly 60 Columbia VA Regional Office Director Carl Hawkins received record-low rates. There is no better refinance product on mination of eligibility. VA will save determinations and supporting offices that process disability benefits compensation claims, almost $80,000 in bonuses despite a doubling in the office’s the market, but it's only for Veterans who have VA loans documentation in an electronic information system to expedite burial collected almost $60,000 in bonuses while presiding over a backlog of disability compensation claims and inappropriate currently. For other Veteran homeowners, the VA cash-out arrangements at the time of need. Because laws and personal circum- near seven-fold increase in backlogged claims. shredding of disability claims documents. refinance allows you to refinance out of any loan type, get stances change, upon receipt of a burial request, VA will validate all Washington, DC rid of mortgage insurance, drop your rate, and turn home pre-need determinations in accordance with the laws in effect at that Waco, Texas equity into cash, if you'd like. Most Veterans would pay time. VA construction chief Glenn Haggstrom collected almost more and cost themselves more time by choosing a non-VA $55,000 in performance bonuses despite presiding over a host Carl Lowe, the former director of the VA regional office in Wa- refinance. VA operates 135 of major construction projects plagued by years-long delays co, Texas, raked in more than $53,000 in bonuses as the office’s national cemeter- and combined cost overruns of $1.5 billion. The Government average disability claims processing time grew to historic levels, Purchase. Likewise, buying a home with a VA loan is ies and 33 sol- Accountability Office documented the delays and cost overruns forcing veterans to wait longer than anywhere else in the coun- probably the least costly way to do it. VA loans do not diers’ lots in 40 for projects in Las Vegas, Denver, New Orleans and Orlando, try. require mortgage insurance. That's a savings of $150 per states and Puerto Fla., in an April 2013 report. When questioned at a House month on a $250,000 home, according to mortgage insur- Rico. More than 4 Committee on Veterans’ Affairs hearing in May, Haggstrom Buffalo, New York ance provider MGIC. And, there's no down payment re- million Ameri- could not explain what he did to earn the bonuses. quired. Instead of saving for years to put 5-10% down on a cans, including David West, a VA health official in New York, pocketed nearly home, you go directly to home shopping immediately. And, Veterans of every St. Louis, Missouri $26,000 in bonuses while overseeing chronic misuse of insulin VA loans are more lenient on credit history than just about war and conflict, pens that potentially exposed hundreds of veterans to blood- any loan type. If you've been sitting on the sidelines, wait- are buried in VA’s More than 1,800 veteran patients of the St. Louis VA Medical borne illnesses. ing for the right time to buy, now could be the perfect time. national cemeter- Center may have been exposed to HIV and Hepatitis as a result VA loan rates are low, and more Veterans are getting ap- ies. VA also pro- of unsanitary dental equipment. The facility has remained un- Dayton, Ohio proved. vides funding to establish, expand and maintain 105 Veterans ceme- der fire for patient deaths, persistent patient-safety issues and teries in 47 states and territories including tribal trust lands, Guam, critical reports. Despite the problems at the medical center, the For nearly 18 years, the dental clinic at the Dayton VA Medical (434) (845-4027 and Saipan. For Veterans buried in private or other cemeteries, VA facility’s director from 2009 - 2013, RimaAnn Nelson, received Center allowed unsanitary practices, potentially exposing hun- Sales & Service provides headstones, markers or medallions to commemorate their nearly $25,000 in bonuses during her tenure there. dreds of patients to hepatitis B and hepatitis C. Dayton VA Med- service. In 2016, VA honored more than 345,000 Veterans and their ical Center Director Guy Richardson then collected an $11,874 loved ones with memorial benefits in national, state, tribal and pri- Fayetteville, North Carolina bonus despite an investigation into the exposures. After nine of Blue Ridge Appliance vate cemeteries. the exposed patients tested positive Hepatitis B and Hepatitis C, A December 2012 audit of the Fayetteville VA Medical Center Richardson was promoted. Eligible individuals are entitled to burial in any open VA national found facility employees did not complete required suicide New & Used ∙ Buy – Sell – Trade cemetery, opening/closing of the grave, a grave liner, perpetual care prevention follow-ups 90 percent of the time for patients at a Pittsburgh, Pennsylvania of the gravesite, and a government-furnished headstone or marker or high risk of suicide. The audit also found the center WAYNE TWEEDY 189 LAKEVIEW DRIVE niche cover, all at no cost to the family. Veterans are also eligible for “noncompliant” in cleanliness of patient care areas, environ- After persistent management failures led to a deadly Legion- Owner & Operator MADISON HEIGHTS, VA a burial flag and may be eligible for a Presidential Memorial Certifi- mental safety, dental clinic safety, training and testing proce- naires’ disease outbreak in the VA Pittsburgh Healthcare Sys- cate. Information on VA burial benefits is available from local VA dures. In July 2012, during an investigation that substantiated tem, VA Pittsburgh director Terry Gerigk Wolf received a per- national cemetery offices, from the Internet at www.cem.va.gov, or patient misdiagnosis complaints, VA’s inspector general found fect performance review and regional director Michael Mo- An Air Force Truism by calling VA regional offices toll-free at 800-827-1000. To make the responsible physician failed to properly review medication reland, who oversees VA Pittsburgh, collected a $63,000 bonus. burial arrangements at any open VA national cemetery at the time of information 56 percent of the time, a step that is “critical to The only time you have too much fuel is when you’re on need, call the National Cemetery Scheduling Office at 800-535-1117. appropriate evaluation, treatment planning, and safety.” (continued on next page) fire.