Kristina Derro
Veteran Advocate

The wars in Iraqa and Afghanistan have dragged on for over a decade now. Since 2001, the U.S. has sent more than 2.2 million troops to battle, more than 6,600 were killed, and 50,000 were injured. This is a dismal reality of war.

However, the strides that have been made in medicine as a result of the war are astounding. The signature wounds of both conflicts, post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI), have led the Department of Defense to apportion hundreds of millions of dollars for research studies and treatment.

In the past six years, the Department of Defense has invested a minimum of $2.7 billion in understanding psychological and neurological injuries. $700 million has been apportioned for TBI research which has included an effort to develop a portable diagnostic tool for TBIs. Additional funding has gone towards researching combat wounds that failed to heal, partly attributable to unique bacteria present in Afghanistan.

The VA has its own set of priorities when it comes to researching. The VA is currently faced with rehabilitating veterans who have suffered complex wounds and are considered “polytrauma”, those who have sustained injuries to more than one organ system, or have severe brain injuries, or are amputees, or were severely burned. VA has worked on improving how it coordinates care to this group of veterans. It’s also worked on developing hearing and vision implants as well as robotic prosthetic devices. It even has pioneered its own TBI program which explores different treatment modalities like personalized medicine and nerve regeneration.

There are challenges in coordinating massive research programs and implementing them for our troops and veterans. A January 2012 report by the Government Accountability Office found that the Department of Defense’s mental health and TBI research needed better quality control mechanisms to report financial data. However, despite these limitations, some of the world’s best researchers and massive amounts of money are being utilized in an attempt to assist our nation’s troops and veterans.

Jim Fausone
Veteran Disability Attorney

One of the saddest situations we help with involves military sexual trauma (MST).  The rape of men and women in the military is a black stain on the Defense Department.  The VA disability process only makes this stain more stubborn.

We have developed an approach that looks at markers that show the MST even when it has not been reported.  The fact is that 70-80% of MST is not reported.  We often approach the VA process to prove the mental aspect of the MST, such depression, PTSD, etc.  We point out the fall off of performance ratings, discipline issues, AWOL, drug use, alcoholism or dark letters home.

This unique problem is now getting Congressional attention. The Ruth Moore Act aims to reduce the standard of proof for victims of military sexual assault so that they can more easily obtain benefits, similar to how the Veterans Administration two and a half years ago relaxed the burden of proof for combat veterans with post-traumatic stress disorder.  The Ruth Moore Act, if it passes, would make it so that victims need only a diagnosis of a mental health condition and a link between the assault and that condition to receive benefits.  This is a step in the right direction. Let’s hope Veteran Service Organizations support this bill and Congress acts on this bill.

http://www.stripes.com/news/us/maine-woman-inspires-federal-bill-to-help-military-sexual-assault-victims-get-va-benefits-1.207371

Legislators in Missouri want a court created specifically for veterans.

Rep. Jay Barnes, R-Jefferson City, has drafted legislation requesting that Missouri circuit courts create a place specifically for current and former U.S. military who are struggling with substance abuse or mental illness issues. Barnes stated that the country owes it to the veterans to get them the treatment they need to get their lives back on track.

The idea is supported by Rep. Charlie Davis, R-Webb City, who said the vet treatment court would run like a drug courts, where a judge would have the ability sentence a defendant to a rehabilitation facility or to perform some community service, without mandatory prison or jail time. Judges overseeing a veterans court can use the power of the court to force a vet to get treatment; proponents believe that recidivism rates for vets processed through a specialized vet court are lower than for those vets who do not go through a veterans court.

The court would be well-versed in Post-Traumatic Stress Disorder (PTSD) issues as well as Traumatic Brain Injury (TBI) issues, two conditions which can lead to law-breaking behaviors among military vets back in civilian life. According to a study in the Journal of Consulting and Clinical Psychology, vets with PTSD or TBI are far more likely than vets without either condition to be arrested. The bill currently proposed would not only help vets get treatment while taking into count their specific circumstances, the court would also be able to more efficiently deal with the backlog of veterans with court issues.

Objections that were previously raised in the Senate when discussing a veterans court included concerns from some that it would be used for veterans accused of committing violent crimes.

The veteran’s court model includes veteran mentors who assist with the program. While some systems vary, generally, a collaborative team made up of the judge, probation officers, a public defender, and a Veterans Administration representative get together to review cases to decide which veterans will be admitted to veterans court for a multi-phase, long-term system.

The first veterans court of this type was put into place in Buffalo, New York, in 2008. As of 2011, there were no reports of recidivism among the vets who completed the Buffalo program. There are now more than 70 veterans courts in the U.S.

To learn more or to contact a Veterans disability lawyer, Veterans disability attorney, Veterans lawyer, or Veterans attorney call 1.800.693.4800 or visit Legalhelpforveterans.com

Jim Fausone
Veterans Disability Lawyer

Legislators in Missouri want a court created specifically for veterans.

Rep. Jay Barnes,R-JeffersonCity, has drafted legislation requesting thatMissouricircuit courts create a place specifically for current and former U.S.military who are struggling with substance abuse or mental illness issues. Barnes stated that the country owes it to the veterans to get them the treatment they need to get their lives back on track. The idea is supported by Rep. Charlie Davis,R-Webb City, who said the vet treatment court would run like a drug courts, where a judge would have the ability sentence a defendant to a rehabilitation facility or to perform some community service, without mandatory prison or jail time. Judges overseeing a veterans court can use the power of the court to force a vet to get treatment; proponents believe that recidivism rates for vets processed through a specialized vet court are lower than for those vets who do not go through a veterans court.

The court would be well-versed in Post-Traumatic Stress Disorder (PTSD) issues as well as Traumatic Brain Injury (TBI) issues, two conditions which can lead to law-breaking behaviors among military vets back in civilian life. According to a study in the Journal of Consulting and Clinical Psychology, vets with PTSD or TBI were far more likely than vets without either condition to be arrested. The bill currently proposed would not only help vets get treatment while taking into count their specific circumstances, the court would also be able to more efficiently deal with the backlog of veterans with court issues.

Objections that were previously raised in the Senate when discussing a veterans court included concerns from some that it would be used for veterans accused of committing violent crimes.

The veteran’s court model includes veteran mentors who assist with the program.  While some systems vary, generally, a collaborative team made up of the judge, probation officers, a public defender, and a Veterans Administration representative get together to review cases to decide which veterans will be admitted to veterans court for a multi-phase, long-term system.

The first veterans court of this type was put into place in Buffalo, New York, in 2008.  As of 2011, there were no reports of recidivism among the vets who completed the Buffalo program. There are now more than 70 veterans courts in theU.S.

http://www.ncsc.org/Topics/Problem-Solving-Courts/Veterans-Court/Resource-Guide.aspx
http://ncsc.contentdm.oclc.org/cdm/ref/collection/spcts/id/233
http://www.economist.com/node/18775315

Kristina Derro
Veterans Disability Lawyer

Heartbreakingly, a new report out from the Department of Defense shows that in 2012 more soldiers took their own lives than died in combat. Through November 2012, 177 active-duty personnel had committed suicide compared with 176 soldiers who were killed in action during the same time frame. Army suicides have increased by at least 54 percent since 2007.

Blame has been placed on the military culture in which soldiers believe they will be deemed weak and denied promotions if they seek mental health aid. There is also the problem that our soldiers today face multiple deployments during their service. However, the Army has referenced the anti-suicide strategy that that it put in place in April 2009 and claims that with the new programs in place it will just be a matter of time until they start making a dent in the issue. The Army stressed that soldiers are assured that seeking mental health counseling will not harm their chances at gaining a security clearance.

In July 2010, the Army released a report that purportedly explained its suicide epidemic. The report referenced loosened recruitment and retention standards due to the furious pace of repeated deployments. The Army claimed this allowed more than 47,000 people to remain in the Army, despite histories of substance abuse and misdemeanor crime. Obviously, this report only angered families who had lost members to suicide because it insinuates that those individuals were in some way “flawed” and prone to suicide, despite the fact that they served honorably. It also completely overlooked the fact that soldiers were subject to multiple deployments.

These findings only highlight the fact that the military culture is still one where mental health treatment is not fully embraced. It is also a sign that further programs need to be put into place in the military to prevent further suicides. Having our active-duty personnel being placed in harm’s way during combat is a necessary evil. Having them end up surviving combat, but dying once they get home due to a lack of a supportive military environment—the same military that sent them to combat—is atrocious.

Vietnam Veterans of America has joined a proposed class action lawsuit in Connecticut against the armed forces. The lawsuit, filed by a veteran last year against the Army, Navy and Air Force, states that Vietnam War-era veterans who suffered PTSD were discharged under other-than-honorable conditions which meant they were ineligible for disability and other benefits. The military has not reviewed or upgraded the discharge statuses of thousands of those vets with service-related PTSD. As John Rowan, national president of

Vietnam Veterans of America, said, PTSD was not understood by mental health professionals when those vets were in service.

“Now that diagnoses have been updated,” says veterans’ lawyer James Fausone, “it seems perfectly reasonable that there are some vets who would like their discharge status changed to reflect that.”

The U.S. Attorney’s Office is currently reviewing the matter and plans to respond in court. The office is representing the military in this lawsuit, which was filed by Vietnam vet John Shepherd. Shepard says he was first diagnosed with PTSD in 2004, but repeatedly has had his discharge upgrade requests denied. Shepherd is being represented by Yale Law School students who are working at a Connecticut-based legal services clinic for vets. According to those students, the Army has approved less than 2 percent of Vietnam vet upgrade applications since 2003, in sharp contrast to the 46 percent of overall discharge upgrades. And, say the students, some of the vets who are being denied an upgrade have been formally diagnosed with PTSD by Veterans Affairs.

The students estimate that some 85,000 of the 250,000 other-than-honorably discharged Vietnam veterans had PTSD. Their PTSD was likely a factor in the discharges that were based on conduct including drug use, unauthorized absence without leave, and shirking.

Sen. Richard Blumenthal, D-Conn., is in support of the vets, and has reportedly been working in concert with the Yale Law Clinic and federal agencies to attempt to resolve the issue. He stated that though PTSD was not understood in the past, that should not preclude how cases are assessed now.

http://www.seattlepi.com/news/us/article/Vietnam-veterans-sue-military-in-Conn-over-PTSD-4087471.php

The issue of veterans and gun rights has been a sticking point in the $631 billion defense bill. Sen. Tom Coburn, R-Okla. has attempted to halt the Veterans Affairs Department plan to place the names of some veterans into the National Instant Criminal Background Check System.  Sen. Coburn has stated that, in order to take away someone’s Second Amendment rights, it should be adjudicated, rather than simply mandated by an automated system.

Inclusion on the list would mean those veterans would be prohibited from buying or owning firearms. Sen. Charles Schumer, D-N.Y., has stated that though he loves the country’s veterans, if they have been deemed mentally unfit, they should not have possession of a gun.

“The Veterans Administration currently appoints fiduciaries, usually the family members of a veteran, to manage his or her pensions and disability benefits when they have been declared mentally incompetent,” said Veterans disability lawyer James Fausone. “When a vet has been declared mentally incompetent, his or her name is automatically entered in the Criminal Background Check System.”

A group, led by Sen. Richard Burr, R-N.C., has been pushing to change that policy, allowing the addition of the name to the list only if a judge deemed the veteran to be a danger. This latest version of the bill, co-sponsored by 21 lawmakers, passed the Senate Veterans’ Affairs Committee. The legislation also has the backing of the National Rifle Association and numerous veterans’ advocacy groups. Meanwhile, the Brady Center to Prevent Gun Violence supports the VA’s current policy. Tom Tarantino, chief policy officer for Iraq and Afghanistan Veterans of America, has stated that vets who have a traumatic brain injury or PTSD, but who pose no actual threat to others might view the current restriction as a disincentive to seek treatment.

As of 1998, 185 of the 127,000 veterans on the gun-check registry list have worked to have their names removed, according to the VA. Veterans can appeal their diagnosis, and can petition for their firearm rights to be reinstated by the agency to have his firearm rights restored on the basis of not posing a threat to public safety.

http://www.foxnews.com/politics/2012/12/03/veterans-gun-rights-sticking-point-in-defense-bill/

Jim Fausone
Veterans Disability Lawyer

The VA compensates veterans for primary and secondary disabilities connected with service.  Traumatic Brain Injury is a signature injury of Iraq and Afghanistan wars because of IED.  So it is good news that VA is considering the secondary effects of TBI.  Last week  VA began the process of adding five illnesses — unprovoked seizures, dementia, Parkinsonism, some hormone deficiencies and depression — as “secondary” illnesses connected to a proven TBI injury.   Researchers from the National Academy of Sciences’ Institute of Medicine have found relationships between brain trauma and these other illnesses.  VA does not anticipate significant changes because of the new rule change, because the secondary illnesses still require an existing TBI diagnosis. Those of us who work with VA would disagree because the recognition of these secondary conditions eliminates proving such to VA which can take years and every RO treats these matters differently.  A secondary condition recognition will force that a national standard be applied.

http://www.stripes.com/news/va-relaxes-rules-for-benefits-for-tbi-related-illnesses-1.199762

Jim Fausone

Veterans Disability Lawyer

It would be easy to get made about this. But many people feel free to comment that PTSD is not a real condition.  I suspect they mean it’s not an “injury” that you can attribute to a single act or event. It is not a sprained knee or back.  You have to remember that some people believe the following (1) man has never walked on the moon; (2) the earth is flat ; (3)  one’s race impacts one’s intelligence; (4) global warming does not exist; (5) there is no god  and a variety of other commonly held believes are not true just because.

So when I hear about the veteran and PTSD haters talk about PTSD, I just lump them in the “it takes all kinds” category.   In 2011, the VA listed the three most common service-connected disabilities among veterans receiving federal compensation that year: tinnitus (ringing in the ears) at 10.9 percent, hearing loss at 7.5 percent, and PTSD at 5.3 percent.   According to the VA the percentage of veterans of World War II and Vietnam who obtained disability compensation is 11 percent and 16 percent, respectively.

So does that mean PTSD has been faked for the last 70 years?  I don’t think so.  Despite exhaustive scientific studies that have explored the symptoms, causes, diagnoses, and prevalence of post-traumatic stress disorder, hardcore skeptics remain.  If you want to read about the skeptics see the following blog:

http://usnews.nbcnews.com/_news/2012/11/26/15395330-ptsd-may-be-overdiagnosed-but-ptsd-deniers-are-wrong-psychologists-say?lite

Kristina Derro
Veteran Advocate

According to an investigation by American-Statesman, of all the Texas veterans who served in Iraq and Afghanistan and were receiving disability benefits when they died, a majority accidentally died from drug overdoses or toxic prescription combinations.

Information released by the U.S. Department of Veterans Affairs indicated that almost 350 veterans from Texas with VA benefits died between 2003 and 2011; investigators from the American-Statesman went on to identify those veterans and confirm that 266 of them, 77 percent, died of accidental drug overdoses or from an accidental and toxic combination of prescription drugs.

There is a dramatic lack of research on veterans’ deaths and drug overdoses. According to Amy Bohnert, a researcher at the University of Michigan and Department of Veterans Affairs, the lack of research is a concern. Bohnert recently published the first-ever systemic examination of overdoses and recent veterans.

Bohnert looked at all the veterans nationally who were receiving VA services in 2005. She deduced that more than 1,000 of them died from accidental drug overdoses, with, accounting for age and gender, is double the rate of accidental drug overdoses for the civilian population. Bohnert conclude that accidental drug overdoses are a far greater threat to military veterans than suicidal acts, through suicide has been far wider publicized.

Analysis by the Statesman suggests that for veterans from Afghanistan and Iraq, drug overdoses may be even more of an issue than for all military veterans.

A review by the Statesman of autopsy reports for Texas veterans determined that while a few of the overdoses were attributed to illegal drugs, most of the drug-related deaths were due to prescription medications, including pain medication, sleep aids and medication for anxiety and depression. While 3 out of the 47 listed overdoses were determined to be suicides, the others were accidental miscalculations of toxic drug combinations or dosages.  The average age of death for the Texas veterans examined as part of the study was 29, and three of the veterans were women.

Prescription drug addictions, especially addictive opiate painkillers, are at the forefront of the drug issue with recent veterans; nearly half of service people returning from Afghanistan and Iraqreported pain-related issues. Military doctors in 2009 prescribed an estimated 3.8 million narcotic pain pills, an increase of 400 percent since 2001. In addition, the Army reports that amphetamine prescriptions to treat adult attention deficit hyperactivity disorder doubled between 2006 and 2009.  An Army study from 2010 found that one-third of soldiers were taking prescription meds, and almost 50 percent of those soldiers were taking opiate painkillers.

Sources

http://thetimes-tribune.com/news/carbondale-vet-tells-of-his-experiences-with-ptsd-and-iraq-war-1.1372306

http://www.statesman.com/news/news/prescription-drug-abuse-overdoses-haunt-veterans/nSPLW/