Veterans Affairs wants to be an advocate, not an enemy

By David Zucchino, Los Angeles Times

May 31, 2010 12 AM PT

John Lamie survived six roadside bombings in Iraq, only to have the Department of Veterans Affairs refuse to accept three months’ worth of medical tests he underwent for jaw and shoulder wounds — tests performed by VA-approved doctors at VA facilities.

Casey Elder, who says she suffers migraines and memory loss from a roadside bomb in Iraq, has been told by the VA that the bombing did not cause those problems — despite a VA doctor’s diagnosis that she suffered a traumatic brain injury.

After Clay Hunt was shot through the wrist by a sniper in Iraq, the VA misplaced his disability paperwork for four months. Then he was required to visit a series of doctors to verify the extent of his wounds.

Many veterans wounded in Iraq and Afghanistan are being buffeted by a VA disability system clogged by delays, lost paperwork, redundant exams, denials of claims and inconsistent diagnoses. Some describe an absurd situation in which they are required to prove that their conditions are serious enough for higher payments, yet are forced to wait months for decisions.

“You fight for your country, then come home and have to fight against your own country for the benefits you were promised,” said Hunt, 28, who served in Iraq and Afghanistan as a Marine Corps sniper.

It took Hunt, who lives in Brentwood, 10 months to receive VA disability payments for his injuries after the agency misplaced his paperwork.

The VA, which still relies on a mostly paper-based system for disability claims, is overwhelmed by a flood of wounded veterans from the long Afghan and Iraq wars. That’s in addition to the Vietnam War, Korean War and even World War II veterans.

Some veterans wait up to six months to get their initial VA medical appointment. The typical veteran of the Iraq or Afghanistan wars waits 110 days for a disability claim to be processed, with a few waiting up to a year. For all veterans, the average wait is 161 days.

The VA says a ruling on an appeal of a disability rating takes more than 600 days on average. The Iraq and Afghanistan Veterans of America, or IAVA, an advocacy group, says the average delay is 776 days.

Up to 17% of veterans’ disability ratings are incorrect, the VA says. Thousands of dollars in disability payments hinge on the ratings, which are determined by the VA. The agency says it hopes to eventually cut the error rate to 2%.

With the VA deluged with 90,000 new claims a month, the backlog has reached 175,000. The VA defines a backlogged case as one that takes more than 125 days to process.

“It makes veterans feel like they’re fighting VA paperwork instead of the enemy,” said Paul Rieckhoff, an Iraq veteran and executive director of IAVA, which has praised the quality of VA medical care but has criticized the claims process.

VA officials concede that many veterans face delays, mistakes and bureaucratic logjams. But they say they are instituting reforms that are making the system more efficient and equitable.

“We absolutely agree it takes too long to process a claim, and we absolutely have to do a better job,” said Michael Walcoff, the VA’s acting undersecretary for benefits.

Walcoff acknowledges that veterans have “a lot of negative feelings” toward the VA.

“A lot of veterans don’t trust the VA because of the hoops we make them jump through” for some claims, he said. “We’ll do whatever it takes to fix this system.”

By 2012, the agency plans to move away from paper-based claims to an electronic data system. The VA has provided some veterans with advocates to guide them through what Walcoff concedes can be “a confusing, difficult process.”

Another reform has allowed service members at many bases to file for VA disability payments before they leave active duty — giving them a head start on the claims process.

This spring, the VA expects to ease requirements for proving post-traumatic stress disorder, the signature wound of the Iraq and Afghanistan wars. Veterans will have to show only that the totality of circumstances during their service caused PTSD. Currently, they must prove that a specific “stressor” incident caused the disorder.

But a huge backlog remains. VA Secretary Eric K. Shinseki, who has promised to eliminate the backlog by 2015, called it “one area in which we did not progress as I would have wanted.”

In a speech to the Veterans of Foreign Wars in March, Shinseki promised “to change the culture inside VA to one of advocacy for veterans.”

The Obama administration has proposed a 27% increase in the VA’s budget for next year. The agency has hired 4,200 employees since 2007 to tackle the backlog and has increased overtime.

For 27,000 veterans in a pilot program, the average wait for benefits — after they finish the disability evaluation process — was reduced to one month, from six to eight months. Another pilot program puts VA employee advocates at 27 military bases, assisting nearly half of the veterans seeking disability benefits.

Tom Tarantino, a former Army captain and Iraq veteran who analyzes the disability system for the IAVA advocacy group, said the changes had made some things easier for veterans, “but I still see things that are so stupid, so ridiculous, it makes me want to slap my forehead.”

Even with reforms, negotiating the disability system can be a maddening slog. Many veterans complain that the burden is on them to prove the severity of their wounds and also verify that they were injured during their service.

Often in severe pain or suffering psychological distress, many wounded veterans are overwhelmed by the task.

Lamie, 25, an Army combat engineer who risked his life uncovering and defusing roadside bombs in Iraq, declared bankruptcy in April. He is unable to work because of his combat injuries, he said, and VA delays have left him short of cash to support his wife and four children. He gets $311 a month in food stamps.

“I did everything the VA asked of me, but they block you at every turn,” Lamie said from his home in Georgia. “They play with people’s lives.”

Last year at a VA facility on his Army base in Kansas, Lamie underwent exams for PTSD and wounds to his shoulder, knees and jaw. But after he left the Army and moved home to Georgia, the local VA office told him he’d have to take the tests again.

Those tests had resulted in a 50% VA disability rating, and Lamie began receiving a monthly disability payment. But he said his Army retirement pay was docked for the disability amount, reducing his monthly retirement check to $86, from $1,085.

After more than a year of placing several hundred angry phone calls to the VA and bombarding the agency with medical paperwork, Lamie was finally told last month that he would soon receive $3,300 a month in VA disability benefits.

The logjam was broken after Lamie stumbled upon a helpful VA employee in Valdosta, Ga. He phoned her 15 to 20 times and visited her office several times.

“They drag their feet, hoping you’ll give up,” Lamie said. “A lot of people do. Not me.”

In Los Angeles, Hunt said he spent weeks visiting various doctors and putting together the 200-page packet of medical records that the VA later misplaced.

“I can track my pizza from Pizza Hut on my BlackBerry, but the VA can’t find my claim for four months,” he said.

Now he has developed memory loss, panic attacks and other symptoms of possible traumatic brain injury, he said. He is deciding whether to apply for increased benefits and dive once again into the VA bureaucracy.

When he volunteered for the Marine Corps, Hunt recalled, a selling point was lifelong medical care if he were wounded.

“But then the time comes to get those benefits, it turns into a lifelong battle with the VA to get what you were promised,” he said.

Elder ultimately received VA benefits for wrist, arm and shoulder injuries from the roadside bombing in Iraq, where she was an Army military police officer. But when she began experiencing migraines, memory loss and vertigo, she filed a claim for traumatic brain injury.

A VA-approved neurologist diagnosed her with traumatic brain injury, she said. But after almost a year’s wait, the VA denied her claim, saying the injuries weren’t caused by her military service.

“Well, I didn’t have these problems before I went into the service,” she said from her home in Billings, Mont.

Now Elder worries that her symptoms will deteriorate into dementia — at age 25.

“I just want them to acknowledge that they broke my brain,” she said.

Lamie said he had to fight for a year, “basically screaming and raising hell to get what I got.”

The experience has left him drained and disillusioned. He said he couldn’t even look at his old Army uniform anymore.

“I can’t stand the sight of it after what I’ve gone through with the VA,” he said. “I’m not proud anymore.”

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