Karen Heller: Veterans Court winning cases

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Needed in IL & CU Area

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Posted on Wed, May. 26, 2010



Karen Heller: Veterans Court winning cases

By Karen Heller

Inquirer Columnist



Today is Veterans Day at the Criminal Justice Center. So is every

Wednesday, when it's time for Veterans Court, the Hon. and U.S. Army

Reserve Capt. Patrick F. Dugan presiding.



Established in March by state Supreme Court Justices Ronald D. Castille

and Seamus P. McCaffery, both decorated veterans, the court is one of

three in the state, and almost 20 nationwide, exclusively handling

veterans' misdemeanor cases.



It's already a success, a "problem-solving" court, like drug court and

mental health court, designed to expedite assistance and avoid costly

legal delays and jail time. Defendants range from age 20 (Iraq) to 80

(Korea), but the cases are remarkably sad and similar - virtually all

male, charged with driving under the influence, disorderly conduct,

possession, spousal abuse.



"A vast majority of the defendants are involved with drugs and alcohol,"

Dugan says. They need treatment and attention.



"I finished the ninth grade," says an Army veteran, picked up for

possession. He looks as if his best years are decades behind him.



"I believe you attended the University of Vietnam," says Dugan, who

speaks respectfully to all veterans. "You need to clean up. You've been

there. You've seen some crazy stuff in your life. This is illegal.

You've been through too much to go through that. So step up."



Normally, the wheels of justice grind slow. That is not the case in

Veterans Court, where 25 cases are adjudicated in two hours.



"In most courtrooms, it takes a long time to get a diversion program to

kick in because of the sheer size of the bureaucracies," says Dugan, a

former infantryman and paratrooper in the 82nd Airborne, who later

served tours in Iraq and Afghanistan. He may also be, quite possibly,

the only judicial candidate who ran partially on an "I hate the Dallas

Cowboys" platform.



"It can take six months for a diversion program to kick in," he says.

"Here, it's almost instantly. Some veterans start the program before

I've heard the case."



This is thanks, in large part, to the work of Rebecca Hicks of the

Department of Veterans Affairs, who works in Courtroom 1003 Wednesdays

along with Kelley Hodge of the District Attorney's Office, public

defender Brunilda Vargas, and a trio of proud, elegant veteran mentors

sitting in the front bench, waiting to help.



"She's outstanding. I can't commend Rebecca enough for the job she's

doing," Dugan says of the soft-spoken social worker. "She goes to prison

to meet with these people. We're blessed to have her in the room."



Veterans represent a tenth of the jail population, according to the VA,

the majority charged with nonviolent offenses. All legal and government

entities present in the courtroom share the same goals: to get these men

help before they seriously hurt others, while keeping them out of jail.



Veterans Court is also there to help defendants from slipping further

and becoming homeless. A third of all men on the street are believed to

have served in the military, according to the National Coalition for

Homeless Veterans.



"The majority of our veterans are really grateful," says Hicks. The

Philadelphia office assists 60,000 veterans annually, a third of them

for behavioral health issues, and drug and alcohol abuse. "We're trying

to turn a negative set of circumstances into a positive, life-changing

experience. I see the veterans as quickly as I can after their first

hearing. Sometimes, the very next day." After each case, Hicks beckons

the veteran to her table and in her old-fashioned daybook schedules an

assessment appointment.



"Obviously, we're in favor of any program that aids our clients," says

Assistant Public Defender Charles Cunningham. "We certainly think people

who have served our country are entitled to some special consideration.

Sometimes the reason they're in this position is because of service to

this country."



Veterans Court is able "to provide therapeutic assistance while reducing

the risk of recidivism," says Hodge, who is chief of the district

attorney's Municipal Court unit. "How an individual does with treatment

dictates whether he 'graduates' out of the system. What benefit is it to

us if he goes into jail and serves his time but is never treated for

alcoholism?"



One Navy veteran, 54, returns to court after his third DUI offense and

detox treatment at the VA's Coatesville facility. "I've been in trouble

with alcohol all my life. You've saved my life," he tells the court, the

public defender requesting that his name not be published. "My life was

going right down the drain. You're giving me the tools to get my life

back. Hospitalization is the best thing that could happen to me."



Dugan addresses three defendants, all charged with DUI. "This is like

shooting a gun into a crowd. I've read your files and, between you guys,

the places you saw, the things that you've done, the ribbons you have,

you've done so much," he says.



"You guys are the good guys. I expect more of you," Dugan says. "So

don't be coming back into my courtroom because I'll hold you to a higher

standard. And I will hammer you. And you would expect that of me."



All three defendants stand at military attention, nodding their heads in

unison.

------------------------------------------------------------------------

--------



Contact columnist Karen Heller at 215-854-2586 or

kheller@phillynews.com.


Karen Heller: Veterans Court winning cases


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sounds like a good program hopefully a few bad apples won't mess it up for all of the men and women who will also need a little help along their way to adjust to "home life again" some people do not understand sometimes veterans just need a friendly kick in the azz to remind them of who and what they were and can be again. All they need is a chance

Sphere: Related Content

War Veteran Says Military Burn Pits Caused His Cancer

War Veteran Says Military Burn Pits Caused His Cancer

Posted: May 17, 2010 12:27 AM EDT





Yuma, AZ May 16 - Iraqi war veterans know the risks associated with combat, but one local soldier never thought he would be put at risk for cancer.

He says government contractors are to blame. He thought Al-Qaeda and the Taliban were deadly but it turned out, that was the least of his worries.

Burn pits in Iraq and Afghanistan, hundreds are speaking out saying they're sick because of toxins in the air from what's getting burned.

Yuma resident Rigo Gonzalez says, "I brought these tents, large all purpose tents that are petroleum base and when you burn these tents, they release a toxin called benzene."

Benzene is a probable cause for the type of leukemia Rigo Gonzalez has been diagnosed with. And he's not the only American hero with these problems.

"The symptoms were exactly the same as mine: leukemia's, cancers, respiratory problems, all kinds of symptoms and diseases that these burn pits were causing."

And now there's a class action lawsuit against KBR, the government contractor in charge of the burn pits.

Gonzalez says, "when you take shortcuts and you don't take into consideration safety and human life, then you have to be held accountable for it."

Hundreds are involved in the lawsuit and Gonzalez says the number is growing everyday. He says concern over the burn pits was never a consideration.

"Your main concern is just to survive that day. You think it'd be things related to the enemy, but when it comes from people that supposedly are on your side, it's hard to take."

Gonzalez says a physical saved his life and he's encouraging all war veterans to protect themselves.

"You need a thorough physical with blood work and everything and I stress that for people coming back from combat in Iraq or Afghanistan."

KBR denies the allegations they are being negligent. On June 4th, a judge will rule whether the case will go to trial. Until then, hundreds of people like Gonzalez and several widows and their families wait.

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I sympathize with this veterans and the tens of thousands others that have been exposed to these toxic materials due to the burn pits since the war began, but I fear as other military contractors of the past have been protected by the DOD and the federal courts as the work the companies were doing were under the rules established by the DOD and that the Feres Doctrine will prevent these injured soldiers, marines and air men and any other military personnel harmed by the toxic environment. KBR will claim they were doing what the military asked them to do, the governemnt supplied them with the JP4 that was used as the accelerants to make everything burn, and that KBR itself is not responsible for what the Generals were asking them to do. Just as DOW and other makers of Agent Orange escaped large financial liability, I forsee KBR escaping financial harm in this case.

I am sorry for feeling this way, and I wish all of the sick veterans a vetter outcome but like the Agent Orange victims the only real financial liability will come from the Veterans Adminsitration for what can be proved as medical problems caused by exposures to the toxic substances, I will give the government credit that this is the first time in history that the VA has recognized the issues emanating from the toxic fumes of the burn pits while the wars are still being fought in Iraq and Afghanistan where the burn pits are still in use in some places. Normally the government will fight for 10-40 years before admitiing any type of liability thru the VA, so in that aspect these veterans are better off than veterans of past wars, look at the veterans of Gulf War One they still have not "found" the cause of the 25% disability rates of that era's veterans.

I wish these veterans well in court but I will not be shocked when the court system rules in favor of the contractor.

Sphere: Related Content

In tide of new PTSD cases, fear of growing fraud

In tide of new PTSD cases, fear of growing fraud


5/1/2010 11:15 AM
In tide of new PTSD cases, fear of growing fraud

By ALLEN G. BREED AP National Writer

Moved by a huge tide of troops returning from Iraq and Afghanistan with post-traumatic stress, Congress has pressured the Department of Veterans Affairs to settle their disability claims _ quickly, humanely, and mostly in the vets' favor.

The problem: The system is dysfunctional, an open invitation to fraud. And the VA has proposed changes that could make deception even easier.

PTSD's real but invisible scars can mark clerks and cooks just as easily as they can infantrymen fighting a faceless enemy in these wars without front lines. The VA is seeking to ease the burden of proof to ensure that their claims are processed swiftly.

But at the same time, some undeserving vets have learned how to game the system, profitably working the levers of sympathy for the wounded and obligation to the troops, and exploiting the sheer difficulty of nailing a surefire diagnosis of a condition that is notoriously hard to define.

"The threshold has been lowered. The question is how many people will take advantage of that," said Dr. Dan G. Blazer, a Duke University psychiatrist who has worked with the military on PTSD issues. PTSD, he adds, is "among the easiest (psychiatric) conditions to feign."

Mark Rogers, a longtime claims specialist with the Veterans Benefits Administration, agrees. "I could get 100 percent disability compensation for PTSD for any (honorably discharged) veteran who's willing to lie," said Rogers, a Vietnam-era vet who is now retired. "I just tell him what to say and where to go."

Some claims are built on a foundation of fake documents; in other cases, the right medals _ plus a gift for storytelling _ secure unearned benefits. Consider:

_Gulf War veteran Felton Lamar Gray told a VA psychologist he was spattered with "blood and chunks of head" when his "best friend" was shot in the face in Iraq. But only after the VA rated Gray 100 percent disabled did anyone check into his stories _ and discover the comrade he spoke of is very much alive and said he barely knew Gray.

_Thomas James Barnhart is a Coast Guard veteran who used forged documents to convince VA doctors he was an elite, much-decorated Navy SEAL. Barnhart's tales of daring rescues and of cradling a dying helicopter pilot in his arms won a congressman to his cause and helped him get a 30 percent PTSD disability rating from the VA, before he was outed by a watchdog group.

_Vietnam-era veteran Keith Roberts of Gillett, Wis., said he was traumatized when he was prevented from rescuing a friend being crushed under a Navy airplane, and was eventually granted 100 percent disability. But when the case was reopened, investigators could find no evidence that Roberts was even present when the accident occurred.

Each of these cases represents potentially millions of dollars in tax-free benefits over the veteran's lifetime _ benefits that may continue while the veteran works and even into retirement.

"There's pressure from the public to sympathize with veterans and treat them with respect," said Assistant U.S. Attorney Craig J. Jacobsen in Roanoke, Va., who prosecuted Barnhart and has handled other such "stolen valor" cases. "And you don't want to go questioning their stories unless you have a very good reason to do so. ... So I think it's hard to sift out the phonies from that."

PTSD is an undeniably real sickness whose symptoms _ flashbacks, vivid nightmares, intrusive thoughts, exaggerated startle response, emotional numbness _ can be debilitating. As of Fiscal Year 2009, nearly 390,000 veterans were receiving benefits for PTSD, making it the fourth-most prevalent service-connected disability, according to the VA.

Authorities have tried to brace the public for a tidal wave of psychically damaged veterans from the current wars. Of the roughly 1.6 million troops who have served in the war zones of Afghanistan and Iraq, more than 134,000 had been seen at VA health care facilities for "potential PTSD" as of late last year, according to a government report. Researchers suggest the numbers of actual sufferers are much higher.

A much-cited telephone survey published in 2008 by the Rand Corp. suggested that 300,000 veterans of the current wars were suffering from PTSD or major depression. A more recent study by researchers at the Naval Postgraduate School and Stanford University estimates that the PTSD rate among Iraq War veterans will be about 35 percent.

In its latest budget request, the VA estimates it will receive more than 1.3 million disability claims in 2011 _ a 30 percent increase over last year. New claims continue to pour in from veterans of Vietnam, Korea and even World War II.

Veterans groups have sued the VA, complaining that claims take months and even years to be approved, and that some veterans had committed suicide as a result.

Last year, U.S. Rep. John J. Hall, D-N.Y., introduced legislation to streamline the VA claims process, especially for veterans in traditionally noncombat roles. Arguing that the system failed to recognize the changing face of war, Hall said the claims process had become an obstacle to healing, "inflicting upon the most noble of our citizens a process that feels accusatory and doubtful of their service."

VA Secretary Eric K. Shinseki responded last summer with a proposed rule change. Until now, the agency has required independent proof that a traumatizing event _ or "stressor" _ occurred. Under the proposed changes, a veteran's "lay testimony" about what happened to him would suffice, as long as it "is related to the veteran's fear of hostile military or terrorist activity" and is "consistent with the places, types, and circumstances of the veteran's service."

Already, VA officials are legally bound to resolve "any reasonable doubt" in the veteran's favor. And Rogers, the retired claims specialist, and others say the system is vulnerable to fraud because of the way it was designed: Doctors make diagnoses without fact-checking the veteran's story, and once that diagnosis is made, claims raters' hands are essentially tied.

No one knows the full extent of PTSD fraud; there is little political will to pursue a systematic investigation. But there have been some hints.

In 2005, a VA Inspector General's review of 2,100 PTSD cases found that a quarter lacked proper documentation of a stressor; if the sample was representative of all PTSD claims, questionable compensation payments would have totaled $860 million that year. Then-VA Secretary Jim Nicholson announced that the review would be expanded to cover 72,000 cases where veterans had received a 100 percent disability rating for PTSD.

But when a veteran from New Mexico was found shot to death, his Purple Heart and a letter about the VA review by his side, a group of senators drafted an amendment to halt the review, which was termed "wrong-headed, costly and unnecessary" by one senator.

The critic? Barack Obama.

A 1990 law allows the Veterans Benefits Administration to crosscheck its rosters with federal tax and Social Security databases to find "unemployable" veterans reporting work-related income. In 2004, this program identified 8,846 such veterans who reported at least $6,000 in earnings, including 289 with income of $50,000 or more.

VBA management referred these cases for review to see if benefits should be revoked or reduced, but the inspector general found the agency "lax in tracking the results."

The best way to catch phonies is on the front end, but that's not how VA operates, said Jim Gaughran, a former VA program director for benefits fraud.

"They never get in trouble for paying; they only get in trouble for not paying," said Gaughran, now a deputy assistant inspector general for the Department of Homeland Security. "They'd rather pay and chase."

Most frauds are uncovered by investigators outside of the VA, observers say.

Barnhart _ the Coast Guardsman who masqueraded as a Navy SEAL _ was exposed by Chuck and Mary Schantag of the P.O.W. Network, which has outed thousands of phony heroes.

The closest Barnhart got to the jungles of Vietnam was a stint on a Navy warship off the coast in 1969 and 1970, Jacobsen told a judge during a hearing in January. But when he switched to the Coast Guard, Jacobsen said, Barnhart would "spin yarns about his secret missions with the Navy SEALs" and even claimed to have been nominated for the Medal of Honor.

"The defendant further admitted that he had lied about his medals and death experiences during his medical exam in the hopes that it would increase his chances to get disability for PTSD," Jacobsen testified. Barnhart was granted a 30 percent disability rating for PTSD and collected $13,923 before he was caught.

Barnhart pleaded guilty Jan. 6 in U.S. District Court in Roanoke, Va., to two counts of violating the Stolen Valor Act. On April 8, Judge James C. Turk sentenced him to 12 months and a day in prison and two years of supervised release, and ordered him to pay $11,098 in restitution.

He hung up on an AP reporter seeking comment.

In the case of Felton Gray, the Gulf War veteran told a psychologist at the VA medical center in Portland, Ore., that he'd put "hundreds of Iraqi soldiers in bags," and that his best friend was hit in the face with a bullet during a mission to clear an enemy trench, spraying Gray with gore. As a result, he said, he could not sleep at night and found it difficult to leave his apartment.

"This man has suffered severe enough traumas to qualify for a diagnosis of post traumatic stress disorder and in fact has serious symptoms," Dr. Ruth Parvin wrote in her evaluation. With other, physical problems, that finding earned Gray a designation of "individual unemployability" _ and 100 percent compensation.

Trouble is, none of what Gray told the doctor happened.

When initially examined by the VA in June 1993, Gray "did not report any stressors in the military relating to combat," his records show. He was later granted service connection for migraine headaches, a shoulder injury and bunions, for a total disability rating of 50 percent.

Gray filed for PTSD in 1996, and was granted service-connected disability two years later.

Normally, such records are closed to the public, unless the veteran signs a waiver. But AP obtained nearly 1,500 pages from Gray's VA claims file because they were part of a criminal investigation.

Gray was charged with murder in the Aug. 4, 1998, shooting of former NFL linebacker Marquise Leslie Thomas. Gray claimed that the larger Thomas had forced himself into his Beaverton, Ore., apartment, and that he had fired in self-defense. He was eventually convicted of first-degree manslaughter and sentenced to 10 years in prison.

Gray's attorney initially planned to mount a PTSD defense. When Beaverton police checked out Gray's war stories, they fell apart, police and court records show.

Although his "best friend," Ronald Rowe, did have an M-16 explode in his face during a training exercise in a mock-up of an Iraqi entrenchment, he only had "a little scratch on my face and ringing in my ears" and didn't require medical attention, he told the AP recently from his home in Madison, Tenn.

As for handling dead Iraqis, Rowe said: "Everybody we captured was alive. There wasn't no body bags."

When the Board of Veterans Appeals granted Gray a 70 percent rating for PTSD, the panel acknowledged that it did so without verifying his stressors or even his dates of service. The board accepted Gray's Combat Infantryman Badge "as sufficient evidence of in-service stressors relating to combat and reasonable doubt has been ruled in favor of the veteran."

The AP recently contacted Gray, 42, at his home in Tigard, Ore. "There was no fake," Gray said. He declined to open his updated VA file but insisted that his disabilities have been "validated." The VA would say only that Gray is currently drawing $2,882 a month _ 100 percent disability.

"All of that is a part of the past, and I choose to move forward," Gray said.

Some critics complain that a lack of personnel _ clinicians to do the evaluations and ratings specialists to handle the claims _ slows down the claims process. But that same shortage makes it more difficult for examiners to make accurate diagnoses and catch frauds.

Gray "fooled me. It's easy," said Dr. Landy F. Sparr.

Sparr _ former acting chief of psychiatry at the Portland VA Medical Center _ conducted a forensic examination of Gray and confirmed the PTSD diagnosis. He said the three hours recommended by the VA for a compensation and pension exam are hardly sufficient to form an opinion.

"If you wanted to do a proper evaluation, it would take you hours and hours _ I'm talking at least five, six hours _ to review the records and do everything," said Sparr, now an associate professor at Oregon Health & Science University. Given rates of $500 per exam for contractors, Sparr said, "It's just not going to happen."

Rogers, the claims specialist, said the clinicians don't feel it's their job to verify a veteran's stories.

Duke's Blazer adds: "Checking behind a patient actually breaks the confidentiality of the doctor/patient relationship, putting (it) into a position of adversarial rather than cooperative."

But claims raters are basing their decisions on diagnoses from psychiatrists and other mental health professionals. Once a diagnosis of PTSD is given, the rater is "prohibited from cross-examining the veteran," said Rogers, who worked at the VBA for nearly 30 years.

VBA workers say they are under enormous pressure to push claims through. Richard Allen, a Vietnam-era veteran who worked in the VBA's Wichita, Kan., office, remembers a sign on the wall there: "Pay if you can, deny if you must."

He recalls one manager telling him, "'You don't get it. Your job is to pay.' Myself and others thought it was our job to take care of veterans and, when they're entitled, to pay them everything they're entitled to. But when they're not entitled, someone has to say, `No.'"

But generally, they say yes.

Robert Warren, 45, of Sullivan, Ill., played the SEAL role to the hilt, right down to the signature trident tattooed on his left calf. He told harrowing stories of action in Somalia and Lebanon, low-altitude parachute jumps and of being a prisoner of war _ stories so convincing that when he applied for PTSD benefits in February 2002, Vietnam War Medal of Honor recipient Allen J. Lynch agreed to personally shepherd the claim.

But in his application to the VA, Warren _ who was in the Navy from 1984 to 1988 and never rose above the rank of petty officer third class _ cited as the event that ruined his life a November 1984 accident aboard the submarine tender USS Hunley that left two sailors badly burned. Warren told the VA he hadn't held a job in five years, and that his condition had made it impossible for him to work around people.

In November 2003, the VA granted 80 percent disability for PTSD and a knee injury, making him eligible for 100 percent compensation and "unemployability." Six months later, the Social Security Administration determined that Warren "suffered from significant and severe mental impairment," making him eligible for simultaneous benefits from that agency.

This continued until late 2008, when investigators at both agencies became suspicious.

Prosecutors found that while Warren was on board the Hunley when the accident occurred, he did not witness it. And his disabilities were as phony as his stories, they say.

As a member of the Sullivan Volunteer Fire Department, Warren had accumulated more than 400 hours on hundreds of emergency calls, and had completed 70 hours of training. And the man who supposedly couldn't work around people was manager of the Dragon Inn, a Sullivan tavern he'd bought in 2000.

By the time Warren's benefits were halted in October 2008, he had received $166,116 from the VA _ including money for his son's college _ and $114,045 in Social Security disability payments.

On Jan. 6, Warren pleaded guilty in U.S. District Court to six counts of wire fraud, four counts of mail fraud, one count of making false statements and one count of Social Security fraud. Under a plea agreement, he faces between 21 and 27 months in prison and must repay all the money he received.

In a telephone interview with the AP, Warren maintained that he did see the accident _ through a catwalk, from below.

"Skin was just dripping off," he said, his voice almost a monotone. "It just had this horrible, horrible, horrible smell of burning flesh that I can't get out of my system."

Warren said the SEAL ruse began as a barroom ploy "to pick up girls," and acknowledges that it has destroyed his credibility. But he insists that his work at the fire department and bar have been blown out of proportion, that his ailments are very real, and that he only pleaded guilty on the advice of his public defender.

A veterans group "filed the paperwork for me on this claim. And I just sat back and kept doing my thing, living my life, going to these doctors, doing whatever I had to do," he said.

Ricky Bell, whose face was severely burned in the Hunley accident, told the AP there is no way Warren or anyone else could have seen the explosion, and that Warren's story got key details wrong. The Atlanta man still gets "jumpy" lighting a brazing torch and has lost numerous air conditioning/refrigeration jobs because of his "frights about fire," yet his four applications for PTSD benefits have been denied.

"I was IN the accident and can't get it," says Bell, 46, his voice rising. "Does that sound like the American way?"

But these cases can be difficult to sort out, as the case of Vietnam-era veteran Keith Roberts illustrates.

Roberts was stationed at the U.S. Naval Air Facility in Naples, Italy, in February 1969 when Airman Gary Holland was crushed to death in the wheel well of a C-54 Skymaster transport plane. Roberts, then a 20-year-old aircraft lineman, said he tried to rescue his "very good friend" by having a forklift raise the craft's nose, but that superiors nixed the plan to avoid damaging the plane.

Starting in 1987, Roberts filed a string of disability claims with the VA, eventually blaming PTSD for everything from smoking addiction to arthritis. In 1999, Roberts was declared 100 percent disabled and got a lump sum payment, retroactive to August 1993.

But investigators later determined that Roberts didn't even participate in the rescue effort and was not as close to Holland as he'd claimed. The Board of Veterans Appeals concluded that Roberts "elevated the rather mundane facts ... into what appeared on the surface to be a bona fide PTSD stressor (his best friend died in his arms)."

The board said the VA's regional office "simply conceded" Roberts' claims "without obtaining credible supporting evidence." After losing his benefits, Roberts was convicted of wire fraud, sentenced to 48 months in prison and ordered to pay $262,943.52 in restitution.

Last month, the U.S. Court of Appeals for Veterans Claims concluded in a 45-page ruling that Roberts "committed fraud in securing VA benefits for his PTSD" and affirmed the BVA's decision to sever them.

In a recent telephone interview, the 62-year-old veteran denied that he lied, but argued that under VA rules, he could have PTSD from merely being "vicariously aware of the situation."

"I could have been downtown Naples (having sex) and I STILL could have PTSD. It's the way you perceive it," Roberts said from the Federal Correctional Institution near Denver, before his release in March.

And these are the standards that VA officials would loosen by taking at face value veterans' testimony that they had endured a traumatizing event.

But even then, Gulf War veteran Paul Sullivan argues that the threshold for PTSD claims would still be too high.

"In our view, someone who's deployed to a war zone should be presumed to have a stressor," Sullivan, executive director of Veterans for Common Sense, told participants in a Washington round-table discussion.

When asked whether the new rule would throw open the doors to more fraud, Shinseki stressed the need for more research into PTSD and traumatic brain injury, the war on terror's other "signature" wound.

"I know if we take your temperature and you're registering at 102 degrees, you've got a fever, and there are ways to cope with that," the VA secretary told the AP. "PTSD and TBI are in need of the same kind of metrics."

But in the meantime, his agency is stuck in a morass that seems to have no solution, typified by the case of one Vietnam veteran from Kentucky.

Over the course of more than a decade of denials and appeals, examiners had caught the man in repeated lies. The worst was a tale of trauma related to the 1968 Tet Offensive _ which occurred more than a year before he arrived in-country.

Yet the Board of Veterans Appeals voted to grant the man service connection for PTSD, making him eligible for disability benefits. In making the grant, the panel basically acknowledged that the claims system was overwhelmed, and that the veteran had simply worn them down.

"In so holding," the panel wrote, "the Board ... observes that to remand once again would be an ill-advised use of VA resources at a time when veterans returning from Iraq and Afghanistan with confirmed PTSD are in need of treatment."

___

AP Writer Kimberly Hefling in Washington, D.C., also contributed to this report. Allen G. Breed, a national writer for The Associated Press based in Raleigh, N.C., can be reached at features(at)ap.org.

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I am surprised at the intesity of this article towards veterans committing FRAUD, normally the AP had a very good reputation to just reporting the news, and using facts rather than innuendo. The writers have taken some very bad cases of a few veterans that have used fraud to obtain benefits which in any program the government has there will be some fraud, in other programs a lot of fraud.

In the case of the 2100 cases of PTSD review mentioned yes there were errors what the article ignored was the fact that the errors were not the veterans fault but rather the VA officer workers themselves, not properly documenting the veterans files, it doesn't say the stressors (incidents) never happened just that the VA employees improperly documented them.

The case of the New Mexico veteran who killed themselves upon learning the review was taken to Congress by the New Mexican Congressman Udall not Senator Obama, now Senator Obama may have used it during the Senate VA Committee hearing to get then VA Chairman Larry Craig to bring an end to the witchhunt for fraud, there were many voices in Congress demanding that mentally ill veterans stop being the focus of the Bush Administrations attempt to cut the VA expenses.

This article is not the work of the caliber I have grown used to reading for the past 54 years, this is more of the style of the AEI's DR Sally Satel, where they think PTSD is not a problem at all.

Yes, veterans should be checked and the stressors should be checked and verified before awards are made, but it has been my experience that is exactly what is done 99.9% of the time, yes mistakes are made but it is not only the veterans committing the fraud but the VA employees handling that claim that allowed it to happen.

Normally a veteran can NOT walk into the VA and walk out a few weeks later with a check for the rest of their life, in many cases it turns into a years long battle for benefits which is rather the normal experience in veterans claims. These cases described in this article are the exceptions that give all veterans a bad name,but I know very few disabled veterans that had this easy of a time getting disability benefits especially for PTSD.

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New Scholarship for the Children of Fallen Service Members

New Scholarship for the Children of Fallen Service Members
Benefit Honors Gunnery Sergeant John David Fry

WASHINGTON (April 30, 2010) - The children of military personnel who
died in the line of duty since Sept. 11, 2001 can apply for an
educational scholarship similar to the new Post-9/11 GI Bill. Benefits
are retroactive to Aug. 1, 2009.

The scholarship, which is administered by the Department of Veterans
Affairs, are named after Marine Gunnery Sergeant John David Fry, 28, a
Texas native who died in Iraq in 2006 while disarming an explosive. He
was survived by three young children.

"The Fry scholarship represents this nation's solemn commitment to care
for children whose mothers and fathers paid the ultimate price for our
country," said Secretary of Veterans Affairs Eric K. Shinseki.

VA begins accepting applications for the Fry scholarship on May 1, 2010.
For more information or assistance applying, call toll-free
1-888-GIBILL-1 (1-888-442-4551), or visit the VA GI Bill Website at
www.gibill.va.gov .

VA estimates nearly 1,500 children will receive benefits under the Fry
scholarship program in 2010. Recipients generally have 15 years to use
their benefits, beginning on their 18th birthdays.

Eligible children attending institutions of higher learning may receive
payments to cover their tuition and fees up to the highest amounts
charged to public, in-state students at undergraduate institutions in
each state. A monthly housing allowance and stipend for books and
supplies are also paid under this program.

VA will begin paying benefits under the Fry scholarships on Aug. 1,
2010. Eligible participants may receive benefits retroactively to
August 1, 2009, the same day the Post-9/11 GI Bill took effect.
Eligible children may be married. Recipients are entitled to 36 months
of benefits at the 100 percent level.

When dependents also serve in the military, the reserves or are Veterans
in their own right, eligible for education benefits under the Montgomery
GI Bill for Active Duty, the Montgomery GI Bill for Selected Reserves or
the Reserve Educational Assistance Program (REAP), then they would
relinquish their eligibility under those programs to receive benefits
under a Fry scholarship.

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UW conference to battle the ravages of war

UW conference to battle the ravages of war

Sponsors of a global health conference this weekend at the University of Washington hope to frame war as a grave but solvable public-health crisis.

By Andrew Doughman

Seattle Times staff reporter

Conference details

WHAT: Western Regional International Health Conference
WHEN: 9 a.m.- 9:30 p.m. Saturday and 9:30 a.m.-

4:30 p.m. Sunday

WHERE: The Husky Union Building (HUB) on the University of Washington campus.

WHY: The UW Department of Global Health and Physicians for Social Responsibility are sponsoring the conference to address war as a public-health problem. They say approaching war in this way will promote peace.

COST: Student/Medical resident/unemployed: $75; nonstudent/professional: $125. Registration is online only: http://wrihc.org/registration


When Evan Kanter adds up the costs of war, he doesn't only consider the cost of fighter jets and tanks, he also counts his patients at a veterans hospital in Seattle, where he works as a psychiatrist treating active-duty military personnel and veterans who have post-traumatic stress disorder (PTSD).

For him, the costs of war include the health strain placed on these people when they redeployed, again and again, to Iraq and Afghanistan.

"You know that, in a sense, they may never really be able to go home again," he said.

Watching people lose their jobs or lose their marriages because of PTSD is devastating.

Kanter will describe these long-term consequences of conflict at a global-health conference at the University of Washington Saturday and Sunday. The organizers hope to frame war as a grave but solvable public-health crisis.

They hope to put war in the same context as tobacco, which evolved in the public perception from habit to health hazard as a result of public-health campaigns in the 1960s.

More than 60 speakers — academics, journalists and doctors — will address how war affects those serving in the military, veterans, refugees, civilians and the environment at the eighth annual Western Regional International Health Conference.

The Department of Global Health at the UW — founded four years ago — and Physicians for Social Responsibility, a nonprofit environmental-advocacy group based in Washington, D.C., are sponsoring the event.

This year, organizers expect about 700 students, faculty and community members to attend.

Organizers such as UW graduate student Rebecca Bartlein want those attending to challenge the ideas that war is inevitable.

"War is not just something that happens," she said. "We can impact those causes of war."

Government could cap its military spending and offer young people an array of nonviolent ways to serve their country, she suggested.

Bartlein said most people envision diseases such as AIDS, malaria and tuberculosis when they think about global health. War is not what springs to mind.

But war ravages more than armies. It upends a society.

Civilians often can't access health care in a conflict zone. Essential services often shut down, making health problems worse.

Governments invest in weapons rather than health, education and the environment, Bartlein said.

But it's not only such indirect effects of war that make it a pressing health concern, conference organizers say. The direct effects of modern warfare are devastating, as well.

"One hundred years ago, 90 percent of the people killed by war were actually combatants, and today 90 percent of the people killed by war are civilians," Kanter said.

Bartlein, the UW graduate student, went abroad several years ago to work at a camp for Somali refugees in Ethiopia.

Her job was to help doctors at the camp deliver care to those who had fled conflict in Somalia.

"It just really hammered home," she said.

"I mean, here you have these camps filled with tens of thousands of refugees. The most cost-effective and efficient way to take care of their health needs is to prevent them from being displaced in the first place," Bartlein said.

"This is a really opportune time as the Seattle global-health community is defining itself and defining what its priorities are going to be," she added.

Seattle has its share of global-health heavyweights. The Bill & Melinda Gates Foundation, which donated millions to start the UW's global-health department, operates out of Seattle. So does PATH, which works in developing countries.

There are enough of these organizations in Seattle that a group called Washington Global Health Alliance formed two years ago to encourage the health organizations to work together.

"The Northwest seems to be a nexus for this kind of work and the development for this sort of strategy," Kanter said.

It's that network of academics, doctors and regional groups the event organizers want to reach.

They're hoping their war-as-health-problem message will last longer than the conference.

Andrew Doughman: 206-464-3195 or adoughman@seattletimes.com

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AACE: Agent Orange Ups Some Thyroid Risks

AACE: Agent Orange Ups Some Thyroid Risks


By Kristina Fiore, Staff Writer, MedPage Today
Published: April 26, 2010
Reviewed by Dori F. Zaleznik, MD

; Associate Clinical Professor of Medicine, Harvard Medical School, Boston and
Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner


§ Explain that veterans who'd been exposed to Agent Orange were three times more likely to develop Graves' disease, but were not at greater risk of other thyroid disorders including cancer or nodules.

§ Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered preliminary until published in a peer-reviewed journal.

BOSTON -- Vietnam veterans who came in contact with Agent Orange are more likely to develop Graves' disease than those who avoided exposure, researchers said here.

The autoimmune disorder was three times more prevalent among veterans who encountered the dioxin-containing chemical, Ajay Varanasi, MD, of SUNY Buffalo, and colleagues reported at the American Association of Clinical Endocrinologists meeting here.

"We also looked at other [thyroid] diagnoses," Varanasi told MedPage Today, "but we didn't find any significant differences in thyroid cancer or nodules."

Varanasi and colleagues originally hypothesized that the latter two diagnoses may be more prevalent among vets exposed to the toxin.

Agent Orange was a defoliant sprayed from U.S. planes and helicopters during the Vietnam War to deprive Viet Cong and North Vietnamese soldiers of cover. Veterans have long complained that exposure to the chemical caused them a variety of health problems, though few have been confirmed.

Since most Vietnam veterans have been assessed for possible Agent Orange exposure, the researchers were able to review their records and correlate that with disease.

In 2008, they assessed the prevalence of major thyroid diagnoses in the Veterans Affairs (VA) electronic medical record database beginning in 1996 for veterans born between 1925 and 1953 who were treated in a VA network in upstate New York.

They compared the frequency of diagnosis with thyroid cancer, nodules, hypothyroidism, and Graves' disease in both exposed and nonexposed populations.

A total of 23,939 vets had been classified as exposed to Agent Orange, while 200,109 were not exposed.

The researchers found that the prevalence of Graves' disease in those exposed to Agent Orange was three times that of the unexposed group (OR 3.05, 95% CI 2.17 to 4.50, P=0.001).

The relationship remained even after multivariate analyses accounted for potential confounders such as smoking (OR 2.76, 95% CI 2.22 to 3.81, P<0.001).

Interestingly, Varanasi said, prevalence of hypothyroidism was lower in those exposed to Agent Orange. Nor was there any difference in the prevalence of thyroid cancer or nodules between those exposed and those not exposed.

"There's no real mechanism as to why it should cause a high prevalence of cancer," Varanasi said.

But the literature holds a likely mechanism linking exposure to Graves' disease, he added.

"In doing a literature search, we found that the dioxin in Agent Orange might have some immune-modulating effects in human beings," he said.

This dioxin -- 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) -- binds to aryl hydrocarbon receptors (AhR) very tightly, leading to prolonged activation of genomic and nongenomic metabolic disorders, the researchers said.

In mice, for example, AhR can regulate the differentiation of regulatory T cells and of T cells that produce interleukin-17. Also, AhR ligands like TCDD can modulate autoimmunity.

"The effects could be through this hydrocarbon, and this receptor is mainly expressed in T-helper-17 cells," Varanasi said. "Through this mechanism, we could have some immune modulating effects, and this could cause a higher prevalence of Graves' disease in exposed patients."

He and colleagues concluded that the relationship of Graves' disease to Agent Orange exposure warrants further investigation.

The researchers reported no diclosures.


Primary source: American Association of Clinical Endocrinologists
Source reference:
Varanasi A, et al "Are veterans exposed to Agent Orange more likely to get Graves' disease?" AACE 2010; Abstract 1046.

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Post-Traumatic Stress Disorder Cases Rise in German Soliders in Afghanistan

Post-Traumatic Stress Disorder Cases Rise in German Soliders in Afghanistan

One Psychiatrist for 4,500 Troops

The Germany armed forces' deployment in Afghanistan appears to be having an impact on soldiers' psyche. Several newspaper reports claim the number of cases of post-traumatic stress disorder is on the rise. And the Bundeswehr lacks psychiatrists to provide the necessary treatment.

The number of Bundeswehr soldiers affected by psychiatric problems has increased rapidly in recent months, with the number of those suffering from so-called post-traumatic stress disorder having risen particularly quickly, two German newspapers reported on Thursday.


Both of the dailies, the Rhein-Zeitung and the Süddeutsche Zeitung, referred to a request for information made to the defense affairs committee of the German federal parliament by politician Elke Hoff of the Free Democratic Party (FDP). "Up until now the government has neglected to do anything to better the psychological care and treatment of soldiers," she told the Süddeutschen Zeitung.

According to the newspapers, the number of soldiers suffering first symptoms of post-traumatic stress disorder had risen by over 30 percent in the first six months of 2009. This resulted in a total of 163 cases. Last year, a total of 245 cases of the psychiatric disorder were reported in the military, with 226 of them occurring in Afghanistan. In 2006, only 55 soldiers were diagnosed with post-traumatic stress disorder. During the past six months, attacks on German forces in Aghanistan have risen.

More Mental Health Care Urgently Needed

Hoff brought up the issue because of the findings of a study she commissioned from German military psychiatrist, Mario Horst Lanczik. He spent time in Afghanistan examining soldiers with PTSD and found that the psychiatric care of German soldiers was not adequate either before, during or after combat. Hoff also pointed out that there are not enough psychiatrists available in the military to provide the necessary support. Only half of the 40 potential positions for psychiatric support in the military's medical corps are currently filled. And there was only one psychiatrist available to the 4,500 German troops in Afghanistan.

According to the Rhein-Zeitung newspaper, two therapists are available directly to soldiers in the Hindu Kush. The Bundeswehr has said that they are part of a network of pastors and army doctors.

Hoff is now demanding more mental healthcare options for German soldiers. She told the Rhein-Zeitung that she wants the empty positions in the medical corps filled and she has said that psychiatric problems following military deployment abroad should not be stigmatized as a hindrance to a career in the army. If this was the case, then soldiers might be tempted to hide their problems, she noted.

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It appears that the American Army and other military forces are the only ones to have problems getting enough mental health care available in the war theater and back at the troops home bases. This is an issue that is not going to go away, as long as troops are in war zones there will be stress related issues and either the troops get treatment early or they will do much like they do now, suck it up, ignore it because they fear it will harm their careers by asking for help, or wait decades like many Vietnam war veterans before they have a melt down.

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