VA DISABILITY COMPENSATION UPDATE 01: Sen. Richard Burr (R-NC), the ranking Member on the Senate Veterans' Affairs Committee, introduced "America's Wounded Warrior Act," S. 2674, last week to overhaul DoD's disability retirement system and modernize the VA's disability compensation program. These reforms are an upshot from last year's Dole/Shalala Commission recommendations and would impact veterans in varied ways dependent on their disability status. Some elements of the bill would:

• Reform the military disability retirement system and streamline the transition of disabled servicemembers from DoD to the VA. Basically, it would simplify the claims process by eliminating the need for duplicative DoD/VA ratings and disability examinations.
• Require DoD to determine a disabled servicemember's fitness for duty, and if found unfit, provide a lifetime annuity based on the member's rank and years of service. VA would then establish compensation for service-connected injuries, disease, or wounds. Under this proposal, the offset between DoD's annuity and future VA compensation would be eliminated.
• Revamped the VA compensation system into three elements - replacement value of average loss of earning capacity; a new payment for loss of quality of life; and a new transition payment provided to servicemembers who participate in treatment or vocational rehabilitation programs or who are within three months of their retirement from service.

However, the jury is still out on what the new DoD disability health care benefit and VA compensation levels would eventually look like. Currently, servicemembers who retire due to a 30% or higher military disability are eligible for lifetime family Tricare coverage (dependent children until majority age). However, the bill directs DoD to study and recommend to Congress new Tricare lifetime eligibility criteria under the new system. In the absence of a law change, the Secretary of Defense would establish eligibility by regulation effective the date of implementation of the new system. Additionally, the bill directs VA to study and provide a report to Congress within nine months and submit a proposal one year later detailing the new compensation and transition payment rate structure. Until the specific rate structure of the new VA compensation system is better understood, most veteran organizations and military advocates are withholding endorsement of this legislation. [Source: MOAA Leg Up 7 Mar 08 ++]

VA DISABILITY COMPENSATION UPDATE 02: The provisions of Senator Burr's America's Wounded Warrior Act (S 2674) and Representative Buyer's Noble Warrior Act (HR 5509), would drastically change the disability compensation system for America's veterans. These bills are loosely based on the recommendations of the President's Commission on Care for America's Wounded Warriors (Dole/Shalala Commission), but the USDR believes the specifics of these bills would do great harm to these veterans in the following ways:

• Will offset VA Disability Compensation by Social Security when the veteran ages 65.
• Applicable to all currently discharging veterans AND any veteran under VA's current compensation system who files a subsequent claim for additional benefits.
• Once under the new system the veteran cannot return to the current system.
• The present protection for ratings in effect for 10 or more years would no longer apply.
• Would require the VA Secretary to examine or consider:
(a) The extent to which disability compensation may be used as an incentive to undergo treatment.
(b) The appropriate injuries to be covered under the new disability rating system.
(c) Age as a determining factor when considering average loss of earnings capacity
• Amends the law to provide the Secretary with authority to adopt and apply a rating schedule for specific injuries. This provision would expressly limit VA authority over the Rating Schedule and places the authority in the hands of Congress. If the Congress can not correct the Sustained Growth Rate formula of Medicare Law how can it be expected the Congress would do any better with the much more complex Disability Rating Schedule?
• Provides for a quality of life payment, but only for those enrolled in the new compensation system.
• Allows or suggests: That VA "may take into account the effect on potential future earnings caused by the age of the veteran at the time a disability rating is assigned." This provision would allow VA to compensate an older veteran at a lower percentage of disability than a younger veteran for the exact same disease or injury. Is this not age discrimination?
• Provides that
(a) As frequently as [the VA] considers it appropriate, [the VA] must reevaluate and ... adjust the disability rating for any veteran receiving compensation;
(b) The VA must ... take into account any adjustments in the rating schedule that occurred since the last assignment of a rating;
(c) The frequency of reevaluations would be determined by an examining physician. This places physicians back in the rating business, allows for frequent adjustments to a veteran's rating based on perceived improvement, and further allows reductions based on a change in the rating criteria even when no improvement in the disability is shown

For these reasons, USDR is encouraging veterans to contact their legislators and strongly urge them to oppose S2674/HR5509 and any other legislation which is detrimental to and/or discriminatory against this nation's veterans. To facilitate doing this they have prepared a letter available at http://capwiz.com/usdr/issues/alert/?alertid=11114251&queueid=[capwiz:queue_id] which can be used as is or modified for forwarding to all legislators representing your zip code by the click of a button. [Source: USDR Action Alert 7 Mar 08 ++]

� Secure this line!

---

Any Veterans Legislation with the name of Rep Steve Buyer (R) Ind on it will be vehemently opposed by the American Legion for reasons too lengthy to go into here.

The American Legion's National Rehabilitation Commission will meet from 29 March through 3 April in Washington DC to be briefed on pending legislation by our National Staff, address this proposed legislation with lawmakers, and meet with the Sec VA on this and other issues.

by R. Jewell on March 16, 2008 7:33 PM

---

Anesthesia Awareness == (Waking up in surgery)

Did that -- scared hell out of the surgeon when he heard me say, "Geez, what a mess," and looked up to see me staring at my guts.

Prolly a good educational class for medicos, right after "Dealing With the Startle Reflex While Wielding a Scalpel."

Ummmm -- *no*, it wasn't recently...

by BillT on March 17, 2008 3:09 AM

---

� Dismissed, Soldier!

Last summer I delivered some Soldiers' Angels Vet Packs to the KC VAMC along with some other items to the Volunteer Coordinator. We had a long talk about what their program needed and how they used the items they received. One of the things that had noted as an important need was money for bus passes. They would give needy veterans two bus passes: one to go home on and one to return on. When they came back, they received two more passes for the same.

This money was available totally by funds provided through different charities and veterans' organizations like the American Legion. They provided these bus passes to insure that these veterans could make it to their appointments. Not all vets have access to DAV buses in the time frames that their appointments existed. By insuring veterans could get to their appointments for routine check ups, follow ups and treatments these veterans receive continuous care and help to maintain their over all health. The end result for the VA is a potential reduction in catastrophic illnesses through better preventative care. That's a direct benefit to the Vets and to the VA's over all budget, allowing them to provide other important care and services.

We talked briefly about how they used the Soldiers' Angels mugs through their home psyche outreach program as "incentives" to get vets to either come in for their treatments or to get them to see the outreach team when they come to their home. The entire program is geared towards getting vets the care they need now so they don't have to see them later for something worse or, in this case, the vets stop taking their meds or getting treatment so they can't take care of themselves and either end up in some institution or homeless.

So, I have a very good idea about what the "free meal" program was used for and exactly what benefit it really gave for both the veterans and the VAMC. That benefit isn't just some financially fragile vets getting a free meal. It has everything to do with insuring that these vets who, upon riding the bus, would be stuck at the VA for some hours waiting for their appointment and transportation home. If they don't have a meal in that time, some of them may decide that it's too much of a pain to come in at all. Others may be medically fragile and require meals at specific times. Diabetes is a huge problem with the aged veteran population and many are taking insulin that also requires regular meals.

As noted, many vets are economically fragile and may not be able to afford to eat at the cafeteria on their own funds. Or, out at a fast food place. That's if there are any near by or the neighborhood the VAMC is in is safe or, finally, if the vet can transport themselves to the restaurant. All of these things would actually have an impact on the decision making of a veteran who knows that a trip to the VA is going to be a long or all day event.

If they go, they might not get a meal. If they stay home, they'll get a meal, not be at the VA all day. Besides, many reason, they aren't feeling that sick. Maybe next time. Anyone who has dealt with the elderly at all knows that is exactly what happens in the decision making process.

The problem, of course, is that there is no direct accounting line between those "fringe" benefits of free meals and the end savings to the health of the veterans or the budget. That makes it easy to overlook those benefits and see them as nothing more than financial drains.

But, they do have real, tangible benefits that it would behoove this VAMC and others like it to consider when they are evaluating these programs.

� Secure this line!

---

bless your heart, Kat, for what you do.

by MajMike on February 27, 2008 8:03 AM

---

Kat, I just want to echo, MajMike, "I pray for the Lord's blessings for you."

There is one thing, you put a spotlight on a real sore spot for me. I really wonder how some of these people would look at this issue if they had some blood investment in the Military. This is NOT true of all! But, the line, when it came time for him to serve was this, "I've got more important things to do!" WHAT, there is nothing more important to do! These vets have done their duty, especially now, this one benefit should stay, even if it mean the President and Vice President and their families take it out of their own pockets. Forget the Damn Libraries! Sell them and put the papers back in the Library of Congress. The artifacts should be sent to the Smithsonian Institution. These people work for us, therefore the papers and artifacts are property of the People of The United States of America.

Kat, Thank you, for just letting me RANT.

Now, you know why they call me-

Grumpy

by Grumpy on February 27, 2008 10:36 AM

---

� Dismissed, Soldier!

1.      Peake's Visit Sparks Optimism Among Montana Vets.   The Billings (MT) Gazette (2/24) reports on Secretary Peake's recent visit to Montana noting that Peake learned about the challenges faced by Montana veterans "in a crash course in rural medicine last week." The Secretary received "instructive insight from veterans who packed a forum in Billings to vent frustrations about VA health care and disability compensation." However it is also commented that "it's uncertain how much progress this secretary can make in a short tenure," but "there's reason to expect he will try," as "Peake worked 32 years as an Army doctor, the last four as Army Surgeon General," and "is eminently qualified to lead the VA."

2.      Changes Sought In VA Healthcare Policy Restrictions.   The Citizen Of Laconia (NH) (2/25, Cook) reports, "Veterans' groups in New Hampshire and Maine want the federal government to ease tight restrictions preventing at least 5,000 New England veterans from getting health care benefits." Many of the people "in question fall into a Department of Veterans Affairs category known as Priority 8, reserved for veterans never wounded in action and who earn more than $28,429 annually." In addition to the veterans' groups, state and federal lawmakers also "believe the VA needs to change its eligibility requirements." U.S. Sen. Daniel K. Akaka (D-HI), chairman of the Senate Committee on Veterans Affairs, "held a hearing on the issue on Feb. 13." During the hearing, VA Secretary James Peake "said he'd be willing to review the current policy."

3.      Concerns Expressed About Dental Care Costs Being Shifted Onto VA.   CQ (2/25, Yoest) reports on the recent interest in "the poor oral health of reservists" in Iraq and Afghanistan. Veterans Affairs Secretary James B. Peake has previously pointed out that dental care "deteriorates in the theater just because of the hygiene, the Coca-Cola and everything else," but CQ says a conflict is brewing over who should pay for the care. Indiana's Steve Buyer, the top Republican on the House Veterans Affairs Committee, "says the Army should -- or at least it should be paying for the dental care it has foisted off on the VA." Army spokesman, Lt. Col. George Wright, defended the Army, however, saying it "has not initiated any practices intended to shift costs" to the VA. CQ adds, "The issue appears destined for further congressional prodding."

4.      Web Chat Critical Of VA, DoD Information Exchange.   Government Health IT (2/24, Buxbaum) reported, "The Defense and Veterans Affairs departments are not exchanging information as well as they could be, at least according to comments received by a Military Health System Web chat on wounded warrior care." On February 14, MHS conducted its "first-ever 'Web hall,'" in which "participants posted questions and comments on a message board on the MHS Web site and several military medical officials responded." In response to the comments posted, "Dr. S. Ward Casscells, assistant secretary of Defense for health affairs, wrote that among other initiatives, the Army's warrior transition units 'now surround our wounded warriors with medical, nursing, and bureaucracy help.'" Casscells also wrote that Defense is "working closely with VA in improving the disability evaluation process, and upgrading our electronic health records to make them more useful, private, portable, and patient-controlled."

 

5.      Electronic Health Records Becoming A Priority For US Healthcare Systems.   The Reno Gazette-Journal (2/25, Hidalgo) reports, "With the federal government setting a 2012 target for all Americans to have manageable electronic health records, replacing the old paper record is becoming a top priority for health care systems nationwide." Retired Army Sergeant Jerry Gunnels "has seen a glimpse of the future with electronic health records -- also known as EHR -- as a patient in the Veterans Administration Sierra Nevada Health Care System," and now "the 63-year-old Carlin resident is wondering how he ever managed without it." Proponents of EHR "said the system offers several advantages," but implementing an EHR system "comes with its set of challenges."

6.      Effort Made To Reach Out To Women Vets Facing Sexual Trauma.   The Tucson Citizen (2/25, Kornman, 28K) reports, "Women veterans can get free counseling and psychiatric services if they experienced military sexual trauma but many haven't asked for help, said Cathy Cosgrove, a Vietnam-era Air Force vet and member of the Honor Society of Women American Legion in Arizona." Cosgrove "organized meetings over the weekend in southern Arizona to reach out to such vets." The Citizen adds that Peggy McClafferty, "the women veterans coordinator for the VA's regional office in Phoenix, encouraged women vets who suffered trauma in the military to ask for help."

7.      Plans For New Super VAMC Bewilders Some New Orleans Residents.   The New Orleans Times-Picayune (2/24, Moran) reports in an extensive story on the neighborhood called Tulane-Gravier which "city, state and federal governments," announced they intend "to demolish the neighborhood and build two teaching hospitals in its place." Already, "political leaders praise the new medical campus, which will be shared by Louisiana State University and the U.S. Department of Veterans Affairs, as a means to revive the crippled health care system, reverse the exodus of doctors and inaugurate a new economy based on medical research and education." However, "for all its benefits, the project comes with significant collateral damage." Residents of the neighborhood say "they have no plans to file lawsuits or otherwise obstruct the hospitals." In fact many "support the ambitious expansion of medical care, but they are angry and bewildered that the city, state and the VA would make plans without calling so much as a neighborhood meeting."

8.      Orlando VAMC Hold Celebration For Returning Veterans.   The Orlando Sentinel (2/24, 242K) reports, "At least 300 veterans are expected to attend the 'Welcome Home Celebration' today at the Orlando VA Medical Center, an outreach event for veterans and active-duty soldiers who have recently returned from action in Iraq and Afghanistan." The event "will provide veterans information on housing, education, jobs, financial assistance, claims and health care."

 

 

 

9.      Partial Proceeds From Film To Benefit Veterans Fund.   The syndicated "Sgt. Shaft" column, appearing in the Washington Times (2/25, Fales, 87K), reported, "The American Film Foundation recently announced that 10 percent of each ticket for Academy Award-winning director Terry Sanders' new documentary, 'Fighting for Life,' will go to the Bob Woodruff Family Fund, a charity that assists those injured while serving in the United States Armed Forces." The fund, which was founded by the family of journalist Bob Woodruff, who was nearly killed in early 2006 by a roadside bomb in Iraq, "places special emphasis on...traumatic brain injury and combat stress injuries, including post-traumatic stress disorder." The column added that the documentary "will open in New York on March 7 with expansion to other cities to follow."
      In a related article, USA Today (2/25, Dugas, 2.28M) says Woodruff is keeping himself "busy flying around the world on assignments" for ABC News "and continuing to draw attention to the signature injury of the war in Iraq: traumatic brain injury." Woodruff "does not have his previous job as a news anchor," working instead "with a team to produce more in-depth assignments. He can better cope with longer projects because his traumatic brain injury (TBI) caused" aphasia, "a language disorder that makes it hard for him to come up with words." But even if Woodruff "is frustrated when he occasionally can't find a word, his family and friends are elated by his recovery."

10.    Slippery Rock University Receives Grant For Veterans Activity Program.   The Pittsburgh Post-Gazette (2/24, Barcousky, 229K) reports, "While older veterans with disabilities have been a familiar sight on the campus of Slippery Rock University, they will be joined this fall by younger men and women." Slippery Rock has received "a $25,000 grant for a student-led effort to introduce activities like wheelchair basketball and rugby to veterans of the Iraq and Afghan wars." The grant is from the Christopher and Dana Reeve Foundation and "will support an expansion of a recreation and physical activity that now works with older patients being treated through the Butler VA Medical Center." In particular the "program will concentrate on those who were wounded during more recent conflicts"

11.    Preparations Made To Commemorate End Of WWI Generation.   The Baltimore Sun (2/24, Scharnberg, 252K) reports on the preparations being made to remember the WWI generation once the last surviving veteran passes away. It is noted that "the event will pay tribute to the 4 million American men and women who answered the call to fight in the First World War," and "will honor the families who sent young soldiers off to battle long before telephones or e-mail allowed them routine updates on their safety." Currently "107-year-old Frank Buckles, the sole surviving U.S. doughboy." Buckles "remains in remarkably good health, still living at home and doing news media interviews, still mentally sharp and physically mobile, still exercising every day." Yet "when he goes, so, too, will a generation" and "plans are being made at the National World War I Museum in Kansas City to commemorate the end of an era." At the time

 

 

 

12.    VA Grant To Help Pay For Iraq Vet's New House.   The Burlington County (NJ) Times (2/25, Hayes) reports a nonprofit organization called Homes for Our Troops will build a house in Burlington County for 24-year-old Andrew Robinson, "a Marine who suffered a severe spinal-cord injury...in Iraq." The "mission of Homes for Our Troops, founded in 2004, is to adapt or construct housing for men and women who return home from military service with serious disabilities and injuries." Robinson "said he will sign over a $50,000 housing grant provided to him by the Department of Veterans Affairs, but otherwise the organization will complete the project through donations."

13.    Paper Highlights Services Not Covered By VA.   In response to a reader question in its "For Your Benefit" column, the Honolulu Star Bulletin (2/25, Kakesako) pointed out that the Department of Veterans Affairs does not cover several benefits and services, including abortions, health club memberships, and "hospital and outpatient care for a veteran who is either a patient or inmate in an institution of another government agency if that agency has a duty to give the care or services."

14.    Army Opens New "Warrior Transition Units."   The AP (2/24, Schreiner) reports, "Staff Sgt. Gerald Gonzalez has seen plenty of changes in a special unit for wounded soldiers since arriving at Fort Knox last summer with injuries from a roadside bomb in Iraq." Currently, "barracks at the Army post in Central Kentucky are being renovated for soldiers placed in the 'warrior transition unit,'" designed to "help the wounded troops recover so they can either stay in the Army or make a smooth transition to civilian life." Already the Army has established 35 such units which were created after "treatment problems were discovered at Walter Reed Army Medical Center."

15.    Older Veterans Attempt To Aid Veterans From Current Wars.   The Quad-Cities Online (2/24, Donaldson) reports, "Many veterans agree that readjusting to civilian life after serving in a foreign land can be like a brand new battle." In particular, mental conditions such as PTSD can be especially trying and difficult for recent veterans to confront. Yet "the plight of today's soldier is much the same as it was when they served, and, fortunately, there's more support available for those who need it." Already older veterans are reaching out to newer veterans in an effort to help them address such issues and facilitate a transition back to civilian life.

16.    VFW Post Helps Homeless Vets.   The Longview Daily News (WA) (2/24, Pederson) reports, "With the grant money, the Longview Housing Authority has teamed up with the Veterans of Foreign Wars Post 3017 to house 12 homeless vets so far." The VFW Post 3017 estimates "there are 1,100 vets who are homeless or living in transitional housing in Cowlitz County. The voucher program can serve 20 vets and eight people in emergency transitional shelter with rent vouchers." It is hoped that the current success of the program "will lead to the grant being extended."

 

 

 

17.    Florida VFW Looks To Repair Poorly Maintained Graves.   The Fort Myers (FL) News-Press (2/24) reports, "The News-Press identified 68 graves of veterans in the trash-strewn Woodlawn and Oakridge sections of the Fort Myers Cemetery." Many of the graves identified "had old, tattered flags next to them. Some were covered with mold that made reading the headstone difficult. And others had broken and missing headstones." The condition of graves "concerned Dale Mangione, Commander of the VFW Fort Myers Beach Post, the largest in Florida with more than 2,000 members." Now, Mangione said "that he and his membership are willing to make it right," noting "we have funds earmarked for things like that." He added that "money is no problem. Manpower is not a problem. We just need to know where there's a problem, and we'll fix it."

18.    Vet Shot Down Over Vietnam In 1972 Back On Active Duty.   The Washington Times (2/25, Smucker, 87K) reports, "Shot down over Vietnam on his first tour of duty in 1972, 1st Sgt. James Spears is back in the USA Army -- one of hundreds of retired soldiers whom the Pentagon has ordered to suit up and serve the nation once more." Spears "said he did not expect to end up in a war zone dodging bullets and rockets, and that such business should be the work of younger warriors." The Times adds, "Retired in 1995 after 24 years in the Army, Sgt. Spears felt the call of duty after watching the World Trade Center's Twin Towers crumble in 2001 and picked up the phone just to let the Army know he was there if he was ever needed."

19.    Marine Organization Strives To Help Fellow Marines.   The San Jose Mercury News (2/24, Hamilton, 231K) reports on Detachment No.1122 of the Marine Corps League, "where heroism is not simply a concept. It is the guiding force that inspires and drives every last person in the room." The league is a volunteer organization of Marine veterans who "look after the needs of the families of Marines who've fallen on hard times,...attend the funerals of fallen Marines and visit wounded vets up at the VA Hospital in Palo Alto." Says one member, "whenever a fellow Marine is in need, we get together and do what needs to be done."

20.    Illinois Declares African American History Day.   The Southern Illinoisian (2/24, Testa) reports Illinois has declared an African American Veterans Recognition Day. The proclamation "came as part of the state Department of Veterans' Affairs efforts to be celebrate Black History Month." Tammy Duckworth, directors of the Veterans Affairs department, said "We honor and give thanks to all those who rose above adversity and answered the call of duty when their nation needed them."

21.    Akaka Submits Budget Recommendation.   Blackanthem.com (2/24) examines plans for the 2008 VA budget. U.S. Senator Daniel K. Akaka (D-HI), Chairman of the Veterans' Affairs Committee and other congressional leaders, "submitted their views and estimates for the Fiscal Year 2009 Veterans Affairs budget to the Senate Budget Committee." They recommended "a $6.6 billion increase in overall discretionary funding over Fiscal Year 2008, of which $4.6 billion would be dedicated to medical care operations." Stated Akaka "Congress has an obligation to our troops returning from combat now, as well as a long-standing obligation to the veterans of previous wars," adding that the "VA cannot fulfill that obligation without the necessary funding."

22.    House Subcommittee Reviews Expiring Veterans Programs.   The Army Times (2/24, Maze) reports, "As a House subcommittee reviews expired and expiring veterans programs, veterans groups are urging the lawmakers to strengthen employment and re-employment rights programs, extend an option for adjustable-rate veterans' home loans, and restore a $100 cut in monthly payments for apprenticeships and on-the-job training." While 13 programs are being re-evaluated, "the one getting the most attention is a lapsed test program that had top government lawyers involved in resolving employment and re-employment rights complaints from federal workers who also serve in military reserve components."

23.    Mikulski Asked To Help Reinstate DAV Program.   In an open letter to Maryland's Senator Mikulski, the Cumberland (MD) Times-News (2/24) derides, the "director approved Martinsburg Veterans Administration Medical Center decision to discontinue allowing veterans who ride the DAV (disabled veterans) vans a meal on the day of their appointments." The letter argues that "the policy has been in effect at the VAMC for approximately 18 years. It has worked very well and truly nothing was broken that required a fix." After describing the circumstances of the programs termination the paper then calls on the Senator to help get the program reinstated.

24.    Iowa General Assembly To Debate Veterans-Related Measures.   The AP (2/24, Glover) reported that this week, the Iowa House of representatives "will debate a measure creating a new lottery ticket game, with the estimated $3 million profits earmarked for the veterans trust fund." The fund, which is controlled by the Veterans Affairs Commission, "provides money to veterans for expenses such as travel for follow-up medical care as well as individual and family counseling." The AP added that a proposed smoking ban is scheduled for an Iowa Senate debate Wednesday, "and it's looking increasingly likely the measure will land on Gov. Chet Culver's desk." The Iowa House "approved the indoor smoking ban last week," although the measure "would exempt...private veterans organizations."

25.    VA Funding Heart Study.   The Buffalo News (2/25, 194K) reports, "Cardiac researchers at the University at Buffalo have received a four-year, $512,000 grant from the U.S. Department of Veterans Affairs to investigate how a common cholesterol- lowering drug increases cardiac- muscle cells and helps to stem the progress of heart failure." The goal of the research "is to develop pharmacological and cell-based approaches to treat patients before advanced heart failure develops."

26.    VA's Education And Training Benefits Noted.   The syndicated "Sgt. Shaft" column, appearing in the Washington Times (2/25, Fales, 87K), reported that the House Veterans Affairs Economic Opportunity Subcommittee "recently heard testimony on a number of bills aimed at improving education benefits for active-duty service members and members of the National Guard and Reserve forces." The column, which said "Department of Veterans Affairs education and training benefits provide veterans and surviving dependents with the opportunity to improve their vocational and financial status," then gave an "attaboy to Rep. John Boozman, Arkansas Republican, for his support and reiteration of his long-standing concern that only about 70 percent of eligible veterans take advantage of the benefit they have earned."

 

27.    Number Of Calls To Pentagon's Hotline Up 40% Since 2004.   USA Today (2/25, 1A, Zoroya, 2.28M) reports on its front page, " The number of troops and their relatives seeking help from a Pentagon employee-assistance hotline -- often linked to war deployments -- has grown 40% every year since 2004, say Pentagon officials and hotline operators." USA Today adds "the program receives a thousand calls daily from military members and families and nearly 6,000 individual visits to its website, says Jane Burke, who supervises the program for the Pentagon's Office of Military Community and Family Policy. ... The increase in help calls underscores concerns raised publicly by military leaders such as Adm. Mike Mullen, chairman of the Joint Chiefs of Staff, and Gen. George Casey, Army chief of staff, that more and longer combat tours strain troops and their families."

28.    Mullen Hears Complaints From Troops.   U.S. News and World Report (2/25, Mulrine, 2.03M) reports Chairman of the Joint Chiefs of Staff Adm. Mike Mullen "said this week that it is a Pentagon priority to provide two years of rest time for troops who serve in combat zones for one year or 15 months. 'But I don't see that happening in the next year or so,' he added." Last week, at a town hall meeting Iraq veterans "asked the chairman pointed questions about equipment in the combat zone and about their vacation time, too. One marine wondered why the officers above him were receiving new M-4 rifles but many enlisted grunts doing regular patrolling in Iraq were not (they have the older M-16s). Another pointed out that when he and some other members of his unit replaced their uncomfortable boots with footwear they bought out of pocket, they were threatened with disciplinary action for not wearing standard-issue gear. Still another soldier asked why he was being charged vacation time when he came back to the United States for his two-week home leave from Iraq."
      Simulations Teach Marines What To Expect In Iraq.   U.S. News and World Report (2/25, Mulrine, 2.03M) reports on a "new Marine Corps effort to not only give its troops a heightened sense of the sights, sounds, and smells of Iraq but also teach them some hard and fast lessons about ethical decision making. As two Camp Pendleton-based marines face court-martial later this month in connection with the 2005 Haditha killing of 24 civilians, including women and children, the Marine Corps is increasingly aware of the importance of preventing lapses in the moral judgment of stressed-out troops that can result in the death of innocents and turn Iraqi families and towns against American forces."

� Secure this line!

VA PERFORMANCE UPDATE 01: Few federal programs have seen the kind of turnaround experienced by the Veterans Affairs Department's health care system in the late 1990s. Formerly a poster child for substandard medical care and incompetent management, VA's health care system now is considered by
many to be the best in the country. Its ratings for quality of care and customer satisfaction have risen even as the patient load has increased. Major media outlets have credited the agency's use of electronic medical records, unprecedented even in the private sector, with improving medical care, and Democratic presidential contenders Hillary Clinton and Barack Obama have held up VA's system as a model for nationwide health care reform. But the department's success is in jeopardy, according to Dr. Kenneth Kizer, undersecretary for health at Veterans Affairs from 1994 to 1999 and
the man many credit with leading the management reforms that ultimately fixed the broken health care system. Kizer now serves on the independent Commission on the Future of America's Veterans, which is examining demographic and budgetary trends, as well as changes in both warfare and health care, with an eye to providing the most effective programs and services to veterans. "We see a future that is not particularly bright for the VA," said Kizer, speaking at a forum in Washington sponsored by the New America Foundation, a nonprofit public policy institute. Rising medical costs, aging infrastructure and an increase in patients with serious, and expensive, medical needs all are
contributing to growing concern that medical care for veterans will deteriorate under the current system. "Economics are going to be driving some very difficult decision-making down the road," Kizer said. For that reason, the commission is planning to recommend later this year that Congress create a government-chartered entity, structured somewhat like the U.S. Postal Service, to manage
health care for veterans, he said. The entity's charter would detail its mission, funding, governance and assets, as well as requirements that senior managers hold specific skill sets and areas of expertise.

As a federal agency dependent on congressional appropriations, Veterans Affairs is increasingly ill-suited to manage health care for veterans, Kizer said. The annual appropriations process creates program instability and prevents strategic planning. In addition, the agency cannot exercise the kind of management judgment that corporations routinely exercise. For example, VA has found it extraordinarily difficult to close underused or outdated hospitals since no member of Congress wants to lose a medical facility in his or her district. As a result, the agency can't close hospitals in areas where they're not needed or build new ones in areas where they are needed. "The average age of VA hospitals is 50 years old," said William Diefenderfer, former deputy director of the Office of Management and Budget and now a commissioner. We haven't built a new hospital in 20 years. A government-chartered entity "would have the authority to buy and sell assets and borrow money against them," Diefenderfer said. It also would be able to create new sources of revenue. For example, it could provide health care to all veterans and their families who have the ability to pay
- something the VA cannot do currently. Arthur Hamerschlag, former chief of staff at the Veterans Health Administration, the health care arm of Veterans Affairs, said he was not necessarily opposed to the creation of a government-chartered health system for veterans, but that a number of issues would first need to be resolved, including how the new entity would negotiate drug prices and whether or not it would accept Medicare - something VHA does not do now. Veterans Affairs has been able to hold down drug costs because federal law allows the agency to negotiate below-market prices from pharmaceutical companies, something private health care systems would likely protest if a
new quasi-private entity were created that could compete for patients, as the commission envisions. "I think VA will find itself in the medical marketplace in a way it does not now," said Hamerschlag. "That's not necessarily a bad thing, but it will require a different skill set." [Source: GOVExec.com Katherine McIntire Peters 16 Jan 08 ++

TRICARE LAP-BAND SURGERY: Tricare beneficiaries whose weight poses a serious health risk now have available a new surgical alternative. For those who medically qualify, Tricare now covers laparoscopic adjustable gastric banding, also commonly called Lap-Band surgery. Although the TRICARE policy change has only recently been made, coverage is retroactive to 1 FEB 07. Maj. Gen. Elder
Granger, deputy director of the Tricare Management Activity said, “We at Tricare are careful to only cover procedures that have been proven safe and effective, and are accepted by the medical community. We’ve added this procedure because, for some beneficiaries, it may be the right course of
action to preserve their health.” Granger added that, like gastric bypass, gastric stapling or gastroplasty, Lap-Band surgery is only for those suffering morbid obesity. In medical terms, that means their body weight is 100 pounds over ideal weight for their height and bone structure, and their weight is associated with severe medical conditions known to have higher mortality rates. Body
weight that is more than twice the ideal weight for the person’s height and bone structure may also indicate morbid obesity. In addition, Tricare will cover the surgery if a patient has had an intestinal bypass or other surgery for obesity and, because of complications, requires a second surgery. Details of the coverage are available in the Tricare Policy Manual, which beneficiaries can view
online at http://manuals.tricare.osd.mil/index.cfm?fuseaction=TMAManuals.DisplayManualSeriesInfo&ManualSeries=POLICY&TP02=67#TP02.
A search for "morbid obesity" goes directly to the correct section. [Source: TMA News Release 16 Jan 08 ++]

VETERAN CHARITIES UPDATE 06: With scores of U.S. soldiers returning home from Vietnam, California businessman and Army veteran Roger Chapin founded a charity in 1971 dedicated to those troops recuperating in hospitals. Over the next three decades, Help Hospitalized Veterans would distribute
millions of therapeutic craft kits to make moccasins, wooden wind chimes and other trinkets and would win accolades from presidents and Hollywood celebrities alike. Yet, as the nonprofit enterprise has ballooned into one of the country's largest veterans charities, reporting $71.3 million in donations during the past fiscal year, its spending practices have drawn sharp criticism from
charity watchdogs. Between 1997 and 2005, the charity paid $3.8 million in salary and benefits to Chapin and his wife and spent more than $200 million on fundraising and public education campaigns, according to a Washington Post analysis of federal tax filings. The public records also show that the charity awarded at least $19 million in contracts during that period to companies owned by Richard A. Viguerie, a prominent conservative political commentator and advertising consultant based in Virginia.

Help Hospitalized Veterans is one of several military-oriented charities whose spending practices are the subject of a congressional investigation. Chapin evaded U.S. marshals trying to serve him with a subpoena last month, said Rep. Henry A. Waxman (D-CA.), chairman of the House Committee on Oversight and Government Reform. Chapin, who has since been served, is expected to testify
today before the committee. Chapin, who has founded more than 20 nonprofit organizations over three decades, also is president and founder of the Coalition to Salute America's Heroes, a smaller charity that provides emergency financial assistance to veterans and their families. That group is also under investigation by Congress, according to committee staff members, and is expected to be a subject of the hearing. Rep. Chris Van Hollen (D-MD), a committee member, said in an interview the committee wants to find a way to distinguish between charities that truly serve veterans and those "committing fraud against the public."

Chapin, reached at his San Diego home last month, said watchdogs and members of Congress are misrepresenting his charities. No laws at the federal or state level regulate the amount of money charities spend on overhead, fundraising or charitable causes. The American Institute of Philanthropy, a leading charity watchdog, issued a report last month suggesting that Help Hospitalized Veterans and 19 other veterans’ charities manage their resources poorly, paying high overhead costs and direct-mail fundraising fees. Help Hospitalized Veterans spends 31% of its funds on charitable causes according to Daniel Borochoff, president of the American Institute of Philanthropy. The
institute recommends that charities spend at least 60% of their funds on charitable programs. Critics have not contended that all veterans’ charities manage their funds poorly. Some charities, including the Fisher House Foundation and the Disabled American Veterans Charitable Service Trust,
consistently have received high marks from watchdogs.

High overhead costs can be expected for start-up charities, Rep. Thomas M. Davis III (R-VA) said in an interview. But he said it is important to determine whether some veteran’s charities have been "a serial swindler in terms of taking people's money and not spending it." Help Hospitalized Veterans paid Chapin $426,434 in salary and benefits in the past fiscal year, The Post's review
of a tax filing showed. His wife, Elizabeth, received $113,623 in salary and benefits as "newsletter editor," the filing shows. In the filing, the charity reports that the Chapins each worked 40 hours per week. In a separate tax filing, the Coalition to Salute America's Heroes reported that Roger Chapin worked another 40 hours per week for his job there but did not collect pay. Mike Lynch,
executive director of Help Hospitalized Veterans, said the charity's board considers Chapin's wages "proper compensation." Help Hospitalized Veterans has spent some of its donations in the real estate market. The charity purchased a condominium unit in Fairfax County in May 2006 for $444,600, according to property records reviewed by The Post. Chapin said the charity purchased the Falls Church apartment because of his frequent travel to Washington. The charity also purchased at least nine properties in the past decade in California, where the group has its headquarters, records reviewed by The Post show. The charity has long had ties to Viguerie. Richard Viguerie has been dubbed the "funding father" of modern conservative strategy, having pioneered important tactics in computerized direct mail strategy in the 1970s and 1980s. He is considered the direct mail titan of the right. In the past fiscal year, Viguerie's companies received $3.9 million from the charity, according to its filings with the Internal Revenue Service. Viguerie has been asked to testify at the hearing. Reached at his office in Manassas this week, an assistant said Viguerie would not
answer questions from a Post reporter, citing a policy against commenting on clients. [Source: Washington Post Philip Rucker article17 Jan 08 ++]

VETERAN CHARITIES UPDATE 07: A congressional investigation 16 JAN uncovered new allegations of questionable spending practices at two veterans charities, including one that paid retired Army Gen. Tommy Franks $100,000 to appear in its solicitation letters using money the nonprofit raised to
help soldiers returning from Iraq and Afghanistan. At a raucous three-hour hearing House members questioned California entrepreneur Roger Chapin about his management of two charities. One charity, Help Hospitalized Veterans, spent hundreds of thousands of dollars in donations that were to help
wounded soldiers on personal expenses for Chapin, executive director Mike Lynch and Richard A. Viguerie, to whom the charity has awarded millions of dollars in fundraising-consulting contracts, the hearing found. The expenses included at least $340,000 in meals, hotels and entertainment; a $135,000 loan to Lynch for a divorce settlement with his former wife; a $17,000 country club
membership; three airplane tickets to Hawaii; and a $1 million loan to Viguerie for a start-up initiative at his firm, several members of the committee said. Chapin said he later repaid the charity for the flights and said the golf club membership was a “perk” for board members. The second charity, the Coalition to Support America ‘s Heroes, used Franks in its solicitation letters, the House
Committee on Government Oversight and Reform found.

Rep. Henry A. Waxman (D-CA) chairman of the committee said Help Hospitalized Veterans raised more than $168 million from 2004 to 2006. The charity spent a quarter of those donations on the veterans, with the rest going to direct-mail fundraising, salaries and other expenses. Republicans and Democrats voiced outrage over what Waxman called an intolerable fraud. “Most of the millions they receive never reach veterans or their families,” Waxman said. “Instead, the groups waste those contributions on bloated overhead costs and self-enrichment.” There are no laws that regulate how much charities spend on fundraising and overhead costs. There also are no requirements that nonprofit groups disclose such breakdowns in their solicitations. Several lawmakers signaled yesterday that they may introduce legislation aimed at helping donors better understand the finances of nonprofit groups. Rep. Christopher Shays (R-CT.) asked Chapin what would happen if his charities told donors how their donations were spent. “If we disclose, which I’m more than happy to do, we’d all be out of business,” Chapin said. “Nobody would donate. It would dry up.”

A spokesman for Franks said the retired general made several speeches for the charity in 2004 and 2005, as well as allowing his name to appear on direct mailings for about a year. He ended his support “when he learned that the percentage of money raised that was going to the troops was less than 85%, a figure which was then and remains today, his criteria for supporting charitable
organizations,” said retired Col. Michael Hayes, Frank ’s chief of staff. Lynch told The Post this week that Help Hospitalized Veterans meets the Better Business Bureau’s standards, but bureau President H. Art Taylor said yesterday that both Chapin charities do not. A committee member, Rep. Chris Cannon (R-UT), expressed anger over his colleagues’ harsh scrutiny of Chapin’s charities. “I
am deeply concerned that we’re whacking on groups that are supporting the military,” Cannon said. Chapin’s nonprofit groups are two of several veterans’ charities under scrutiny for their spending practices. The American Institute of Philanthropy, a leading watchdog group, has suggested that Chapin’s groups are among 19 military-oriented charities that manage their resources poorly. Some other veteran’s charities consistently received high marks from the institute and other watchdog groups... [Source: Washington Post Philip Rucker article 18 Jan 08 ++]

OKLAHOMA VET INSURANCE PLAN: Saying one out of eight veterans is uninsured, Sen. Andrew Rice (D-Oklahoma city) proposed 15 JAN creating an Oklahoma Veterans Health Insurance program. He said many people think all veterans qualify for free health care through the U.S. Veterans affairs Department. "Sadly, that's not true, and when the Legislature sets our priorities at the beginning of this session, Oklahoma's military veterans deserve to be at or near the top,” said Rice. The proposed insurance program would not be free. Veterans would be required to pay premiums and co-payments based on their household income. According to the latest census information, Oklahoma has 340,000 veterans. Under his proposal, the veterans' health insurance program would be administered by the Oklahoma Veterans Affairs Department. [Source: NewsOK.com 16 Jan 08 ++]

GULF WAR VETERAN ADVISORY COMMITTEE: A U.S. congressman is asking the U.S. Department of Veterans Affairs to establish a committee that would give Persian Gulf War veterans a better and simpler way to access VA resources. In a 3 JAN letter to VA Secretary James Peake, U.S. Rep. Chet Edwards
(D-TX) requested the formation of a Gulf War Veteran Advisory Committee, writing that the current setup does not adequately address the range of issues facing those who fought in that 1991 war. Edwards also chairs the U.S. House Military Appropriations Subcommittee. Currently, the VA’s Research Advisory Committee (RAC) is the only “Gulf War-focused entity” within the department, Edwards writes, and that committee’s charter is focused on medical research recommendations. Kirt Love, a Gulf War veteran who served with the 1st Armored Division, asked for Edwards’ help in an effort to better communicate the needs of veterans from his war, which he feels are neglected. Love said in
an e-mail that he became “deathly ill” after the war and has struggled for answers. “Currently VA pretends that Gulf War veterans do not exist and is non-responsive to any request made of them,” Love wrote in an e-mail. “Things are worse than ever before and VA doesn’t seem to care about that
fact. So veterans like myself struggle with inferior care and minimal benefits, forgotten by the country we served faithfully in 1991.” VA representatives have not yet responded to requests for comment. But Josh Taylor, an Edwards spokesman, wrote in an e-mail that “In general, Chairman Edwards
felt this was an important issue to bring to the attention of the Secretary.” And as the legislative session gets under way, there will be opportunities to discuss the committee further, Taylor said.

Excerpts from the letter include, “As you know, many of these veterans have felt neglected by the government — both the VA and the Defense Department — and while there are a wide range of issues they would like to raise, there is no common venue within the VA for them to raise their concerns…While these issues are brought to the RAC, simply because its charter deals with Gulf War
Illness, the RAC is not equipped or authorized to address them. A committee focusing on Gulf War veterans would help identify and prioritize unmet needs while consolidating improvements to care and services for those veterans… In May the VA established the Advisory Committee on OIF/OEF Veterans
and Families, which provides support for veterans of those wars. A similar entity should be available for Gulf War veterans …Including veterans of the conflict in the committee would be “critical. I would hope the committee would have some autonomy, its own staff, and some members of the committee from outside the government. I believe this would help the committee build trust with Gulf War veterans and therefore improve the committee’s ability to succeed from the outset.” [Source: Stars and Stripes George Ziezulewicz article 15 Jan 08 ++]

DOD DISABILITY EVALUATION SYSTEM UPDATE 09: The Army’s new Warrior Transition Unit led by Lt. Col. Chip Pierce is a brigade designed specifically to address the administrative needs of injured soldiers. In February, Army Times reported that soldiers languished for months — even years — in
the medical hold system, facing bureaucratic tangles as they worked their way toward the physical evaluation board to determine their disability rating for retirement pay. The stories, as well as reports from the Pentagon Inspector’s General and Government Accountability Office and testimony of injured soldiers before Congress, brought about a series of investigations and planned changes. And the new Warrior Transition Unit meant officials could immediately put some of those changes into effect. Since then, the Army has added staff, improved training for counselors and lawyers, and ensured every soldier has someone overseeing his or her progress through the system. And Building
18, Walter Reed’s dilapidated symbol of the breakdown in the system, no longer houses wounded soldiers.

While the number of soldiers medically retired — meaning they received a disability rating of 30% or higher or had at least 18 years of service when they went through the disability process — declined from 2005 to 2006, it increased by several hundred in 2007, according to figures provide by Col. Carlton Buchanan, deputy commander of the Army’s Physical Disability Agency. Moreover,
Buchanan said, while 270 fewer soldiers were medically retired in 2006 than in 2005, the percentage of those completing the evaluation process that were medically retired went up over that time, and has continued to rise in 2007:
• In 2005, 13,048 soldiers went through the process and 2,232 were medically retired, about 17.1%.
• In 2006, 10,460 soldiers went through the process and 1,956 were medically retired, about 18.7%.
• In 2007, 10,400 soldiers went through the process and 2,397 were medically retired — about 23%.
The 8,003 soldiers who weren’t medically retired in 2007 either were found fit and remained in the
Army, were awarded a lump-sum severance payment based on rank and years of service, or were separated without benefits if their condition was found to be pre-existing and they hadn’t been in the military for at least seven years. About 8,900 soldiers remain in the Warrior Transition Unit waiting for their final disability evaluation board.

Things still aren’t perfect; Pierce said it’s hard to judge how soldiers feel about the improvements because they weren’t in the system a year ago. And there are still cases taking longer than they should to go through the process. But now, rather than justifying a months-long quagmire, as had been done by other officials in the past, Pierce said his office tracks, by name, every soldier whose transition takes longer than 60 days. Prior to the 60-day mark, soldiers’ squad leaders in the Warrior Transition Units are responsible for making sure soldiers move through as quickly as possible. The Marine Corps also stood up a Wounded Warriors regiment last spring to keep track of Marines and sailors going through the disability retirement system. Though the Navy and the
Marine Corps have a better track record for getting service members through the process, there have been worries about the equity of their ratings system. An Army Times investigation last spring found that enlisted Marines lag far behind enlisted sailors and airmen in the size of the average disability payments they are awarded. The 2006 data released by the Defense Department’s Office of the
Actuary show Marines and soldiers continue to lag, even though they have higher injury rates and could be expected to have a greater proportion of serious injuries because of the wars in Iraq and Afghanistan than do sailors or airmen. Their ranks and times in service were also comparable. The
average monthly disability payments for all enlisted members receiving disability pay from the military in 2006:
• Enlisted: • Air Force: $963 • Navy: $845 • Army: $792 • Marine Corps: $774.
• Officers: • Air Force: $2,668 • Navy: $2,392 • Marine Corps: $2,336 • Army: $2,067.

According to the Office of the Actuary, the number of Marines medically retired in 2006 went up by about 200 compared with the previous year — far more than any other service. The Air Force and Navy also saw increases in permanent disability retirements from 2005 to 2006 of 125 airmen and
36 sailors. Buchanan said part of the reason for the Army’s increase of more than 400 disability retirements in 2007 was that combat-related injuries rose to 18% from about 15% the year before. Among soldiers going through the military disability evaluation process, more than half of those with combat-related injuries are retired, Buchanan said. Another reason for the increase, he said,
is “increased training of physicians and adjudicators, coupled with greater precision in describing injuries, such as scars, muscle and nerve injuries, as well as mental disorders. That gives medical boards better information to determine proper disability percentages”. [Source: ArmyTimes
Kelly Kennedy article 15 Jan 0 ++]

TRICARE EOBS UPDATE 03: The Defense Department is limiting the amount of Tricare paper it sends to military retirees age 65 and older and their families by sending explanations of benefits forms only once a month. Others covered under Tricare, including active-duty families, will continue to have the choice of receiving a paper copy of their explanation of benefits (EOB) mailed each time
a claim is processed, even if there are multiple claims in a month. An explanation of benefits provides details of what action Tricare has taken on claims by doctors and other health care providers seeking payment for services to a patient. Officials said the monthly statement will allow easier comparison with the quarterly Medicare Summary Notice. There are exceptions to the monthly policy for these retirees and their family members; statements will be sent if the EOB includes a check to the patient, or if a claim is denied and the patient has appeal rights for those services. As in the past, patients can view an EOB online any time a claim is processed. Those who are not already registered for this service can do so at https://www.tricare4u.com/apps-portal/tricareapps-app/unauth/tricarehome.jsp. Beginning 14 FEB
patients will have the option of receiving an e-mail notification when a claim is processed. They can then log on to the website to view and print their EOBs. Once patients sign up for this option, however, they will not receive a mailed monthly summary of explanations of benefits. Patients will be able to view the EOBs for any claim processed within the last 27 months. Beneficiaries with
questions about the registration process can call (866) 773-0404. [Source: MRGRG Karen Jowers article 15 Jan 08 ++]

MILITARY DEATHS: CRS Report for Congress (Order code: RL32492) American War and Military Operations Casualties: Lists and Statistics at http://www.fas.org/sgp/crs/natsec/RL32492.pdf is written in response to numerous requests for war casualty statistics and lists of war dead. It provides
tables, compiled by sources at the Department of Defense (DOD), indicating the number of fatalities and numbers of wounded among American military personnel serving in principal wars and combat actions from the Revolutionary War to the current Operation Iraqi Freedom (OIF) and Operation Enduring
Freedom (OEF) (operations in Afghanistan and related conflicts). A review of the composite data reveals the following.

• During the period between the Revolutionary War and the Persian Gulf War, it was the Civil War that produced the most American fatalities, when Union statistics and Confederate estimates are taken into account.
• World War II was the first war in which there were more battle deaths than deaths from other causes such as accidents, disease, and infections.
• With a total of 382 in-theater deaths, 147 of which were battle deaths, the Persian Gulf War was the least costly in terms of fatalities.
• The ongoing Operation Iraqi Freedom to date has produced more than nine times the number of in-theater deaths than the Persian Gulf War (which lasted seven months).
• During the Clinton presidency total military deaths from all causes were 13,417 whereas during the Bush presidency total military deaths through 2006 from all causes were 9.016.

• The latest census, of Americans, shows the following distribution of American citizens, by Race:

>>European descent (White) ....... 69.12%
>>Hispanic ................................ 12.5%
>>Black...................................... 12.3%
>>Asian ...................................... 3.7%
>>Native American ...................... 1.0%
>>Other ...................................... 2.6%

• Fatalities by Race; over the past three years in Iraqi Freedom are:
>>European descent (white) ..... 74.31%
>>Hispanic ............................. 10.74%
>>Black ................................... 9.67%
>>Asian ................................. . 1.81%
>>Native American .................... 1.09%
>>Other .................................... . 33%

• The casualty statistics for wars long ended are updated periodically, sometimes yearly. This almost always reflects the identification of remains of persons previously listed as missing in action and those persons’ reclassification as dead. Other reasons, much rarer, include the discovery of errors in casualty records for individuals or categories of people. [Source: Honolulu-Eagles Military statistics msg 14 Jan 08 ++]

CALIFORNIA & FEDERAL DISABLED BENEFITS (100% SC): Veterans who are residents of California who are rated 100% totally disabled by the VA as a result of a service connected (SC) determination are entitled to the following state and federal benefits. This list was last updated OCT 06. For residents of other states the federal benefits are the same but the state benefits will be in accordance with that state’s laws. To determine what they are check the VA website associated with the state in question:
1. Eligibility for additional allowance for dependents—spouse, children, dependent parent(s).
2. Eligibility for additional aid and attendance allowance for disabled spouse.
3. Enrollment in VA Healthcare Priority Group 1 (no co-payments required).
4. VA fee basis outpatient medical card (all conditions requiring treatment, whether SC or not).
5. Eligibility for all necessary dental care.
6. Eligibility for sensorineural aids—hearing aids, eyeglasses, contact lenses—without regard to whether the condition producing need for such is service-connected.
7. Eligibility for long-term VA Nursing Home care for any condition.
8. Eligibility for health care coverage under CHAMPVA for spouse and children (unless they are also eligible for TRICARE).
9. Eligibility for Service-Disabled Veterans’ Insurance (RH), including up to $20,000 supplemental insurance beyond regular amount.
10. Waiver of VA life insurance premiums, if under age 65 (but not on additional amounts).
11. Possible eligibility for special monthly compensation for loss or loss of use of a creative organ; loss of a female breast; loss or loss of use of one hand, one foot, or one eye; loss of use of both buttocks; complete deafness in both ears; or, complete organic aphonia (loss of ability to communicate by speech).
12. Possible eligibility for special monthly compensation for loss or loss of use of both eyes, both hands, or both feet, or one hand and one foot. Includes paired extremities or organs (one SC, the other NSC, 38 CFR § 3.383) and combinations of losses.
13. Possible eligibility for special monthly compensation because of being permanently housebound or having one disability rated 100% plus other conditions independently ratable at 60% or more.
14. Possible eligibility for special monthly compensation because of being so helpless as to require the regular aid and attendance of another person.
15. Possible eligibility for payment of annual clothing allowance for specified SC disorders resulting in need for prosthetic appliance or use of a wheelchair, or for certain skin conditions.
16. Possible eligibility for one-time assistance in purchase of specially-adapted automobile.
17. Possible eligibility for Automobile Adaptive Equipment Allowance.
18. Eligibility for education or training under VA Vocational Rehabilitation.
19. Possible eligibility for Special Adapted Housing Assistance.
20. Possible eligibility for Special Home Adaptation Grant.
21. Possible eligibility for Veterans’ Mortgage Life Insurance (VMLI).
22. CAL-VET Home Loan Disability Insurance.
23. Eligibility for property tax exemption on principle residence.
24. Home loan guaranty funding fee exemption.
25. Possible eligibility for Home Improvement and Structural Alteration (HISA) home modification grant.
26. Golden Access Passport for U.S. National Parks.
27. California State Park pass (requires SC wartime-incurred disability) ($3.50 one-time fee).
28. Reduced fee for hunting license.
29. Reduced fee for basic sport fishing license.
30. Eligibility for 10-point preference for Federal Civil Service employment. Under certain circumstances, may be employed on a noncompetitive basis. The 10-point preference is also applicable for the spouse and/or natural mother of a permanently totally service-disabled veteran.
31. Eligibility for 15-point preference for State of California employment. The spouse of a 100% disabled veteran is eligible for 10-point preference.
32. Eligibility for Survivors’ and Dependents’ Education Assistance for spouse and/or children under 38 U.S.C., Chapter 35.
33. Eligibility for CAL-VET College Tuition and Fee Waiver for spouse and children (Plan A). Requires wartime service. May not e authorized concurrently with VA education assistance under Chapter 35.
34. Eligibility for CAL-VET College Tuition and Fee Waiver for children (Plan B). May be authorized concurrently with VA education assistance under Chapter 35.
35. Eligibility for son(s) and/or daughter(s) to compete for admission to military academies.
36. Eligibility for military identification card.
37. Possible eligibility for DMV Disabled Veteran license plates.
38. Eligibility for exemption from vehicle license fees.
39. If a 20-year military retiree, possible eligibility for CDRP or CRSC.
40. Withdrawal from SBP program participation (military retirees) after having been rated SC, totally disabled for 10 continuous years, or, if out of service less than 10 years, having been rated SC, totally disabled for at least 5 continuous years from date of last active duty.
41. Possible eligibility for the California Disabled Veteran Business Enterprise (DVBE) and the Federal Service Disabled Veteran Owned Business (SDVOB) programs. [Source: CA Dept of VA website Nov 07 ++]

CALIFORNIA & FEDERAL PENSION BENEFITS: Veterans who are residents of California who are disabled as a result of non-service connected (NSC) determinations by the VA are entitled to a number of state and federal benefits. Following is a checklist that can be used to assist in obtaining these benefits. This checklist was last updated OCT 06:

A. Claim Requirements:
1. Minimum of 90 consecutive days of active service or was discharged because of SC disability. If veteran entered service after 1980, the service requirement is 24 continuous months or the full period for which called to active duty, whichever is less, unless discharged sooner because of hardship, reduction-in-force, or SC disability. In any event, at least one day of service must have been during a wartime period.
2. If veteran is under age 65, evidence that veteran is in receipt of any disability benefit administered by the Social Security Administration (either SSA or SSI); or, is a long-term patient in a nursing home because of disability; or, medical evidence showing the veteran is unable to work because of disability.
3. Medical evidence to show that veteran is in need of regular aid and attendance or is housebound (if applicable).
4. Report projected family income—include income from all sources, including farm and/or business. Also list deductions/exclusions—unreimbursed medical expenses, children’s wages, etc.
5. Report net worth.
6. Dependency documents—marriage certificate, birth certificate(s), death certificate(s), divorce decree(s), VA Form(s) 21-674(as applicable). If an adult child is claimed as disabled (helpless), submit appropriate medical evidence in support.

B. Benefits:
1. Possible additional pension payable if housebound or if so helpless as to require the regular aid and attendance of another person (includes nursing home patients).
2. Additional pension payable if veteran served during World War I.
3. VA outpatient medical card if entitled to aid and attendance or housebound benefits, or if a World War I veteran.
4. Enrollment in VA Healthcare Priority Group 4 (no co-payments required) if entitled to aid and attendance or housebound benefits.
Enrollment in Priority Group 5 (no co-payments required) if entitled to basic pension. Enrollment in Priority Group 6 (no co-payments required) if a World War I veteran.
5. Eligibility for sensorineural aids—hearing aids, eyeglasses, contact lenses—if housebound or in need of regular aid and attendance.
6. Waiver of VA insurance premiums, if under age 65 (but not on any supplemental RH insurance).
7. CAL-VET Home Loan Disability Insurance.
8. Golden Access Passport for U.S. National Parks.
9. Possible eligibility for DMV Disabled Person Parking Placard.
10. Eligibility for 10-point preference for Federal Civil Service employment.
[Source: CA Dept of VA website Nov 07 ++]

VETERAN LEGISLATION STATUS 30 JAN 08: The House of Representatives returned to work on JAN 15th and the Senate on January 22nd.for the second session of the 110th Congress. Up for election/re-election in 2008 are 35 Senators and 435 Representatives. All of these will be more receptive to their veteran constituent’s inputs in hope of obtaining their vote so this is the year we should be pushing for the legislation that will benefit us most. Those seeking to remain in the Senate or be elected to it are:

Lamar Alexander, R-TN
Tom Allen, D-ME (1st District); running for Senate
John Barasso, R-WY
Max Baucus, D-MT
Joseph Biden, D-DE
Saxby Chambliss, R-GA (Armed Services)
Thad Cochran, R-MS (Ranking Minority Member-Appropriations, Defense Appropriations)
Norm Coleman, R-MN
Susan Collins, R-ME (Armed Services)
John Cornyn, R-TX (Armed Services)
Elizabeth Dole, R-NC (Armed Services)
Richard Durbin, D-IL (Defense Appropriations, Senate Majority Whip)
Michael Enzi, R-WY
Lindsey Graham, R-SC (Armed Services, Veterans Affairs)
Tom Harkin, D-IA (Defense Appropriations)
Duncan Hunter, R-CA (52nd District); running for President (Ranking Minority Member-Armed
James Inhofe, R-OK (Armed Services)
Tim Johnson, D-SD (Chairman-Military Construction Appropriations)
John Kerry, D-MA
Mary Landrieu, D-LA (Military Construction Appropriations)
Frank Lautenberg, D-NJ
Carl Levin, D-MI (Chairman-Armed Services)
Mitch McConnell, R-KY (Defense Appropriations, Senate Minority Leader)
Steve Pearce, R-NM (2nd District); running for Senate
Mark Pryor, D-AR (Armed Services)
Jack Reed, D-RI (Armed Services, Military Construction Appropriations)
Pat Roberts, R-KS
John Rockefeller, D-WV (Veterans Affairs)
Jeff Sessions, R-AL (Armed Services)
Gordon Smith, R-OR
Ted Stevens, R-AK (Ranking Minority Member-Defense Appropriations)
John Sununu, R-NH
Tom Tancredo, R-CO (6th District); running for President
Mark Udall, D-CO (2nd District); running for Senate (Armed Services)
Tom Udall, D-NM (3rd District); running for Senate
Roger Wicker, R-MS
Heather A. Wilson, R-NM (1st District); running for Senate

For a listing of Congressional bills of interest to the veteran community that have been introduced in the 110th Congress refer to the Bulletin’s House & Senate attachments. By clicking on the bill number indicated you can access the actual legislative language of the bill and see if your representative has signed on as a cosponsor. Support of these bills through cosponsorship by other legislators is critical if they are ever going to move through the legislative process for a floor
vote to become law. A good indication on that likelihood is the number of cosponsors who have signed onto the bill. A cosponsor is a member of Congress who has joined one or more other members in his/her chamber (i.e. House or Senate) to sponsor a bill or amendment. The member who introduces the bill is considered the sponsor. Members subsequently signing on are called cosponsors. Any number of members may cosponsor a bill in the House or Senate. At http://thomas.loc.gov you can also review a copy of each bill’s content, determine its current status, the committee it has been assigned to, and if your legislator is a sponsor or cosponsor of it. To determine what bills,
amendments your representative has sponsored, cosponsored, or dropped sponsorship on refer to http://thomas.loc.gov/bss/d110/sponlst.html. The key to increasing cosponsorship on veteran related bills and subsequent passage into law is letting our representatives know of veteran’s feelings on issues. At the end of some listed bills is a web link that can be used to do that. Otherwise,
you can locate on http://thomas.loc.gov who your representative is and his/her phone number, mailing address, or email/website to communicate with a message or letter of your own making. [Source: RAO Bulletin Attachment 13 Jan 08 ++]

Lt. James “EMO” Tichacek, USN (Ret)
Director, Retiree Assistance Office, U.S. Embassy Warden & IRS VITA Baguio City RP PSC 517 Box RCB, FPO AP 96517
Tel: (951) 238-1246 when in U.S. & Cell: 0915-361-3503 when in Philippines.
Email: raoemo@sbcglobal.net Web: http://post_119_gulfport_ms.tripod.com/rao1.html
AL/AMVETS/DAV/FRA/NAUS/NCOA/MOAA/USDR/VFW/VVA/CG33/DD890/AD37 member
BULLETIN SUBSCRIPTION NOTES:
== To subscribe first add the above RAO email addees to your address book and/or white list and then provide your full name plus either the post/branch/chapter number of the fraternal military/government organization you are currently affiliated with (if any) “AND/OR” the city and
state/country you reside in so your addee can be properly positioned in the directory for future recovery. Subscription is open to all veterans, dependents, and military/veteran support organizations. This Bulletin sent to 63,292 subscribers.

� Secure this line!

NDAA 2008 UPDATE 14: The Senate passed a $696 billion 2008 Defense Authorization Bill H.R. 4986 22 JAN and President Bush signed it into law on 28 JAN. The fiscal 2008 defense budget has been laden with challenges, from Congress' inclusion of non-defense-related earmarks to its insertion of controversial language regarding Iraq. Bush announced 28 DEC that he wouldn't sign the bill until it was revised. Instead, the president signed an executive order authorizing a 3% military pay raise. The amount was 0.5 % lower than the 3.5% rate provided for in the authorization act, but took effect 1 JAN 08. All pays and incentives included in the authorization act will be retroactive to 1 JAN, a defense official said. The bill became law just a week before the next budget cycle begins as Bush sends his fiscal 2009 request to Capitol Hill. That budget proposal, along with a requested $70 billion in emergency war spending, is expected to be delivered to Congress 4 FEB.

The NDAA contains provisions improving the transition from active duty to veterans’ status and improving VA health care for returning service members, especially those with traumatic brain injury (TBI) or mental health issues, including post-traumatic stress disorder (PTSD). Among the key provisions to improve care for veterans and their families, the NDAA:

• Provides an additional three years of access to free VA health care for returning service members from Iraq and Afghanistan.
• Improves and expands VA’s ability to care for veterans returning from Iraq and Afghanistan with TBI, including research, screening, care coordination, and working with non-VA providers to provide the care needed by our veterans;
• Requires a comprehensive policy to address mental health conditions, including PTSD;
• Requires DOD and VA to streamline the records transmission process, including moving forward with fully interoperable medical records;
• Provides for a more seamless transition between active duty and veterans’ status, including a single physical exam for DOD and VA benefits;
• Creates Wounded Warrior Resource Center to serve as a single point of contact for service members, their families, and primary caregivers to report issues with facilities, obtain health care, and receive benefits information;
• Requires VA to provide age-appropriate nursing home care for our veterans;
• Allows members of the National Guard and Reserves that are eligible for Reserve Educational Assistance Program (REAP) to use their education benefits for ten years after separation;
• Requires a study on the feasibility of streamlining statutory provisions addressing GI Bill benefits for active duty and guard and reserves.
[Source: AFPS Donna Miles article 28 Jan 08 ++]

PRESIDENTIAL PROPOSALS TO AID VETS: Democratic lawmakers reacted with skepticism 29 JAN to President Bush's new proposals to aid the families of military personnel and veterans, noting that his administration has repeatedly underfunded the Veterans Affairs Department (VA). In his State of the Union address 28 JAN, Bush proposed a series of measures intended to help military families, including the creation of hiring preferences for the spouses of military personnel and legislation to allow servicemembers to pass on unused GI Bill educational benefits to their spouses and children. “They endure sleepless nights and the daily struggle of providing for children while a loved one is serving far from home,” Bush said of military families. “We have a responsibility to provide for them.” The president also called for expanding military families' access to child care. Democrats and some veterans' advocates sharply criticized the proposals, which they said came after years of lean administration budget requests for the VA and military personnel. “The difficulty . . . that we've had on this issue is that the budgets for Iraq have sucked out all the air,” said Susan A. Davis (D-CA) chairwoman of the House Armed Services Military Personnel Subcommittee. “Families have not been nearly as high a priority as they should be. Maybe that'll change. I doubt it.”

Paul Rieckhoff, executive director of Iraq and Afghanistan Veterans of America, said the GI
Bill proposal would come as “a slap in the face” to newly returning veterans if it is not accompanied by broader improvements, which have proved difficult to advance in Congress because of administration opposition and tight budgets. Bush asserted that VA funding had increased by more than 95% since he had taken office -- another suggestion met with barbs from Democrats. “He didn't tell them that his budget proposals have repeatedly cut funding for veterans, and that the only reason spending on veterans' programs has increased is because Congress raised the level of spending,” said Daniel K. Akaka (D-HI), chairman of the Senate Veterans' Affairs Committee. Bush is set to unveil his 2009 budget proposal 4 FEB Lawmakers already have begun to push for funding of their priorities. Akaka and Bernard Sanders, (I-VA), sent a letter on 25 JAN asking new VA Secretary James B. Peake for increased funding for the VA's National Center for Post-traumatic Stress Disorder, which they said had to cut staff in recent years because of insufficient resources. Bush also will have to include funding to enact proposed recommendations of a presidential commission on “wounded warriors” led by former Sen. Bob Dole (R-KS) (1969-96), and former Health and Human Services Secretary Donna Shalala. In his address, Bush called on Congress to pass the remaining recommendations of
the commission, including a major overhaul of the veterans' disability benefits system. [Source: GQ Today Patrick Yoest article 29 Jan 08 ++]

VDBC UPDATE 24: The Department of Veterans Affairs (VA) has awarded a $3.2 million contract to Economic Systems Inc. of Falls Church, Va., to develop information relating to possible changes in the composition of disability payments to disabled veterans. The contact is based upon recommendations of the Dole-Shalala Commission, which issued its final report in July 2007, and the OCT 07 final report of the Veterans Disability Benefits Commission. The contractor will provide its findings in AUG 08. Economic Systems Inc. will address three basic research questions in two studies.
• 188,000 Chapter 61 medical disability retirees with less than 20 years denied CRDP.
• Examine the nature and feasibility of making “long-term transition payments” to service members separated from the military due to disability while those veterans undergo rehabilitation.
• Provide information on the appropriate levels of compensation necessary to compensate for any loss in earnings capacity caused by service-incurred or service-aggravated conditions.
• Provide information on potential “quality of life” payments called for by both studies.
[Source: VA News Release 30 Jan 08 ++]

VA CLAIM BACKLOG UPDATE 14: Advanced technologies such as artificial intelligence could help the Veterans Affairs Department reduce a backlog of disability claims that has spiked past 1 million, according to computer experts and veterans advocates. The Veterans Benefits Administration, which processes the claims, has a backlog of 650,000 pending claims and another 147,000 that are under appeal and working their way through a process that "is paper intensive, complex to understand, difficult to manage and takes years to learn," Chairman of the Veterans Affairs Subcommittee on Disability and Memorial Affairs Rep. John Hall (D-NY) said at a 29 JAN hearing of the House Veterans Affairs Committee. Training an employee to rate VBA claims can take two to three years and many leave within five years, Hall said. Experienced raters can adjudicate only about three claims a day, spending two to three hours on each claim. He said the VA should consider the use of artificial intelligence technologies, such as automated decision-support tools that can determine disability payments, which would speed up claims processing.

Computer experts who testified at the hearing said technology exists today that can automate the claims process and eliminate the backlog. Tom Mitchell, chairman of the Machine Learning Department at the School of Computer Science at Carnegie Mellon University in Pittsburgh said the VBA needs to emulate health insurers such as Highmark Inc., a Pittsburgh-based company that uses computers to process 90% of its claims. Mitchell said the computer system automatically determines payments because it contains a large collection of rules, each one specifying the payment to be made in some very specific case, defined by the details of the patient's policy, treatment and history. The complex policy for determining what payment is due under which condition is encoded in these rules inside the computer." While the type of claims processed by Highmark are not identical to the kinds of claims processed by the VBA, Mitchell said they are similar enough to "conclude online processing will be of considerable value to the VA." Mitchell said other AI techniques that could work for VBA include case-based reasoning systems, which tap into a database of historical data to
compare past cases with a current case, and machine learning and data-mining, which could discover patterns in a current claim that indicate more information is needed to process the claim.

The VBA could automate its processes by developing a document naming system for paper documents, which are then electronically scanned into a database to make it easier to retrieve, said Ronald Miller, professor of biomedical informatics at Vanderbilt University. VBA repeatedly loses paper records submitted by claimants. Robin Cleveland, wife of retired Marine Gunnery Sgt. Tai Cleveland, told the hearing that since November 2005, she has submitted multiple copies of Tai's medical record and was told that the VBA could not find the records and she needed to resubmit them. She said her husband, a paraplegic after injuries incurred in AUG 03 during a hand-to-hand training exercise in Kuwait, only started to receive benefit payments this month after Congress intervened. Dr. Marjie Shahani, senior vice president of operations at QTC Medical Services, which conducts medical examinations on veterans and active duty personnel seeking VBA compensation, said her company has developed an application called the Evidence Organizer, which creates an electronic file for a claim, which can include multiple medical conditions and is accessible at the click of a mouse. Shahani said the organizer cuts the time to rate an individual claim from 3.5 hours to 2.2 hours. The time savings should allow a VBA ratings specialist to review 711 claims compared with the 533 a specialist processes today, he said.

Kim Graves, director of business process integration for the VBA said the VBA already has bbegun to develop technologies to increase the number of claims that specialists can process. The agency has a comprehensive strategy to develop the Paperless Delivery of Veterans Benefits initiative, which will employ a variety of enhanced technologies to support end-to-end claims processing, Graves said. In addition to imaging and computable data, it will also incorporate enhanced electronic workflow capabilities, enterprise content and correspondence management services. Graves said VBA also is considering the use of business-rules-engine software for workflow management, which could improve processors' decision-making. Stephen Warren, principal deputy assistant secretary for the VA Office of Information and Technology, said the department is preparing a statement of work to engage the services of a lead systems integrator to develop strategy and business requirements for Paperless Delivery of Veterans Benefits, though he did not provide a timeline. Gary Christopherson, who served as chief information officer for the Veterans Health Administration in 2000 and principal deputy assistant secretary for Health Affairs in the Defense Department, said "using artificial intelligence or electronic decision support tools is nothing new." Government and corporations routinely use those tools, and VBA claims processing is no more difficult than any other application of AI. He also called for a radical policy change in how VBA provides benefits. He said that it should presume that a veteran has a valid claim and is entitled to benefits for a period of a year until it completes the processing of that claim, with payment starting in 30 days of the date the claim is filed. [Source: GOVExec.com Bob Berwin article 30 Jan 08++]

VA MILEAGE REIMBURSEMENT UPDATE 03: In the FY2008 Omnibus Appropriations $125 million was allocated to pay for an increase in the travel reimbursement rate for disabled veterans to go to VA hospitals for care. The present 11 cents a mile was set in 1977. The increase is 17.5 cents per mile. However, it could not go into effect until VA Secretary Peake announced the change and directed the VA to put it into effect. In JAN 12 bi-partisan rural Senators wrote the Secretary asking him to put the change in effect as soon as possible. The Secretary of Veterans Affairs has now made the decision to increase VA’s beneficiary travel mileage reimbursement rate effective 1 FEB 08, to 28.5 cents per mile for travel related to health care per VHA Dir 2008-006 . This would include travel for recalls due to a deficient lab, electrocardiogram (EKG), and x-ray in relation to a Compensation and Pension (C&P) examination (convenience of the Government). Mileage reimbursement claims for travel prior to 1 FEB 08, may still be submitted. Such claims will be processed using the previous rates and deductibles.

Title 38 U.S.C. § 111(c)(5) requires VA to adjust proportionately the beneficiary travel mileage reimbursement rate deductibles for travel in relation to examination, treatment or care (currently $3 one way; $6 round trip; with a maximum of $18 per calendar month) effective on he date of a beneficiary travel mileage reimbursement rate change. Therefore, based on the increase of the beneficiary travel mileage reimbursement rate, the deductible is adjusted proportionately to $7.77 per one way trip; $15.54 for a round trip; with a maximum deductible of $46.62 per calendar month. These deductibles may be waived in accordance with Title 38 Code of Federal Regulations (CFR) §17.144(b) when their imposition would cause severe financial hardship. Mileage reimbursement claims for travel prior to February 1, 2008, may still be received. Such claims will be processed using the previous rates and deductibles. [Source: TREA Washington Update 25 JAN 08 ++]

VET BENEFIT EXPIRATION DATES: Many of your benefits have an expiration date. Below are a few important ones to remember so you don't lose out.

• Montgomery GI Bill for Active-Duty (MGIB): 10 years from date of last discharge or release from active duty.
• Veterans Education Assistance Program (VEAP): 10 years from date of last discharge or release from active duty.
• Montgomery GI Bill for Selected Reserve (MGIB-SR): 14 years from the date of eligibility for the program, or until released from the Selected Reserve or National Guard. Some extensions available if activated.
• Vocational Rehabilitation and Employment (VocRehab): Generally, 12 years of separation from service or within 12 years of being awarded service-connected VA disability compensation.
• Servicemembers' Group Life Insurance (SGLI): Coverage ends 120 days after separation or can be extended up to 1 year for totally disabled veterans.
[Source: Military.com http://www.military.com/benefits/veteran-benefits/veterans-benefit-expiration-dates 28 Jan 08 ++]

SBP LAWSUIT: On 30 JAN 08 a group of military widows will get their day in federal court,
pressing their case that a DEC 04 law change should have awarded them full payment of military SBP annuities in addition to the Dependency and Indemnity Compensation (DIC) they receive from the VA because military service caused their husbands' deaths. At the time, the House Veterans Affairs Committee believed its language would not only restore DIC benefits to previously eligible survivors who remarried after age 57, but would also end the deduction of DIC from SBP annuities. Subsequent government legal review indicated the 2004 law didn't, in fact, make the latter change, but the difference of opinion hasn't entirely gone away. And now three widows are taking the government to court. When the case was filed in SEP 07, the Department of Defense responded with a motion to dismiss the case. The widows' lawyers filed a rebuttal, and now there will be a hearing before the US Court of Federal Claims, 717 Madison Street, NW in Washington, DC so the judge can make a decision on the DoD motion to dismiss. The oral arguments in the case will be open to the public at 9:30am. A specific court room won't be assigned until the morning of the 30th. Past efforts to sue the government in this way have rarely been fruitful, but one never knows how the courts might rule when legislative language is murky. [Source: MOAA Leg UP 25 Jan 08 ++]

VA VOLUNTARY SERVICE (VAVS): VAVS was founded in 1946 to provide for our nation's veterans while they are cared for by VA health care facilities. It is a volunteer organization run by the VA which helps veterans in VA facilities throughout the country. Volunteers assist in routine administrative functions to help free VA employees to concentrate more on health care. There are also several VA cemeteries that have VAVS volunteers assisting in maintenance chores. It is one of the largest centralized volunteer programs in the Federal government. Over 350 organizations support it and volunteers have provided over 676 million hours of service since its conception. As a community service volunteers assist veteran patients by augmenting staff with end of life care programs, foster care, community-based volunteer programs, hospital wards, nursing homes, and veteran outreach centers. The program receives annual contributions of over $50 million in gifts and donations. There are two convenient ways to sign up to be a VAVS volunteer:

1) Contact the Department of Veterans Affairs facility nearest you, ask for Voluntary Service, and tell their staff of your interest in becoming a VAVS Volunteer. The staff will take care of everything else including your interview, orientation, and assignment! To locate the VA facility is
nearest you refer to http://www1.va.gov/directory/guide/home.asp?isFlash=12) Volunteer now by filling out and submitting the form located at http://www1.va.gov/volunteer/volnowDB.cfm. Someone from your local VAVS office will contact you with additional information.
[Source: NAUS Weekly Update 25 JAN 08 ++]

NDAA 2009: The previous National Defense Authorization Acts (NDAA) of 2006, 2007, 2008, did not address or correct the following issues --
• 188,000 Chapter 61 medical disability retirees with less than 20 years denied CRDP.
• 375,000 military retirees with less than 50% disability denied CRDP (Concurrent Retirement Disability Pay, 10 US Code 1414)
• 327,000 military retirees age 70 and 30 have paid up to an excess of 6 years' premiums for the Survivor's Benefits Program (SBP).
• 61,000 widows denied full relief from SBP/DIC

The 2008 NDAA did extend CRSC (Combat Related Special Compensation) to a yet to be determined number of Chapter 61 retirees (possibly as many as 40,000) with less than 20 years of service. It also did authorize $50/month "special allowance" to be incremented $10/year for 5 years. This is not much help to restore an offset that approximates $900-$1000/month. Further, it is a shallow gesture as it is valid from 1 OCT 08, and expires 1 MAR 16.

HR 333 would extend the benefits of CRDP to some 375,000 retired career veterans who are
rated less than 50% disabled by the VA and repeal the 10 year phase in of CRDP for those 180,000 retired career veterans who are rated 50 to 90% disabled. While other relevant bills in the Senate and House would correct either deficiency, none of those bills would correct both deficiencies.
Veterans who would like to see this bill enacted and correct the above inequities are urged to contact their legislators to request cosponsorship and inclusion of relevant portions of HR 333 in the 2009 National Defense Authorization Act. USDR has provided sample messages at
http://capwiz.com/usdr/issues/alert/?alertid=10871981&queueid=[capwiz:queue_id] and
http://capwiz.com/usdr/issues/alert/?alertid=10869241&queueid=[capwiz:queue_id] for your use to facilitate doing this. [Source: USDR Action Alert 27 Jan 08 ++]

VETERAN GRAVE VANDALS: A Texas lawmaker has introduced a bill that would make vandalizing the grave of a service member or veteran a federal crime, even if the grave is on private property. The bill sponsored by Rep. Ted Poe R-TX) comes after the grave of a Marine killed in Iraq was vandalized just two days after his burial in Liberty, Texas. “The person responsible has since been arrested and charged with a state felony, but no federal provision exists,” Poe said. Federal laws making it a crime to damage or destroy a memorial, headstone or gravesite apply only to public land, not to gravesites in private cemeteries. This is not the first time the federal government has had to stand by when a veterans’ grave was damaged. Last year, American flags were replaced with Nazi flags on Memorial Day weekend at the gravesites of veterans in Orcas Island WA, but the federal government could do nothing because the graves were in a private cemetery. Poe’s bill, HR 4973, was referred to the House Judiciary Committee for consideration. If enacted into law, it would apply the same penalty for the destruction of graves on public lands — a fine of up to $10,000 and up to 10 years imprisonment — to graves on private property. [Source: MarineTimes Rick Maze article 25
Jan 08 ++]

MOBILIZED RESERVE 30 JAN 08: .The Army, Air Force and Marine Corps announced the current number of reservists on active duty as of 2 JAN 08 in support of the partial mobilization. The net collective result is 1808 more reservists mobilized than last reported in the Bulletin for 9 JAN 08. At any given time, services may mobilize some units and individuals while demobilizing others, making it possible for these figures to either increase or decrease. The total number currently on active duty in support of the partial mobilization of the Army National Guard and Army Reserve is 73,197; Navy Reserve, 5,024; Air National Guard and Air Force Reserve, 7,231; Marine Corps Reserve, 8,695; and the Coast Guard Reserve, 334. This brings the total National Guard and Reserve personnel who have been mobilized to 94,481, including both units and individual augmentees. A cumulative roster of all National Guard and Reserve personnel, who are currently mobilized, can be found at http://www.defenselink.mil/news/Jan2008/d20080130ngr.pdf. [Source: DoD News Release 30 Jan 08 ++]

TEXAS VETERAN TUITION: Tuition waivers are available to Veterans honorably discharged who served at least 180 days of active duty military service, were Bonafide Texas resident at time of entry into service, and who have exhausted all Federal educational benefits. Veterans will receive exemption for payment of tuition and some fees at public colleges and universities. Exemptions from charges for continuing education courses are optional on the part of the institution. Application should be made to the financial aid officer of the state-supported institution of choice. The Texas State Attorney General has ruled that Texas veterans who are legal residents but not U.S. citizens are entitled to free college tuition at Texas public colleges. This ruling reverses an earlier policy that had prompted a federal lawsuit. The Mexican American Legal Defense and Educational Fund sued the State of Texas in 2007 on behalf of six Hispanic veterans who were legal permanent residents when they entered the military. They had applied for benefits under the Hazlewood Act, which waives tuition at Texas public colleges for honorably discharged veterans who served on active-duty. Texas also offers the following education benefits to:

• Dependent children of MIA / POWs: Dependent children of Texas military personnel, MIA, or POW. Exemption for payment of tuition and some fees at public colleges and universities. Exemptions from charges for continuing education courses are optional on the part of the institution. Application should be made to the financial aid officer of the state-supported institution of choice.
• Children of Deceased Veterans: Children of veterans killed or died as a result of service in WWI, WWII, and Korea or since 2/1/55. Exemption for payment of tuition and some fees at public colleges and universities. Exemptions from charges for continuing education courses are optional on the part of the institution. Application should be made to the High school guidance counselor, or financial aid officer of the state-supported institution of choice.
• Orphans of National Guard and Texas Air National Guard: Exemption of certain orphans of National Guard and Texas Air National Guard. Exemption for payment of tuition and some fees at public colleges and universities. Exemptions from charges for continuing education courses are optional on the part of the institution. Application should be made to the financial aid officer of the state-supported institution of choice
[Source: Military.com Benefits 28 Jan 08 ++]

MTU TUITION BREAK: Starting with the first summer term of 2008, Michigan Technological
University will offer in-state tuition to out-of-state students who are the offspring or spouse of a person on active U.S. military duty. Students will be eligible for a Military Family Education Award if a parent or spouse is on active military duty or has been on full-time duty with the National Guard for more than a year. If a parent or spouse goes on active-duty after a student is admitted, the student will be eligible for a Military Service Award at the beginning of the next semester. Once a student receives the award, he or she will continue to receive it until graduation. To learn more call the MTU Admissions office at 888-688-1888. [Source: Military.com 28 Jan 08 ++]

DIABETES UPDATE 04: A new study gives the strongest evidence yet that obesity surgery can cure diabetes. Patients who had surgery to reduce the size of their stomachs were five times more likely to see their diabetes disappear over the next two years than were patients who had standard diabetes care, according to Australian researchers. Most of the surgery patients were able to stop taking diabetes drugs and achieve normal blood tests. The patients had stomach band surgery, a procedure more common in Australia than in the United States, where gastric bypass surgery, or stomach stapling, predominates.Gastric bypass is even more effective against diabetes, achieving remission in a matter of days or a month, said Dr. David Cummings, who wrote an accompanying editorial in the journal but was not involved in the study. "We have traditionally considered diabetes to be a chronic, progressive disease," said Cummings of the University of Washington in Seattle. "But these operations really do
represent a realistic hope for curing most patients."

Diabetes experts who read the study said surgery should be considered for some obese
patients, but more research is needed to see how long results last and which patients benefit most. Surgery risks should be weighed against diabetes drug side effects and the long-term risks of diabetes itself, they said. Experts generally agree that weight-loss surgery would never be appropriate for diabetics who are not obese, and current federal guidelines restrict the surgery to obese people. The diabetes benefits of weight-loss surgery were known, but the Australian study in the JAN Journal of the American Medical Association is the first of its kind to compare diabetes in patients randomly assigned to surgery or standard care. Scientists consider randomized studies to yield the highest-quality evidence. The study involved 55 patients, so experts will be looking for results of larger experiments under way. "Few studies really qualify as being a landmark study. This one is," said Dr. Philip Schauer, who was not involved in the Australian research but leads a Cleveland Clinic study that is recruiting 150 obese people with diabetes to compare two types of surgery and standard medical care. "This opens an entirely new way of thinking about diabetes."

Obesity is a major risk factor for diabetes, and researchers are furiously pursuing reasons
for the link as rates for both climb. What's known is that excess fat can cause the body's normal response to insulin to go haywire. Researchers are investigating insulin-regulating hormones released by fat and the role of fatty acids in the blood. In the Australian study, all the patients were obese and had been diagnosed with type 2 diabetes during the past two years. Their average age was 47. Half the patients underwent a type of surgery called laparoscopic gastric banding, where an adjustable silicone cuff is installed around the upper stomach, limiting how much a person can eat. Both groups lost weight over two years; the surgery patients lost 46 pounds on average, while the standard-care patients lost an average of 3 pounds. Blood tests showed diabetes remission in 22 of the 29 surgery patients after two years. In the standard-care group, only four of the 26 patients achieved that goal. The patients who lost the most weight were the most likely to eliminate their diabetes.

The death rate for stomach band surgery, which can cost $17,000 to $20,000, is about 1 in
1,000. There were only minor complications in the study. Stomach stapling has a 2% death rate and costs $20,000 to $30,000. In the United States, surgeons perform more than 100,000 obesity surgeries each year. The American Diabetes Association is interested in the findings. The group revises its recommendations each fall, taking new research into account. Sixty million Americans are unaware they have diabetes or are at risk for developing type 2 diabetes. Your risk for type 2 diabetes increases as your get older, gain too much weight, or if you do not stay active. Diabetes is more common in African Americans, Latinos, Native Americans, Asian Americans and Pacific Islanders. Risk factors for type 2 diabetes include:
- Having high blood pressure (at or above 130/80)
- Having a family history of diabetes.
- Having diabetes during pregnancy or having a baby weighing more than nine pounds at birth. [Source: Associated Press Carla K. Johnson article 23 Jan 08 ++]

VA ESTATE DEBT COLLECTION: A bill that would block the Department of Veterans Affairs from trying to collect money from the estates of service members who die in combat was introduced Tuesday by Sen. Kay Bailey Hutchison (R-TX). Her bill, S 2536, applies only to debts to the VA, and not to money owed to private-sector creditors or other federal agencies, such as the Internal Revenue Service. Hutchison is asking Senate leaders for quick passage of the bill, hoping to bypass the normal process in which new bills are sent to committee for consideration. She could get high-level support. VA Secretary Dr. James Peake is expected to write a letter to the Senate endorsing her call for expedited passage of the bill, according to Senate sources. VA officials said they supported the bill but did not confirm that Peake would write a letter. Waiving normal procedures would require the Senate Veterans’ Affairs Committee, on which Hutchison serves, to allow the bill to proceed without its involvement. Sen. Daniel Akaka (D-HI) the veterans’ affairs committee chairman, would have to approve the move. Akaka aides said the committee staff would study the measure first.
Few people die owing VA money, but Hutchison aides found that VA has collected more than
$56,000 from the families of 22 deceased soldiers, mostly National Guard and reserve members called to active duty who received overpayments of GI Bill education benefits. Her bill would be retroactive to Sept. 11, 2001, allowing families or estates that paid a debt to VA to receive a refund of any payment made since that date. Hutchison spokesman Matt Mackowiak said few people may be affected, but Hutchison considers it improper for any family of a service member who dies in combat to be contacted with a demand for money. Current law requires contacting a family or estate if there is any outstanding debt to VA at the time of death. A family has 180 days to file a grievance, with the VA secretary permitted to waive the debts. Three of the 22 cases involved constituents of Hutchinson in Texas. One was an Army soldier killed by a sniper while on his third tour to Iraq whose family repaid the government for a $389 overpayment of GI Bill benefits. The family of another Army soldier was billed for $2,282 in outstanding loans after the sergeant, who was married with four children, was killed in an explosion on his second tour in Iraq. Another case involved a Marine Reservist killed by an explosion in Iraq who owed VA $845. Hutchison aides said their review found similar cases in California, Colorado, Connecticut, Georgia, Kentucky, Illinois, Iowa, Michigan, Nebraska, New York, North Carolina, South Carolina, Washington and Wisconsin. [Source: NavyTimes
Rick Maze article 23 Jan 08 ++]

SHINGLES UPDATE 05: Some people are still having problems understanding Tricare overage for the shingles immunization. The problems are occurring primarily in the area of getting reimbursed for the expensive vaccine (Zostavax.). Basic rules published by Tricare for reimbursement eligibility are:

• Tricare cannot pay for any immunization received before it became a Tricare benefit on 19 OCT 07.
• The beneficiary must be at least 60 years old for Tricare to cover the immunization.
• The shot must be given in the provider’s office.
• The vaccine is not a Tricare Pharmacy Program benefit.

The beneficiary cannot buy the vaccine and be reimbursed by filing a pharmacy claim. The doctor should provide the shingles vaccine as he would any other. To be reimbursed by Tricare, he must include its price on the bill for the office visit. Tricare advises all beneficiaries who plan to get the shingles immunization to call their Tricare Service Center first so they can be fully
informed. Some beneficiaries and doctors have complained that claims processor Wisconsin Physician Service was unable to tell them how much it would allow for the vaccine. Tricare indicated on 28 DEC that this problem had been resolved. Beneficiaries and providers can call WPS to confirm the amount allowable for the vaccine.

According to the Tricare the Red Book (a national pharmacy price guide), the average
wholesale price for Zostavax is $196. WPS will allow 95%of that amount, or $186.20. You or the provider should file a claim for the shingles vaccination exactly as you would any other Tricare claim (or Medicare claim, for Tricare for Life beneficiaries). The provider should bill for an office visit, but he must include the price of the vaccine as an item on the bill. The vaccine will be reimbursed as a medical supply item on the provider’s bill. It cannot be covered as a prescription drug through the Tricare Pharmacy Program. That’s the standard operating procedure for vaccines. Providers should know all this. Most who balked did so because they were unable to figure out how much Tricare would allow for the cost of the vaccine. Now they can get that information, officially, by calling WPS. If the above rules are followed, Tricare claims for the shingles shot will be processed and paid in the usual way for beneficiaries who don’t have Tricare for Life.

There is some not-so-good news for Tricare for Life members since federal law requires Medicare and Tricare to process their claims separately. When your original Medicare provider files a claim for the office visit, which includes the price for Zostavax, Medicare will pay its share for the visit only. Medicare will deny payment for the vaccine because, by federal law, it is not a
covered service under Medicare. As usual for TFL beneficiaries, Medicare will pay the provider its share for a covered office visit and automatically forward the claim to Tricare. As usual, Tricare Standard will pay the balance on the Medicare claim for the office visit. You should have no out-of-pocket expense for the visit but there’s still the cost of the Zostavax. Because Medicare paid nothing for the vaccine, Tricare is your only insurance for that part of the claim. All Tricare claims processing rules will apply to that part of the claim. You would file a Tricare claim, which would be subject to a deductible and cost share for which you would have to pay out-of-pocket. Tricare will allow $186.20 for the vaccine. Thus, after your $150 deductible and 25% cost share, Tricare will pay the provider only $27.15. So out-of-pocket costs for the shingles immunization for Tricare for Life members are likely to be $159.05. Questions about any of this should be directed to your Tricare Service Center. (Note: If you are enrolled in a Medicare Advantage Plan or a Medicare Part D Pharmacy Plan, the aforementioned may apply differently or not at all to you. Call your plan’s carrier for more details). [Source: NavyTimes James E. Hamby article 21 Jan 08 ++]

CYBERSPACE COMMAND: Keesler Air Force Base is one of 16 finalists to become the nation's headquarters in the fight against cyberterrorism. The first national command to fight in cyberspace, its location there would be a major coup for Biloxi and Mississippi - "as big as any Nissan plant, Toyota plant, or large casino project”, said Ret. Air Force Lt. Gen. Clark Griffith. He presented the proposal to the Biloxi City Council on 22 JAN and said the Cyberspace Command Headquarters would bring up to 10,000 jobs to the city. That includes several generals, about 500 high-salary, high-ranking Air Force personnel and thousands of civilian employees. The average command comprises about 12,000 people, Griffith said, and contractors, industry and possibly a Mississippi State University engineering-technology center would follow the Cyberspace Command to the Coast. Every 18 seconds the nation's computers, cell phones, radios and other electronics are being hacked. And increasingly, the attacks are coming from China and Islamic extremists, said Griffith. These cyberterrorists have forced shutdowns of computers at the CIA, FBI and other top federal agencies and they have
stolen classified information. The command would protect military cyberspace and homeland
security. The field of candidates narrowed from 56 to 16 and Griffith considers Keesler among the top five contenders.

Biloxi's chief competition is Langley Air Force Base in Virginia; Offutt in Nebraska; Colorado Springs, Col.; and Barksdale in Shreveport, La. All the others except the Shreveport base already have major commands. “Keesler is already the electronics-training headquarters for the Air Force and the home to the second-largest medical facility in the Air Force," said Mayor A.J. Holloway, who is working with Griffith to bring the command to Biloxi. If Biloxi is chosen as the site of the Cyberspace Command, "this will solidify Keesler plus Keesler Medical Center as a major base forever because the Air Force has never closed a major command headquarters.", he said. A meeting should take place at the Pentagon or Sen. Thad Cochran's office in Washington on 13 or 14 FEB. The decision on where to locate the Cyberspace Command is expected by early March; by fall, work should begin to establish the headquarters. Wherever the new Cyberspace Headquarters is located, Keesler will get a piece of the pie. Air Force personnel who staff the center will be trained at Keesler.
[Source: SunHerald Mary Perez article 23 Jan 08 ++]

MEDICARE NEWS:
1. Emergency Room Waiting Times: The average wait time for heart attack patients at American emergency rooms rose 150%, from 8 to 20 minutes, between 1997 and 2004, according to a recent study published in Health Affairs. Researchers attributed the increase to an overall rise in emergency room visits, emergency room closures and barriers to routine or outpatient care.

2. Complaints: New York state residents with Medicare filed only 343 complaints with the state’s Medicare Quality Improvement Organization between 2005 and 2007, a statewide response rate of .01% for the state’s three million people with Medicare, according to a 18 DEC report by IPRO, which contracts with the Centers for Medicare & Medicaid Services (CMS) to resolve quality-of-care complaints. While the .01% complaint rate is the second highest in the nation, the response rate is viewed as inadequate by state officials. By comparison, the New York State Department of Health had received 4,856 general complaints about hospitals and 21,481 about nursing homes during the same period. The IPRO complaint process differs from that of the Department of Health. Although people with Medicare can use either organization to report substandard care, complaints to IPRO must be submitted in writing and do not result in financial penalties. Instead, if IPRO determines a provider or institution provided a substandard quality of care, it will develop and monitor a quality improvement plan.

3. Health Insurance Impact on Deaths: Recent studies by a government advisory group underestimated the number of Americans who die because they lack health insurance, according to a recent report by the Urban Institute. According to their recently released study, Uninsured and Dying Because of It, estimates by the Institute of Medicine that 18,000 Americans died in 2001 due to a lack of health care coverage may be off by as much as 20%. The Urban Institute instead estimates that 21,000 people died in 2001 because they lacked health insurance, amounting to one death every 24 minutes. Between 2000 and 2006, the Urban Institute believes that 165,000 people died because they were uninsured. Researchers at both the Institute of Medicine and the Urban Institute say Americans face an average 25% increase in the likelihood of death when uninsured. Uninsured Americans are at greater risk of death because they do not receive diagnoses, chronic disease checkups or essential medications as quickly or as often as those with coverage, according to the Urban Institute. With life-threatening diagnoses like cancer, stroke or hypertension, the lack of frequent or timely
treatment can lead to premature death. The Institute came up with higher mortality rates because it estimated that older Americans without insurance face higher mortality rates than their younger counterparts.

4. Physician Access: New research suggests the percentage of doctors accepting new Medicare patients has remained stable since 2004. Researchers for Congress’ Medicare Payment Advisory Commission recently presented data showing that 80%of office-based doctors surveyed accepted new Medicare patients in 2006. Data for 2006 also shows that 93% of doctors who depend on Medicare for 10% or more of their revenue accepted new Medicare patients, a figure that has remained unchanged since 2004. Patient surveys yielded similar findings. A survey of 2,036 people with Medicare and 2,025 commercially insured Americans between 50 and 64 found that people with Medicare often have an easier time finding providers for specialty care. Eighty-five percent of respondents with Medicare reported no trouble locating a specialist in 2007, compared to 79% of privately insured Americans. Data on the search for a primary care provider was less encouraging, but has remained relatively constant since 2005. Seventy percent of Medicare patients surveyed had no problem finding a new primary care physician, a drop from 75% in 2005. In contrast, 82% of privately insured patients had no problem finding a new primary care physician, an increase of 7% since 2005. In addition to locating providers, survey data shows stable rates in accessing and receiving care. Three-fourths of respondents with Medicare who have a primary or routine care provider had never experienced care delays. In contrast, only 67 percent of privately insured Americans gave a similar response. [Source: Medicare Watch www.medicarerights. org 22 Jan 08 ++]

ARIZONA TAXES: Arizonans interested in providing financial help to military families now can reap a state tax break in the process. Starting JAN 08, donations made to a new fund that assists the families of Arizonans injured or killed in the line of duty can qualify for a state tax credit worth up to $200 for singles and $400 for married couples filing joint income-tax returns. Credits are dollar-for-dollar reductions in a person's tax bill and thus are more valuable than deductions, which reduce taxable income. The new state tax break, which is applicable for the 2008 through 2012 tax years, is designed to encourage donations to the Military Family Relief Fund. Gov. Janet Napolitano signed the legislation in December. The fund has started to receive donations and will begin to provide assistance in coming months. The fund will help meet costs incurred by relatives in the event of the death or injury of a member of the armed forces. Arizonans who give more than the $200/$400 credit limits can receive federal and state deductions for excess amounts, as would normally apply on itemized charity donations. However, taxpayers won't have to itemize to receive the credit on their state tax forms. As it stands now, credits for the program will be capped at $1 million, raising the possibility that the tax break might not last the full five years if a lot of people take advantage of it. The Arizona Department of Revenue doesn't yet have forms for the new credit and won't have them until it prepares 2008 tax-filing documents later this year, said Dan Zemke, an agency spokesman. The credits won't be refundable, he added, meaning they can be used only to whittle down a person's tax liability to the state. Robert Hockensmith, a Phoenix certified public accountant, certified financial planner and colonel in the Arizona National Guard, called the credit an "amazing" benefit that complements other efforts by the state to ease the tax burden on military families. Specifically, he referred to a new Arizona policy under which the state no longer taxes military pay received by Arizonans, including members of the National Guard and reservists. That began in 2007 and builds on a tax-free military-pay rule that has applied for active-duty personnel since 2006. [Source: The Arizona Republic Russ Wilues article 20 Jan 08 ++]

VET CEMETERY VIRGINIA: A University of Virginia study says a new veterans cemetery in Nelson County may be needed to serve the tens of thousands of veterans living in the area. The study, commissioned by the state Department of Veterans Services, said the cemetery would serve the area including Lynchburg, Buena Vista, Lexington, Waynesboro and Charlottesville. "The most important finding is the location and need of another cemetery," said Terance Rephann, an economist with University of Virginia’s Weldon Cooper Center for Public Service, who conducted the study. The study also found that veterans cemeteries should have a 50-mile service-area boundary to properly serve the veteran population, though the current service area is 75 miles. "Veterans have a strong preference for the burial site to be close to their family," Rephann said. The Nelson cemetery would be mandatory if the state adopts a 50-mile service area as the study recommends, especially if the veterans cemetery in Culpeper Virginia closes as expected in about 15 years. There are three national cemeteries in Arlington County, Quantico and Culpeper County, and two state veterans’ cemeteries in Amelia County and Suffolk. An additional state veteran’s cemetery will be built in Dublin in Pulaski County within a few years. The study also found that many veterans are not aware of their cemetery veteran benefits and recommended that the department improve its outreach. [Source: AP article 19 Jan 08 ++]

TAX AUDITS: The Internal Revenue Service is increasing its audit presence. A new Act has been passed that penalizes preparers who take unacceptable positions on tax returns. IRS is turning its attention to auditing Form 2555 - Foreign Earned Income Exclusion - and Form 1116 - Foreign Tax Credit. And the national debt, funded by income taxes, has exceeded $9 trillion. So with the taxman increasing his presence in the lives of American taxpayers, both at home and abroad, tax compliance this year will have to be more carefully orchestrated to avoid problems with the IRS. Approximately 6.6 million Americans live outside the United States excluding military. Beginning in 2008, the Internal Revenue Service in its Form 1040 National Research Program will increase audits of American expatriate tax returns claiming the Foreign Earned Income Exclusion and the Foreign Tax Credit. The Service will also be improving its use of Forms 1042-S information documents as well as information provided by US treaty partners via the Exchange of Information provisions. Audits will be conducted for the purpose of assessing penalties for understated tax liabilities, particularly where the Foreign Tax Credit applies when the taxpayer's tax rate is below 30%. [Source: Tax Barron Report Jan 08 ++]

TAX FILING OBLIGATIONS OVERSEAS: Residents of foreign countries generally have to report and pay taxes on their world-wide income to the tax authority of the country wherein they reside. But US citizens or deemed US residents are also obliged to report world-wide income to the Internal Revenue Service (IRS). And without due diligence in how to go about reporting that income, they could in certain circumstances end up paying taxes stateside in spite of double taxation treaties. Understanding whether there is a filing requirement is therefore essential - since anyone receiving earnings below a threshold is not obliged to file. This threshold is merely the combination of two categories: exemption(s) and standard deduction (or itemized deductions). Anyone receiving income below the following combined category amounts need not file:

- Single: $8,750 / Over 65 $10,050
- Head of Household: 11,250 / Over 65 12,550
- Qualifying widow(er): 14,100 / Over 65 15,150
- Married filing jointly: 17,500 / 1 spouse over 65 18,550 / both spouses over 65 19,600
- Married filing separately: 3,400

So any taxpayer whose earnings exceed an applicable threshold amount must file a tax return. Foreign earned income (wages, salaries, self- employment) must also be included in the calculation of total income even if excluded by the foreign earned income exclusion (FEIE). To reduce the chances of double taxation, IRS allows that FEIE be applied against foreign earnings; $87,500 in 2007. Foreign earnings above this $87,500 excludable amount are taxable stateside, but the US tax may be offset by a foreign tax credit (FTC) applied against taxes paid to the foreign country of residence. In fact, the FTC is available on any income taxes paid abroad. A problem is that the FTC does not always fully offset US taxes.

Certain penalties apply for failing to comply with US tax laws. IRS assesses penalties at 5% a month against any unpaid taxes up to 25%. In cases where fraud is deemed to have been committed - for instance, in failing to report foreign earned income - IRS can assess 75% while denying the taxpayer the foreign earned income exclusion. It may also seek criminal penalties for not reporting foreign earnings, in which case the taxpayer could face jail time. Americans are also obliged to file information returns on investments in foreign corporations, foreign partnerships and foreign accounts, or risk very severe penalties. The due date for filing tax and certain information returns is 16 JUN 08 (15 OCT by filing Form 4868). However any taxes due for 2007 must be paid by 15 APR along with first quarter 2008 estimated taxes. Any US citizen or deemed resident living abroad who has not filed a tax return for some years should promptly do so as an offensive position is always better than a defensive one. IRS is actively increasing its powers of audit in order to catch non-compliers. Generally the revenue service will only require the last three years tax returns be filed. [Source: Tax Barron Report www.taxbarron.com Jan 08 ++]

TAX CHANGES 2007: The following changes are applicable to your 2007 Federal tax:

• Standard Deduction: MFJ $10,700
• Head of Household: $7,850 / Single $5,350 / MFS $5,350. The additional deduction for the aged is $1,050 if married or $1,300 if Single or Head of Household.
• Tax Rates Single: $0 - $7,825, 10%; $7,826 - $31,850, 15%; $31,851 - $77,100, 25%; $77,101 - $160,850, 28%; $160,851 - $349,700, 33%; $349,700, 35%.
• Tax Rates MFJ: $0 - $15,650, 10%; $15,651 - $63,700, 15%; $63,701 - $128,500, 25%; $128,501 - $195,850, 28%; $195,851 - $349,700, 33%; $349,700, 35%.
• Tax Rates MFS: $0 - $7,825, 10%; $7,826 - $31,850, 15%; $31,851 - $64,250, 25%; $64,251 - $97,925, 28%; $97,926 - $174,850, 33%; $174,850, 35%.
• HH: $0 - $11,200, 10%; $11,201 - $42,650, 15%; $42,651 - $110,100, 25%; $110,101 - $178,350, 28%; $178,351 - $349,700, 33%; $349,700, 35%.
• The Capital Gains Tax Rates are 5% for taxpayers in the 10% and 15% tax brackets and 15% if they are in the upper 25% - 35% brackets.

On 17 DEC 07 Representative Gregory Meeks introduced the Working American Competitiveness Act. The proposed legislation stipulates: At the election of a qualified individual, there shall be excluded from the gross income of such individual, and exempt from taxation under this subtitle, for any taxable year, the foreign earned income of such individual. The bill has been referred to the House Ways and Means Committee. If this legislation passes both houses of Congress, the foreign earned income exclusion will be unlimited. [Source: Tax Barron Report Jan 08 ++]

FLUORIDATION: California’s largest water agency, the Metropolitan Water District (MWD) of Southern California, has completed its efforts to fluoridate the water that reaches some 18 million residents in Southern California. The MWD serves 26 cities and water systems in Los Angeles, Orange, Riverside, San Diego, and Ventura counties. The California Dental Association Foundation subsidized the effort with $5.5 million to design and construct fluoridation facilities at MWD’s five treatment facilities. Since 1995, California state law has required fluoridation of any public water supply with at least 10,000 customers, provided funding is available. Los Angeles and Santa Monica proceeded without outside funding. Long Beach, Beverly Hills, Fountain Valley, Huntington Beach had fluoridated water prior to passage of the law. The U.S. Centers for Disease Control and Prevention (CDC) estimates that approximately 67% of Americans who receive water from a public water supply now drink water with optimal fluoride levels for preventing decay. [Source: Consumer Health Digest 15 Jan 08 ++]

VETERAN EMPLOYMENT UPDATE 02: This New Year brings new job opportunities for transitioning servicemembers and veterans interested in careers in health care, technology and consulting. The Bureau of Labor Statistics (BLS) predicts that these industries will have the largest employment, salary and wage growth into 2016. If clicking on the below items does not open a website for further details refer to http://www.military.com/NL_MR/1,14852,5391,00.html. Here are the top jobs for 2008:

1) Network systems and data communications analyst
2) Personal and home care aides
3) Home health aides
4) Computer software engineers, applications
5) Veterinary technologists and technicians
6) Personal financial advisors
7) Medical assistants
8) Veterinarians
9) Substance abuse and behavioral disorder counselors
10) Financial analysts
11) Social and human service assistants
12) Gaming surveillance officers and gaming investigators
13) Physical therapist assistants
14) Forensic science technicians
15) Dental hygienists
16) Mental health counselors
17) Mental health and substance abuse social workers
18) Dental assistants
19) Computer systems analysts
20) Database administrators
21) Computer software engineers, systems software
22) Gaming and Sports book writers and runners
23)- Environmental science and protection technicians, including health
24) Physical therapists
25) Physician assistants
[Source: Military.com article 14 Jan 08 ++

VA BURIAL PROGRAM SURVEY: The VA is conducting a program evaluation of the Burial Benefits program. VA will use information gathered from the evaluation to ascertain how well it has reached its goals and the impact of its burial program on the lives of veterans and their families. This information will enable VA to evaluate current and potential burial benefits, consider new policies and set priorities for the future. As part of the evaluation, a national survey on burial preferences will be conducted with veterans. Focus groups with veteran next of kin and funeral directors will also be conducted. Data collection from the survey and focus groups will take place from 3 JAN thru 28 FEB 08. Approximately 38,000 veterans and 1,000 next of kin and funeral directors have already been randomly selected from VA administrative databases to participate in the evaluation. A notification letter was mailed to these participants on 3 JAN, informing them of their selection to participate in either the survey or a focus group. Sites selected for focus groups include Springfield VA; Tampa FL; Minneapolis MN; Denver CO; and Los Angeles CA. Participation of veterans, veteran next of kin, and funeral directors in this evaluation is voluntary. Respondents will be assured that their answers will be kept confidential under the Privacy Act, will be used for research purposes only, and will be reported at the group-level only. If you have questions about the survey or focus groups, call an ICF International Caliber representative at 1(888) 556-6355 09-1700 EST. [Source: NAUS Weekly update 18 Jan 08 ++]

GI BILL UPDATE 17: At a hearing before the House Veterans Affairs Economic Opportunity Subcommittee on 17 JAN the MOAA and others presented their recommendations for upgrading the Montgomery GI Bill (MGIB). Vic Snyder (D-AR), a member of the Subcommittee and former Chairman of the Armed Services Military Personnel Subcommittee, was thanked by the Military Officers Association of America (MOAA) representative COL Bob Norton, USA (Ret) for his pivotal role in winning a 10-year post-service readjustment benefit for reservists who earn MGIB benefits for service on active duty. That change will take effect when the FY2008 National Defense Authorization Act is signed into law. MOAA endorsed the seven legislative proposals under consideration at the hearing, especially bills such as H.R. 2702 that would raise MGIB reimbursement rates. The bill also would allow 15 years (vice 10) of post-service use eligibility and extend eligibility to all entering recruits, without the current $1,200 fee. MOAA believes strongly that
• GI Bill benefits should be raised to cover the average cost of a four-year public college or university. They now cover about 75% of that amount.
• Reservists should be entitled to full active-duty MGIB benefits if they complete a cumulative 36 months on active duty. At present, that only earns them 80% of the full benefit.

Rep. John Hall (D-NY), whose district includes West Point, asked about educational incentives to retain military academy graduates. Norton noted that the Army already has lost more than half of the West Point class of 2002 and has growing shortages of mid-grade officers. He urged making service academy graduates and ROTC scholarship recipients (who are excluded on the rationale that the military funded their undergraduate degrees) eligible for the MGIB if they agree to extend their initial service commitment. [Source: MOAA Leg Up 18 Jan 08 ++]

VA BUDGET 2008 UPDATE 12: In a White House conference call on 17 JAN the President announced he had approved the $3.7 billion in emergency supplemental appropriations passed by Congress in the waning days of 2007. VA needs the additional $3.7 billion in emergency funding to help reduce the unacceptable claims backlog and hire PTSD counselors and claims adjudicators to work with returning OEF/OIF veterans. Under the strange rules of appropriations, Congress authorized the extra money, over and above the President's budget request. But because it exceeded the budget authority, Congress designated it as "emergency" supplemental spending. Under the budget rules, the President has the discretion to decide whether or not to spend that extra money. In this particular case, the extra $3.7 billion to meet VA health care and other needs would only be available if the President sent a special budget notice to Congress by 18 JAN. [Source: MOAA Leg Up 18 Jan 08 ++]

WEP/GPO: On 16 JAN the House Ways and Means Subcommittee on Social Security conducted a hearing on the impact of the Government Pension Offset (GPO) and the Windfall Elimination Provision (WEP), taking testimony from Social Security and Congressional Research Service officials as well as a diverse group of advocates for state government employees and teachers. Social Security covers approximately 96% of U.S. workers. But 25% of public sector employees (federal, state, and municipal) have unique retirement systems that aren't covered by Social Security. Federal civilian employees who were hired before 1984 also fall under an independent retirement system. In all, about 6.5 million federal, state and local workers aren’t covered by Social Security. If people in this category also held at least one job during their working lives that was covered by Social Security, they find in retirement that they suffer a statutory penalty called the Windfall Elimination Provision (WEP). This entails a complicated formula that reduces their Social Security benefit by up to $340 per month.

They may also suffer a penalty if they themselves held Social Security-exempt jobs that provide an independent retirement annuity, but are married to someone who spent a working career under Social Security. If the Social Security-covered spouse dies and the remaining spouse draws a Social Security benefit as a survivor, the spouse runs into a separate penalty called the Government Pension Offset (GPO). The GPO reduces the survivor's Social Security benefit by an amount equal to two-thirds of the survivor's federal civilian/state/teacher's retirement pension. According to the National Active and Retired Federal Employees Association (NARFE), the GPO affects 400,000 people, and causes the vast majority to lose their entire Social Security benefit. When WEP and GPO offsets were enacted decades ago, their intent was to mitigate the progressive nature of Social Security benefits, which were seen as providing disproportional rewards for people who spent a relatively small part of their careers paying into Social Security.

MOAA and NARFE believe the WEP and GPO impose disproportional penalties, and actively discourage public service just when there's a crying need for more teachers and experienced personnel in state and municipal governments. Also that GPO and WEP significantly undermine important programs like Troops to Teachers. But changing the law will be a major challenge, to say the least. Repeal would cost $80 billion over ten years, and more modest reforms would still carry daunting price tags for Congress at a time when long-term financing of Social Security is already a major national issue. Those who believe that something needs to be done to ease the current inequity can support this effort by asking your legislators to cosponsor H.R.82 and S.206. An easy way to accomplish this is to enter your ZIP code in the indicated box at http://capwiz.com/moaa/issues/bills/?bill=9286191 for H.R.82 &
http://capwiz.com/moaa/issues/bills/?bill=9287906 for S.206 to send them a MOAA-suggested message.
[Source: MOAA Leg Up 18 Jan 08 ++]

This data is too long for this software! The rest will be in a separate post.

� Secure this line!

---

I as wondering when they were getting around to imaging documents

by kat-missouri on February 1, 2008 12:06 PM

---

� Dismissed, Soldier!

NDAA 2008 UPDATE 13: Ending its sine die adjournment (sine die adjournment is an adjournment that terminates a session of Congress), the House convened on 3 JAN to begin the second session of the 110th Congress as prescribed by the Constitution of the United States . The House convened at 12 noon and pursuant to S. Con. Res. 61, 110th Congress, adjourned at 12:03 p.m. until noon on Tuesday, 15 JAN 08. Similarly, the Senate met on Jan. 3 to convene the 2nd session of Congress as prescribed by the Constitution. The Senate met for 46 seconds in a pro forma session from 12:04:26 and recessed at 12:05:12 noon. It is scheduled to meet again in pro forma session at 9 a.m., on Monday, Jan. 7, with formal session scheduled on Jan. 22 pursuant to S. Con. Res. 61,

As previously reported, President Bush used a pocket veto to reject H.R. 1585, the FY 2008 National Defense Authorization Act (NDAA), because a provision in the bill would render the new Iraqi government responsible for compensation claims against the Saddam Hussein led former government. The President’s pocket veto decision drew immediate criticism from several House and Senate leaders. At question is the constitutionality of President’s ability to use the pocket veto. Under Article 1 Section 7 of the Constitution, the President has 10 days to approve or disapprove legislation (excluding Sundays) after it is presented. If the President doesn’t approve the bill—that is that he wishes to veto it—his obligation is to return it with his objections to the House where it originated, unless the Congress by its adjournment prevents its return, in which case the bill “shall not be law” if unsigned after 10-days (the House adjourned sine die Dec. 19). Withholding signature in such a case is known as a “pocket veto,” and unlike a regular veto, it cannot be overridden by a two-thirds vote in Congress. It is absolute. Once a pocket veto occurs, the only way for Congress to enact the legislation would be to resubmit the measure in the form of a new bill once it returns from adjournment.

House leader Nancy Pelosi (D-CA), has said the House may still vote to override the veto. She has said that because the Senate has been in Pro Forma sessions, President Bush cannot pocket veto the bill. The White House argues the bill originated in the House and because the House is in recess, the bill has been pocket vetoed. A Constitutional battle could ensue before a new authorization bill is developed. There is much at stake in resolving this issue quickly. Passage of the NDAA authorizes a 3.5% military pay raise; reauthorizes enlistment, reenlistment, and specialty bonuses; expands Combat-Related Special Compensation to all combat-related disabled veterans; and provides full Concurrent Retirement and Disability Pay for disabled retirees rated as Individually Unemployable by the VA. The bill also lowers the minimum Guard and Reserve retirement age by 90 days for every 3 months served on active duty and establishes a Special Survivor Indemnity Allowance beginning 1 OCT 08. Each of these items remains on hold as we await the resolution of this matter. [Source: NAUS Weekly Update 4 Jan 07 ++]


TRICARE EOBS UPDATE 02: Tricare for Life (TFL) beneficiaries can soon print a copy of their Explanation of Benefits (EOB) from the convenience of their own homes. Starting in JAN 08, the only paper EOB’s that beneficiaries will receive are monthly summaries. The exception to this is if a claim includes services that are rejected, and those services have appeal rights; or if the EOB is mailed with a payment to the beneficiary. In February, beneficiaries will have the option to receive an electronic notification every time a claim processes. Beneficiaries can then log on to the secure web site at https://www.tricare4u.com/apps-portal/tricareapps-app/unauth/tricarehome.jsp, to view and print their EOB. The EOB will be available online and beneficiaries will have the ability to access EOB’s for any claim processed during the last 27 months. Once a beneficiary signs up for this option, they will not receive a monthly paper summary. TFL beneficiaries will receive letters notifying them of the changes, either with their current EOB’s or any other correspondence. If there are any questions about the registration process beneficiaries can call 1-866-773-0404. Those requiring a Telecommunications Device for the Deaf (TDD) can call 1-866-773-0405. [Source: TMA News Release 9 Jan 08 ++]


SS RETIREMENT AGE UPDATE 01: About half of the soon-to-be-62-year-olds are expected to do just what their parents generally did: file for Social Security benefits at the youngest possible age, in exchange for a smaller benefit than they'd get if they waited to retire at 66. Many are relying on conventional wisdom that suggests they're better off filing for Social Security as soon as possible. Yet if they follow that advice, millions of the oldest boomers may be about to make a colossal error — one that would be magnified by their record-setting longevity. Over time, taking benefits early could mean a smaller payout, hefty taxes on their retirement savings and a heightened risk of outliving their money. In fact, the roughly 50% of the oldest baby boomers who the Social Security Administration estimates will tap their benefits starting this year will absorb a permanent 25% cut in benefits. Up to three-quarters of them are expected to file for benefits before age 66, their full retirement age. How much their benefits will shrink depends on how close they are to full retirement age once they begin to take those benefits.

Those who wait till after age 66 will enjoy an 8% annual increase in benefits until age 70. (After that, there's no advantage to delaying benefits.) Yet on the most fateful financial decision most of them will make, only about 5% of retirees wait until after they've reached full retirement age to claim benefits. And it's a trend that's likely to persist, says Stephen Goss, chief actuary for the Social Security Administration.
Many retirees who plan to start taking their benefits early assume it won't make much difference over time. In reality, boomers who live the longest stand to lose the most by taking benefits early, according to an analysis by the American Academy of Actuaries. Retirees who file for Social Security at age 62 and live into their mid-90s could lose nearly $150,000 in benefits, says Ron Gebhardtsbauer, senior pension fellow with the academy. Factors that could hurt boomers who take early Social Security benefits at age 62:

1. Longevity
· There's a 41% chance that a 62-year-old woman today will live to 90; a 62-year-old man has a 29% chance. For a married couple, there's a 58% chance that one of them will live to 90 and a 29% chance that one will reach 95.
· The Social Security Administration projects that the average retiree's "break-even" age for Social Security benefits is 77. A retiree who dies before then would have fared better by taking benefits at 62. Those who live past 77 would earn more by delaying benefits.
· Retirees who take reduced benefits at 62 and live to 90 would lose $39,000 in benefits; those who live to 95 would give up $54,000, the SSA says.

Some financial analysts say your losses would be far greater tansy’s projections. If, for example, you include the annual cost-of-living increases that boost Social Security checks, Gebhardtsbauer's estimate of how much you'd lose by taking benefits early far exceeds the SSA's: $83,000 for those who take benefits at 62 and live to age 90 and nearly $149,000 for those who live to 95. Gebhardtsbauer sets the break-even age a bit higher than the SSA does. That's because he takes into account interest earned by those who take benefits starting at 62. Even so, by including the annual cost-of-living increases, he calculates even more value in delaying benefits. The reason: The cost-of-living adjustments will apply to a larger sum. Thanks to compounding, "those cost-of-living adjustments will be huge, especially if you live long in retirement," says James Mahaney, a retirement specialist at Prudential Financial. Even if you're convinced you won't live so long, taking your benefits early could hurt your spouse. When a married beneficiary dies, the survivor can continue receiving his or her own benefit or the deceased spouse's benefit, whichever is more. So spouses who take their benefits early don't just shrink their own payouts; they also reduce the amount the surviving spouse will be eligible for.

2. Taxes. Analysts generally urge retirees to delay withdrawing money from their 401(k), IRA and other retirement savings accounts as long as possible. That way, the thinking goes, the tax-deferred investments can grow and compound. But that advice, Mahaney says, ignores the punishing effect of taxes on Social Security benefits. If all your income comes from Social Security, your benefits usually aren't taxable. But retirees with other income, including withdrawals from most retirement plans, could owe taxes on a huge chunk — 50% to 85% — of their benefits. The tax was originally designed to target wealthy seniors. But because the income thresholds weren't indexed to inflation, the tax has spread to middle-income retirees.
Married couples with $32,000 in combined income face taxes on half their Social Security benefits.
Couples with a combined income of at least $44,000 could owe taxes on 85% of their benefits. (For the purposes of the tax, combined income includes half of a retiree's Social Security benefits, wages from a job, pensions and withdrawals from most retirement plans.) Retirees can avoid this by using their retirement savings to pay living costs in the early years of retirement, Mahaney says, and then taking their Social Security benefits later.

3. Risk of outliving your full benefit: Unless Congress acts, by 2017 Social Security will start paying out more in benefits than it receives in tax revenue. By 2027, it will have to tap its trust fund to pay benefits. And by 2041, Social Security will be able to pay only about 75% of promised benefits, according to the agency's report to Congress. But the 79 million people born from 1946 through 1964 represent an extraordinarily potent voting bloc. Reducing their benefits "would be a huge political burden," Prudential's Mahaney says. He thinks lawmakers are more likely to raise payroll taxes on workers than reduce benefits for retirees.
[Source: USA Today Sandra Block article 14 Jan 08 ++]


VA EYE CARE: Eye-care services are available at the VA Medical Center. The following veterans are eligible to receive eye care and eyeglasses from VA:
· Veterans rated 10% or more service-connected for any condition;
· veterans rated service-connected for an eye condition that requires corrective lenses;
· former prisoners of war;
· veterans enrolled in a VA-approved Vocational Rehabilitation Training Program; and
· veterans in receipt of increased VA nonservice-connected pension based on need of regular aid.
For more information on VA eye care, call your local VA Medical Center. [Source: Honolulu Star Bulletin Gregg K. Kakesako article 13 Jan 08 ++]


MEDICARE EYE CARE: Medicare covers most doctor services and routine medical care required to keep you healthy. However, there are some services, such as eye care, that Medicare will only cover in very limited circumstances. For instance, Medicare will only pay for routine eye care if`
· You have diabetes. Medicare will pay for an eye exam once every 12 months to check for vision loss due to the condition; or
· You are at high risk for glaucoma. Medicare will cover 80% of the cost of an eye exam by a state-authorized eye doctor once every 12 months, after you pay your Part B deductible. You are considered to be at high risk for glaucoma if you have diabetes; have a family history of glaucoma; are African American and age 50 or older; or are Hispanic and age 65 or older.

Glaucoma is a group of eye diseases in which damage to the nerve located in the back of the eye (the optic nerve) results in loss of eyesight. Over three million Americans, and nearly 70 million people worldwide, have glaucoma. Experts estimate that half of them don’t know they have it. Although the most common forms primarily affect the middle-aged and the elderly, glaucoma can affect people of all ages. If glaucoma is not treated, vision loss may continue, leading to total blindness. There’s no sure way to prevent glaucoma, but early treatment helps slow the disease and prevent blindness. Note: if you have Medicaid health coverage, then you are eligible for routine eye services through Medicaid. Medicare will also pay for certain nonroutine eye-care services if they are related to a chronic eye condition, such as cataracts or glaucoma. Medicare will cover
· Surgical procedures to help repair the function of your eyes due to these conditions. For example, Medicare will cover surgery to remove the cataract and replace your eye’s lens with a man-made intraocular lens.
· Eyeglasses or contacts only if you have had cataract surgery to replace your eye’s lens with a man-made lens (an “intraocular” lens). Medicare will cover the dark glasses that you must wear immediately after surgery to protect your eyes, as well as a standard pair of untinted prescription eyeglasses or contacts if you need them after surgery. If it is medically necessary, Medicare may pay for customized eyeglasses or contact lenses.
· An eye exam to diagnose potential vision problems. If you are having vision problems that may indicate a serious eye condition (for example, having constant double-vision, progressive blurring vision or the decrease of sight on the edges of your vision), Medicare will pay for an exam to see what is wrong, even if it turns out there is nothing wrong with your sight.
[Source: The Medicare Counselor Jan/Feb 08 ++]


VA VET CENTERS UPDATE 03: U.S. Senator Russ Feingold led a letter from the Wisconsin congressional delegation in an effort to establish more Veteran Centers in Wisconsin . In the letter, Feingold and all nine other members of the delegation urged the Department of Veteran Affairs (VA) to open two additional Vet Centers in Wisconsin ’s La Crosse and Brown counties. The delegation expressed its disappointment that none of the 23 new centers the VA plans to open in the U.S. this year would be built in Wisconsin, which ranks seventh worst in the nation for veterans’ access to these centers. Approximately 40% of Wisconsin veterans do not have a Vet Center close enough for them to go on a regular basis. Vet Centers provide counseling in a non-medical setting to complement the services provided in VA medical centers and outpatient clinics. Wisconsin only has two Vet Centers, both in the southern part of the state, to serve the state’s 469,000 veterans. States with similar veteran populations have more than double this number of Vet Centers. Maryland , for example, has fewer veterans than Wisconsin and is one fifth its size but has four Vet Centers. Massachusetts is about one eighth the size of Wisconsin , and has only a slightly larger veteran population, but it has seven Vet Centers. If Vet Centers were established in La Crosse and Brown counties in Wisconsin , roughly 82% of Wisconsin veterans would be within an hour drive of a Vet Center . A copy of the letter can be viewed at http://feingold.senate.gov/pdf/ltr_vets_121107.pdf. [Source: Sen. Feingold Press Release 7 Jan 08 ++]


ALABAMA VETERANS HOMES UPDATE 01: Pell City won the competition 11 JAN to get Alabama 's fourth veterans nursing home. The state Board of Veterans Affairs voted unanimously to place the home on a 27-acre site near the intersection of Interstate 20 and U.S. 231. The St. Clair County Economic Development Council offered the site, along with roads and water and sewer lines, worth $2.2 million to attract the nursing home. The veterans’ board, which was looking for a location convenient to the Veterans Administration Medical Center in Birmingham , also received proposals for sites in Helena and Tuscaloosa . Ken Rollins of Oxford , chairman of the board's nursing home committee, said the St. Clair County site stood out because it adjoins the Pell City campus of Jefferson State Community College . The college plans a nursing program at the campus, and is next to the proposed location of the St. Vincent 's St. Clair Hospital. The board plans to begin work on the home in 2009 and open it in 2011.

The federal government has set aside $26 million toward building the home. The Department of Veterans Affairs plans to put up $12 million from the portion of the state property tax that it receives to help veterans. The $2.2 million in donations from Pell City will push the total project to $40 million, according to Alabama ’s Veterans Affairs Commissioner Clyde Marsh. The state's three veteran’s nursing homes in Huntsville , Alexander City and Bay Minette are filled to capacity with 450 people and have waiting lists. The Pell City home will be the state's largest with 280 beds. That will include 50 beds for Alzheimer's disease and dementia patients and, for the first time, 50 to 80 beds that will be more like assisted-living care than a nursing home. The cost of staying in one of the nursing homes is $156.82 per day, but the patient pays only $11.64, making it much cheaper than paying for a privately owned nursing home. The remainder of the cost is paid by the state and federal government. Changes approved by the board provide for the state to pay $73.76 and the federal government $71.42. [Source: AP Phillip Rawls article 11 Jan 08 ++]


USERRA UPDATE 05: The Labor Department once again has sole jurisdiction to investigate military service members' complaints about their federal employment, even though a study examining the processing of such claims was considered inconclusive. A pilot project created by Congress in 2004 sought to determine which of two federal agencies -- Labor's Veterans Employment and Training Service (VETS) or the Office of Special Counsel -- was better suited to investigate alleged violations of the 1994 Uniformed Services Employment and Reemployment Rights Act. The law protects veterans from employment discrimination resulting from their service. Lawmakers allowed the demonstration project to expire on 1 JAN 08, and federally employed service members now must return to consulting VETS for initial investigation of their claims. The project, which was launched after criticism from Guard and Reserve personnel that VETS took far too long to investigate alleged violations of USERRA, was designed to determine whether OSC's expertise in enforcing federal sector prohibited personnel practices could strengthen the law's enforcement for government employees. But the project did not give lawmakers the definitive answer they expected.

In July, the Government Accountability Office issued a report that did not reach a conclusion about which agency was better suited to handle USERRA cases. George Stalcup, director of strategic issues at GAO, testified at an OCT 07 hearing of the Senate Veterans Affairs Committee that data problems at both agencies affected GAO's ability to draw conclusions. Sen. Daniel Akaka, D-Hawaii, proposed at the hearing a one-year extension for the demonstration project. But a congressional aide said 11 JAN that lawmakers opted not to extend the project, largely because GAO had determined that further analysis would not be possible. Jim Mitchell, a spokesman for OSC, said that the major concern is stepped-up withdrawal of troops from Iraq and Afghanistan could result in a surge of claims to VETS. According to Pentagon figures released 9 JAN, the number of National Guard and Reserve personnel who have been mobilized currently stands at 92,673. Mitchell proposed allowing OSC to have jurisdiction over federal claims, which would free VETS to focus on providing services to USERRA claimants in the private sector.
OSC will continue to have a role in USERRA enforcement, however, if VETS is unable to resolve a federal sector claim. The claimant may request that VETS refer the matter to OSC, which may then represent the claimant before the Merit Systems Protection Board.

The congressional aide noted that there may be an additional role for OSC in the future, but lawmakers have not yet decided what it would be. Akaka and Sen. Edward Kennedy (D-MA) recently introduced legislation that would strengthen USERRA by imposing deadlines on federal agencies to assist service members. The legislation also would implement the recommendations in GAO's report to reduce inefficiencies and improve data collection by the government on USERRA issues. The real issue, the aide said, is that federal response to USERRA claims has been lacking, especially when the government should be a model employer in enforcing the law. To address this, lawmakers are considering whether to require that an agency's Chief Human Capital Officer (CHCO) be notified when a USERRA claim is filed. CHCOs then could then determine whether more training and education on the law was necessary. He said, "This is a very complicated law and many may very well not understand it. I think it comes down to making sure that the education and outreach is there and that the federal government is setting the role as a model employer." [Source: GOVExec.com Brittany R. Ballenstedt article 11 Jan 08 ++]


VA LAWSUIT (LACK OF CARE) UPDATE 04: Veterans' advocates can proceed with a lawsuit claiming that the federal government's health care system for troops returning from Iraq and Afghanistan illegally denies care and benefits, a federal judge in San Francisco ruled 10 JA. U.S. District Judge Samuel Conti, a conservative jurist and a World War II veteran, rejected Bush administration arguments that civil courts have no authority over the Department of Veterans Affairs' medical decisions or how it handles grievances and claims. If the plaintiffs can prove their allegations, Conti said, they would show that "thousands of veterans, if not more, are suffering grievous injuries as the result of their inability to procure desperately needed and obviously deserved health care." He said federal courts are competent to decide whether those injuries were caused by flaws in the health care system and the VA's grievance procedures. Conti did not rule on the adequacy of the treatment system, which will be addressed in future proceedings. But he decided one disputed issue, finding that veterans are legally entitled to two years of health care after leaving the service. The government had argued that it was required to provide only as much care as the VA's budget allowed in a given year. A lawyer for the plaintiffs, Melissa Kasnitz of Disability Rights Advocates, said the judge had rejected the VA's "shameful effort to keep these deserving veterans from their day in court."

The next step is a hearing on the plaintiffs' request for an injunction that would require the federal agency to provide immediate mental health treatment for veterans who suffer from stress disorders and are at risk of suicide, said Sidney Wolinsky, another Disability Rights Advocates lawyer. That hearing is scheduled for 22 FEB. The suit claims that the federal government's failure to provide timely treatment is contributing to an epidemic of suicides among returning soldiers. The suit was filed in July by two organizations, Veterans for Common Sense and Veterans United for Truth, as a proposed class action on behalf of 320,000 to 800,000 veterans or their survivors. The groups said the VA arbitrarily denies care and benefits to wounded veterans, forces them to wait months for treatment and years for benefits, and gives them little recourse when it rejects their medical claims. The department has a backlog of more than 600,000 disability claims, the suit said. A Pentagon study group reported in June that the system was understaffed, prompting the VA to announce staffing increases in July. The study group also found that 84,000 veterans, more than one-third of those who sought care from the department from 2002 through 2006, had been diagnosed with post-traumatic stress or another mental disorder.

In seeking dismissal of the suit, the Justice Department argued that Congress had barred federal courts from hearing complaints about the VA system when it established a special Court of Appeals for Veteran Claims in 1988 to review grievances over treatment and benefits. But Conti said the special court can examine only individual cases and has no power to consider "systematic, constitutional challenges." He said those belong in regular courts. Conti also said the VA system, originally intended as an informal procedure to help veterans resolve their claims, has morphed into an adversarial process in which claimants have to comply with formal legal rules, often without a lawyer. "It is within the court's power to insist that veterans be granted a level of due process that is commensurate with the adjudication procedures with which they are confronted," Conti said. Efforts to reach the Justice Department for comment were unsuccessful. [Source: San Francisco Chronicle Bob Egelko article 11 Jan 08 ++]


TRICARE UNIFORM FORMULARY UPDATE 23: On 10 JAN the DoD Beneficiary Advisory Panel (BAP) met to review DoD proposals to elevate some cardiovascular disorder, prostate, and immune disease medications to the third tier, or $22 copay level. In the cardiovascular disorder category, the BAP concurred with keeping Zebeta, Coreg, Toprol XL, and Lopressor at $3 or $9 copays. Within the prostate medications, DoD proposed a "prior authorization" requirement which would require beneficiaries to try Uroxatral before Hytrin, Cardura, or Flomax unless they had a current prescription within the last 180 days. Even after trying Uroxatral without success, a "medical necessity" statement from a physician is still needed for Flomax or beneficiaries would have to pay a $22 copay. The BAP agreed to the prior authorization requirement but urged DoD to move Flomax back to a lower copay.

The targeted immunomodulatory biologics (TIB) -- Enbrel, Kineret, Humira, Raptiva, and Amevive -- are used to treat various forms of arthritis, psoriasis, Chron's Disease, and ulcerative colitis. By a one-vote margin, the BAP concurred with moving Enbrel and Kineret to the third tier but recommended delaying implementation for 120 days to allow time for patients to consult with their doctor and a rheumatologist.
The BAP agreed to move Exforge, a combination drug for high blood pressure, and the contraceptive Lybrel to the third tier with a 60-day implementation period. However, the BAP did not concur with moving Vyvnase, used to treat ADHD, to a $22 copay. This is the first case where DoD has recommended third tier status when there was no clinically meaningful therapeutic disadvantage or cost advantage. The BAP concurred with DoD's recommendations to place the generic version of the hypertension drug Norvasc back on the formulary at a lower copay than the current $22 price. All recommendations will be submitted to the Assistant Secretary of Defense (Health Affairs) for final decision. Beneficiaries can use the Formulary Search Tool located on TRICARE's pharmacy web site http://www.tricare.mil/mybenefit/home/Prescriptions for additional information about medications, their availability and cost. [Source: MOAA Leg Up 11 Jan 08 ++]


VA BUDGET 2008 UPDATE 11: President George W. Bush recently signed HR 2764, the Consolidated Appropriations Act, 2008; which, the Military Construction and Veterans Affairs and Related Agencies Appropriations Act of 2008 falls under Division "I" of this bill. The 11-bill Omnibus, one that increases the VA budget by $6.6 billion above the 2007 level, calls for $3.7 billion above the President's request for fiscal year 2008, which is the largest single increase in the 77-year history of the Veterans Administration. The $3.7 billion increase for veterans is designated as emergency funding under the final bill, and is contingent on approval by the President before it can be released to the VA prior to the 18 JAN deadline. The president has indicated he will approve this by the deadline. VA needs the additional $3.7 billion in emergency funding to help reduce the unacceptable claims backlog and hire PTSD counselors and claims adjudicators to work with returning OEF/OIF veterans. [Source: AL Philippine DNL Jan 08 ++]


RESERVE RETIREMENT AGE UPDATE 12: The President issued a pocket veto of the defense bill just after Christmas because of an unrelated provision about lawsuits against the current Iraq government. Lawmakers are expected to resolve this issue and resubmit it for the President's signature within the next few weeks. The vetoed legislation included language sponsored by Senator Saxby Chambliss (R-GA) that lowers the reserve retirement age below age 60 by three months for each cumulative 90 days of active duty served on "contingency operation" orders. The activation orders, whether involuntary or not, must indicate a contingency operation. The activated member need not be deployed to qualify. Reservists could retire as early as age 50 with 10 years' qualifying active duty service, if otherwise qualified for a reserve retirement. The pending change, however, is prospective only. That means only active duty service after the date the defense bill is signed into law (hopefully, later this month) will be credited toward reducing the retirement age. A second concern is that reservists who qualify under the new law to retire before age 60 would not be entitled to TRICARE until they reach age 60.

The new retirement upgrade doesn't go far enough. But it's at least a first-ever beachhead on this issue. Now that Congress has explicitly recognized the obsolescence of a retirement system built 50 years ago for a different force and the Cold War, members of the Military Coalition (TMC) should pursue more comprehensive reform until it's achieved. The next step is to make the "90 days retirement credit for 90 days active service" change retroactive to cover active service in the post-911 era. Since then, more than 600,000 Guard and Reserve warriors have served contingency operation active duty. More than 142,000 have served multiple tours.

While Congress contemplates a remedy for the current National Defense Authorization bill, Representative Joe Wilson (R-SC) has taken a preemptive measure to address reserve retirement pay. Wilson has introduced H.R. 4930 a bill that would make the early reserve retirement pay language of NDAA Section 647 retroactive to September 11, 2001. The legislation would count any aggregate of 90 days of qualifying service performed in any fiscal year after 911 toward reducing the 60-year eligibility age by three months. Proposals that would simply change the reserve retirement age from 60 to 55, including H.R. 690 (Rep. Jim Saxton, R-NJ) and S. 1243 (Sen. John Kerry, D-MA), are also still in play. But it's more likely in the future that Congress will tie additional service, including operational service, to any broad plan to lower the reserve retirement age. Such proposals need to include TRICARE eligibility. It makes no sense to provide access to TRICARE (TRICARE Reserve Select) for Selected Reserve families and then cut off that coverage for "gray area" and other pre-age 60 reserve retirees. The evolution of the reserve forces from a strategic to an operational role means more service on active duty, more time away from home, and diminished civilian career prospects. Now that Congress has begun to recognize these realities, it's time for more aggressive steps by the military community in communicating with their legislators to improve the reserve retirement system. [Source: NGAUS LEGIT & MOAA Leg Up 11 Jan 08 ++]


VETERAN CHARITIES UPDATE 05: Many people want to donate money and assets to help veterans. To help you make an informed decision, the Florida Department of Veterans’ Affairs has compiled a list of resources provided below:

· www.sunbiz.org• : For information on organizations registered with the Florida Department of State’s Division of Corporations, including non-profit organizations.
· http://app1.800helpfla.com/giftgiversguide• : The Florida Department of Agriculture and Consumer Services’ Gift Givers’ Guide provides revenue information, as well as costs, surplus and more on charitable organizations.
· www.charitynavigator.org• : This national Web site hosts information on large charitable organizations that take in at least $500,000 per year and have existed for a minimum of five years. Charity Navigator also includes helpful tips for donating.
· www.charitywatch.org• : The American Institute of Philanthropy is a nationally prominent charity watchdog service whose purpose is to help donors make informed giving decisions.
If you want to donate money to help your fellow veterans or current servicemembers, a good rule of thumb to go by is to donate to organizations that you know are legitimate and well-established. The VA has published a Directory of Veterans Service Organizations, which you can access by logging onto www1.va.gov/vso. [Source: eFlorida Vet News 11 Jan 08 ++]


VA PERFORMANCE: The health care system of the Department of Veterans Affairs (VA) received a highly favorable review in an interim report recently published by the Congressional Budget Office (CBO). The report credits organizational restructuring and management systems, performance measurement and information technology (IT) as contributors to VA's success. It also outlines ways in which VA can continue serving as a model for other health care systems. The interim report is featured on CBO's Web site at www.cbo.gov. The final report, expected in early 2008, will address the potential for other public and private health care systems to apply similar approaches and other issues. The report, completed at the request of the chairmen of the House Committee on Veterans’ Affairs and the Subcommittee on Military Construction, Veterans Affairs, and Related Agencies of the House Committee on Appropriations, reviews the quality of VA’s health care, examines VA’s achievements and looks at lessons learned from both its management initiatives and application of information technology. Key factors cited in the report included VA’s restructuring efforts to permit more shared decision making between VA’s central office, regional managers and facility directors; measuring performance, process and outcomes; and system-wide use of health information technology.

The improvement in VA’s health care quality in recent years has been well-documented in a number of independent studies including those by the Institute of Medicine (IOM). VA’s accomplishments are all the more noteworthy as they came during a period of increased demand for services. From 1999 through 2007, enrollment in the VA health care system, mandated by the Veterans’ Eligibility Reform Act of 1996, swelled from just over three million to nearly eight million veterans. Consequently, the number of veteran patients treated each year increased from approximately 3.2 million to more than five million. The CBO report pointed to VA’s structure as an integrated health care system that allows the use of two important tools: incentives given to managers and providers to meet quality of care and practice guideline targets; and health IT systems that provide reminders about tests and treatments recommended by the practice guidelines. It also examined the low cost of care for veterans as an incentive for seeking care. VA has an electronic health record for every patient, which provides up-to-date information about a patient at the point of care, including his or her history, allergies, and medications. It also consists of relevant diagnoses and laboratory tests, enabling providers to avoid duplicate tests and adverse drug interactions. Research indicates that computer reminders and prompts can significantly improve adherence to clinical guidelines, particularly for preventive care.

The CBO said that VA’s integrated structure and appropriated funding may have helped VA focus on providing the best quality care for a given amount of funds as contrasted to fee-for-service incentives toward billable services and procedures. These and other issues will be addressed in the final report.
VA is the second largest cabinet department, with about 250,000 employees, a health care budget last year of $32 billion and an overall budget exceeding $82 billion. VA will provide care to more than 5.8 million veterans this year in its 153 hospitals and nearly 900 clinics. VA also provides disability compensation and pensions to 3.5 million veterans and family members, and operates 125 national cemeteries. [Source: VA News Release 9 Jan 08 ++]


IRS DATA BREACH UPDATE 01: In addition to addressing less than 30% of the information security weaknesses highlighted in a 2007 Government Accountability Office report, the Internal Revenue Service provided false claims about its progress, according to a Government Accountability Office auditor.
A new GAO report (GAO-08-211) released 9 JAN states that the agency corrected or mitigated 29 of the 98 information security weaknesses highlighted at the time of GAO's last review in 2007. Among other findings, the IRS failed to consistently enforce strong password management for identifying users, authorize user access according to job functions, encrypt sensitive data, monitor changes on the mainframe computer server that supports the agency's general ledger for tax administration, and physically protect computer resources. That, combined with failure to implement internal controls and system configuration policies, continues to threaten financial and taxpayer information, according to the report. "IRS needs to establish a risk-based approach for mitigating weaknesses and ... fully implement an information security program on an agency wide basis in order to ensure that issues don't reoccur later," said Gregory Wilshusen, director of information security issues at GAO.

Also of concern to GAO were incorrect reports from the IRS about steps made to improve information security. "Our objective was to follow up on previously reported weaknesses to see progress," Wilshusen said. "Interestingly, they reported several weaknesses as being mitigated, but when we went in to do our follow-up exam, we found they had not been corrected." Wilshusen could not specify which vulnerabilities the IRS erroneously claimed to have been dealt with, saying that release of specific information could spur malicious attacks against its networks. The IRS declined comment for this article. The agency has made some progress, tightening access controls for certain critical servers, limiting computer room access to authorized individuals, developing a security plan for a key financial system, and updating servers that were running unsupportable operating systems. In addition, the IRS began efforts to establish security policies, procedures and practices with six enterprise wide goals that would help protect and encrypt data, secure information technology assets, and build security into new applications. GAO also made seven recommendations to improve information security, including updates to policies and procedures for configuring mainframe operations, specialized training, expanded testing, enhanced contractor oversight and contingency planning. In addition to implementing a strict information security program, the IRS will initiate a performance standard focused on resolving security weaknesses and reporting the security compliance status of computer systems connected to its network.

The IRS is not alone. In APR 07, GAO reported (GAO-07-751T) that 24 major federal agencies continue to have weaknesses with information security controls. A number of other GAO reports highlight the failures by specific agencies to deal with problems. "The guys at GAO are wonderful, but this report could have been written every year for the past eight years -- at least -- and for nearly every agency," said Alan Paller, director of research at the SANS Institute, a nonprofit cybersecurity research organization in Bethesda , Md. In SEP 07, IT security firm Symantec released its Internet security threat report, which found that one in four security breaches occurred in the government sector. "It's almost like Groundhog Day -- we're entering 2008 with this report on IRS, but the title of the agency could just as easily be left blank," said Jim Russell, vice president for public sector at Symantec. "A lot of the issues cited can be solved through policy compliance. IRS needs to get a handle on what their environment looks like, but more importantly, they need to look at endpoints and servers and make sure they they're standardized with the latest security software and have the latest patches. [Source: GovExec.com Newsletter 9 Jan 08 ++]


CONGRESSIONAL COLA 2008: Fortunately for members of Congress, their pay isn’t tied to their approval ratings. Lawmakers in 2008 will receive salaries of $169,300, a boost of $4,100 over the pay they have lived with since January 2006. That 2.5% increase is mirrored by similar raises for associate justices of the Supreme Court, who will see their pay go from $203,000 to $208,100, and Chief Justice John Roberts, whose pay will rise to $217,400 from $212,100. House Speaker Nancy Pelosi, D-Calif., will get a pay boost from $212,100 last year to $217,400, the same as Chief Justice Roberts. The majority and minority leaders of the House and Senate and Senate president pro tempore Robert Byrd, D-W.Va., will get increases from $183,500 to $188,100. Dick Cheney, in his last year as vice president, will receive $221,100, up from $215,700. President Bush’s salary of $400,000 is unchanged.

The salary figures were published in the 8 JAN edition of the Federal Register. Last year was the first since 1999, when the pay was $136,700, that members of Congress did not receive a cost-of-living allowance raise along with other federal employees. Democrats, newly elected to the majority, had vowed to block an increase in their paychecks until Congress raised the minimum wage. With the minimum wage increase accomplished last year, House Democratic leaders joined with their Republican counterparts to oppose a procedural vote to bring the COLA issue to the floor, leaving the way clear for their automatic raise. The congressional COLA is linked, under a complicated formula, to the cost-of-living increase awarded civil servants. As part of a 1989 ethics bill, Congress gave up its ability to accept pay for speeches and made annual cost-of-living pay increases automatic unless lawmakers voted otherwise. Rep. Jim Matheson (D-UT) a leading critic of the COLA process, said in an interview that he’s not proposing that members of Congress never get a pay raise. But he said that, in a time of budget deficits when many people are undergoing economic hardships, “at least we ought to have an up-and-down vote on it. The whole process appears so secretive.” Reluctance to openly discuss the salary issue comes at a time when Congress has been suffering low public approval ratings. In a December AP-Ipsos poll, only 25% of those surveyed approved of the job Congress was doing. [Source: AP Jim Abrams article 9 Jan 08 ++]


MERCHANT MARINE WWII COMPENSATION UPDATE 01: Thousands of civilians who ferried troops and supplies through World War II's combat zones are closer than ever to receiving lifetime federal pensions, but things don't look so good for their wives. Legislation in Congress (HR 23) that would give merchant mariners $1,000 a month for life passed the House last year and, for the first time, has a healthy list of Senate sponsors. But the bill's new version eliminates the provision that passed the benefit on to surviving spouses, as long as their mariner husbands were living when the bill was approved. Cutting the spousal benefit was proposed in the House last year as a cost savings. The VA continues to oppose the bill, saying the monthly payments would be greater than what some disabled veterans receive and that mariners already receive other VA benefits. The Senate version (S. 961) could be heard by the U.S. Senate Committee on Veterans Affairs within the next few months. Sen. Larry Craig of Idaho , who staunchly opposed the measure because he believed it might open the door to compensating other civilian service groups, no longer is the committee's chairman. And the number of sponsors has risen from 37 last year to 57.

The benefit is to compensate the mariners for not being included under the GI Bill, which gave money to returning World War II soldiers and sailors for home loans and college tuition. People in the Merchant Marine were classified as civilians, even if they served in combat zones, and did not receive veteran status until 1988. Today, mariners and some other civilian groups, such as the Women Airforce Service Pilots, can get health care, disability and burial benefits through the U.S. Department of Veterans Affairs. About 250,000 mariners served during World War II. The Congressional Budget Office estimated about 16,000 mariners would meet the pension requirements and apply. The bill allocates about $605 million to the Merchant Mariner Equity Compensation Fund, enough to fund pensions for an initial 10,000 mariners through 2012. Mariners would need an honorable discharge and proof they served "in harm's way" from 7 DEC 41 through 31 DEC 46. The Merchant Marine, which sometimes took boys too young to join the Army or Navy, lost 7,000 to 9,000 men during the war. [Source: South Florida Sun-Sentinel 10 Jan 08 ++]

VA FRAUD UPDATE 06: A Wichita man has been federally indicted for claiming he was a Purple Heart recipient. Albert Barker, 58, is charged with one count of making a false claim to the U.S. government, and one count of making a false statement in writing that he was awarded a Purple Heart medal. Prosecutors say the crimes occurred in OCT 05 and JAN 06 in Sedgwick County KS . The indictment alleges that in 2005, Barker applied to the Department of Veteran’s Affairs for a disability rating based on his suffering from post traumatic stress disorder. He caused documents to be filed in support of the claim falsely stating he had served in a combat infantry and had received a Bronze Star. In JAN 06 he caused his American Veterans representative to submit a fraudulent Army General Order 164 claiming Barker had been awarded a Purple Heart medal. If convicted, he faces a maximum penalty of 5 years in federal prison and a fine up to $250,000 on the charge of making a false claim to the U.S. government, and a maximum penalty of 1 year and a fine up to $100,000 on the misdemeanor charge of making a false claim of receiving a Purple Heart medal.
Man gets probation in fraud

A Billings man who stole Veterans Affairs checks sent to a man who was incarcerated out of state will spend four years on probation and have to pay $11,778 restitution. U.S. District Judge Richard Cebull on Wednesday sentenced James Gus Georgacopoulos, 61, at the low end of the guideline range, noting he had no previous record and the crime appeared to be an isolated incident. Georgacopoulos offered no excuses. He said it was the "first time I've ever done something stupid like this and it will never happen again." Prosecutors said Georgacopoulos, while working as a desk clerk at the Esquire Hotel, stole the victim's mail and VA checks, forged the victim's signature and gave them to a co-defendant, Lowell Timothy Howell, to cash and deposit. The two split the proceeds. The victim is incarcerated in Florida . Cebull previously sentenced Howell, of Georgia , to six months in prison and also ordered him to pay restitution. [Source: Lakeland KS KAKE 10 News & Billings MT Gazette 10 Jan 08 ++]


SPIN CODE LAWSUIT: This case was originally filed in the US District Court, Northern District of New York, Syracuse and aspects of it are still being litigated. The lawsuit began in MAR 76 when Edwin Cosby with an Honorable Discharge discovered he had a bad “Spin Code” (i.e. Separation Program Number). Unknown to him and most other veterans beginning 11 JUN 56 under D.O.D. Instruction 1336.3 DOD ordered the military departments to begin putting a coded number on the main employment reference document of veterans. This document known as the DD-214 is often by employers of veterans seeking employment and benefits. DoD prepares eight or more copies of a veteran’s DD-214 of which copy one goes to the veteran and others are eventually sent to State Adjutant General, VA Data Processing Center, Austin , TX . State Director Selective Service, and National Military Records Center , St. Louis MO. At a congressional hearing in 1974 DoD told Congress that only a couple hundred thousand documents had a code number and the "SPN" coding system would be stopped. However, in 1972, DoD started changing their “SPN” system to the "SPD" (separation program designator) and by 1977 nearly 20 million veterans with Honorable Discharges had a coded number. Congress subsequently attempted to pass a law regarding the use of the coded numbers; however, this failed to pass.

Numerous major corporations have admitted to having the codes and use them in their employment decisions regarding veterans. Banks, life insurance companies, State Government & Federal Government Agencies have them as well. Lists of the codes were sent to FAA, (federal aviation admin.), HUD, (housing & urban development), and Office Personnel Management. Even on an Honorable discharge, a "Spin Code” can hurt a veteran's chance of being hired by a prospective employer, obtaining a loan, and/or obtaining insurance. A few examples of spin codes and their meanings are:
SPN 258 - Unfitness, multiple reasons
SPN 263 - Bedwetter
SPN 41A - Apathy, lack of interest
SPN 41E - Obesity
SPN 46C - Apathy / Obesity
SPN 463 - Paranoid personality

A complete listing of spin codes can be found at http://www.landscaper.net/discharg.htm. Veterans can request a new DD 214 with the spin codes removed. If you were in the US Army, written requests for having a SPN code removed from your DD 214 (Report of Separation from Active Duty) or earlier discharge papers, should be sent to: Commander, Reserve Components Personnel & Administrative Center , Box 12479 , Ollivette Branch, St. Louis , MO 63132 . Additional info on this subject is available at http://veterancourtcodes.com which contains a 90 minute video on the subject. [Source: Veteran’s Forum 9 Jan 07 and Ed Crosby ecrosby1@rochester.rr.com ++]


MEDICARE PART D UPDATE 17: The Centers for Medicare & Medicaid Services (CMS) may have overpaid private contractors millions of dollars for services tied to the start-up of the Part D prescription drug benefit, according to a recent study by the Government Accountability Office (GAO). From 2004 to 2006, CMS was provided $1 billion in federal funds for administrative start-up of the Medicare drug benefit. The vast majority (81%) of the funds were used in private sector contracts for support services, including call center support, media buys, promotional tours and research reports. According to the GAO, 45% of CMS contracts were awarded without competitive bidding, while 78% were structured for the government to assume the risk of cost overruns. GAO identified close to $90 million in questionable payments to private companies with federal contracts. For these contracts, CMS did not conduct the audits, monitoring and other oversight to verify contractor charges, as required by federal regulation.

As contract awards more than doubled, CMS increased oversight staff by only 11%. As a result, many contracted agencies were reimbursed for costs not directly related to the contract or at rates higher than market value. In one audit where the GAO found that CMS paid out $40.6 million for unsubstantiated costs, the contracted agency had charged CMS for property depreciation, grounds maintenance and recycling services, and placed questionable items such as basketball goals within its invoice package. In another audit, two companies that were contracted for similar services were found to have subcontracted the services to each other and billed CMS for $4.2 million in overlapping indirect costs. For many contracts, CMS reimbursed labor costs at inflated rates, which included vacation or sick time, or rates that were far higher than wage rates within the company. One research firm charged CMS for labor at 14 times its average rate. The GAO recommended that CMS review its oversight policies, improve training for audits and pursue reimbursement of unsubstantiated costs outlined in the report. CMS responded to GAO that it will continue to update its policies, but otherwise defended its contracting practices. CMS said the agency has been exemplary in its use of competitive contracts.

The Medicare prescription drug benefit (Part D) saves enrollees $9 or less per month, according to researchers who tracked purchases of over 100,000 older adults before and after the benefit began in 2006. The program will cost about $1 trillion over the next ten years but these small savings to beneficiaries is the result of the Part D benefit being run by private companies and not by Original Medicare. According to Consumer Union most Medicare Drug Plans continue to hike costs into 2008 two-to-three times rate of inflation, Consider these two facts from a recent overview of health spending published in Health Affairs by researchers for the Centers for Medicare & Medicaid Services:
· Of the $41 billion in Part D spending in 2006, $5.3 billion, or 13% went for administrative costs and the profit siphoned off by the insurance companies offering Part D. By contrast, just 3% of spending for coverage of doctor visits and hospital care under Original Medicare goes to administrative costs.
· The Part D plans cannot negotiate discounts and rebates from drug manufacturers that come close to matching what Medicaid received, when that program provided drug coverage for low income people with Medicare. In fact, even though enrollment in Part D plans is more than double the number of people enrolled in Medicare and Medicaid, the total amount of rebates received by Part D companies are less than Medicaid received before Part D took over coverage.

It is becoming more and more clear that the privatized structure for Part D has created a boondoggle for drug manufacturers and insurance companies even as it has fallen woefully short in providing people with Medicare the kind of drug coverage they need. It is time to for Congress to eliminate the middle man and provide a drug benefit directly through Medicare. Older adults and people with disabilities deserve that choice. [Source: Medicare Watch www.medicarerights. org 8 Jan 08 & Consumer Advocacy Update ++]


MISSOURI RETIREE TAX EXEMPTION: Military retirees in Missouri might have a state tax cut coming, if lawmakers go along with a proposal by Gov. Matt Blunt. The governor proposed to eliminate the state income tax on military pensions for tens of thousands of veterans in Missouri . The tax cut would cost the state about $24 million a year, Blunt said. Veteran’s officials said the tax cut was one of their priorities. Of the 41 states that have an income tax, 12 do not tax military pensions, including neighboring Illinois . Blunt outlined the proposal at a Veterans of Foreign Wars post in Springfield , the first of several statewide stops to promote the tax cut. The tax change would need approval by the legislature, which started its 2008 session 7 JAN. “I think there will be strong support in the legislature,” Blunt said. He was flanked by state Sen. Jason Crowell, R-Cape Girardeau, head of that chamber’s veteran’s affairs committee, and House counterpart Rep. David Day, R-Dixon. Both men said they supported the tax cut. “The best that we can do to help is to let you keep more of your money in your wallet,” Crowell said. The governor said state economic growth made the tax break possible without having to cut any programs or raise taxes elsewhere. The proposed tax cut for military veterans follows one enacted last year for retirees in general. The 2007 law exempted additional Social Security benefits and certain other retirement benefits from the state income tax. Those tax cuts are projected to cost $154 million when fully phased in by 2012. [Source: Columbia Missourian AP article 7 Jan 07 ++]


VA HOSPICE CARE UPDATE 01: The Department of Veterans Affairs (VA) is providing hospice and palliative care to a growing number of veterans throughout the country as the need continues to rise for care and comfort at the end of life. VA provides palliative care consultation services at each of its medical centers and inpatient hospice care in many of its nursing homes throughout the country. VA contracts with community-based hospice programs to enhance VA’s ability to provide this critical service when and where needed. Nearly 9,000 veterans were treated in designated hospice beds at VA facilities in 2007, and thousands of other veterans were referred to community hospices to receive care in their homes. The number of veterans treated in VA’s inpatient hospice beds increased by 21% in 2007. In addition, the average daily number of veterans receiving hospice care in their homes paid for by VA increased by 30% this past year. Because of the large number of World War II and Korean era veterans and a tripling of the number of veterans over the age of 85 from 2000 to 2010, the increase in the need for hospice care is expected to continue. The proportion of Vietnam-era veterans over the age of 65 will continue to increase through 2014, when Vietnam veterans will account for nearly 60% of all veterans in that age group.

VA’s expansion of its hospice and palliative care capabilities came about through collaboration with community-care providers. In 2001, the National Hospice-Veteran Partnership Initiative began to build partnerships between VA facilities and community hospice providers, funded in part by the VA and by nonprofit groups such as the National Hospice and Palliative Care Organization and the Advanced Illness Care Coordination Center . To date, VA has partnered with community hospice programs in 35 states to promote hospice services that are not provided directly by VA staff. These partnerships help veterans transition from VA hospitals to their homes in the community. Palliative care adds a focus on quality of life and comfort to veterans with life-limiting illness, and their families. Palliative care consultation teams include physicians, nurses, social workers and chaplains. Additional support may be provided by pharmacists, rehabilitation therapists, recreation therapists, mental health professionals and other specialists. VA provides palliative care consultation teams at all of its hospitals nationwide, although such services are provided at only about one-fourth of all American hospitals. Nearly half of all veterans who died in VA facilities received care from a palliative care team prior to their deaths. For more info on VA’s programs and obtaining services refer to http://www1.va.gov/geriatricsshg/page.cfm?pg=65. [Source: VA News Release 8 Jan 07 ++]


SBP PAID UP PROVISION UPDATE 04:

1) What is Paid-up SBP? Paid-up SBP refers to a provision of the Survivor Benefit Plan (SBP) law passed by Congress in OCT 98and which is due to take effect in OCT 08. This change in the law applies to qualified members who will no longer be required to pay SBP premiums once they satisfy certain age and premium payment requirements.

2) Who is eligible to have their SBP premiums stopped? Any retiree who is age 70 or older and whose retired pay has been reduced for SBP premiums for at least 360 months will qualify to have their SBP costs terminated.

3) Are retirees with Reserve Component SBP (RCSBP) coverage eligible? Yes. Any reference made to SBP premiums also includes RCSBP premiums.

4) Is a retiree who has paid SBP premiums for 360 months or more but has not reached age 70 eligible to have premiums terminated? No. In order to qualify for the termination of SBP premiums, a retiree must satisfy both requirements of the law. The retiree must be age 70 or older and made payments for at least 360 months of SBP costs.

5) Does the termination of premium payments also apply to retirees with RSFPP coverage? Yes. Congress amended the law in OCT 99 to include Retired Serviceman’s Family Protection Plan (RSFPP) participants. Any retiree who is age 70 or older and currently enrolled in the RSFPP is eligible to have their RSFPP costs terminated.

6) When does Paid-up SBP begin? The earliest effective date that a qualified retiree may stop paying SBP premiums is 1 OCT 08. The first retired pay payment affected will be the payment dated 1 NOV 08.

7) What if the retiree has paid more than 360 months of premiums before 1 OCT 08? Will there be a refund? No. There will be no refund of excess premiums paid prior to the 1 OCT 08, effective date of Paid-up SBP.

8) When will SBP premiums stop for retirees who reach age 70 and have paid 360 months of premiums after 1 OCT 08? Retirees who fall into this category will not be charged SBP premiums beginning with the month they reach age 70 and have paid 360 months of premiums.

9) How will the 360 months of paid-up premiums be determined? The retiree will receive a one-month credit for each month retired pay was reduced. This will be determined by using both current election records and historical records of the initial SBP election.

10) What if the retiree does not have 360 months of paid-up premiums on 1 OCT 08? A retiree who does not have 360 months of paid-up premiums on 1 OCT 08 is not eligible to have the SBP costs stopped. In these cases the retiree will receive an additional one-month credit for each month retired pay is reduced until 360 months of paid premiums is reached.

11) What if the retiree does not have SBP costs deducted from retired pay but pays by direct remittance? For the purpose of computing the number of months of retired pay reductions, direct remittance payments shall apply as if retired pay was reduced.

12) Will retirees be notified of their paid-up status? Notices will be mailed to retirees informing them of the number of months of coverage that have been credited to their account toward paid-up status.

13) When will retirees receive notification from DFAS? Details regarding a retiree’s personal account will not be ready for release until May 2008. DFAS will begin the notification process at that time.

14) Who can expect to receive notification letters from DFAS in May 2008? Retirees enrolled in either the SBP or RSFPP programs that are at least 68 years of age or have been retired and paying premiums for at least 27 years will receive notification letters in MAY 08.

15) What type of information will be provided in the notification letter? The notice retirees will receive will provide Paid-up SBP information as well as specific information about their account, the number of months of paid-up premiums and their current paid-up status. The notice will also instruct retirees of the right to challenge their paid-up status if they disagree with the number of months of paid-up premiums calculated by DFAS.

16) What if the retiree does not agree with the number of months of coverage provided on their notice? If the retiree does not agree with the number of months of coverage credited to their retired pay account the retiree will have the option to prove differently.

17) What information must the retiree provide to have their months of coverage adjusted? The retiree must submit DD Form 2656-11, “Statement Certifying Number of Months of SBP Premiums Paid.” In addition, the retiree may be requested to provide documentary evidence for each month of Paid-up SBP credit claimed. Upon receipt of the DD Form 2656-11, DFAS will review and adjust the retired pay record to reflect the number of months that the retiree certifies has been paid.

18) Can the DD Form 2656-11 be filed at any time? No. Retirees who elect to submit a DD Form 2656-11 must do so within one year after initial notification of the number of months of Paid-up SBP credited.

19) How often may retirees challenge their paid-up status by filing a DD Form 2656-11? Retirees will be permitted to challenge their paid-up status only once. They will not be permitted to submit multiple forms to DFAS.
[Source: Retiree Activities Office 314AW/

� Secure this line!

---

sweet!

thx

by MajMike on January 23, 2008 4:03 PM

---

TL;DR. Also MEGO, and some paragraph breaks would be nice.

I mean, I sympathise with the intent of the poster, but it's some work to read all of that and make sense of it.

by Justthisguy on January 23, 2008 5:11 PM

---

Actually, JTG - the format issue is my fault, and fixed now.

As for MEGO, that's why I only put the TOC in the post - and only those with an interest or need to know need wade through it all.

Not intended as a conventional post.

by John of Argghhh! on January 23, 2008 9:45 PM

---

I can always .pdf the whole thing - I'll give that consideration, too. But part of the thought here is aimed at Google.

by John of Argghhh! on January 23, 2008 9:50 PM

---

Tichacek does his homework......which saves me a great deal of time, especially with his links to pending legislation.

I'd be lost without his references.

Besides, it's so much fun to be able to ask your Congressman why he (or she)won't support a certain piece of really good Veteran's legislation that was authored by someone across the aisle......the answers are priceless!!

by R. Jewell on January 23, 2008 10:15 PM

---

Yup, I see yer point. There is something to be said for being exhaustive, as exhausting as it might be to read the thing.

And, yes, somebody with a serious personal interest in that kind of thing might be more inclined to pay attention than I would.

by Justthisguy on January 23, 2008 10:50 PM

---

� Dismissed, Soldier!

I understand we want to defend all of our troops. Jules wanted to know where the reports are the show all of the veterans who either do not suffer the after effects or that go on to cope with their symptoms, living productive, fairly normal lives. Well, if we reverse this study information on the fact sheet, if 18% develop PTS or the more chronic PTSD, that means at least 82% of all troops come home to healthy, productive lives. With over 1 million already having served in Iraq and Afghanistan, that's approximately 820,000 troops. With 11% of the 18% that goes on to have the more chronic "disorder", that means another 70,000 who have the "acute", short term PTS and go on to live fairly healthy lives.

That is good news. Especially for our troops who may be concerned that they will be part of some overwhelming number of troops who will not be able to return to "normal". However, that's really not the point. These troops, by and far, do not need our "defense". They know they are fine and going on with their lives.

There are still 11%, over 110, 000 troops, who will struggle with PTSD. Some of the 70,000 with the "acute" variety, will not receive treatment, will stop treatment or will refuse treatment and may go on to develop the chronic disorder. Then, there are the unknown numbers who will not report any symptoms, not seek treatment and be below the radar, with both soldier and family suffering. These are the people that we need to worry about, that we need to "defend".

I don't know exactly how many visits all of the "big" milblogs get. Based on some reported numbers, places like Blackfive get about 10k visits a day. My guess is, somewhere in there, there are deployed or recently returned troops. Out of these, my guess is there are some troops who might be experiencing either the "acute" or short term conditions of PTS and some might have the chronic disorder: Post Traumatic Stress Disorder. They might need a little "acceptance" and "encouragement".

The best way to mitigate stigmatization of these conditions, improve acceptance, increase treatment and reduce the chances of PTS becoming "chronic" or even PTSD turning into suicidal tendencies, is to accept it ourselves.

Isn't it time we milblogs stopped worrying about "the politics" started having a real conversation?

� Secure this line!

---

My impression is that PTS and PTSD are going from an undiagnosed or underdiagnosed problem to an overdiagnosed and overtreated problem.
The problem of institutionalization of the people suffering for this problem, when the best way to treat this and many other mental disease is to try hard to reinsert the person in his/her family/workplace. People need to be given help there, not in hospitals away from their home.

Hospitalizing people for long terms (weeks, months) have a grave risk to make them dependent from the institution. They start behaving like the institution expect they will behave.

In the rush to help and protect, people sometimes do more damage than good. The problem is that the good done is seen, but the damage is not.

by Mirco on November 16, 2007 8:34 AM

---

My impression is that PTS and PTSD are going from an undiagnosed or underdiagnosed problem to an overdiagnosed and overtreated problem.

Actually, that can occur for any mental health problem. It's really up to the patient to work with the doctor and for family members to make themselves cognizant.

In regards to the hospitalization, that is an issue, but that is actually pretty limited. Most are "voluntary" not "involuntary" inpatient stays. Thus, I have to assume that there is a great risk to the patient or others. also, the beds for "inpatient" are limited. I mean , very limited, so it seems a little overstated to claim that hospitalization happens "too much". Most clinicians also believe that patients are better off either at home or in a setting that is open and includes compatriots. which is why a lot of PTSD programs are group therapy with similar troops.

Although, I did hear a complaint from a combat soldier about having to share his issues with "pogs" who hadn't seen half of what he did, but part of that is really anger about talking about it at all.

One thing I would like to see a lot more of is peer oriented therapy. People are less afraid to share things with their peers. Particularly ones that are in the same boat with them. everyone else they think is judging them even if it is a sincere desire to help.

by kat-missouri on November 16, 2007 8:46 AM

---

As I understand how the military does it - they are not taking the institutionalization approach. We learned the hard way as long ago as WWI that approach was one that actually made the problem worse. The French and German approach which mirrors what Mirco spoke of, was much more effective for treating what was then termed "battle fatigue".

by John of Argghhh! on November 16, 2007 8:50 AM

---

Shipmates,

Ah hell. I kept trying to write what i wanted to say, but no matter how hard I phrase it, it'll piss off someone for sure.

Certainly there are times when suicide is the result of mental health issues, and those should, indeed, be assessed and discussed. However, there are other times when it is a viable and perhaps even desired form of death.

I have known three veterans who killed themselves, including my grandfather. He was dying of cancer, in agony, and before he became unable to help himself anymore, he made peace with grandma, said goodby, and checked himself out. I see no mental health issues there, and I would hope that i could have the same courage were I faced with that sort of fate.

However I certainly agree tyhat mental health issues are over-diagnosed. That's a function of both the health care industry having a financial stake in the matter, as well as from a liability angle. Good heaven's, even religion and government proscribe suicide because it deprives both of revenue from the deceased, although the IRS tries to still get a bite through the estate taxes.

I am not suicidal, but I have thought often about this issue. In the end, my life is the ONE thing that I have control over, or at least should be allowed to have control over. I should be able to decide when it's time to leave, when I've had enough, when I've done all I can to help out the world.

I'm NOT trying to be cold and cynical, although I am a tad bit jaded these days. Still and all, anytime there is money to be made, an industry will arise to take advantage of the situation, and that is where much of our mental-health and NGO's are headed: suicide-prevention.

Respects,

by AW1 Tim on November 16, 2007 12:08 PM

---

Okay John, you asked for it, you got it. My maiden post.

In the current health care environment, people with mental health issues are not hospitalized unless they are in severe crisis. Nor should they be. Kat has done a really fine job of outlining the difference between PTS and PTSD and the many issues surrounding these disorders. The standard of care for PTSD includes both individual and group therapy, as well as appropriate medications (antidepressants and anxiolytics) when they are necessary. The group component is very important in helping people understand that their experience is not unique and that they are *not* crazy.

Others here have also mentioned the stigma surrounding mental health issues and this is something with which our culture struggles mightily. That is one reason we are beginning to see services labeled as behavioral health. I work in the field of health psychology, which didn't exist when I was an undergrad back in the dark ages. When I am working with people, I try to help them understand that it is impossible to separate the mind from the body. Is your brain not a part of your body? Depression and PTSD should carry no more stigma that diabetes or hypertension. They are problems that need to be dealt with to lead a healthy life.

by Kathy on November 16, 2007 12:18 PM

---

I don't think your anymore jaded than I am Tim.

As long as Illegal Aliens are getting better healthcare than Veterans, I don't have anything i can add to the context of this without the use of what my father labeled "sailor words"

by BloodSpite on November 16, 2007 12:54 PM

---

Everybody, meet my sister.

Keep that in mind, too.

She's my sister.

Pick on me, she'll kick your butt.

by John of Argghhh! on November 16, 2007 1:13 PM

---

In case of death, I would suggest to try crionic conservation.
It is probably a 1% bet. But the alternative is a 0% bet.

by Mirco on November 16, 2007 1:43 PM

---

And welcome to our commenter from Italy... Mirco.

by John of Argghhh! on November 16, 2007 2:29 PM

---

Kathy ~ nice to meet you!

This is an incredibly interesting discussion. I want to focus on AW1 Tim's comments. The logical, practical side of my brain agrees wholeheartedly with the concept of assisted suicide and/or one's ability to determine at what point their life no longer contains the quality necessary to continue (how's that for a run-on sentence??).

The Christian part of me says that only God has the power to decide when and where and why my life will end. Tough quandry.

by HomefrontSix on November 16, 2007 4:00 PM

---

Well, when we are talking about "suicide" here, we are not talking about "end of life" decisions regarding the terminally ill. Mental health is not a terminal condition unless someone absolutely chooses it. It is almost always something that can be addressed either through therapy and/or medications.

Having dealt with several people with the chronic condition, usually the issue is that they either believe they are a burden on their family or they simply cannot deal with how they perceive their own behavior. Typically because it's extreme ups and downs, but also complicated by sleep deprivation, alcohol and drug abuse, family issues (which invariably occur as families try to deal with it). They can't see a way out though it is there.

They can't see who they are going to be beyond what they are experiencing right that second.

Most of our job is to assure them that this is not the end or the only thing they will ever experience. There is a future, even for those who experience chronic PTSD. The symptoms can be controlled and eventually recess to nothing or a minimum. There are a lot of coping skills that clinicians can teach and that people naturally have if they reach for them.

Here's some thoughts on the "over diagnosed"...it happens in every medical condition, it can be "undiagnosed". Secondly, there was a time when it was "under diagnosed" and in reality, that happens today as many try to avoid the diagnosis and hide the symptoms. At this point, "over diagnosed" is not nearly the problem that "under diagnosed" is.

by kat-missouri on November 16, 2007 4:06 PM

---

Kathy! Nice post. Thanks for being a part of all this.

KAT: I hope you understand that I support fully the VA mental health programs, both inpatient and outreach.

My big gripe (and not with you, mind you) is the perception by so many that someone who chooses suicide is, by default, mentally ill, depressed, whatever. It's to the point where nearly every state has laws that DEMAND that physicians report anyone who talks about it to them. Seriously, how many folks have given up on talking about the subject with their own doctor, or anyone else because they fear being reported and detained against their will?

That sort of legislation, the one that requires doctors to report such comments and individuals, is to my mind the real illness.

respects,

by AW1 Tim on November 16, 2007 7:55 PM

---

I know that there is the distinction to be made between PTS and PTSD, but to those affected it is a moot point if there are long waits for assistance and lack of facilities in addition to the stigma. Unfortunately, in my experience, the stigma is most fostered by the NCOs with interference, intimidation, threats and punishment. Whether this was (is) ignorance on their part or the pressures top down to train up and have sufficient personnel mission ready.... it exists.

Only those [soldiers] in crisis mode (they must tell someone they are considering or have attempted suicide or violnce) are seen on an emergency basis. If a soldier is then determined to be a threat to himself or to others he is hospitalized -- but typically in a civilian facility because the services cannot afford to spend capital dollars on "housing" for mental health conditions. If they are not in crisis, they have to call and get an appointment and wait for weeks to be seen. If they are experiencing crisis symptoms (extreme anxiety, aggitation, severe depression, suicidal urges) they must go to the medical ER where they might sit for 6, 8, 10 hours before they are seen... and most soldiers in crisis leave in frustration. Self medication -- alcohol, drugs and "cutting" (self-mutilation) -- are big time among returning troops... and little is done to discover or discourage such behavior: so long as you show up at formation and pass the occasinal urine screening (and your Sgt. isn't called out to bail you out or break up a fight) -- you're good.

I know that they are trying to change the culture within the services and that efforts are underway to up treatment availability in the VA system... but it's going to be a long, difficult and costly process. But it all starts with truthful answers when asked, "Have you ever ______" and the willingness to speak up and/or seek treatment when the answer is "yes".

by Some Soldier's Mom on November 17, 2007 12:34 AM

---

Kat - I hear you, but there's a political dimension to this that can't be ignored, and that has to be countered at every turn. You can separate the personal coping and support for treatment from that political dimension, but it's something that can't go unaddressed. The public has to understand both sides.

The politicization of this condition by some quarters has forced the issue. Some media outlets use health data to support a political agenda, and have the side effect of even further stigmatizing of vets. Of course, the bulk of them, that 80%, don't need defending. It's not so much in defense of the vets per se as it is a stop sign to put up against the exploitation of PTSD and it's sufferers -- under the pretense of compassion -- to serve other agendas.

When it comes to familial coping, we get an email on what to say, what not to say, how to act, what questions not to ask, etc...But it can't be denied that high political emotion surrounds this publically, and will, if allowed to continue, come back around and aggravate things further on a personal level.

The hysterical waving of PTSD by some groups does have an effect, even on those who understand it. And I see the effect of this reckless use of the problem when I get a frantic call from my sister that, "He was scanning for targets the whole drive to the hotel! Oh my God! It's PTSD!"

by jordan on November 17, 2007 9:16 AM

---

Heh. That last part is good training.

I still do that now and then.

And watch for good ambush positions along the highways.

It's how you *react* that matters. What's going on inside the head that matters.

Good perspective, though.

It's one of the things I've actually been hammering Gun Owners of America about - their major argument against the NICs change for Brady Checks has been that vets with PTSD will get denied.

Aside from being misleading - it's damn dangerous among the vets who need help.

by John of Argghhh! on November 17, 2007 10:26 AM

---

The hysterical waving of PTSD by some groups does have an effect, even on those who understand it. And I see the effect of this reckless use of the problem when I get a frantic call from my sister that, "He was scanning for targets the whole drive to the hotel! Oh my God! It's PTSD!"

Well, as John notes, that's good training, but beyond that, it's part hysteria and ignorance. There is obviously a lot more to PTS and PTSD than that. A good place to start is by giving her simple advice:

1) They aren't going to be the same when they come back

2) they are going to be trying to fit that "other life" into "civilian life"

3) There are a lot more symptoms that would have to take place in order to be worried about the condition.

4) Tell her to go to the National Center for Post Traumatic Stress Disorder website.

They have a lot more information on what is or isn't the "signs". Maybe knowing more and talking to you will help her adjust as well. You know, this isn't just about the soldier. It's their family, too. They are trying to adjust to the new person as well. You might want to give her a little sympathy, too.

by kat-missouri on November 17, 2007 11:58 AM

---

Thanks for the above website -- very informative for the worried mother who thinks anything unusual means "my baby has PTSD".

Said baby, 6 ft. tall and 200 lbs., doesn't welcome the mothering.

by jordan on November 17, 2007 2:30 PM

---

Yes. actually, the "worry" part is natural, but can also be a bit of an "enabler" either by said "baby" rejecting it and going completely introverted when he might need to talk about it or by over-stating the responses and ingraining them.

Sad to say, there is no "right" response. It's all "feeling it out" as we go.

Maybe give her the "spousebuzz.com" site for some sharing by people who do deal with the "normal" effects of separation and the "different" people they have to adjust to when they come back.

I should have posted that site on the other websites as well.

by kat-missouri on November 17, 2007 3:18 PM

---

"1) They aren't going to be the same when they come back"

Might there be a different, better way to say this?

by Synova on November 17, 2007 8:25 PM

---

Well, I admit that is very general thought. We could break it out to say:

They are not going to look at the world as the same. They will be more mature. They will think different things are funny. somethings they did as "fun loving young men" will not seem as important nor fun anymore.

They may love more deeply and feel the need to be more protective of those people. They may be more outgoing or less so. They may be more introspective. They may be more independent or they may be likely to cleave to their families and friends.

It can be a lot of different "not the same". But maybe the best is to say they will almost always be changed by their experiences in small and large ways.

by kat-missouri on November 18, 2007 7:10 AM

---

I know that they are trying to change the culture within the services and that efforts are underway to up treatment availability in the VA system... but it's going to be a long, difficult and costly process. But it all starts with truthful answers when asked, "Have you ever ______" and the willingness to speak up and/or seek treatment when the answer is "yes".

Addressing the first part last, I would like to say that, beyond talking bout it as if it was a regular process that we need to discuss, it might be more easily acceptable if we put it in terms that our service members are familiar with. for instance: being mission ready.

I had a similar, long conversation at Blackfive. Both soldiers, NCOs and officers need to be aware that being mission ready, in all respects, both physical and mental, are important in order to insure the safety of the soldier in question, the soldiers they serve with and the successful completion of mission.

Unfortunately, as I noted there, being able to physically assess someone for mission readiness is easier than assessing their psychic readiness. You can use quantitative assessments for physical conditions. You can use your eyes to see. But the psychic evaluation of "mission readiness" is about paying attention, knowing the soldiers and using our intuition. And, being overly cautious in stating someone has it or doesn't could create a different risk.

In regards to available services, upon reading information available, it is apparent that we are basing the funding and addition of services based on a study from 2005. Where this issue is coming to a head right now is that we have had over 175k troops serving in Iraq during some of the heaviest combat. That means that there is a greater number at risk than any 2005 study can assess and recommend for. that goes the same for Afghanistan where, right now, combat and attacks are up significantly for the year.

Our problem lies in the several aspects:

1) No one could know in 2005 that more troops would be sent than have been sent on average. Thus, no one could no the added burden. The same goes for the post 2003 invasion. Who could know how long it would go on? but, you would think we had learned our lessons from the past (we're not really that good at it).

2) Our budgeting practices. In order for certain programs to be funded, there must be some very specific numbers and assessment tied to it. These take time and, of course, invariably are based on old data. We are not very quick or flexible with this process. It's meant to protect against abuse, but, based on our spending on this compared to other things, it does appear under represented and under appreciated.

3) Our budgeting practices based on number two and then being presented as the budget for the next year well in advance of that year, leaves little room for that flexibility. It is why we need to be more proactive in reviewing programs and requesting the passing of bills within the entire year to insure these services get proper attention and funding as they are needed, not somewhere down the road.

by kat-missouri on November 18, 2007 7:34 AM

---

kat-missouri... as for the "mission ready" argument, that is all part of the current but we- hope-they-are-changing culture. Wars and readiness have to do with warm bodies; mental health status has never been a big component unless it's to bully and punish those who dare speak such heresy.

as for anticipating the need for budgeting purposes, the services (and the VA) have always known what was down the pike and it is/was a matter of wilfully not budgeting or preparing for the mental health needs of service members and veterans. From the outset -- based on numbers of the National Vietnam Veterans' Readjustment Study conducted 20+ years ago -- everyone knew (or should have known) that at least 11% of combat veterans would develop a level of PTS/PTSD sufficient to require treatment (with 20% or more experiencing symptoms); with 1.7 million having served in OIF and OEF, that is more than 185,000 who will at some point require treatment (and 340,000 symptomatic)-- and if I can run those numbers, so can DoD and the VA and (hopefully) members of our illustrious Congress. The 2003 and 2005 study numbers were simply validation of what should have been easily identified as a budget need. It was/is the culture of denying the problem that has led to the current treatment morass.

the perfect example is 3ID: on its third deployment to Iraq... 40,000 active duty troops and more counting NG & Res. units + 80,000 contract employees and family members. Martin Army Hosp. (Benning) has 13 in-patient psych beds. that is not a typo: 13. If only 11% of the soldiers require treatment that is at least 4,400 soldiers... and if even 1% require some form of intensive treatment, they need 44 beds. If those numbers are even reduced by half for argument's sake, that's still almost double the number of current beds. My reading and feedback tells me that the situation at other Army bases is comparable. IMO It's not the budgeting process: it's the refusal (not just a failure) to identify a need, plan for it and request the appropriate funding.

by Some Soldier's Mom on November 18, 2007 9:46 PM

---

Unfortunately the numbers reported on PTSD are most likely very low as they rely on people seeking help. Men are far les likely to seek treatment for mental health issues than their female counterparts thus skewing the numbers. As far as the medical proof of PTSD, it is becoming irrefutable as pre-test, post test data of brain scans is conducted. We are seeing changes a decrease in the mass of the hippocampus post stressful event which leads to poor emotional regulation, memory difficulty, etc. Now that they are able to target how the brain is effected, the good news is that the guess work on treatment decreases and they should be able to create more effective interventions.

by Therapist1 on November 19, 2007 9:34 AM

---

therapist, thank you for your input. I really do think this has spawned another whole list of posts that can be created on the subject. Causes and treatment can demystify the situation for all involved, soldiers and families alike. We definitely need to get past the "hocus pocus" aspect of the condition and into the biological reality.

Some Soldiers' Mom...I understand estimations and projections, I just don't think the GOA, VA, budgeting processes is good at it unless they are basing it on what they feel are "real" numbers. For instance "these are actual percentages seen in this time frame" extrapolate to create expectations. I don't think they are working off of Vietnam period numbers at all, but numbers within the current war period.

That is my expectation based on working with the government over Medicare and Medicaid projections, utilization and funds. They are hard wired for hard numbers and they do not like to deviate from that.

Further, in 2005, they could not have known that we would surge another 30k plus rotations since it wasn't planned until 2006. Not that it is a defense, just working with the "hard number" aspects.

Then they try to factor in that many who serve go more than once as if this reduces the number that might need services, when it actually increases the probability.

As for the "inpatient" bed situation, I am torn over it. I think that some numbers do show that an increase is needed. yet, there is reluctance to make "inpatient" the basis for treatment when it is a lot about re-adjustment to the outside world. Some of this is twisted up with trying to create the right processes for treatment and therapy.

But, I'll agree with you in the long run, it needs increased. It's why I am perturbed about the hold up on the VA budgeting. Many additional beds were going to be added and some more outside programs with this budget. No one can even begin to go forward without the budget approved. That's a problem.

by kat-missouri on November 19, 2007 1:37 PM

---

kat-missouri... just by way of info, soldiers in excess of the 13 beds requiring intensive (in patient) hospital treatment at benning are sent to a civilian facility in columbus, ga... and there are anywhere from 50-75 soldiers at that facility 365 days a year with a constant population (which includes those soldiers who have found basic training too stressful)... and the rumor is that the cost is near $1000 PER DAY PER SOLDIER... but at least the approved "head count" and payroll for Martin Army Hosp. is on budget.

by Some Soldier's Mom on November 19, 2007 8:50 PM

---

� Dismissed, Soldier!