Army & VA can't keep up with wounded
Find a Conversation
| Tue, 08-10-2004 - 8:30am |
THE CONFLICT IN IRAQ
Army and VA can't keep up with numbers of badly wounded soldiers and
their families awaiting benefits.
http://www.latimes.com/news/nationworld/nation/la-na-wounded8aug08.story
By Esther Schrader,
LA Times Staff Writer
8 August 2004
MANASSAS PARK, Va.  The yellow ribbons are faded and fraying outside the
neatly appointed house where Jay Briseno lies tethered to a respirator, his
nearly motionless, 21-year-old body a shrunken shadow of the young man who last
year went marching off to war.
Shot in the back of the neck in Baghdad on a sweltering afternoon in June 2003,
Briseno was rushed with all the speed and efficiency the Army could muster to
one hospital after another, brought back from multiple heart attacks and
strokes.
But Briseno isn't a soldier anymore. He is a veteran, facing a lifetime of
excruciating disability. The efficient war-fighting machine he was a part of has
moved on. His care is left to his parents and sisters, who, bent over his bed
day and night, are struggling to adjust.
For Briseno and his family  as for thousands of others wounded in the Iraq
war  the transition from the life they knew as soldiers to a future as
disabled veterans is filled with frustration and pain. The military is more
efficient than ever in treating its wounded. But after the battle-scarred leave
Army hospitals, they often find themselves on their own in an unfamiliar and
difficult-to-navigate thicket of benefits and services.
Since the wars in Afghanistan and Iraq began, 6,239 troops had been wounded in
action, according to a recent Pentagon count. Of those, 57% were so severely
injured that they were unable to return to duty. Medically retired from active
duty military service, they need immediate assistance from the Department of
Veterans Affairs healthcare system.
The surge of newly disabled veterans represents a challenge of a magnitude
unseen since Vietnam.
Aware of potential pitfalls, the Army and the VA have started programs to reach
out to the most severely wounded soldiers. Among the steps being tried are
putting social workers in hospitals where the severely wounded are being
treated, adding benefits experts willing to meet bedside with soldiers and
creating call centers that offer advice and help after the injured are sent
home.
The pilot programs are small and nascent, and both the Army and the VA
acknowledge they are not nearly enough.
Congress has yet to allocate funds for the programs, which are being covered out
of general soldier and veterans healthcare budgets. But already, case workers
say, they have helped some former soldiers get pay owed them and helped others
get needed medical equipment and services.
In the case of Briseno, Army officials interceded with the VA to get him a
specialized bed that his parents said made it far easier to care for him. The
bed has a built-in scale so a nurse can weigh Briseno without moving him, and a
platform that makes it easier to turn him the dozen times a day needed to avoid
bedsores.
"From the beginning all we got from the VA was lip service," said Joe Briseno,
who quit his job to care for his son at home full time. "They questioned every
piece of equipment we asked for. They told us Jay should be in an institution.
They told us to give up on him. We were desperate when these people from the
Army called and said, 'Do you have what you need? Is there any way we can help?'
"
Veterans Administration and Army officials say privacy laws prevent them from
discussing Briseno's case. But they acknowledge that with soldiers as severely
wounded as Briseno being evacuated from Iraq regularly, questions about the
adequacy of the system to care for them over the long term are real.
"We found when we looked into this that there seems to be a gap in helping
people transition into private life," said Brig. Gen. Michael C., who as
director of the Army's Human Resources Policy Directorate is in charge of that
service's new program.
"In previous wars the programs existed, but there was no one who was an advocate
for the soldier, so the soldier basically navigated through the programs his or
herself," Flowers said. "That's awfully tough when you are in the hospital and
people say, 'Sign this. Sign that. Everything will be OK,' and then you get out
and you're suddenly at the VA and people say, 'Where are your medical records?
Where is this? Where is that?' And you don't know."
In looking to the government for their healthcare needs, new veterans follow a
long line of their predecessors who, since the Civil War, have been assured that
the country they fought for would make its best efforts to take care of them.
But there have always been difficulties in following through. And the VA is a
difficult bureaucracy to navigate in even the best of circumstances, much less
when dealing with devastating injuries.
For decades, the VA, with 7.5 million veterans enrolled, has struggled to keep
up. At any one time, more than 3,000 vets are waiting for their first visit to
the doctor. Those whose injuries from battle qualify them for disability
compensation often wait six months to two years to receive it. The VA has taken
steps to cut the wait for veterans of the Iraq and Afghanistan wars, said Terry
Jemison, a VA spokesman. In recent months, it has begun to station benefits
experts at the military bases of returning units. Newly discharged soldiers who
have been helped by these experts have waited 54 days on average to get their
first veteran disability compensation checks.
But with the VA's costs increasing by 10% to 15% a year, with aging facilities
in need of modernization and with the newly disabled veterans draining
resources, "the system is under a strain, a serious strain," said David Uchic,
spokesman for Paralyzed Veterans of America, which was founded in 1946 to
represent soldiers with spinal cord injury or disease.
"Having new patients coming into the system puts a strain on a system that is
already under pressure," Uchic said. "It doesn't just end with them going to
Walter Reed and being treated. This is a
lifelong situation for them for the next 60 to 80 years. So is the system going
to be ready to serve them for all those years? That is the question."
At Walter Reed, most often the first stop in the United States for soldiers in
need of extensive medical treatment, VA social workers have been meeting with
injured soldiers and their families about healthcare benefits since last summer.
"This is really a new idea. Before, we would wait for new veterans to knock on
our door. Now we are going out to find them," said Xiomara Telfer, one of the
social workers who is spending time with patients at Walter Reed.
But the VA program is still small  a handful of social workers at Walter Reed
and a few Army medical centers. Telfer and others say that, judging by their
experiences, problems with delayed paychecks, confusion about benefits and
entitlements are rife.
"There are holes we are trying to plug," said Dr. Michael J. Kussman, acting
deputy under secretary for health for the veterans health administration of the
VA. "The flow of information from the Department of Defense to the VA is
something that both agencies are working hard on improving. We're trying to
raise the bar."
The VA has not allocated any money for the effort; the social workers it has
assigned were already on staff. The Army's program  called the Disabled
Soldier Support System  is run by fewer than 10 people on a budget of $1
million this fiscal year.
It was born when Gen. George W. Casey Jr., then the Army's vice chief of staff,
visited recovering soldiers at Walter Reed and was struck by their anxiety and
confusion about what lay ahead. Since it was started last fall, the program's
small staff has been able to reach out to nearly 200 severely wounded soldiers.
Crammed into a crowded office suite in Rosslyn, Va., staff members spend much of
their time struggling to locate wounded soldiers who have been discharged.
The Army doesn't keep track of their addresses, and the Veterans Administration
doesn't keep track of their disability status in a way that would help pinpoint
those most in need. To fill in the gaps, employees have gotten creative â€â€
combing through newspaper articles and databases to locate the most seriously
wounded former soldiers and get them help.
Working under banners that say "Army Families Are Special," and "We Love Our
Troops," two women, both wives of soldiers, take 60 calls a day from wounded
soldiers seeking help. One spent four months unraveling a problem that had
prevented a soldier who lost a limb in the war from getting paid for six months.
Another got a former soldier who lost both legs and his sight into Braille
classes. The young man had been sitting at home since getting out of the
hospital, depressed and confused. Now he is working with the VA to build a home
that meets his physical needs.
"We really pushed ourselves into this guy's life. We knew he needed help," said
Col. Jacqueline E. Cumbo, director of the program. "We'll continue to follow
this service member until he says, 'I no longer need your services.' This is not
a one-time shot."
Flowers said he was proud of the program's initial successes but acknowledged it
was only a beginning. "It is not enough," he said. "This just has to grow."
Kristopher Atherton, 24, lost his left arm on July 26, 2003, when an improvised
explosive device hit the Humvee he was driving near Abu Ghraib. With the remains
of his arm dangling, he clenched a rag in his mouth to blunt the pain and drove
another 20 minutes to get himself and his passengers to a hospital.
"I had a lot of things going for me," Atherton, now living in Orting, Wash.,
said of that day. "About a month before I got injured my daughter was born. I
had not seen her yet. I was thinking about coming home alive at least and making
sure everybody else comes home. I had a newborn daughter I hadn't seen. I didn't
know about the other guys. Maybe they had someone they hadn't seen."
Atherton spent five months at Walter Reed getting what he said was excellent
care, even though the amputee ward was severely understaffed at the time. He
said it was not until he got out of the hospital and left the Army that his
troubles began.
For almost two months, he wasn't paid at all. He arrived at Ft. Riley, Kan.,
where his family was waiting, and was told he had to be out of his free, on-post
housing in 60 days.
"There were times like that I didn't know who to talk to, but Hank helped
me out when he came into the picture," said Atherton, referring to Hank
Minitrez, one of the civilians working to help the newly Army disabled veterans.
Within a month, the new Army support program found Atherton and his wife a
townhouse in Orting and got his pay reinstated.
They also helped him get a specially outfitted car through a VA program he
hadn't been aware of. The VA paid $11,000 of the total cost of his 1999 Jeep
Cherokee.
A local American Legion post gave him $1,000.
He and his wife are still struggling. Changing diapers is nearly impossible
one-handed, he says, and Atherton winces when he visits friends who are able to
toss his daughter, squealing with delight, up in the air.
But Atherton said the help from the Army and from social workers with the VA had
made a difference. Starting in September, the VA will be putting him through
school  first at a community college and then at St. Martin's College  to
study civil engineering.
The future is far more limited for Jay Briseno.
In his parents' home, he lies in his bed, a stuffed animal from his childhood
tucked into his motionless arms.
A photo of him in uniform rests on the mantle nearby. Although conscious, he is
unable to move and his ability to communicate is severely impaired.
His teenage sisters have dropped many of their after-school activities to help
out. The deacon of their church comes by three times a week.
His mom and dad don't stay in their bedroom anymore  they sleep on a futon
next to their son's bed to care for him through the night.
They have to: The money they get from the VA is only enough to pay for 19 hours
a day of nursing care and he needs help all 24.
If you want other stories on this topic, search the Archives at
latimes.com/archives.
