Army & VA can't keep up with wounded

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Registered: 05-28-2003
Army & VA can't keep up with wounded
Tue, 08-10-2004 - 8:30am
I'll leave it to you to decide what part of this story is the worst...

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 —

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.

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