This is just the beginning. You may think that nine years after troops were sent into Afghanistan that this would be close to the end but then you’d have to think that all other veterans had been taken care of. The fact is, they haven’t been. There were many Vietnam veterans unaware of what was “wrong” with them along with many more wanting nothing to do with the VA. They had heard horror stories about claims being denied leading them to believe they would be subjecting themselves to even more suffering turning to the government they no longer trusted. All of this topped off with the stigma hanging over their heads of being labeled as a “mental cases” or “crazy Nam vet” not worth much at all. It has taken over 40 years to make up for one year of their lives in hell yet there are many more who have not gotten the message yet that help and hope is waiting for them.
The other issue is that they know they will have to wait in a very long, ever growing, line. They will stand behind a quarter of a million men and women waiting over 125 days just to be told if their claim is approved or not. Most of the time when it is finally approved, they do not receive the 100% for a service connected disability like PTSD preventing them from working. They have to fight for the rest of the percentage they should be entitled to. Others will wait until their claim works to the top of the pile only to be informed their claim has been denied or more paperwork is needed to be done.
PTSD claims alone have increased 125% and there have been 200,000 new Agent Orange-related claims, only 30,000 of which have been decided, the department said.
New claims flow into the sea of other claims from other groups of veterans because when men and women were sent into combat, no one thought to make sure the VA was ready for the increase in need war would create.
Veterans Affairs faces daunting job of reducing medical claims backlog
From Jennifer Rizzo, CNN National Security Producer
December 17, 2010 11:20 p.m. EST
A quarter-million medical claims have been in the system for 125-plus days, official says
Secretary Shinsheki had vowed to eliminate that delay time by year’s end
Changes in guidelines contributed to a higher number of claims
Washington (CNN) — Veteran claims for medical benefits are still piled high at the Veterans Affairs Department, despite a major push from the secretary of the department for quicker claims processing.
There are a quarter of a million claims in the system that have not been assessed within 125 days of being filed, according to Mike Walcoff, acting under secretary for benefits. Backlogged claims amount to more than one-third of the cases in the system, a similar ratio to last year.
Veterans Affairs faces daunting job of reducing medical claims backlog
While they wait, bills are not paid if they are unable to work. This adds to the long list of symptoms PTSD comes with. Depression is part of PTSD. Waiting month after month to hear if their service will be honored or not feeds depression along with paranoia because they know what the truth is and justice would not allow them to suffer instead of being taken care of. They see their families suffer because they can no longer provide for them. This builds all of the other symptoms of PTSD as they feel their lives are being threatened while watching it all fall apart.
In combat, the only safe emotion is anger. When PTSD takes over, that is the strongest emotion allowed to come out. The extra battle of fighting the VA feeds anger at the same time it robs them of hope. Advocates tell them the sooner they get treated the better but what we don’t tell them is they will go through hell to get treated. We don’t tell them that while they are suffering, seeing it all turn to crap, they will have to face months, if not years, of fighting the VA to get it. We won’t tell them that getting the help they need may take longer than the reason they need help in the first place.
For Vietnam veterans, most of them served 12 months overseas. One year in hell caused a lifetime of suffering in far too many. According to a 1978 publication from the Disabled American Veterans’ study, Readjustment Problems Among Vietnam Veterans by Jim Goodwin Psy.D, there were well known issues that have since been forgotten as if none of these studies had ever been published. While veterans wait, millions are wasted on repeating what was already known. By 1978 there were 500,000 Vietnam veterans suffering Post Traumatic Stress Disorder even though the VA had no yet accepted the term. These men and many female veterans ended up fighting to heal at the same time they spent years trying to get the VA to help them heal, which made it all worse.
Trauma is Greek meaning “wound” and it was used because PTSD comes from an outside force after exposure to life threatening events. It really means a wound to a person’s emotional part of their brain caused by the stressful situations creating disorder. In other words, had they lived without the traumas of combat, or in the case of civilians without exposure to other causes, they would not be suffering. But the process of filing claims with the VA and then waiting for their claims to be approved adds more trauma into their lives instead of easing their already wounded minds. If help was waiting for them there would have been less chronically ill lacking the ability to support themselves. It all gets worse as time goes by because what happens in their lives adds to it. The last thing they need is a prolonged battle with the VA.
“The Evolution of Post Traumatic Stress Disorder, Jim Goodwin Psy.D
It was not until World War 1 that specific clinical syndromes came to be associated with combat duty. In prior wars, it was assumed that such casualties were merely manifestations of poor discipline and cowardice. However, with the protracted artillery barrages commonplace during “The Great War” the concept evolved that high air pressure of the exploding shells caused actual physiological damage, precipitating the numerous symptoms that were subsequently labeled “shell shock.” By the end of the war, further evolution for the syndrome being labeled “war neurosis.”
It was also in this study that WWII was addressed going on to say that,
At one point in the war, the number of men being discharged for psychiatric reasons exceeded the total number of men being newly drafted. (Tiffany and Albertson 1967) During WWII 23 percent of he evacuations were for psychiatric reasons.
Yet there were changes made by the Korean War
During the Korean War, the approach to combat stress became even more pragmatic. Due to the work of Albert Glass (1954) individual breakdowns in combat effectiveness were dealt with in a very situational manner. Clinicians provided immediate onsite treatment to affected individuals, always with the expectation that the combatant would return to duty as soon as possible. The result was gratifying.
This response time factor has been known for many years and has been practiced in the civilian world when trauma teams respond immediately after a crisis for the survivors as well as the first responders. The military however has forgotten this lesson which has created more and more troops in need of help but not getting it. When they are lucky they are given medications that include warning labels suggesting it is dangerous to even drive while taking them but these soldiers are not only driving, they are firing and targeted by weapons. Very few receive help from a clinician offering therapy.
But in Korea, psychiatric evacuations dropped to only six percent (Bourne, 1970) It finally became clear that the situational stresses of the combatant were the primary factors leading to a psychological casualty.
Vietnam was different
Surprisingly, with American involvement in the VIetnam War, psychological battlefield casualties evolved in a new direction. What was expected from past war experiences and what was prepared for–did not materialize. Battlefield psychological breakdown was at an all time low, 12 per 1,000. (Bourne 1970)
With troops in Vietnam, older veterans were experiencing the revisiting of ghosts.
As the war continued for a number of years, some interesting additional trends were noted. Although the war progressed, a previously obscure but very well documented phenomenon of World War II, some men suffering fro acute combat reactions, as well as some of their peers with no such symptoms at war’s end, began to complain of the common symptoms. These included intense anxiety, battle dreams, depression, explosive aggressive behavior and problems with interpersonal relationships, to name a few. These were found in a five year follow-up (Futterman and Pumpain-Mindlin 1951) and in the 20 year follow-up (Archibald and Tuddenham 1965)
Even with what was known all these years there are studies being redone to death. A recent study suggested there is no tie between PTSD and sleeplessness but this would mean that millions of family members must not be hearing their veteran scream in the middle of the night or wander around the house in the dark on patrol. This report just came out.
Sleep and PTSD: No firm ties found
By MARK BRUNSWICK, Star Tribune
Last update: December 17, 2010 – 7:35 PM
Time after time you hear stories of people with PTSD complaining of sleepness nights. It fits the classic conception of the tortured sufferer, awakened in a sweat from visions of some calamity or tragedy.
There’s no dispute that people with PTSD (post-traumatic stress disorder) feel that there is a connection between the illness and their inability to get to sleep. But a study conducted by the Minneapolis VA hospital says the evidence is not so clear. While preliminary, the study, conducted by Minneapolis VA psychiatrist Dr. Joseph Westermeyer and his colleagues, shows that more work needs to be done to reach a definitive conclusion.
Sleep and PTSD
This would also mean that troops deployed with medications to help them sleep are no longer needed since the headline says there is no tie between PTSD and sleep problems. Just goes to show what was known back then has been forgotten now. But this is nothing new.
Vietnam had several unique things going on. One was DEROS, Date of Expected Return from Overseas, which was 12 months for soldiers and 13 months for Marines. This kept them thinking that if they survived until DEROS, they could just go back to the lives they had before. It was also termed a war fought by teenagers, which came with the additional problem of the part of the brain controlling the emotions is not fully developed until the age of 25.
The frontal lobe is home to our cognitive thinking, and it is this process that determines and shapes an individual’s personality. In human beings, the frontal lobe attains maturity when the individual is around the age of 25. This means that by the time we are 25 years of age, we have achieved a level of cognitive maturity. The frontal lobe is extremely vulnerable to injury due to its location as it’s in front of the central cranium. The frontal lobe is made up of the anterior portion (prefrontal cortex) and the posterior portion, and is divided from the parietal lobe by the central sulcus. The anterior portion is responsible for higher cognitive functions, and the posterior portion consists of the premotor and motor areas, thus, governing our voluntary movements. The functions of the frontal lobe include reasoning, planning, organizing thoughts, behavior, sexual urges, emotions, problem-solving, judging, and organizing parts of speech and motor skills (movement).
Back to the DAV study and Vietnam veterans
What was especially problematic was that this was America’s first teenage war. (Williams 1979) The age of the average combatant was close to 20 (Wilson 1979) According to Wilson (1978) this period for most adolescents involves psychological moratorium (Erickson 1968) during which the individual takes some time to establish a more stable and enduring personality structure and sense of self. Unfortunately for the adolescents who fought the war, the role of combatant verses survivor, as well as the many ambiguous and conflicting values associated with these roles, led to a clear disruption of this moratorium and to the many subsequent problems that followed for the young veterans.
We still see this happening today when deployments begin right out of high school in many cases and continue on until enlistments are ended. Redeployment study by the Army found that redeployments increased the risk of PTSD by 50% for each time back. Yet this practice goes on when we still have not taken care of the older veterans.
Vietnam Veterans of America have filed suit on behalf of soldiers discharged under “personality disorders” but the hidden truth is, they were victims of this practice as well but no one was fighting for them. To this day it is hard to grasp how many were given less than honorable discharges from Vietnam when it was PTSD just as we see today.
Many men, who had either used drugs to deal with the overwhelming stresses of combat or developed other behavioral symptoms of similar stress-related etiology, were not recognized as struggling with acute subtype. Rather their immediate behavior had proven to be problematic to the military and they were offered an immediate resolution in the form of administrative discharges often with the diagnosis of character disorders. Kormos 1978)
The administrative discharge proved to be another method to temporarily repress any further overt symptoms. It provided yet another means of ending the stress without becoming an actual physical or psychological casualty. It therefor served to lower the actual incidence of psychological breakdown as did the DEROS. Eventually, this widely used practice came to be questioned and it was recognized that it had been used as a convenient way to eliminate many individuals who had major psychological problems dating from heir combat service. (Kormos 1978)
That was what we knew yet it is still going on. The claim backlog is the direct result of two major storms colliding. A congress that was not concerned with the number of casualties who would need to go to the VA and a military with no plan to address the redeployments of young troops. The truth is they were willing to accept the loss of their lives due to enemy forces as well as being wounded by them, but they were not asked if they were willing to suffer because the government was not ready for them. To ask them to come home after care was denied while in the military is reprehensible but it is not new as we can see by what the Vietnam Veterans faced yet they still wait for help, for healing, for justice and care this nation promised them at the same time they fight to make sure no veteran from another war has to suffer the way they did. In the claim backlog pile are new veterans but along with them are veterans waiting and suffering for all these years. Some may say they can wait longer than but considering we lose 18 veterans a day to suicide, time is running out and the pile will get smaller because more will die waiting.
Posted by Chaplain Kathie on December 18, 2010, With 3018 Reads Filed under Veterans Affairs. You can follow any responses to this entry through the RSS 2.0. You can skip to the end and leave a response. Pinging is currently not allowed.