thedrifter
08-23-03, 07:01 AM
Coming Home: Disabled Soldier Faces Battle in Seeking Benefits
Coming Home: Disabled Soldier Faces Battle in Seeking Benefits
12 August 2003
By ROBERT TOMSHO and RACHEL ZIMMERMAN
Staff Reporters of THE WALL STREET JOURNAL
BLUFFTON, Ind. -- Jason Stiffler, a high-school dropout, hoped the U.S. Army could help him make something of himself. But two years after enlisting, the 20-year-old veteran of the Afghanistan war struggles just to care for the tiny garden outside his rented trailer home.
On a recent afternoon, Mr. Stiffler eased himself from his crutches to weed the flowers, dragging himself on his bottom. Half an hour is usually all he can take. "I still can't feel parts of my legs," says Mr. Stiffler, a gaunt man with dark, buzz-cut hair.
Mr. Stiffler was injured while manning an Army watchtower near Kandahar in April 2002: He plunged to the ground, leaving him in a coma for days and without memory of the incident. The Army says it was an accident, although it has never provided the veteran with details.
He continues to suffer from partial paralysis, memory loss and episodes of post-traumatic stress disorder. He and his wife have struggled to make ends meet. After missing payments on their car, they lost it in January. Trying to save on heat, they dragged mattresses into the living room of their trailer and slept around a space heater.
Since his discharge last October, Mr. Stiffler has relied on payments from the Department of Veterans Affairs, or VA, to provide for his wife and toddler son. When he argued that he deserved more than the $731 a month he was receiving -- because his disabilities were more serious than doctors originally thought -- he ran up against a vast medical bureaucracy. The wait for final disposition of his disability claim and appeal took seven months, a timetable that the VA concedes would have been even longer if it wasn't prompted to act by inquiries from The Wall Street Journal for this article.
Mr. Stiffler's story shows the human toll when critical benefits judgments are delayed, and the confusion veterans and their families often feel when they're forced to confront bureaucracy. It also illustrates some of the flaws in the $60.4 billion veterans agency, and how those problems could prove overwhelming as veterans of the conflicts in Afghanistan and Iraq start to enter the VA's rolls.
The roughly 175,000 military personnel who have served in the war against terror have not begun to apply for VA services in big numbers. But about 50,000 of them will file disability claims in coming years, if the 30% rate of VA utilization after the Gulf War is any guide.
That will place added burdens on a system that has been swamped for years. The average wait to get a medical appointment with the VA is seven months, according to a recent survey by the American Legion. There's a backlog of 280,000 veterans awaiting a disability rating, which determines how much they should receive in benefits; 108,000 veterans are waiting to hear back on appeals of rating decisions.
One reason for the backlog: a 1996 Congressional decision that expanded benefit eligibility to all veterans. Previously, the VA had been open only to indigent veterans and those wounded or injured during service. Since the change, the number of veterans seeking VA medical services has doubled to 6.8 million, while VA spending has risen 56%.
VA Secretary Anthony Principi says he "decided something was terribly wrong" last summer. He ordered the agency to stop enrolling higher-income veterans without disabilities, and to place its priority on those with service-related injuries. The freeze is expected to lock out about 525,000 veterans by the end of 2005. The Bush administration's 2004 proposed budget also calls for new premiums and higher fees. For certain categories of higher-income veterans, for example, the budget calls for increasing drug-prescription copayments to $15, from $7. The move is expected to dissuade about 1.3 million veterans from enrolling for VA services next year.
Under Mr. Principi, who has been in office since January 2001, the agency has made progress in reducing its backlogs and speeding up claims processing, which is down to 5½ months from nearly eight a year ago. But the General Accounting Office, in May testimony to a Congressional committee, said too many veterans continue to wait too long for care and disability decisions.
Cheyne Worley, a former Army supply sergeant, filed a claim for VA disability benefits in 1991, soon after returning from the Gulf War, where he suffered injuries in a fall. The VA denied the claim, saying it couldn't locate his Army medical records. After 12 years of appeals, "I still haven't seen them," says Mr. Worley, who says he endured bouts of drug addiction and homelessness before becoming an aide to U.S. Rep. Dennis Moore, a Kansas Democrat.
A VA spokeswoman says that, while the VA didn't realize it at the time, the military medical records obtained from the Army after Mr. Worley filed his initial claim in 1991 didn't cover his last eight months or so in the service. Those medical records, which do contain information about his fall, were not located until last November. The spokeswoman said the VA cannot explain the error.
The VA system is particularly slow when it comes to assessing veterans with permanent disabilities. The agency is divided into separate medical-care and disability bureaucracies, which have a history of not communicating effectively with each other on disability cases. So, when a veteran is treated at a VA hospital, changes in his or her condition aren't automatically reported to officials who consider disability claims. As a result, those changes can't immediately be factored into claims decisions.
Moreover, in making disability decisions, the VA relies heavily on military records. But these largely consist of paper files that must be located and shipped when a request is made, slowing response times. Often files are misplaced or incomplete. "Stuff just goes into a big black hole sometimes," says Mr. Principi.
Under Mr. Principi, the VA has made a priority of fostering better cooperation and communication between its Veterans Health Administration, which operates VA hospitals, and the Veterans Benefits Administration, which makes disability and pension decisions. Last year, the VA centralized management of the two entities' information-technology operations. And, to streamline the transfer of files, the Department of Defense has begun sending certain military medical records into an electronic database that VHA doctors can tap into. But most Defense medical records are still kept only on paper and must be transferred by hand.
Jason Stiffler had no memory of his fall when he awoke from a coma at a military hospital in Germany, a few days later. From there, he was transferred to Walter Reed Army Medical Center in Washington. Mr. Stiffler and his wife made available copies of his medical records for this story, and signed waivers requested by Walter Reed, giving it permission to discuss his case. But Walter Reed spokeswoman Beverly Chidel declined to answer questions about him, citing privacy concerns.
After just over a month of daily therapy at Walter Reed, Mr. Stiffler was using a walker by the end of May 2002. But he continued to complain about insomnia, irritability and depression, hospital records show, adding that he frequently lost his train of thought and forgot things. Walter Reed doctors said in the records that his mental capacity had been damaged and warned that psychological factors could hamper his physical recovery. But they also projected that such problems would ease as Mr. Stiffler continued regaining use of his legs.
Toward the end of his stay at Walter Reed, Mr. Stiffler began his trip into the military's health-care bureaucracy. On Aug. 2, 2002, an Army review board determined that Mr. Stiffler was too injured to return to active duty. He was placed on the "temporary disabled retirement list," meaning he could go back to civilian life but would have to be periodically re-evaluated for up to five years to see if he was fit to return to duty.
The Army reviews the case of every soldier who has been injured badly enough to possibly be discharged, and assigns the soldier a disability rating, in 10% increments up to 100%. Because of the loss of strength and sensation in Mr. Stiffler's legs, the board deemed him 40% disabled, but boosted the rating to 50%, the minimum rating required to be placed on the temporary disabled retirement list. In related records, the board indicated, without explanation, that Mr. Stiffler's psychological condition wasn't severe enough to boost his rating.
continued.........
Coming Home: Disabled Soldier Faces Battle in Seeking Benefits
12 August 2003
By ROBERT TOMSHO and RACHEL ZIMMERMAN
Staff Reporters of THE WALL STREET JOURNAL
BLUFFTON, Ind. -- Jason Stiffler, a high-school dropout, hoped the U.S. Army could help him make something of himself. But two years after enlisting, the 20-year-old veteran of the Afghanistan war struggles just to care for the tiny garden outside his rented trailer home.
On a recent afternoon, Mr. Stiffler eased himself from his crutches to weed the flowers, dragging himself on his bottom. Half an hour is usually all he can take. "I still can't feel parts of my legs," says Mr. Stiffler, a gaunt man with dark, buzz-cut hair.
Mr. Stiffler was injured while manning an Army watchtower near Kandahar in April 2002: He plunged to the ground, leaving him in a coma for days and without memory of the incident. The Army says it was an accident, although it has never provided the veteran with details.
He continues to suffer from partial paralysis, memory loss and episodes of post-traumatic stress disorder. He and his wife have struggled to make ends meet. After missing payments on their car, they lost it in January. Trying to save on heat, they dragged mattresses into the living room of their trailer and slept around a space heater.
Since his discharge last October, Mr. Stiffler has relied on payments from the Department of Veterans Affairs, or VA, to provide for his wife and toddler son. When he argued that he deserved more than the $731 a month he was receiving -- because his disabilities were more serious than doctors originally thought -- he ran up against a vast medical bureaucracy. The wait for final disposition of his disability claim and appeal took seven months, a timetable that the VA concedes would have been even longer if it wasn't prompted to act by inquiries from The Wall Street Journal for this article.
Mr. Stiffler's story shows the human toll when critical benefits judgments are delayed, and the confusion veterans and their families often feel when they're forced to confront bureaucracy. It also illustrates some of the flaws in the $60.4 billion veterans agency, and how those problems could prove overwhelming as veterans of the conflicts in Afghanistan and Iraq start to enter the VA's rolls.
The roughly 175,000 military personnel who have served in the war against terror have not begun to apply for VA services in big numbers. But about 50,000 of them will file disability claims in coming years, if the 30% rate of VA utilization after the Gulf War is any guide.
That will place added burdens on a system that has been swamped for years. The average wait to get a medical appointment with the VA is seven months, according to a recent survey by the American Legion. There's a backlog of 280,000 veterans awaiting a disability rating, which determines how much they should receive in benefits; 108,000 veterans are waiting to hear back on appeals of rating decisions.
One reason for the backlog: a 1996 Congressional decision that expanded benefit eligibility to all veterans. Previously, the VA had been open only to indigent veterans and those wounded or injured during service. Since the change, the number of veterans seeking VA medical services has doubled to 6.8 million, while VA spending has risen 56%.
VA Secretary Anthony Principi says he "decided something was terribly wrong" last summer. He ordered the agency to stop enrolling higher-income veterans without disabilities, and to place its priority on those with service-related injuries. The freeze is expected to lock out about 525,000 veterans by the end of 2005. The Bush administration's 2004 proposed budget also calls for new premiums and higher fees. For certain categories of higher-income veterans, for example, the budget calls for increasing drug-prescription copayments to $15, from $7. The move is expected to dissuade about 1.3 million veterans from enrolling for VA services next year.
Under Mr. Principi, who has been in office since January 2001, the agency has made progress in reducing its backlogs and speeding up claims processing, which is down to 5½ months from nearly eight a year ago. But the General Accounting Office, in May testimony to a Congressional committee, said too many veterans continue to wait too long for care and disability decisions.
Cheyne Worley, a former Army supply sergeant, filed a claim for VA disability benefits in 1991, soon after returning from the Gulf War, where he suffered injuries in a fall. The VA denied the claim, saying it couldn't locate his Army medical records. After 12 years of appeals, "I still haven't seen them," says Mr. Worley, who says he endured bouts of drug addiction and homelessness before becoming an aide to U.S. Rep. Dennis Moore, a Kansas Democrat.
A VA spokeswoman says that, while the VA didn't realize it at the time, the military medical records obtained from the Army after Mr. Worley filed his initial claim in 1991 didn't cover his last eight months or so in the service. Those medical records, which do contain information about his fall, were not located until last November. The spokeswoman said the VA cannot explain the error.
The VA system is particularly slow when it comes to assessing veterans with permanent disabilities. The agency is divided into separate medical-care and disability bureaucracies, which have a history of not communicating effectively with each other on disability cases. So, when a veteran is treated at a VA hospital, changes in his or her condition aren't automatically reported to officials who consider disability claims. As a result, those changes can't immediately be factored into claims decisions.
Moreover, in making disability decisions, the VA relies heavily on military records. But these largely consist of paper files that must be located and shipped when a request is made, slowing response times. Often files are misplaced or incomplete. "Stuff just goes into a big black hole sometimes," says Mr. Principi.
Under Mr. Principi, the VA has made a priority of fostering better cooperation and communication between its Veterans Health Administration, which operates VA hospitals, and the Veterans Benefits Administration, which makes disability and pension decisions. Last year, the VA centralized management of the two entities' information-technology operations. And, to streamline the transfer of files, the Department of Defense has begun sending certain military medical records into an electronic database that VHA doctors can tap into. But most Defense medical records are still kept only on paper and must be transferred by hand.
Jason Stiffler had no memory of his fall when he awoke from a coma at a military hospital in Germany, a few days later. From there, he was transferred to Walter Reed Army Medical Center in Washington. Mr. Stiffler and his wife made available copies of his medical records for this story, and signed waivers requested by Walter Reed, giving it permission to discuss his case. But Walter Reed spokeswoman Beverly Chidel declined to answer questions about him, citing privacy concerns.
After just over a month of daily therapy at Walter Reed, Mr. Stiffler was using a walker by the end of May 2002. But he continued to complain about insomnia, irritability and depression, hospital records show, adding that he frequently lost his train of thought and forgot things. Walter Reed doctors said in the records that his mental capacity had been damaged and warned that psychological factors could hamper his physical recovery. But they also projected that such problems would ease as Mr. Stiffler continued regaining use of his legs.
Toward the end of his stay at Walter Reed, Mr. Stiffler began his trip into the military's health-care bureaucracy. On Aug. 2, 2002, an Army review board determined that Mr. Stiffler was too injured to return to active duty. He was placed on the "temporary disabled retirement list," meaning he could go back to civilian life but would have to be periodically re-evaluated for up to five years to see if he was fit to return to duty.
The Army reviews the case of every soldier who has been injured badly enough to possibly be discharged, and assigns the soldier a disability rating, in 10% increments up to 100%. Because of the loss of strength and sensation in Mr. Stiffler's legs, the board deemed him 40% disabled, but boosted the rating to 50%, the minimum rating required to be placed on the temporary disabled retirement list. In related records, the board indicated, without explanation, that Mr. Stiffler's psychological condition wasn't severe enough to boost his rating.
continued.........