Disabled Veterans Face A Faceless Bureaucracy
Paul Sullivan, executive director of Veterans for Common Sense, pictured here in 2007, - Paul Sullivan, executive director of Veterans for Common Sense, pictured here in 2007, has been fighting the Department of Veterans Affairs for years for having an unmanageable backlog of disability claims. He says the department's problems are only beginning. (Paul Sakuma / AP)
The Department of Veterans Affairs is struggling to cope with tens of thousands of veterans filing for disability benefits. Because there are applicants from two current wars -- plus a new wave from the first Gulf War and Vietnam -- thousands are now stuck in the clogged pipeline.
Although the department and its critics differ on exact numbers, everyone agrees that way too many vets are waiting way too long to get benefits.
Veterans Affairs Secretary Eric Shinseki is experimenting with ways to get the old, crippled bureaucracy to do better.
A Tidal Wave Of Applicants
The number of outstanding claims at the VA for service-related disabilities -- amputations, injured limbs, PTSD, brain trauma -- hovers around 500,000. Nearly 40 percent of those have been waiting on a decision for more than four months.
And to make matters worse, another 100,000 claims are waiting for a decision at the Board of Veterans Appeals. The department has responded by hiring thousands of new claims adjudicators, a kind of brute force approach.
But Paul Sullivan of Veterans for Common Sense says that won't solve the problem.
"The Department of Veterans Affairs is so complicated, it would drive a normal person insane in 3 minutes," Sullivan says.
Sullivan has been battling the VA for years over the backlog issue. For six years, he worked inside the VA. Complexity, he says, is the department's backbreaking burden, beginning with a veteran's first perplexing hurdle: a 23-page application form.
"The Department of Veterans Affairs takes three years to train a new employee on how to read that 23-page claim form," he says.
Because of the intense training, those new hires won't be online for some time. And Sullivan says the department's problems are only beginning -- he says 440,000 Iraq and Afghanistan veterans have filed disability claims.
"We expect that number to go up to about a million in the next four or five years," he says. "And more tidal waves are right behind it."
Those tidal waves will be rolled in by Secretary Shinseki's new rules allowing claims from Agent Orange exposure in Vietnam and chemical exposure in the first Gulf War. The VA acknowledges that at least 200,000 new applicants will slow down claims processing even more in the future.
A Faceless Bureaucracy
Vietnam veteran John Wood knows something about how long it can take to get benefits. He served in the Army from 1969 to 1972. In Vietnam, he was a cavalry reconnaissance scout near the border with North Vietnam, where he saw several of his fellow soldiers cut down in combat.
"It took me from 1972 to 2006 for the VA to admit that I had post-traumatic stress disorder," he says. "They were saying that I couldn't prove that I had any combat status in Vietnam, and so it couldn't possibly be post-traumatic stress disorder because I wasn't in combat, which I was."
The VA insisted that because he had been trained as a clerk, he would not have been sent into combat. But Wood was reassigned when he got to Vietnam. The burden was on Wood to prove that he had been in combat. He solicited testimonial letters from fellow soldiers and dug up after-action reports from Army records to make his case. Thirty-four years later, the VA Board of Appeals acknowledged that he had been in the shooting war and granted his claim.
Another veteran who faced a hard process was Tia Christopher, who was raped in her barracks while she was attending language school to learn Arabic. When she got out of the Navy, she went to a VA hospital for psychological help. Staff at the hospital advised her against filing for disability benefits.
"Even though we got really good health care, they told us it would be really traumatic, a re-traumatizing process to file a claim, and that you basically have to kind of defend yourself. You would basically be put on trial to do this claim. That idea scared the hell out of me," Christopher says.
But it didn't scare her enough to keep her from filing a claim, which was denied. Then, with the help of the veterans service organization Swords to Plowshares, she filed an appeal. Eight years later, she won.
For both of these vets, the VA remained a faceless bureaucracy throughout their ordeal.
Critics say it's not surprising that the VA's medical branch advised Christopher against filing a claim with the benefits branch because it would be too traumatic. There is a widespread perception that the VA stands against vets rather than for them, they say. And that's something Secretary Shinseki has set out to change.
"When the new secretary came in, one of the first things that he said to us was a recognition of the fact that many veterans do perceive us that way," says Michael Walcoff, the VA's undersecretary for benefits, "and that we need to do whatever we can do to make sure that our people understand that their role is to be an advocate for the veteran, not an adversary."
It's a tall order to turn around a huge bureaucracy encumbered by a culture and rules developed over the decades since World War II. But the VA has launched a number of pilot programs to streamline and simplify the application process.
A Possible Solution: Team Delta
One program is in the VA regional office in downtown Pittsburgh. Downstairs in the service center, row after row of white file cabinets stretch across the room, and piled on top are thick bundles of files so big they can't be put away. Paper rules at the VA; electronic files are years away as the VA builds a new system. All of this paper now lumbers back and forth between the veteran and the VA via snail mail, while veterans almost never have any face-to-face -- or even telephone -- contact with people handling their claims.
Beth McCoy, the regional office director, says the staff of the pilot program, known as Team Delta, aims to change that by actually making personal calls to veterans.
"We're surprising them," McCoy says. " 'Is this really the VA calling? No one from VA has ever called me before.' It's a positive experience for the veterans, and it's really a positive experience for our employees. Rather than working with paper files, they're working more directly with veterans."
And there are almost unheard-of face to face contacts with veterans -- contacts which, the team has discovered, can be wrenchingly emotional.
Vietnam veteran Arthur Rhone says his experience with Team Delta is the best he's had with the VA.
"They all introduced themselves to me, they're all nice people and they seem like they're concerned for me," he says. "They not here for a paycheck; they here for me."
Rhone starts his session about a PTSD claim with a tense recitation of the horrors he witnessed in Vietnam, and he ends with a story about the time a mother and daughter were stopped at an American checkpoint. The mother was a Viet Cong suspect carrying a large sum of money. Rhone's squad leader told him to use the daughter to pressure the mother to confess that she had more money hidden away.
"So they told me ... it was during the rainy season ... get the girl, jump down in the rice paddy. I'm up to here, I grabbed the girl, she's about 8 years old, and I ducked her down in the rice paddy till the mama-san told where the money was. I almost drowned her. I live with that every day of my life, OK? It's with me all the time. I wish you could take your hands and scrub it out my damn brain. You think you can do that for me? Y'all think you can help me do that?"
Rhone jams his chest with his thumb for emphasis. People in the office calm him, but when he sits to sign a document, his hand is shaking so badly he has to steady it with his other hand.
"I appreciate that, you guys. Thank you," he says.
But Team Delta has only eight people in a bureaucracy of nearly 20,000. The jury is still out on whether its personalized approach is feasible for the entire Veterans Benefits Administration.
9(MDAyNzUwMDI2MDEyNTA3MTU5NzcyNTQyNA004))
ROBERT SIEGEL, host:
From NPR News, this is ALL THINGS CONSIDERED. I'm Robert Siegel.
MICHELE NORRIS, host:
And I'm Michele Norris. All this week, we're exploring how America cares for its veterans. The Department of Veterans Affairs is struggling to cope with hundreds of thousands of vets filing for disability benefits. There are applicants from two current wars plus a new wave from the first Gulf War and from Vietnam.
The department and its critics both agree too many vets are waiting too long to get benefits. Now, the department's new leader, retired General Eric Shinseki, is experimenting with ways to get the troubled bureaucracy to do better. John McChesney has the story.
JOHN McCHESNEY: Vietnam veteran John Wood knows something about how long it can take to get benefits from the VA. In Vietnam, he was an Army reconnaissance scout. Near the border with North Vietnam, he saw fellow soldiers cut down in combat.
Mr. JOHN WOOD (Vietnam Veteran): I was, you know, having nightmares and flashbacks. I couldn't get along with people, a lot of anger issues.
McCHESNEY: Wood filed a disability claim, which was denied.
Mr. WOOD: They were saying that I couldn't prove that I had any sort of a combat status in Vietnam, and so therefore it couldn't possibly be post-traumatic stress disorder because I wasn't in combat, which I was.
McCHESNEY: So Wood on his own had to prove that he'd been in combat. He solicited letters from fellow soldiers and dug up after-action reports to make his case.
Mr. WOOD: It took me from 1972 until 2006 for the VA to admit that I had post-traumatic stress disorder.
McCHESNEY: The number of outstanding claims at the VA for service-related disabilities injured limbs, PTSD, brain trauma hovers around 500,000. Nearly 40 percent of those have been waiting on a decision for over four months. And to make matters worse, there are over 100,000 claims on appeal.
The department has responded by hiring thousands of new claims adjudicators, but Paul Sullivan of Veterans for Common Sense says that won't solve the problem.
Mr. PAUL SULLIVAN (Veterans for Common Sense): The Department of Veterans Affairs' rules are so complicated it would drive a normal person insane in about two or three minutes.
McCHESNEY: Paul Sullivan has been battling the VA for years over the backlog issue. For six years, he worked inside the VA. Complexity, he says, is the department's backbreaking burden, beginning with a veteran's first perplexing hurdle: a 23-page application form.
Mr. SULLIVAN: The Department of Veterans Affairs takes three years to train a new employee on how to read that 23-page claim form.
McCHESNEY: And, Sullivan says, the VA's problems are about to get worse.
Mr. SULLIVAN: Four hundred and forty thousand Iraq and Afghanistan veterans have filed disability claims against VA. We expect that number to go up to about a million within about the next four or five years, and more tidal waves are right behind it.
McCHESNEY: That's because Secretary Shinseki is inviting even more claims. New rules allow claims for Agent Orange exposure in Vietnam and chemical exposure in the first Gulf War.
Many veterans perceive the Veterans Benefits Administration as an opponent. Take the case of Tia Christopher. She says she was raped in her barracks while attending language school to learn Arabic. When she got out of the Navy, she went to a VA hospital for psychological help. Staff at the hospital advised her against filing for disability benefits.
Ms. TIA CHRISTOPHER (Veteran, U.S. Navy): Even though we got really great health care, they told us that it would just be really traumatic and that you'd basically have to kind of defend yourself. Like, you were going to basically be put on trial to do this claim. That idea scared the hell out of me.
McCHESNEY: But not enough to keep her from filing a claim, which was denied. Then, with the help of a veterans' service organization called Swords to Plowshares, she filed an appeal. And eight years later, she won.
Now, why would the medical branch of the VA advise Tia against filing a claim with the benefits branch? Not surprising, critics say, because there's a perception that the VA's benefits office stands against vets rather than for them. And that's something Secretary Shinseki has set out to change.
Undersecretary MICHAEL WALCOFF (Veterans Administration): When the new secretary came in, one of the first things that he said to us was a recognition of the fact that many veterans do perceive us that way.
McCHESNEY: Michael Walcoff is the VA's undersecretary for benefits.
Undersecretary WALCOFF: And that we need to do whatever we can do to first of all make sure that our people understand that their role is to be an advocate for the veteran, not an adversary.
McCHESNEY: It's a tall order to turn around a bureaucracy encumbered by a sluggish culture developed since World War II. But the VA has launched pilot programs to streamline, simplify and personalize the application process. One is in downtown Pittsburg.
(Soundbite of footsteps)
Beth McCoy, the regional office director, leads us downstairs to the service center.
Ms. BETH McCOY (Regional Office Director, Team Delta): We're looking at our primary file bank. We have outgrown this space, as far as our claims folders. As you can see, sometimes they don't even fit inside of the file cabinets.
McCHESNEY: Row after row of white file cabinets stretch across the room. All this paper now lumbers back and forth between a veteran and the VA via snail mail. Beth McCoy says the staff of the pilot program, known as Team Delta, aims to change that by actually making personal calls to veterans.
Ms. McCOY: We're surprising them. Is this really the VA calling? No one from VA has ever called me before. And that is a positive experience for the veterans, and it's really a positive experience for our employees.
McCHESNEY: And there are almost unheard-of face-to-face contacts with veterans, contacts which the team has discovered can often be wrenchingly emotional. We sat in when decorated Vietnam veteran Arthur Rhone met with a Team Delta member. He says it's the best experience he's had with the VA.
Mr. ARTHUR RHONE (Vietnam Veteran): They all introduced theirself(ph) to me, they're all nice people, and they seem like they're concerned for me.
McCHESNEY: Rhone begins his session about a PTSD claim with a tense recitation of the horrors he witnessed in Vietnam and ends with this story: the time a mother and a daughter were stopped at an American checkpoint. The mother was a Viet Cong suspect carrying a large sum of money. Rhone's squad leader told him to use the daughter to pressure the mother to confess that she had more money hidden away.
Mr. RHONE: So they told me - it was during the rainy season to get the girl, jump down in the rice paddy. Like I'm up to here, and I grabbed the girl, she was about eight years old, and I ducked her down in the rice paddy till the mama-san told where the money was. I almost drowned her. I live with that every day of my life.
Unidentified Woman: We're going to help you today. We're going to work with your claim.
Mr. RHONE: It's with me all the time. I wish you could take your hands and scrub it out my damn brain. You think you can do that for me? You all think you can help me do that?
McCHESNEY: Rhone jams his chest with his thumb for emphasis. People in the office calm him, but when he sits down to sign a document, his hand is shaking so badly he has to steady it with his other hand.
Mr. RHONE: And I appreciate that, you guys, okay? Thank you.
McCHESNEY: But Team Delta, this pilot program in Pittsburgh, is only eight people in a bureaucracy of nearly 20,000. The jury is still out on whether its personalized approach is feasible for the entire Veterans Benefits Administration.
For NPR News, I'm John McChesney.
NORRIS: Tomorrow on ALL THINGS CONSIDERED: What to do with veterans who get in trouble with the law. Transcript provided by NPR, Copyright National Public Radio.
