The Post-9/11 Veterans Educational Assistance Act is designed to offer the brave men and women who have served honorably since September 11, 2001 a level of educational benefits on par with those provided to veterans of the World War II era.

Many people enlist to earn money for college, and almost everyone signs up for the education benefits -- which, in the case of the main GI Bill, requires a service member to pay about $1,200 into the plan-- but not everyone takes advantage of it. And that buy-in is not returned even if the benefits are unused.

About 70 percent use at least some part of it, said Keith Wilson, director of the education service, but the VA does not track how many earn degrees.

An independent study found that just over half use some part of the benefits, said Ray Kelley of AMVETS, a veterans support group, and only 8 percent use all. "Congress is realizing we're not giving them the benefits we say we're giving them," Kelley said. "They only have 36 months from the time they start using it to the time they finish." That means going to school full time, year-round.

The suit claims that many disabled combat veterans are in dire need of counseling and other services they are not currently receiving from the U.S. government. Erspamer [the plaintiff's counsel] estimates that 120 veterans who served in Iraq or Afghanistan commit suicide each week. The veterans' groups are not seeking monetary damages but want reform of a health care system in which they allege a huge backlog of cases prevents veterans from receiving timely care.

A majority of the VA's counselors, doctors, social workers and psychologists "don't have the tools and the information that they need to intervene effectively with suicidal vets," said Maris, a former president of the American Association of Suicidology who has been a consultant to the Army on suicide prevention.

He was particularly critical of the VA's top health care administrator, William Feeley, who said in a pretrial deposition April 9 that the agency has no systematic national plan for suicide prevention. Feeley also said he was unaware of any methods of tracking veterans at risk of suicide and that suicide rates "are not a metric we are measuring."

Among our recommendations is that effective treatments documented in the scientific literature — evidence-based care — are available for PTSD and major depression. Delivery of such care to all veterans with PTSD or major depression would pay for itself within two years, or even save money, by improving productivity and reducing medical and mortality costs. Such care may also be a cost-effective way to retain a ready and healthy military force for the future. However, to ensure that this care is delivered requires system-level changes across the Department of Defense, the Department of Veterans Affairs, and the U.S. health care system.

They gave various reasons for not getting help, including that they worried about the side effects of medication; believe family and friends could help them with the problem, or that they feared seeking care might damage their careers.

Rates of PTSD and major depression were highest among Army soldiers and Marines, and among service members who were no longer on active duty (people in the reserves and those who had been discharged or retired from the military). Women, Hispanics and enlisted personnel all were more likely to report symptoms of PTSD and major depressions.

Last November the Pentagon opened the Defense Center of Excellence for Psychological Health and Traumatic Brain Injury in an effort to bring together education, treatment, and research.  From the Department of Defense:

The center also will set standards and assess, survey and validate DoD programs, and decide, in part, how resources are directed... Center officials are reviewing hundreds of research project proposals that hope to claim a piece of the $300 million set aside by Congress last year for brain injury research. The office also will work with the military services to see which of the many programs funded with another $600 million from Congress are working and how to direct those funds to programs most beneficial to servicemembers and families.

The day when Iraq alone can defend its shores — and protect its critical offshore oil installations — seems remote.

Iraq’s navy now has five Chinese-made patrol boats and 26 fast-attack aluminum vessels — fewer than half of which are operational. Its personnel number about 1,350, including 350 Marines.

“They think they are an elite unit, but they are not,” said Capt. Jock Alexander of the British Royal Marines, who is in charge of training Iraqi Marines to guard the 1.8-mile exclusion zone around each of the country’s two oil platforms.

The struggle to build a credible Iraqi navy is mirrored — on larger scales — by the mounting delays and costs to form a new Iraqi army and air force after Washington disbanded Saddam Hussein’s military.

While Veterans Affairs officials appreciate the support of community groups like Bobrow's, they're careful about embracing them. Because of privacy regulations, the VA can't disclose who has used their services. Often, VA employees are reluctant to even hand out flyers from fledgling groups until thoroughly checking them out.

"The veterans and their families have suffered enough. So when they put up a public profile or say they need help, we want to make sure they don't get injured again," said Patricia Matthews, a spokeswoman for the Veterans Affairs Palo Alto Health Center.

She was surprised at the men being upset at having women in their units. "I would get long responses about how useless women are in war ...; not sexist but how they don't belong there."

Men said they created sexual tension and diverted attention. They require involvement from male colleagues for their safety, for example, having to guard their showers or to calm them during a difficult time. "And I think they felt it was unfair that woman could get pregnant and go home," she says. "I was just listening, thinking this is amazing."

Donald H. Rumsfeld, who resigned as secretary of defense in late 2006, will write his memoirs for the Sentinel imprint of Penguin Group USA. Mr. Rumsfeld, 75, will cover not only his years in the Bush administration but also his experiences with Presidents Richard M. Nixon, Gerald R. Ford and Ronald Reagan; his work in the private sector; and his early life. In contrast to other recent political figures who have produced memoirs, Mr. Rumsfeld is forgoing an advance and will donate profits to a nonprofit foundation he recently established to make educational grants to young people interested in public service and establishing links between the United States and Central Asia.

The Marine Corps Times reports that Sen. Dianne Feinstein (D-Calif.) is proposing new measures that would provide homes for severely injured veterans on VA property.  The proposal came during a Senate defense appropriations subcommittee hearing where issues of long-term veterans care were raised.  Sen. Feinstein cited VA property in West Los Angeles that includes 300 acres of undeveloped land:

Feinstein said she offered VA’s West LA campus as an example because she often visits the site, but she believes such housing also could be built at other VA facilities around the country.

Feinstein and other California lawmakers have been trying to block VA from leasing out the unused land for commercial purposes, but they have not agreed on what to do with the property. Some want the land to be public park land, some have proposed building housing for homeless veterans and others have talked about leaving it completely undeveloped so it can be used by future generations.

Two of the bill's sponsors, Sens. Patty Murray, D-Wash., and Lisa Murkowski, R-Alaska, said they'd attended town hall forums for veterans where men were outspoken about their health problems, but women waited until after the meetings to whisper some of their concerns, including sexual assault.

"Women don't have to whisper to me anymore," Murray said.

“As the Department of Veterans Affairs works to ensure that those who serve our Nation are not left behind, it is essential for them to recognize the physical, mental and reproductive health challenges that face women veterans may require a different menu of services, delivered in a different way than the VA has grown accustomed to."

Writing on TheHill.com earlier this month, Rep. Stephanie Herseth Sandlin (D-S.D.) offered up a helpful set of statistics on just how many women veterans are out there serving, or having recently served:

Approximately 70,000 women have served and separated from military service in Operation Enduring Freedom or Operation Iraqi Freedom (OEF/OIF). Among this group, in 2006 nearly 37.2 percent, or 25,960 sought and received healthcare from VA since separation from military service — up from 32.9 percent (15,903) in 2005. According to the Department of Veterans Affairs, the prevalence of potential Post Traumatic Stress Disorder (PTSD) among new OEF/OIF woman veterans treated at the VA from fiscal year 2002 to 2006 has grown dramatically from approximately one percent in 2002 to nearly 19 percent in 2006.

“There’s a lot of women who have residential needs who I think are less likely to come to the VA because it’s literally spending 24-7 with guys,” Miklos Losonczy, one of two VA psychiatrists behind the creation of the treatment center, told The Sunday Star-Ledger of Newark.

Losonczy worried that women veterans who need treatment might not be seeking it because “they think the VA is all men and wonder, ‘Why would I get my military sexual trauma treatment surrounded by men?”’

For a detailed description on Military Sexual Trauma (MST), check out this info from the VA.

...from that first impact, among many on the roof, the mood was scarcely one of cool detachment, or at least not as cautioned as it might have been by the longer-term implications of what we were seeing. Part of it, no doubt, was the air show — the sheer, astonishing, overwhelming demonstration of power, more like an act of God than man, unleashing in those watching from the roof something approaching awe.

The fifth anniversary of the start of our war in Iraq is a little more than a month away. There will be retrospectives looking back to those early days of shock and awe, in addition to news analysis and the nation's self-reflection. Even a month out from the anniversary, conversations about the upcoming day seem to revolve around the same theme: "can you believe it's already been five years?"  It is a sobering thought.  And even if you believe in the war, or are staunchly at odds with its premise, five years is a unit of time to view not so much in length, but in the various phases that occurred.

The summer of 2003, as I saw it, was a honeymoon period. The optimism for Iraq's future still ran high (at least in some circles), and at the same time I could see questionable expressions on the faces of Iraq's citizens as we patrolled past them. No one knew how it would all play out. Personally the fragile tensions that held together a shaky peace ended on November 12, when a suicide bomber destroyed the building in An Nasiriyah that at one time was my platoon's headquarters.

Homecoming was also different. There were no VA scandals, or talk of PTSD, or advocacy groups comprised of Iraq veterans. We simply came home and quickly immersed ourselves back into civilian life. To watch how that has changed is to examine the evolution of the war in Iraq and on the home front. To ask a veteran about his or her experiences in Iraq yields not an overall glimpse into the war, but an occasion to see just one phase of it. This is what needs to be remembered as the anniversary coverage begins. I remember seeing soldiers entering Iraq July 2003 and feeling bad for them. They'd missed the defining war of our generation. They would spend a few months in post-invasion mopping up, and go home on the tail end of the operation. Of course, the irony in this cannot be overstated.

We have enough perspective over five years to eschew generic "looks back" for a more nuanced analysis of how our country has fared over this time. It must be broken into phases: the invasion, the time surrounding 2004's battle for Fallujah, the grinding years of 2005 and 2006, the Abu Ghraib and Haditha investigations, and the controversial surge plan that's brought us to this point. At home the fascination with the invasion's pyrotechnics has given way to simply reading of the daily casualty figures ticking away over the news wires. There's also the trends in media coverage to consider, the heightened focus of home front veterans issues, and how artistic mediums have sought to portray the war and inform us.

Looking back on the fifth anniversary means not so much seeing what happened, but understanding how we got to where we are today, and how driven we are to look at Iraq not simply as a war, but as a series of distinct eras.

The timing of deaths among WWI's final survivors continues to be remarkable as today the Associated Press reports only one WWI veteran is now alive in the United States.  This comes after the death of Harry Richard Landis, 108, who passed away Monday in a Florida nursing home.  Over the past few weeks this blog has covered the deaths of French and German WWI veterans, as well as the last American commander who fought with volunteers in the Spanish Civil War.  Our ties to that era are disappearing at an alarming rate.  Frank Buckles, 107, is now the final remaining American vet of the WWI era.

As the AP reports, Landis never served overseas but enlisted during wartime in 1918, training as a recruit for 60 days before the armistice came.  Here he recalls his unit's final march as the war ended:

“We went down through the girls college, marching down the street. We got down to the courthouse square and there was a wall around this courthouse. We got to the wall and [the drill instructor] didn’t know what to do and we were hup, two, three, four, hup, two, three, four,” Landis said, laughing at the memory. “Finally, we jumped up on the wall and kept going until we got to the courthouse — hup, two, three, four — and he said dismissed.”

The VA tried to reach out and find other survivors last year, said Jim Benson, VA spokesman. There were a few leads, but nothing panned out.

"I think it's amazing for us to realize that you have this population of individuals who served during the first great war, and at that time, it was the war to end all wars," Benson said. "Soon, we will no longer have a living contact. It will all be from the histories left behind."

• An E-4 with more than three years of service now earns $1,949.10 per month; that would rise to $2,015.40 per month on Jan. 1 under the Pentagon plan.
• An E-7 with more than 10 years of service now earns $3,263.10 per month; a 3.4 percent raise would turn that into $3,374.10 per month.
• An O-3 with more than six years of service now earns $4,763.10 per month; that officer would earn $4,925.10 per month with a 3.4 percent pay increase.

A Hospital
Veterans in the Orlando, FL area are speaking out against what they perceive as the proposed budget's lack of funds for a local VA hospital.  As the Orlando Sentinel reports:

President Bush put $120 million in his proposed budget Monday for the long-awaited Orlando VA hospital, but area veterans said they were disappointed that more of the nearly $600 million needed will not come right away.  Michael Kussman, undersecretary of health at the Department of Veterans Affairs, said $120 million is all the agency needs this year to begin work on the facility...But area veterans are not so trusting after waiting years for a hospital. Orlando is the largest metropolitan area in the country without a VA hospital, forcing veterans to drive to Tampa or Gainesville for care.

"What a disappointment," said retired Air Force Col. Joseph Kittinger, a decorated veteran. "All of the politicians give lip service to the veterans, but that is all it is, lip service." He added, though, that the $120 million "is a start and better than nothing."

Long-term
The Iraq and Afghanistan Veterans of America took a long-term look at where it sees facets of the budget allocated for veterans ultimately ending up.

For veterans, the 2009 budget provides $47 billion in funding for veterans’ health care, benefits, and other services. This reflects a modest increase over 2008 levels. However, starting in 2010, the budget predicts sudden (and unrealistic) drops in costs for veterans’ care. The administration’s argument is that the deaths of earlier generations of veterans will reduce expenses, but this line of reasoning fails to account for the dramatic increase in the cost of caring for Iraq and Afghanistan veterans. This will push future budget expenditures up, not down. Like the budget as a whole, the long-term accounting in the VA budget is improbable.

•Increasing the size of the Army and Marine Corps: $20.5 billion, an increase of $8.7 billion or 73%, compared with 2008. This year, the Army would grow to 532,000 soldiers, and the Marine Corps would increase its ranks to 194,000. By 2012, the plan would be complete, with the Army topping out at 547,000 soldiers, while there would be 202,000 members of the Marine Corps.

•Aircraft and weapons: $45.6 billion, a $4.9 billion increase, that would include purchases of fighter planes such as the F-22A Raptor and F/A-18 Hornet and unmanned aircraft like the Predator and Reaper.

•Cyberspace security: The budget shows at least $65 million for research and development projects tied to computer security. Some elements of the effort are secret, and funding levels are not disclosed.

•Pay and health care: $149 billion to increase salaries and fund health care. Military salaries would increase by 3.4%.

Yesterday we learned from the Washington Post of the record-breaking number of Army suicides during 2007. This is the latest edition of veteran suicide news that's made national headlines--further evidence that this is one aspect of the homecoming experience that isn't getting any better despite all the attention.The latest figures as reported by the Post:

• In 2007, suicides among active-duty soldiers reached their highest point since the Army began keeping records in 1980.
• 121 soldiers committed suicide in 2007, a 20 percent increase over 2006.
• Attempted suicides or self-inflicted injuries rose sixfold since the Iraq war began: there were 350 cases in 2002 compared to 2,100 in 2007.
• Historically, suicide rates within the military decreases during wartime; the current trend is the opposite of that.
• In 2001 the suicide rate was 9.8 per 100,000 active-duty soldiers--in 2006 the rate jumped to 17.5 per 100,000.
• In 2007 twice as many soldiers committed suicide in the U.S. as they did in Iraq or Afghanistan.

The Post provides this sober passage about a young Army reservist currently hospitalized after her suicide attempt:

On Monday night, as President Bush delivered his State of the Union address and asked Congress to "improve the system of care for our wounded warriors and help them build lives of hope and promise and dignity," Whiteside was dozing off from the effects of her drug overdose.

Taking a look at the issue of veterans suicides it's somewhat alarming to read this USA Today article from 2003. The language, the sense of urgency, the utter surprise in statistical findings can make one wonder if five years from now we'll still be reading the same type of articles--waiting for things to get better. The lead paragraph from the article could easily be substituted for a story about the current findings:

Alarmed by the number of suicides among soldiers in Iraq, the Army has asked a team of doctors to determine whether the stress of combat and long deployments is contributing to the deaths.

One very simple idea that would have helped relieve the mental burden of our troops (short of finding a way out of Iraq), and help them get the care that they need, is to give them substantial time off between deployments. Spend two years in Iraq, spend two years at home. And, on the homefront, aggressively test, treat, and monitor troops for mental injuries...

...Even without dwell time, and a much deserved rest for our forces, we have got to be more diligent about mandatory and exhaustive screening of returning troops, and providing adequate care and monitoring.

Our Readers Who Comment for the most part commend The Post and reporter Dana Priest for continuing to report on what happens to mentally and physically wounded soldiers returning from Iraq. They express sympathy for the individual around whom this story is built, call for a change in political leadership, improved patient car...Some contend that such reporting aids the enemy and question the patriotism of the journalist and her news organization. And, as sometimes happens, commenters take the opportunity to issue boilerplate condemnations of the Iraq War, some of which are anti-Semitic.

OCTOBER 30 -- A study by the American Journal of Public Health reports findings that younger veterans are more prone to suicide. This is the opposite of suicide trends among the general public.

NOVEMBER 13 -- CBS News concludes a five-month investigation into the "hidden epidemic" of military suicides.

DECEMBER 12 -- The House Veterans Affairs Committee holds a hearing on how to stop veterans suicides.

As the last days of 2007 come upon us, I've compiled a timeline of veterans news throughout the year. What struck me is the vast number of veterans stories pouring out from all media outlets. Will this continue to be the case in 2008? Most likely it will be for the simple fact that the number of Iraq/Afghanistan vets is getting bigger. 

Here are selected stories from throughout 2007:

FEBRUARY 18 -- The Washington Post exposes decrepit living conditions for wounded soldiers recovering in Building 18 at the Walter Reed Army Medical Center:

Behind the door of Army Spec. Jeremy Duncan's room, part of the wall is torn and hangs in the air, weighted down with black mold. When the wounded combat engineer stands in his shower and looks up, he can see the bathtub on the floor above through a rotted hole. The entire building, constructed between the world wars, often smells like greasy carry-out. Signs of neglect are everywhere: mouse droppings, belly-up cockroaches, stained carpets, cheap mattresses.

MARCH 8 -- A New York Times study finds vast inequities in how veterans receive disability checks based on location and type of service.

Yesterday we took a look at the background of retired Lt. Gen. James Peake, who spent Wednesday in confirmation hearings as the nominee for Secretary of Veterans Affairs.  Today brings reactions to his testimony:

VA nominee disappoints Senate panel
Skepticism ran high at Wednesday's hearing for Lt. Gen. James Peake, the nominee to be Secretary of Veterans Affairs. But problems at the VA and a leadership vacuum led most senators to say they would support the nomination, which is expected to go to the full Senate later this month...His background as a Vietnam veteran, a military physician and Army surgeon general was widely praised at the hearing. But several senators questioned whether Peake would be a forceful, independent advocate for veterans.

VA Secretary nominee gets favorable Senate hearing
Retired Lt. Gen. James Peake, President Bush's nominee for Veterans Affairs secretary, breezed through a Senate confirmation hearing today with bipartisan support. Members of the Veterans' Affairs Committee praised Peake, 63, a highly decorated veteran with 38 years of Army service including time in Vietnam and two years as its surgeon general. They also told him his task ahead would be difficult if confirmed.

Somewhere in the middle is where most senators and veterans advocates fall when summing up Peake.  They're giving him a clean slate, but are strongly strongly reminding him of VA woes yet to be sorted out.  And with thousands of new veterans returning from the War on Terror, the scope of their needs will cease to slacken anytime soon.

What's perhaps most interesting about Peake's confirmation hearing yesterday is the lack of press coverage detailing the event.  We're at war and this is a cabinet position, and sure, most papers had a blurb about the hearing -- but nothing expansive.  I wonder what would've happened if the hearing took place right after the Walter Reed scandal broke when vets were in the daily headlines.

One guy who's taking the hearing very seriously is Paul Rieckhoff from Iraq and Afghanistan Veterans of America.  Over at the Huffington Post, Reickhoff sets out a list of questions he believes Peake needs to answer.  Some highlights:

***In 2007, the scandal at Walter Reed finally drew attention to the tremendous obstacles facing wounded troops coming home from Iraq. But many of these issues were already coming to light years earlier, even in 2003 and 2004, when you were Surgeon General. You have said that you were unaware of any problems during your tenure. How will you ensure these mistakes aren't repeated at VA?

***According to the Pentagon's Task Force on Mental Health, "the current complement of mental health professionals is woefully inadequate" to provide the mental health care to today's military. Do you agree with this assessment? Should you have done more to alleviate this shortage in the military, and how will you address this problem at VA?

***Do you believe the current World War Two-style GI Bill adequately covers the cost of college tuition today? If not, what specific improvements to the GI Bill would you recommend?

***Disabled veterans are waiting too long for their disability benefits. The number of backlogged claims has increased over 50 percent over the past three years to almost 400,000 pending disability claims. Just last week, a new report showed that the average time for claims processing has risen again, to 183 days. What will you do to reduce the backlog?

***The VA budget is late again this year, and temporary funding bills leave veterans' hospitals unable to plan their budgets accurately. Do you think mandatory VA funding is the answer?

***You will have much less time than your predecessors to influence VA policy under this Administration. What are the top three specific changes you hope to implement during your tenure and what can you realistically hope to accomplish?


Rieckhoff's questions mirrored some asked by senators during Peake's hearing.  As Senator Patty Murray (D-Wash.) said:

"I've always said the VA secretary has to be an advocate for our veterans, not just an apologist for any administration."


Now that the confirmation hearing is over and it's seeming more than likely Peake will be confirmed, he's about to step into a job where decisions need to be made now -- decisions that allow little room for error.  So, let's give Peake the last word:

“I look forward, if confirmed, to moving forward with making the system less complex, more understandable and better supported with the tools of information technology...A veteran should not need a lawyer to figure out what benefit is due or to get that benefit.”

 

Name: Dr. James Benjamin Peake
Age: 63
Born: June 18, 1944; St. Louis, Mo.
Education B.S., United States Military Academy, 1966; M.D., Cornell University, 1972; graduate, U.S. Army War College, 1988.
War Service: Vietnam
Awarded: Silver Star, Bronze Star with "V" device, Purple Heart with oak leaf cluster
Other: former Army surgeon general with 40 years in military medicine; if confirmed, he will be the first general and first physician to hold the job

"The disability system is largely a 1945 product, 1945 processes, around a 1945 family unit. About everybody that has studied it recently said it is time to do some revisions."

When a veteran first applies for that compensation, a doctor conducts a physical to help determine how much money he or she deserves. Historically, VA doctors do most of those examinations. But increasingly they are being performed by QTC Management, the for-profit contractor that employed Peake as its chief operating officer from 2006 until now.

The company has a virtual lock on the expanding business of performing the physicals on veterans, which help determine how much they should get in disability checks from the VA.

To alleviate other possible conflicts of interest, Peake also told the Senate committee that he would divest stock holdings in more than 57 companies, many of them major pharmaceutical companies such as Aventis Pharmaceuticals, Bristol Myers, Medtronic, Wyeth and Pfizer, that either currently or might do business with the VA, said a Senate staffer who demanded anonymity because the information had not been made public.

Even the administration's most ardent critic on the committee, Sen. Patty Murray, D-Wash., plans tough questions but expects him to be confirmed.

"The problems at the VA are huge, and lives are at stake," she said. "I hope General Peake's the guy for the job, because this administration has failed to plan and failed to be honest and we simply can't waste any more time when it comes to getting this right."