The National Alliance for Caregiving is conducting a study to learn about the types of resources, programs, and supports that family caregivers need to adequately assist our nation’s veterans. Information is being collected through focus groups, telephone interviews and an online survey. Family caregivers of veterans from all eras are needed to participate in the study.

Earlier this year, VetsFirst celebrated the passage of the Caregivers and Veterans Omnibus Health Services Act of 2010. Now, family caregivers of veterans will have more resources, including training and other supports, available to them. We hope that the National Alliance for Caregiving’s study will lead to a better understanding of additional programs and supports needed by family caregivers for our nation’s veterans.

If you would like to participate in the online survey, please sign up at: www.gwsurvey.com/caregiversofveterans.html

For additional information about the study, please click here.

The U.S. House of Representatives and the U.S. Senate have passed the Caregivers and Veterans Omnibus Health Services Act of 2010 (S. 1963), which includes critical supports for caregivers of veterans with disabilities. VetsFirst has advocated for the passage of this legislation and is hopeful the President will quickly sign the compromise bill.

As urged by VetsFirst, the legislation includes at least some supports for caregivers of veterans from all eras. Caregivers for eligible veterans of all eras will have access to education sessions, support services, counseling, mental health services and respite care. VetsFirst believes that providing these tools to caregivers will ensure that veterans receive quality supports and services in their homes and communities.

The legislation also provides certain caregivers of OEF/OIF veterans who have a serious injury, such as a traumatic brain injury, with a monthly stipend and access to medical care.

Veterans have the right to receive their services and supports in the least restrictive environment. Most people with disabilities want to live in their homes and have the opportunity to be a part of their communities. Although funding services for caregivers requires an upfront investment, the long-term gains that result from assisting veterans with disabilities in their efforts to reintegrate into their communities are significant.

In addition to the new caregiver benefits, the legislation also seeks to expand and improve care for women veterans who seek care through the VA. The legislation also improves access to mental health services and eliminates the ability of the VA to demand copayments from veterans who have catastrophic disabilities.

VetsFirst will continue to advocate for legislation that ensures that veterans from all eras, their families and dependents have access to vital services and supports.

When I became an individual with a physical disability in the late 1960s—a level C-6 quadriplegic as the result of a spinal cord injury—I was fortunate to go through an outstanding rehab program. By the time I left the VA Spinal Cord Injury (SCI) Center nearest my home, I was able to provide some of my personal care, dress myself, move safely from my wheelchair to my bed and vice versa, drive my car, etc.

I was pretty independent back then, but still from the day I was discharged from the SCI Center, I needed a trained caregiver for a couple of hours per day, three times each week.

When my job took me out of town, I simply planned ahead by hiring a nurse or a nursing assistant and renting any needed medical equipment from a company in the city to which I was traveling. No sweat. I did this all the time, including for some fun and much-needed vacations.

I was also very lucky to have found some excellent caregivers over the years. The first nursing assistant I hired was with me for six years, and he left my employ to take care of his ailing spouse. Three other health professionals worked with me for 10, 13 and 16 years respectively. They were all wonderful people who became my friends as well.

Today, I’m not as independent as I used to be, but I can still come and go as I please, and I stay out of my spouse’s hair by serving on three Boards of Directors, including VetsFirst. Mostly, I’m blessed with a terrific wife who believes, “you take care of the one you love.” My lovely spouse is my primary caregiver and she provides tender, loving care every single day.

All caregivers, however, need a break, and many need critical supports like counseling and respite care. To help caregivers, the U.S. House of Representatives has passed “The Caregiver Assistance and Resource Enhancement Act,” H.R. 3155, and the U.S. Senate has passed “The Caregivers and Veterans Omnibus Health Services Act,” S. 1963.

Both bills contain language that would provide critical supports for caregivers of our nation’s severely disabled veterans, yet both have undesirable limitations: the House bill provides stipends and medical care only for caregivers of Operation Enduring Freedom/Operation Iraqi Freedom veterans, with the authority to provide those benefits sunseting on October 1, 2012; and the Senate bill, while providing a full range of benefits for primary caregivers, only makes them available for caregivers of seriously disabled veterans who entered military service on or after September 11, 2001.

The House and Senate must each pass a bill with the same language before caregivers can get the help they need. A compromise is pretty obvious to me: a full range of caregivers benefits must be available to the caregivers of all seriously disabled veterans of all wartime periods, and without any sunset provisions. Please write to your Congressional representative and both of your Senators today to advocate this outcome. The caregivers of seriously disabled veterans have earned these benefits as much as their loved ones.

For fiscal year 2011, which begins on October 1, 2010, the President is seeking $125 billion for the VA. Specifically, the President is requesting $60.3 billion for discretionary spending for the VA, which is nearly on par with the $61.5 billion called for by veterans service organizations in the Independent Budget (IB). Discretionary funding is mainly used for health care for veterans. The President’s budget request also includes $64.7 billion in mandatory funding, which is spending mainly for disability compensation and pensions for veterans.

One of VetsFirst’s top public policy priorities is to reform the VA’s benefit claims process to reduce the backlog. The President’s budget requests $2.149 billion for the Veterans Benefits Administration’s (VBA) operating budget, which is one of the few categories for which more was requested than was suggested by the IB. The 27 percent increase over the last fiscal year is intended to help reduce the claims backlog. In 2011, the VA estimates that veterans will submit 1,319,000 claims, which would be a 30 percent increase from 2009. The VA believes that hiring additional staff members and better business practices will help decrease claims processing times. The budget request also includes $145 million for the creation of a paperless claims processing system.

Unfortunately, increases in funding and staffing levels for the VBA have not yet been effective in reducing the backlog of claims and appeals. According to the Government Accountability Office, the VA has made only limited progress in recent years toward decreasing average claims processing times. Although VetsFirst believes that VBA must have the resources necessary to meet the current challenges, the VA claims process and substantive regulations and adjudicative principles must also be reformed.

As the budget process continues to move forward, VetsFirst will continue to advocate for the level of funding the VA needs and the strategies that must be adopted to efficiently and effectively address the challenges facing today’s VA. Both the Senate and House Budget Committees will create budget resolutions that must be voted on by their respective bodies. Once a concurrent resolution is agreed to that reconciles any differences between the House and Senate passed resolutions, each body will vote on the concurrent resolution. Although not law, the concurrent resolution provides broad spending guidelines for the appropriations process.

Click here for more information about the President’s fiscal year 2011 budget.

Heather Ansley
The VetsFirst Team

The VA’s decision means that veterans who served within the geographic boundaries of the Republic of Vietnam (including inland waterways) and in the Korean demilitarized zone (DMZ) during the Vietnam era will be able to establish service connection for these three diseases without the need to provide medical evidence of an association between their disease and their military service. The new presumption of service connection in these cases will eliminate the need to submit such evidence in claims for VA benefits and health care and will speed up the adjudication process for these claims.

Agent Orange is the military designation for a blend of herbicides that contained dioxin, an extremely toxic chemical that was widely used in Vietnam from 1962 to 1971 during the war. The U.S. military sprayed millions of gallons of Agent Orange and other herbicides to destroy jungle foliage that enemy troops could hide in. Agent Orange was also used to clear vegetation from the Korean DMZ during the same time.

Because claims for VA benefits generally require veterans to submit medical evidence of a causal relationship between a current disability and military service, and because many veterans have difficulty finding doctors who were willing to provide that kind of medical opinion, the Agent Orange Act of 1991 set up a procedure to simplify and speed up the claims process for these approximately 2.6 million veterans. It essentially replaced the requirement for medical evidence of a link between military service and a current disease with twin presumptions that Vietnam veterans who served in-country were exposed to Agent Orange and other herbicides, and that certain diseases that they may currently have were caused by their exposure. In order for a disease to qualify for the presumption, the U.S. Institutes of Medicine (IOM) must determine that there is at least “limited or suggestive” scientific evidence of an association between exposure to Agent Orange and that disease. Once the IOM makes such a determination, the VA has a limited time to decide whether to afford presumptive service connection to the disease in question.

Based on a recent IOM report that found “limited or suggestive evidence” of an association between Agent Orange exposure and the later development of Parkinson’s disease and ischemic heart disease, as well as “sufficient” evidence of an association between Agent Orange exposure and B-cell leukemia,
VA Secretary Eric K. Shinseki decided to add these three new diseases to the Agent Orange presumptive list.

Interestingly, the VA has made no announcement as to whether it would afford presumptive service connection to hypertension, even though the IOM found that there was “limited or suggestive” evidence of an association between hypertension and herbicide exposure. It is possible that the VA is hesitant to do so because of the massive number of Vietnam veterans who suffer from hypertension and the enormous cost of providing them with VA disability compensation. The VA faced a similar dilemma when it considered adding Type 2 diabetes to the Agent Orange presumptive list.

Other illnesses previously recognized as presumptively service- connected to herbicide exposure include:

• Acute and Subacute Transient Peripheral Neuropathy
• Amyloidosis
• Chloracne
• Chronic Lymphocytic Leukemia
• Diabetes Mellitus (Type 2)
• Hodgkin’s Disease
• Multiple Myeloma
• Non-Hodgkin’s Lymphoma
• Porphyria Cutanea Tarda
• Prostate Cancer
• Respiratory Cancers
• Soft Tissue Sarcoma (other than Osteosarcoma, Chondrosarcoma, Kaposi’s sarcoma, and Mesothelioma)

If you are an in-country Vietnam veteran or served near the Korean DMZ during the Vietnam War, and you have Parkinson’s disease, a B-cell leukemia, ischemic heart disease or any of the conditions listed above, please contact us immediately at http://helpdesk.vetsfirst.org/. We are available to answer your questions and to assist you in filing a claim for VA benefits and health care 24/7.

However, an article by Carl Glassman entitled “Healing the Wounds of War Downtown” reveals some interesting perspectives from veterans of Iraq, Afghanistan and Vietnam on the services that are available from the VA’s 232 commmunity-based Vet Centers nationwide.

While I have been known to be critical of the VA, Vet Centers deserve a lot of credit when they’re getting accolades like these from veterans who’ve been there. Well done.

Note: In the interest of full disclosure, I am doing a graduate social work internship at the Manhattan Vet Center, but I had nothing to do with Mr. Glassman’s article or any of the veterans who are quoted therein.

Paul J. Tobin
President, VetsFirst

It was an involved case and you could tell that the vet had some misgivings about tapping into his VA benefits. The email ended with the Service Officer stating the following:

“Finally, NEVER feel guilty for applying for a benefit you are entitled to. You have EARNED every single benefit you are receiving and will receive in the future. You served this great country honorably and proudly during a period of war and in the warzone. NEVER feel guilty for sacrificing. Your service is deeply appreciated.”

I have known scores of veterans over the years who have felt the same way. These patriots would have served their country regardless of any promise or realization of benefits. Yet, there often comes a time when those who have served and sacrificed require their benefits. These have been earned and are in keeping with the covenant that we as Americans have made with those who have honorably served.

There should be no guilt or shame in pursuing or receiving earned benefits. The granting of benefits to a veteran is the act of a nation demonstrating its gratitude and a way of honoring our most deserving Americans.

If confirmed, he will be facing a host of issues that include a backlog of disability benefits, implementing the new GI bill, and building Obama’s “21st century VA that will better serve all who have answered our nation’s call.”

From USA Today:
“Shinseki, a Japanese-American born in Hawaii, won two Purple Hearts in Vietnam for injuries that included the loss of part of his right foot. He vowed Sunday to improve a Department of Veterans Affairs that has been widely criticized for failing to meet disabled veterans’ needs.”
Read the entire article at USA Today.

Insiders expect that President-elect Barack Obama will nominate retired Gen. Eric Shinseki to be Secretary of Veterans Affairs.

From CNN Politics.com
"Shinseki, a highly decorated Vietnam veteran, has been the patron saint of Pentagon critics who say the former Army chief’s sage advice was ignored in 2003, resulting in too few U.S. troops being sent to Iraq after the invasion. Shinseki testified before the Senate Armed Services Committee in February 2003 that "something on the order of several hundred thousand soldiers would be required" to pacify the country. The comment infuriated some Bush administration officials, and he retired just a few months later."

Shinseki served in a number of command and staff assignments in the Continental United States and overseas, including two combat tours with the 9th and 25th Infantry Divisions in the Republic of Vietnam. During one of those tours, he stepped on a land mine, which blew off the front of one of his feet.

Ret. General Eric Shineski has been awarded a number of decorations during his career. They include:

• Defense Distinguished Service Medal (with Oak Leaf Cluster)
• Army Distinguished Service Medal (with Oak Leaf Cluster)
• Navy Distinguished Service Medal
• Air Force Distinguished Service Medal
• Coast Guard Distinguished Service Medal
• Legion of Merit (with Oak Leaf Cluster)
• Bronze Star with "V" Device (with two Oak Leaf Clusters)
• Purple Heart (with Oak Leaf Cluster)
• Meritorious Service Medal (with two Oak Leaf Clusters)

It is often difficult for us to render into words the gratitude and pride that we feel toward our Veterans. Though words may not always do justice to our true emotions, they ring with clarity and capture the essence of our feelings when offered with sincerity from the heart.

The following heartfelt writings were submitted by VetsFirst donors. They express what we all feel toward our veterans and men and women serving in the military.

America’s First
By Betty K.

The Navy and Army, Marines and Air Force too
America’s Coast Guard, all have their jobs to do
The best of USA, our service personnel
With pride in their country, they’d march forward through hell

Each stands ready to serve, whatever it may be
To defend our freedom, or help across the sea
Wherever duty calls, on water. air or land
Our soldiers are prepared, for war or helping hand

Some serve in foreign lands, so far away from home
Loved-ones must let them know, that they are not alone
To come home is joyful, for some it’s not to be
They are forever gone, they died for their country

We honor veterans with their own special day
We cherish those brave souls, with more than words can say
We all salute our vets, both dead and those alive
With those brave souls of ours, our country will survive.

Soldiers
By Misty L.
Dedicated to the American soldiers, past and present, for their courage, honor, and dedication in protecting our nation. Thank you and God be with you.

They are born from all races,
And colors of skin.
They are born into brotherhood,
No boundaries within.

They are men and women,
From all ends of the earth.
They are sisters and brothers,
Not tied by their birth.

They are each their own person,
Yet they stand as one.
They march into battle,
Until the battle is won.

They protect the walls of our country,
That we may sleep at night.
They are trained to be heroes,
They are trained to fight.

To fight for our freedom,
As much as their own.
To fight for their country,
Of mortar and stone.

They stand tall with dignity,
Honor and pride.
They chose to be soldiers,
So we need not hide.

They are American soldiers,
With each living breath.
They are American soldiers,
Even after their death.

And unto these soldiers,
My life is in debt.
They have given me choices,
I will never forget.

Without them I would not be here,
With tears in my eyes.
Thanking God for their courage,
Of risking their lives.

Thanks be to the soldiers,
Of this nation, my home.
And know in your hearts,
You are never alone.