Soldiers struggle to find therapists to take their insurance

•June 13, 2007 • 7 Comments

WASHINGTON (AP) — Soldiers returning from war are finding it more difficult to get mental health treatment because military insurance is cutting payments to therapists, on top of already low reimbursement rates and a tangle of red tape.

Wait lists now extend for months to see a military doctor and it can takes weeks to find a private therapist willing to take on members of the military. The challenge appears great in rural areas, where many National Guard and Reserve troops and their families live.

To avoid the hassles of Tricare, the military health insurance program, one frustrated therapist opted to provide an hour of therapy time a week to Iraq and Afghanistan veterans for free. Barbara Romberg, a clinical psychologist in the Washington, D.C., area, has started a group that encourages other therapists to do the same.

“They’re not going to pay me much in terms of my regular rate anyway,” Romberg said. “So I’m actually feeling positive that I’ve given, rather than feeling frustrated for what I’m going through to get payment.”

Joyce Lindsey, 46, of Troutdale, Oregon, sought grief counseling after her husband died in Afghanistan last September. The therapist recommended by her physician would not take Tricare. Lindsey eventually found one on a provider list, but the process took two months.

“It was kind of frustrating,” Lindsey said. “I thought, ‘Am I ever going to find someone to take this?”‘

Roughly one-third of returning soldiers seek out mental health counseling in their first year home. They are among the 9.1 million people covered by Tricare, a number that grew by more than 1 million since 2001.

Tricare’s psychological health benefit is “hindered by fragmented rules and policies, inadequate oversight and insufficient reimbursement,” the Defense Department’s mental health task force said last month after reviewing the military’s psychological care system.

The Tricare office that serves Fort Campbell, Kentucky, and Fort Bragg, North Carolina — Army posts with heavy war deployments — told task force members that it routinely fields complaints about the difficulty in locating mental health specialists who accept Tricare.

“Unfortunately, in some of our communities … we are maxed out on the available providers,” said Lois Krysa, the office’s quality manager. “In other areas, the providers just are not willing to sign up to take Tricare assignment, and that is a problem.”

Tricare’s reimbursement rate is tied to Medicare’s, which pays less than civilian employer insurance. The rate for mental health care services fell by 6.4 percent this year as part of an adjustment in reimbursements to certain specialties.

Read the rest of the article at CNN.


D.C. Notes: Disability claims from Iraq, Afghanistan vets top 176,000

•June 11, 2007 • Leave a Comment

Sunday, June 10, 2007

By Lisa Hoffman
WASHINGTON — Deep in a newly released 300-page report on the benefits system for the nation’s veterans lies a first look at the dimensions of the disabilities the Iraq- and Afghanistan-war injured are suffering.

Through March, more than 176,000 U.S. veterans of those ongoing conflicts had filed claims for disability compensation, according to a report released by the Institute of Medicine of the National Academies of Science.

Some of the most common conditions were tinnitus, or ear ringing (36,000 claims granted); back strain (33,000); problems with ankle motion (16,000) and post-traumatic stress disorder (16,000).

More than 550 troops have become amputees. Almost one-fourth of those suffered the loss of more than one limb. At least 1,100 “war on terror” vets have been treated for blindness or significant visual injuries.

The report also estimates that at least 300,000 U.S. veterans of Operations Enduring Freedom and Iraqi Freedom ultimately will be added to the nation’s disability-compensation rolls, which currently number 2.7 million veterans receiving a total of $27 billion a year.

Vets’ disability claims keep piling up

•June 1, 2007 • Leave a Comment

By Rick Maze – Staff writer
Posted : Thursday May 31, 2007 7:16:34 EDT

Two pieces of good news for veterans — a possible $6.5 billion increase in the 2008 Veterans Affairs Department budget and passage of six bills to improve veterans programs — were overshadowed May 23 by a discussion that showed there is no quick or easy solution to the huge backlog of veterans’ disability benefits claims.

Retired Navy Vice Adm. Daniel Cooper, VA’s undersecretary for benefits, who has spent five years wrestling with claims processing, said headway is proving difficult because new claims are being filed faster than old claims can be handled. In fiscal 2006, the VA received 806,382 claims, and expects 811,000 this fiscal year, he said.

Claims also are becoming more complicated, he said. More than 25 percent include eight or more disabling conditions, each of which must be weighed. And more cases involve chronic progressive disabilities, such as cardiovascular problems and diabetes, which will worsen and likely result in additional claims, if only to increase a disability rating.

The $6.5 billion increase in VA funding approved by a House Appropriations subcommittee will help modestly by allowing the VA to hire 1,500 more claims staff. But Cooper cautioned that “increased staffing levels do not produce immediate production improvements,” and in fact could slow things down as experienced staffers are diverted to help new employees learn procedures. It could be a year or more before improvements are seen, he said.

“We are at a crisis stage and it will certainly get worse,” said Rep. Bob Filner, D-Calif., the House Veterans’ Affairs Committee chairman who hosted the discussion that involved veterans’ groups, VA workers who process claims, legal experts and academics who have looked at the VA’s problems.

“This is very frustrating,” Filner said, “Some people have died before their claims are adjudicated. Some have lost their homes to foreclosure.”

The VA has about 800,000 claims pending, about 400,000 involving disability claims. The rest are changes in status or requests for education benefits that are not generally considered a problem.

Read the rest at Army Times.

Students returning from military services face challenges

•May 31, 2007 • Leave a Comment

Here’s one story very close to home…

COLUMBIA, Mo. (AP) – Students returning to the University of Missouri-Columbia from military service can find their efforts to resume their studies hampered by bureaucracy.

Aaron Rinehart studies for his corporate finance final in the MU Memorial Union, May 9 in Columbia. In May 2005, Aaron Rinehart – then a senior – was given three weeks notice that his Marine unit was about to be deployed to the African nation of Djibouti. He didn’t know which option to take. (Photo via The Associated Press)

When students are called to active military duty, school policy gives them two options: Drop their classes and receive a tuition refund, or take incomplete grades and finish the coursework when they return.

What’s lacking, one student said, is any sort of guidance.

In May 2005, Aaron Rinehart – then a senior – was given three weeks notice that his Marine unit was about to be deployed to the African nation of Djibouti. He didn’t know which option to take.

Neither, he told the Columbia Missourian, did his professors.

“They were asking me, ‘Well, what do you want me to do?’ and I didn’t know,” Rinehart told the newspaper. “It felt like we were making these half-cocked decisions, and I said, ‘God, this is going to come back and bite me.’ And it did.”

Rinehart chose both. He withdrew from his three economics classes and took incompletes in his other two courses, computer programming and philosophy.

After his return from Africa in April 2006, he checked in with the school’s veterans official, Carol Fleisher, and was told he had been given F’s in all five of his classes.

“I was glad I didn’t know that when I was gone,” he said, “or I would’ve been really stressed out.”

Fleisher worked out the situation, with some difficulty.

“I can’t imagine what I’d do without her help,” Rinehart said. “I’d be doing it all on my own.”

In response, student veterans have organized.

They formed the Mizzou Student Veterans Association a year ago, and the group now has about 80 members.

Besides giving student veterans a chance to socialize with each other, it also works to help them resolve problems with university policies.

In one case, the association wrote to Chancellor Brady Deaton to complain about the school’s financial aid department, which was charging late fees to veterans because their G.I. Bill payments didn’t arrive until after the university’s due date for semester fees.

That got the issue resolved, said Jerod Mickelson, the organization’s former president.

Mickelson, who has twice been deployed to Iraq, said he would like to see a one-stop help center at the university, similar to one at the University of Minnesota.

Read the full article at News Tribune.

Getting past the stress of war

•May 30, 2007 • Leave a Comment

Pride, reputation keep troubled soldiers from reaching out for help they need

Chad Graham
The Arizona Republic
May. 28, 2007 12:00 AM

When Charles Thomas returned to Phoenix’s Water Services Department in April 2006 after serving a year in Iraq, the once gregarious and outgoing man had turned quiet.

He was abrupt with co-workers.

He was nervous around crowds.
He looked exhausted. “I thought I looked fine,” Thomas said in an interview. “Other people looking at me saw the difference.”

For many of the 3,000-plus Arizona National Guard and military reserve members who have served in Iraq or Afghanistan in the past 5 1/2 years, their return home has been a struggle as they try to adjust from the battlefield to the workplace.

“In general, there’s a dramatic need for more post-service care and attention to the needs of these individuals,” said Scott Essex, chairman of the Arizona committee of the Employer Support of the Guard and Reserve, a liaison between veterans and employers.

Always on alert

There are no data on how many are suffering at Arizona workplaces, but one study published in March in the Archives of Internal Medicine revealed that 25 percent of veterans who fought in Iraq or Afghanistan received a mental health diagnosis.

Of those, more than half had two or more such diagnoses.

Back on the job, many vets begin “reverting back to the behavior that kept them alive for 12 months,” said Matthew Friedman, executive director of the National Center for Posttraumatic Stress Disorder in White River Junction, Vt.

In interviews with The Arizona Republic, members of the Guard and reservists described spending months on alert every second of the day, dodging death in surprise firefights and watching members of their units, as well as civilians, die.

They returned in a hypervigilant state, unable to convey their emotions to family, friends and co-workers.


Read the rest at AZ Central.

Bill seeks commission for veterans

•May 29, 2007 • Leave a Comment

Would target gaps in mental health

State lawmakers proposed yesterday the creation of a commission to assess a mental health crisis among combat veterans returning from Iraq and Afghanistan. Service men and women too often fall through the cracks of the sprawling bureaucracy of the federal Department of Veterans Affairs, they said.


“The VA has not been there enough for veterans with mental health problems,” said Representative Anthony Verga, a Democrat from Gloucester, chairman of the state’s Veteran and Federal Affairs Committee and a bill sponsor. “We see the stories of veterans committing suicide and waiting for benefits and struggling to find care, and we wonder what’s happening.”

The proposed 11-member commission would study the “effects of war on the citizens of the Commonwealth” and report, within a year, on ways to improve services for returning veterans.

An emotional hearing before legislators yesterday featured five hours of testimony by veterans, their families, and advocates.

According to research by Verga’s committee, 28,000 service members have returned to Massachusetts since Sept. 11, 2001, and about 25 percent of them have faced “serious mental health challenges.”

That roughly matches national findings by the National Alliance on Mental Illness that one in six returning soldiers suffered severe depression or post-traumatic stress disorder. Fewer than half of them seek help because they fear “hurting their career or being stigmatized,” Phil Hadley, president of the alliance’s state chapter, said in testimony with the committee.

Lieutenant Governor Timothy P . Murray also testified, saying the administration of Governor Deval Patrick was preparing to fully support the bill.

Murray described PTSD and Traumatic Brain Injury, which is the physical injury to the brain caused by trauma such as a bomb blast, as the “signature injuries” of the wars in Iraq and Afghanistan. He said they both require a comprehensive approach to treatment, not just by state and federal agencies but also by private medical institutions.

Read the rest of the article at the Boston Globe.

Dartmouth president helping put wounded veterans in college

•May 25, 2007 • Leave a Comment

By Tamar Lewin

Published: May 23, 2007


When he first met James Wright, the president of Dartmouth College, two years ago, Samuel Crist was in a hospital bed at the National Naval Medical Center in Bethesda, Maryland, recuperating from gunshot wounds from a firefight in Falluja, Iraq.

“I was pretty heavily medicated, so my memory is a little bit foggy, but he was visiting people and asking about their experiences in the war and pushing people to get an education,” said Crist, 22, who grew up in Lafayette, Louisiana. “He said he’d been a marine, too, and he’d gone to college after he got out as a lance corporal, the same rank I separated at.”

That hospital visit changed things for Crist and Wright: On Wright’s advice, Crist enrolled in college courses in Texas, and next autumn he will transfer to Dartmouth.

Wright, 67, meanwhile, has made eight more visits to wounded veterans at Bethesda and at the Walter Reed Army Medical Center in Washington and, with the American Council on Education, started a program to provide individualized college counseling to seriously wounded veterans.

Because of advances in medical care, and the speed with which those wounded on the battlefield are treated, the survival rate for service members with serious wounds is far higher in the Iraq and Afghanistan conflicts than in previous wars. These circumstances have created a pool of young men and women who must remake their lives with brain injuries, amputations and other significant limitations.

Wounded or not, veterans get extensive educational benefits. But while service members on active duty have access to many educational counseling programs, such access is harder for those who have left active duty and face long recuperation, especially if they are from families where college is not a given.

Wright said news of the 2004 battle for Falluja spurred him to think about what he could do for wounded veterans.

“I worried about the injured servicemen and how much suffering there was,” said Wright, who spent three years in the Marines in California, Hawaii and Japan but never saw combat. “So I decided that I’d like to go down to Bethesda and visit them and see what I could do to encourage them to go back to school.”

Read the rest of this exemplary article at the International Herald Tribune.