Purple Heart Routinely Denied For Some With TBI

Purple Heart image from granitegrok.com

The denial of Purple Hearts to some soldiers who had concussions and TBI from tours of duty in Iraq or Afghanistan was reported last week on NPR and Propublica last week (find the reports here and here). According to NPR, Purple Hearts are routinely denied to soldiers who have had concussions, even though in the guidelines for the awarding of Purple Hearts , examples of enemy-related injuries which clearly justify award of the Purple Heart include, g-5″concussion injuries caused as a result of enemy generated  explosions” and g-9 Post Traumatic Stress Disorder (PTSD).

The NPR article said some soldiers were denied the award by their commanders despite well documented concussions. TBI has often been called the signature wound of the Iraq and Afghanistan conflicts, but because it is not a visible wound is not always easy to identify. Also, symptoms sometimes are not apparent right away. This is compounded by the fact that, “Most people who sustain such blows, also known as concussions, recover on their own, but studies show 5 percent to 15 percent may have long-term impairments”. To be awarded the Purple Heart the soldier must have medical treatment and the injury must be documented.  The article also said in 2008, Brig. Gen. Joseph Caravalho sent out a memo which blocked medical personnel from discussing the Purple Heart with TBI patients. For the above reasons some commanders have been reluctant to award it.

Soldiers who have been denied the Purple Heart may appeal, it can take quite a while. For assistance locally you can contact COVO , The Veterans Service Office or The VA Outpatient Clinic in Bend.  Also mentioned in the article was an organization called, Recognize the Sacrifice a website devoted to soldiers with TBI and the Purple Heart.

VA Adding Three Health Issues to Agent Orange List

Somebody visited my blog looking for information about updates in diseases that were after effects of exposure to agent orange. Well, I hadn’t heard anything. If I haven’t heard anything about it, I doubt you have. So, I went looking around and here is what I found out:

According to the Business Wire , three new health issues have been identified as the results of exposure to agent orange which was used during the Viet Nam war.  “The regulation adds Parkinson’s disease and ischemic heart disease to the list of presumptive disorders associated with Agent Orange and will expand chronic lymphocytic leukemia to include all chronic B cell leukemias, such as hairy cell leukemia.” the Business wire said. Many veterans are potentially eligible for retroactive disability payments based on past claims. The article said, the “VA will review approximately 90,000 previously denied claims from Vietnam veterans for service-connection status for the conditions.”  This applies to veterans who served in Vietnam anytime from Jan. 9, 1962, to May 7, 1975. To read Business Wire’s full article go here.

There is a 60 day review period before it goes into effect. If you would like to find out if you can put in a claim or have yours reviewed call:

• Central Oregon Veterans Outreach (COVO) 541-383-2793
• Central Oregon Vet Center 541-647-5276
• Bend Va Outpatient Clinic 1-800-949-1004

Please tell them you read about it in The Central Oregon Veteran.

You can find a short interview (a little over 3 minutes) with VA Secretary Eric Shinseki here at the American Legion Convention.  He spoke about reducing the backlog of claims and the new guidelines. There is also an article.

If you would like the full details in the Federal Register, you can find them here. It starts at the bottom of the middle column. It runs from page 53202 to 53216.  The Federal Register is the official journal of the Federal Government of the United States that contains most routine publications and public notices of government agencies. It is a daily (except holidays) publication.

Of course in these economic times, there is some concern about the added cost to the VA budget. An article at politico.com presents some of those issues. You can read it here.  And, NPR ran an article as well. You can read it here.

9.17.2010 NPR ran another story.

Hyperbaric Oxygen Therapy (HBOT) to Undergo Clinical Trials for TBI Starting January 2011

I have heard of a new way but controversial way of treating TBI and PTSD. It’s called hyperbaric oxygen therapy (HBOT). The patient has a number (usually 40 or 80) of hour to an hour and a half long sessions in a high pressure pure oxygen environment,  the type they use for divers who have the bends (see an article about hyperbaric oxygen therapy here). The whole process takes under a year.

It was mentioned as a new innovative treatment for TBI and PTSD at a round table discussion in the House Committee on Veteran’s Affairs. It also can help heal  the ulcerated foot wounds of diabetics (Dr Harch in his testimony below shows some images of such a foot that are amazing on pages 13 and 14).

You will find the press release about the meeting here.

Prepared testimony and a link to the webcast are available at this link. The webcast can be found in the upper right portion of the screen- Dr. Harch starts speaking at 15 minutes. And, again at one hour six minutes.

And the testimony of Dr. Paul G. Harch on behalf of The International Hyperbaric Medical Association can be found here. I found his testimony very interesting.

New clinical trials start in January 2011, information about them can be found here.

If you are interested in participating in the government trials, you can find information here.

There are hazards to the treatment which you can find here (scroll down and you will find the section about the hazards).

And, one more article that’s interesting is here

John Salcedo made an award winning 44 minute film “Brain Storm: Oxygen Under Pressure”

I have found out the Boise VA center does not have a Hyperbaric Chamber and I need to call the Portland VA to find out if they do.

Bend Memorial Clinic has one or is getting one because they are looking for a technician.

Obama Speaks of VA Changes at DAV Convention

The President at the convention of Disabled American Veterans, White House Photo, Pete Souza

Today, the President spoke at the Disabled American Veterans convention in Atlanta. Most of the major news sources focused on his comments about Iraq and Afghanistan, which was the first half of the speech. In the second half , he addressed what changes have been made at the VA and what is happening in the future. Below is a summary of his remarks from the second half of the speech taken from the full text in, The Wall Street Journal.

The President speaks of , “our commitment to cut those backlogs, slash those wait times, and deliver your benefits sooner.”  To this end, they are working on a, “single lifetime electronic record that our troops and veterans can keep for life.” He said veterans will be able to download their personnel health records directly from the VA website starting this fall. To speed the claims process along Obama said, they are hiring thousands of new claims processors and , “reforming the claims process itself, with new information technologies and paperless systems.” Veterans will also be able to, “check the status of their claims on-line and from their cell phones.” He went on to say that changes to the rules should make it easier for Viet Nam vets who have chronic diseases because of exposure to Agent Orange to get health care and benefits. Along the same line for Desert Storm veterans, “nine infectious diseases are now presumed to be related to your service”. 

 He spoke of stopping required co-pays for catastrophically disabled veterans and for severely disabled vets there is legislation in the works that, “would allow severely disabled retirees to receive your military retired pay and VA disability benefits.” 

Other issues in the works are ending homelessness for veterans and a design contest is bringing the best minds into service to develop the best technologies to overcome traumatic injuries. And, more support for the Iraq and Afghanistan veterans who are transitioning back home.  PTSD and TBI were also mentioned.

If you would like to read the speech in its entirety you will find it here. Or, if you would like to listen to it, it’s right below. The part about veterans starts at about 20 minutes.

Trips to Portland VA Medical Center Still to Have Same Day Reimbursement- Temporarily

According to The Bulletin, the Veterans Affairs Department will still temporarily provide same day reimbursement for travel expenses to the Portland VA Medical Center. This occured after loud protests from the VA community and Oregon law makers. 

In 2008, in response to dramatically increasing gas prices (the record high in Oregon was $4.29 in July of 2008 according to fuelgaugereport.com), the amount the VA would reimburse for travel increased from 11 cents per mile to 41.5 cents a mile. An example of the amount reimbursed is, from La Pine to the Hospital and back is 378 miles for a reimbursment of $41.58 at 11 cents per mile and $156.87  at 41.5 cents per mile. The number of vets asking for same day reimbursements increased.  According to the Bulletin, the VA announced earlier this year that they were going to stop the practice of same day reimbursements to discourage fraud. But, it said, if the veteran could show a need they could get same day reimbursement.

Some veterans need to make multiple trips during a month, some even weekly. This can cause a bottle neck of funds, stranding the veteran or discouraging them from making the trip at all.

The closing of same day reimbursements is only delayed, The Bulletin said while there is a review of the impact the new policy would have.

A press release dated July 13th from Senator Ron Wyden’s office  stated that the Senator had secured a commitment from the new Portland VA Director,  John Patrick that he will, “address concerns over a backlog of Fee Basis appeals stretching back more than two years as well as what appears to be improper charging of third-party health insurance for service-related care. The Director has also committed to exploring ways to maintain systems that allow for immediate reimbursement for travel expenses.”   You can read the entire press release here. And, a link to contact Senator Wyden is on the left hand side of that page.

Veterans Program Project Healing Waters Coming to Central Oregon

In the near future, a chapter Project Healing Waters, a program which assists in the healing of veterans through the enjoyment of and recreation in the outdoors will be started here in Central Oregon. The national website  of Project Healing Waters states the group is, “dedicated to the physical and emotional rehabilitation of disabled active military service personnel and veterans through fly fishing and fly tying education and going on outings” The Canadian branch of Project Healing Water‘s slogan is, “Rehabilitation and Healing on the Fly “.

In March of 2007, NPR ran the following series of stories about soldiers taking part in the program.

• Healing Waters; A Soldier’s Recovery, via Fishing
• Casting a Line, Making a Recovery: Neil Frustaglio
• An Injured Sergeant Goes with Life’s Flow
• Disabled Veteran: ‘We Get Where We Need to Go’

Orvis Casting Course in Bend, Oregon

Brad Emery, along with many other people, have been working for several months to get the project up and running . He said a number of people and businesses have come forward with offers to help. The Orvis store in The Old Mill will be providing a classroom for the fly tying, rods for casting instruction and use of their (only one of its kind in North America) casting course. Fly and Field Outfitters and Deep Canyon Outfitters are interested in helping. Owners have offered the use of private lakes.  He went on to say, they are working on acquiring some adaptive equipment to aid veterans who need it to tie flies.

Vets can be in a wheel chair, have PTSD or be an amputee and take part in the program, Brad said. The Bend Chapter will be out of the ordinary  because, there is not a VA hospital close by. He said, “Ours will be more of an out patient group, hopefully to follow up where the groups at the hospitals left off and a link to other Project Healing Waters groups and have them come and see Oregon’s finest.”

They will start out with one or two events and build up to an on-going, long term program. He said, all they are waiting on is confirmation of their affiliation with Trout Unlimited  (to provide an umbrella nonprofit status) before they begin taking vets referred from the Bend VA.

July 20, 2010 I recieved word from Chuck at COVO that they got the confirmation and are working out some details so they can start the program!

If you would like to help, have questions or would like further information you may contact Brad at bdemery1@aol.com.    Their website is located here.

This is a video montage from the National website of Project Healing Waters

VA Revises Guidelines For PTSD Identification

The following is a summary of an article which ran in the New York Times July 7th, 2010.

According to the New York Times, this Monday, July 12, 2010 new rules will go into effect for the identification of veterans with Post Traumatic Stress Disorder (PTSD). They will make it easier for veterans from any war to qualify for disability benefits. The article went on to say, this could qualify hundreds of thousands of veterans.

No longer will veterans need to have documentation tracing the cause of their PTSD to specific events. The Times wrote, “if they can simply show that they served in a war zone and in a job consistent with the events that they say caused their conditions”. The new rules would also cover veterans who lived in conditions where there was an ongoing fear of traumatic events- but never experienced actual ones.

The new rules have been met with some dissention, the article said. Some have voiced concerns that there will be a dramatic increase in fraudulent claims. Others are concerned about the added costs.  Mental health experts have voiced concerns that younger veterans with cases that can be treated and recovered from will instead become economically dependant on the disability money.

Lastly, the article said the final determination for qualifying will be made by a psychiatrist or psychologist working for the VA. Some have disagreed with this because they think it will be a way of controlling the number who qualify the Times wrote.

If you would like to read the Complete new VA guidelines for PTSD you can read them here. I will warn you it’s long and wordy.

To get assistance with putting in a claim in Central Oregon, you can make an appoinment with Nancy the VSO person at COVO by calling 541-383-2793 or emailing covo.org@aol.com. They are located at, 354 NE Greenwood Ste. 113 in Bend- next to the Arco gas station on the corner of Third and Greenwood.

If you would like to read the complete New York Times article my summary was from, you will find it here.

On July 10th the Presidential Weekly address was focused on this change in rules and other issues facing veterans. You can hear it or read it here. The audio lasts 4 minutes 25 seconds.

On July 11th NPR Sunday Morning Edition’s Liane Hansen interviewed Dr James Dwyer, a psychiatrist with the VA of Greater Las Angeles about this change in rules. You can hear it or read it here. The audio lasts 3 minutes and 38 seconds.