VA Math

I have a friend who was rated by the VA recently for a several serious medical conditions brought on by military service. His ratings were:

Diabetes brought on by Agent Orange exposure:     80%

 

PTSD from numerous firefights:                                 50%

Lost of vision in one eye:                                                30%

Degenerative disc disease caused by multiple injuries while serving as a paratrooper over 8 years:                                                                                  20%

Hearing Loss in both ears:                                             10%

Final Disability rating by the VA :                                 90%

Total Award:                                                                      $1,661 a month

Surprised? I will tell you below, after a short digression, how that is possible. Chinese math has nothing on the VA version….

When I was stationed at Ft. Sam Houston I roomed with a college educated draftee who was also teaching at the Academy of Health Sciences. He was less than enthused about having to wear an enlisted man’s uniform and was generally part of G2 (Intelligence) for any anti-authority prank that was pulled in our department. I came home one day to find him reading  The Officer’s Handbook. When I asked him why he had bought it he replied, “Sound philosophy, Lon: Know your enemy.”

While I don’t consider the VA an enemy, for there are a host of caring and dedicated individuals employed there, the system is clearly broken and in dire need of repair. To reform a system you must understand it. From time to time I will post articles to help you understand VA benefits and some of the barriers vets encounter as they try their hand at the toughest confidence course of their careers. I have found that few vets really know how it works so, I will try to explain in plain language.

The VA awards benefits based on a rating decision made by a specialist in one of 16 regional offices. The specialist begins with the most severe condition first. In this case the diabetes. He rated the vet at 80% disabled. Note: He had to be pretty sick to receive a rating that high. Next, he is rated for PTSD. 50% indicates he is functional, but debilitated. So, the rater now applies VA math: At 80% disabled he is thought to have 20% usable resources remaining. So, he is thought to be only 50% of the good 20% disabled. That ups his disability rating by 10%. Then the rater applies the formula to his disc disease: He has 10% usability left and 30% of the remaining 10 points of usability allows him to add 3% more to his total rating. His hearing is rated at 10% (the maximum they allow for claims) and that brings him to a grand total of 94.96% disabled according to VA math. And the VA rounds up at 95% and rounds down at 94.9% so, he is 90% disabled. and paid at that rate.

He/she can, if completely unemployable, receive compensation at the 100% rate ($2700), but must apply and be evaluated again. That takes another 6-16 months. It can be sped up if the veteran is certified as homeless by the VA, but the documents proving that could take 3-6 months to be entered into the file. The VA can give 100% unemployability, but does not seem to very often. One vet who had fought for his 80% rating for over a decade had not worked in ten years. He is still waiting for an unemployability decision.

So, for those of you who thought our wounded warriors were headed off to Aruba with their largesse, just do the math… It is difficult to get benefits and the ratings often vary wildly and do not always reflect the severity of the problem. A lot of money and personnel are being thrown at the problem. Here is hoping it works sometime before vets waiting for answers and benefits pass away.

I will post soon about how the VA arrives at a rating for each disability. That too should be an eye opener.

 

 

My PTSD (Part I)

“What the mind doesn’t understand, it worships or fears.”
― Alice Walker

PTSD  has now become a part of our lexicon. PTSD hashtags appear on Twitter feeds in reference to everything from a chance encounter with a spider in a trash bin to more serious revelations by survivors of sexual abuse, combat, accidents or tragedies like the one today in Aurora, Colorado.

I began working with PTSD in the 70’s when I was a behavioral science instructor and field placement supervisor at the Army’s Academy of Health Sciences and later while assigned as a therapist in the outpatient psychiatry clinic for the Army’s 97th General Hospital in Frankfurt, Germany. The Vietnam war had officially ended in 1975, but soldiers of my generation, entrenched within themselves, rarely spoke of their time “in country” and still could not connect many confusing thoughts and actions to their battlefield experiences until their symptomatic storms raged so severe that they were ordered to see me. For them, the war was hardly over.

And after my discharge, in later years, I was a Certified Employee Assistance in charge of front line counseling for senior employees of the city of Raleigh and Wake County in North Carolina. It was there that I guided police officers, fire chiefs and health care workers through the guilt, shame and torment they experienced because anxiety debilitated them. Shootings, being surrounded or assaulted by a mob in a riot situation, having to performing triage (deciding who would be best left to die at an accident scene and who would be a survivor if transported first to the hospital), carrying screaming burn victims from burning homes, and former soldiers who just could not make nightmares stop were part and parcel of my day. And too, there were rape and molestation victims, intensive care nurses who simply couldn’t bear to see another patient die and their families who had become no less distressed. They stayed in difficult relationships hoping the person they once loved would reappear from the ashes of anguish and self-destruction.

Fiction writer Dean Koontz once wrote that, “Because God is never cruel, there is a reason for all things. We must know the pain of loss; because if we never knew it, we would have no compassion for others, and we would become monsters of self-regard, creatures of unalloyed self-interest. The terrible pain of loss teaches humility to our prideful kind, has the power to soften uncaring hearts, to make a better person of a good one.”  I am still learning those lessons. And in some ways I am a better person for enduring PTSD for decades. I will share the stressors with you in future posts, but suffice it to say, I have been abused, psychologically,medically and physically, and endured torture in ways only concentration camp survivor or POW might understand. I will share some of what I experience here in hopes you better understand issues surrounding PTSD:

Post-traumatic stress disorder symptoms typically start within three months of a traumatic event. In a small number of cases, though, PTSD symptoms may not appear until years after the event and they may be triggered during other stressful periods in a person’s life.

Post-traumatic stress disorder symptoms are generally grouped into three types: intrusive memories, avoidance and numbing, and increased anxiety or emotional hyper-arousal. I had many symptoms for years, but became totally overwhelmed in the middle of a meeting. My heart rate jumped to 140 and I couldn’t breathe. I thought I was going to die.

The hospital where I worked tested me for cardiac issues. I had none. I was having panic attacks. The doctors prescribed mild anti-anxiety medicine that had little or no effect. The panic attacks increased and soon I was having up to five a day and they would last between 5 and 40 minutes each. Imagine being on a balcony one day when when you experienced a sudden feeling like you might fall or even jump.Most of us have felt that at least once. Now, multiply the confusion and fear you had by a factor of two or three and you are close to feeling like I often did without warning or provocation.

At the time I was teaching college courses in Psychology, lecturing at national conferences across the country on wellness topics, I had just won a National Endowment for the Arts Fellowship for my poetry, I was an international Tae Kwon Do Master Instructor and had begun feeling reasonably successful professionally in most areas of my life. I had managed my symptoms up to this point (hid them well) but, those days were clearly at an end.   All I wanted  to do was hide from any responsibility, anything that might cause stress. I prayed nightly that I would die in my sleep before having to endure, or putting friends and family, through another day of terror. I thought I would gladly give up an arm or leg if the anxiety would just stop. Suicide was never a distant option.

Then came the constant reliving of traumatic event for minutes or even days at a time. My sleeping habits were bad before, but horrifying dreams, and night terrors now dominated.  I became housebound. I tried to avoid thinking, talking or engaging in any activity that might trigger an attack or increase my anxiety. I was hopeless about the future. I couldn’t concentrate and I had trouble remembering events both near and far. All my relationships suffered as I worked diligently to hide how far I had fallen.

I was easily angered, though too weak and afraid to be much of threat to anyone unless cornered or assaulted. I was easily startled and often heard or saw things that simply were not there. I over indulged in anything that would distract me from my anxiety: Drinking, television, gambling….

I tried to return to work. I tried teaching, but was carried out of my classroom once by paramedics. I was lost for an answer. Finally a military psychiatrist proposed a long-lasting benzodiazepine. The panic attacks stopped, but my personality changed. I was depressed, irritable and devoid of creative thought. And worse, I was seriously addicted.

A recent pop psychology article was titled “What doesn’t kill you, makes you weaker. There is more than a little truth to that if you understand the classical conditioning paradigms and the heavy toll negative events can exact from mind, spirit and body. When anxiety generalizes it is hard to get a handle on how to stop it from flooding every corner of your consciousness. You cannot just will it away. Drugs are one way out of the trouble and the Army and the VA have used them in excess. The effect of benozos is to behave and think like someone who has just downed three or four glasses of wine, but the effect lasts twelve hours. I often wish I had dived headlong into alcoholism. It would have been easier to kick. I stayed lost in a drug haze for over a decade….

 

 

Postscript: My heart goes out to the victims and families of the Aurora Shooting today. I know the area well: My father was evacuated there after being critically wounded during a mortar attack in Vietnam. My sorrow is miniscule in comparison to the pain that must be felt today. I pray for the survivors and a speedy recovery from senseless physical and emotional wounds.