‘I’m pushing the mental limits’

In February, the Washington Post’s Dana Priest and Anne Hull literally stunned the nation with an investigation of the outpatient services at Walter Reed. Americans simply couldn’t believe the treatment veterans of the wars in Iraq and Afghanistan were receiving. The ensuing scandal led to three major resignations among top Army officials.

Today, Priest and Hull add to the story with a devastating report on the treatment veterans with post-traumatic stress receive — or in too many cases, don’t receive. Take, for example, Army Spec. Jeans Cruz, who helped capture Saddam Hussein and who received a hero’s welcome upon returning to the Bronx.

In public, the former Army scout stood tall for the cameras and marched in the parades. In private, he slashed his forearms to provoke the pain and adrenaline of combat. He heard voices and smelled stale blood. Soon the offers of help evaporated and he found himself estranged and alone, struggling with financial collapse and a darkening depression.

At a low point, he went to the local Department of Veterans Affairs medical center for help. One VA psychologist diagnosed Cruz with post-traumatic stress disorder. His condition was labeled “severe and chronic.” In a letter supporting his request for PTSD-related disability pay, the psychologist wrote that Cruz was “in need of major help” and that he had provided “more than enough evidence” to back up his PTSD claim. His combat experiences, the letter said, “have been well documented.”

None of that seemed to matter when his case reached VA disability evaluators. They turned him down flat, ruling that he deserved no compensation because his psychological problems existed before he joined the Army. They also said that Cruz had not proved he was ever in combat. “The available evidence is insufficient to confirm that you actually engaged in combat,” his rejection letter stated.

This despite the abundant evidence of his year in combat with the 4th Infantry Division.

Cruz has trouble working, but even more trouble fighting the VA and the Army to correct his medical records and his personal file so that he might qualify for aid. “I’m pushing the mental limits as it is,” Cruz said. “My experience so far is, you ask for something and they deny, deny, deny. After a while you just give up.”

Of course, Cruz’s case is not unique — as many as one-in-four American troops return from Iraq “psychologically wounded.”

Unlike the Walter Reed debacle, which was largely a matter of breathtaking neglect, a variety of factors have created the mental-health problems for war veterans, including:

* Bureaucratic delays — Massive backlogs prevent efficient treatment and make it easier for troops in need to fall through the cracks.

* Lack of trained professionals — Licensed psychologists are leaving the military at a fast clip, in part because of the stress associated with treating pained soldiers. Troops who qualify for care end up with inexperienced counselors, who use “therapies better suited for alcoholics or marriage counseling.”

* Stigma of mental-health problems — Only 40 percent of the troops who screened positive for serious emotional problems sought help. Lt. Gen. John Vines, who led the 18th Airborne Corps in Iraq and Afghanistan, said countless officers keep quiet out of fear of being mislabeled, and many believe they will be denied future security clearances if they seek psychological help.

* Disability qualifications — “To qualify for compensation, troops and veterans are required to prove that they witnessed at least one traumatic event, such as the death of a fellow soldier or an attack from a roadside bomb, or IED. That standard has been used to deny thousands of claims.” The VA’s chief of mental health explained, “One of the things I puzzle about is, what if someone hasn’t been exposed to an IED but lives in dread of exposure to one for a month? According to the formal definition, they don’t qualify.”

It’s a painful and sobering piece about veterans who deserve a lot better than what they’re receiving. Take a look.

The pro-war crowd is quite fond of the expression “freedom isn’t free,” as if the cost of war in human lives is quite an acceptable burden. But when it comes to paying the cost of the care for those who survive the war, the neocons balk at the expense of making the troops whole again. So which is it? Is our “freedom” worth the cost of paying for mental health care and rehabilitation, or is the cost of war too high and thus we should end it?

  • The Nation and NPR both did major stories on this month’s ago. That it is still a problem is just another sign of the total contempt this administration has for its cannon fodder. Truly disgusting and disgraceful

  • What is it with the Republican contempt for the military? Sure, they say they support it in the abstract and want to lead all the parades, but they don’t want to spend money that will directly benefit elisted personnel. I haven’t been in support of the invasion and occupation of Iraq, and I’m usually one of the first people to gripe about military mega-expenditures on dubious new weapons systems, but I’ve always been in favor of decent pay and whatever training, equipment, and support soldiers need while enlisted and afterwards.

  • “Republican contempt for the military.”

    “Republican contempt for the military.”

    “Republican contempt for the military.”

    “Republican contempt for the military.”

    “Republican contempt for the military.”

    “Republican contempt for the military.”

    Repeat it until it sticks to that party like a burr on velcro.

  • Jeans Cruz is lucky to have that name brand recognition. It got him star billing in Priest and Hull’s story. Presumably his problems with the VA bureaucracy will now magically disappear.

    But for the rest of the soldiers in the same boat, it’s still going to be the “Eff you, Charlie!” that counts as supporting the troops in the time of Bush.

  • Ensuring that US military personnel receive adequate medical care would cut into profits for contractors and Halliburton subsidiaries. Shrub’s misadministration has clearly demonstrated which is more important to them and it is not our troops. This will bite us in the ass with the toll of suicides and ex-soldiers having flashbacks going on shooting sprees because they didn’t receive needed medical care.

  • I don’t want to downplay the experience of U.S. veterans, but this kind of (non) treatment is business as usual for any org that wants to keep costs in line. Right now, my husband is suing his disability insurer for denial of benefits. Their response to his loss of ability to work in 2004 on account of severe clinical depression was dismissed with the line “… we recognize that you are limited, but [you could work is you *wanted* to] ….”
    As his lawyer said, “You think that the insurance co is your friend. Believe me, they’re not.”
    Being that I’m now the sole breadwinner, trying to cope with a disabled spouse who is not getting very much better (and who will now never return to his occupation) because we can’t afford to pay for the independent treatment that might have rehabilitated him, and fending off demanding creditors at every turn while I try to pay off bills that accumulated in the first year of his illness, both of us know all too well the costs of this shoddy behavior.
    That these soldiers are not getting care that should be *automatic*, given their profession, is beyond the pale.

  • This has been a major topic in the GI antiwar newsletters for over two years now, that’s how long it’s been going on. This is part and parcel of how the scumsuckers at the VA said that Agent Orange had no effect on GIs in Vietnam, and that Gulf War Syndrome doesn’t exist. The kind of letters Specialist Cruz received are totally maddening. The only way a veteran can fight this stuff is to get in touch with organizations like the Military Law Task Force (www.mltf.org) and get an attorney to fight them – it’s like dealing with the rest of the American (non) insurance industry: delay, deny, defend – that’s their mantra. From personal experience, I’ll tell you not to get messed up in combat and don’t get involved in a car accident inside the continental United States. You will be fucked both times, for the crime of being a victim.

    I’m starting to think that my attitude from 40 years ago – that what we need is a revolution, where all the corporate pinstriped pimps get taken to the nearest light pole and are strung up and left to rot, then we start over – may well be far more true than I thought it was then, given that things today are only worse on all levels than they were back then.

  • If it wouldn’t be too much of a bother, could someone please send Spec. Cruz’s “VA disability evaluators” to my home? I think it’s time to give these yokels a nice, medieval-esque wake-up call. And while you’re at it, you might want to remind ol’ George that he’s only got 19 months left to dole out those box-car-loads of wholesale pardons—none of which I intend to recognize as being legitimate., of course….

  • Anything to save a buck; be it mental health or…

    From a comment on today’s TPMMuckraker:

    Second up is the appeal of a Wisconsin Navy vet, now in jail for-you guessed it-mail fraud. Determined by the Department of Veterans Affairs to be 100% service connected disabled, this vet had the temerity to file a claim for retroactive payments going back to the date determined by the VA to be the start of his disability. But a typically crank policy paper churned out by the American Enterprise Institute recommending that these sorts of claims were sapping the finances to fight the war in Iraq and must be stopped led to the DOJ policy of prosecuting earlier-effective-date claimants for fraud based on misuse of the mails.
    So despite doing everything by the book and at the direction of VA officials, this vet nonetheless was indicted, charged, tried, convicted and jailed while he appeals. This is exactly the same trial of tears foisted upon Georgia Thompson.
    The VA stopped the checks for his existing benefits and billed him for benefits already paid, Social Security ended his monthly disability payments, and he is now in his fourth month in jail awaiting his first appeals brief before the 7th CCA at the end of June.
    And in California, the state Department of Veterans Affairs is making threatening calls to vets who have filed claims for earlier effective dates on their existing 100% service connected disability benefits, usually zeroing in on the most vulnerable, the PTSD claimants. The CVA caller threatens the vet with a full review of existing benefits, intimating that they could be taken away if the vet doesn’t withdraw his claim. A FAX number is given-619-400-0071-so that the vet can immediately cancel his claim. The The CVA caller, Diane Hiltman-619-400-5390, works for Tracy Greenamyer-619-400-5310.
    Give ’em a jingle. They are standing by, waiting to take your call.

  • I remember, back in the early Seventies, being terrified of the draft. I wasn’t even ten years old yet, but I was afraid I’d be called up to do war on someone who was probably a lot like myself, just speaking a different language. Thankfully (I guess), the draft ended before I was old enough to be conscripted.

    Later, as a senior in high school (early Eighties), I signed up for the deferred enlistment program, to go into the military (Navy in this case), but that was the year I came out. I wanted to do something positive for my country, when that counted for something, but “Thanks, but no thanks” was the response I got. Part of me wonders what would have happened had I “not told”, but the majority of me is glad that I did. I love my life, and the husband I’ve had for over fifteen years now.

    The mental trauma these combatants have suffered is more than I can even imagine, but our country should certainly be supporting them and helping them to recover from what they have been through–for the sake of the country they love and want to defend.

    I don’t really have a point with this, but I do want to say that I am beyond disgust with the current adminstration and the way they have treated our troops.

    If people don’t think there’s a difference between Dem and Repug, then they ought to look at who tries to give funds to the troops, and who tries to put a stop to it.

  • I hate to say it guys, but it’s not “the current administration.” I was messed-over by the Veteran’s Administration under Johnson and Nixon and my son got his messing-over under Bush-41 and Clinton. I think the only time vets weren’t messed-over was after WW2 when there were so many of them and they’d won such an important victory – altho if you go look at 60-year old GI Bill houses, you can certainly see they weren’t “built forthe ages.” And nowadays I must say the VA health system is doing a pretty good job for me (not as if I have any alternative, being “one of hte 45 million” otherwise).

  • I disagree with the tactic of just repeating a “Republican contempt for the troops” sound-bite. People have already been sold on the line that the Republicans support the military and liberals don’t, so people really have to tell them the whole story of how Republicans are failing the troops.

    If you use the sound-bite without explaining where you’re coming from first, rank-and-file Republicans and swing-voters are going to tune you out.

  • When I returned from a year in the Mekong Delta I was given a check for my back pay and accrued leave and then allowed to exit the base via the main gate.

    Never saw a doctor though I’d lost 40 pounds there, a shrink – no way.

    Twenty years later I found myself in a twenty-eight day program for drug and alcohol abuse. I was lucky enough to draw a psychiatrist who’d treated other vets. He diagnosed me with PTSD.

    It took a long time to crawl out of that hole and if I hadn’t had good insurance I’d probably still be there – only I’d be dumpster diving to live.

    Sending people to the pisshole that is Iraq over and over again then denying their legitimate claims on our government for help is a shame on the nation.

  • Please bear with me for a sort of long story that is right on target for this subject. I was at a party two weeks ago and one of the people at the party was a recruiter for the Army (23 years in as only a recruiter). While I was talking to a young man who is a nurse and in the National Guard he mentioned that some in his unit were having PTSD symptoms. An older man (late-sixties) in the conversation mentioned that he volunteers at the local VA hospital and he has seen a huge increase in mental issues. That was when the recruiter said ‘Well you know that all that talk about post-traumatic stress is horseshit because there is no such thing’. The three of us were just stunned and we all looked at him to see if he was joking – he was not joking, not even a little bit. The nurse was the first to speak and he asked what the guy was talking about and was he drunk. The recruiter said that “It’s well known in the Army that PTSD is just lazy guys who want a free ride after they get out.” For a minute I thought someone would hit this moron but he soon wondered off to be stupid with other people. Since then I’ve asked several people who are on active duty or reserve or Guard what was going on with this recruiter. The explanations have run from moron to cognitive dissonance because of him being a recruiter to this is somewhat Army policy. Any thought from you folks?? Is this related to why getting help for PTSD is hard??

  • I don’t think it’s what Dale says, “Republicans are generous with the rich and stingy with the poor.”, but a more specific fear, the idea that the unlucky will reproduce and somehow contaminate, or drain off, their own unearned (zero sum) good fortune.
    More like Tom Cleaver says, ” You will be fucked … for the crime of being a victim.”

  • Note to conservatives: THIS is what your movie darling Rambo was talking about, not some ginned-up image of liberals trying to undermine the troops.

  • Any thought from you folks?? Is this related to why getting help for PTSD is hard??

    [HG from WI]

    Has this fine sample of humanity ever been in combat? However, I suspect he’s just one more person who has his head up his arse about an issue he thinks will go away if he ignores it. Yes, when there are too many of this type of person they can screw things up for the rest of us.

    See: Global Warming.
    See: The disaster that is Iraq.
    See: The erosion of civil rights…

  • The reason getting a PTSD disability is so hard in the VA system is deliberate. Most of the time I opt for the “incompetence” answer, but the VA (and the present administration) seems to have found the only psychiatrist on the planet who does not believe in the concept of PTSD and has written that most sufferers are malingering. (I wish I could remember her name, I was so incensed when I heard her speak that it left my brain.) Knowing a good thing when they hear it, the VA politicos followed her guidelines probably because the administration does not want the scandal of troops actually having PTSD because it would make them look bad.

    But war is hell, and we have known that for years. The Army has several studies showing the mental effects of this war published and the horrendous increase in suicides, marital problems and PTSD. Apparently the VA leadership is not allowed to read these things so they can prepare.

    In general the VA tries very hard to help veterans. Go to any facility and you will find warm and interested people who want to help. They have been thwarted by the upper echelon politicos who want to look good. When I was in medical school the VA hospitals practically had to invent disease in order to keep funding. Now that there is an epidemic of mental illness amongst vets, the story is different. This reflects the policies of the administration, no question, because the problems is there for anyone to see.

    If you ask my bona fides in this subject, I proudly served as a member of the first Combat Stress unit, the 528th MedDet (CS) in Operation Desert Storm. Even then we thought that there was too little and now with a war of IEDs and uncertain goals, the stress factor is multiplied by 1000.

    A national disgrace, if you ask me. It makes me, a conservative republican, pine for the days of Bill Clinton.

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