The VA is better than most healthcare options

In the past I have railed against the VA. Where the Veterans Administration (VA) has a lot of work to do, it is still better than most healthcare options. I work with a lot of veterans who struggle with the VA system. When asked about their experience with other healthcare systems, most veterans had not utilized the broken medical system in the United States and have nothing to compare it to. Struggling with the VA is not new for most veterans, but in my experience, it is still better than the alternative in many instances. I am not sure if you tried to get into your regular doctor lately, but it has been a nightmare for both veterans and civilians. The one thing the VA is good at and has been working on for years is the use of technology in healthcare. Technology is difficult for some of us who are older. The lack of shifting to tele health is problematic for civilian doctors, many did not invest in HIPPA compliant technology, leaving them scrambling to provide the needed services. I even know a lot of mental health professionals who have refused to shift to an online platform. This is detrimental to everyone.

The Choice program, aka, the Community Care Program started by President Obama has been a huge asset for veterans and the community at large. The VA's budget continually increases and has been increasing since the Obama administration. The Trump administration has been following suit to keep the VA well-funded to ensure we are taking care of like we were promised. Where the VA differs from civilian healthcare options is the VA has invested its money in technology. Unlike civilian medical systems the VA is not required to turn a profit. That is why we did not see any issues for Personal Protective Equipment (PPE) surrounding the VA during the pandemic. It was the civilian hospitals funded by insurance companies and private owners that suffered the most. I have multiple clients who have outside insurance and the VA, when they need medical attention, they choose the VA in just about every instance.    

One of the biggest issues I hear from veterans is how many young doctors the VA has working for them. If you look at it in a positive perspective new doctors have new ideas. They can utilize new technology effectively making the VA system more efficient than their civilian counterparts. The VA has been utilizing telehealth for years and their forward-looking stance is now paying off during this pandemic. Throughout history the military and veterans have been used as Guinea pigs when it comes to medical issues, and telehealth is one of the advancements. In my opinion the VA is on the cutting edge of medical innovations with younger doctors and telehealth. 

When dealing with other healthcare systems you can see the differences. Other healthcare systems only answer to one group, their shareholders. That is why there was a shortage of equipment such as respirators and PPE. It appears the VA had a stockpile of equipment and PPE because they were willing to spend the money where private healthcare systems had a limited stock of needed equipment. It appears the for-profit healthcare systems and doctors’ offices did not want to spend the money for something that just sit there. They did not care about our needs; they gave the money needed to have necessary equipment on hand to their shareholders.   

If you question a veteran about the VA healthcare system most talk positive about their treatment. The same might not be the same for normal hospital. If you want to see what Socialized medicine looks like, just look at the VA. This pandemic might be showing the weakness of the civilian healthcare system, and NO I do not work for the VA, I am just trying to be realistic.   

For questions or comments you can contact me at afterdutyvets@gmail.com or visit our website at www.afterdutyvets.com. I also have 2 books on Amazon if anyone wants to read more about veterans and their struggles. Living the Dream: Nightmares of Military Re-integration and Living the Dream II: Nightmares of Navigating the VA System. 

Veterans need to reframe their PTSD

I have had multiple clients into my office who have been struggling with what is going on in society. So many people in the United States has Post Traumatic Stress Disorder (PTSD) from one cause or another. There are an estimated 8 million of Americans who have PTSD. Wayne’s story about his upbringing and how he had dealt with the situation was interesting. Wayne was raised by an alcoholic and lived in fear of his father most of his childhood. Wayne had a gun to his head multiple time as a teenager. He decided to go into the US Army because he felt he need to get out of his situation. Wayne was in Vietnam during the TET offensive and saw heavy combat while there. Client did not realize how his horrific background and what his father did to him would pay off in the future.

As we discussed his situation and his upbringing, I offered a possible positive out of the negative upbringing. I made the comment that his upbringing and living with his alcoholic father prepared him for Vietnam. I explained how his hypervigilance probably saved their hides in combat and on patrol in the jungle. People with PTSD are more aware of their surroundings than the average person. They are always looking for the dangers. Once I asked Wayne to think back of situations he was in and if his hypervigilance saved him and his people. Wayne went home and came back to session the next week with a different attitude. Wayne had discovered that he had spotted multiple trip wires and boobytraps because he was so hypervigilant. 

Since the conversation with Wayne I have had multiple discussions with others with combat and non-combat veterans with PTSD. I have even run the thought by civilians with PTSD. It appears that they had a revelation around the idea that their PTSD could be a good thing and not all bad. The idea of PTSD being looked at as a positive has been extremely helpful for some. In any instance where there are crowds someone with PTSD will be more aware of their surroundings. By being hypervigilant they can observe suspicious behaviors before others.  By having PTSD it allows the use of your PTSD to your advantage, helping make you and your family feel safe.

I know it is emotionally draining to be that hypervigilant all the time, but what happens is after a while your brain gets so used to looking for danger it becomes second nature and the hypervigilance runs in the background of your brain allowing you to enjoy the event. Look at it this way, you do not have to think when you drive your car… why because it is second nature and your brain does it automatically. You can train your brain to do the same thing in crowds over time.

I know this will not work for everyone, nothing does. But what it can allow is being able to try something different and go into situations and keep telling yourself… I am same my PTSD is keeping me safe. When I explained this to Wayne, he thought and said… you know I think it has already helped me and I did not even realize I was doing it. I even had another client call it a “Super Power” The ability to see danger before it happens.   

Employers Don’t Understand the VA System

One of the issues my clients deal with is the lack of money usually brought on by their Post- Traumatic Stress Disorder and not being able to gain employment because of it. While they struggle to gain employment, they can wait for their Veterans Administration (VA) disability to be completed. It takes the VA a long time to get a veteran’s disability rating completed as they struggle physically, mentally, emotionally, and financially during the wait. I consistently tell my clients that they need to file a claim as soon as possible once they get out of the military. It appears to be easier for the disability rater at the VA to approve your claim quickly if it is submitted when you separate. The evidence is there, and the VA can’t argue that the problem is not service connected if it was documented while on active duty. I have been told that after a veteran is separated a year it is harder to get a disability approved because the disability can be blamed on something outside the service.

The longer a veteran wait to file the claim the more the process gets in the way. It is possible to get the claim processed in your favor, it just takes longer, and you continue to struggle finically.

This struggle is especially true for the older veterans whose medical issues have started to become a problem as they age. I have heard from too many veterans that they have not completed their disability claim because they would have to miss work, some have even said they were worried about being fired for missing work to deal with the VA and the system.

Once I retired from the Air Force, I ran into a major problem with an employer. They were unaware of the amount of time it took to deal with the VA, even after I told them.

As with every job you just start you have not accrued any leave or Payed Time Off (PTO). This makes it hard to deal with your VA appointments or any other appointments for that matter. As we know the VA can be on their own time and don’t care about your needs. I had to go to the VA on a consistent basis once I separated for my disability claim, multiple appointments at differing times on different days. I even submitted the claim while on terminal leave and it still caused an issue.

Because I was a “good troop” I followed the VA’s direction, not realizing that I could have re-scheduled the appointments. I thought that I was held to the appointment they set.

I found out the hard way that Employers do not like you taking off for VA appointments. Often,they believe you are looking for another job because they don’t understand how the VA system works. When it comes to employment, we need to tell our employers that we will be having VA appointments that you need to go to for your medical benefits. If they are unaccepting of the need it might be best to look for other employment. You have to you really ask yourself if you want to work for someone like that anyway? I did find another job as quickly as possible, I just had to be available, and it was a much better job.

Some Veterans Feel We are being sold as a Fighting Force

I really try to stay out of the political issues around the military, but recent events have made me feel the need to speak up. I have been seeing a lot of clients that are struggling with the way things are being handled in our country concerning foreign policy, specifically the Middle East.

Most veterans I see have an issue with the way President Trump is conducting foreign policy in the Middle East, specifically the abandonment of the Kurdish, and sending troops to Saudi Arabia. Many of our veterans have trained with and fought with the Kurds, this alliance goes back to the first Gulf War. The Kurds have helped fight Sandam Hussain and ISIS throughout the years. John fought beside the Kurds and came into session visually shaken because they were now being slaughtered because of the Trump policy in Syria. John appears to be struggling with the morality of leaving our allies when they need help. John feels the United States Military isnow becoming known as a mercenary military instead of a moral fighting force. John is startingto feel that the US military will be ordered to fight and die for the highest bidder and not US interest.

Some veterans have speculated for years that the US military has been fighting for big business and big oil, especially when we have gone to war with Iraq. But the President Trump squelched that speculation when he told the nation that he was renting out our armed forces in his roundabout way. Talking about the Saudi’s he stated that “They buy millions of dollars of merchandise from us!” so we will be sending our troops to Saudi Arabia to help the Saudi’s handle a possible attack by Iran, a threat partially made possible by the US pulling out of the Iranian deal and placing sanctions on them.

Pulling out of Syria and leaving the Kurdish fighters to fend for themselves against the second largest standing army in NATO is an insult to those fighters who have fought beside and been allies with the US for almost 30 years. The Kurdish people helped the US fight Saddam Hussain in the first gulf war and have continued to fight helping with US interest and hoping for a homeland. These Kurdish fighters are now on their own because they don’t buy weapons from us because they don’t have money. It is now known that the US is sending troops to Saudi Arabia to protect them because they have money. It is bothersome for some of those who have fought for the US to realize that we have given up the principles that make our country great. We only take up for the little guy if they buy their weapons from the US. Looks like a pay to play deal to me.

I know this has always been done to a point, but it has never been this “in your face” Desert Storm was a perfect example, when the oil supplies were threatened and the little guy was Kuwait with its large oil reserves the US was there. The president carefully words it so there is plausible deniability, and that should scare all of us as American citizens. But make no mistake about it, the ties the politicians and businessmen have with those countries that have money is the true reason our troops are sent to fight.

I know and understand that other presidents have done similar things like President Trump, the difference… the pullout of American troops in Syria has alienated a prime ally in the Middle East and opened the possibility of the resurgence of ISIS. The Kurds have been holding captured ISIS members in prison camps, it has been reported that ISIS troops and their families have escaped due to Turkey bombing the camps. If this is true the failed foreign policy by the Trump Administration would not only be a blow to the Middle East, it would be a huge blow to the world because ISIS could be allowed to be resurrected.

Since the Americans have pulled out of Syria and abandoned them the Kurds have had no choice but to turn to the Syrians and Russians for help fighting Turkey. This move is seen as an issue because many high-ranking Americans including Generals, and members on both sides of Congress appear to be forming alliances to stop President Trumps policy of pulling out of Syria and helping to de-stabilize the middle east worse than it was. It might be too late, the genie is out of the bottle and we have lost respect as a fighting force, one that is seen as being disloyal and quick to cut and run if there is no money to be made.

There are a lot of Veterans who support President Trump, but there is also a lot of veterans who do not like his policy. The President’s policy is adding stress to those who feel the US has lost the values that they fought for. John served with the Kurds and feels a loss because they were his brothers. They had that military combat bond that veterans have, something John says the President will never understand. It appears that President Trump is selling out to those with money and leaving out the values the US military is supposed to have. It scares a lot of Veterans about where we are going as a country and makes them wonder, what did we fight for?

Is Our Military Might Being Sold?

I really try to stay out of the political issues around the military because it is such a divisive topic. However, recent events have made me feel the need to speak up. I have been talking to a lot of veterans who are struggling with the way foreign policy is being handled concerning the Middle East, specifically the abandonment of the Kurdish, and sending troops to Saudi Arabia.

Many of our veterans have trained with and fought with the Kurds and feel they are being abandoned. The alliance with the Kurds goes back to the first Gulf War. John fought with and supported the Kurds; he was mad they were being slaughtered because of the Trump policy in Syria. John is struggling with the morality of leaving our allies for a political agenda. Pulling out of Syria and leaving the Kurdish fighters to fend for themselves against Turkey, the second largest standing army in NATO, is an insult to the US troops who have fought beside and been allies with them for almost 30 years. The Kurdish people helped the US fight Saddam Hussain in the first Gulf War and most recently ISIS helping fight for US interest and hoping for the homeland they were promised after World War I. The Kurdish are now on their own because they don’t buy weapons from the US, primarily because they don’t have a homeland. It is now known that after pulling away from the Kurds that the US is sending troops to Saudi Arabia toprotect them because they buy US equipment.

Some veterans have speculated for years that the US military has been fighting for big business and big oil, especially when we have gone to war with Iraq. But President Trump squelched that speculation when he told the nation that he was renting out our armed forces to Saudi Arabia.

Talking about the Saudi’s he stated that “They buy millions of dollars of merchandise from us!”so we will be sending our troops to Saudi Arabia to help them handle a possible attack by Iran.

John feels the United States Military is now becoming a mercenary military instead of a moral fighting force. He fears the US military will be ordered to fight and die for the highest bidder and not US interest.

I know this has always been done to a point, but it has never been this “in your face” Desert Storm was a perfect example, when the oil supplies were threatened and the little guy was Kuwait with its large oil reserves the US was there. But make no mistake about it, the ties the politicians and businessmen have with Saudi Arabia is the true reason our troops are sent there.

I know and understand that other presidents have done similar things, the difference… the pullout of American troops in Syria has alienated a prime ally in the Middle East and opened the possibility of the resurgence of ISIS. The Kurds have been holding captured ISIS members in prison camps, it has been reported that ISIS troops and their families have escaped due to Turkey bombing the camps. If this is true the failed foreign policy by the Trump Administration would not only be a blow to the Middle East, it would be a huge blow to the world because ISIS could be allowed to be resurrected.

Since the Americans have pulled out of Syria and abandoned them the Kurds have had no choice but to turn to the Syrians and Russians for help fighting Turkey. In a rare instance of bipartisanship high-ranking Americans including Generals, and members on both sides of Congress appear to be forming alliances to stop President Trumps policy of pulling out of Syria.

There are a lot of Veterans who support President Trump, but there is also a lot of veterans who do not like his policy. John served with the Kurds and feels a loss because they were his combat brothers, something John says the President will never understand. It appears that President Trump is selling out to those with money and setting aside the values the US military is supposed to have. It scares a lot of Veterans about where we are going as a country and makes them wonder, what did we fight for?

Its Holiday Season Again

It’s coming quickly, the family gatherings, traveling to see loved ones, but the holidays can be a trigger for someone with Post Traumatic Stress Disorder (PTSD). Often, we know there is something that causes some of those with PTSD to not want to take part in family get-togethers, but we can’t quite put our finger on why. Some family members know that it can be family dynamics or worse childhood trauma. I most families there are family secrets and some folks struggle to keep the family secret because it caused their PTSD. George and I were talking about the upcoming holidays and what his plans were. George was in the Army and decided to get out after a training incident killed a fellow soldier. As George was talking about the incident that caused his PTSD, I had assumed it was from the accident. Surprisingly it had nothing to do with the accident, it had to do with family.

George explained the tell tail signs of PTSD and I assumed it was due to the accident. After we talked a while, I discovered it was not the accident that caused his PTSD. George was sexually molested by a family member while staying at their home over the holidays when he was 12 years old. Even though it happened over 40 years ago it still affects his life, especially around Christmas. Throughout the years George has never set up a Christmas tree in his house since he became an adult. He was also the first person to volunteer to work during Christmas, so he did not have to participate in family gatherings. George never put together the reasons he did not want a Christmas tree, or why he disliked family gatherings and Christmas. We discovered during a session that he was triggered by the smell of Christmas trees. So often the trauma that caused the PTSD comes from childhood trauma, just like Georges and it is not even realized by themselves or family. Family gatherings can be a big trigger for someone who was assaulted by a family member because the victim feels that others know the secret, or they might have to face their abuser, so they choose not to go or try and avoid the situation.

When someone is a veteran family tend to believe that a veteran’s trauma comes from military service, and George played along with the accident as the reason for his behavior. But in Georges’ case came from childhood and the accident made his PTSD symptoms worse. One study shows that only six present of PTSD comes from combat. Family members are one of the leading perpetrators in childhood trauma. This abuse can be anywhere from neglect, assault, molestation and sexual assault. About 90% of children who are victims of sexual abuse know their abuser. Approximately 30% of children who are sexually abused are abused by family members. I know that abuse in the family is something that is not talked about. I have been told stories that the abused child spoke up about the abuse and was not believed or worse told to shut up and not say anything about the incident. The triggers usually arise when someone with PTSD is forced to face their abuser over the holidays because family expects them to come to the gathering not knowing the abuser or perpetrator is there. Unfortunately, this happens more than it is admitted too or even known about.

Families need to become aware of the triggers that can arise during the holidays. The signs of trigger’s usually start about a month before the holiday. I would like family members to be aware of why their loved one with PTSD might struggle over the holidays. The issues above are just a few that those with PTSD have over the holidays. I just wanted family members and even folks with PTSD to understand why they might struggle over the holidays. George never linked the lack of participation in family gatherings during the holidays with his PTSD. I challenged George to put up a Christmas tree this year, we will see if he does.

The Holiday Stress

John came to session and was upset about what he had to do over the holidays because of the pressure placed on him by family members. John gets upset because he feels his extended family believes he is working the system. John is unable to work because of his Post Traumatic Stress Disorder (PTSD) and is getting Veterans Administration (VA) disability. John has a combat tour in Iraq and another in Afghanistan and spent 2 of his 6 years in the Army deployed. He now lives with decisions he had to make while deployed. I am in constant awe of what some of our veterans have endured throughout their young lives. John is only 29 years old and has seen and done more than folks three times his age. John deals with his issues concerning his family by isolating, especially over the holidays. John chooses not to participate in the gatherings whenever possible because of the way he perceives his family feels about them.

John has spent a lot of his time being alone because of his shame, guilt, and pain of his time in combat. Isolation is a huge sign of depression and the holidays tend to be a trigger. John must travel for the holidays and one of his triggers is driving. He constantly feels pressure from family members to come to the gatherings causing him more anxiety. John feels he is looked down on by family members because he hears comments about him milking the system. John struggles with the way he is being treated and wants to tell them why he is in such pain, but he is too ashamed and feels guilt for what he did in combat. What makes it worse is family who talk about him are very religious and John had to kill people to make it home alive. He is worried about how he will be perceived by his family this year. He feels that if he told them that he would be criticized more for his PTSD.

Most families have no idea how to support their veterans through the holidays. I have researched and found 5 things Geoff Millard; a fellow veteran believes you can do to help your veteran with PTSD through the holidays.

1) Understand why the holidays are hard for veterans. Veterans often deal with “Moral injuries”, having to be OK with what you had to do to get back home, this is especially hard when you are in a religious family where there is a lot of judgement. Survivors guilt is another issue many veterans struggle with. The loss of a loved one in combat can play a huge part in a veteran not wanting to enjoy the holidays. Many families don’t understand the intimacy in combat units can rival the intimacy the military members have with their spouses and families.

2) Communicate with the veterans in your life. It is always best to communicate. Families need to know what the veteran’s needs are, what their fears are, how they want to be supported. Be prepared to hear the unpleasant because they might need something you don’t want to do. The reality might be is you are a part of the problem.

3) Never shame or “guilt trip” veterans. Often veterans can’t do things they used to do both physically and mentally because of their physical pain. Don’t shame them for the inability to do fun things, especially involving crowds. Some veterans have physical ailments and can’t chase the kids around or play with them the way they used to.

4) Prepare family members before any visits. Talk to the veteran first about what you plan to tell other family members. Ask your veteran what you can and cannot tell others about their private business, especially if it is related to medical conditions. Also discuss the need to bring up alcohol if it is an issue for the veteran. Remember do not tell stories or things that are not yours to tell. If you tell too much it can cause stress for the veteran and an erosion of trust between you and them.

5) Find new traditions. Do not give up on having fun during the holidays, but instead build new traditions as you grow together. Look for ways to do things different. These changes can be as simple as no black Friday shopping, eating desert first at holiday dinner, not going to extended family gatherings, there are multiple things you can do to help them not feel guilt for their inability to do what families see as normal.

It is important to be creative, and above all do not give up on each other. Veterans struggle with the holidays for reasons that are often not their fault. It is helpful if you choose to adapt to their needs instead of forcing them to do what you want them to do. Try not to place them in a bad situation that might cause a trigger and ruin the holidays for all involved.

Have a great holiday and enjoy your time together!

Getting a Real ID can be a Real Pain for some Military Brats

George came to session last week and was upset that he could not get his class “A” driver’s license renewed. George is required to have a Real ID for his class “A” and the California Department of Motor Vehicles (DMV) would not accept his birth certificate because it was not issued by a state or county official, it was issued by the Department of the Navy in Japan. Not only is George a military brat, he is a US Army veteran. It appears that the Real ID is going to be an issue for a lot of people. I have been researching this issue since George came in and it looks like it could be a Real pain for all, especially military Brats. It seems that some people who have US government issued ID cards are not required to get a Real ID unless it is needed for your Job like George. Getting a Real ID might be a good idea just in case though.

Effective October 1, 2020 anyone who flies or enters federal buildings and military bases must have a “Real ID” or a federally issued ID such as a retired military ID card, or a VA card with a pictured ID. This can be a problem for someone who was born into a military, state department, or embassy officials’ family in a foreign country. There are other documents that can work, but for George he must have the information to get his class “A” driver’s license so he can work. According to the regulations, for citizenship purposes, overseas military bases are not considered “U.S. soil,” the children of military personnel who are born on them are not automatically entitled to a state-issued birth certificate. Which is what you need to get a “Real ID”. Military brats born overseas will have to apply for a “Consular Report of Birth Abroad”which must be gotten from a U.S. consulate or embassy. This will allow a military brat to get a “Real ID” or passport if they were born overseas. It will take 4-8 weeks to return your U.S. birth certificate. In the meantime, George is unable to work because he is a truck driver and can’t get his Real ID because he is a military brat born overseas. and he might even lose his job because he was unaware of the requirement to get his drivers license renewed. It might be in your best interest to get your Real ID even if you are not a military brat born abroad. If you want to fly, enter a federal building, or military installation you will need to get this done. Don’t wait until the last minute.

The biggest issue I am seeing is people do not know if getting the Real ID is necessary or not. It is best to check to see if your government ID, if you have one, will work before you assume you are OK to get on an airplane flight though. This law was enacted in 2005 and the government has not educated the public about what they need to do to get the Real ID, or what passes for a Real ID. I have limited the scope of this column to helping Military Brats because of my client and it is too complex to put in a short column.

Below is what you need to do to get your birth certificate if you are a military brat and do not have one that meets the Real ID requirements. Please check with your local DMV to see if your birth certificate meets the criteria. In a Bureaucracy as large as the Department of State and the DOD not all documents are the same and change over time.

Requesting Your Consular Report of Birth Abroad

The Consular Report of Birth Abroad means you were born abroad or at a U.S. military base outside of the United States and your parents registered your birth with the local consulate. If your parents are living, you can ask if they registered your birth. For those born before December 2010, your Consular Report of Birth Abroad will be a form FS-240 or DS-1350. However, if your child was born after 2010, you will have a form FS-240. Because the Department of State maintains all registered records of birth abroad, you can request your replacement birth certificate online or through the mail. You need the following information to replace your birthcertificate:

 Your full name at birth.

 Any adoptive names.

 Your date and place of birth.

 Your passport information including date of issue, date of expiration, and passport number if available.

 A valid photo ID such as a state issued driver’s license, photo ID, military ID, passport, veterans’ affairs ID, or prison ID. Or, an expired photo ID with two secondary proofs of identification. For example, utility bills or bank statements with your full name, included with the signed statement: “I declare that I do not have a valid state or government issued photo ID and I am presenting two additional documents.”

 Full names of parents or legal guardians. In case of adoption or guardianship, a copy of the court order granting guardianship.

 The serial number of your Consular Report of Birth Abroad where available.

 Address and contact number.

Where to Send Your Request to Get a Birth Certificate for Americans Born Abroad

You will have to sign this request with your vital records in front of a notary. You can find the request form at your local bank and most post offices. The U.S. Department of State charges $50 via check or money order and you can mail your request to:

U.S. Department of State

Passport Vital Records Section

44132 Mercure Cir.

PO Box 1213

Sterling, VA 20166-1213

In most cases, it will take 4-8 weeks to return your U.S. birth certificate. If you need an original copy of your birth certificate, contact the hospital or records keeping body in the country you were born.