On another note, watch for changes, or at least additions to come in the future as Terry, myself, and others decide the new direction of the web site.

Have any suggestions for improvements, or new site features? Leave a comment, and I’ll try to pass them along, or incorporate them.

NPR Labs, in partnership with the International Association of Audio Information Services, received a federal grant from the National Institute on Disability and Rehabilitation Research to create a practical way to identify RRS programs by category, transmit that information as Program Service Data in an HD Radio channel, and develop a working HD Radio receiver that enables blind and low-vision listeners to select desired programs for capture and later listening — including traditional rewind/fast forward/scan transport functionality.

Read about it here.

Well, BVA members might remember that the veteran service organizations all worked for years to get legislation enacted last year that would provide VA health care with Advanced appropriations each cycle so that the veterans who depend upon there health care from VA would not be negatively impacted by these forever delays in enacting funding for each federal agency at the start of the budget year on October 1st that had occurred in 19 of the last 22 years. Well the loop hole is that the Continuing Resolution (CR) covering FY 2011 then does not allow for “advanced appropriations for FY 2012” because for this process to work, it requires that the regular appropriations bill must be passed each year for VA. In other words, even though because the FY 2010 appropriations, enacted last year, funded the VA for FY 2011 on estimated health care services, there won’t be funding for FY 2012 passed this year since the FY 2011 budget was never passed.

Worse, in the effort to cut all discretionary funding programs across the board, the coffee shop rumors are flying that in late January the House of Representatives will drop bill to reduce all federal agency funding to the FY 2008 levels. A 22 percent cut across the board for everything, leaving a mess since obviously the VA has hired a lot more health care staff the last three years to improve access and health care services and would not have the funds to cover those positions under this budget gimmicks.
1. THE AX MAN COMETH. The next time Congress hashes out government funding beyond a continuing resolution could get interesting. House and Senate Republican leaders say they want to reduce non-security discretionary spending back to 2008 levels, which would mean a cut of about 22 percent overnight — the deepest in decades. What Republicans haven’t said is which programs should get the ax, and by how much. Only about $16 billion can come from rescinding unspent stimulus money and remember the $ 1 trillion deficit or red ink leaving a big hole to plug. And while many conservatives might love to cut energy, education, and safety-net programs, they would have no choice but to hack away at more basic programs: law enforcement, tax collection, immigration enforcement, scientific medical research, space exploration, environment, agriculture, transportation, etc. It should make for a lively intraparty debate because every one here likes to cut some other congressman’s special program, but then they want to protect there own programs funded by the federal government that benefits there farmers, researchers, space centers, border security, transportation highway project, or new airport runway!

No one yet is sure how this is going to all fly, but we here are working and talking with the other veteran service organizations to figure out how we will respond if these rumors of massive cuts take place with various legislation being introduced for the rest of the fiscal budget year of FY 2011. We at BVA have had a lot of success in the past four years with major legislative accomplishments, and new benefits and health care programs for disabled veterans and now will face some very uncertain times in the new year.
Thanks,

Thomas Zampieri Ph.D.
Director Government Relations
Blinded Veterans Association

Thomas Zampieri Ph.D.
Director Government Relations
Blinded Veterans Association
477 H. Street NW
Washington DC 20001
Direct Office 202-355-9525
Cell 301-204-3291
BVA 202-371-8880
tzampieri@bva.org

Originally published: December 12, 2010 9:31 PM
Updated: December 12, 2010 10:23 PM
By MARTIN C. EVANS martin.evans@newsday.com

Photo credit: Newsday / Alejandra Villa | Diane Lake photographed at Pinelawn National Cemetery where her husband, Robert Lake is buried. (Sept. 8, 2010)

When Diane Lake began visiting her late husband’s resting place at Long Island National Cemetery in Farmingdale, she became alarmed by what she saw nearby: memorial markers that showed many of her husband’s fellow Vietnam veterans had died even younger than he had. The markers, spaced along a wall where the ashes of her husband, Spc. 4th Class Robert Lake, and others are interred, indicate which war a veteran served in, along with rank and branch of service.

“I would look up on the wall and see this one was only 62 and this one was only 61, and say to myself these men were pretty young to be dying already,” said Lake, whose husband was 65 when he died of an aggressive skin cancer May 13.

Lake, of East Northport, is among an increasingly vocal number of Vietnam veterans or their loved ones who are questioning whether participation in the Vietnam War is hastening the deaths of soldiers who survived it.

John Rowan, of Queens, national president of Vietnam Veterans of America, said his organization had been frustrated that the Department of Veterans Affairs has not done current research on the death rates of Vietnam vets. But he said he sees change coming. In September, VA Secretary Eric Shinseki said his department has begun a study of the health impacts of the war, which he said would be complete in about three years. “The insight we gain from this study will help give us an understanding of how to better serve America’s veterans,” Shinseki said in a news release.

Death rate concerns veterans

The VA study could go far in addressing concerns of Vietnam veterans groups who believe the war has had a devastating effect on their health and life expectancy. Their evidence is mostly anecdotal, though. Some experts familiar with limited data regarding veterans’ deaths say they have seen nothing that supports the charge that Vietnam vets are dying at unusually high rates. Still, many Vietnam veterans believe it is true.

“The Vietnam guys are going faster than the World War II guys,” said Joe Ingino, president of the Nassau County chapter of Vietnam Veterans of America. He said he has come to believe this from stories he has been told across the region. Examples on Long Island include a Medal of Honor awardee, Army Spc. George C. Lang, who grew up in Hicksville. Lang, who was paralyzed during a 1969 firefight, was 57 when he died of cancer five years ago.

Sharing a section of the memorial wall, known as a columbarium, in Farmingdale are the names of Staff Sgt. Leslie Garcia, formerly of Central Islip, who was 58 when he died of a heart attack this year, and PV2 Angel Gonzalez, of Manhattan, who was 53 when he died in 2009. The marker for another soldier nearby – Pfc Lawrence Gilmore was 61 when he died of a heart attack last year – reads “No more pain beloved son and brother.” “He was a loner, and never married,” said his mother, Eva Gilmore, of Port Richey, Fla., who said Gilmore battled diabetes before he died. “He was in a lot of pain.”

Many veterans note with alarm that the VA this year again expanded the list of more than a dozen diseases – including a host of cancers, Type 2 diabetes, and ischemic heart disease – directly linked to exposure to Agent Orange and other herbicides sprayed in Vietnam between 1962 and 1971. A diagnosis on the list can entitle a veteran to compensation related to a service-connected disability.

Other factors at play

Advocates say factors other than service in Vietnam also likely undermined the health of veterans. Because returning troops were rejected by a war-weary public, many turned inward, battling anxiety, depression and Post Traumatic Stress Syndrome on their own, often made worse by alcohol or drugs, experts say. And for most of the war, troop rations included free cigarettes. “I can’t say if his heart attack had anything to do with him being in the war because he was a heavy smoker,” said Jocelyn McIntee, of Greenlawn, whose husband, Eugene, served in Vietnam in the mid-1960s, and died in 1992 when he was 49. “He really didn’t talk about it, but do I think he came back with a lot of stress, yes. He saw a lot of people killed, and that must have been disturbing.”

As early as 1987, the Centers for Disease Control and Prevention reported that troops who had been in Vietnam were dying faster because of risky or violent behaviors after their return. In its 1987 Vietnam Experience Study, the CDC reported that the death rate for U.S. troops who served in Vietnam was 1.5 times higher than for troops who served elsewhere in the first five years after their discharge. Violent deaths accounted for much of the increase in that study, with Vietnam veterans twice as likely to die from car crashes, suicide and homicide as were troops who served elsewhere during that era.

A 1996 study by Australia’s Department of Veterans Affairs showed that Australian troops who served in Vietnam died younger than Australian troops who served elsewhere in the same period. They were twice as likely to die of lung cancer and three times as likely to die of cirrhosis of the liver, the study showed. More recent data on the rate of Vietnam veteran deaths is anything but clear, says Mary Paxton, of the national Institute of Medicine, a sister organization of the National Academy of Sciences that evaluates health data for the Department of Veterans Affairs. Paxton said studies of U.S. veterans cannot be regarded as definitive because incomplete record-keeping by the U.S. military means researchers cannot reliably track the health outcomes of the 2.6 million Americans who served in Vietnam.

No ‘massive die-off’

But her reading of research has convinced her that there is no epidemic of early deaths among Vietnam vets. “I get calls from veterans who say they are dropping like flies, but that doesn’t seem to be the case,” Paxton said. “I think they are at somewhat higher risk, but there is not the massive die-off that is being claimed.” Paxton referenced a 2004 update of the 1987 CDC study, which followed 18,313 male Army veterans. “Death rates from disease-related chronic conditions, including cancers and circulatory system diseases, did not differ between Vietnam veterans and their peers,” the report said.

To families of many Vietnam veterans, the statistics only go so far, as many now wonder whether their service in Vietnam so long ago is threatening their lives a second time. That’s a question that tugs at Diane Lake, who said it became clear her husband knew he would not live past 65. “He said, ‘Diane, I don’t have much time,’ ” she said, recalling his words shortly before his death. “He was with us another 10 days, and he was gone.”

The Veterans History Project is an opportunity to honor the selfless work of our men and women in uniform. By volunteering to record the one-of-a-kind personal recollections of our veterans, we can preserve an important part of American history–what it was like for our veterans to serve our nation during times of conflict and times of peace. Since the creation of the Veterans History Project, volunteers have recorded close to 80,000 veterans’ stories, which are now housed in the permanent collection in the Library of Congress.”

Listen: http://www.c-spanvideo.org/program/HouseSession3952/start/30079/stop/30559

The Mission of the Veterans History Project of the Library of Congress American Folklife Center is to collect, preserve, and make accessible the personal accounts of America’s war veterans so that future generations may hear directly from veterans and better understand the realities of war. Learn more at http://www.loc.gov/vets.

This service is provided by the Library of Congress at www.LOC.gov.
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Every Visual Impairment Service Team Coordinator VIST has been sent instructions on this and would recommend that if a veteran is having a local problem they talk with the VIST and your primary health care provider to ensure that your records document your blindness. There is a number listed below to call if a veteran needs assistance from the VA and link.

Department of Veterans Affairs VHA DIRECTIVE 2010-054
Veterans Health Administration
Washington, DC 20420 December 9, 2010

CATASTROPHICALLY DISABLED VETERAN EVALUATION, ENROLLMENT, AND CERTAIN COPAYMENT-EXEMPTIONS

1. PURPOSE: This Veterans Health Administration (VHA) Directive issues policy for the clinical evaluation, enrollment in Priority Group 4, and the discontinuation of inpatient, outpatient, and medication copayments of eligible Veterans who are catastrophically disabled.

2. BACKGROUND

a. Public Law 104-262,Section 104(a) of the “Veterans’ Health Care Eligibility Reform Act of 1996,” established a system of annual patient enrollment, in order of priority, for the provision of Department of Veterans Affairs (VA) hospital care or medical services (see Title 38 United States Code (U.S.C.) 1705. Under this system, VA must enroll in Priority Group 4, Veterans who are catastrophically disabled (see 38 U.S.C. §1705(4)).

b. This cohort of veterans was still, however, subject to copayment requirements applicable to their receipt of VA care. This requirement has changed with the enactment of Pub. L. 111-163 Section 511 of the “Caregivers and Veterans Omnibus Health Services Act of 2010,” which is codified in 38 U.S.C. 1730A. Section 511 prohibits VA from requiring Veterans who are catastrophically disabled from paying copayments for the receipt of hospital care or medical services. VA’s General Counsel (GC) has held that this statutory provision extends to copayment requirements that would apply to the receipt of prescription drugs (see subpar. 5g). In a separate opinion, the GC held that Section 511 does not, by operation of law, prohibit the collection of copayments applicable to the receipt of nursing home care (see subpar. 5h). Therefore, veterans with catastrophic disabilities must still pay applicable copayments for the receipt of nursing home care.

NOTE: Examples of extended care include: nursing home care, domiciliary care, respite care, geriatric evaluation, and adult day health care. Although these Veterans are still subject to applicable copayments for the receipt of nursing home care, certain extended care services (essentially “noninstitutional alternatives to extended care”) fall within the definition of “medical services” for purposes of 38 U.S.C. Chapter 17. As a result, Veterans with catastrophic disabilities are exempt from copayments applicable to the receipt of noninstitutional respite care, noninstitutional geriatric evaluation, noninstitutional adult day health care, Homemaker/Home Health Aide, Purchased Skilled Home Care, Home-based Primary Care, and any other noninstitutional alternative extended care services.

c. Veterans are considered to be catastrophically disabled if they have a permanent, severely disabling injury, disorder, or disease that compromises the ability to carry out the activities of daily living to such a degree that the individual requires:

(1) Personal or mechanical assistance to leave the home, or bed; or
(2) Constant supervision to avoid physical harm to self or others.

NOTE: This is met if the individual’s circumstances meet the terms of Title 38 Code of Federal Regulations (CFR) 17.36(e) (see Att. A).

d. An evaluation to determine whether a Veteran is catastrophically disabled, as defined by the Secretary, may be initiated at the request of the Veteran, the Veteran’s representative, or facility clinical staff. For all requests, facility staff must use and complete VA Form 10-0383, Catastrophically Disabled Veteran Evaluation & Approval (Fillable), which can be used for local reproduction. This form is available on the VA Forms Web site at http://vaww.va.gov/vaforms/. NOTE: This is an internal VA Web site not available to the public.

e. Veterans whose medical conditions involve permanent severely disabling injuries, described above, should be encouraged to seek or undergo the Catastrophic Disability Evaluation. NOTE: To request a Catastrophically Disabled Veteran Evaluation, Veterans may call 1-877-222-VETS (8387) or the Enrollment Coordinator at their local VA medical facility. Positive determinations will enable them to enroll in VA’s health care system (particularly if they would otherwise be ineligible to enroll in VA’s health care system due to an existing administrative enrollment restriction, e.g., certain Priority Group 8’s). Currently enrolled veterans who are similarly clinically situated need to be encouraged to seek or receive the Catastrophic Disability Evaluation in order to elevate their enrollment status to Priority Group 4 and thus receive the benefits of enhanced enrollment, and more specifically, the copayment exemptions applicable to catastrophically disabled Veterans. As explained in VA’s regulation, some evaluations may involve only a pertinent medical records review.

3. POLICY: It is VHA policy to provide, upon request, a Catastrophically Disabled Veteran Evaluation within 30 days. Veterans determined to be catastrophically disabled, are placed in priority group 4, unless qualified to be enrolled in a higher priority group, and are exempt from copayments for hospital care, outpatient medical care and medications prescribed on an outpatient basis.

4. ACTION

a. Office of the Assistant Deputy Under Secretary for Health (10A5). The Office of the Assistant Deputy Under Secretary for Health is responsible for collecting Catastrophically Disabled Veteran Evaluation data for reporting and analysis purposes. The data is to be posted quarterly at: http://vaww4.va.gov/vhaopp/cdvet_eval.htm. NOTE: This is an internal VA Web site not available to the public. Using appropriate VA Form 10-0383, Veterans Health Information and Technology Architecture (VistA) entries, and the following data, which is to be collected; the:

(1) Number of new catastrophically disabled evaluations completed, both by record review and clinical examination;

(2) Number of cumulative catastrophically disabled evaluations completed, both by record review and clinical examination; and

(3) Number of total estimated or potential catastrophically disabled evaluations.

b. Medical Center Director. Each Medical Center Director is responsible for ensuring:

(1) VA health care facility staff initiates Catastrophically Disabled Veteran Evaluations for known Veteran- groups whose conditions reasonably indicate potential eligibility for this enhanced enrollment status, such as Veterans participating in Spinal Cord Injury Programs, in Traumatic Brain Injury Programs, in blinded Veterans programs, etc.

(2) Appropriate staff involved in the Catastrophically Disabled Veteran Evaluation is properly trained and knowledgeable in the following process:

(a) Upon request, the facility Enrollment Coordinator, or designee, must initiate a VA Form 10-0383, for each Veteran requesting such evaluation or on whose behalf such a request is made.

(b) The Enrollment Coordinator, or designee, must obtain all relevant VA clinical records or non-VA medical records provided by the Veteran, or obtained for the Veteran by VA staff, and have them reviewed by the Veteran’s clinician.

1. If sufficient documentation is available from the health records to determine the Veteran is catastrophically disabled, the clinician is to complete VA Form 10-0383, front and back, and make a recommendation as to whether the Veteran is or is not catastrophically disabled (as defined by 38 CFR 17.36(e). The clinician forwards the complete package to the Chief of Staff, or equivalent clinical representative, for approval or disapproval of the recommendation.

2. If the medical record information is not available or sufficient to make a determination of catastrophic disability, the Enrollment Coordinator, or designee, must request a Catastrophic Disability Examination be performed consistent with the medical center policy on conducting Catastrophic Disability evaluations. Upon completion of the evaluation, the examining clinician must complete and return VA Form 10-0383 to the Enrollment Coordinator, or designee, who is responsible for forwarding the completed package to the Chief of Staff, or equivalent clinical representative, for approval or disapproval of the recommendation. The data is then forwarded to the Veterans Integrated Service Network (VISN) within the timeframes established by the VISN.

BVA will continue to follow this implementation process and this legislation was one of our highest priorities in the past two years.

Thomas Zampieri Ph.D.
Director Government Relations
Blinded Veterans Association
477 H. Street NW
Washington DC 20001
Direct Office 202-355-9525
Cell 301-204-3291
BVA 202-371-8880
tzampieri@bva.org
–
BVA’s Legislative Alerts Group

Myths and rumors persist everywhere, but they are especially dangerous when it comes to VA health care eligibility.
At VA’s blog VAntage Point, five common myths are debunked and explained by VA’s health care eligibility professionals.
By Alex Horton at the VA:
Five Myths About VA Health Care Eligibility
Myth Number One
I wasn’t injured in the service, so I’m not eligible for VA health care.
Status: False
One of the most common myths revolves around eligibility for health care at VA. Many think that you have to first establish a disability rating before you can start to make appointments, see doctors and receive medication. That is not the case. If you served in the military, even during peace time, and were honorably discharged, you likely qualify for VA care. Even if you don’t meet those requirements, special circumstances might apply, like Vietnam service, exposure to Agent Orange and household income. The best way to find out if you qualify is to submit an application for health benefits. You can fill one out online or at a VA Medical Center. If you are an Iraq or Afghanistan Veteran, there are special combat Veteran benefits from VA, like temporary access to dental care and guaranteed access to Priority 6 for five years (unless you are eligible for a higher priority group). See the priority enrollment groups here.
Also, if new regulations are established regarding health benefits, VA will automatically reassess your case if it’s on file.
Myth Number Two
I can only receive care for service connected injuries.
Status: False
You can receive VA hospital and outpatient care for any ailment, service connected or not if you are enrolled in the VA healthcare system, but you may have to pay a copayment. For example, if a Veteran is service-connected for a bad knee, any VA hospital and outpatient care and medication for the knee is free of charge. However, if the same Vet goes into surgery to remove an appendix and it’s not service connected, he may be subject to a co-pay depending on the amount of his disability rating and other factors. Familiarize yourself with co-pay guidelines and rates.
A small number of Veterans, such as those with bad conduct discharges that VA has determined were issued under conditions other than honorable and who are not subject to certain statutory bars to benefits, can only be treated for their service connected disabilities and nothing else. If one of those Vets is service connected for their left foot, they can only use VA health care for their left foot and nothing else.
Myth Number Three
I make too much money to qualify for VA health care.
Status: It depends
If you do not have a service connected disability, you may want to use VA’s financial calculator to see if you qualify for free VA care, medication and travel benefits. If your income is too high (over a maximum income level set every year), you may have to pick up the tab for traveling and receive your care and medication by paying a co-pay. Recently, the rules have been changed for Priority 8 Veterans to permit more of them to enroll for VA health care. Go here for more information and an income calculator to see if you qualify under the new rules.
Myth Number Four
I can’t use VA health care if I have private health insurance.
Status: False
From VA’s Health Eligibility Center Director Tony Guagliardo:
“We strongly encourage Veterans to receive all your health care through VA. However, if you choose to receive treatment from private doctors, VA will work with them to meet your health care needs and coordinate effective treatment. We call this Co-managed Care or Dual Care — which means that your VA and private doctors will work together to provide safe, appropriate, and ethical medical care.”
Myth Number Five
If I’m 100 percent disabled, that means I’m permanently disabled
Status: False
You could have a 100 percent disability rating as a temporary status while you undergo surgery, and have it reduced to its previous rating after you heal. 100 percent doesn’t necessarily stay with you.

“These handbooks will give Veterans everything they need to know and leave out everything that doesn’t apply to them,” said Secretary of Veterans Affairs Eric K. Shinseki. “Our Veterans will now have a comprehensive, easy to understand roadmap to the medical benefits they earned with their service.”

In addition to highlighting each Veteran’s specific health benefits, the handbook also provides contact information for the Veteran’s preferred local facility, ways to schedule personal appointments, guidelines for communicating treatment needs and an explanation of the Veteran’s responsibilities, such as copayments when applicable.

“Enhancing access isn’t just about expanding the kinds of services VA provides. It also includes making sure we do everything we can to ensure Veterans have a clear understanding of the benefits available to them so they can make full use of the services they have earned,” Shinseki said.

The new handbooks will initially be available only to certain Veterans in Cleveland and Washington, D.C., areas. Following the pilot phase, full implementation is scheduled to begin in the fall of 2011 for across the county.

For additional information, go to www.va.gov/healtheligibility or call VA’s toll-free number at 1-877-222-VETS (8387).