Persian Gulf War, The Untold Story
©David Barker 1997 2004 2005 AMVETS Department of Ohio
THIS INFORMATION IS FOR:
THOSE WHO HAVE FOUND IT DIFFICULT TO OBTAIN THE TRUTH, FROM THEIR GOVERNMENT.
WRITTEN BY: DAVID A. BARKER, AMVETS STATE SERVICE OFFICER,
Formerly the senior veterans service officer, for Franklin County Veterans Service Commission.
David Barker has filed thousands of claims in his career as a veterans advocate.
He filed his first post traumatic stress disorder claim in February 1983, the claim was approved in January 1984.
DAVE BARKER IS A VETERAN OF THE U.S. NAVY
CHAPTER ONE: DESERT STORM TO IRAQI FREEDOM
In 1991 and 1992 we all watched the VA slowly put the same squeeze on the DS troopers as they have so well done the Vietnam veteran in the past. First the news came down that the President of the U.S. had personally taken interest in the DS troops and was to assure all of America, the claims of the troops and their families would receive top priority. Many strange ideas were put into effect, such as reducing the beds in VA hospitals to make room for combat casualties. After all, America was supporting the operations in Desert Storm and if a little inconvenience was to be had by a few veterans, so be it. As a matter of fact most of the veteran organizations were willing to turn aside their cheeks and allow the VA hospitals to place veterans on the streets in January!
. . . most of the veteran organizations were willing to turn aside their cheeks and allow VA hospitals to place veterans on the streets . . . and they indeed did put veterans on the street!
In order to utilize the Desert Storm emergency hospitals available, the President was in a position known as "between a rock and a hard place". This is not to take anything away from the importance of the position of the Administration at that time; nor, am I critical of the Joint Chiefs of Staff. It becomes necessary to advise you that due to budget cuts, many Military hospitals had been eliminated or greatly scaled down. We had not the method of dealing with the casualties that were feared to happen. In order to prepare for the casualties, our political representatives decided to empty beds in the VA hospitals to gain the required safety numbers for emergency care. After all, the veterans in the VA hospitals usually are those without much political clout. So, the VA hospitals were set up to handle those patriots who were in Desert Storm. No doubt at all, these people needed proper facilities to be set up for their care, just not at the expense of those who had already borne the battle. The next idea to come from the Administration was to handle VA claims quickly. A group of VA specialists were taken from the normal routine and assigned to a special task force to handle the expected high rate of claims. This in itself was not a bad idea, as a matter of fact the theory was very good. They should have gone one step further and hired new employees in the VA to assist the back log of claims. After all in 1995 it was a seven month wait for the average claim to be processed. In 2005 it is an eleven month wait. Unless it is a chemical exposure claim, or Post Traumatic Stress Disorder, which can take years.
Well as time marches on, so does the political thoughts of politicians. Soon the President quietly canceled the special programs for Desert Storm veterans; but, only after he had placed into effect the streamlined special task group to handle the claims and reduced the caseload in the VA hospitals. What did this mean to the veterans? Simple, the Desert Storm veteran had achieved the ire of nearly all other vets in getting more quicker and easier (at least in the minds of other vets). The other veterans were now being served with less people in the various areas of the VA Regional Offices due to the personnel shift. In other words they were being short changed by the VA to accommodate the Desert Storm veteran. In reality the Desert Storm veteran was not being given all of the priority as promised, only the publicity. So they were in the eyes of there fellow vets of prior encounters, being placed on a pedestal, while in reality they were on the chopping block. . . . as time marches on, so does the political thoughts of politicians. So in 2005 we see history repeating itself and veteran standing up to support those who are cutting away benefits, all in the support of their politics!
Well here it is a decade later and we are still in the Persian Gulf, still fighting the same war against the same groups as before. In the between time of media interest, we saw the loss of personnel on the USS Cole, the 911 attack on New York City. This time the VA appears to respond to the PGW veteran. It is costly as older veterans are deleted from the system to make room. We had major problems in 1992 and to give you an example we will discuss a veteran for the sake of a name is Jorge.
To give some background we will identify Jorge's problem. He was wounded in action and declared to be 70% disabled by the Army. Jorge received full Army pay until May 1, 1991. At that time he was separated from active duty and placed on the Temporary Disabled Retirement List. He then had to wait two months without income until the disability check was to come in the mail. He was shocked to learn the amount of his check was far less that he earned while on active duty. Jorge had properly applied for VA Compensation while on active duty and expected to be quickly approved under the promises made to the public by the President. The problem was due to the swift work of the DS troops, the war came to a swift end. As did the special efforts on the part of the VA and the Army. To make matters even worse for my client he does not speak and understand English as well as he does Spanish, so a lot of his expectations were never to be. He thought the VA would make up what he had lost; but, alas, they didn't and won't.
Again we have a generation of veterans who are receiving some disdain of the WW2 veterans, who are quick to criticize our recent hero’s, who were in the media held in such high esteem (as long as it sold papers and TV time). Then much to my surprise many Vietnam veterans began to become critical of the treatment of the PGW veterans, not knowing the government once again had "kicked the props out from under the vet". Sound familiar? It happens every time.
CHAPTER TWO: PERSIAN GULF WAR VETERAN BENEFITS
In a 1993 meeting of the Veterans Service Organizations with the Director of the VA Out Patient Clinic in Columbus, in early February, Desert Storm exams were the main topic. It was stated by the coordinator for the Desert Storm program that there is a 60% no show on examinations. The VA OPC did go all out to provide excellent medical care and preventive medicine to all Desert Storm veterans who cared to take advantage. It seems as many will indicate a need for medical examinations and cancel for nearly any reason; or, no reason apparently.
We were told the VA Clinic staff, lost a doctor due to the no show attitude. A second doctor has left as well, somewhat discouraged. We are now on our third doctor. With this pattern, we could see an end to a vital program. It seems as if for some it is easy come, easy go. Maybe the terrible lessons learned by the ATOMIC VETERANS have not been passed on to the Desert Storm veterans. It is a possibility these same veterans have not heard of the destruction of minds and bodies of those who were exposed to herbicides also known as AGENT ORANGE.
Now we are in the midst of a struggle again in Iraq. As we work constantly to improve the lot of the veteran in our everyday struggle with bureaucrats to protect what we have; we must insure those in need take advantage of available benefits. It is easy for some people to sit around in a veterans post canteen, or elsewhere and talk about how much is "handed" to a certain group of veterans. Let me tell you, that in my personal experience, nothing has ever been "handed" to any group of veterans. It took over 400,000 lives during WWII to bring this country to establish a viable program to reintegrate American fighting men and women back into society. The battle has never waned in all that fifty years. It has actually become much tougher to hold onto many of our benefits. Currently there is a raging battle over entitlement. This is a word that may cease to exist as we know it. When veterans do not care enough about their health to keep a medical appointment, the appropriation for that care will soon cease. We had the exact same problem in 1995 as we have in 2005!
What does it take to get the attention of a PGW veteran?
In 1992 we were told that Saturdays were set aside at the VA Clinic for Desert Storm veterans to come in for their examinations. Six of every ten failed to show. The doctors feel the persons involved are not interested. It seems as if the doctors may well be right. These same people did not want to miss work to go to the VA Clinic during the work week (as do all other veterans). They were given an opportunity to see the "free", to them, VA doctor on the weekend. The scenario was deleted from the current action. It is strictly Monday to Friday.
Please take the rumors seriously regarding VA benefits being threatened. Several years ago the word "entitlement" was used by ranking veteran organization officers to insure our benefits were more than benefits. Well that was just not true. In the past decade multiple benefits have been simply ended for most veterans. Just because you have not needed the VA as of yet, does not mean you will never need those benefits. Congressional Representatives have proven recently only Social Security will not be on the table, for cuts.
If you are a PGW veteran and have no obvious medical problems congratulations. If you are one of the many who we have seen at the AMVETS office, make sure you show up for your exams!
THE DESERTED STORM , NOW WHAT?
In the 1992-95 years, we watched another generation of veterans suffer; from the wrath of a system that was designed to help them. It seems as if the bureaucratic officials throw every possible block into the paths of those suffering most. I have watched in literal shock, as the Department of Veteran Affairs, the VA, prevent people from recovering their lives. It seems as if the system works against the veteran. I will cite two examples to start.
First is Jorge, who was injured in a truck which was hit on the Iraqi border. Jorge has severe injuries that have left him permanently disabled. The VA took nearly a year in processing the claim. The claim was straight forward with little or no interpretation needed. The veteran had suffered extreme injuries and was totally disabled. He had multiple broken bones up and down one complete side of his body. First the Army rated him 70% and placed him TDRL. Then the VA rated him 30%. The veteran received the letter of award. The veteran was happy, 70% plus 30% equaled 100%, right? Wrong! The VA had found his condition much less than totally disabling. However, the Social Security Administration found him 100% disabled. He in fact, four years later, is barely able to get around. To add insult to injury, late in 1994, the VA discovered he had received severance pay and has decided to stop his compensation until they recoup the funds paid. This is one month after the Army had sued to get the unused bonus back as he did not finish his reenlistment period. The Army almost went berserk over the $191.31 debt incurred because he was hit by a rocket in Iraq. At this point I would expect him to receive a bill for the Army health care he received. The Army almost went berserk over the $191.31. Upon his return to Columbus, Jorge found he could not get health care at the VA Clinic. He was not eligible. He had to go to Dayton or Fort Knox for each visit. There were many visits. His time meant nothing to the Army or the VA. We filed his claim and after nearly a year the VA approved it. But, every month he seems to get another letter from a government agency of some sort, wanting him to send them money.
Jorge is a warm and friendly man. His Spanish is excellent and his personality is as warm as the sun drenched beaches of his native Puerto Rico. You see, Jorge joined the Army to serve the nation he loves, the United States of America.
Enter Ellie. You could never find a bubblier, kind young lady. Ellie was a very happy reservist who loved her Army and drilled like there was no tomorrow. Ellie as many others went to Saudi. There she performed her job as she was trained. She worked for the Army as she worked for her self. After all she owned her own company at home. She knew the need to give 100% effort in the job. She gave 100% in her company and 100% for the Army. She is a proud American, proud to serve. She went to Desert Storm on a mission. While there, one of her subordinates was mangled in a pump; and she was exposed to something that changed her life forever.
Upon her return to CONUS she decided to get on with her business. Then suddenly out of the clear blue sky. Bang, she found herself very ill and unable to do anything about it. She went to the VA Clinic. It was to no avail. No cause could be found. Suddenly seizures set in and she became further disabled. Suddenly she had to be rushed to a local hospital for intensive care treatment. It was there that I visited with her. She signed releases of information and we went to work. I spoke with her physician at the hospital who explained that the condition was indeed very serious and that she had been extremely over medicated by accident.
It did not take but a few minutes on my part to discover that she had seen several doctors who had prescribed medications not knowing that other VA doctors were prescribing either the same or conflicting medications. You must understand, none of the doctors knew what they were looking for. Our government has this habit of covering up the mistakes made on the troops. Well we had properly filed a claim for disability. Ellie went off to Washington to visit the VA facility that supposedly had all answers. Again, few answers but many more questions. Ellie was told that she was one sick soldier.
It seems as if the Bureaucrats look for ways to bring discomfort on the already disabled veteran. She was told by her doctors to get her affairs in order. She was now losing more weight than any one could believe. She went under 90 pounds. Then came a VA letter. "You have been found able to secure employment." She was stunned and so were we. I have spoken with each of her doctors. Not one of them agree with the VA decision. It is not a simple matter of calling the VA office in Cleveland; the Desert Storm claims are being worked in Louisville, Kentucky. No access with people we can work with. Well the Social Security Administration came through in championship form. Ellie was found to be 100% disabled. Now what makes this highly suspect is the fact she was examined seven times for reenlistment in the Army. Now Social Security recognizes her as 100% and the VA 20%. Someone is in a fog zone.
CHAPTER FOUR: A 1995 LETTER TO THE VA RATING BOARD
To the Rating Board:
RE: Name withheld due to privacy act
August 2, 1995 should go down in history as another fiasco with the Department of Defense (DoD). The announcement from the DoD has created much concern within the veteran community. It is with utter disgust, I listen to the media reports that "Persian Gulf Syndrome" is not in reality a problem. We have documented cases in Franklin County as one that prove their theory is incorrect. This is exactly what happened during and after Vietnam with Agent Orange. It used to seem as if the government would forget the veteran when he or she arrived home. Now the government goes out of their way, to prove they forget the veteran.
As it has been written in previous articles several of my clients have suffered great physical and emotional damage as a result of the tour in the Persian Gulf. As mentioned in the past "Desert Storm is now the Deserted Storm". Ellie, my client, has completely changed in physical appearance as well as physical health. She lost so much weight, she was prescribed supplements such as Ensure to stop the weight loss, she still fell to ninety pounds. It is again important to remember she had passed at least five reenlistment examinations. Yet, the VA only found her 20% service connected for seizures. According to the DoD her total hair loss was all in her head. It doesn't take a rocket scientist to realize the total hair loss was not in her head, it was off her head. All this information was documented by St Ann's Hospital, the VA Outpatient Clinic in Columbus, the VA Medical Center in Chillicothe, as well as the VA Medical Center in Washington, D.C. The Washington VAMC trip was well documented by WBNS 10-TV in Columbus. It is impossible for the DoD or the VA to show any reason for Ellie having the problems she has encountered without pinpointing it on her exposure to some form of substance in the Persian Gulf. She was there. She had excellent health prior to going to the Persian Gulf. She has been sick every day since she returned.
We have several other formerly healthy individuals who are suffering from maladies similar as Ellie. Where is the answer to their problems? I'll tell you where their answers are, they are in the trash bin with all of the other difficult situations veterans are confronted with. It is so easy for Congress to pass watered down legislation and allow the VA to interpret it in any form they wish. It is even easier for the VA Legal Counsel to rule out help for needy veterans, knowing the veterans are nearly defenseless. It seems to many deals are made to protect the sacred budget, human beings are sacrificed. The sad part of the situation is so many non veterans are making decisions that literally destroy our comrades for life. It amazes me how the government can justify hiring so many non veterans for life altering decision making.
A few years ago, my letters and articles upset a few people in the Regional Office. It seemed as if they felt no one should question their decisions. Well it seems as if the decisions need questioned. I tell you, that this woman suffered within the first one year, from her separation of service, total disability. It is not her fault, doctors do not have the ability to diagnose her condition. Hire new doctors if you need to. Don't kill my client. Veterans made one sacrifice when they went off to war, one sacrifice is enough.
The Assistant Secretary of Defense William Winkenwerder has issued a Memo regarding deadly conditions facing our troops in Iraq which I read October 9, 2003. This is a stern warning for all persons in Iraq to be aware of the deadly situation.
Leishmaniasis is a parasitic disease spread by the bite of the sandfly. This is a preventable disease native to Iraq. The Assistant Secretary has asked this be given to all distribution possible. It now looks like we are going to have problems with our returnees that could be catastrophic. One condition is cutaneous leishmaniasis Baghdad boil) which creates terrible skin lesions which may look like STD’s. This leaves permanent disfiguring. the other is visceral leishmaniasis (Kala-azar) which can be fatal.
Overview, Causes, & Risk Factors Leishmania are tiny protozoa. Their parasitic life cycle includes the sandfly and an appropriate host. Humans are one of those hosts. Leishmania infection can cause skin disease (called cutaneous leishmaniasis).
It can affect the mucous membranes with a wide range of appearance, most frequently ulcers. It may cause skin lesions that resemble those of other diseases including cutaneous tuberculosis, syphilis, leprosy, skin cancer (basal cell carcinoma, and fungus infections.
Leishmania can also cause systemic disease (visceral leishmaniasis) with fatal complications. When introduced into the body by the bite of a sandfly, the parasite migrates to the bone marrow, spleen, and lymph nodes.
Systemic infection in children usually begins suddenly with vomiting, diarrhea, fever, and cough . In adults, fever for 2 weeks to 2 months is accompanied by nonspecific symptoms, such as fatigue, weakness and loss of appetite Weakness increases as the disease progresses.
The skin may become grayish, dark, dry, and flaky. The parasites damage the immune system by decreasing the numbers of disease-fighting cells so death usually results from complications (such as other infections) rather than from the disease itself. Death often occurs within 2 years.
Upon separation from active duty the Iraq veterans need to contact the nearest VA Environmental Physician as soon as possible!
It seems as if the issues affecting veterans health are short lived, that is until they start dying. Then it is to late. Hopefully this time all returnees would be examined. Since it will be volunteer and since many fail to get the word, it is unlikely all will be examined in time!
As far as insecticide goes, it has been reported to me that the military has advised Iraqi Freedom troops to soak their clothes in an insecticide. At least one soldiers wife advised me her husband broke out in a severe rash. Possibly that would be a good reason, to kill the sand flies and other deadly insects.
By the way this problem was known at the time of all of the critical health issues with PGW-I veterans. The government just failed to advise those folks who were coming up with severe and deadly medical problems.
To everyone who cares, many insecticides have carcinogens causing cancer in them. I am not aware of the type of insecticide used so am only asking a question: is the prevention as bad as the disease?
I wrote In Search Of The Truth For Vietnam Combat Veterans. A book about herbicides. I certainly hope I will not have a sequel about insecticides!
Meanwhile back at the VA Central Office....
Amyotrophic Lateral Sclerosis and Persian Gulf Veterans
There is no doubt that we have all read the recent link of Amyotrophic Lateral Sclerosis and Persian Gulf Veterans by the National Academy of Sciences (NAS), the Institute of Medicine, which was released in early December 2001. However, the AMVETS has a much different twist than any other veteran organization.
On December 6, 2001 AMVETS State Service Officer David Barker and AMVET member of the Portsmouth (Ohio) Post 2352 appeared in the VA Regional Office in Huntington West Virginia for a video-conference Board of Veteran Appeals personal hearing.
The issue was the Amyotrophic Lateral Sclerosis and their unyielding belief that this condition was directly related to the exposure of chemicals and gases in the Persian Gulf. Only a few people believe there was much of a chance in this scheduled hearing, that the Board of Veterans Appeals (BVA) would grant benefits. After an hour of questions and responses the Hearing Officer stated she would review the transcript and any evidence currently in the file and give a response. Service Officer Barker asked if the NAS report would be finalized and the VA accepted the report, would it be considered? The Hearing Officer said if the report was released, the AMVETS must be sure to fax it quickly to the BVA.
The report was released December 13th and it was hand delivered by U.S. Congressman Ted Strickland (D-Ohio) to the BVA the same day. On December 13th 2001, one week after the teleconference, the very first award for Amyotrophic Lateral Sclerosis and Persian Gulf Veterans was approved. The veteran was rated 100% service connected for Amyotrophic Lateral Sclerosis linked to his Persian Gulf service, with the date of issue being February 1999.
CHAPTER SEVEN INTRODUCTION TO THE POST TRAUMATIC STRESS DISORDER:
Some people feel that personal experience is needed when dealing with PTSD cases, many others feel it is not a factor at all, just a situation. During my experience as a Veterans Service Officer, I have been told by an overwhelming majority of my PTSD clients that they relate better to a person who has actually experienced a combat stressor.
As a person who personally experienced combat, I have found it is easier to relate to a veteran who is under stress at the time. However, it has been my experience that the person who assists the combat veteran needs compassion and empathy as well.
POST TRAUMATIC STRESS DISORDER
The essential feature is the development of characteristic symptoms following a psychologically traumatic event that is generally considered to be outside the range of usual human experience.
The developed characteristic symptoms involve re-experiencing the traumatic event; numbing of responsiveness to, or reduced involvement with, the external world; and a variety of autonomic, dysphoric, or cognitive symptoms.
The stressor producing this syndrome would evoke significant symptoms of distress in most people, and is out of the range of such common conflict. The trauma may be experienced alone (rape or assault) or the company of groups of people (military combat). Stressors producing this disorder include natural disasters (floods, earthquakes), accidental man made disasters (car accidents with serious injuries, airplane crashes, large fires), or deliberate man made disasters (bombing, torture, death camps). Some stressors frequently produce the disorder (e.g. torture) and others only occasionally (e.g. car accident). Frequently there is a concomitant physical component to the trauma which may even involve direct damage to the central nervous system (e.g. malnutrition, head trauma). This disorder is apparently more severe and longer lasting when the stressor is of human design. The severity of the stressor should be recorded by professionals and the specific stressor is noted on Axis: IV.
The traumatic event can be re-experienced in a variety of ways. Commonly the individual has recurrent painful, intrusive recollection of the event, or recurrent dreams or nightmares during which the event is re-experienced. In rare instances there are dissociative like states, lasting from a few minutes, to several hours, or even days, during which components of the event are relived and the individual behaves as though experiencing the event at that moment. Such states have been reported in combat veterans. Diminished responsiveness to the external world, referred to as psychic numbing or emotional anesthesia, usually begins after the traumatic event. A person may complain of feeling detached or estranged from other people, that he or she has lost the ability to become interested in previously enjoyed significant activities, or that the ability to feel emotions of most types, especially those associated with intimacy, tenderness, and sexuality, is markedly decreased.
After experiencing the stressor, many develop symptoms of hyper-alertness, exaggerated startle responses, and difficulty falling asleep. Recurrent nightmares in which the traumatic event is relived and which terminal sleep disturbance may be present. Some have impaired memory and difficulty concentrating. Symptoms are often intensified when activities resemble the actual trauma (e.g. cold snowy weather or uniformed guard for death camp survivors or hot humid weather for Vietnam veterans).
Associated features: symptoms of depression and anxiety are common, and in some instances may be so severe as to be diagnosed as an anxiety or depressive disorder. Increased irritability, unexpected explosions of aggressive behavior, with minimum or no provocation. Impulsive behavior also can create problems such as unexplained trips, unexplained changes in life styles. Symptoms may begin immediately or soon after the trauma. It is not unusual, however, for the symptoms to surface months or years later following the trauma.
Impairment may be mild or affect every aspect of life. Phobic avoidance of situations or activities that resemble the trauma are common and often create occupational or recreational impairment. Psychic numbing often interferes with interpersonal relationships, such as family life. It often leads to self defeating behavior sometimes including suicide. Substance disorders are common.
The appearance of apparent psychotic symptoms are interpreted by many professionals as psychosis; but, are actual symptoms of PTSD in a normal person.
CHAPTER EIGHT DISGRACED BY OUR OWN
Early in 1990, one of my clients came into my office to discuss his VA claim for Post Traumatic Stress Disorder. After we reviewed the stressor letter regarding his being 50 meters from a falling helicopter, which exploded upon impact, killing all aboard, two on the ground (his comrades) and knocking the veteran several steps back while being singed by the fire from the blast; and, the VA stated: " that was not a life threatening situation, out of the normal range of human emotion", etc. He gracefully presented me a bill from the VA Out Patient Clinic in Columbus, Ohio. The bill totaled $129.00, including interest and fees, for his PTSD, which the VA had determined was non-service connected. Of course, we all know the VA had treated many veterans for nervous disorders for years with no mention of cost to the veteran. We have accepted that the treatment for a combat veteran, be automatic according to law, well, we were wrong. Even a combat veteran, with the proof and stressors to go with his proof, did end up paying for his treatments, prior to the claim being service connected.
Now some of our fellow comrades may think if the veteran makes enough money to be in category B or C, he or she should be able to afford the charges. Well, this is not necessarily true. Often, the veteran may have insurance the VA can bill for the treatment; but, not always. The veteran was disabled due to his PTSD in combat, and as a result his insurance was not in force at that time. He had been placed in category C by the VA due to his prior years income, which had ceased. Even if he still worked, the idea of the VA charging a combat veteran for PTSD treatments should make us ill. I asked one of my contacts in the VA why the charges could not be processed on the Agent Orange provision passed by the Congress (HR 1961 Radiation/Ionization- Agent Orange Act) and signed by former President Ronald W. Reagan. He asked: "could we do that? Agent Orange doesn't cause nervous problems, does it?" My response to him was there is scientific evidence that dioxin contamination creates anxiety problems in animals and possible in some humans. This was enough for a change in the policy at that time. I was then told: "we are going to have to change the Agent Orange processing of claims anyway, due to the new rules on what the VA will accept as Agent Orange residuals". This was stated to me by a contact who wished to remain anonymous, and to this day he still remains that way. Again, why subject a veteran to insurance claims and probably alert his/her employer to the fact he/she needs treatment for mental hygiene conditions and risk more prejudicial treatment at work and make it worse than it was before.
This veteran was finally rated as service connected for PTSD at 10%. This could be looked at in the context of DSM-IV, in advance. The veteran had witnessed the helicopter crash. He was not on the chopper, he witnessed the crash.
CHAPTER NINE BASIC STRESS PROBLEMS: FRUSTRATION
The major characteristics of frustrated behavior are aggression, regression and fixation. Each of these has been experimentally produced in the laboratory. Another symptom which is called RESIGNATION is frequently found in case studies. Since the attitudes developed through frustration gives the situation an interpretation which justifies the action to the person involved, he considers his action reasonable. This explains why it is so difficult to explain or convince such a person their behavior is out of reality. These symptoms may show in mixed form and may be difficult to detect.
Aggression in behavior represents some kind of attack. The attack may be one of furious physical violence against the innocent, as he just stepped in line ahead of the subject, it may well be directed against an object; such as, he kicks his car because it won't start (after the kick, it still won't start). Aggression is also verbal in form and the result is taking the frustration out on another person or object; such, as someone being angry and cursing an object or even as far out as blaming an innocent person and knowing the innocent person was not involved.
Regression is a breakdown of constructive behavior and represents a return to childish action. Extreme cases result in infantile behavior and must be treated as babies. Speech and cleanliness may also be that of a baby. Some of the traits are longing to return to the past as a place of refuge and be unwilling to face the future; reflect regressive or childish attitude; easy influence over the subject, or suggestibility; follow the leader, even if the subject knows the leader is wrong; the refusal to delegate responsibility, for fear of losing complete control; blind loyalty, which in the past has destroyed nations.
Fixation is a compulsion to continue an activity that has no adaptive value. The action is repeated over and over, despite the fact the person knows it will accomplish nothing. The subject will literally beat his head against the wall. A common illustration is panic, in a burning building people persist at pushing at barred exits knowing the exit is blocked, fear has created fixation. This shows why unfavorable attitudes are difficult to change.
Resignation is the most severe of the degrees of frustration as the person has given up. The fight for survival is gone, the "I don't care" attitude prevails, he surrenders; thus, "all is lost". This is the form dictators will use to take control of the mind. It may be a dormant situation and most people do not realize it is there. People in a state of resignation obviously have low morale and will remain socially neutral unless their mental condition changes.
The causes of the differences in behavior undoubtedly depend upon personality differences, cultural differences, and to some extent, intellectual differences. Many differences may be heredity. Acquired differences depend on previous experience: develop emotional adjustments, learning cooperation, feelings of insecurity and social status within the group.
The various individual differences complicates predicting behavior; however, the general effect of frustration will cause change in the behavior pattern. Some have said "the Desert Storm veteran is frustrated", now we know why.
In review of the essay Basic Stress Problems: Frustration, please indicate any of the conditions that have appeared in your life since your discharge from active service.
Please list each situation you have experienced and what triggered that experience.
Please list as many specific periods as possible that it has happened to you.
Did you have any guilt of the reactions you may have had, and did the situation remind you of your stressor?
CHAPTER TEN COP AN ATTITUDE
Today it seems as if it is very popular in some scenes to be a Desert Storm veteran; but it is still far from popularity we watch and observe. It is possibly the oldest reason to care, profit. Many dollars are being made on the sweat and blood of the Desert Storm veteran. Millions on millions of dollars have been made on the sales of T-shirts, hats, and jewelry, as well as literally billions of dollars on movies, TV, records and tapes. All of them shared with very few Desert Storm veterans, if any. The same TV networks that bring in this entertainment, for very large profits, are the very same networks that brought the Desert Storm war and its protests, with criticism, of the service people to your living room These people who avoided the war by deferments found time to go into business, get ahead and start a home. The terrors of war were only on their TV or movie screen. Others who aggravated the situation of the returning Desert Storm veteran, by aiding and abetting the disgusting show of apathy. Many just tried to forget, while anti war protestors, movie stars, TV personalities, political leaders and school teachers, went on about their lives and carved out respectable livelihoods. The Desert Storm veterans, after their discharge, would enter the same market areas, only on a much smaller scale. In the big time, big money positions the veterans may find themselves represented by such people as Sly Stallone, or the TV anchor Dan Rather, who did go to Vietnam as a correspondent. We had CNN in the center of Desert Storm. Wow! What a difference our TV makes in our lives.
Is it any wonder we have problems with our returned heroes? Yes, they are real live heroes. Many forgotten, a few remembered. Sly Stallone of Rambo fame was never in Vietnam, he claims the throne of "hero of the Vietnam war", yet he is only a high paid pretender. The real heroes came back to America and were blended into society quietly and mostly never heard from again. Why? Because the war was so bad, so distressing, so depressing, that it was just easier to go along with the crowd upon return and just try to forget it. The problem was and still is: you just cannot forget it, it just will not go away. The same people who were highly critical of the individual soldier are now in positions of high authority. We have watched a steady stream of anti-war protestors take charge of America, and the Vietnam veteran had to hibernate to forget the pain of it all. The Desert Storm veteran is simply ignored. Nothing is pressing their issues. No special organizational push. Just business as usual. With the "old timers" complaining "they want it all handed to them!"
It seems as if we have forgotten the years of struggle of the preceding generation of veterans. These too found a strange welcome home. Upon their arrival they were met with very unfavorable reaction and many questions. Each common sense answer always seemed to have another common sense answer that was the exact opposite. The thoughts became very intrusive, the war seemed as if it had never ended. The veteran could now relive the war in his or her mind. It became never ending dreams, nightmares and flashbacks. All so real and all so misunderstood. Many veterans chose suicide as the way out. Others chose to seek professional help. The route of suicide of course did not cure anything but the ceasing of life. The psychiatric help was not all that great either, as many members of the profession did not recognize the problems for what they were. Most in the profession felt the Vietnam veteran was shameful and wrong in their action and very little was done in the late 60's or early 70's to correct the problems that beset the beleaguered Vietnam veteran. The American Psychiatric Association did not address the issue until 1980 when the all out effort on the part of a few became a part of history. The Diagnostic and Statistical Manual of Mental Disorders was revised and included the condition we know as Post Traumatic Stress Disorder. We saw the actual revision in 1981 and recognized PTSD as a condition that explained the actions and reactions of a significant segment of the Vietnam veterans. The year 1987 saw another edition of the Diagnostic Statistic Manual of Mental Disorders (third edition, revised) DSM-III-R. It would be of great help for anyone interested in this anxiety disorder to read carefully the section 309.89 Post Traumatic Stress Disorder. One will find the true criteria to show this condition as defined today. This is not to say the book is final and ultimate, it is based on 10 year old information and studies. It was revised again as DSM IV in 1994. After all, the others were revised as well. Effective November 6, 1996 the Rating Board was directed to use DSM-IV replacing the DSM-III-R. This will be a positive for many Desert Storm veterans. This will allow the VA to rate some claims as service connected, that would have been denied under the old criteria. This seems to be a very positive step forward in bringing favorable justice to those who serve.
In the very latter part of 1988, the Veterans Administration, now the Department of Veterans Affairs, finally admitted to part of the dilemma that faces veterans of war. Post Traumatic Stress Disorder is experienced by much higher numbers of veterans than projected in the past. The Associated Press article entitled Stress Disorder Found To Affect 15 Percent Of Viet Vets, indicated that a four year study ordered by Congress concluded more than 15 percent of the men who served in the Vietnam war are suffering from post traumatic stress disorder. It also went on to say that about 20 percent had sought treatment. The VA also admitted that 30.9 percent had suffered the full disorder at some time and an additional 22.5 suffered partially. The same study also shows the Vietnam war women veterans have suffered from the condition of PTSD. Currently 8.5 percent of the women who served in Vietnam have the disorder. The report states the women who have suffered the full disorder are at 26.9 percent and 21.2 percent as a partial disorder. We are over a half of a decade away from Desert Storm and no significant studies have shown the PTSD affect upon these troops.
Why not address the real issue: Post Traumatic Stress Disorder. PTSD has existed and was the reason for the inability to adjust for a large group of Vietnam veterans. This was not the first time our government had just walked away from a conflict. It was at least the third time. First, it was the Korean Conflict, then the ill fated Bay of Pigs, Cuba, incident was so secret that the President was unaware of the involvement of the U.S. Navy and the average American did not know what actually happened. Vietnam was very different. It was brought into the living room of America. Walter Cronkite, David Brinkley, and Chet Huntley, all gave us graphic details of what our sons had done to these seemingly wonderful peaceful people. It seems as if the networks had totally forgotten that the people of that geographical area had warred with one another for many decades prior to our arrival. The operation in Desert Storm was even more vividly projected into our homes. It seemed as if CNN had a camera on every target. They were in the middle and so was America. Many of the Desert Storm veterans were exposed to various stressors.
The VA study shows a significant number of veterans who suffer from PTSD, yet, the VA makes it so difficult for the veteran to prove a claim. Many give up and walk away. Some have, no doubt, died as a result of poor treatment or no treatment in the past. In handling many claims for PTSD, I have found that very often the claim must go to the Board of Veterans Appeals in order for the veteran to win his or her claim. The VA will deny the claim, even when their own doctors have diagnosed the condition and the service records show significant combat and records of valor. The VA excuses range from: not enough proof of unusual life threatening conditions, or, the VA may state the veteran was not in a MOS that matches their criteria. To expand on that thoughtless position of the VA, I represented a veteran for PTSD in 1983 who was a member of the Marines. His MOS was not considered a combat position. He was in operation Starlight. During this operation, he was wounded in action, he also earned the Armed Forces Expeditionary Medal. The veterans DD 214 clearly states: #25 Specialty number and title 0311 Machine gunner. The original VA letter to my client was a denial, which included a sentence "your MOS was not clearly of a combat position". How utterly wrong can the VA be? Needless to say, we appealed and won the case with a large amount of back pay to the veteran. This was not all well and fine, the veteran was forced during those years to live on the streets and in the VA hospitals, until justice was done. An obvious ploy by the VA to have the veteran to just give up and quit. The veteran had decided to quit when I begged him to keep with me on the claim. In 1986 we finally saw the fruits. After, much abuse of society, as well as bureaucratic red tape which continued to plague him as well as all other veterans who are suffering from this disorder. Now we have hope that this issue will be forever resolved with the acceptance of DSM-IV as the guide. Now an acceptable stressor is to include trauma being invoked on someone close to you, possibly your comrade is killed or seriously wounded. As a result you have nightmares, flashbacks, sleeplessness and a valid claim. In October 1996 you would have been denied. Today you have the opportunity to be fairly rated for the first time in the PTSD process.
Once the veteran has established the condition, the VA begins its three year cycle of cutting the percentage or removing the veteran from the program. I have represented several veterans who suffer from PTSD and unable to work at any type of employment. Verified by VA doctors, the veterans were found to be less than 100% by schedule; however, over the 60% minimum required to be granted Individual Unemployability (IU). Because of policy, the nervous conditions were exempt from the IU allowances and the veterans were continually denied. In early 1992, we found victory at last in this area. Many promises, to most veterans, have not been honored.
Yes, we have some solid doctors in the VA system. Their diagnosis are as often overlooked as a combat record. Which again is no longer going to be a major issue. The VA needs to look at its structure of the rating criteria; rather than trying to silence their critics, as the VA had often attempted. The answers are there if the VA would only listen.
We have come a long way since the day of the closest diagnosis being that of: Anxiety Disorder, adult situational reaction. Let us all attempt to understand the plight of our fellow veteran who suffers from PTSD, after all, their war continues on, even today.
Please describe how attitudes of the general public affect VA policies, keeping in mind VA policies are actually a result of congressional action.
How important do you feel a persons MOS would be in determining a claim for VA compensation involving PTSD? Why?
CHAPTER ELEVEN SOMETHING'S WRONG!
Many more than one would think, will visit with me and tell me some of the reasons they feel something is wrong. "I don't know what it is Dave; but, my life just doesn't work like everyone else". I will ask them a few questions to warm up for our one on one discussion. During the critical questioning, we must come to the question of family. Often, very often, the veteran has been married five, six or even more times. The siblings have rejected the veteran, and the veteran has become isolated from the world. Parent rejection is difficult for the veteran to accept and this often occurs. The veteran will strike out at the nearest loved one, even though he knows the cost: a loss of another relationship. Why? He knows what will happen, another rejection, loss, but he cannot help it, the inner control is not his, it belongs to stress. More specific, Post Traumatic Stress Disorder. Not everyone who has the aforementioned problems has PTSD; however, this is a warning sign.
The veteran with PTSD finds he no longer has a trust for his friends, close relationships soon are a part of history. The former social activities are no longer interesting. He does not actually make new friends, as the trust is gone. Where can the veteran turn? To the VA? A part (in his mind) of the system? He thinks "I can never trust those people!"; thus, we arrive at the point where we must guide our client properly. We must assist the veteran to choose either the VA Medical Center, its Post Traumatic Stress Disorder Clinical Team, or the VA Outpatient Clinic that will afford him the opportunity to receive therapy to overcome his stress. The Vet Center(s) offer help, valuable counsel is available to the veteran at no cost.
When many of the veterans returned to America, they faced the cruel adverse judgment of certain veterans organizations. Many, if not most, heard the phrase, "we don't need your kind in our post, you are not real veterans". It was several years before this barrier was broken. It took strong leadership in the organization, coupled with strong Vietnam veterans to break this seeming impasse. When the veteran was rejected by his peers of the preceding wars, the problem of rejection became anchored into the mind. Then to be told the infamous words, "that was not a real war". Some of the violators were Vietnam Veterans.
Today, we recognize some of the problems that exist, no person has all the answers; but, the attempts to help are at hand. The VA is long and slow in answering the needs of the veteran; but, as a result of legislation passed in Congress, help is on the way.
We still find in America a "love/hate" relationship with the veteran and their relation with the community. There are those who strongly feel the veteran has been short changed in their readjustment benefits and allowances over the years. There are a growing number of others who actually feel the veteran who asks for the readjustments are crybabies, and expect more than what is deserved. Most of us, in the veteran community feel we should have certain rights as veterans, and we most certainly do, in fact. However, for many to collect their rights, the path was very rough indeed. There were and still are many obstacles in the path that are very difficult to over come, due to the fact that many of the protesters of the Vietnam war are now in policy making positions in government, business, education, industry as well as the VA!
It is rare indeed, to find a Veterans Service Officer who will admit that prejudicial attitude shown during the 70's; but, we all know it did exist. Today's school teacher may well be the student of the streets in the 60's. The teacher may teach the facts of the Vietnam war or the Desert Storm in their opinion, not ours, as she/he sees it, not as it actually happened. This problem will haunt the PTSD patient for many years to come. We have watched a decline in Veterans Day celebration involving children. Few are ever brought to the parades. Few schools have programs to honor veterans, Most, seem not to want to be involved in the healing process. The first answer to the dilemma is the healing process. The process that should have started upon their return, but didn't. The PTSD victim who becomes a client of the Veterans Service Officer has seen the two faced, double talking system at work. It now becomes paramount to open an honest line of discussion. This must be an opportunity for the veteran to tell his story, his way, his words. The very last thing the veteran needs is someone to tell them to watch their language or "you must be nice now". We must again be reminded the problem is not only the Desert Storm, and the Vietnam veteran; but the Korean conflict veteran, the WWII veteran and some of those in actions in between, now have PTSD problems.
Prior to 1981, the term Post Traumatic Stress Disorder did not exist, except in a very limited area of some psychiatrists researching trauma reaction. Most articles one reads today will refer to the World War I condition known as shell shock; or, the World War II/Korean Conflict term combat fatigue, as types of the condition Post Traumatic Stress Disorder. To assume that shell shock and PTSD are one and the same is to err. Combat Fatigue may be a form of psychosis; but, it is not necessarily the same as PTSD in development or the ultimate reaction. A person who suffered shell shock or combat fatigue may well have incurred PTSD; but, this condition did not always result.
For several years, the VA has recognized the condition of PTSD as service connected disabling condition, if the PTSD meets certain criteria. The prominent cases which were first recognized included the combat veteran of Vietnam and former prisoners of war (POW) who applied under the special POW legislation. Although the hard fought battle for recognition of the condition was allowed in 1981, very few veterans could meet the rigid standards set forth by the VA. To understand the position of the criteria of the VA, which has become more flexible in the past decade, is difficult for the layman. It seems to be the opinion and policy of the VA, combat is not enough to indicate the required stressor for a claim of service connected disability PTSD. One of the basic requirements is a life threatening situation out of the normal realm for human reaction and emotion.
The VA has now found WWII and Korean Conflict veterans who were not POW's to have PTSD to varied degrees. This condition is not limited to Desert Storm or Vietnam veterans, although the Vietnam veteran rate of incident is far greater as are the reasons. To complicate the process that is required to establish PTSD, the VA has a special examination that is used in the rating procedure. To be honest, the preparation for the examiner gives enough information to understand the veterans dilemma. The major problems have been the examiner not being familiar with the subject of combat stress or first hand knowledge of how much stress can be placed on veterans who were involved in an unpopular war; also, who were brought into action literally overnight and swept back into civilian life with no adjustment time at all. The veteran is seen on a regular basis by an assigned VA psychiatrist, who knows the veteran and the problems on a first hand basis. However, when the time comes for the deciding examination the veteran is seen by a doctor; who usually has not seen the patient before. They do the examination sometimes in less than ten minutes. Thus, the entire future of the combat veteran, who already has a great distrust of the system, is in ten minutes, diagnosed by a person who has never before seen the veteran. The months and years of treatment by the attending physician may or may not be considered. In nearly every case, the ten minute examination carries the weight. There are several areas of concern for the veteran and the development of the claim. First and foremost there must be a diagnosis of PTSD and a stressor of life threatening situation. Without these two basic factors, there is no claim for PTSD.
In order to prepare a claim, the service record must be reviewed. Prior to filing the claim the evidence must be assembled. To order the records a SF 180 must be submitted. A request for the records should be: Army, the DA form 20; Navy, the Enlisted record of Transfers and Receipts, Administrative Remarks and/or Officer Data Card; Air Force, AF form 7, Officer AF 11; Marines, NAVMC 118 (3) (9) (17); Coast Guard, Endorsement on Order Sheet.
PTSD can exist without the condition being service connected. In several cases, we have the diagnosis as PTSD, yet, the condition is non-service connected due to the absence of actual stressor while on active duty. We must be constantly reminded that even when the condition is apparent, the reason may be other than what we expect. Prior to filing the claim, a complete review of the psychiatric treatment must be considered, hand in hand with the military history. We must expect discomfort on the part of the veteran as well as his representative in this very long claim process. This is not an easy task, the representative must listen well and ask questions that lead the veteran into a full disclosure of the traumatic event as well as the reactions after the event.
Remember, we are still in a learning process, PTSD was only recognized as a mental disorder in 1980. In order for the representative to have a firm grasp on handling claims for PTSD veterans, he/she should become familiar with DSM-III-R, Post Traumatic Stress Disorder, section 309.89.
CHAPTER TWELVE SAGA OF THE MORGUE
Raymond was a reservist called on active duty during Desert Storm. He was assigned to the morgue at the Dover AFB. Raymond did not desire to be assigned to morgue duty, nor did his MOS in any manner resemble that type of duty. He was a Material storage and handling specialist, yet he found himself handling every corpse of those Americans killed in the Desert Storm operation. Raymond did not want that job, but as things go in the Army, that was his job.
As a result of that duty, Raymond suffers all of the symptoms found in DSM-IV for PTSD. The criteria are met line by line, in the newest DSM. However, the VA has not yet recognized, as of January 1997, this book published by the American Psychiatric Association in 1994
CHAPTER THIRTEEN VETERANS VS. WANNABES
It seems as if intelligent beings as we are, and with compassion that we allegedly have within our souls. The VA would be able to consider PTSD as a condition that can exist without combat being a prerequisite; but, it is not exactly the way we want it; nor, it is not the way it should be. It is very difficult to convince the VA that a person's PTSD is service connected without the benefit of a combat MOS, such as 11B in the Army or 0311 in the Marines, etc. or the recipient of a medal for valor.
Let us use a case in point. A veteran has filed a claim for PTSD, Chronic, delayed. The veteran has a documented diagnosis from a qualified physician, who is a psychiatrist. The veteran has presented a stressor, which is a life threatening situation, out of the normal realm of human experience. This veteran is a clerk, who is assigned to the headquarters unit in a normally safe area. During a rocket attack on the post, the veteran is in a storage area that is the brunt of the rocket attack. The veteran is not physically harmed, has not been discovered to be in an unauthorized area, has not performed any act of courage, in other words, this veteran has done nothing to get their name logged into a military report. Thus, we have a stressor, that is very real, very terrifying, and very undocumented in scope. This leads us to the unfortunate situation of not being able to prove the stressor to the VA. Why is this so? Is there not the "buddy statement" to be considered? The answer is yes, there is the good ol' buddy statement to be considered. The problem is they are not given much credence by the Rating Boards of the VA. Why? Well, one reason is the overwhelming fabrications that have come about in the past several years, especially since being a veteran has become popular. There is a group know as "wannabes", who have made life very difficult for those that actually have borne the battle. The people who are called "wannabes" often were in the service; but, as a result of some factor, did not achieve the degree of heroism they desired. They add to their saga and now are able to compete in the war stories at the local post or tavern. Just as tragic as the "wannabes" are those who actually did the claimed situations, but cannot prove it. Today, we find people who were never in the service falsifying someone else’s DD-214 to join veterans organizations or attempting to gain benefits from the VA or other governmental agencies.
When a veteran has requested their military personnel file and the file does not produce the required documentation for a stressor, such as there is no combat MOS, there is no mention the veteran was in or near a rocket attack, is the veteran to just quit? The answer is definitely, No! The resources are available, send a letter to the U.S. Army Environmental Support Group, and request "unit data" being sure to give the complete and exact identification of the unit involved. You must also ask for "After Action Reports" as well as "Lessons Learned Reports" and the "Duty Officers Log" When you have the unit records at your disposal you can then start trying to locate more than one "buddy" to get statements from to prove the event actually happened. The After Action , Lessons Learned reports, or the Duty Officers Log, will often give you the information sought.
Even with this information to document the veterans statement, the VA is often unwilling to yield on the stressor. We need to firmly plead our case before the VA in person, taking as much documentation as possible. I have found with all of the above data in hand, the Hearing Officers will give positive consideration to the veteran.
CHAPTER FOURTEEN EPILOGUE REAL LIFE
Today the veteran faces many problems. There are imitators of veterans who lie about their status. There are those who are in positions of power over veterans who never served in the military. The veteran of today has organized enemies. A large group of them are politicians, in congress. Those tricky individuals who woo and court the veterans vote. Then forget them, until the next election. They will do whatever is necessary to get votes from all sides of the issue. The veteran also has the self styled do-gooder who will work on their own, away from the veteran organizations. These people often have a personal vendetta and the general welfare of the veteran community may well suffer. Sometimes the self styled do-gooder is unaware of the need of the veteran organizations to bring us together. Lincoln said, "In union there is strength." Lincoln was right.
It seems as if the bureaucrats look for ways to bring discomfort on the already disabled veteran. It reminds me of the many times I watch healthy young people, with no sticker, pull in the Handicap Parking Zone in front of the video store. It just makes me sick.
APPENDIX I INSTRUCTIONS FOR PTSD DEVELOPMENT SHEET AND STRESSOR LETTER
Attached is a PTSD Development Sheet. Due to the intricate work of this type of claim, I found several years ago that in order to obtain the proper statements and serve the veteran, myself, and the VA, the attached form needs to be completed. I tell everyone the same thing, there are no exceptions when it comes to PTSD.
To better express myself, I want you to know that I used to sell insurance and when I first started to sell insurance, the company made me memorize what I told my clients. At first I did not understand why, but after a while by telling everyone the same thing it left no margin for error.
I want you to use the PTSD Development Sheet by printing and using only black ink. Be sure to answer every question that applies. Please do not ask another person to complete this form for you, except your spouse (partner), may assist.
When I first developed this form one of my clients came in and asked me who was the moron that made this form. I was embarrassed, but I told him: "it was me." Since that incident I tell everyone, this is my form. After completing the questions on the back page, you will come to the no BS clause. BS means bull shooting. Everything that is listed on this form must be the truth, it may be used in your claim development. Any fabrication that is intentional dissolves our working arrangement.
Finally, we need a stressor letter. The guideline helps you remember many things you had forgotten. Stressor means life threatening situation in combat that is out of the normal range of human experience.
When the form is completed carefully detach it, and return the form as well as the stressor letter to your Veterans Service Officer.