From one of the Los Angeles Times' best reporters.,0,4239158.story?coll=la-tot-callocal&track=ntothtml

VA failing Mideast vets, lawsuit contends Troops returning from Iraq and
Afghanistan are not getting proper medical and mental health care, the suit
says, citing post-traumatic stress disorder as a particular problem.
By Henry Weinstein
Times Staff Writer

July 24, 2007

SAN FRANCISCO  The U.S. Department of Veterans Affairs was accused in a
major lawsuit Monday of "shameful failures" in providing medical and mental
healthcare to injured servicemen and women returning from the wars in Iraq
and Afghanistan.

The 73-page suit, filed in federal court here on behalf of hundreds of
thousands of veterans, is the first of its kind and seeks to dramatically
transform the way the VA operates.

The suit targets what it describes as the agency's "unconscionable" backlog
of 600,000 claims, the adequacy of its services and the long waits to
receive mental health care, particularly for post-traumatic stress disorder,
which is described as the "signature problem" of vets returning from the
current fighting.

A recent report by a special Pentagon task force found that 38% of soldiers
and 50% of National Guard members coming home from Iraq or Afghanistan have
mental health issues, ranging from stress disorder to brain injuries. But
only 27 of the VA's 1,400 hospitals around the country have in-patient
post-traumatic stress disorder programs, the plaintiffs' lawyers said.

The individuals suffering from post-traumatic stress disorder, or PTSD, are
being deprived of mental health services in the early phases of the illness,
when identification and treatment are critical, the suit alleges. Left
untreated, severe PTSD can lead to substance abuse, depression and suicide,
the lawyers said.

"A number of veterans have committed suicide shortly after having been
turned away from VA facilities either because they were told they were
ineligible or because the wait was too long," the lawsuit states.

In response to the suit, the VA issued a formal statement, saying it "is
committed to meeting the special needs of our latest generation of heroes,
and it would be inappropriate to comment directly upon a potential or
pending lawsuit."

"Through outreach efforts, the VA ensures returning Global War on Terror
service members have access to the widely recognized quality healthcare they
have earned, including services such as prosthetics or mental health care.
VA has also given priority handling to their monetary disability benefit

Attorney Gordon P. Erspamer, one of the lead lawyers for the plaintiffs,
said at a news conference that the lawsuit, which seeks class-action status,
is an attempt to establish a basic set of "civil rights" for veterans.

"This isn't a case about isolated problems or the type of normal delays and
administrative hassles we all occasionally experience with bureaucracies,"
said Erspamer, of San Francisco's Morrison & Foerster, which has taken the
case pro bono. "This case is founded on the virtual meltdown of the VA's
capacity to care for men and women who served their country bravely and
honorably, were severely injured and are now being treated like second-class

"This is the first class-action lawsuit to directly challenge" the adequacy
of care for post-traumatic stress disorder and "the VA's unconscionable
backlog of claims," added attorney Sid Wolinsky of Disability Rights
Advocates, a nonprofit advocacy group that also is representing the

Symptoms of post-traumatic stress syndrome, the suit says, include intense
anxiety, persistent nightmares, depression, uncontrollable anger and
difficulties coping with work, family and social relationships.

Veterans suffering from PTSD and other psychiatric problems are less able to
handle battles with the VA bureaucracy than other vets, according to retired
Marine Col. James Cook, who spoke at the news conference. He brandished a
23-page standard form that veterans must fill out to seek help.

"The VA's outmoded systems for providing medical care and disability
benefits" have been overwhelmed by "the huge influx of injured troops
returning from Iraq and Afghanistan," the suit states. About 1.6 million men
and women have served in the two countries since the Sept. 11, 2001,
terrorist attacks.

The VA had significant problems even before the two current wars were
launched, but its current backlog has become an "insurmountable barrier"
that has made a mockery of the VA's mandate, said attorney Melissa Kasnitz,
of Disability Rights Advocates.

"The VA's motto, taken from Abraham Lincoln's second inaugural address is,
'To care for him who shall have borne the battle and for his widow and
orphan.' The VA is not living up to its motto or its obligation to care for
our disabled veterans," she said.

The named plaintiffs are two veterans' advocacy groups, Veterans for Common
Sense, based in Washington, D.C., and Veterans United for Truth, based in
Santa Barbara. The case was not filed on behalf of individuals because
"veterans fear retaliation," Erspamer said.

However, Paul Sullivan, executive director of Veterans for Common Sense,
said that individual veterans would be speaking out in the future. "Since
the Iraq and Afghanistan wars began, the VA has betrayed our veterans," said
Sullivan, who served in the Army during the first Gulf War and worked as a
project manager for the VA from 2000 to 2006, monitoring the disability
claims of veterans from the Gulf War and the recent wars in Afghanistan and

"Instead of hiring more doctors and claims processors," as he recommended,
Sullivan said, "the VA instituted new policies that block veterans' access
to prompt mental health care."

Sullivan is scheduled to testify Thursday at a hearing of the House
Committee on Veterans Affairs, which will be considering a recently issued
report by the Institute of Medicine examining how the VA handles treatment
and compensation claims for PTSD.

The defendants in the lawsuit include R. James Nicholson, outgoing VA chief,
several other ranking VA officials and Atty. Gen. Alberto R. Gonzales. A
spokesman for the Justice Department said the agency would have no immediate
comment because its lawyers were just beginning to review the suit.

The plaintiffs' lawyers emphasized that they were not seeking monetary
damages. Rather, they said the suit was designed to stop repeated violations
of federal laws that guarantee healthcare for returning veterans.

The plaintiffs' lawyers assert that the VA's claims-processing and appeal
procedures for denied claims violate the veterans' constitutional rights to
due process under the 5th Amendment and their right to petition for redress,
guaranteed by the 1st Amendment.

Erspamer said the VA had created perverse incentives to deny claims by
awarding employees bonuses based on the number of claims processed. Rather
than considering veterans' claims carefully, he said it was much easier and
faster to deny a claim, particularly a complicated one, than to grant it.

Moreover, the suit contends that the VA "has consistently presented
misleading statistics" understating the length of time it takes to decide a
claim, the number of veterans who need mental health services and the amount
of money the agency needs to meet its obligations to veterans.

Sullivan said the two recent wars have generated more than 220,000
disability claims. The lawsuit also alleges that government officials have
improperly persuaded many soldiers suffering from PTSD to accept
"personality disorder" discharges by telling them they will get help faster.
In fact, the suit states, agreeing to that bars veterans from obtaining
disability benefits and from receiving ongoing medical treatment because the
"disorder" is characterized as a "pre-existing condition."

Unless "systemic and drastic measures are instituted immediately, the costs
to the veterans, their families and our nation will be incalculable,
including broken families, a new generation of unemployed and homeless
veterans, increases in drug abuse, increases in alcoholism and crushing
burdens on the health care delivery system and other social services in our
communities," the suit charges.

The attorneys said that although they were hoping for help from the federal
court, congressional action also was needed to increase funding and other
resources for the VA.

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Michael Balter
Contributing Correspondent, Science
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