Foundation Urged Cognitive Screening For Veterans

(Photo credit: Wikipedia)
Recent revelations about the myriad failings of the Veterans Administration to address the physical health of many who served their country have overshadowed the quality of care those who do manage to get treated receive.
A posting on the website of California-based The SCAN Foundation, “an independent, non-profit public charity devoted to transforming care for older adults in ways that preserve dignity and encourage independence,” a few years ago points out a VA failing that may be just as problematic for servicemen and women.
“The Veterans Administration does a good job of screening hospital patients for physical functions when they are discharged,” states the posting. “However, it does a poor job of screening to see if they have cognitive problems that might require them to need extensive long-term services and supports.”
The SCAN Foundation announcement was based on a 2010 report by the Office of the Inspector General of the Department of Veterans Affairs titled, “Healthcare Inspection – Hospitalized Community-Dwelling Elderly Veterans: Cognitive and Functional Assessments and Follow-up after Discharge.”
Cognitive problems include issues with memory, confusion and concentration.
The Inspector General report ““… found that assessments of functional status were completed for more than 97 percent of the hospitalized elders whose medical records we examined.”
“In contrast, less than 40 percent of patients had evidence of any cognitive assessment during their hospitalization or in the six months prior to admission,” the SCAN Foundation stated. “Hospitals with and without geriatrics academic programs did not differ substantially in these aspects of performance. The inspector general stated that the DVA should ‘implement a plan to ensure that vulnerable elderly veterans admitted to VA hospitals have a documented assessment of cognitive functioning.’ ”
The SCAN Foundation went on to recommend that the “Under Secretary for Health develop and implement a plan to ensure that vulnerable elderly veterans admitted to VA hospitals have a documented assessment of cognitive functioning.”

Supreme Court Ruling Unintentionally Harmed Disabled Veterans

A U.S. Supreme Court ruling made three years ago is coming back to haunt a group it wasn’t even aimed at: disabled veterans.

Disabled veteran, ca. 1943
Disabled veteran, ca. 1943 (Photo credit: The U.S. National Archives)
“The court’s decision concerned a convicted murderer who had beaten a man to death,” according to a story in The New York Times. “But now it is being applied to bar claims from disabled veterans who fumble filing procedures and miss deadlines in seeking help from the government. The upshot, according to a dissent in December from three judges on a federal appeals court in Washington, is ‘a Kafkaesque adjudicatory process in which those veterans who are most deserving of service-connected benefits will frequently be those least likely to obtain them.’ ”
The original ruling said that some filing deadlines are so rigid that even those caused by bad information from a federal judge don’t excuse missing them, Adam Liptak wrote in the story.
Relief, at least for disabled veterans if not convicted murderers, may be on the way, however.
“The Supreme Court will soon consider whether to hear an appeal from David L. Henderson, who was discharged from the military in 1952 after receiving a diagnosis of paranoid schizophrenia,” the story stated. “He sought additional government help for his condition in 2001, and he was turned down in 2004. Mr. Henderson, who served on the front lines in the Korean War, had 120 days to file an appeal, but it took him 135 days. He had a pretty good excuse.
“His psychiatrist has said under oath that he is ‘incapable of rational thought or deliberate decision-making.’ As a consequence, the psychiatrist added, “Mr. Henderson has been incapable of understanding and meeting deadlines.”
In conclusion Liptak wrote:
“Before the Supreme Court leaves for its summer break, the justices are likely to decide whether they will hear Mr. Henderson’s appeal. If they do, they will consider whether they really meant to shut the courthouse door on veterans as well as murderers.”

Budget Cuts Affect Veterans and Survivor Benefits

A budget cut in last month’s budget agreement will not only affect all military retirees, but also the benefits received by surviving spouses, according to a recent article. The budget agreement included a cut to the annual cost-of-living increases of one percent, which according to the Pentagon will save $6 billion dollars over the next ten years.

Veteran (Photo credit: las – initially)
The cut, however, will affect annual payments by the military insurance plan known as the Survivor Benefit Plan. The Plan pays surviving spouses monthly annuities amounting to up to 55 percent of the retiree’s coverage to cover the retirement income lost. The cut will also affect all active duty, reserve and disabled military retirees, as well as combat related special compensation program payments.
House members defended the cut by highlighting what they see as only a marginal loss in payments. For example, according to House Budget Committee Chairman Paul Ryan, the cut would drop pension payments from $1.8 million to $1.7 million for a service person who retires at 38 over the person’s lifetime. Also, according to Congressman Ryan, a majority of military retirees have second careers after leaving the service.  However, in reaction to outcry from veteran’s groups, House members are working to reduce the impact of the cut on disabled veterans through an omnibus bill containing over $1 trillion in spending expected to roll out next week.

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Two Benefits That Provide Care for Veterans

There are various government programs and tax benefits available to those who provide significant care for veterans and their family members. If you are caring for a veteran at home, a recent article discusses the benefits you may be eligible to receive.
If the veteran you are caring for would otherwise be eligible to receive care in a nursing home, you may be eligible to receive the Veteran-Directed Home and Community Based Services program. Through this program, veterans are able to manage their own care. Importantly, veterans are able to select, hire, and compensate their own caregivers.
A wartime veteran or his spouse may also be eligible for the Aid and Attendance benefit. This benefit assists in paying for any necessary in-home caregivers, or care in an assisted living facility or nursing home. Even family members of the veteran or spouse may collect under this benefit. The Aid and Attendance benefit pays a maximum of $2,054 per month of tax free income for a married veteran, $1,732 for a single veteran and $1,113 for a widowed spouse.
In order to qualify for the Aid and Attendance benefit, the veteran must have served at least 90 days of active duty service, with one day during a period of wartime (the veteran does not have to have been in combat). Further, the veteran or spouse that you are caring for must require assistance with daily activities such as dressing and bathing. The VA also has income and asset requirements. However, proper planning with an elder law attorney can help in becoming eligible for those benefits.

Bill would help veterans capitalize on military skills

They fought for our freedom. They shouldn’t have to fight for jobs.
Too often, veterans of the various recent conflicts abroad return home to discover the skills they needed in Afghanistan, Iraq and elsewhere aren’t appreciated by potential employers, and that they don’t have a way of explaining just how prepared their experiences make them for all kinds of jobs.
Fortunately, a first-term U.S. Senator from Virginia and a Congresswoman from Illinois are jointly sponsoring a measure, one that has significant bipartisan support, to alleviate the situation.
“The Troop Talent Act of 2013 improves the alignment of specialty skills acquired in the military with civilian certifications or licenses required for post-service employment,” according to a recent press release put out by the office of U.S. Rep. Tammy Duckworth . “The legislation will also enable Military Tuition Assistance (MTA) and the Post 9-11 GI Bill to be used on courses and programs that guarantee a credential or industry certification after successful completion.”
The statement goes on to announce that 66 members of the House of Representatives and 10 members of the Senate have signed on as cosponsors of the legislation.
“Veterans who return from Iraq, Afghanistan, and any other place where they wore one of the nation’s military uniforms should get more help converting their specialized military training into a civilian career, U.S. Sen. Sherrod Brown said (Oct. 24) in Toledo,” according to an item in The Blade newspaper.
Brown is among the cosponsors of the measure, which was introduced by U.S. Sen. Tim Kaine of Virginia, a former governor of the state.
“If you’re a medic in the military you ought to have a leg up on getting EMT certification,” Sen. Brown was quoted as saying. “If you’re a driver in the military you ought to be able to get a commercial driver’s license easier and you should be able to get a job when you come back to Lucas County. The purpose of this bill is to connect better than we’re doing. If you’re an electrician in Iraq you have a leg up on electricians’ apprentice programs.”
“None of us can feel good if we hear the unemployment stats that our veterans are facing in a tough economy,” Kaine said in the statement from Rep. Duckworth’s office. “As we draw down out of Afghanistan and as more transition from active to veteran life this challenge could compound if we don’t tackle it. It’s something that we owe to those who serve. It’s also good for our country and economy. Military training is an enormous public investment in skills. We should take advantage of those skills and talent that is there among our folks who are transitioning out of active duty for the benefit of our entire society.”

Veterans Should Not Be Held Hostage in Budget Impasse

As the government shutdown continued, there was plenty of blame and lots of shame to be passed around.
For veterans, it’s looking like they may become hostages to the political infighting and budget impasse.
“Veterans groups have reacted angrily to news that an extended government shutdown will leave the Department of Veterans Affairs unable to make disability compensation and pension payments to veterans,” according to a Sept. 30 story in The Washington Post.  “Losing the payments could have a devastating impact, particularly on severely wounded veterans who are unable to work and depend on VA checks, said Tom Tarantino, chief policy officer for Iraq and Afghanistan Veterans of America.”
“Congress and the White House, they’re playing chicken with people’s lives,” Tarantino was quoted as saying. “That’s where this becomes scary.”
“We have to be hopeful that Congress will reach some sort of compromise before millions of disabled veterans and survivors are financially devastated,” Joe Davis, spokesman for Veterans of Foreign Wars, told the newspaper.
If that happens, it will be shame on everybody.

Private bar increasingly coming to aid of military

More and more attention is, at last, being paid to the needs of military families, and that includes the area of legal help.
A recent article on the website of the Chicago-based Sargent Shriver National Center on Poverty Law discussed not only the increase in assistance to veterans and their family members, but also the types of legal problems they can sometimes encounter.
“Improving the focus on military family issues is welcome, as the burdens placed on the men and women of our armed forces have increased throughout the past decade, where active-duty service members have become accustomed to frequent and lengthy deployments overseas,” the article states. “This trend has imposed great challenges on our military families, which may not end upon the service member’s discharge into our already-sizable veteran population. These include, unfortunately, a full range of legal issues, many of which are unique to those currently and formerly serving in the armed forces. As these legal needs have grown, they have been met with many local, state, and national initiatives enabling attorneys to step forward to deliver much-needed legal help to active-duty service members and veterans.”
Along with a greater focus on the needs of those serving their country, there has been a decrease, the article notes, in the “we take care of our own” mentality when it comes to legal concerns, paving the way for more private attorneys to become involved in the process.
“There is much that a private bar attorney can to do aid our current and former service members,” the website states.
The types of legal issues service members and their families can face include:

  • Landlord/tenant matters, including deposit recovery problems
  • Family law issues, especially child custody disputes arising around overseas deployment
  • Credit and lending problems, which can include payday loans, auto sales contracts, and interest rate reductions
  • Employment issues, particularly for National Guard members and Reservists needing to enforce reemployment rights
  • Guardianship needs, or estate matters on behalf of families of deceased service members
  • Securing vitally needed benefits for veterans from the Department of Veterans Affairs

Law would treat military parents of children with disabilities with the same respect as it does their civilian counterparts

On the plus side, a member of the U.S. House of Representatives and of the Senate recently had the courage to introduce a bill that would greatly aid children with disabilities who have a parent in the military.
On the down side, the website gives the measure only a 1-percent chance of making it out of the House Armed Services Committee and no chance at all of being enacted.
And that, as the website for the National Association of Elder Law Attorneys points out, is a shame.
Introduced in early June by Congressman Jim Moran (D-Virginia) and Senator Kay Hagan (D-North Carolina) the Disabled Military Child Protection Act of 2103 would allow military retirees to transfer Survivor Benefit Plan annuities to a Special Needs Trust to provide long-term care for a disabled child.
“While the general public can transfer funds into an SNT, there is currently no mechanism for members of the military to do the same.”according to the announcement of the legislation on Rep. Moran’s website.
“As a father of a special needs child, I know how important it is for parents to be able to provide the best possible care for them,” Moran stated. “The Disabled Military Child Protection Act will give peace of mind to middle class military parents of more than 1,000 dependents that their children will receive good care after they are no longer able.”
“The Disabled Military Child Protection Act ensures that special needs dependents of our service members receive the care they need, deserve and have earned while making sure military special needs children are treated the same as those of civilians,” Hagan said in the announcement. “North Carolina is the most military-friendly state in the nation, and I am committed to supporting commonsense legislation like this that will support our military families that sacrifice so much to protect us.”
“The bill would allow more than 1,000 severely disabled military dependents to receive survivor benefits without losing access to Medicaid and SSI,” according to the National Association of Elder Law Attorneys.
The measure would not, the organization insists, lead to any abuse of the system.
“The benefit of the SNT is that it allows this individual with disabilities to have supplemental funds to pay for basic living needs and extra care above that provided by the government without disqualifying the individual for government benefit,” the website also states.

Post-traumatic stress, sadly, isn’t exclusive to young soldiers

Although their numbers are sadly and rapidly dwindling, veterans of World War II, the Korean War and even of the War in Vietnam are increasingly coming to realize they suffered and are still suffering from post-traumatic stress syndrome.
“Who knew much about post-traumatic stress syndrome in 1945? The term didn’t enter the official manual of psychiatric diagnoses until 1980; effective treatments didn’t become widely available until the late 1990s.”

Age-standardised disability-adjusted life year...
Age-standardised disability-adjusted life year (DALY) rates from Post-traumatic stress disorder by country (per 100,000 inhabitants). (Photo credit: Wikipedia)
Soldiers were discharged at the end of World War II with the simple expectation that, in spite of what they had seen and done, what they had experienced, they would just resume the lives they had before service to and sacrifice for their country intervened.
The prevailing medical advice … amounted to ‘put it all behind you,’ ” Span wrote.
“The John Wayne approach,” the article quoted Joan Cook, a Yale psychiatry professor and researcher with the National Center for PTSD, as saying. “Older vets believed in that. For many years, they hid their symptoms.”
“Because post-traumatic stress syndrome can trouble veterans’ physical health, their emotional lives and their relationships — here is also a connection to dementia, researchers are finding — the Department of Veterans Affairs and veterans advocacy groups have made it their mission to inform service members returning from Iraq and Afghanistan about their PTSD risk,” according to Span. “But older veterans tend to know less about the syndrome, even as it haunts many of them. Their generation had less experience with psychotherapy, which once carried a stigma. Even now, if they do seek help, they are likely to describe their problems as physical.”
“Because post-traumatic stress syndrome can trouble veterans’ physical health, their emotional lives and their relationships — here is also a connection to dementia, researchers are finding — the Department of Veterans Affairs and veterans advocacy groups have made it their mission to inform service members returning from Iraq and Afghanistan about their PTSD risk,” according to Span. “But older veterans tend to know less about the syndrome, even as it haunts many of them. Their generation had less experience with psychotherapy, which once carried a stigma. Even now, if they do seek help, they are likely to describe their problems as physical.
“Aging itself can exacerbate the syndrome, as the sheer number of Vietnam-era vets streaming into Veterans Affairs centers for treatment in recent years seems to demonstrate. As those men (it is primarily men) experience illness, disability and bereavement, the sense of vulnerability and loss of control that arose in combat can re-emerge. Nursing homes — people in uniform, intercoms, semi-authoritarian routines and schedules — can trigger old fears.”
There is some good news on this sad front.
“Yet even veterans who have suffered quietly for decades can benefit from the contemporary treatments offered by the VA.,” the article stated.
“We can help them out,” said Dr. Steven Thorp, a research psychologist at VA San Diego Healthcare, mentioning such options as relaxation and stress reduction training, cognitive processing therapy and exposure therapy.

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Veterans benefit from financial planning, just like everyone else

Everyone can benefit from financial planning.
One group of people who may not think so is veterans of the military.
“For members of the U.S. military, traveling and re-locating often, returning home following a lengthy deployment and living with uncertainty isn’t always easy,” according to an article on the website of Ameriprise.
Establishing a routine after a big life event like a re-location, deployment or completion of your military service can be challenging, and comes with many new decisions, including new or changing financial choices and obligations.”

English: PACIFIC OCEAN (July 16, 2009) Sgt. Kh...
English: PACIFIC OCEAN (July 16, 2009) Sgt. Khristian Colon, armory chief of Command Element, 13th Marine Expeditionary Unit (13th MEU), cleans the upper receiver of an M16A4 service rifle aboard the amphibious assault ship USS Boxer (LHD 4). Boxer and the 13th MEU/Boxer Amphibious Ready Group are underway in the Pacific Ocean returning from a 7-month deployment. (U.S. Marine Corps photo by Lance Cpl. Jesse D. Leger/Released) (Photo credit: Wikipedia)
The Kiplinger Newsletter recently offered a series of financial planning tips geared specifically toward members of the military.
These include:

  • “Take advantage of low-cost investments. Service members are lucky to have access to one of the lowest-cost retirement-savings plans around. The Thrift Savings Plan charges just about 25 cents a year for every $1,000 invested, and it lets you choose one of five index mutual funds or a target-date fund.”
  • “Benefit from tax-free in, tax-free out. Saving in a Roth IRA can be a particularly good deal if you’re receiving tax-free combat-zone pay. In that case, your money goes into the Roth tax-free and your contributions as well as your earnings come out tax-free, a double tax benefit that’s tough to beat.”
  • “Sign up for inexpensive life insurance. Service members have access to one of the lowest-cost life insurance programs available”
  • “Take advantage of low loan rates. The Service Members Civil Relief Act provides special legal benefits for service members, including an interest-rate cap of 6-percent on any loans you took out before you were called to active duty. You have to apply to the lender for this benefit, which is intended to help you if your ability to pay is affected by military service, as it may be if you take a pay cut when activated to the Reserve or National Guard.”