Saturday, January 17, 2015

EJF newsletter - Why Veterans Can't Get Jobs - Part Three - Dying to get an appointment with the VA 1/16/15



Subject: EJF newsletter - Why Veterans Can't Get Jobs - Part Three - Dying to get an appointment with the VA 1/16/15



Why Veterans Can't Get Jobs

by Charles E. Corry, Ph.D.
President, Equal Justice Foundation

Veterans have always faced some difficulties reintegrating into society after their discharge. That is particularly true if the veteran has been injured or wounded, even invisibly, by combat, training accidents, sexual assault, or the many other hazards of military service.
However, society has compounded the problems for veterans of the perpetual wars of the new millennium in at least three major ways: (1) deceptive advertising, (2) mala prohibita laws like the War on Drugs, and (3) a malfunctioning Veterans Administration.
I have broken these into three sections. I don't have pat answers as to how balance might be restored but these problems don't exist (or are ignored) unless and until they are documented and publicized.
If nothing else perhaps these essays will chart some of the rocks and shoals veterans must avoid if they are to reach safe harbor.

Part One — Hire a veteran! Not!

An examination of the hypocrisy, lies, deceit and Congressional acts that underly veteran unemployment.

Part Two — And justice for none

The impact of an overcriminalized justice system on veterans

 Part Three — Dying to get an appointment with the VA

It is self evident that in order to hold a job a veteran must be physically and mentally fit. In order to provide for that insofar as possible with the human debris of our endless wars our benevolent government has established a huge bureaucracy.

Background

What is today the cabinet level Department of Veteran Affairs has its roots in the Continental Congress of 1776. They provided pensions for soldiers who were disabled in the Revolution but, initially, medical care, if any, was provided by individual states and communities.
Federal medical facilities and housing for veterans were authorized in 1811 but none were opened until 1834. Assistance was later expanded to include benefits and pensions for veterans and also their widows and dependents.
It became the Department of Veteran Affairs (VA) on July 21, 1930, and was elevated to cabinet status on March 15, 1989. As with most government programs these worthy and essential services have grown to gargantuan proportions with a current budget of ~$153 billion with over 313,000 employees.
Under President Obama, the VA's budget has grown by more than 60% over the past six years, although congressional overseers and veterans' organizations complain that the department continues to be hobbled by what they consider a bloated and inefficient bureaucracy.
The Department currently has three subdivisions each headed by an Undersecretary:

       During the Vietnam conflict 2.59 million veterans served in country, 58,209 were killed, 153,303 were wounded, and 1,643 are still MIA. But these casualty figures grossly underestimate the burden on the VA and as of September 2011 some 7.4 million Vietnam-era veterans were enrolled with the VA. And 5.9 million Gulf War I as well as 5.7 million peacetime-only veterans have sought VA assistance. Throw in WW II and Korean veterans and the VA clientele amounts to over 23 million and the need for a gargantuan bureaucracy becomes obvious.
Of the ~2.6 million veterans who served in-theater during Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OEF), and Operation New Dawn (OND) in Iraq since 2001 only 6,843 (includes 17 DoD civilians) were killed and 52,281 were wounded in action as of October 30, 2014 (Table 1) thanks to advancements in body armor, transportation, and battlefield medicine. That tally excludes hundreds of thousands of others because the Pentagon counts only those injured as a "direct result of hostile action." If a wound or injury did not occur on a combat operation, or it was the result of an accident, or it was caused by simply wearing body armor every day for a year, it does not make the list.
Despite these relatively low casualty figures 1.76 million veterans are currently eligible for VA benefits and 1.03 million of have already sought treatment at a VHA medical facility at least once since 2002, usually (93%) for outpatient care. About 45% of them have sought compensation for service-related disabilities. By comparison, about 21% of those who fought in the 1990-91 Persian Gulf War (Gulf I) filed similar claims.
However, 1.76 million new cases is only a 7% increase in the total number of veterans the VA has to deal with. Why then the multiple problems so evident today?
First, the history of the VA is one scandal after another since the Revolutionary War so the current problems are nothing new.
Second, the endless wars of the 21st Century, with their advances in body armor and armored vehicles, together with the multiple combat tours required of OEF/OIF/OND veterans, has produced a much higher percentage of wounded and disabled veterans than previous conflicts. In Iraq and Afghanistan, where there were no front lines; where improvised explosive devices were the enemy's weapon of choice; where troops wore bulky protective gear most of the time; wounds such as traumatic brain injury, persistent ringing in the ears, elevated blood pressure, post traumatic stress, etc. that do not fit the military's classic definition became the norm.
Once troops returned home and the adrenaline ebbed they began to confront the cost of all they wore to protect themselves, of the bone-jarring trips in mine-resistant trucks, of inhaling desert sand pulverized into jagged particles by armored vehicles, back pain, blown-out knees, headaches, chronic coughs, etc.
As noted above, for more than 1 million vets, serving in these wars has left them in worse physical health according to a poll run by the Washington Post and the Kaiser Family Foundation. Eighteen percent — about 470,000 current and former service members — reported being seriously injured while deployed to Iraq, Afghanistan or in support of the wars. Some of those wounds have been profoundly life altering — lost limbs, widespread burns, massive brain damage. Others are more prosaic, often the results of accidents or wear and tear on the body, but nonetheless they have saddled veterans with enduring pain.
More than 600,000 veterans who have become partially or totally disabled from physical or psychological wounds resulting from military service in the new millennium are already receiving lifelong financial support from the government. That figure is certain to grow substantially as the VA slowly processes a large claims backlog. Additionally, the types of injuries and disabilities have changed with advances in war, medicine, and mental health adding to the burden and delays in receiving disability determinations and compensation.
The difference between the ~1 million veterans seeking compensation and the 600,000 who have received it may help to explain why almost six in 10 vets believe the VA is doing an "only fair" or "poor" job in meeting the needs of their comrades.
One in three veterans surveyed by The Post and Kaiser said the VA or the Defense Department has determined they have a service-connected disability, a ratio that is almost identical to the VA's overall tally.
What problems are OEF/OIF/OND veterans reporting? The three most frequent medical diagnoses of disabled veterans today are:
  • Musculoskeletal ailments (principally joint and back disorders),
  • Mental disorders, and
  • "Symptoms, Signs and Ill-Defined Conditions," that most veterans would say translates as "If it isn't simple and obvious we don't know what it is, and it certainly doesn't qualify for disability benefits."
Each of these areas is addressed sequentially below.

Physical wounds and musculoskeletal ailments

Waits of months to sometimes a year or more to even see a doctor have been frequently reported. But once admitted the VHA, to all appearances, deals well, if not always timely, with physical wounds.
Advances in prosthetics for lost limbs has been remarkable and the VHA is a leader in such medical research. But the problems don't stop there.
Obviously major limb amputations fall under this category and for the period 2003-2014 some 1,577 (Table 4) have been reported for OIF/OEF/OND veterans. However, a veteran may lose the use of a limb, hand, or foot without it being amputated and such accidents may happen outside of a combat theater. Veterans are commonly subject to crippling injuries during training and in other accidents and there is little doubt that the total number of such injuries, both from combat and other accidents far exceeds this number.
The signature wound of the current conflicts is a traumatic brain injury (TBI). These wounds result from impacts to the skull from an external force, e.g., projectiles, blasts, acceleration or deceleration, contact with a fixed object, etc. The impact may or may not penetrate the skull or result in fracture. The result is permanent or temporary impairment of cognitive, physical, and psychosocial functions, with an associated diminished or altered state of consciousness. Repeated blows to the head increase the likelihood of permanent impairment and such injuries may occur in combat, in training, and on or off base in an auto accident or fall, for example.
For the period 2000-2014 the VA reports 307,282 (Table 3) cases of TBI for all military, including OIF/OEF/OND veterans. That number is certain to increase. TBI is also known to be associated with early onset of dementia and increased numbers and severity of the disability of veterans with TBI can be expected in the years ahead.
In addition to direct injuries, the weight of man-packed combat gear in Iraq and Afghanistan was far beyond recommended loads. A basic load out for personal armor, water, helmet, weapon, ammunition, and other ancillary equipment was typically 60 kg (135 pounds) and often ranged to 90 kg (200 pounds) or more. As a result there will be tens of thousands of veterans with back, hip, and knee problems as they age and many have these problems now.
Qualifying for disability payments for any of these conditions, however, is typically dependent on such injuries being documented in a veteran's medical records before discharge and getting an honorable or general discharge. Otherwise the veteran usually faces a years-long battle with the VA before they can hope to obtain benefits, if any.
All of these conditions are going to make it difficult or impossible for OEF/OIF/OND veterans to get or hold jobs that require them to stand for long periods, carry heavy loads, or walk any distance on pavement or over uneven surfaces. Many are also limited in the types of tools or machines they can operate particularly if they have TBI.
Obviously these conditions are not caused by the VA but the failure to provide prompt and effective treatment exacerbates the veteran's problems. That is particularly true when payments for these disabilities are also delayed or denied.

Mental health and psychiatric assistance

Veterans suffering from mental health issues are particularly problematic. The problems are compounded by a shortage of mental health professionals in the VA and a crisis in the way psychiatry is practiced.
Wars have always produced more psychiatric casualties than physical wounds. Prior to 1980 little seems to have been done for mentally-impaired veterans other than to put the most severe cases in care facilities. Otherwise veterans were largely left to self medicate while telling war stories around the bar in the VFW or American Legion halls. If the laws hadn't changed, as noted above, that would still be a good therapeutic approach for many veterans.
In 1980, the American Psychiatric Association (APA) added PTSD to the third edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM-III) nosologic classification scheme. The PTSD diagnosis has filled an important gap in psychiatric theory and practice. The significant change ushered in by the PTSD concept was the stipulation that the causative agent was outside the individual, i.e., a traumatic event, rather than an inherent individual weakness. Bremner (2006) reviews known changes to the brain associated with PTSD.
The types of trauma that can lead to PTSD varies widely between individuals but certainly includes witnessing or being a victim of violent crime including sexual assault, being a victim of or witnessing an accident or natural disaster, death of a loved one, and certainly combat particularly if severe, protracted, or repeated and especially if the veteran is wounded. Other causes are, of course, known. Training and genetics also play a role with, apparently, Asians being less susceptible.
To understand why PTSD has such a drastic impact on employment for veterans it is necessary to review the characteristic symptoms and behaviors. Endnote 1 presents the symptoms of post traumatic stress as commonly seen in veterans. Most individuals initially experience only a few of these symptoms, with sleeplessness and nightmares being the most common. Dissociation is diagnostic, particularly in flashbacks. Symptoms such as irritability, irrational anger, anxiety, hypervigilance, etc. may develop later. Or initial symptoms may disappear only to be reignited years or decades later by some new traumatic event. Rarely if ever does an individual exhibit all these symptoms. Commonly some symptoms come and go while others are persistent. Veterans with PTSD may be high functioning for some period and then regress for no externally apparent reason, usually to the detriment of their employment and those around them.
Onset of post traumatic stress may occur within weeks or a few months of the trauma or delayed for years and decades. Symptoms must persist for at least a month to be considered a disorder. If PTSD is going to clear up it usually does so within one or two years, otherwise it often becomes chronic. Even if initial PTSD symptoms disappear a later traumatic event may trigger a renewed onset.
I know of no universal treatment for PTSD. The DoD and VA favor cognitive behavior therapy (CBT) and continuous exposure therapy but not all veterans respond favorably to either of these treatments. Eye movement desensitization and reprocessing (EMDR) is also used with some success.
Gore (2014) points out that many different drugs have been used to treat specific PTSD symptoms such as benzodiazepines for anxiety, anticonvulsants for impulsivity and emotional stability, and clonidine for nightmares. However, the principal agents of treatment have been the various antidepressants and beta-blockers. Atypical antipsychotics have been used for patients who do not respond to antidepressants. Some studies suggest that fluoxetine demonstrates some efficacy for all three symptom clusters. Various sleep medications have also been used. But what appears to work best for most veterans who have tried these drugs is marijuana either because they no longer have prescriptions, expense, or superior benefits.
DSM-5 notes that individuals with PTSD are 80% more likely to have symptoms that meet diagnostic criteria for at least one other mental disorder, e.g., depressive, bipolar, anxiety, or substance abuse as well. There is also increased risk of suicide and suicidal ideation. DSM-5 also notes that co-occurrence of PTSD and mild TBI is 48% in Iraq and Afghanistan veterans. I would suggest that for more severe TBI the co-occurrence of PTSD approaches unity and that it becomes difficult, if not impossible, to distinguish one from the other in many veterans.
Studies of Civil War veterans recognized that veterans suffering from mental trauma were at increased risk of disease and early mortality (Pizarro and others, 2006) so recognition of the problem is not new but effective treatment is still uncertain.
There is considerable debate over the percentage of Vietnam veterans who suffered from PTSD, e.g., see review by Richardson and others (2010). For in-country veterans who actually engaged in combat studies suggest around 30% lifetime occurrence although some estimates suggest that 50% is more accurate.
A RAND study (Tanielian and Jaycox, 2008) estimated 300,000 (19%) of the 1.62 million Iraq and Afghanistan veterans who had been deployed at the time or their study suffered from PTSD or major depression based on a telephone survey of 1,925 veterans. They also estimated 320,000 suffered some level of TBI. The authors note that "…respondents were concerned that treatment would not be kept confidential and would constrain future job assignments and military-career advancement." These concerns suggest the veteran's problems were underreported, a recurring problem.
Fischer (2014) reports that the Army Office of the Surgeon General has only identified 164,817 new cases of PTSD among deployed and not deployed troops between 2000 and 2014 (Table 2). Since veterans with all but the mildest cases of TBI are likely to have PTSD as well, and she reports 307,282 cases of TBI, the number of OEF/OIF/OND veterans who have or will develop PTSD is grossly underestimated.
These rather low estimates for PTSD lend credence to anecdotal evidence from veterans that the Army and VA grossly underdiagnose the problem.
Of course a failure to correctly diagnose disabilities, whether deliberately or through incompetence translates into denied benefits and often great hardship for tens of thousands of veterans.
Thomas and others (2010) studied both Active duty Army and National Guard troops at 3 and 12 months post deployment. They observed PTSD rates across active duty and National Guard study groups after a single deployment. Using the least stringent definition, the mildest cases, ranging from 20.7% to 30.5%, and depression rates ranging from 11.5% to 16.0%. Using the strictest definitions with high symptom rates and serious functional impairment, PTSD prevalence ranged from 5.6% to 11.3% and depression prevalence from 5.0% to 8.5%. Between 8.5% and 14.0% of all soldiers reported serious functional impairment due to either PTSD or depression symptoms. They also noted that the incidence of PTSD is 2 to 3 times higher among those exposed to combat compared with those who did not report significant combat exposure and that PTSD is more frequent among National Guard and Reserve troops. My experience suggests the highest rates of PTSD occur in medics, corpsmen, and truck drivers in daily convoys.
A weakness of the above surveys is that they were done with troops who had completed a single combat tour, as was also true of most Vietnam veterans. Conversely, many OEF/OIF/OND veterans served multiple combat tours lasting from nine to fifteen months, many enduring three, four, five or more with only nine to twelve months back home as the operational tempo increased.
The March 29, 2014, Washington Post and Kaiser Foundation survey is more inclusive. They found that of those deployed to Iraq, 47% were sent on two or more combat tours, and 29% — more than a half-million veterans — spent two years or more in-country. Of veterans who deployed to Afghanistan, 29% had two or more tours, and 16% spent at least two years there. And many veterans served combat tours in both Iraq and Afghanistan but I haven't found data on veterans who served in both countries or three or more combat tours.
The Washington Post and Kaiser Foundation poll found that the wars have caused mental and emotional health problems in at least 31% of OEF/OIF/OND veterans — more than 800,000 of them. When more specific questions were asked, the rates increased: 41% — more than 1 million — report having outbursts of anger, and 45% have relationship problems with their spouse or partner. Both are symptoms of post-traumatic stress (see Endnote 1) and data on other mental health problems, e.g., suicidal ideation, schizophrenia, depression, etc. are not reviewed. More than half of veterans polled say the government is not doing a good job addressing the requirements of this generation of veterans. But when asked to rate their own treatment, almost 60% said the government's response is "excellent" or "good." Greater than 50% finding VA not doing a good job versus less than 60% pleased with their own treatment is probably within the margin of error for the survey. When asked about their own health care more than 80% stated their physical, mental and emotional needs are being well met by the VA. So once in the system veterans generally seem pleased with the care they receive.
As reviewed by Grossman (1995, rev. 2009, p. 43-45), WW II studies found that after 60 days of continuous combat 98% of surviving soldiers became psychiatric casualties. The 2% who were able to endure sustained combat showed a predisposition toward "aggressive psychopathic personalities." I have not found any comparable studies that quantify the effects of multiple combat tours on veterans although a qualitative difference seems well established. When troops who have completed multiple combat missions are polled the rates of PTSD are much higher. Everyone has a breaking point past which they cannot continue to function. While that point cannot be individually measured I do know that far too many veterans of the current conflicts have been pushed too far.
Available data suggest the Army and the VA are badly underdiagnosing the prevalence of PTSD and other mental health problems.
Part of that issue might be a sampling problem as it is becoming more apparent that these problems first occur or become worse later in life as suggested by the veteran arrest study of Corry and Stockburger (2013). If valid, many mental health problems for OEF/OIF/OND veterans won't become apparent until they reach age 40 or so.
Not only is the VA understaffed in the mental health arena, and apparently underdiagnosing the prevalence of PTSD, but the field of psychiatry itself is in a state of crisis. Daniel Carlat, M.D., in his 2010 book Unhinged details how psychiatry has largely forsaken the practice of talk therapy for the seductive — and more lucrative — practice of simply prescribing drugs. Thus, when troubled veterans do manage to get an appointment with a shrink the likely outcome is the psychiatrist will spend the session typing notes into his computer and send the veteran off with a shopping bag full of drugs. Veterans on 12 and 14 different medications are reported and, because of their condition, they have little idea of what each drug is for and often report feeling like a zombie on them and this "treatment" may be fatal.
These policies are dangerous. There are many cases of premature deaths in veterans that are linked to the multitude of prescription drugs they are often prescribed. Of particular note are the fatalities associated with both legal and illegal drugs, notably opioids, veterans take for pain and relief from the multiple symptoms of PTSD.
The death of young veterans by heart attack was reviewed by Rappaport (2012) based on the research of neurologist Fred Baughman, Jr. M.D., Fellow, American Academy of Neurology, and Diplomate, American Board of Psychiatry and Neurology. Dr. Baughman refers to these cases as Soldiers Dead In Bed and as of September 2014 he has tabulated over 400 such cases. As he notes, this is far from a complete list and the problem continues unabated. Seroquel (an antipsychotic) is the drug most frequently linked to these deaths but other antipsychotic and antidepressants have also been identified in such cases particularly when Paxil (antidepressant) and Klonopin (benzodiazepine) are prescribed and taken together. And the negative effects of these drugs are magnified when dosage is suddenly interrupted, as for example; the veteran is thrown in jail.
Accidents, often deliberate, and alcoholism also account for numerous, but usually uncounted veteran deaths as reviewed by Alan Zarembo in a December 2013 article in the LA Times.
The cumulative impact is horrific. Between 2,709,918 to 3,173,845 American veterans served in country and in interior waters of Vietnam between 1954 and 1975 (American War Library, 2007). Yet less than one third of the veterans who survived ground combat in Vietnam are alive today although most would only be in their 60s or early 70s. For example, see the discussion by Duff (2009).
Suicide is the factor most talked about but Katz (2013) points out that homelessness is as large a factor. And homelessness results directly from a veteran's inability to get a job.
It is estimated that at least 22 veterans a day commit suicide. These statistics only count cases where suicide is the stated cause of death and the individual is known to be a veteran. In the military bastion of El Paso County, Colorado, the coroner has no way to know whether or not a suicide case is a veteran or not and that is likely true of many other coroners.
Veteran suicides are much more common than published values.
The prognosis for current veterans is no more favorable. Already it is estimated that more OEF/OIF veterans have died from suicide than in combat in both wars.
The total number of Iraq and Afghanistan veterans who have died since returning from those theaters isn't known but certainly far exceeds any published figures.
Without effective and accurate diagnoses and treatment veterans with PTSD and TBI are poor candidates to get and keep a job.
While an accurate diagnosis and proper treatment are critical for mental health problems suffered by veterans, lets face it, any veteran who admits they are under psychiatric care by the VA isn't likely to get much of a job, if any.
One is left with the impression that in many cases the veteran would be better served sitting around the bar at the VFW or American Legion and swapping war stories. For sleeping and keeping calm marijuana is clearly a better drug choice although that almost certainly hurts the veteran's job options whereas the alcohol doesn't.

Symptoms, signs and ill-defined conditions

For chronic conditions the VHA record is not stellar. For example, they strongly resisted recognition of such conditions as exposure to Agent Orange in Vietnam veterans. Veterans began to file claims in 1977 with the VA for disability payments for health care for conditions they believed were associated with exposure to Agent Orange, or more specifically, dioxin. However, their claims were denied unless they could prove the condition began when they were in the service or within one year of their discharge. It wasn't until 1991 when Congress enacted the Agent Orange Act that gave the VA authority to declare certain conditions "presumptive" to exposure to Agent Orange/dioxin, making these veterans who served in Vietnam eligible to receive treatment and compensation for these conditions. Of course many of them were dead by then!
But by April 1993, the Department of Veterans Affairs had only compensated 486 victims, although it had received disability claims from 39,419 soldiers who had been exposed to Agent Orange while serving in Vietnam.
The effects of Agent Orange on veterans and their children is draining, debilitating, and sometimes disfiguring. Such conditions make it very difficult, if not impossible, for them to get or hold many jobs. And that says nothing about the time, energy, and money they have had to spend in getting the VA to recognize, let alone compensate them for these conditions.
A similar scenario has played out for veterans suffering from what is known as Gulf War Syndrome. Approximately 250,000 of the 697,000 veterans who served in the 1991 Gulf War are afflicted with a wide range of acute and chronic symptoms including fatigue, muscle pain, cognitive problems, rashes and diarrhea. There are also reports that Iraq and Afghanistan veterans of the current conflicts suffer from this syndrome. Clearly veterans with these conditions are going to have difficulty finding and holding a job.
The same game of delay, denial, and obfuscation appears to be playing out for OEF/OIF/OND veterans.
While these games are played employment prospects for these wounded warriors are dismal. And they frequently must wait months and often years to receive the disability compensation their service entitles them to. In the meantime they are often dependent on family and friends, if any, for food and shelter. And many simply become homeless.

Dealing with the Veteran Administration

Unless and/or until they can find a job and become self sufficient, timely support from the VA is critical. But it is difficult to find a veteran who hasn't had problems dealing with the Veterans Administration. The first problem a veteran or their relatives face is finding the right branch among the three that they should be dealing with. Then, like in any good bureaucracy, there are forms to be completed. And fill out the wrong form or in the wrong sequence and it is usually back to square one.
One would hope that the Internet and a functional web site would alleviate many of these problems. So I tried it and when I went to download the veteran pension form I was led to I got this error message:
To view the full contents of this document, you need a later version of the PDF viewer. You can upgrade to the latest version of Adobe Reader from http://www.adobe.com/products/acrobat/readstep2.html
For further support, go to
The reader will never guess that I tried to download the latest version of Adobe Reader only to find that is what was already on my machine (Mac with OS 10.10, Adobe Reader 11.0.10, January 3, 2015). It is these types of problems that drive technically-challenged users up the wall, and don't make me too happy either. And this presumes the veteran has access to a computer and knows how and is physically able to use one.
Numerous other examples of this and many other problems might be given but to little purpose. The problems exist, they are common, and they are unworthy of a government agency of such importance.
Without the assistance of groups like the Disabled American Veterans (DAV) and Paralyzed Veterans of America, independent non-profit organizations, many veterans find it impossible to navigate through the VA bureaucratic maze and determine what forms need to be filed for what condition in what office or branch of the VA, with what documentation, when, and in what order.
A sad commentary on one of our government's largest bureaucracies inability carry out even its simplest mission.
But the games don't end there. Once the proper form is filed with the proper VA office the wait begins. One hears of routine delays of 2 to 5 years for disability determinations. Assuming the VA reviewer cannot find a reason to deny the application, and the disability is determined to be service related, a standard practice seems to be to award it with 0% monetary award. The veteran then has to file another claim for monetary award with current date, wait another couple of years for decision, with back pay only to date of second filing.
Should the initial claim be denied, as is reportedly routine, the veteran must then file an appeal and wait more years. It is not unusual to find Vietnam veterans still trying to get their disabilities recognized and just compensation from the VA.
Clearly the civil servants within VA offices are now in fear of their lives from such mad beasts as we. Veterans entering a VA facility are now scanned and searched. Even pocket knives are banned in case a "trained killer" goes insane and attacks an incompetent, pettifogging bureaucrat. Of course that approach ignores our bare hands, if they haven't been blown off. Soon we may need to be handcuffed or placed in a straightjacket in order to enter what is presumably a public building dedicated to serving veterans. But the recent event at the VA Hospital in El Paso, Texas, suggests a more immediate problem may be their own employees "going postal."
As noted above, a few arrests and veterans are homeless, but the VA hotline for homeless vets isn't reliable. It takes time to get appointments, run through the rain dances, and frequently they have no means of transportation to the VA clinic or hospital. Often their only means of communication is through a free email account at a public library. It is little wonder then that vets often get pissed off and say the hell with it. Suicide is too often the final option for them.
We can and must do better!

Summary

It is tragic the way many veterans are treated both by their government and by many businesses. After WW II veterans largely built the most advanced and prosperous nation the world has ever seen. But overcriminalization by mindless legislators, who have passed an incomprehensible multitude of punitive mala prohibita laws, has now filled America's prisons with more of our citizens and veterans than any other nation on earth.
Where the War on Drugs left off poisonous dogma by feminist ideologues stepped in to destroy the children, families, marriages, and lives of millions of veterans, e.g., see the Last Statement of Retired Army Sergeant Ball. Thus even those veterans who managed to find employment and reintegrate often found their lives destroyed.
With actions like the H1-B and similar visa programs it seems the Congress is actively attempting to prevent veterans and other Americans from finding lucrative positions.
Most disabled veterans seem to spend a lifetime fighting with the VA. Without the assistance of the Disabled American Veterans (DAV) and similar non-profit organizations many veterans find it impossible to navigate through the VA bureaucratic maze and determine what forms need to be filed for what condition in what office or branch of the VA, when, and with what documentation. A sad commentary on one of our government's largest bureaucracies inability carry out even its simplest mission.
It is a lucky veteran who navigates the rocks and shoals enumerated here without going aground. And the anchor supposedly provided by the Veterans Administration is dragging.

Endnotes

Summary of symptoms of post traumatic stress disorder (PTSD) observed in local veterans:
  • Sleeplessness (probably the most common and the first thing one notices);
  • Dissociation from actual events and no memory of them is diagnostic;
  • Nightmares often accompanied by kicking, fighting, or choking a partner in one's sleep and are much more persistent and disturbing than what Grossman and Christensen (2007, 2nd Ed., p. 156-157) call the Universal Warrior Nightmare; 
  • Impotence in males;
  • Irrational anger or irritability accompanied by emotional or violent outbursts;
  • Anxiety and a need for unconditional control of almost every situation in order to feel safe;
  • Panic attacks and hyperventilating (veterans are known to put on their body armor in such cases);
  • Social withdrawal and fear of crowded places (often will not leave house or go shopping until early morning hours);
  • Difficulty concentrating, focusing, or remembering (short-term memory loss);
  • Hypervigilance often expressed as a fear of crowds and a need to do a reconnaissance before entering an area or building, e.g. Wal-Mart;
  • Flashbacks to the event(s); and
  • An exaggerated and often violent startle response.
For a comprehensive diagnostic description of post traumatic stress disorder see the Diagnostic and Statistical Manual of Mental Disorders DSM-5 pages 271-280.
To officially fall within the diagnostic guidelines the symptoms must last for at least a month.



About the author

Dr. Corry is a Senior Fellow of the Geological Society of America and an internationally-known earth scientist whose biography has appeared in Who's Who in the World, Who's Who in America, Who's Who in Science and Engineering, among others, for sixteen consecutive years.
He has been doing research on domestic violence, particularly abused men, since 1997.
In 2008 he and former EJF Director Robert Alvarez began pushing for a veteran court in Colorado Springs. That court is now up and research continues on veteran arrests.
After service with 1 st Marines Dr. Corry became involved with the early space program in 1960, doing preflight testing and failure analysis on Atlas and Centaur missiles, including all the Project Mercury birds. In 1965 he switched to oceanography and did research at both Scripps Institution in San Diego and Woods Hole Oceanographic on Cape Cod. He has also taught geology and geophysics at two universities and worked as a research manager for a Fortune 500 company.
Among other pursuits he has climbed high mountains, been shipwrecked and marooned on an unexplored desert island, ridden horseback through Utah, Arizona, and Colorado, and enjoyed many other adventures during his long career.
Presently Dr. Corry is president and founding director of the Equal Justice Foundation.
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Prohibitions and the War On Drugs
Vote Fraud and Election Issues
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Equal Justice Foundation
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Colorado Springs, Colorado 80906-5820
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The good men may do separately is small compared with what they may do collectively.

Benjamin Franklin
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