Tagged: veterans benefits

Chained CPI and the Battle Over Veterans’ Benefits

Posted by Jason Van Steenwyk

Veterans groups and elder advocacy organizations such as the AARP are lobbying overtime to protect their constituents from the long-term effects of a budget-saving measure designed to reduce the rate of increase of future Social Security benefits, retirement income and VA disability compensation. 

The United States Government, still smarting from a nasty recession and suffering the fiscal hangover effects of the so-called ‘Stimulus’ package, is looking for ways to rein in spending in order to preserve the long-term financial stability of Social Security. According to the Social Security Administration’s own actuaries, the program has enough in hand to pay planned benefits through approximately 2033 – after which time its portfolio of bonds will be exhausted. At that point, projected revenues coming into the program from payroll taxes would be sufficient to fund only about 75 percent of currently projected benefits. 

One proposed solution – which the President himself is said to favor – is to slow down the rate of growth in benefits by switching to a new method of accounting for inflation. Specifically, the President, and certain fiscal hawks would like to switch over to a Chained CPI measurement.

The Chained CPI is thought to be a more accurate measure of the true cost of living because it takes into account dynamic consumer reactions to changes in prices. Under current methodology, if the price of steak doubles but the price of chicken stays the same, the current measure simply assumes that the retiree or veteran will still buy the same amount of steak. The Chained CPI method, on the other hand, will assume that higher steak prices will result in less purchases of steak and more substitution of chicken.

The result, chained CPI advocates say, is a more accurate picture of the true cost of living, given that consumers are able to mitigate the effects of inflation by making smarter purchases.

It will also result in COLA adjustments being reduced by half. That means lower cost-of-living increases to Social Security recipients, veterans, and any other beneficiaries of programs affected by chained CPI methodology.

As a result, the Veterans of Foreign Wars has come out strongly against the measure, as has the American Association of Retired Persons.

According to a report issued in 2011 by a group called Strengthen Social Security, a switch to chained CPI would result in a relatively small decrease in planned benefits of less than 1 percent in the first year for a 65 year old veteran. But the reduction would become much more noticeable as he grows older: Benefits would be 9.2 percent lower than an unchained CPI would generate by the time the veteran turned 95 years old.

That’s a significant difference – both for the veteran and the taxpayer.

Moreover, a switch to chained CPI would most severely affect younger veterans, who will be reaching their retirement years decades away, or living on disability compensation payments for many decades to come. According to the same report, a disabled veteran who started receiving VA disability benefits at age 30 would have his or her benefits reduced by $1,376 at age 45, $1,821 at age 55 and $2,260 at age 65.

Reduction in VA Comp

 

 

 

 

 

 

 

 

 

 

 

 

A switch to chained CPI would also disproportionately affect women, who both live longer than men, on average, and rely on Social Security for a greater proportion of their retirement income than men. And finally, a broad switch to chained CPI would also doubly affect the young, since it would quickly result in a higher and higher tax burden. This is because the chained CPI would also reduce the annual adjustments to tax brackets every year, resulting in more and more money becoming taxable at higher tax brackets.

Ultimately, it’s up to Congress to reconcile the competing interest groups. Last week, the Senate expressed its opposition to transitioning to a chained CPI for veterans in a non-binding voice-vote. There was no roll call on the vote, so there is no real record of how your Senator voted. The measure’s sponsors were Senators Bernie Sanders (I-Vt.), Tom Harkin (D-Iowa), Mazie Hirono (D-Hawaii) and Sheldon Whitehouse (D-R.I.)

While early indications are that Senate liberals and Democrats generally oppose the adoption of chained CPI – as does the AFL-CIO, for that matter – the liberal-leaning Brookings Institution has come out in favor of considering chained CPI, and including veterans’ benefits in the equation:

“We are in an era where benefits are going to be reduced and revenues are going to rise,” said Isabel Sawhill, a Senior Fellow at the Brookings Institution, according to reporting by Federal News Radio. There’s just no way around that. We’re on an unsustainable fiscal course,” Sawhill said. “Dealing with it is going to be painful, and the American public has not yet accepted that. As long as every group keeps saying, ‘I need a carve-out, I need an exception,’ this is not going to work.”

Sawhill argued that making changes now will actually make it easier for veterans in the long run.

“The longer we wait to make these changes, the worse the hole we’ll be in and the more draconian the cuts will have to be,” she said. 

Nonsense. Veterans disability compensation, especially, needs to be carved out and protected from any move to a chained CPI, for the simple reason that these veterans have already sacrificed for the good of the Republic. In many cases, these veterans have had limbs carved off in the service of their country – something not generally true of most Social Security beneficiaries.

Social Security is a fundamentally different program than veterans’ benefits. First of all, its original design was to be self-supporting. Current benefits were to be paid by current workers. That was the deal all along. It is, at its core, an insurance program, and we are all policyholders. Because Social Security’s reach is so broad, there is no real way to ‘carve out’ segments of the population, because any decisions made for Social Security ultimately affect all of us.

This is not the case with veterans benefits. It is not a mutual aid program. It is not predicated on a veteran having paid into the system, and benefits were never meant to be actuarially driven. Any veteran who served, and some who were wounded or injured in the service to their country, did so under the understanding that they would qualify for disability compensation if they were wounded or injured in the line of duty, and that these benefits would increase with inflation.

As the Veterans of Foreign Wars points out in its own talking points memo on the issue, Chained CPI is based on changes in purchasing habits during poor economic times (buying hamburger instead of steak, renting a movie instead of going to the movies). However, military families and disabled veterans are often on fixed incomes and do not have the luxury of making these choices; they already buy hamburger and rent movies.

First Same-Sex Spouse Burial at a National Cemetery Approved

Posted by S.E. Davidson Parker

First same-sex VA burialOn January 29th, 2013, Secretary of Veterans Affairs Eric Shinseki approved the first ever same-sex spouse burial at a national cemetery. Retired Air Force Lt. Colonel Linda Campbell will now be able to intern the ashes of her spouse, Nancy Lynchild, who died of metastatic breast cancer on December 22nd, 2012, at the Willamette National Cemetery in Oregon. Services are being planned.

Shinseki’s approval comes on the heels of Department of Defense Leon Panetta’s announcement to extend several benefits to same-sex spouses of military members. Benefits that were not extended to same-sex couples were housing allowances, on-base housing, health care, and burial benefits. Campbell had actually requested a waiver from Shinseki for burial benefits in May 2012 when making burial plans with Lynchild, and then again shortly after Lynchild’s death in December 2012, both dates before Panetta’s announcement.

Congress struck down the years-long policy of “don’t ask, don’t tell” regarding the sexual orientation of military members in 2010. However, this policy only applied to the Department of Defense and not the Department of Veterans Affairs. In addition, the 1996 Defense of Marriage Act (DOMA), which defines a marriage as between one man and one woman, is still federal law.

Campbell was active duty Air Force for four years, followed by many years in the Oregon Air National Guard then the Air Force Reserves, where she retired in 1994. She and Lynchild had tried on several occasions to legalize their twenty-plus year relationship, including registering as domestic partners twice, marrying in Multnomah County, Oregon in 2004, and marrying again in Vancouver, B.C. in 2010.

Campbell had two advocates assisting her in the push for burial benefits; Brad Avakian, Oregon’s Commissioner of Labor and Industry, and Senator Jeff Merkley. Nonveteran same-sex spouses cannot be buried in a national cemetery as long as DOMA stands. However, Avakian found a small portion of Section 6 of the laws regarding burial that states burial in a national cemetery can happen with “such other persons or classes of persons as may be designated by the Secretary.” Both Senator Merkley and Commissioner Avakian wrote multiple letters to the Veterans Affairs Offices, advocating for such a “designation by the Secretary.” In addition, Avakian’s office believed the policy was in violation of civil rights laws and was planning to challenge the policy in court should the burial not be approved.

Shinseki approved Lynchild’s burial based “in part, on evidence of a committed relationship between the veteran and the individual.”

Nancy Lynchild’s ashes will be interned with the ashes of Joyce and Gordon Campbell, Linda’s parents. There is one spot left at the site, reserved for Linda.

Military, Veteran Pay Held Hostage in Debt-Ceiling Fight

Posted by Jason Van Steenwyk

military pay at riskWhite House to GOP: Let us increase the debt or the troops get it.

That’s the message Obama had for Congress during a press conference last week, in which reporters asked about the ongoing negotiations over the debt ceiling – a Congressionally-imposed cap on the amount of debt the federal government is authorized.

“If congressional Republicans refuse to pay Americans bills on time, Social Security benefits and veterans’ checks will be delayed,” stated President Obama. “We might not be able to pay our troops or honor our contract for small business owners.”

A Republican representative and War on Terror veteran Duncan Hunter of San Diego, California, has introduced legislation that authorizes the federal government to pay military salaries regardless of the debt limit.

“America’s military men and women fight to defend our freedom without asking for much in return,” said Hunter, a veteran of the wars in Iraq and Afghanistan. “Whether they are fighting in Afghanistan or supporting operations elsewhere, servicemembers deserve assurance that they will not be denied a paycheck. And if paychecks are withheld, it’s because the President, as commander in chief, made a decision not to pay them.

“Especially for those who are serving overseas while their families are at home, the threat of not getting paid can create unnecessary distractions. Removing the threat that paychecks might be withheld or delayed will provide a sense of relief and allow our servicemembers to stay focused on their duties.”

Duncan is currently a major in the U.S. Marine Corps Reserve.

About the Debt Ceiling

The Constitution of the United States gives Congress overall responsibility for determining the fiscal policy of the United States. That is, it is Congress, not the President, who primarily decides major tax and spending issues. Constitutionally, the President cannot direct the government to borrow without the approval of Congress.

At the same time, the President cannot refuse to spend money as directed by Congress. He must, by law, operate all the departments and programs he is directed to by Congress – which puts the President on the horns of a dilemma: For years, the amount of money Congress has ordered the government to spend has been greater than the amount coming in. The U.S. government has been forced to borrow the difference by selling bonds, which the government must eventually repay, with interest. The total amount financed by borrowing increases every year.

Meanwhile, though, Congress has also established an overall cap on borrowing, beyond which the President cannot go without getting further authorization from Congress.

This discussion is separate from the “sequestration” cuts that will slash about 10 percent from federal department funding across the board. Military pay and VA benefits will generally continue under sequestration, should it come to pass. The debt ceiling, on the other hand, is a separate argument.

Currently, the Congressional Budget Office projects that we will hit the borrowing limit next month – currently set at $16.4 trillion. Divided equally among every resident of the United States, the per capita national debt is over $52,000 for every man, woman and child.

Once that happens, the President must cease borrowing. The government must then, technically, limit its spending to current revenues coming in, minus those committed to paying existing interest payments. When that happens, the government will begin bouncing checks.

Congress has been extending the debt limit to allow Presidents to finance the operation of government routinely since WWII, including 18 times under President Reagan.

In recent years, however, under pressure from fiscal conservatives and Tea Party representatives in Congress, the legislative branch has been driving a harder bargain. The government almost came to a halt in 2011, for example, when Democrats and Republicans crafted a deal at the last minute that allowed for the increase of the debt limit to today’s level of $16.4 trillion.

The government also shut down, briefly, from November 13 through November 19, 1995, and from December 15, 1995 through January 5, 1996. This occurred after Republicans swept into power in the 1994 Congressional mid-terms and elected Newt Gingrich, a representative from Georgia, as the Speaker of the House. The GOP Congress and Clinton Administration were unable to come to an agreement on the debt ceiling and forced the government to suspend much of its operations and furlough hundreds of thousands of federal workers. Congress was successful in forcing a balanced budget for four years in a row, though revenues were artificially buoyed in the late 1990s by the Internet revolution and inflated equity prices.

Troops continued to be paid during that 21-day shutdown, though, because the defense spending law had already been passed.

Some Congressional Representatives, including Pat Toomey, have also proposed legislation directing the Treasury Department to keep paying active duty military pay and debt service, which is prioritized to ensure that the full faith and credit of the United States Government shall not be questioned. Failing to do so would potentially result in a default on U.S. bonds, which would cause interest rates to spike and make it much more expensive for the government to raise new debt.

Attempts to direct the Treasury Department to prioritize certain payments over others encounter a significant technical hurdle, however: The Treasury Department’s computer systems just aren’t designed to identify and prioritize millions of separate payments every day. It would take time and money to create a new system to do that.

So even if Congress does pass an eleventh-hour law exempting military pay, VA benefits, or other electoral sacred cows from interruptions as a result of the government hitting the debt ceiling, it is far from clear that the Treasury Department will be able to execute the measure.

This document from the Congressional Research Service details the processes by which some DoD functions can continue and some can be curtailed. Essential functions necessary to protect life and property can likely continue, but the troops and civilian workers actually executing the President’s orders (at Congress’s direction) would not be paid until Congress authorizes new borrowing or otherwise appropriates funds that need not be borrowed.

As a result, military pay, veterans’ benefits and contractual payments to defense contractors are all very much at risk of disruption if Congress and the President do not reach an agreement to lift the debt ceiling.

And each party to the conflict will do its best to blame the other.

Defense Bill Gets Rave Reviews from Iraq and Afghanistan Vets’ Lobbying Organization

Posted by Jason Van Steenwyk

Iraq and Afghanistan veteransIraq and Afghanistan Veterans of America, a lobbying and advocacy group representing GWOT veterans, has come out in favor of the National Defense Authorization Act of 2013 (NDAA), passed by Congress on the eve of the Christmas recess. Specifically, IAVA applauds features in the bill that favor younger veterans, specifically, as opposed to the older generation combat veterans of the Gulf War, Viet Nam and earlier wars. For example, while Viet Nam-era veterans are now beginning to enter their retirement years, Iraq and Afghanistan War veterans benefit much more from job transition and employment initiatives in the DoD, Veterans Administration and elsewhere.

The IAVA issued a press release lauding the passage of the bill on December 21st, praising the bill’s following features:

Helping Veterans Transition to the Workforce: The NDAA addresses the significant challenge many veterans face in translating their military training to state civilian licenses and certifications. The NDAA requires states to consider military training and education for civilian certifications and licenses in comparable civilian jobs. The NDAA also enhances and simplifies the Troops to Teachers Program that provides a path for veterans to continue their service as teachers.

Protecting the New GI Bill: The NDAA helps service members avoid predatory for-profit schools by requiring military bases and posts to review which for-profit schools and their recruiters are allowed access on base.

Improved Access to Mental Health Care: The NDAA is a big step forward in improving access to and the quality of mental health care for active-duty, Guard and Reserve service members, military families, and veterans. It also establishes a pilot to use community partners to provide mental health services for Guard and Reserves who often struggle to find care. In addition, the NDAA strengthens suicide prevention programs, by both standardizing some of these efforts across the VA and DoD and by creating suicide training and prevention programs for Guard, Reserves and their families.

Protecting Victims of Military Sexual Trauma: The legislation establishes a DoD Special Victims Units to respond to and investigate all reports of sexual misconduct. It also requires an independent review of all judicial proceedings and investigations on sexual misconduct. In addition, the NDAA mandates improved victim protections and reporting policies. It also requires that the military get its level of care for military sexual trauma victims up to what is done in civilian health care systems.

Focus Efforts on Traumatic Brain Injury (TBI): The bill mandates detailed planning to eliminate gaps and redundancies in DoD programs on psychological health and traumatic brain injury.

Addressing VA Claims Backlog: Recognizing the lengthy backlog for getting claims processed at the VA, the NDAA requires the VA to provide a detailed report to Congress on how the claims backlog will be solved. This report is due no later than 60 days after the president signs the bill into law.

Women Veterans Services

Posted by S.E. Davidson Parker

female veteransFrom the WACs, WAVEs, SPARs, WASPs, BAMs of World War II to the modern citizen soldier serving next to service men in combat situations, women play an important part in America’s modern military. Consisting of approximately 15-percent of 2012’s active duty armed forces and 20-percent of reserve forces, these women come out of military service with distinctive and unique needs that may not be met with current Veterans Affairs (VA) services, particularly in the medical arena.

Historically, the military service has been part-and-parcel a male endeavor, and the services available to veterans have reflected this. However, with women entering the armed services in increasing percentages, there are currently about two million women veterans, the fastest growing group tract by the VA.

Issues regarding VA medical care and female veterans include inequalities in services between male and female patients; lack of consistency in services to those who have experienced a sexual assault;  lack of provider knowledge in gender-specific medical and psychological care; and  lack of awareness of services  and service advocacy for female veterans, just to name a few. Additionally, female veterans access other VA benefits such as employment training and education in far fewer numbers than male veterans.

The VA has been and continues to actively try to remedy this situation. In 2012, the Women’s Health Care Services Office became the “go to” point for female veterans, bringing together primary care, specialty care, and mental health under one umbrella for better collaboration, communication, and service delivery. (This reorganization builds on the blocks set in place by the 1988 Women’s Veterans Health Care Program.)

The 2012 Women Veterans Task Force Report outlined several areas the VA has improved on, including but not limited to:

  • More women accessing services;
  • A higher percentage of patients, compared to their civilian counterparts, that receiving regular breast and cervical cancer screenings;
  • The development of the Military Sexual Trauma Support Team; and
  • The creation of Women Veteran’s Coordinators to provide outreach and advocacy.

However, they report there are still multiple issues needing to be resolved.

  • Continuing gender-based gaps in service and care;
  • Significant lack of female veterans applying headstone or marker burial benefits;
  • Homeless outreach, programs, and resources are almost all male-oriented;
  • The need to develop access to child-care services; and
  • There is still a disparity between the percentages of male veterans that access overall services versus female veterans.

 

 

If you are a female veteran, first and foremost you must become your own best advocate. After enrolling for your veterans’ benefits, find your region’s Women’s Veterans Coordinator (WVC) to answer any questions and to help guide you through the medical system. (Find your region here; from that link you can discover where medical services are provided and from there which center and/or clinic have a WVC.) Don’t forget that the VA goes beyond medical care and administering G.I. Bill benefits; check here to discover more about life insurance, home loans, vocational rehabilitation, and other programs available to eligible veterans.

Improvements in the VA benefits system for female veterans, medical and otherwise, will improve the VA system for all veterans. The need for childcare access and resources, while stereotypically considered to be a woman’s issue, is needed by both parents, male and female. Improved public relations and communications, while targeting women, will also make more men to be aware of and use their benefits. A healthier, better trained, and better educated veteran demographic will help improve the economy.

Most of all, they’ve earned it. Men and women alike.

Veterans COLA Adjustment Clears Senate

Posted by Jason Van Steenwyk

describe the imageThe Senate passed a 1.7 percent cost of living increase for veterans benefits this week. The bill, HR 4114, has now passed both houses of Congress and heads to the President’s desk for his signature.

Assuming the President signs the bill into law, the benefit would go to about 3.9 million armed services veterans currently collecting benefits. The benefits affected include disability compensation and dependency and indemnity compensation for surviving spouses and children.

The law’s passage could mean as much as $500 per year to some benefit recipients, according to the bill’s sponsor.

The bill actually passed the House of Representatives last summer, but was blocked in the Senate by a “secret hold” put in place by an anonymous Republican. The hold was cleared, however, and the Senate passed the bill in time for the Veterans Administration to update its pay mechanisms to account for the change, according to VA officials.

Upcoming Veterans Day Offers

Posted by Jason Van Steenwyk

military discountNovember 11th is Veterans Day. And every year, there are more and more special deals for veterans. Veterans get a free meal or at least an appetizer out of the deal – and the businesses themselves get to generate some brand goodwill for themselves – and reach customers they might otherwise never see. It’s a win-win. 

Our colleague Ryan Guina at TheMilitaryWallet does a great job of doing the roundup every year. He’s been at it since 2008, so full credit to him.

A few highlights:

  • Applebee’s offers a good selection of free entrees each year. This year you can choose from seven of them.
  • The Golden Corral Veteran’s Day buffet I went to last year was fantastic. In that Air Force chow hall kind of way. Golden Corral does a first-rate job – and has donated more than $6 million to Disabled American Veterans over the years. 4 to 9 p.m. only.
  • Hooters. God bless America. Ok, all you get are 10 boneless wings. And you have to buy a drink first. But hey! Hooters!
  • McCormick & Schmick’s. Free lunch or dinner. This one is more upscale than the others. This is probably the most upscale offer on the list. You’re going to have to wear a shirt for this one.
  • Sizzler. Vets eat free until 4 pm. Great way to boost the lunch crowd. And what warrior doesn’t appreciate a steak.
  • TGIFriday’s. Free lunch on Monday! That’s the 12th! The day after Veterans Day! That means you can take advantage of two lunch offers! Smart move on their part, too!
  • Olive Garden. Free entrée.
  • Red Robin. Like TGIFriday’s, they are doing their offer on Monday the 12th, not the 11th. They’re also donating $10,000 to the Wounded Warrior Project.
  • Outback. Free “bloomin’ onions” and Cokes. I’m including this offer as a highlight because it’s good all week long. Also, they’ve donated some $2 million to Operation Homefront over the years – a great charity that helps veterans in need nationwide.
  • Denny’s. Get an early start – free all-you-can-eat pancakes from 6 a.m.

You should bring a military ID or other proof of service. Also, be sure to tip your waitress as if you were paying full price. Don’t be “that guy.”

And bring some family members who aren’t freebies. Like the food? Go there the rest of the year, too! The more successful these events are for restaurants, the more of these offers we’ll see.

Also, keep in mind that some of these restaurants may have independently-owned franchises, which may or may not participate. So you may want to call ahead and confirm.

There are lots more discount offers, including theme parks like Knott’s Berry Farm and Anhauser-Busch theme parks, as well as special offers from regional restaurants at the link.

Happy Veterans Day.

American Red Cross Services for Military Service Members and Families

Posted by Kelli McKinney

militaryYou might know the American Red Cross as “those people who do the blood drives,” but like the military, they have a rich history of service. A national service organization for more than a century, the 700 locally-supported chapters of the American Red Cross has helped more than 15 million people each year people mobilize to help their neighbors. These volunteers learn valuable skills to prepare for and respond to emergencies in homes, communities, and around the world. In addition, almost four million people also donate blood each year through the Red Cross, making it the largest supplier of blood and blood products in the United States.

The American Red Cross also maintains a strong commitment to serving all members of the military, whether active-duty, Guard, and Reserve service members or their immediate family members. They are an important resource for our service members and those they love.

American Red Cross services for military members and their families include:

Emergency communications

Communicating important news with family members is one area the Red Cross supports. Whether it’s to share the birth of a child or the loss of a loved one, the immense worldwide network maintained by the Red Cross  helps keeps military personnel anywhere (including on ships at sea, at embassies, and in isolated military units)linked  with their loved ones.

If you need to send an emergency message, contact the Red Cross and have the following information on hand:

  • service member’s full name, rank, Service branch, Social Security number, and military address
  • information about the deployed unit and the location of the rear detachment unit (for deployed service members only)
  • name, phone number, and relationship of person in the city or town where the emergency occurred (to provide more information if required)
  • name and contact number for hospital or funeral home to verify the emergency

 

Social services and disaster assistance

The Red Cross provides counseling, family support and help with VA appeals for service members and their families. There are some chapters that offer special courses or support groups for military families to help themselves and others deal with the psychological challenges of the deployment cycle.

 

Direct support to service members

Red Cross staff members deploy overseas to provide direct emergency communications. In overseas locations, the Red Cross may offer respite from harsh conditions and bring a little bit of home to the troops by operating a twenty-four-hour canteen service with coffee, cold drinks, snacks, games, videos, and books. Red Cross teams also visit patients in clinics and hospitals.

Military family members who wish to volunteer with the Red Cross can also find opportunities such as:

  • positions as greeters, hospital guides, wheelchair escorts, patient chaperones, and pharmacy aids working at medical facilities in areas such as physical therapy, the emergency room, pediatrics, dermatology, and radiology
  • volunteer caseworker positions at Red Cross locations
  • a Dental Assistant Program (DENTAC) for training as a dental technician
  • pet-therapy volunteer positions to cheer up patients in military hospitals
  • blood donation center positions to assist with blood drives
  • disaster-response positions to provide relief support 

 

The American Red Cross is accessible in a number of ways:

  • Active-duty service members stationed in the US and their immediate family members may call the Red Cross Armed Forces Emergency Service (AFES) Centers for help at any time 877-272-7337.
  • Members of the Guard and Reserve, retirees, and extended family members can access services through their local Red Cross Chapter, listed in local telephone directories and in the chapter directory.
  • Overseas personnel stationed on military installations may call installation operators or the on-installation Red Cross office.

The Presidential Candidates on Veterans Issues

Posted by Jason Van Steenwyk

Obama Romney on veteransBarack Obama and Mitt Romney went head to head this month on opposing pages in VFW Magazine – the official print magazine of the Veterans of Foreign Wars.

The editors of VFW posed the same set of questions to both candidates. Most of the responses from both sides were pretty bland, consisting of nice language but few specifics. However, there were a few salient points, where both men distinguished themselves from one another. Here is a ‘hot wash’ of the candidates’ positions on important issues concerning veterans. You can read the piece in its entirety here.

On partial privatization and vouchers

Obama

“There are instances where the targeted use of fee-basis care can be a tool for extending VA’s ability to care for veterans, in remote rural or in hard-to-fill specialties. But our first responsibility should be strengthening VA, and as long as I’m President, I will not allow VA health care to be turned into a voucher system, subject to the whims of the insurance market.”

Romney

“Private care may have a role in that the existing network of private providers in the military’s TRICARE system can be an excellent optional supplement to VA, but it cannot be a replacement for the VA program…

…With veteran suicide rates and mental stress soaring, we must consider offering veterans optional access to private providers already available through the TRICARE system to supplement the VA system of care.”

On Increases and Cuts in the Defense Budget

Obama

“We need a military that is more agile, with cutting-edge technology and capabilities and we need to focus more on emerging regions like Asia. And my proposed budget grows defense spending every year after 2013 – albeit at a slower rate as we wind down the wars. My balanced plan to get our fiscal house in order over the long run includes less in defense reductions than recommended by the bipartisan Simpson-Bowles Commission.”

Romney

“I would increase the naval shipbuilding rate from 9 to 15 per year, improve force structure throughout the services and increase the number of active-duty troops by 100,000… there are savings to be found in the Pentagon’s civilian workforce that can be put toward our fighting men and women and the equipment they need.”

On protecting Retirement Benefits

Obama

“I am committed to providing sustainable retiree benefits to our military personnel, and I strongly support protecting the retirement benefits of those who currently serve by grandfathering their benefits.”

Romney

“I will not propose TRICARE fee increases or cuts to military benefits especially while the size of the federal budget is exploding. Time and again, we have seen that efforts to balance the budget on the backs of the military end up costing more, not just in treasure, but in blood.”

 

What do you think? Are they blowing smoke? Sound off in the comment section!

VA Won’t Pay for PTSD Service Dogs. Should They?

Posted by Jason Van Steenwyk

Service dogs for PTSDThe battle’s been brewing for years. Veterans coming back from wars with symptoms of post-traumatic stress disorder, as well as other psychological ailments such as depression and anxiety disorders that may or may not be directly related to trauma, are fighting to claim a benefit: A trained service dog – at government expense.

The problem: The expense is significant. It can cost anywhere from $10,000 to $30,000 to breed and fully train a service dog. And the Veterans Administration says it has more productive uses for the money.

Veterans groups and a loose association of dog breeders and trainers that have formed a small cottage industry providing service dogs to veterans, of course. And the veterans who have them love their service dogs and are grateful for the benefit. But after reviewing the issue, and after a period of public comment, the Veterans Administration has elected not to cover service dogs for PTSD and other psychiatric conditions.

Service dogs have long been used to help vision-impaired and hearing-impaired people and people with mobility issues. And the benefits and cost-effectiveness of seeing-eye dogs for the blind has been accepted for years.

Originally, the VA could only provide seeing-eye dogs to blind veterans. However, President George W. Bush expanded that authorization when he signed the Department of Veterans Affairs Health Care Programs Enhancement Act, which authorized the Veterans Administration to provide service dogs as a benefit for other conditions as well. However, in a 2007 memorandum, the VA concluded that there was not sufficient evidence that service dogs were a cost-effective remedy for vision and mobility-impaired veterans. However, the VA left the door open to providing a service dog on a case-by-case basis to individuals who could show that the therapeutic value of a dog and the potential cost savings over other forms of therapy justified the use.

In 2009, Congress voted to expand authorization of a service dog benefit to veterans with mental illnesses. And in 2010, Congress passed the Franken Amendment, which directed the executive branch to launch a three-year pilot program to study the therapeutic effects of service dogs for PTSD.

So What Can a Dog Do?

According to the Psychiatric Service Dog Society, a trained service dog can help an individual with PTSD or other depressive or anxiety disorders in the following ways:

  • Help overcome reclusiveness by accompanying the individual on trips outside the home
  • Awaken an individual suffering from night terrors
  • Turn on a light to alleviate night terrors
  • Help with hypervigilance by searching a room for intruders
  • Interruption of dissociative spell
  • Alert and intervene or distract in moments of emotional escalation

Benefits of Pet Ownership

There is little doubt that pet ownership correlates strongly with improved mental and physical health outcomes. Studies indicate that pet owners are less likely to commit suicide, get more exercise, are less likely to have heart attacks, and less likely to suffer from severe depression than those with no pets. It is not clear to what extent that relationship between pet ownership and improved health outcomes is causative versus correlative. For example, people who are more active may be more likely to go out and adopt a pet in the first place.

In any event, though, it is not necessary to have a highly-trained service animal with a five-figure price tag to realize these benefits. Most of the beneficial effects can be had with any reasonably well-behaved and affectionate dog, without any specialized training whatsoever.

So the argument for highly trained service animals for PTSD patients at government expense must go beyond the basic therapeutic effects that you can get with any good pet, and address the possible law of diminishing returns. It is possible that the government could spend larger and larger sums for trained service animals for smaller and smaller benefits.

Testing the Theory

It occurred to us that if there is any validity to the use of service dogs to treat PTSD, they would already be in common use among psychiatric patients in other contexts – possibly for rape survivors. Are dogs effective in helping rape survivors recover and function? Do they help with agoraphobia symptoms, and hypervigilance? And if they do, are they typically professionally trained and certified service dogs? What do women do who are survivors themselves but who don’t qualify for VA services? Do they seek out trained dogs? Is the benefit powerful enough that those who can afford it choose to pay for the costs associated with a trained dog with their own money?

It turns out that there is, indeed, a precedent for the use of dogs to help survivors of rape and other violent crimes overcome anxiety and other PTSD symptoms. Service Dogs for Victims of Assault, which is now defunct, was formed in 1999 to help provide dogs to survivors and raise awareness of their value in helping survivors. We spoke to their chief clinical practitioner, Carmen Davis, Ph.D., via telephone.

Dr. Davis’s Portland, Oregon practice centers largely on patients who are struggling with PTSD, often through severe child abuse. Symptoms include dissociative disorders – a psychological phenomenon in which the patient re-experiences the trauma. Other therapists sometimes refer patients to him if there is a potential need or desire for a service dog.

Davis was not familiar with any clinical studies demonstrating the effectiveness of service dogs for the PTSD population, though he did report positive results on an anecdotal basis. However, none of his patients required dogs that needed extremely high-end, specialized training that would result in a five-figure price tag. None of Davis’s clients could afford that, anyway.

“You really just need a dog with good basic obedience training, and public access training.”

However, Davis did point out there were instances where a dog could sense when an owner was going through a dissociative episode and could bring them out of it. In Carmen’s experience, though, the owners would obtain dogs with good temperaments and obedience training, and continue training the dogs themselves. Expense to the government was generally nil in these cases, but these patients did, by and large, believe that the dogs were helpful enough to justify spending their own money.

From the VA’s point of view, absent a solid clinical study demonstrating effectiveness, it would be extremely difficult to justify awarding service dogs as a benefit to treat PTSD – especially when the assumption is that a fully-trained service dog would cost tens of thousands of dollars.

However, there is a whole continuum of needs within the PTSD community. Only a very few veterans will require a high-end service dog for PTSD symptoms. It may make sense to recalibrate our thinking, and scale down the cost assumptions to reflect it.

For example, of the population of veterans collecting 50 percent or greater disability compensation because of PTSD, how many of them would trade 20 percentage points of disability for a service dog? After all, if the dog doesn’t make them less disabled, then you cannot justify the expenditure. But if the dog does result in a significant reduction of disability, then the cost of the dog could be offset by a reduction in VA benefits – perhaps on a sliding scale, reflecting the training cost of the dog. The veteran could select the desired training level himself, though it would affect VA disability compensation benefits.

If enough veterans jump at the chance, even where it costs them money, then we probably have a worthwhile benefit. If nobody takes the dog over the cash, then the whole push to cover service dogs for PTSD appears to be an attempt to latch on to the VA benefit gravy train.

 

Photo credit: Ed Andrieski/AP