{"id":47721,"date":"2021-12-05T21:55:56","date_gmt":"2021-12-05T21:55:56","guid":{"rendered":"https:\/\/one.sightlinemg.com\/airforcetimes\/uncategorized\/2021\/12\/05\/veterans-affairs-work-just-beginning-as-20-years-of-war-end\/"},"modified":"2026-08-08T07:58:55","modified_gmt":"2026-08-08T07:58:55","slug":"veterans-affairs-work-just-beginning-as-20-years-of-war-end","status":"publish","type":"post","link":"https:\/\/one.sightlinemg.com\/airforcetimes\/veterans\/2021\/12\/05\/veterans-affairs-work-just-beginning-as-20-years-of-war-end\/","title":{"rendered":"Veterans Affairs work just beginning as 20 years of war end"},"content":{"rendered":"\n

Editors Note: This <\/i>article<\/i><\/a> first appeared on <\/i>The War Horse,<\/i><\/a> an award-winning nonprofit news organization educating the public on military service. Subscribe to their <\/i>newsletter<\/i><\/a>.<\/i><\/p>\n\n\n\n

Jen Burch served a seven-month tour in Afghanistan a decade ago.<\/p>\n\n\n\n

It has haunted her ever since.<\/p>\n\n\n\n

Burch, who was 23 when her tour ended, worked as an operations manager for an Air Force combat engineer unit. She aspired to be a physician. She spent her downtime as a volunteer medic at a Kandahar trauma hospital<\/a>.<\/p>\n\n\n\n

\u201cI saw the worst of war and the best of humanity,\u201d she says.<\/p>\n\n\n\n

She came home with the service\u2019s prestigious Commendation Medal<\/a>, awarded for acts of valor or meritorious service. She also brought home a case of post-traumatic stress<\/a>, frequent migraine headaches<\/a>, and bronchitis and other breathing problems. But help has been slow in coming \u2014 both for Burch and for other veterans, she says.<\/p>\n\n\n\n

\u201cThey need peer community support and easier access to health care and benefits,\u201d says the 34-year-old retired Air Force staff sergeant. \u201cEverything moves at this bureaucratic pace.\u201d<\/p>\n\n\n\n

While many Americans may have seen the end of the forever wars as the cap on two decades\u2019 worth of war spending, the job of Veterans Affairs has only just begun \u2014 and will continue for decades. But some fear the antagonistic relationship between VA and veterans will continue as advocates are forced to fight bureaucracy to gain benefits, even as VA officials say they\u2019re ready to move forward.<\/p>\n\n\n\n

\u201cAs we look to the future, we\u2019re not trying to build a VA that goes back to the old normal,\u201d VA Secretary Denis McDonough recently said at the National Press Club<\/a>. \u201cInstead, we\u2019re going to continue to do better for vets, we\u2019re going to continue to be better for vets.\u201d<\/p>\n\n\n\n

While VA projects the numbers of veterans will decline \u2014 from 20.8 million in 2015 to 12 million in 2045<\/a> \u2014 VA spent almost $218 million<\/a> on veterans in fiscal year 2020. That\u2019s nearly double what it spent in fiscal year 2010. The benefits go far beyond health care and disability benefits: Veterans can get help buying their first homes, money for college, and even end-of-life benefits like a burial plot.<\/p>\n\n\n\n

\"\"
Secretary of Defense Lloyd J. Austin III, Secretary of Veterans Affairs Denis McDonough, and former Sen. Elizabeth Dole arrive at an event celebrating children of military and veteran caregiving families in the East Room of the White House, Nov. 10, 2021. (Sgt. Jack Sanders\/Air Force)<\/figcaption><\/figure>\n\n\n\n

But veterans and their advocates say they have immediate needs, life-or-death needs, that must be met as two decades\u2019 worth of battles end. They want presumption for the harmful chemicals and particulate matter they were exposed to both in war and at home. They want better mental health care. They want their friends to stop killing themselves. They want a truly seamless transition from active duty to VA. And they want better treatments.<\/p>\n\n\n\n

They want those things for yesterday\u2019s veterans, too.<\/p>\n\n\n\n

\u2018The issues are clear\u2019<\/h2>\n\n\n\n

Health concerns like PTSD and toxic exposures are not new. But the veterans\u2019 community, including VA and its allies in Congress, needs to redouble its efforts, supporters said.<\/p>\n\n\n\n

\u201cThe issues are clear,\u201d says former VA Secretary David Shulkin<\/a>. \u201cIn hospitals, we need more centers of excellence on issues that impact veterans and more open approaches to new treatments. We need updated payment systems and technology for VA in order to better fulfill its mission.\u201d<\/p>\n\n\n\n

With almost 400,000 employees, VA is a sprawling government agency that manages everything from hospitals where cutting-edge medical technology restores bodies broken by the savagery of combat, to the cemeteries where so many veterans find their final rest.<\/p>\n\n\n\n

It is seen as both a source of empathetic outreach and support to those who have worn the uniform and their families, and a vast, cold bureaucracy more concerned with costs than its mission.<\/p>\n\n\n\n

\u201cI don\u2019t believe there is anyone at VA that is malicious and tries to harm veterans,\u201d said Michael Figlioli, deputy director of the Veterans of Foreign Wars<\/a>\u2019 National Veterans Service. \u201cIt\u2019s such a big bureaucracy. It just takes a long time to get things done.\u201d<\/p>\n\n\n\n

Looking to previous wars \u2014 Vietnam, Desert Storm, even World War II \u2014 doesn\u2019t leave veterans hopeful. It took years before VA began to recognize that exposure to Agent Orange was harmful. The compound was a chemical defoliant used during the Vietnam War to eradicate the jungle cover used by the Viet Cong. Exposure led to cancers and other health problems among U.S. troops.<\/p>\n\n\n\n

\"\"
Marines of Company L, 3rd Battalion, 5th Marines, take a rest on rocky terrain near Dong Ha during Operation Hastings in Vietnam, July 1966. (Staff Sgt. R.E. Wilson\/Marine Corps)<\/figcaption><\/figure>\n\n\n\n

It\u2019s been the same story with Gulf War illness<\/a>, a chronic disorder with multiple medical symptoms experienced by troops who served in Iraq. They have battled VA since the 1990s over its deleterious impact on their health.<\/p>\n\n\n\n

And World War II veterans fought for benefits after being exposed to radiation in Hiroshima and Nagasaki, Japan, after the atomic bombs, as well as because of exposure during nuclear tests<\/a> conducted by the United States. They did not receive benefits<\/a> until 1996.<\/p>\n\n\n\n

Much of the problem comes from bureaucracy \u2014 paperwork and backlogs and appeals.<\/p>\n\n\n\n

Figlioli told an investigations subcommittee of the House Committee on Veterans Affairs in July that VA insists on requiring veterans with Gulf War illness claims to fill out a Disability Benefits Questionnaire for every symptom they experience. It only considers Gulf War illness to be the cause of their condition \u201cas a last resort,\u201d he said.<\/p>\n\n\n\n

Instead, VA should just decide that the medical evidence meets the criteria.<\/p>\n\n\n\n

\u201cThe current system of assigning separate [Disability Benefits Questionnaires] for each symptom being claimed in association with GWI [Gulf War illness] promotes the potential for incorrectly assigning a diagnosis to a condition linked to GWI \u2026 which ultimately results in the veteran\u2019s claim being denied,\u201d Figlioli told the subcommittee.<\/p>\n\n\n\n

But much of it also comes from the sense of an antagonistic relationship between veterans and VA employees \u2014 that the hurdles veterans face are intentional.<\/p>\n\n\n\n

Shulkin, a physician, said \u201cbad policy\u201d causes the disability claims of so many veterans dealing with toxic exposures to be turned down.<\/p>\n\n\n\n

\u2018We\u2019re not waiting for Congress\u2019<\/h2>\n\n\n\n

But with the withdrawal from Afghanistan and new leadership at VA that might be more receptive to their concerns than the previous administrations, veterans, their advocates, the organizations that lobby for them, and other allies all say that toxic exposure is one of the top issues that demand immediate attention.<\/p>\n\n\n\n

\u201cHow many people need to die,\u201d Burch says, \u201cbefore they figure out they need to get something done?\u201d<\/p>\n\n\n\n

She had been stationed in the sandy deserts in southern Afghanistan where toxic particles in the thick black smoke from the burn pits<\/a> mingled with the dust and permeated the air she breathed.<\/p>\n\n\n\n

\"\"
Warrant Officer Jack Rosarius, left, is pictured with fellow allied soldiers in northeast Saudi Arabia en route to Kuwait during Operation Desert Storm in the early 1990s. (C.J. Lovelace\/Army)<\/figcaption><\/figure>\n\n\n\n

She had hoped to stay in the Air Force and eventually become an officer. But her health began to deteriorate, and she medically retired in 2014. She was in and out of emergency rooms and hospital beds for several years because of migraines and pulmonary problems.<\/p>\n\n\n\n

Now she uses an inhaler.<\/p>\n\n\n\n

\u201cBefore Afghanistan, I was an avid runner,\u201d she says. \u201cI came home barely able to run a mile without stopping to cough.\u201d<\/p>\n\n\n\n

The burn pits have been linked to a variety of serious ailments among veterans who were deployed to the Middle East and Southwest Asia, including cancer and respiratory problems. Yet between 2013 and 2020, VA denied 78 percent<\/a> of the disability claims related to toxic exposures, according to department data.<\/p>\n\n\n\n

\u201cIt\u2019s the modern-day Agent Orange<\/a>,\u201d Burch says. \u201cThere are a lot of veterans suffering, who are coming down with cancers and all sorts of health conditions.\u201d<\/p>\n\n\n\n

But the Biden administration says it is paying attention<\/a> \u2014 and making changes. Recently, VA gave presumptive status to asthma, rhinitis, and sinusitis for all veterans who served in Southwest Asia since 1990 \u2014 as well as in Afghanistan, Djibouti, Syria, and Uzbekistan during the Persian Gulf War or since Sept. 19, 2001.<\/p>\n\n\n\n

Burch, however, says she is impatient with the White House plan to have VA do a 90-day review of rare forms of cancers that might qualify for service connection.<\/p>\n\n\n\n

\"\"
Smoke billows in from all sides as Sgt. Richard Ganske, 84th Combat Engineer Battalion, pushes a bulldozer deep into the flames of the burn pit at Balad Air Base in 2004 to keep burnable items constantly ablaze. (Defense Department)<\/figcaption><\/figure>\n\n\n\n

\u201cWe have all this information,\u201d she says. \u201cWe don\u2019t need to take another 90 days. There are people who don\u2019t have 90 days. It keeps getting pushed back. It\u2019s like, c\u2019mon. Cut the bureaucracy and get this done.\u201d<\/p>\n\n\n\n

McDonough says<\/a> they\u2019re updating the system they use to determine which conditions should be presumptive more quickly, and that, \u201cfor the first time in VA history,\u201d they\u2019re \u201cpresumptively paying toxic exposure claims\u201d to Gulf War veterans for several conditions.<\/p>\n\n\n\n

McDonough acknowledged the new presumptions have led to a backlog \u2014 but said VA had hired 2,000 people to help push through those claims.<\/p>\n\n\n\n

\u201cVeterans have waited far too long for those benefits,\u201d he says, \u201cand we\u2019re doing everything in our power to make sure they won\u2019t have to wait any longer.\u201d<\/p>\n\n\n\n

As evidence, VA spokesman Randal Noller says the 78 percent denial rate for burn pit exposures is no longer accurate because the department no longer asks veterans to specify \u201cburn pits\u201d in their disability claims.<\/p>\n\n\n\n

\u201cIn Iraq, Afghanistan, and Djibouti on the Horn of Africa, from approximately 2001 to the present, the U.S. military has used large burn pits to dispose of waste at every location wherein the military has positioned a forward operating base [FOB],\u201d Noller said in an email. \u201cTherefore, if a veteran was deployed to one of these locations or elsewhere in Southwest Asia, VA will concede exposure to burn pits.\u201d<\/p>\n\n\n\n

From Agent Orange<\/a> to Gulf War illness<\/a> to burn pits<\/a>, veterans and their advocates have battled VA for decades over the medical legitimacy of their claims that their health problems are the result of their military service. Presumption means veterans receive VA health care and benefits because of that connection.<\/p>\n\n\n\n

\"\"
Military personnel observe one of the tests in the Buster-Jangle Series in the fall of 1951. (National Nuclear Security Administration)<\/figcaption><\/figure>\n\n\n\n

But there\u2019s been a change in tone.<\/p>\n\n\n\n

VA recently changed its website language about burn pits from \u201cno known connection\u201d to, \u201cDepending on a variety of factors, you may experience health effects related to this exposure.\u201d<\/p>\n\n\n\n

\u201cWe\u2019ve already processed more than 3,800 claims, delivering millions of dollars in benefits that vets so rightly deserve,\u201d McDonough said about burn pit claims while talking with reporters in October. \u201cWe\u2019re not going to wait for Congress to act on this. We\u2019re acting ourselves and we\u2019ll have more news on that front.\u201d<\/p>\n\n\n\n

\u201cMore news\u201d referred to a fact sheet released by the White House<\/a> on Veterans Day that, among other things, highlighted efforts to let veterans know they have been exposed, train all health care workers about toxic exposures so they can better treat veterans, set up a toxin-specific call center, and ask Congress to extend recent veterans\u2019 free VA health care program for veterans who deployed to Iraq or Afghanistan.<\/p>\n\n\n\n

On Capitol Hill, several bills are in the works that would make toxic exposure eligible for presumptive care: If former troops can show service near where burn pits were in operation and suffer from the kinds of illness associated with them<\/a>, they would automatically qualify for VA treatment and disability benefits.<\/p>\n\n\n\n

\u201cProviding health care and benefits to veterans suffering from the effects of toxic exposure is a cost of war that must be paid, and it\u2019s well past-time for Congress to deliver on this promise,\u201d Sen. Jon Tester, D-Montana, said in an email. \u201cVeterans simply can\u2019t rely on piecemeal legislation any longer, and this legislative package is our best shot at ensuring past, present, and future generations get their due health care and disability benefits.\u201d<\/p>\n\n\n\n

\u2018I have concluded it\u2019s faster than me\u2019<\/h2>\n\n\n\n

Advocates also want more programs to help veterans suffering from post-traumatic stress<\/a> and other mental health problems brought on by their military service.<\/p>\n\n\n\n

\u201cThis is something we see everyone struggling with,\u201d said Kelly Hruska, government relations director at the National Military Family Association<\/a>. \u201cFor the military, especially transitioning military, there is an acute need.\u201d<\/p>\n\n\n\n

Jason Kander knows all too well what many veterans are going through and how, without a concerted outreach effort, they can become adrift and tormented by their memories.<\/p>\n\n\n\n

Kander was an Army intelligence officer in Iraq in 2006. It was a job that put him \u201cwith no backup \u2026 outside the wire meeting with people of questionable allegiance, not knowing whether you\u2019d be able to get out of the room alive,\u201d he tells The War Horse.<\/p>\n\n\n\n

His work took a toll on his mental health. But he refused to acknowledge it and tried to paper over his anxieties with public service. After he came home, he catapulted to political prominence.<\/p>\n\n\n\n

A liberal Democrat in a conservative red state, he did stints in the Missouri Legislature and as secretary of state before running for the U.S. Senate in 2016 and nearly toppling a powerful Republican, Sen. Roy Blunt.<\/p>\n\n\n\n

Suddenly, Kander became an up-and-coming political star. In 2018, he was considered the frontrunner in the race for Kansas City mayor when he suddenly folded his campaign. He said he needed to finally deal with the mental health issues that had been plaguing him since he left Iraq.<\/p>\n\n\n\n

\"\"
Missouri Secretary of State Jason Kander visited Fort Leonard Wood in 2013 to meet with the post\u2019s senior leaders and to get a firsthand look at the Army\u2019s elite chemical, engineer, and military police training. (Robert Johnson\/Army)<\/figcaption><\/figure>\n\n\n\n

\u201cSo after 11 years of trying to outrun depression and PTSD symptoms, I have finally concluded that it\u2019s faster than me,\u201d Kander announced at the time. \u201cThat I have to stop running, turn around, and confront it.\u201d<\/p>\n\n\n\n

He now serves as president of the Veterans Community Project<\/a>, which addresses health care, poverty, homelessness, and other concerns in veterans.<\/p>\n\n\n\n

In an interview, Kander says one of the difficulties in getting veterans with PTSD to seek help is that so many of the portrayals on TV and in movies end tragically.<\/p>\n\n\n\n

\u201cWhat I think of as \u2018PTSD porn,\u2019\u201d he said. \u201cIt keeps people from getting help. If you get diagnosed with PTSD, it\u2019s the end of the story. It\u2019s not.\u201d<\/p>\n\n\n\n

Burch\u2019s dreams also changed because of PTSD. When she left the service, Burch switched from pre-med to public health. But just being inside a hospital awakened her memories of the damage and the devastated lives she saw while working in the Kandahar hospital.<\/p>\n\n\n\n

\u201cAnytime I would do shadow in the ER, I started to have a lot of flashbacks,\u201d she says. \u201cI was feeling like I was reliving a lot of it. I started having cold sweats.\u201d<\/p>\n\n\n\n

Burch changed her professional goals. She accepted a position at Iraq and Afghanistan Veterans of America<\/a> in December after serving as a senior military fellow there since September.<\/p>\n\n\n\n

\u2018It\u2019s a crisis\u2019<\/h2>\n\n\n\n

The huge number of veterans killing themselves also concerns the advocates. They kill themselves at a rate 1.5 times greater<\/a> than civilians do, with post-9\/11 veterans killing themselves at a rate of 2.5 that of civilians the same age \u2014 and service members are screened for mental health issues before they join the military. More than 17 veterans took their lives every day in 2019, according to VA\u2019s latest report<\/a>. More than half had never had any contact with VA\u2019s Veterans Health Administration.<\/p>\n\n\n\n

Military Times<\/a> reported in August that calls to VA\u2019s Veterans Crisis Line spiked around the time the U.S. pulled out of Afghanistan.<\/p>\n\n\n\n

\"\"
Secretary of Defense Chuck Hagel, second from right, and Secretary of Veterans Affairs Eric Shinseki, third from right, participate in a congressional roundtable discussion hosted by Sen. Barbara Mikulski, third from left, the chairwoman of the Senate Appropriations Committee about the Department of Veterans Affairs claims backlog in 2013 in Washington. The backlog has been an issue at VA since before 2007, when it became a national scandal. (Glenn Fawcett\/Defense Department)<\/figcaption><\/figure>\n\n\n\n

\u201cIt\u2019s a crisis,\u201d says Tom Porter, who heads the Washington office of Iraq and Afghanistan Veterans of America<\/a>.<\/p>\n\n\n\n

A new law<\/a>, sponsored by Tester and Sen. Jerry Moran, R-Kansas, and signed into law in October of 2020, allows VA to hire more mental health care workers, adds suicide prevention coordinators to VA hospitals, holds VA accountable for suicide prevention programs, and ensures veterans in rural areas have access to suicide prevention resources.<\/p>\n\n\n\n

Advocates say some of these needs could be addressed with one seemingly simple measure: automatic enrollment into VA as soon as troops leave the military so they can immediately access health care if they need it. It serves as a gateway to a variety of other VA services, including home loans, the G.I. Bill, insurance, programs for women, and more.<\/p>\n\n\n\n

\u201cIt\u2019s super important,\u201d Kander says. \u201cYou get out of the service on Tuesday. Monday, your government knew everything that was going on with you. Tuesday, you show up at the VA. It\u2019s like they, like, never heard of you.\u201d<\/p>\n\n\n\n

This War Horse feature was reported by David Goldstein, edited by Kelly Kennedy, fact-checked by Ben Kalin, and copy-edited by Mitchell Hansen-Dewar.<\/i><\/p>\n\n\n\n

David Goldstein<\/i><\/a> is a freelance journalist in Washington who has covered government and national politics, including several presidential campaigns, for more than two decades. During stints with McClatchy Newspapers, Knight Ridder, and The Kansas City Star, he has written about the pre- and post-deployment health problems of troops deployed during the Iraq War, their struggles with Veterans Affairs, and the toxic exposure of veterans involved in Cold War chemical experiments.<\/i><\/p>\n","protected":false},"excerpt":{"rendered":"

While many Americans may have seen the end of the forever wars as the cap on two decades\u2019 worth of war spending, the job of Veterans Affairs has only just begun \u2014 and will continue for 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