Veterans have no legal right to specific types of medical care, the Bush administration argues in a lawsuit accusing the government of illegally denying mental health treatment to some troops returning from Iraq and Afghanistan.
The arguments, filed Wednesday in federal court in San Francisco, strike at the heart of a lawsuit filed on behalf of veterans that claims the health care system for returning troops provides little recourse when the government rejects their medical claims.
The Department of Veterans Affairs is making progress in increasing its staffing and screening veterans for combat-related stress, Justice Department lawyers said. But their central argument is that Congress left decisions about who should get health care, and what type of care, to the VA and not to veterans or the courts.
A federal law providing five years of care for veterans from the date of their discharge establishes “veterans’ eligibility for health care, but it does not create an entitlement to any particular medical service,” government lawyers said.
They said the law entitles veterans only to “medical care which the secretary (of Veterans Affairs) determines is needed, and only to the extent funds … are available.”
The argument drew a sharp retort from a lawyer for advocacy groups that sued the government in July. The suit is a proposed class action on behalf of 320,000 to 800,000 veterans or their survivors.
“Veterans need to know in this country that the government thinks all their benefits are mere gratuities,” attorney Gordon Erspamer said. “They’re saying it’s completely discretionary, that even if Congress appropriates money for veterans’ health care, we can do anything we want with it.”
The issue will be joined March 7 at a hearing before U.S. District Judge Samuel Conti, who denied the administration’s request last month to dismiss the suit. While the case is pending, the plaintiffs want Conti to order the government to provide immediate mental health treatment for veterans who say they are thinking of killing themselves and to spend another $60 million on health care.
The suit accuses the VA of arbitrarily denying care and benefits to wounded veterans, of forcing them to wait months for treatment and years for benefits, and of failing to provide fair procedures for appealing decisions against them.
The plaintiffs say that the department has a backlog of more than 600,000 disability claims and that 120 veterans a week commit suicide.
In his Jan. 10 ruling that allowed the suit to proceed, Conti said federal law entitles veterans to health care for a specific period after leaving the service, rejecting the government’s argument that it was required to provide only as much care as the VA’s budget allowed in a given year. A law that President Bush signed last week extended the period from two to five years.
In its latest filing, however, the Justice Department reiterated that Congress had intended “to authorize, but not require, medical care for veterans.”
“This court should not interfere with the political branches’ design, oversight and modification of VA programs,” the government lawyers argued.
They also said the VA “is making great progress in addressing the mental health care needs of combat veterans.” Among other things, they cited a law passed in November that required the department to establish a suicide-prevention program that includes making mental health care available around the clock.
The VA has hired nearly 3,800 mental health professionals in the last two years and has at least one specialist in post-traumatic stress disorder at each of its medical centers, the government said.
Since June, government lawyers said, the VA has had a policy that all veterans who seek or are referred for mental health care should be screened within 24 hours, that those found to be at risk of suicide should be treated immediately, and that others should be scheduled for full diagnosis and treatment planning within two weeks. A new suicide-prevention hot line has been responsible for “more than 380 rescues,” the lawyers said.
Erspamer, the plaintiffs’ lawyer, was unimpressed.
“Nowhere do I see any explanation of what kind of systems they have in place that deal with suicidal veterans,” he said. “There’s no excuse for not spending the money Congress told them to spend on mental health care and leaving $60 million on the table when people are going out and killing themselves.”
Why did it take a near-tragedy for the Army to do the right thing in the Whiteside case?
Sunday, February 3, 2008; B06
“ONE OF THE Army values is integrity, which is defined as doing what is right, legally and morally. The moral thing to do is dismiss these charges . . . . ” That recommendation of an Army investigator more than a month ago in the case of 1st Lt. Elizabeth Whiteside was not acted on until after this vulnerable young woman attempted suicide a second time. The delayed reaction offers another troubling glimpse into the military’s attitude about mental health issues.
Lt. Whiteside is the 25-year-old Army reservist who faced a court-martial after she suffered a breakdown and tried to commit suicide in Iraq. Post reporters Dana Priest and Anne Hull chronicled her story: how she had a spotless record; how she had been harassed by a superior and how she snapped one night in war-torn Baghdad, pulling a gun on a superior before shooting herself in the stomach. The diagnosis of her psychiatrists that she suffered significant mental illness was brushed aside by her commanders, who saw it as an excuse and pressed ahead with charges. In December a hearing officer sided with the doctors and recommended against a court-martial. To do so, he said, would be “inhumane,” but no action was taken. Nor could Lt. Whiteside and her attorneys get any answers. Distraught about her legal limbo, she attempted suicide last Monday, and, with The Post again looking into the circumstances, the charges were finally dropped.
The mishandling of this case is indicative of a military culture dismissive of psychiatric ills as real sickness. Those who seek treatment are too often stigmatized and punished. How else to explain the worry of service members who say they fear being labeled as weak? Think of the message that was sent by the Army’s pursuit of Lt. Whiteside and its apparent reluctance to do the right thing.
The case is also a poignant illustration of the dramatic rise of suicides and attempted suicides in the Army. A draft internal study obtained by The Post showed suicides among active-duty soldiers increased nearly 20 percent in 2007, to the highest level since the Army began keeping such records in 1980. The numbers of attempted suicides and self-inflicted injuries also are increasing.
The Army, to its credit, is paying new attention to mental health issues, including hiring more service providers and putting in place new assessments. The Wounded Warrior legislation increases the coordination between the military and the Veterans Affairs Department for treating troops and veterans with mental health issues. The Joshua Omvig Suicide Prevention Bill, which improves the VA’s suicide prevention procedures, was signed by President Bush in the fall. None of those efforts will succeed, though, if not accompanied by a change in culture and leadership in the Defense Department. Lt. Whiteside, in a desperate note, put it this way: “I’m very disappointed with the Army.”
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“I want to speak directly to our men and women on the front lines. You have
done everything we’ve asked of you and more. Our nation is grateful for your
courage.”
So spoke President George W. Bush in his State of the Union speech last week.
We don’t question his sincerity. But our nation — and especially Mr. Bush’s
administration — seems to have a funny way of showing its gratitude.
Item: The number of regular Army and National Guard troops who killed
themselves, or tried to, was up again last year. As many as 121 soldiers
committed suicide in 2007, a 20 percent increase over 2006. Since 2002, the
number who attempted or committed suicide has increased six-fold, from 350 to
about 2,100 last year.
The leading cause, military officials say, is failed personal relationships,
followed by legal and financial problems. Speaking of difficult personal
relationships, the Pentagon extended normal combat tours from 12 to 15 months
last year.
Item: Army officials at FortDrum in upstate New York last year instructed
Veterans Administration representatives not to help injured soldiers fill out
disability paperwork, National Public Radio reported last week. The paperwork
is crucial to get disability payments and qualify for continued care.
Army policy allows the help. But members of a special Army investigative “Tiger
Team” that visited FortDrum last year apparently decided it was inappropriate.
They asked administrators at the VA’s regional office in Buffalo to stop the
practice.
In 2006, NPR reported that soldiers with post-traumatic stress disorder at Fort
Carson, Colo., were being forced out of the military, shunned or discouraged
from getting care.
Item: Nine months after VA Secretary Jim Nicholson promised to set up new
traumatic brain injury screenings for combat veterans, the VA is having trouble
working out the kinks. Officials still are trying to decide if the tests are
reliable. Meanwhile, thousands of Iraq war veterans may have received
inadequate care because doctors failed to notify them they’d tested positive.
Item: About one in every six soldiers or Marines returning from Iraq has
suffered at least one concussion, often from roadside blasts, according to a
large-scale study paid for by the Army and published last week the New England
Journal of Medicine. Those soldiers are at increased risk for post-traumatic
stress disorder.
Soldiers involved in the study had been home from Iraq for three to four
months. Those who’d had concussions were more likely to report lingering
symptoms such as headache, poor sleep and balance problems.
In his speech last week, Mr. Bush said “we must keep faith with all those who
have risked life and limb so that we might live in freedom and peace.” He has
said something similar in each State of the Union speech since he ordered the Iraq invasion in 2003. But there is an obvious disconnect between his words
and his actions.
Somewhere between the well-crafted lines of Mr. Bush’s speech and the blurred
front lines of wars he started in Iraq and Afghanistan lie thousands of injured
veterans who still aren’t getting the care they need or the benefits they have
been promised. Mr. Bush has 11 months to make good on his promise. Congress
should help him. Americans should insist on it.
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Thursday, July 13th, 2006
‘Meet Me in Fort Lewis’ - Protests Planned for Army Specialist Who Went AWOL After Charging Sexual Harassment
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Army Specialist Suzanne Swift remains confined to base. She went AWOL when the military did not address her charges of sexual harassment and abuse. We take a look at sexual harassment in the military. [includes rush transcript]
We take a look at the case of Suzanne Swift. She is the Army Specialist who has been arrested and confined to base for going AWOL after her charges of sexual harassment and assault went un-addressed by the military.
Swift served in Iraq for a year but decided she could not return and went AWOL. She said her superiors repeatedly sexually harassed her while serving in Iraq. On June 11th, the Eugene police knocked on her mother’s front door and Suzanne was arrested and taken to the county jail. She has since been transferred to Fort Lewis Washington where she is confined to her base. So far, no charges have been filed against her and Fort Lewis officials have said they will assign an independent investigator to look into her charges of sexual harassment.
Suzanne Swift turns twenty-two on Saturday. Her family and supporters are urging a national day of action on her behalf. A “Meet Me in Fort Lewis” rally and vigil are planned for noon outside Fort Lewis. Another in her hometown of Eugene, is planned for noon at the Federal Building.
A few days ago, we brought you Suzanne Swift’s mother, Sara Rich. Today we bring you Suzanne Swift’s grandfather, Jim Rich. I spoke with him at the Oregon Country Fair near Eugene.
Jim Rich, Suzanne Swift’s grandfather.
For more on the issue of sexual harassment in the military we are joined by:
Susan Avila-Smith, a Military Sexual Trauma Specialist and founder and director of Women Organizing Women, an advocacy group for survivors of rape in the military.
More information at SuzanneSwift.org. Email Suzanne Swift’s mother, Sara Rich, at formydaughtersuzanne@yahoo.com
We invited a representative from Fort Lewis military base to be on our program but they declined our request.
RUSH TRANSCRIPT
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AMY GOODMAN: Today, we bring you Suzanne Swift’s grandfather, Jim Rich. I spoke with him at the Country Fair. I asked him how he felt when Suzanne first joined the Army.
JIM RICH: I was very sorry when she succumbed to the blandishments of a very smooth-tongued recruiter. And I thought when she decided not go back, she had made the best possible decision, considering the things that she had gone through, things that no male soldier would ever, ever, ever in his wildest dreams have to endure.
I hope that justice is served. I hope that light is shown on this aspect of the Army that makes women recruits the prey of sexual predators, and that Suzanne is honorably discharged. I also hope that the rest of our soldiers get to come home soon, and no more sent.
AMY GOODMAN: That’s Jim Rich, Suzanne Swift’s grandfather. He’s also a blacksmith, and he was at the Oregon Country Fair, made the iron tools for the new film Pirates of the Caribbean.
Well, we’re joined on the phone right now by Susan Avila-Smith. She’s a Military Sexual Trauma Specialist, founder and director of Women Organizing Women, an advocacy group for survivors of rape in the military. We invited a representative from Fort Lewis military base, where Suzanne is confined, to be on our program, but they declined our request.
Susan Avila-Smith, thanks so much for being with us. I realize it’s tough for you to come out of your recovering from cancer, and yet you have chosen to take the time to stand up for Suzanne. Why?
SUSAN AVILA-SMITH: Good morning. Well, I think it’s an extremely important problem going on in the military right now, and they continue to keep sweeping this under the rug. Congress has done multiple investigations, but they have made no changes to any of the accountability within the military. And it’s really time that somebody stands up, and the fact that Suzanne stood up and went AWOL is showing how bad the problem is.
JUAN GONZALEZ: And you had an opportunity to meet with her. In terms of her experiences, how they compare to others that your organization has dealt with in recent years?
SUSAN AVILA-SMITH: The experience that she’s had has been similar to the 600 other cases that I’ve had. It’s usually a command rape. It’s usually covered up. It’s usually that they try to persecute the victim, rather than persecute the perpetrators.
JUAN GONZALEZ: And have there been any instances where actual rapes or assaults have been prosecuted by the military?
SUSAN AVILA-SMITH: Yeah, there’s been a few, usually the high-profile cases, and sometimes, you know, justice is done. There’s been a 30-year sentence. But generally speaking, of the hundreds and thousands — there’s probably a hundred thousand women who have been raped over the lifetime of women in the service — generally speaking, no, the perpetrator usually is running free, and the victim is usually kicked out of the military.
AMY GOODMAN: Susan, can you tell us your own story, how you got involved with helping women in the military?
SUSAN AVILA-SMITH: When I was in, I experienced some domestic violence and sexual assault, and both times it was dismissed by the military. When I finally got out, I was in a women’s support group at the Seattle V.A. and found out that so many women had been raped in the military, and nobody really knew what to do. And the paperwork to file claims with the V.A. was impossible for anybody with post-traumatic stress disorder. And so we got together and started helping other women with the paperwork, and it evolved into helping other women nationwide with claims as old as from World War II. And now I’m doing a lot of active duty cases.
JUAN GONZALEZ: In Suzanne Swift’s case, apparently she was asked to fill out a 700-question psychological questionnaire. It seems to me quite extreme in the situation that she was under. Do you have similar instances where those who have come forth, the target then has been on them and on their psychological situation?
SUSAN AVILA-SMITH: Yeah. That was also the same with the Sergeant Audra Wood. I think it’s very typical of the military to do an MMPI on the soldiers. Unfortunately, they’re doing it on the victims, rather than the perpetrators. But it also — it does help to find a baseline to see if there is damage to the victim and to see if there’s mental health counseling that needs to be taken care of and addressed.
AMY GOODMAN: In the case of Suzanne Swift, and we’ve talked to her mother several times, she says that when she was in Iraq and she got into a vehicle with a sergeant, he immediately talked about having sex with her. Even back at Fort Lewis at the base, when she showed up and asked where she should report for duty, she said another sergeant said, “In my bed, naked.†Right before July 4th weekend, at the big formation where hundreds of soldiers are there, the person in charge said he wanted 21-year-olds to step forward to tell them, you know, they shouldn’t be drinking on July 4th weekend. And then he said, “Anyone who has gone AWOL in the last six months I want to step forward.†And, of course, Suzanne was the only one to step forward. Then, she was also that week earlier taken for this psych evaluation without telling her mother, without telling her attorney, taken alone until her mother raised such a fuss she was taken back from the psych testing area, though she had to take it the next week.
What about the response of the military in all of these cases, and her saying she even went to her E.O. officer in Iraq, equal opportunity, to complain about harassment, and the message that was sent when he did nothing about it?
SUSAN AVILA-SMITH: Well, she has followed the chain of command or attempted to follow the chain of command, which has failed her. And they have reprimanded the first sergeant who singled her out at formation. And I don’t believe that that’s going to be happening again. She’s currently with a new command, who has been sensitive to her needs and is acting, what I believe, above and beyond what a normal military command would do. They recognize that this is a high-profile case, and they seem to be now doing the right things for her.
JUAN GONZALEZ: And also, the issue of the impact of war itself on these situations, are you finding that the number of victims is greater in war situations, like in Iraq or Afghanistan, than it is in peacetime efforts of the military?
SUSAN AVILA-SMITH: It’s a little bit more during the war, but I think maybe perhaps people are reporting a little bit more. It continues to go on stateside, continues to go on overseas at other bases. Generally speaking, the concept of sexual assault in the military is handled the same and is the same on every single base.
AMY GOODMAN: Finally, Susan Avila-Smith, you’re well known in the Puget Sound area as an advocate for sexually assaulted military veterans, have been working very hard on this. Again, you’ve been going through radiation. And you’re quoted in the Seattle Post-Intelligencer saying, “Cancer is curable. PTSD is not.â€
SUSAN AVILA-SMITH: Well, coming to terms with having my own PTSD has taken about a decade to learn to manage my symptoms, rather than my symptoms managing me. I’m lucky that I’m a highly functional person with PTSD, because I sought treatment very early on, after I was diagnosed. And as a result, my level of functioning is good, and that’s my hope for Suzanne, is that she gets out and she’s able to get the treatment that she needs so that she can deal with this. As far as my cancer goes, it’s a bump in the road. It’s kind of unfortunate, because I’m not able to help the number of women that need help, but I’m not looking at this as, you know, a life-threatening illness or something that’s going to be continuing to linger like my PTSD.
AMY GOODMAN: Susan Avila-Smith, we thank you very much for joining us, founder and director of Women Organizing Women, an advocacy group for survivors of rape in the military. Again, protests are planned for Eugene and outside Fort Lewis, “Meet Me in Fort Lewis,†in Washington state, for Suzanne on her birthday on Saturday and, her mother says, for all women in the military to protect them. The website, suzanneswift.org. The email address is formydaughtersuzanne@yahoo.com.
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