show me the money

Below is a link to a page that helps calculate disability pay from the
Army and VA, and how those payments relate to one-another.
I have only included the severance pays from the Army - it is the most
common form of Army Medical Separation Compensation. About 90% of all
medical separations are severance based (0% - 20%). Retirement is
effective from 30% and higher. Retirement warrants an entirely separate
calculation process.

monetary and staff problems at WRAMC

But these problems only came to this point because of leadership failures. Somewhere in the chain of command or concern a leader failed to provide accurate reports and another failed to inspect within their sphere.
The Army probably doesn't need more money - but there needs to be accounting of Total Military spending to ensure proper spending priorities. I'm one of those guys that worries about contractors over-charging for services and lining the pockets of corporate execs at the expense of Military Readiness Spending. I would rather have had more bullets, even toilet paper for that matter, than to have Internet and satellite TV available.
But the Military spends the money congress sends (or the prez pushes) on "stuff," I'd really like to know what "stuff" is. Half of the "wazzuu" expensive toys we take to the sandbox suck. They break or just don't work with other systems already in place. Computer programs don't share the same platforms - but what difference does it make when the sand ruins the electronics.
I'm sure Walter Reed could have found money SOMEWHERE to make sure soldiers were well cared-for. The Army CAN authorize TLA - Temporary Lodging Allowances - to house soldiers in adequate living conditions. But in order to save money the administrators (they don't deserve to be called leaders anymore) tucked the troops away and hoped that no one would look.

Making the problem worse

Everyone's hoppin' and poppin' in DC now trying to looks busy, trying to look like they care, trying to make it look like they have been doing their jobs all along.
Stop trying to cover your tracks!! You're wasting time generating lies for press releases, just fix the problems.
The major problem that is destroying the medical system right now is the leadership. It just plain sucks. And there is no accountability of that leadership. The President answers to NO ONE - he's made that crystal clear, but with all that authority, where is his responsibility.
And then the head of the VA has obviously had his head up someone's ass, if not his own.

After meeting with the president, Nicholson defended the Veterans Administration, but acknowledged there is room for improvement.

"When you're seeing over 1 million patients a week, you have to be very good, and if there is any one patient who doesn't get the care that they deserve, that's unacceptable," Nicholson said

He said his agency is hiring 100 new patient advocates who will help troops returning from war deal with the bureaucracy.

"The American people can feel very good about the health care system that their VA is providing to veterans," Nicholson said, "but if there is a case where a veteran gets lost in the system, or suffers anxiety or their family does as a result of something we're not doing, that is unacceptable."

From:

Bush: No Tolerance for Medical Neglect

By DEB RIECHMANN

The Associated Press
Wednesday, March 7, 2007; 1:46 PM

By saying a patient is not getting the necessary care he is basically admitting that his whole organization is a failure.

And now he's hiring 100 more "advocates." The VA doesn't have advocates. The VA has bureaucrats. If a patient is to have a proper advocate - a person who will actually look out for the Patient's BEST INTEREST - not the interest of the institution, then that advocate cannot come from within the VA PERIOD!

The DAV (Disabled American Veterans) and the VFW help Vets fight the VA bullshit - THEY have advocates and representatives that act on patients' behalves.

And why are we changing the subject to the VA, anyway? Their system is in desperate need of repair, too, but Walter Reed is TOTALLY separate from the VA.

The problems at WRAMC are with ACTIVE DUTY Soldiers - and WRAMC is supposed to help them heal to a STABLE STATE where then the VA can help provide further medical care after the soldier leaves the service.

It could happen to you . . .

And who holds providers to standards of practice? What motivation could there possibly be for providers to cross a line somewhere and put troops in such a bad position in life.

And why do I believe this story - I SAW IT HAPPEN HERE.
Same type thing, just different names. That practice is so wrong, such a breach of ethical standards it makes my blood boil.

The transition area from Active Duty to Veteran status is a no-man's land. The laws get real fuzzy in there and bureaucratic policies and politics add to the confused process.

I find myself explaining Catch-22's over and over to young troops going through the MEB process and they are baffled by how distorted the whole system is. It's backward, crooked, disorienting. It is not user friendly and somewhere along the way the people involved in the process have developed an attitude that enables the PROCESS, not the TROOP.

It just kills me to watch an MEB officer act "unbiased" as they tell a young, injured soldier "just how easy this will all be if you just sign it now." "Oh, you don't want to take your 10 days to think about it, that just makes things drag on." "Oh no, the DAV rep or VFW rep can't help with THAT, they only do Veteran stuff, they'll help you after you sign."
Bullshit!!
Troops - talk to vet groups, other vets who have been through the system, look online, read the regs. Whatever you do, don't take anything at face value who looks at you like a statistic. Because that's what the system sees - statistics of how many are med-boarded and how fast. If the army can put you out without a medboard, THEY WILL - it's cheaper. And if they can medboard you faster, without proper treatment - THEY WILL - it's cheaper, AND - it makes THEM look better for "healing" you faster. A troop is not supposed to get medboarded until their condition is stable - and the VA doesn't pick up "where the army left off," either.
Getting into the VA for treatment takes time, and with an unstable condition this can mean deterioration and worsening of the condition.
I don't know where things went awry in the medical system, I had a great doc - the MEB office pissed me off, but medically, I got treated well - I was very fortunate to have an awesome doctor. Some of the other providers I have seen are a malpractice suit waiting to happen - oh yeah, FERES, how'd I forget.
I guess a good sign is that if a provider is never available to see civilians at the hospital, there may be a reason. Maybe that's why untrustworthy doctors end up treating all the MEDHOLD soldiers and only the MEDHOLD soldiers.

These docs are treating the most seriously injured troops from war. They're not treating guinea pigs. These troops have families, they have lives. They deserve the BEST care possible. And the doctors must be held to that same standard of accountability that other doctors must uphold.

You do the math

So Bush wants to take this opportunity to talk about how he has grown the VA budget under his administration -- Way wrong answer for those paying attention. He forgot to mention that the budget increase (decrease) is due to the increased co-pays and the decreased per-vet spending for the VA. The numbers of disabled Vets are growing faster than the budget is increasing, so claiming to increase the budget is BULLSHIT!!

Bush also will emphasize in the address that more than 1 million veterans have been brought into the Veterans Administration health care system since 2001 and that his fiscal 2008 budget proposal includes a request for more than $86 billion for veterans' services, representing a 77 percent increase since he took office.

---Bush Orders Review of Service Members' Care
By William Branigin

Washington Post Staff Writer
Friday, March 2, 2007; 5:18 PM

Military Med system FUBAR -- part 3 (5? 67?)

But it also should not have taken newspaper articles to bring change to outpatient conditions at Walter Reed. And while filthy conditions at Building 18 are a temporary problem for these veterans, lowball settlements may leave soldiers and their families impoverished for life.

-- Washington Post Editorial, "Rotten Homecoming" -- 21 FEB 07

I find it nearly impossible to explain how this stuff can happen, when family or friends ask. If I'm bitching about how frustrated I am with being denied treatment or only getting it after a 3-year fight, it's understandably bizarre. I got tired of trying, because it always ends up in, "Well why don't you just...(..)?"

Which would work in any OTHER HMO.
And which wouldn't be necessary if more of the leadership were more interested in patient care and troops' well-being, than number-crunching and avoiding conflict with unethical practitioners.

Here's the systematic issue:

The biggest problem is: most of us wounded, maimed or disabled get
stuck at our shitty little "Army Community Hospitals" (ABHs) on our
own posts--away from the specialty clinics, support programs &
publicity of Walter Reed. Honestly, I'm horrified things got so bad
at Walter Reed, thank god for WaPo--but those articles exposed maybe
5% of the systematic failure to do right by injured troops.

It kills me how the Pentagon makes it sound like all "severely
injured" troops are getting care at Walter Reed. Or its sister-Army
Medical Centers (AMCs).
Bullshit--it's where a severely injured troop goes ONLY if he/she's
wicked lucky, Knows Someone or has a dramatic external injury. The
rest of us "severely injured" hospital-bunnies would all but pull out
a buddy's IV to get to Walter Reed. It's like Xanadu, heaven, a place
of wonder.
The difference? At Medical Centers like WallyWorld you get, you
know, medical treatment along with your
moldy/infested/condemned barracks... Rumor has it: the troops are
sometimes even treated like patients instead of weaklings or shitbags.
WOW!

The majority of us-- shrapneled digestive systems, organ failures,
traumatic brain injuries, spinal cord issues, single-arm amputations,
or whatever (even cancer) get scattered around the country, out of the
public eye (i.e., in little army towns with no investigative
reporters). At these ACHs, hospital administrators can deny
treatment, falsify records, or otherwise screw us with no
repercussions that I've seen, ever.

To be fair: most of the people at these Army Community Hospitals on
tactical/"grunt" posts are AWESOME. Many are army wives or formerly
troops themselves. 90%+ are professional, sweet, and busting their
ass to keep things going. They're so exhausted from dealing with
overcrowded clinics and increasingly pissed off patients, I truly
don't know how they stay sane. I submit "Good Job!" reports on them
whenever possible.

The problem, as usual in a bureaucracy, lies with:
A. Pentagon bean-counters (generals or senior civilians)
shortchanging the outlying hospitals to fund whatever rusty-ass
Artillery system got porked in again this year
B. Hospital admin types (senior officers) who pretend everything's
SUPER instead of grabbing their sack and addressing , or
C. A few unithical & power-trippy doctor or nurse (usually one in
charge of a clinic) too senile, incompetent, ambitious or psychotic
for the whole "medical care" thing

Of course, they're the "authority" or "professionals" so they're the
ones who get to give all the official input. We start thinking we're
just crazy, til we figure out the odds of simultaneous, identical mass
hallucinations are slim. Even on wacky pain meds.

I just don't know how to get help for all of us at outlying hospitals.
I've tried. Others here have worn themselves out trying. How do you
raise hell in Pudunk, Kentucky/Tennessee border for Peter's sake. ANY
suggestions would be genuinely appreciated. Congressionals get shot
down as fast as...quail-hunting partners. We're not allowed to sue
for malpractice (not that most of us would...but the threat might help
quality control)

Guide to helping soldiers and their families through Army Medicine

Here is a link to a handbook that looks to be a good resource for helping soldiers and their families deal with the many stresses that come from injuries and wounds from military service. There is a lot of great information in this book that I hope can find its way into the hands of many otherwise confused soldiers and family members.

[Our Hero Handbook]


- Ragin' Ranger Out

Negligent Medical Care

I saw this and wanted to share.
From the Army Times website:

• Negligent medical care
Have you or a family member experienced what you regard as negligent medical care at a military hospital? We'd like to hear from you, whether you're uniformed or not. Send your comments to Military Times staff writer William McMichael. Please include a preferred way for us to get in touch with you; we won't use your name in a story unless you give us permission to do so.

To: bmcmichael@navytimes.com
Subject: Negligent medical care


From Army Times Link: http://www.armytimes.com/story.php?f=1-292925-getinvolved.php

- Ragin' Ranger Out

National Symposium for the Needs of Young Veterans

Lots of Veteran's advocacy groups going to this. I'm looking forward to it and hope it brings strong positive results.

National Symposium for the Needs of Young Veterans' official Web site. This first-of-its kind event will be hosted by AMVETS on Oct. 18-21 at the Hyatt Regency O'Hare (please use special event code 26168 for the best rate) in Chicago.

One of the greatest and yet largely unrecognized challenges facing America is how we will provide for the needs of future veterans—especially those younger people who are serving in Iraq, Afghanistan and other parts of the world today. It’s an issue we must address now if our nation is to keep its promise to those who defend us.

Homepage:
http://www.veteransnationalsymposium.org/home.htm


- Ragin' Ranger Out

Call me, ask me, I want to help you, too!!

One morning I woke up to a phone call. I felt very much "cloak and dagger" when the voice on the other line said "I'm having trouble at the hospital and someone told me to call this number. Do I have the right person?" The wise guy side of me wanted to respond with "who are you looking for," or better still, "is this for pick-up or delivery?" But I knew exactly why he was calling.
My wife and I have been through a very ugly medical situation with our army hospital. Only strong expletives could accurately describe how I feel. So I knew this caller had heard something about us.
He went on to describe how the doctor he saw told him that "back pain is normal in the army," and "you'll just have to learn to live with it." And that was it. When the first doctor left the hospital for another assignment this soldier got another doctor. Instead of a real second opinion the second doctor just said "well if you've already been seen there is nothing more I can do for you." And now, because of his intense pain, he will be separated from the army.

Second opinions are hard to come by in the army. If a soldier is fortunate enough to be granted one the second doc will often just defer to the opinion of the first doc. It's just easier that way. It separates soldiers faster and is cheaper. The misconception that "the VA will take care of disabled vets," must be the only threads left holding these doctors' consciences together.

check out this site if you think the VA is doing its job: www.dav.org

I've been out for over 8 months and I still haven't seen a dime from VA for some of my well-documented disabilities.

In a nutshell on claims: I developed acid reflux during service. The VA considered that condition "service connected," which means the VA will assume responsibility for treating my indigestion at VA clinics and the VA pays for my antacid meds.
However, the VA claims that my bone spurs and joint degeneration in my neck (from wearing a Kevlar Helmet and Body Armor) is not service connected. I guess back pain just happens!?!?

It does according to the VA.

Disability ratings are based on two measures: subjective pain scale (1-10) and objective range of motion.
In the civilian world doctors use objective functional assessments to determine the effects of a patient's disability. These examinations often span a period of time (at least 2 days) and monitor many motions and actions on each day. Using this method gives and accurate description of how a patient's disability affects their activities of daily living (ADLs).

But the Army won't use this method!!

WHY is the easy question, at least it seems to be -- MONEY. A functional assessment would likely show higher disability ratings for veterans and that would increase VA spending greatly. The VA budget is a joke already. The VA will fight increasing disability ratings as long as it can. The current payments for disability is already sad as it is.
Check it out here: http://www.vba.va.gov/bln/21/Rates/comp01.htm

As you can see, a lone veteran who is 100% disabled gets $2,393.00 per month. That is tax free, but how far can that really go? That's $28,716 a year. Increases to that come at Congress's leisure.
Is that really the best America can do to reward a kid who went to war (perhaps didn't even want to go) and came home with a disability so bad that they can't work again, EVER, AT ALL!?!?!?!? And what of their mental health, family life, recreation, and overall quality of life!?!?!?!? There is no dollar amount worthy of the sense of wholeness and many vets feel themselves to be in pieces, broken shards of war's destruction.

Where else can this disabled vet get money?
Hopefully the Army retired them from active duty -- not a guarantee. A young soldier with 4 years of active duty service can get $514 a month for being considered 30% or more disabled by the Army. There is some fuzzy math that goes into these calculations but now this disabled vet is up to $29,230 a year.

Some perks come with this: guaranteed medical treatment, but how much does a disabled vet trust the Army's medical system. PX and Commissary privileges as a retiree but if the vet wants to get away from the seedy Army town this means little to nothing.

And that is sad considering all that this person sacrificed.

In all of my anger at the Army's medical system I remind myself that my personal experience wasn't too bad. I had a great surgeon who I trusted and fixed my shoulders very well. I just can't do certain Army tasks now. (But who really should carry an 80 lb. pack!?!?) I loved the physically demanding environment of the Infantry, my body just couldn't hang together any more.
I also had cartilage removed from my knee -- I was rucking (back-packing) exactly 6 weeks later. For those of you familiar with the Sapper School road march course at Ft. Leonard Wood, MO, I finished it in 2:45 (2nd place) only 2 and a half months out from surgery. Those docs did a great job!!

- Ragin' Ranger Out

Going away . . . coming back . . .

I was in Iraq just under a year but part of me never came home. I am different now. I can't quite put my finger on it but I changed.
I check the casualty list every day. I have friends over there now, some who want to be there, some who hate it there (for more than just the geography) and/or hate being away from family, and some who are torn between wanting to be home with family and wanting to stay there.
I respect my friends that want to stay in -- hey, if it works for them that's great, I hope they can stay happy. I hope they never have to deal with the medical side of the military.

Here's the page I look at. I wear a black bracelet for one who is listed.

http://icasualties.org/oif/default.aspx

Forgot to mention: the reason I like this page is the search function at the bottom and the statistical information the website provides.

Don't miss the link to Afghanistan casualties as well

- Ragin' Ranger Out