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Suing for Systemic Relief - Q&A w/Melissa Kasnitz, Managing Dir. of Disability Rights Advocates

by rcs1

originally posted Wed Jul 25, 2007 at 09:28:13 AM EST --bumped

[Note: Thank you, Cho, for giving everyone the head's up on the busy day today, and for all who have joined to welcome Melissa Kasnitz and Jeff Peskoff. Have added content to this commentary, rather than create another for the Q&A so that we can keep all of the information in one place. -- Ilona Meagher]

It's been a busy day and week as far as veterans' affairs are concerned.

Hearings, reports and lawsuits have come together to bring issues regarding the care received by returning troops front and center. [Additional commentary on the hearings can be found in my diary at Daily Kos posted this morning.]

This commentary will focus on the work being done by Disability Rights Advocates, a non-profit legal center working to ensure dignity, equality, and opportunity for people with all types of disabilities throughout the United States and worldwide. Melissa Kasnitz, is managing director in charge of the the lawsuit brought against the Veterans Administration on Monday, and explains the intention of the legal action:

This class action does not seek money damages, nor does it address the claims of any individual veteran. It seeks systemic relief for the flawed system of providing heath care and benefits to veterans. Currently, there is a backlog of over 600,000 cases in the veterans benefit system, and veterans with PTSD are not able to promptly get treatment for mental health problems, despite a statute that requires free healthcare for two years after service. We are asking to the courts to order VA to fix these problems.
Melissa has been interviewed on MSNBC this morning and will be on again later. Ilona has invited Melissa to ePluribus Media to answer questions -- between 2 and 3 Eastern Standard Time. Also, please welcome IraqWarVeteran who has posted below, as he has been extraordinarily instrumental in focusing our attention on how the Iraq Vets are tossed out of the "care queue" with the label personality disorder.


More information as well as the question and answercomments below the fold.


commentary :: :: :: buzz-it!
Important Resources

From DRA's press release:
The complaint, filed in the United States District Court for the Northern District of California, seeks to prohibit the VA from continuing a number of improper practices in handling claims for health care and disability benefits.

Most disabled veterans cannot receive medical treatment without a disability claim approval. However, the VA now has a backlog of over 600,000 claims, and a decision on a claim can take up to twelve to fifteen years. Some pending claims go back to the Vietnam era. In the meantime, many disabled veterans give up in despair or frustration, fall into drug or alcohol dependency, or commit suicide.

Even after claims have been approved, veterans face ongoing problems receiving care. Because the demand for medical care and treatment by the VA has risen dramatically since the U.S. became involved in the current conflicts in Iraq and Afghanistan, the VA has long waiting lists and, in some cases, no appropriate treatment for disabled veterans is available.

The suit claims that numerous VA practices violate the constitutional and statutory rights of veterans with Post Traumatic Stress Disorder (PTSD) by denying veterans adequate procedural safeguards in the VA benefits process, access to the judicial process, mandated medical care, and VA benefits as a result of their PTSD.

In addition to seeking a declaration from the court that these practices violate the constitutional and statutory rights of the Plaintiffs, the lawsuit seeks an injunction preventing the defendants from continuing certain policies and procedures. No damages are being sought. Plaintiffs in the case include two non-profit organizations, Veterans for Common Sense and Veterans United for Truth, on behalf of all veterans who are seeking or receiving health care or disability benefits from the VA. Plaintiffs are represented by the California-based public interest law firm Disability Rights Advocates (DRA).

“The VA’s motto, taken from Abraham Lincoln’s second inaugural address, is ‘to care for him who shall have borne the battle and for his widow and orphan,’” said Melissa Kasnitz of DRA. “The VA is not living up to its motto or its obligation to care for our disabled veterans. Instead it is abandoning our veterans, shamefully following a path that will lead to broken lives and staggering social costs.”

The lawsuit includes the issue of personality disorder discharges being given out (rather than the more costly PTSD diagnoses) as covered in a recent article in The Nation:

Whistle-Blower

On the day he was discharged in the fall, Town met with Jeff Peskoff, a civilian employee in the personnel office at Fort Carson in Colorado, and learned he owed the Army $3,000 to repay his enlistment bonus. "At some points it looked like he wanted to cry and at some point he looked like he wanted to rip my head off," Peskoff said.

Peskoff, who served 10 years in the Army, including a tour of Iraq, recently quit his job in disgust and is now speaking publicly for the first time. "If you have a combat tour and you are getting labeled as a personality disorder, there is something wrong. &0133; It's a lie," Peskoff said. "It's a quick way to get rid of that body and bring in another body. And it's a quick way to save money."

In the span of several months, Peskoff said he processed the personality disorder discharges of Schmidt, Town and hundreds of other combat veterans he believed were actually suffering physical and psychological trauma because of the war. "They [Army officials] are basically washing their hands of them," Peskoff said.

Fort Carson officials declined to talk to ABC News about this story. The Government Accountability Office is currently investigating Fort Carson as part of a larger study of mental health services for veterans.

If you are a veteran and wish to add your name to the lawsuit:
Disability Rights Advocates (DRA) is interested in hearing from veterans with Post Traumatic Stress Disorder who served in Iraq and/or Afghanistan. We are investigating the experiences of these veterans as they seek benefits through the Department of Veterans' Affairs.

We are seeking information on how the existing system serves veterans, including whether or not they are satisfied with the speed that their claims are addressed and the outcomes. We also are interested in hearing from veterans about the quality of care they receive at VA facilities.

We encourage any Iraq or Afghani veterans with PTSD who are interested in sharing their experiences to contact us. You can call, write, or email us at: Disability Rights Advocates, 2001 Center Street, Fourth Floor, Berkeley, CA 94704, (510) 665-8644; veterans@dralegal.org. Collect calls will be accepted.

All information will be kept confidential.

Join Us in welcoming both IraqWarVeteran and Melissa Kasnitz.
Display:
...appreciate the help with this. Am looking forward to joining everyone here for the Q & A later today!
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by ilona on Wed Jul 25, 2007 at 10:18:29 AM EST
very happy to do whatever little I can to help our vets and our folks in the military.

by Cho on Wed Jul 25, 2007 at 10:20:32 AM EST
[ Parent ]
Read this and thought about the Meagher/ePMedia collaboration.

by rba on Wed Jul 25, 2007 at 10:32:14 AM EST
[ Parent ]
time to get the letterpress cranked up.

by Cho on Wed Jul 25, 2007 at 11:20:46 AM EST
[ Parent ]
...I'll be around.

by Aaron Barlow on Wed Jul 25, 2007 at 10:30:51 AM EST
[ Parent ]
I guess I made it in!

by IraqWarVeteran on Wed Jul 25, 2007 at 11:58:18 AM EST
always happy to have new "faces"!

by roxy317 on Wed Jul 25, 2007 at 12:02:49 PM EST
[ Parent ]
And thank you so much for your service.

by Cho on Wed Jul 25, 2007 at 12:06:12 PM EST
[ Parent ]
It's always nice to see a new "face" 'round here.  

by GreyHawk on Wed Jul 25, 2007 at 12:32:41 PM EST
[ Parent ]
glad you're here.

by rba on Wed Jul 25, 2007 at 12:43:05 PM EST
[ Parent ]
Gearing up for our Q&A w/Melissa and so happy to have you here, too.

Have a question for you, Jeff (and Melissa, feel free and chime in when you arrive as well).

What's your reaction to Rep. Stephen Buyer's grilling of Joshua Kors? It just seemed waaaaay out of line. He was practically oozing contempt as he barked at the reporter who only fault seems to be that he bothered to devote months of his life to this story. Where the heck was Buyer on this issue when he was House Vet Affairs Chair?

"Have you served? Then you have no personal experience in what you're talking about."

Um, reporters don't have to have personal experience to report facts that have been given them by their sources. It's called reporting.

Heaven forbid if all the entertainment reporters covering the Lohan saga would be required to have just as many DUIs as she has.
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by ilona on Wed Jul 25, 2007 at 12:44:42 PM EST
[ Parent ]

I've been to busy to watch the hearing.  I'll be reviewing the transcript later.

by mwk on Wed Jul 25, 2007 at 02:06:07 PM EST
[ Parent ]
Too busy here as well.. but Ilona, I am sure, will fill us in.

by Cho on Wed Jul 25, 2007 at 02:07:46 PM EST
[ Parent ]
speaking out!  We have to endeavor to turn over every grain of sand...and that takes a village.  Welcome to a great supportive community!  We cannot let Democracy wither!!!!!

by avahome on Wed Jul 25, 2007 at 12:47:03 PM EST
I have limited internet availability this afternoon but wanted to say thanks for the work you are doing for the vets.  

It is a travesty for our government to once again ignore the responsibility we have to provide care for those serving our nation.  We owe the vets our gratitude, respect and the benefits that they were promised when they signed onto serve.  

I do not know military regulations but am familiar with workers' compensation laws and coverage.  In many states, the workers comp laws require an employer (and their insurer) to provide coverage for aggravations of pre-existing conditions.  We do receive claims for PTSD and other mental conditions.  Is there anything similar to this in the armed forces regulations?  What I am wondering is even if they can successfully assert a person has a personality disorder, if they made it through all of the screening processes and go into combat, why shouldn't that be accepted?  

I can't believe they are so short sighted with this issue.  The idea that this will save money is ridiculous.  It might not come out of the same budget but there will be a cost to society and the taxpayers at some point.  The sooner people receive the assistance and treatment they need, the lower the cost and we know that to be the case.  

by standingup on Wed Jul 25, 2007 at 01:56:51 PM EST

We have seen with the experience of Vietnam veterans and Gulf War veterans that the VA will oppose providing appropriate care and benefits for as long as it can.  Just last week, the U.S. Court of Appeals for the 9th Circuit issued a scathing opinion against the VA for failing to honor the agreement it reached with Vietnam veterans who had been exposed to Agent Orange.  With this lawsuit, we are telling the VA that they can't wait years or decades to provide for veterans who need support now.

by mwk on Wed Jul 25, 2007 at 02:13:06 PM EST
[ Parent ]
...just who the people at the top of the VA see as their constituency, the veterans or the administration.

Is there any possibility that the VA careerists can start pressuring their political bosses?

by Aaron Barlow on Wed Jul 25, 2007 at 02:17:44 PM EST
[ Parent ]

more about how the we are not caring for our vets.  They need to be both educated and informed.  Then they can take that information and get on the backs of Congress to stop this from happening again.  We really need to get beyond the lip service of "supporting the troops."  

Thanks for your answer.  Keep the pressure up in the courts and everywhere possible until the federal government does right by these people.  

by standingup on Wed Jul 25, 2007 at 02:20:53 PM EST
[ Parent ]


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by ilona on Wed Jul 25, 2007 at 02:34:27 PM EST
[ Parent ]
Hi everyone.  I'm happy to be here, and I want to thank Ilona and everyone in this community for their concern over the treatment of veterans.  We are working to play our part to improve the system, and make sure that veterans get the health care and benefits they need.  The treatment they currently receive is a disgrace, and it needs to change.

by mwk on Wed Jul 25, 2007 at 02:03:49 PM EST
...sorry I'm a few minutes late in getting the updated copy up.

Adding my welcome and thanks for taking the time to come and chat with us a bit.

My first question: What can you tell us about the genesis of DRA's involvement in this issue? Have you advocated for veterans in the past? If not, what other groups has DRA fought for previously?
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by ilona on Wed Jul 25, 2007 at 02:11:35 PM EST
[ Parent ]

DRA advocates for the civil rights of all people with disabilities, including those with mobility disabilities, sensory disabilities, learning disabilities, and mental disabilities.  If you want to know more about our organization, you can go to our website, www.dralegal.org (sorry, I don't know how to do links here).

We have not specifically represented veterans before, though we did bring an action against Ft. Lewis, a military base in Washington state, about the physical accessibility of its housing units.  The defendant in that action was a private contractor hired by the military to run the housing, not the military directly.

In this new case, we are working in conjunction with a private law firm, Morrison & Foerster, with attorneys who have substantial experience on veterans's benefits.

We wanted to bring this case because returning veterans are a large (and, unfortunately, growing) segment of the disability community, and their needs are so acute we felt we had to take action.

by mwk on Wed Jul 25, 2007 at 02:18:42 PM EST
[ Parent ]

with you on the treatment and care the vets receive.  What can we do to help?  

by standingup on Wed Jul 25, 2007 at 02:15:02 PM EST
[ Parent ]
Our lawsuit is asking a federal judge to issue an order to stop certain VA practices that we claim are unconstitutional or in violation of federal statutes.  

Some of the problems veterans are experiencing are not within the scope of the litigation.  Everyone should continue to pressure their members of Congress to pay attention to veterans issues, and to support policies that truly support the troops, including efforts to provide effective care and benefits, as well as appropriate funding and staffing to ensure veterans get what they need.

by mwk on Wed Jul 25, 2007 at 02:22:39 PM EST
[ Parent ]

of veterans that aren't covered?  

by roxy317 on Wed Jul 25, 2007 at 02:27:28 PM EST
[ Parent ]
Our lawsuit addresses veterans with PTSD who have disability claims pending in the VA process (either the initial application or an appeal).  It also includes veterans with PTSD who are eligible for medical care either because they have a disability rating or because they are within the two year statutory window for free care for troops who have deployed to a war zone.

As Ilona noted, we are seeking changes to the system of providing care and benefits, so others will benefit if we succeed.

I should also note that this is the class that has been proposed in the complaint; there is no official class until a court certifies one following a motion seeking class certification.  The final class definition, which determines who is part of the law suit, will be set by the court following a full briefing.

by mwk on Wed Jul 25, 2007 at 02:38:46 PM EST
[ Parent ]

As a layperson, what are the steps that we can expect from this point forward?

Is there a usual timeline for these types of class action lawsuits?

When would such a case be expected to have its first day in court? And once it arrives at that point, and receives the OK to move forward, how how long would such a lawsuit be expected to take before a decision is made generally?

Also, I'm not sure if you can comment on this, but I'm also curious how evidence and testimony will be given at trial. Would veterans be expected to testify publicly?
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by ilona on Wed Jul 25, 2007 at 02:23:55 PM EST

Complex actions in federal court move slowly.  The next formal step will be a response by the VA, which is not due until 60 days after formal service of the complaint.  At that time, they can either answer the allegations in the complaint, or file a motion to have the complaint dismissed.


by mwk on Wed Jul 25, 2007 at 02:27:25 PM EST
[ Parent ]
I heard Joe Courtney, Democratic Congressional Representative from CT-04 speak this weekend.  Joe won by 83 votes over his incumbent Republican appointment last november.

Joe recently visited Iraq and talked about walking around the Green Zone in a flak jacket.  But what really stunned him was, bad paraphrase here, a man who walked into his office last week with his orders for a fourth deployment in one hand and a ziplock bag full of prescription medicines for PTSD, anxiety, heart palpations etc. in the other.  

My question, does your suit address the damage done through the multiple deployments so that we can stop their use?

by Cho on Wed Jul 25, 2007 at 02:24:26 PM EST

We do have allegations that multiple deployments make members of the armed services more susceptible to PTSD, but we are not able to address the decisions on who gets deployed through our lawsuit.

by mwk on Wed Jul 25, 2007 at 02:33:06 PM EST
[ Parent ]
I just stepped aside for a moment to talk by phone with MSNBC -- they are giving this story a great deal of attention.  We're pleased with the interest in this issue.  

by mwk on Wed Jul 25, 2007 at 02:34:13 PM EST
way back in February of 2006 Blaming the Veteran, they mention Sali Satel...as a powerful force that is trying to push the reason that vets get PTSD is that they were pre-disposed to it before joining the military.  

What is your impression of her testimony?

by Cho on Wed Jul 25, 2007 at 02:47:30 PM EST
[ Parent ]

Sorry, but I still have not had the opportunity to see any of the hearing.  I expect to review the testimony.

by mwk on Wed Jul 25, 2007 at 02:59:48 PM EST
[ Parent ]
From the lawsuit:

12. Veterans with service-connected disabilities, including PTSD, are statutorily entitled to hospital care and medical services. These veterans, as well as their survivors, are also entitled to monetary benefits for service-connected disabilities or deaths. The process for a veteran to establish his or her right to these benefits is set forth in the Veterans Judicial Review Act...

We here at ePluribus Media have been tracking some of the tragic case of troops that have been slipping through the cracks in the ePluribus Media PTSD Timeline. There are far too many cases that we've discovered where veterans have gone into receive care from the VA, only to be given a number. Some have committed suicide before their first appointment date arrived.

Can you explain the statutory rights veterans (and the rest of us) have to receiving health care in a timely fashion?

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by ilona on Wed Jul 25, 2007 at 02:44:00 PM EST

In brief, there are two separate ways for veterans to be eligible for health care from the VA.  

The first is by obtaining a disability rating through the claims process (which is the process we claim in our lawsuit to be fundamentally flawed and unfair to veterans).  Depending on the rating a veteran is assigned, he or she is entitled to various benefits including health care.

There is also a separate statute, passed in the late 1990s (I believe), that provides two years of free healthcare through the VA for all veterans who have served in a war zone.  Unfortunately, some veterans have great difficulty accessing care that is supposed to be available under this statute because of limited availability of care and delays in the process.

by mwk on Wed Jul 25, 2007 at 02:57:57 PM EST
[ Parent ]

Based on the number of disabled we know about today, which for obvious reasons can't include those soldiers that will become disabled in the next two years based what we learned yesterday about the pentagon's plans to stay for another two years, what's your best estimate for what it will cost to take care of our disabled through their lifetimes?

by John Michael Spinelli on Wed Jul 25, 2007 at 02:44:44 PM EST
A study was issued by Linda Bilmes of the Kennedy School at Harvard addressing this issue.  I don't have it at my fingertips, but the estimated costs are astonishing.

We cite to this study in our complaint, which is linked at our website.  It may also be available on line if you try to search for it.

Sorry I can't be more helpful.

by mwk on Wed Jul 25, 2007 at 02:53:54 PM EST
[ Parent ]

The study you mentioned, Soldiers Returning from Iraq and Afghanistan: The Long-term Costs of Providing Veterans Medical Care and Disability Benefits.

Direct link to PDF.

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by ilona on Wed Jul 25, 2007 at 03:03:34 PM EST
[ Parent ]

Thank you for posting the link.

by mwk on Wed Jul 25, 2007 at 03:08:10 PM EST
[ Parent ]
There have been a number of suggestions made over the years to deal with the difficulties of providing care for our returning troops as the wars drag on.

The VA system is obviously over-taxed; my understanding is that there hasn't been much of an update in the way that it processes claims or makes its determinations (as to what percentage disability to give give a certain type of injury).

Harvard economist Linda Bilmes, for example, has suggested that in order to provide some immediate relief the VA should consider approving all claims for a certain period of time (6 mo. to a year) in order that we can keep veterans from slipping into bankruptcy, etc. while they wait for the backlog to be eased:

President Bush is now talking about spending more money on recruiting in order to boost the size of the Army and deploy more troops to Iraq. But what about taking care of those soldiers when they return home? The VA's solution is to hire an additional 1,000 claims adjudicators to cut the backlog.

A better idea would be to stop examining each application and instead automatically accept all disability claims, then audit a sample (like the IRS does for tax filings) to weed out fraud. Or at a minimum, simple claims should be fast-tracked and settled within 60 days. We should also place more counselors and more claims experts in the Vet Centers and harmonize recordkeeping so veterans can move seamlessly from the Army's payroll into VA hospitals and outpatient care.

Does the lawsuit offer suggestions in how to fix the system? If not, would you care to offer any of your own personal ideas on this, if you could?

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by ilona on Wed Jul 25, 2007 at 02:57:21 PM EST

We do have ideas for solutions, including some that could be ordered by a court, as well as others that will need to be addressed by policymakers.  

In brief, a judge can order the VA to stop some of its problematic practices, which we allege are unconstitutional.  For example, it can order VA to address all claims within a reasonable amount of time if it finds that the current delays violate a veteran's right to due process.  However, Congress will have to allocate resources to VA to allow it to meet any court order.  

Other issues, like the availability of health care for all veterans, are already in the political arena.  For example, there is a bill pending in Congress to increase the time for a veteran to receive free health care from two years to five years.  This is something a court could not order, but it is something people could ask their member of Congress to support.

I'll try to come back and expand my response later today, and also to respond to any new questions.  Unfortunately, I need to sign off for now.

Thank you all for your concern for veterans, and for your work on veterans' issues.

by mwk on Wed Jul 25, 2007 at 03:06:56 PM EST
[ Parent ]

...for sharing some of your busy day with us!

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by ilona on Wed Jul 25, 2007 at 03:18:35 PM EST
[ Parent ]
There's much I need to learn about this issue, but your answers have helped immensely.  I look forward to hearing replays of your MSN interviews.   Good luck.

by Cho on Wed Jul 25, 2007 at 03:27:54 PM EST
[ Parent ]
about that, was taking a nap. Don't get much sleep at night

by IraqWarVeteran on Wed Jul 25, 2007 at 03:00:37 PM EST
and thanks for exposing the technique of "personality disorder" as a way to dump the PTSD suffering vet out of the system.

by Cho on Wed Jul 25, 2007 at 03:06:55 PM EST
[ Parent ]
soldier, I would like to inform everyone of the Retired Army motto "Still Serving". Thats all I was doing, I was taking care of troops and still serving.

by IraqWarVeteran on Wed Jul 25, 2007 at 03:10:32 PM EST
[ Parent ]
I remember how the GI Bill which included VA medical benefits, housing assitance for new homeowners and money so that every veteran could go to college and greaduate school.

These days recruiters come to high schools and tell young kids a bunch of lies and even abuse the young women who volunteer to serve, while the hard-won rights of veterans are cutback. This kind of chiselling is typical of the present administration, and goes part and parcel with Bush's "philosophical" disinclination to adequately fund medical care for needy children whose parents are considered to be above the poverty line.

I think Michael Moore's powerful point in his new film "Sicko" is that the disgraceful failure of the U.S. medical system across the board reflects the governing class's contempt for the average--not to speak of the poor--American. Contempt for the individual, but not for power and the almighty buck says it all.

If they have no respect for the the worth of the young men and women whom they sent to fight an unwinnable war are of no concern to them, It really says it all.

by carol white on Wed Jul 25, 2007 at 03:50:54 PM EST

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