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War, Memory, and the Self: What Memento and Japanese Pottery Can Tell Us about Trauma Recovery

Humans love nothing more than a good story. In fact, we ARE stories. Our “self”– our perception of who we truly are — is nothing more than a story we tell ourselves, based on our memories and our perception of the world around us. The human brain is the most complex computer to have ever existed, and its main purpose is to tell us this story about who we are and about our place and purpose in the world.

The movie Memento is about a man named Leonard, who awakens each morning with his memories wiped clean. Using photos, a collection of notes, and his tattoos as a sort of surrogate memory, Leonard spends the first few hours of each day trying to piece together his past. Leonard, however, is not just reconstructing his past; he is also constructing a new identity to take with him into the future. It is this identity that will determine the actions his future self will take. We discover later that the data in the photos and notes is not reliable, and so the identity he constructs from this data leads him to take actions he would not have taken were he able to truly remember the past. PTSD is a real-world dysfunction of memory which can create a similar effect as this movie fiction.

We take photographs at family parties, on the days our children are born, on our wedding days. There were many “never forget” banners and bumper stickers after 9/11. We do this because we define ourselves and create our identities with these things that have happened to us, these things which we experience deeply, and our reactions to those situations. They are the bricks with which we construct our identity; they are Leonard’s tattoos. Normally, we experience events and we integrate the memories into our concept of our “self.” Memories of your children help define you as a father, memories of performing good deeds help define us as “good” or “moral.”

The brain does not only create this “self,” but it also works hard to maintain our current concept of the “self” and of the world around us. When we have new experiences, the brain integrates these experiences into our memory, and fits the experience into our pre-existing concept of ourselves and the world.

War, however, changes everything.

Imagine an 18-year-old soldier’s mind as a filing cabinet. The cabinet is full of folders, and each memory is stored in a folder with a label. His graduation from basic training is filed under “success” and “pride.” Spending Christmas at home is filed under “family” and “love.” His squadmates are filed under “brotherhood” and “unity.”

He is sent to Afghanistan for reasons he doesn’t quite understand, and he is in the backseat of a Humvee that runs over an IED. He is the lone survivor. He sees his best friends dismembered, maimed, screaming in pain but he is powerless to help them. He collects the body parts of Afghani children who were killed when he ordered an airstrike on insurgents, not knowing they were using children as shields.

The young man’s brain struggles to file these experiences, but no appropriate folders exist. In fact, some of the pre-existing folders don’t even make sense anymore. He feels such severe guilt for his actions, even for his survival, but there is no folder called “killer,” and he is beginning to question everything in the “good” or “moral” folder. The “invincible” folder that is so large in most teenagers now seems completely ludicrous, as death has suddenly become something real and tangible. Upon his return home, he may feel betrayed by the very country he swore his life to defend and protect. The trauma of war is so completely destructive to his sense of self that it shatters his perception of the world as meaningful and comprehensible. War has robbed him of who he is on a fundamental level, and decimated his feeling of control over the external world.

For those with PTSD, there are many treatments that alleviate symptoms. Medication helps with panic attacks and anxiety, family and group therapy helps with isolation and detachment, Imagery Rehearsal Therapy helps with nightmares, and Exposure Therapy helps reduce re-experiencing and fear. These therapies help a PTSD sufferer better deal with everyday life, but true healing cannot begin until the veteran is able to reconstruct his sense of self and rediscover meaning in his life.

In 2001, the PTSD program at the Connecticut Veteran’s Hospital realized that many of the veterans under their care were experiencing these existential problems. They incorporated Logotherapy, a therapy centered on finding meaning, into their regular treatment plan. Logotherapy was developed by Victor Frankl, a Jewish Psychiatrist imprisoned in Nazi concentration camps during world War Two. Amidst the horrors of the concentration camp, Frankl noticed that the defining characteristics of the prisoners were not fear or hopelessness, but love, compassion, and “tragic optimism.”

The VA’s Logotherapy program centers around these principles, helping vets rediscover meaning and purpose in their lives- not despite their painful experiences, but because of them. They learn to view themselves not as victims of unfortunate circumstances, but as people who have seen the worst the world has to offer, and become stronger because of it.

Community Service is a mandatory part of the program, and veterans find meaning in helping others. Some Vietnam Veterans raise money for Cambodian schoolchildren. Veterans who have lost friends with children set up scholarships in their name, tutor the underprivileged, or throw birthday parties for foster children. The vets begin to realize that although they lost the “self”` they had been building before the war, their understanding of human suffering, of pain, of horror has led them to create an even better “self,” and that the world around them has become a better place because of their existence. They have become the heroes they intended to be at enlistment. As one vet put it:

“War is about destroying lives and everything beautiful. I was a kid then, but now that I’m older, it just makes me want to create and build things and appreciate the beauty around me.”

Before I was a disability advocate at Hill & Ponton, I worked for years in inpatient psychiatry. Part of my job was designing and leading group therapy sessions for our patients — typically people who suffered from severe and persistent mental illness. Many suffered abuse, addiction, abandonment, tragedy, and hopelessness. The group that most patients responded to best was a discussion about a style of Japanese Pottery called Kintsukuroi. When a beautiful bowl has been broken, the artist uses gold and silver solder to mend the bowl, and the resulting lines of gold and silver make the bowl even more striking than before the break. Like the veterans, it is the bowl’s fragility and vulnerability which ultimately lead to its value and its unique character.

The piece has become more beautiful for having been broken.

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by Chris Amidon, Veterans Advocate
April 21, 2014

Hazardous Exposures of The Gulf War, OEF, OND, and OIF

There are many environmental and chemical hazards that veterans may have been exposed to. These hazards carry potential health risks for veterans. The exposures include infectious diseases, inhalation of sand, dust, and other airborne particles.

Veterans that were deployed to dusty environments were exposed to sand, dust, pollution, and other airborne particles. These particles are inhaled by veterans and become trapped in the nose and throat or inhaled deep into the lungs. This can cause respiratory and cardiopulmonary problems.  Some of the exposures may have been dust, soil, metals, or liquid droplets that can include acids and chemicals.  Symptoms of exposure may include irritation of the eyes, nose, throat, and skin, or cold or flu-like symptoms, such as coughing, runny nose, and shortness of breathe.

The VA has ongoing studies to learn more about the affects on Veterans health after hazardous material exposure.

There are nine infectious diseases that the VA presumes to be related to military service in the first Gulf War starting August 2, 1990, through the Iraq conflict, and on or after September 9, 2001 in Afghanistan. The veteran must have one of the diseases within the time frame the VA specifies for that disease, and the veteran must have a disability as a result of the disease to qualify for compensation.

The VA will recognize the following diseases if the veteran develops the disease with in one year of military separation and is at least 10% disabling:

Brucellosis

Campylobacter Jejuni

Coxiella  Burnetii ( Q Fever)

Nontyphoid Salmonella

Shigella

West Nile Virus

Malaria has the same time frame as the above listed diseases but does have an exception as to when the incubation period began during a quali

The VA has not given time frames for the development of the following diseases:

Mycobacterium Tuberculosis

Visceral Leishmaniasis

The VA has the Gulf War Registry Health Exam that allows Veterans to be alerted of possible long-term health problems relate to environmental exposures. These exams are free to eligible Veterans, enrollment in the VA health care system in not necessary, and can receive other registry exams if other problem develop. The VA is working on opening a new registry for Airborne Hazards and Open Burn Pit exposures.

If you feel that you have been exposed to any of the above listed hazards and are suffering from health problems, contact your local VA health care system or VA Environmental Health Coordinator.

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by Amanda Martin, Veterans Advocate
April 16, 2014

Separation Due to Personality Disorders: A Study in Contradiction

The United States Army put the 36 year-old man in handcuffs. They isolated him in a six-by-eight foot cell. The lights were kept on all night, and loud heavy metal music often blared, ensuring the man would remain sleep-deprived. They denied him food and showers for lengthy periods of time.  The guards would ridicule and humiliate him nearly constantly.  Whenever the man became angry or despondent, the guards would hold him down and inject him with sedatives. The Army was trying to force the man to sign a paper, and the man had decided he was going to hold out as long as he possibly could. He was given a choice: sign the paper, or remain in his cell indefinitely. Finally, the man could not hold out any longer, and signed the paper.

Who was this man, and what was he signing? Was this a member of Al Qaeda in GuantanamoBay, refusing to sign a confession? A member of the Afghani Resistance, refusing to reveal the locations of Taliban weapons caches?

The man was Chuck Luther, and he was a Sergeant in the US Army. He was the recipient of three Army Achievement Medals, and a Combat Action Badge. Luther was on guard duty in Iraq one night, when a mortar struck near his guard tower. The noise was deafening, and his head and right shoulder slammed into the concrete. Sgt. Luther sought medical attention for his shoulder, his headaches, hearing loss, tinnitus, and vision problems. The doctors on base, however, told him that he was faking his symptoms due to a personality disorder. The papers he was forced to sign were discharge papers stating that his behavior (“lying” about his health problems) was the result of a personality disorder.

If a veteran was discharged under Regulation 635-200, Chapter 5-13: “Separation Because of Personality Disorder,” that veteran isn’t eligible for disability, VA healthcare, and even needs to repay his signing bonus. The rationale is that the military considers a Personality Disorder a pre-existing condition. On average, there are over one thousand discharges due to personality disorders every year.

The Military’s stance on personality disorder discharge raises several questions:

1.)   If Personality Disorders are pre-existing conditions, why are they not properly screened for upon enlistment?

2.)   Is the Military’s stance that personality develops during childhood and adolescence, but abruptly stops right before the minimum age for enlistment?

3.)   If a veteran truly DOES have a personality disorder, and personality disorders (by definition) cause significant impairment, how are they not a disability?

The rationale used by the military in regards to Personality disorders is rife with contradiction.

The answer to the first question is fairly obvious: the military DOES screen enlistees for mental health problems. If asked how so many enlistees with personality disorders made it through entrance processing, no doubt the military would reply that tests that measure personality traits are highly subjective, and are subject to falsification.   Of course, it follows that they are using the same subjective and easily falsified measures to discharge vets as well.

Even the study of personality is subjective. There is no one true definition of personality. Most theorists will say something similar to “an individual’s persistent way of behaving, thinking, and feeling.” There are numerous traits that compose one’s personality. When certain traits are high or low in combination with each other, AND this combination of traits leads to distress, social, or occupational problems, you have a personality disorder.

The military’s contention that personality traits are fixed in childhood or adolescence is also a contradiction. Military basic training is precisely designed to change an individual’s persistent way of behaving, thinking and feeling.  This works particularly well in recruits under the age of 25, as the human brain is not fully developed until around that age. In fact, the research shows that personality traits such as conscientiousness change quite a bit before the age of 30, after which the change slows. Some traits, like agreeableness actually change MORE after the age of 30 than before.  The fact that personality traits are malleable, coupled with the fact that soldiers are subjected to extreme cultural and environmental factors, leads one to believe that the military and VA assertion that all personality disorders are pre-existing conditions seems dubious at best.

Further, personality disorders often cause cognitive and emotional changes that can drastically affect an individual’s occupational and social functioning, often even more severely than mental disorders the military and VA recognize as disabilities. This would seem to warrant the classification of personality disorders as disabilities.

The military’s current use of personality disorders is troubling, to say the least.   It would appear that the military is using personality disorders as a cost-saving measure. Cheating veterans out of compensation and healthcare undoubtedly saves millions of dollars. However, it comes at an even greater cost- ruining the lives of veterans who fought for our freedom.

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by Chris Amidon, Veterans Advocate
April 10, 2014

Denied Social Security or Disability Benefits? Seek Legal Advice

legal adviceEach year, millions of Americans apply for Social Security Disability (SSD) and Supplemental Security Income (SSI), and the vast majority of those applicants are denied. Between September 2012 and June 2013, only 29.4% of initial SSD/SSI applications were accepted, and just 10.2% were reconsidered.

If you’ve been denied Social Security benefits because of a disability, you may need to contact a Social Security disability attorney for legal advice about how to get your benefits.

What are Social Security Disability and Supplemental Security Income benefits? SSD and SSI benefits ensure that low-income aged, blind, and disabled individuals receive necessities such as food, clothing, and shelter. For many elderly individuals over the age of 65, SSI is sometimes their only source of income, and without it, millions of Americans would lose their homes and go hungry. In the state of Florida alone, SSI is the only source of income for one-third of residents over age 65; without those benefits, over one million elderly Floridians would fall into poverty. As the number of Americans reaching age 65 increases over the next two decades, with some figures putting that increase as high as 31%, it is important that individuals who are aged and unable to work have the protection that Social Security offers.

The dispersal of SSD and SSI benefits also affects those with disabilities, including but not limited to blindness, physical disabilities, mental illness, chronic illnesses, persisting injuries or conditions, and other impairments. This service is especially important for our country’s veterans, many of whom may suffer from post traumatic stress disorder and other types of military trauma, including lasting physical injuries. Whether the claimant in question is a veteran or not, those who apply for SSD benefits must be able to prove their inability to work due to a medical condition that will last at least one year. This proof is often provided through medical records or other data.

Before applying for SSD/SSI, many applicants seek legal advice, as a lawyer can provide defense in a disability hearing. For as many as 70% of applicants, however, it is common to be denied SSD/SSI the first time around, especially without Social Security legal help. From there, some applicants may choose to reapply, but this is unnecessary and time-consuming. Instead, if you have been denied, be sure to request an appeal for your case, and do so before the 60-day deadline for an appeal. Having a lawyer present at an appeals hearing can not only increase your chances of winning your case but also potentially help you see more in backpay resulting from your denial.

If you require additional legal advice on your disability or Social Security case, make sure to contact a lawyer who specializes in Social Security law. Many of these practices also help veterans receive their VA disability benefits as well. Overall, don’t get discouraged if you are denied SSD/SSI. Find out why you were denied, follow protocol for appealing, and, if necessary, consult a Social Security lawyer for legal advice in order to get the money you deserve.

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by Matthew Hill
April 9, 2014

“What Was I Fighting For?” – Veterans, Mental Illness, and Criminal “Justice”

On a chilly night in February, 2014, Marine veteran Jerome Murdough sought shelter in the warm stairwell of a housing project in Harlem. Jerome suffered from both schizophrenia and bipolar disorder, and was homeless. Police arrived, and instead of assisting the veteran, decided to throw him in a small cell on Riker’s Island, in a wing devoted to “close observation” of mentally ill criminals. In this unit, inmates were to be observed at least every 15 minutes. It is clear that this did not happen.

Mr. Murdough was found “baked to death” the next morning, a condition officials blame on an “equipment malfunction” with the heating system. His core body temperature was still 100 degrees when the medical examiner performed the autopsy.

95-year-old WWII veteran John Wrana sat in his retirement home, refusing to undergo yet another surgery. Police arrived to force the frail old man, who required the use of a walker, to comply with medical staff. The staff pleaded with police to allow them to calm Wrena. Police refused, and burst through the veteran’s door with a riot shield. They tazed the man, and fired several beanbag rounds from a shotgun into the veteran’s chest as he sat in his chair. Police claimed the man had a 12-inch butcher knife, but staff and family knew of no way Mr. Wrena would have been able to acquire such a knife, and no knife was found at the scene. Before Mr. Wrena passed away, he asked to speak to his daughter. A doctor held a phone up for the dying veteran, and John spoke his last words to his daughter: “Thank you for everything you’ve done for me. I love you and goodbye.”

In November of 2011, retired Marine Kenneth Chamberlain, Sr. accidentally activated his Life Aid medical alert necklace while sleeping. He wore this necklace because of his severe heart condition, and it alerted a dispatcher, who dispatched an ambulance and police officers to his home. When the police arrived, Mr. Chamberlain told them he did not need any help. He talked to the Life Aid dispatcher, who attempted to cancel the call. Mr. Chamberlain refused to open the door for officers, who threatened him through the door, and yelled racial epithets. The police burst through the door, tazed the veteran, shot him with beanbag rounds from a shotgun, and finally shot him twice in the chest with live ammunition. Police claimed Mr. Chamberlain had a knife, but video footage from the camera mounted on the taser showed a calm, unarmed Chamberlain, with his hands at his sides. No knife.

Parminder Singh Shergill was suffering from a panic attack from his Iraq War-related PTSD when police were called to his house in January, 2014. His mother had called the police, expecting them to assist him, to take him to the VA hospital for acute treatment, as had been done in the past when Shergill had had PTSD-related attacks. Instead, police fired at him 14 times, killing him in front of eyewitnesses and his family. Police say he ran towards them brandishing a knife, but according to eyewitnesses and the family’s lawyer, the veteran had no knife, and did not lunge towards the officers. Shergill, who had degrees in Electrical Engineering, and Biochemistry, was buried with full military honors.

There are many stories like this, Justin Crowley-Smilek was shot 7 times, including in his back, by an officer in Farmington, Maine after going to the police station to ask for help with his mental illness. Gulf War vet Stanley Gibson was shot by police after being taken in for psychiatric evaluation twice in the preceding 48 hours, due to a psychiatric crisis caused by running out of a prescription. He received no psychiatric help, and was unarmed at the time of his death, his hands raised in the air in surrender.

These stories, and the many more like them, raise several important questions:

  1. Are veterans being provided with adequate care and medical treatment?
  2. Are law enforcement officers being adequately trained in appropriate procedure in dealing with psychiatric crises?
  3. Exactly what freedoms were these veterans fighting for?

All of the above stories feature a veteran of the United States armed forces- a person who volunteered to fight against foreign and domestic enemies to preserve and protect the freedoms we hold dear. They signed up believing that the United   States was not a country whose militarized police force killed unarmed citizens with little or no consequence. They signed up believing we are a country who reveres its veterans, and protects its citizens from harm, even those with mental disorders. Jerome Murdough not only shouldn’t have been “baked to death” on Riker’s Island for a misdemeanor trespassing charge- maybe he should never have been homeless to begin with.

So many of our veterans fight for years overseas, believing they are fighting to preserve liberty back home, and then are entered into a fight for their own rights- the fight against their illness, the fight for adequate healthcare, the fight against poverty as their VA claims are denied, and they are unable to work due to their disabilities. They are fighting a justice system where they veterans account for 9% of the total prison population in a country with the highest per-capita prison population in the world.

So many vets have fought enough already. Perhaps it’s time we fight for them.

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by Chris Amidon, Veterans Advocate
April 7, 2014

The United States Department of Veteran Affairs

As long as we’ve had people in this country, we’ve had some sort of help available for disabled veterans.  History tells us that in 1636, the Pilgrims of Plymouth County established a law for the soldiers who fought the Pequot Indians.  The law stated that the disabled soldiers would be supported by the colony.  What history doesn’t tell us is how long it took to pass that law, and how many soldiers suffered until help was established.

The Department of Veteran Affairs has come a long way.  The VA, as one major administration, was established by Congress in 1930.  Before that, the states managed veterans’ homes, which included healthcare and support.  As the years have passed, the VA has grown to include things like the GI Bill in 1944, the establishment of a Cabinet position in 1989, and a host of expanded benefits for veterans and their families.

The VA has also become mired in a sea of red tape.  Veterans’ benefits have become a political pawn, subject to the whims of politicians. There’s a backlog of veteran claims, and veterans are dying, waiting for claims to be decided.

Last month, the Senate shot down a bill that was proposed in Congress for Veteran Benefits.  Senator Bernie Sanders (I-Vt.), chairman of Veteran Affairs Committee, had proposed a bill that offered numerous new benefits and broadened current benefits to our veterans.  The legislation included allowing many uninsured veterans, ones who didn’t have service connected disabilities, access to the VA health care system.  It included increasing the period of time veterans are allowed to enroll in the VA health-care system from five years to 10 years after deployment.  It would have allowed the VA to open up 27 new treatment facilities.  It would have repealed a military pension cut for future troops.

Why?  Why would anyone shoot down a bill that benefitted our veterans?  What possible reason could anyone have for making the people who fought for our freedom suffer more?

One of the major reasons given (besides the cost, of course; money is always a factor) was the burden to the current VA system.  Opponents argued that the current VA disability system could not handle add any more claims to its burden—that before they (the opponents) would add anything else, we had to fix the system that we currently have.  How can we add people to the system, they argued, when we can’t even help the ones that are already there?

So okay, then.  In my next couple of blogs, we are going to examine the system.  We are going to look at just what the system is, what it does, where its problems lie, and how it can be fixed.  Check back for more information in the coming weeks.

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by Lora Wentzel, Veterans Advocate
April 2, 2014

VA Ebenefits and service connected compensation


Matthew:  Hello, and welcome to the Hill and Ponton Veterans Video blog. My name is Matthew Hill and I’m here with Carol Ponton. Today we’d like to talk to you about eBenefits. It’s the VA’s system for veterans to be able to check on their claims and look at their medical records online. This is a good start.

Carol and I were talking about how this is progress in that veterans now can access the VA more easily. They don’t have to call the 1-800 number. The VA is using technology of modern era and the veteran can see some of what’s going on in their claim. But there’s a catch.

Carol: Like usual with the VA, it’s good news and bad news. The good news is they finally are trying to get online. When that’s complete, it’s going to be wonderful. But right now it’s not complete and it’s not wonderful. It’s very concerning for a lot of the veterans.

One of the good things about it is that the eBenefits will allow you to go online and get all of your medical records for the last year and see what’s going on as far as the doctors are saying. It also shows what payment you’re getting. It shows what’s going on with some of your decisions. But there’s the catch. In order for anything to get into this electronic modern age site, somebody has to put it there.

You see on your eBenefits site that you don’t have a claim for whatever you file for and it’s because it’s sitting on somebody’s desk in a huge stack of paper. Until somebody actually gets to working on your file for whatever issue it is, usually nothing goes into that eBenefits site. The medical is very updated because it is totally online. It’s wonderful.

Matthew:  It’s paperless.

Carol:  They are totally paperless.

Matthew:  The benefit system says they want to be paperless. The VA Health Administration actually is paperless. So, as soon as it’s input, it’s there.

A lot of our veterans have trouble – and frankly, we do as well – with that in that their VA health records are there immediately, yet any records that are sent in to the Veterans Benefit Administration don’t show up, so we actually get a lot of flak from our veterans saying, “Where did this document go? What’s going on?”

We send all of our documents – appeals, claims, all of those – via certified mail, signed receipt because we too are concerned that they don’t show up. But they’re there, and as Carol said, there’s this element of human input that is still frightening for us, and frankly still delays the system.

Carol:  It’s very frightening. I had a client that was furious because she was sure we hadn’t filed the appeal,. and this had been eight months ago. We not only filed them. We filed them twice. We fax and we send by certified mail. We can prove it. She had gotten the congressman to look in. The congressman looked online and said, “There’s nothing there.” They just hadn’t put it up yet.

It’s not that it takes a couple of months. Often it can take years until they’re ready to get around to working on that issue.

Matthew:  One suggestion we have for the VA is to timely send out a receipt of a Notice of Disagreement. They send them out sometimes. They don’t send them out on others. As it is now, as Carol said, we’ll send the Notice of Disagreement two times. Sometimes we send it four times. We get flak about that from the VA adjudicator saying, “Why are you trashing this file with all this paperwork?”

We say, “You never told us you got it.”

There’s still a work in progress there as far as how the eBenefits system works, as far as how their electronic system works, when it comes to actually showing what has been sent in, showing what has been received by the VA.

Carol:  Don’t necessarily have a heart attack when you look on there. But if you’re concerned, do continue to send letters to the VA just in case. This is one of the cases where they haven’t got any records. If you might send to the VA comments about the concerns that you have, maybe that will help them work on this.

Matthew:  This is Matthew Hill and Carol Ponton of the Hill and Ponton Veterans Video blog. We hope to see you again soon.

Carol:  Have a great day!

 

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by Matthew Hill
April 1, 2014

Ionizing Radiation and What You Need to Know

There are several presumptive diseases related to ionizing radiation exposure. The diseases include:

-        Cancers of the bile ducts, bone, brain, breast, colon, esophagus, gall bladder, liver (primary site, but not if cirrhosis or hepatitis B are indicated),   lung (including bronchiolo-alveolar cancer), pancreas, pharynx, ovary, salivary gland, small intestines, stomach, thyroid, urinary tract (kidney/renal, pelvis, urinary bladder, urethra).

-        Leukemia (except chronic lymphocytic leukemia)

-        Lymphomas (except Hodgkin’s disease)

-        Multiple Myeloma (cancer of the plasma cells)

Veterans that suffer from one of the above diseases do not need to prove connection between their disease and their service to be eligible for disability compensation. If the veteran were to pass away from one of these diseases, the surviving family members may qualify for survivors’ benefits. The VA has recognized that these diseases are related to ionizing radiation exposure.

There are other diseases that the VA recognizes that may have been caused by exposure to ionizing radiation. These include:

-        All cancers

-        Non-malignant thyroid nodular disease

-        Parathyroid adenoma

-        Posterior subcapsular cataracts

-        Tumors of the brain and central nervous system

With these diseases, the VA will look at these claims on a case by case basis. They will take into consideration how much radiation the Veteran was exposed to and the period of time between the exposure to radiation and the development of the disease.

There are groups of Veterans that participated in “radiation-risk activity” and may have been diagnosed with one of these diseases or may be at risk of developing one of these diseases. These groups include:

-Veterans that were prisoners of war in Japan during World War II

-Participated in the occupation of Hiroshima and Nagasaki, Japan between Aug. 6, 1945   and July 1, 1946.

-Participated in atmospheric nuclear weapons tests conducted in Nevada and the Pacific Ocean between 1945 and 1962.

- Veterans that were a part of underground nuclear weapons testing at:

- Amchitka Island, Alaska before January 1, 1974

- One of the following gaseous diffusion plants for at least 250 days before   February 1, 1992: Paducah, Kentucky; Portsmouth, Ohio; or K25 in Oak Ridge, Tennessee.

There is an ionizing radiation registry exam that Veterans may take advantage of at no cost to them. Being on the registry can allow for alerts to be sent to the Veterans regarding possible long term health problems related to ionizing radiation exposure. It is important to understand that this exam is not a disability compensation exam, nor is it required for other VA benefits. If a Veteran would like to be considered for disability compensation for ionizing radiation exposure, they must file a claim. The VA will then confirm the exposure by checking military records. Veterans do not need to be enrolled in the VA’s healthcare system. The exam is based on what the Veteran recalls and not on military records. The exam does not confirm exposure to radiation. If further problems develop, additional registry exams can be obtained.

Veterans that have been exposed to the above stated areas during service are eligible for the exam. Family members are not eligible. Veterans can contact their local VA Environmental Health Coordinator to find out more information about getting an ionizing radiation registry exam.

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by Amanda Martin, Veterans Advocate
March 28, 2014

Traumatic Brain Injury Benefits Expanded

In December of 2013, the U.S. Department of Veteran Affairs published a proposed rule to expand benefits for veterans suffering from a traumatic brain injury. The new proposal stems from a report from the National Academy of Sciences, Institute of Medicine, which found sufficient evidence to link moderate to serve levels of TBI to five additional ailments. These ailments include Parkinson ’s disease, dementia, depression, seizures, certain diseases of the hypothalamus and pituitary gland.

As of January 15, 2014, a veteran with a TBI and is diagnosed with one of the five ailments, will be able to collect additional benefits.

There are time frames from the time of the TBI and the onset of the secondary disease that the VA will look at when granting the additional benefits.

If a vet that has suffered from a TBI develops Parkinsonism, including Parkinson’s disease, there is no time limit between the TBI and the onset of the disease.  In the studies performed, three primary and one secondary, with 196 participants, there was sufficient evidence that there was an increased risk for the onset of Parkinsonism after suffering from a moderate to severe traumatic brain injury.

Seizures that occur seven or more days after a TBI, is considered to be unprovoked. As with Parkinsonism, there is no time frame from the time of the traumatic brain injury to the time of the first seizure. In the study performed, ten primary studies and 19 secondary, there was sufficient evidence that unprovoked seizures were strongly associated with most types of TBI.  The group with the highest risk for seizures was those who suffered from a penetrating head injury. 32%-53% had seizures. After a closed injury to the head, seizure risk is based on the severity of the trauma.

Specific forms of Dementias have time frames from the time of the TBI to the time of the onset of the disease. For the VA to recognize the secondary disease, the vet would have to have been diagnosed with presenile Dementia of the Alzheimer’s type or post-traumatic dementia within 15 years of the traumatic brain injury. The study investigated WWII Navy and Marine Corps veterans in one primary study and nine secondary studies with 548 veterans with a closed injury. The study found that the more severe the brain injury, the more likely for the development of a form of dementia.

Depression is recognized as part of a traumatic brain injury if the onset is within three years of a moderate to severe TBI and 12 months after a mild TBI. The study included four primary studies and five secondary with 939 participants. In the study, it was found that major depression after a TBI is more significant in someone that had major depression before the TBI. It did find that there were higher rates of major depression 6 months or longer after a TBI.

With diseases of hormone deficiency, the VA will recognize it if there is an onset of the disease within 12 months of a moderate to severe traumatic brain injury. The most common is growth hormone insufficiency. There were five primary studies with 102 participants. The studies found that 9 subjects were in acute phase, 5 recovered after 6 months and 2 additional subjects developed a deficiency. After one year, 5 had a growth hormone deficiency.

If you suffer from a traumatic brain injury and one of these five ailments, be sure to consult with someone to see if you are eligible for additional benefits.

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by Amanda Martin, Veterans Advocate
March 26, 2014

VA Disability Benefits, Agent Orange and Heart Claims


Matthew: Hello, and welcome to the Hill and Ponton Veterans video blog. I’m Matthew Hill.

Carol: I’m Carol Ponton.

Matthew: We’re here to talk to you today about heart claims. Ever since the VA passed the new legislation on Nehmer cases, or what we all know as Agent Orange cases, and finally admitted that Agent Orange causes heart disease, the number of heart claims has increased dramatically.
What we’ve been seeing at Hill and Ponton is, after the VA concedes that the veteran has heart disease, they’ve been underrating the veteran. Meaning, they say, “Okay, you have this,” but then they don’t rate it properly.
I just want to give you a quick synopsis on how the rating works. The VA looks to what are called METs. It’s a fancy medical term which essentially means what your energy equivalent is, what you’re able to do physically. There are two ways to measure METs. The first way is a nuclear stress test, which is essentially an objective way of doing that.

Carol: You actually are exercising, but they have all kinds of things hooked up to your body to see exactly how stressed your body is and how much it is able to work. You get a grade. You get how many METs you were able to achieve.

Matthew: The other way is for an examiner to subjectively assign METs just based on the examiner’s conversation with the patient, with the veteran. To give you a rundown, the VA groups the METs. The higher the METs, the more physically active you are, the healthier you are.
The VA says 1 to 3 METs, for example, the veteran receives 100% rating. I think 3 to 5 is 60% and 7 to 10 is 30% rating. But what they don’t tell the veteran is the VA examiner is given a sheet to fill out. That examiner is supposed to look at activities the veteran is doing.
For example, to show that a veteran’s METs are from 7 to 10, that would be the equivalent of being able to climb stairs quickly, moderately going on a bicycle ride, or jogging at six miles an hour. If you’re able to do that, you are rather healthy.
When you get down from 5 to 7 METs, the VA says, that’s equivalent of walking one flight of stairs, golfing without a cart, mowing your lawn with a push mower (the push mower being without a motor) and then doing heavy yard work.
What the VA examiner is supposed to do is check the box that reflects the lowest activity you as the veteran can do before you start getting symptoms of dizziness, of fatigue.

Carol: Shortness of breath.

Matthew: Problems like that. The problem I’ve seen with this is the veteran will go in and have an exam and the VA will check a box saying that he’s got 5 to 10 METs, saying that he can golf without a cart or he can push a mower without a motor.
I’ll talk to the veteran and I’ll say, “What’s the most active thing you do?”
They’ll say, “Sometimes I mow my lawn.”
I’ll say, “Okay. Was that a lawnmower without a engine?”
They’ll look at me and laugh and say, “No. I have a sit-on, ride-on lawnmower because I can’t walk very far.”
It’s important for you, when you go into these exams and they’re measuring what your rating should be that you are thinking about, “What is the most strenuous thing I can do in a physical activity standpoint without having the symptoms of fatigue or dizziness?”

Carol: Also, you need to think of the qualifications. If they answer, “Yes, I can mow my lawn,” it’s fine with the examiner. He just checks the box. You need to make sure that any qualifications to what you can do are noted and made very clear to the examiner: “But it has to be a riding lawnmower. Sometimes I can’t even do that because of the sun. I just become fatigued and I start getting chest pains.” Anything he asks you, if it’s something that’s “yes but,” make sure you go ahead and make sure you tell him all the limitations you have of that.

Matthew: On that note, I would strongly recommend for male veterans having heart pains that they bring their wives. I can’t tell you how many vets I’ve spoken with where they say, “Yeah, I can go out and mow my lawn,” and say it as if it was nothing, and then the wife will chip in and say, “Yes. But he’s in bed for the rest of the day.”

Carol: Exactly.

Matthew: I found that it’s very important to have a wife there or someone who sees the veteran on a day-to-day
basis because sometimes the vet doesn’t even realize his limitations.

Carol: Sometimes men don’t like to admit that there are some problems and it hurts them. That’s really not fair to anyone.

Matthew: As Carol says, they’re going to check a box. The VA examiner has more patients to see, other things going on. They’re not going to probe and see what’s really going on. It’s important that you think about that when going in. Even if you can do an activity, even if you can go out and jog, if that makes you have to go to bed for the rest of the day or it really destroys your physical abilities after that, you need to keep that in mind.
Thank you for joining us here on this blog about heart disease. It’s important to remember the least physical activity you do when you get symptoms and bring your spouse/significant other when you do go to the exam.

For Questions About Your Disability Claim... Contact Us



by Matthew Hill
March 21, 2014

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