Support to Help Combat Veterans
“Support” may be necessary if a veteran is unwilling or unable to take the necessary action that is required to confront psychological, medical or readjustment problems caused by Combat that are negatively and progressively affecting the veteran and/or family.
Sometimes, family members and friends notice changes in a veteran that cause them to be concerned. If those changes last longer than 6 months and are progressively worsening, then it may be helpful to intervene to “support” the veteran in finding assistance. Veterans are extremely strong and resilient and incredibly talented in guarding our safety. All strengths can also be challenges (no matter who you are). Sometimes, veterans have endured such extremes to keep us safe, that they may have difficulty recognizing when or if they need personal care. After all, their life has been committed to caring for us above themselves. Also, the “systems of care” might be overwhelming and too complicated. So, whether you are a veteran or the family or friend of a veteran, the following is a “check list” and some helpful steps that can be taken to obtain good records and good care.
A very important note is that many people think that all of the veterans medical records and care is “seamless” and that it is in one location and easy to obtain. This is not correct. In fact, the VA and the Dept. of Defense have been working very hard to computerize and align these systems but the earliest time of completion is projected in 2015 and some reports indicate that it will be 2017. That means that the veteran OR a loved one or friend will need to keep careful and systematic records because that is currently not available, and if it is, it is often not available in a timely or systematic manner.
Hopefully, you will have immediate support from the veterans’ unit, the VA and the healing community, but if not, these steps may be helpful in finding the support you need to help the veteran in your life. If you have questions about any of these items, feel free to “contact us” and we will try to help you.
| Getting Organized | |
| 1. | Start a file tub or cabinet drawer. Suggested files to label as a start are:
DD-214
Copies of VA Benefit Rulings (Education, Disability, etc.) Copies of VA Medical Documents Other official documents |
| 2 | Consider beginning a journal that logs dates, times and circumstances of important issues affecting your veteran. This can serve as a helpful guide as you discern ways to help your veteran and family. |
| Registering For VA Medical | |
| 3 | If the veteran has just returned from active duty, insist that he/she registers with the VA Hospital in your region. This is ESSENTIAL. The veteran may have other forms of medical care, but this MUST be done. Go to www.va.gov and to the “health care” link to find out how to register.
The veteran should go when he/she IS NOT SICK or having problems. The process can be long and frustrating. Do NOT wait for illness to go to register. It is a benefit they have earned and it will be very important if later illnesses are discovered. (Note: Many times soldiers procrastinate with this when coming home. This is to be expected. However, putting this off can have very negative impact later. Lovingly ask your veteran to be accountable to you by showing you his/her VA Hospital Card to validate it has been done and/or offer to go with your veteran to register).
ALL VETERANS WHO HAVE BEEN IN ACTIVE DUTY SHOULD REGISTER IMMEDIATELY UPON RETURN.
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| 4 | If the veteran is eligible for TriCare Reserve Select or other TriCare Health Insurance benefits, insist that he/she registers for this insurance as well. Many veterans do not like going to VA and have civilian options with TriCare. It is low cost and good coverage. (tricare.osd.mil then click on Reserve Select).
THERE IS A TIME LIMIT TO REGISTER, SO BE AWARE.
SERVICES “CLOSER TO HOME”: Veterans who live in areas that are not close to Regional VA medical offices may be eligible for an “Outpatient Fee Card” (VA document M-1, Part 1, Chapter 18) which states, “When appropriate VA officials determine that certain VA services are unavailable or cannot be economically provided due to geographic inaccessibility, the veteran with special eligibility may be authorized fee-basis care, but only as described in this chapter”.
Therefore, if you live in a rural area or an area that cannot easily access VA Medical benefits, make sure that you apply immediately for an “Outpatient Fee Card.”
MEDICATIONS: VA Hospitals can mail medications to Veterans who have been approved for the services. This is helpful for Veterans that live in remote areas or who do not have transportation. As will all medications, they should be distributed and administered with great care. If your Veteran has a substance abuse disorder, or you are aware that your Veteran may “loose track” of when/if meds were taken, discuss this with your Veteran and caseworkers at the VA Hospital. Care and caution should be paramount.”
CASE MANAGEMENT: It will be important for you to get to know the social workers/case managers who are working with your Veteran. You have the right, as much as the Veteran does, to contact them and inquire about services and your Veterans status. Social Workers/Case Managers can help pull together all aspects of a Veterans care. They can be the first line of communication with regard to concerns, assistance, updates, etc. and you should not hesitate to use them.
OUTPATIENT TREATMENT: This is the type of treatment a veteran receives when they are NOT hospitalized, which is referred to as in-patient treatment. In many regional VA Hospitals, veterans do not make their own appointments, they are assigned appointments and notified by mail. Many times the notification does not include specific information, like why or what the appointment is for. You and your veteran have a right to this information and should call the case manager or appointment desk to inquire if you do not understand. It is a good idea to take notes about what is said so that you can refer to them later if needed.
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| Getting The Help You Need | |
| 5 | If the veteran begins to get sick and it begins to worsen AND if he/she shows resistance to help, AND if the veteran is still enlisted, call and his COMMAND. If you DO NOT KNOW the phone number of name of the Command Unit, you can contact Military One Source at 1-800-342-9647 or at www.militaryonesource.com. Ask to speak with someone who can help you locate the phone number of the veterans Command Unit.
BE ADVISED that, if the service member/veteran is still in the military, and the Commanding Officer becomes aware that the soldier has a problem, then the Commanding Officer will probably begin steps to Separate the Veteran. This means that your veterans unit will begin taking action to get your veteran out of active duty. This will end your veterans status and pay and may have many consequences that need to be addressed very carefully and not quickly.
Therefore, you may want to call and speak with the Chaplain initially. This intervention may be an indirect way of addressing issues and may be considered if the problem is mild to moderate in nature.
The veteran may be very resistant to this intervention and it is not meant to be a threat, but if the veteran is sick and needs help, it is the RESPONSIBILITY OF THE MILITARY to intervene if the veteran is still enlisted. The command has rights that YOU DO NOT have with regard to the veteran’s welfare.
Regardless, do not be uncomfortable or intimidated if you need to call the Chaplain or Commanding Officer. If the veteran’s life is at stake and the well being of your veteran or family is threatened, then this is a necessary step.
NEW! The VA has just developed a new process to help. It is called “Coaching Into Care”.
Phone: (888) 823-7458 (M-F 8a-8p EST)
Web: www.mirecc.va.gov/coaching/ Email: CoachingIntoCare@va.gov |
| 6 | It is important at this point (if not before) to seek help for yourself/family. See Helpful Tips for Families in Crisis. |
| 7 | If the phone call to the Commanding Officer is not effective, then you may choose to WRITE a letter to the Commanding Officer stating the concerns that you have and the need for intervention. You do not need to be specific, but can mention that the veteran needs help and that you believe that help is necessary for the well being of your family and ASK FOR A RESPONSE and KEEP A COPY OF ALL LETTERS THAT YOU SEND and date and sign all letters. |
| 8 | If the veteran does not respond and the Commanding Officer does not respond, then seek the help of the next highest in command and ASK FOR A RESPONSE. Always communicate in writing (and log all calls-use your cell phone if you have one. Keep copies of the cell phone bill in which all calls are listed by date, time and duration of the call) and keep a copy of what you have written. |
| 9 | If the veteran continues to regress (get worse) then it may be essential to take further and more direct action. Most of the time, veterans who are exhibiting psychological and readjustment symptoms may not even recognize how sick they are becoming. If it gets to a point that their judgment is deeply affecting their own well-being and the family, then more direct action may need to be taken.
So, if you DO NOT get timely response from the veteran or his/her commanding officers, then you may need to seek legal counsel. You may try obtaining JAG (Judge Advocate General-legal help for veterans). You may inquire about this service also through Military One Source at www.militaryonesource.com or 1-800-342-9647.
If you seek civilian legal counsel, this may be a costly and time-consuming task. There are often attorneys that will offer to help “pro bono” or at no cost as a public service offering. Do not be afraid to ask. Call your local American Bar Association to get referrals to attorneys that may be able to assist you.
Legal counsel can help you to determine what actions that you can take on behalf of and for the welfare of your veteran and your family. This is especially important when a sick veteran begins to make poor financial decisions that may put the family at risk.
Be aware that if the veteran is single, you will have NO LEGAL RIGHTS to access medical or financial information. You will not be able to check insurance eligibility, payment balances, medical history, etc. You will not be able to call on behalf of the veteran to inquire about any of the above or any information protected under the Privacy Act. It can be very difficult to advocate for your veteran if he or she has become seriously ill without obtaining shared rights.
You CAN ask the veteran to sign a “release of information” so be sure and ask EVERY entity (insurance, medical providers, etc.) for a Release Form which will allow you to have access.
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| 10 | Write your State Senator and Representative and your United State Senator and Congressman. Tell them what is happening and ASK for intervention. (http://www.senate.gov for Senator and http://house.gov/ for Congressmen) Ask for a RESPONSE on how they can help you help your veteran. |
| Registering For VA Benefits | |
| 11 | Contact the Veterans Administration Benefits branch at www.vba.va.gov/VBA/. This branch should give you information needed to begin to file for VA disability and other benefits.
It is VERY difficult to understand and you may need the help of the American Legion at www.legion.org then go to “Find a Post” to find an American Legion office near you. You can also look at the “Veteran” link that shows the services they can provide Veterans.
Or you may go to www.vfw.org for the Veterans of Foreign War website. Go to “Assistance” to find how they can help you apply for Veterans benefits. Another source is the Disabled American Veterans at www.dav.org.
Any of these organizations should be able to help you understand and file for VA Disability Benefits.
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| 12 | When you are able to get the veteran to agree to go to appointments for medical and psychological attention, whether at the VA or with private physicians/mental health practitioners, TAKE THEM TO THE APPOINTMENTS OR ASK SOMEONE TO GO WITH THEM. As mentioned many times, veterans often do not understand the severity of their problems. They have learned to “numb” and “minimize” their symptoms and the consequences to themselves and their family.
They NEED support and input from you, even if they are resistant, YOU are involved in this too and have a right to be a part of the solution.
If you cannot go with them, call Disabled American Veterans (www.dav.org), the American Legion (www.legion.org) or Veterans of Foreign War (www.vfw.org) and ask for their help (look for “local chapters” to call). There are MANY Veterans who are willing to help other Veterans and many volunteers that can help.
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| 13 | If the veteran has a disability determination (this would include a diagnosis from a military recognized and approved medical practitioner), the the Veteran may apply for VA Disability Benefits.
VA Disability Benefits take a long time to receive and there is a lot of paperwork involved. It can take from 1 to 4 years to receive benefits, BUT the sooner that you make OFFICIAL application, IF the veteran is deemed disabled, the disability payments will be retroactive to the DATE of the OFFICIAL filing.
The most important thing is to file immediately for VA Disability Benefits. The veteran will need an advocate to have Power of Attorney over the disability process that is recognized by the VA Benefits Branch. This can be The American Legion (www.legion.org), the Disabled American Veterans (www.dav.org) or Veterans of Foreign war (www.vfw.org).
For veterans with physical disabilities/dismemberment, there are emergency funds available.
Be aware that almost all psychological VA Disability Benefits are REFUSED by the VA “the first round”. Be prepared for a very long and anxiety laden process.
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| Receiving Disability Benefits | |
| 14 | FINALLY, if the veteran is awarded Disability Benefits AND has been found incapacitated (unable to manage his/her own money) it is suggested that you DO NOT ASSUME FIDUCIARY RESPONSIBILITY. There is TREMENDOUS stress involved in caring for a veterans Disability Benefits. You are help accountable for every penny that must be spent exactly as determined by the initial budget and you must write checks for everything. This is a huge burden and one in which your veteran may become resentful and feel even more helpless.
The VA Disability Branch can hire specific people to be appointed as your veteran’s fiduciary agent. These agents are paid OUT OF THE veteran’s DISABILITY funds to manage his/her money. YOU ARE NOT PAID and the burden and accountability is tremendous. VA Disability requires a yearly accounting of every penny and they audit it more closely than the IRS.
If you have questions about this process, please feel free to contact us.
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| Incapacitation Pay | |
| 15 | If the veteran has become so ill that he/she cannot work AND he/she is unable to attend drill AND he/she IS NOT YET RECEIVING benefits and is still in the military, you may also want to review the possibility of FILING FOR INCAPACITATION PAY. This pay is described as “when a soldier has incurred or aggravated an injury, illness, or disease during active duty or inactive duty that renders the Soldier unable to perform military duties and/or demonstrates a loss in nonmilitary earned income, he/she is RESPONSIBLE for initiating an incapacitation pay claim.” (DA PAM 135-381, 29 Sept 2005).
In most cases, the veteran will be too ill to initiate the claim, therefore it will be the responsibility of the family/loved ones to follow through. Sometimes the veterans unit and/or DAV, American Legion or VFW can be of assistance, but ultimately, this is left up to the soldier, which means it is left up to the family. This could be a substantial amount of income that the veteran has a right to receive. It will take a LONG time to receive these benefits, but this should be considered as it may take a LONG time for the soldier to heal.
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| Social Security Benefits | |
| 16 | If the veteran is found to have a significant disability assigned by the VA, your veteran may also be eligible for Social Security Disability Benefits. You will need to go to your local Social Security office to make application. The veteran must do this personally, or you may go with him/her and sign a consent to release information, and/or you must have a legal document that indicates that you have rights to help/support your soldier. Always take the DD-214, VA Medical and Disability Benefits rulings with you to these appointments (3 ring binder notebook with page protectors help keep it all together). |
| Separation Benefits | |
| 17 | If the veteran is SEPARATED from the military, PRIOR TO SEPARATION, visit the Army, Air Force, Navy and Marine programs designed to provide assistance to service members who are severely injured due to combat or terrorism.
Typical qualifying injuries are those resulting in loss of limbs or sight, spinal cord injuries, traumatic brain injuries, and post-traumatic stress disorder.
The Marine program assists any current or former Marine who was injured, regardless of where or how the injury was suffered. More information on these programs is available by googling the following at the following websites: U.S. Army Wounded Warrior Program, Navy Safe Harbor and Marine is Marine for Life (the link for this is difficult to traverse for this specific resource).
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| VET Centers And PTSD Programs | |
| 18 | Be advised that the VA Medical has programs for PTSD and Depression and the Vet Centers (http://www.va.gov/rcs/) in your area also have programs.
Some veterans are willing to go to these programs. Others are too upset to go to military or government related programs.
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No matter what, encourage the veteran to connect with others who are supportive. Isolation and/or ignoring unhealthy behavior only makes things worse for both the veteran and the family. If the veteran is NOT willing to “connect”, the family and friends will need to seek help for themselves to support them and help them find healthy boundaries.
DO NOT settle for “no action” being taken.
As mentioned earlier, these problems do NOT get better on their own, so do not be afraid to seek help. Recognize that the service member/veteran may not be willing or able to advocate for him/herself. Seek as much assistance as possible, but recognize that ultimately, YOU may be responsible for initiating and following up on all these issues.
Disclaimer: Veterans’ Families United Foundation does not guarantee results or outcome of the information provided in any of its materials.
