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ROBERT SIEGEL, host:

From NPR News, this is ALL THINGS CONSIDERED. I'm Robert Siegel.

MICHELE NORRIS, host:

And I'm Michele Norris. All this week, we're exploring how America cares for its veterans. The Department of Veterans Affairs is struggling to cope with hundreds of thousands of vets filing for disability benefits. There are applicants from two current wars plus a new wave from the first Gulf War and from Vietnam.

The department and its critics both agree too many vets are waiting too long to get benefits. Now, the department's new leader, retired General Eric Shinseki, is experimenting with ways to get the troubled bureaucracy to do better. John McChesney has the story.

JOHN McCHESNEY: Vietnam veteran John Wood knows something about how long it can take to get benefits from the VA. In Vietnam, he was an Army reconnaissance scout. Near the border with North Vietnam, he saw fellow soldiers cut down in combat.

Mr. JOHN WOOD (Vietnam Veteran): I was, you know, having nightmares and flashbacks. I couldn't get along with people, a lot of anger issues.

McCHESNEY: Wood filed a disability claim, which was denied.

Mr. WOOD: They were saying that I couldn't prove that I had any sort of a combat status in Vietnam, and so therefore it couldn't possibly be post-traumatic stress disorder because I wasn't in combat, which I was.

McCHESNEY: So Wood on his own had to prove that he'd been in combat. He solicited letters from fellow soldiers and dug up after-action reports to make his case.

Mr. WOOD: It took me from 1972 until 2006 for the VA to admit that I had post-traumatic stress disorder.

McCHESNEY: The number of outstanding claims at the VA for service-related disabilities injured limbs, PTSD, brain trauma hovers around 500,000. Nearly 40 percent of those have been waiting on a decision for over four months. And to make matters worse, there are over 100,000 claims on appeal.

The department has responded by hiring thousands of new claims adjudicators, but Paul Sullivan of Veterans for Common Sense says that won't solve the problem.

Mr. PAUL SULLIVAN (Veterans for Common Sense): The Department of Veterans Affairs' rules are so complicated it would drive a normal person insane in about two or three minutes.

McCHESNEY: Paul Sullivan has been battling the VA for years over the backlog issue. For six years, he worked inside the VA. Complexity, he says, is the department's backbreaking burden, beginning with a veteran's first perplexing hurdle: a 23-page application form.

Mr. SULLIVAN: The Department of Veterans Affairs takes three years to train a new employee on how to read that 23-page claim form.

McCHESNEY: And, Sullivan says, the VA's problems are about to get worse.

Mr. SULLIVAN: Four hundred and forty thousand Iraq and Afghanistan veterans have filed disability claims against VA. We expect that number to go up to about a million within about the next four or five years, and more tidal waves are right behind it.

McCHESNEY: That's because Secretary Shinseki is inviting even more claims. New rules allow claims for Agent Orange exposure in Vietnam and chemical exposure in the first Gulf War.

Many veterans perceive the Veterans Benefits Administration as an opponent. Take the case of Tia Christopher. She says she was raped in her barracks while attending language school to learn Arabic. When she got out of the Navy, she went to a VA hospital for psychological help. Staff at the hospital advised her against filing for disability benefits.

Ms. TIA CHRISTOPHER (Veteran, U.S. Navy): Even though we got really great health care, they told us that it would just be really traumatic and that you'd basically have to kind of defend yourself. Like, you were going to basically be put on trial to do this claim. That idea scared the hell out of me.

McCHESNEY: But not enough to keep her from filing a claim, which was denied. Then, with the help of a veterans' service organization called Swords to Plowshares, she filed an appeal. And eight years later, she won.

Now, why would the medical branch of the VA advise Tia against filing a claim with the benefits branch? Not surprising, critics say, because there's a perception that the VA's benefits office stands against vets rather than for them. And that's something Secretary Shinseki has set out to change.

Undersecretary MICHAEL WALCOFF (Veterans Administration): When the new secretary came in, one of the first things that he said to us was a recognition of the fact that many veterans do perceive us that way.

McCHESNEY: Michael Walcoff is the VA's undersecretary for benefits.

Undersecretary WALCOFF: And that we need to do whatever we can do to first of all make sure that our people understand that their role is to be an advocate for the veteran, not an adversary.

McCHESNEY: It's a tall order to turn around a bureaucracy encumbered by a sluggish culture developed since World War II. But the VA has launched pilot programs to streamline, simplify and personalize the application process. One is in downtown Pittsburg.

(Soundbite of footsteps)

Beth McCoy, the regional office director, leads us downstairs to the service center.

Ms. BETH McCOY (Regional Office Director, Team Delta): We're looking at our primary file bank. We have outgrown this space, as far as our claims folders. As you can see, sometimes they don't even fit inside of the file cabinets.

McCHESNEY: Row after row of white file cabinets stretch across the room. All this paper now lumbers back and forth between a veteran and the VA via snail mail. Beth McCoy says the staff of the pilot program, known as Team Delta, aims to change that by actually making personal calls to veterans.

Ms. McCOY: We're surprising them. Is this really the VA calling? No one from VA has ever called me before. And that is a positive experience for the veterans, and it's really a positive experience for our employees.

McCHESNEY: And there are almost unheard-of face-to-face contacts with veterans, contacts which the team has discovered can often be wrenchingly emotional. We sat in when decorated Vietnam veteran Arthur Rhone met with a Team Delta member. He says it's the best experience he's had with the VA.

Mr. ARTHUR RHONE (Vietnam Veteran): They all introduced theirself(ph) to me, they're all nice people, and they seem like they're concerned for me.

McCHESNEY: Rhone begins his session about a PTSD claim with a tense recitation of the horrors he witnessed in Vietnam and ends with this story: the time a mother and a daughter were stopped at an American checkpoint. The mother was a Viet Cong suspect carrying a large sum of money. Rhone's squad leader told him to use the daughter to pressure the mother to confess that she had more money hidden away.

Mr. RHONE: So they told me - it was during the rainy season to get the girl, jump down in the rice paddy. Like I'm up to here, and I grabbed the girl, she was about eight years old, and I ducked her down in the rice paddy till the mama-san told where the money was. I almost drowned her. I live with that every day of my life.

Unidentified Woman: We're going to help you today. We're going to work with your claim.

Mr. RHONE: It's with me all the time. I wish you could take your hands and scrub it out my damn brain. You think you can do that for me? You all think you can help me do that?

McCHESNEY: Rhone jams his chest with his thumb for emphasis. People in the office calm him, but when he sits down to sign a document, his hand is shaking so badly he has to steady it with his other hand.

Mr. RHONE: And I appreciate that, you guys, okay? Thank you.

McCHESNEY: But Team Delta, this pilot program in Pittsburgh, is only eight people in a bureaucracy of nearly 20,000. The jury is still out on whether its personalized approach is feasible for the entire Veterans Benefits Administration.

For NPR News, I'm John McChesney.

NORRIS: Tomorrow on ALL THINGS CONSIDERED: What to do with veterans who get in trouble with the law.

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