Many Veterans Face Health-Care 'Purgatory' Reports of poor conditions at Walter Reed Army Medical Center also underline obstacles veterans face in obtaining adequate care. Navigating the health-care system can be a nightmare.
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Many Veterans Face Health-Care 'Purgatory'

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Many Veterans Face Health-Care 'Purgatory'

Many Veterans Face Health-Care 'Purgatory'

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It's MORNING EDITION from NPR News. I'm Steve Inskeep.


And I'm Renée Montagne.

Even as President Bush announced the bipartisan commission to investigate conditions at the nation's military and veterans' hospitals, one veteran, John McCain was among the voices on Capitol Hill calling for action.

Senator JOHN MCCAIN (Republican, Arizona): We also have a responsibility to ensure that there's a future for our wounded that is better than the past. If legislation is necessary, we will pursue it.

MONTAGNE: Senator John McCain. Red tape is one of the big problems shared by all the war-wounded when it comes to getting health benefits.

To walk us through the system, we turn to Paul Sullivan. For six years, until last year, Paul Sullivan was a project manager at the Department of Veterans' Affairs. He monitored the disability benefit activity of veterans from the Gulf, Iraq, and Afghanistan wars. He describes what wounded service members face once they arrive at the military's medical facilities in the Washington area.

Mr. PAUL SULLIVAN (Former Project Manager, Department of Veterans Affairs): That service member who's wounded is going to get first-rate care at those military hospitals. Here's where the problems starts. The service member really needs two discharges. The service member first gets discharged from the hospital, because their acute medical needs are taken care of. Then the service member, who's not yet a veteran, is waiting to get discharged from the military. And they may be going through some very intensive therapy at this time.

It's during this limbo that can last from six months, 18 months, and sometimes several years that the service member - who's about to become a veteran - must make a lot of choices about military benefits and Department of Veterans Affairs benefits. And those systems are swamped with service members trying to navigate the system with little guidance.

MONTAGNE: Give us a list of the sorts of decisions that wounded soldier, Marine, sailor has to make.

Mr. SULLIVAN: The first decision is whether or not to stay in the military. The military is going to examine the service member and say you are either fit or unfit. If the service member is found to be fit, then that service member is patched up, given an M16, and sent back to the frontlines.

MONTAGNE: Pretty simple at that point.

Mr. SULLIVAN: Yes, it's pretty simple. On the other hand, if the Department of Defense says the service member is unfit, that's where the purgatory starts. And the service member has to make decisions about - does he want to have Department of Defense benefits as a medical retiree or does he want to receive Department of Veterans Affairs benefits as a veteran?

MONTAGNE: That already seems like it could be confusing. Are there two clear paths - one better than the other for any given wounded service members?

Mr. SULLIVAN: No, there aren't. Each has its pluses and it minuses. For example, if the service member was to decide to keep his military benefits, they might get care at a military treatment facility and they may for a while be able to retain some of their housing and education benefits until they're thoroughly pushed out of the military system. On the VA side, it seems to be that VA pays more money, but then there aren't benefits and stuff for the family.

So there's pluses and there are minuses and here's the big problem - service members are coming back from the war in large numbers with mental health issues. They're coming back from the war with traumatic brain injury. And here we have the Department of Veterans Affairs and the military pushing all these different benefit packages on the service member. And if they're not 100 percent up to speed, it can become a very difficult process.

MONTAGNE: Is there a gap between leaving the military for the wounded service members in need of on-going care and entering the VA?

Mr. SULLIVAN: Yes, there is a gap in the time it takes VA to get the medical records of some of these service members. It was recently described in the Washington Post how VA doctors were not getting critical information about the wounded. And it took the intervention of some senators and some others to fix the problem. The Department of Veterans Affairs should receive the information from the Department of Defense on who went to the war and have all their records in place.

So as soon as that new veteran comes into any VA medical facility, VA is ready to take care of them. But what you have is a large bureaucracy that just can't get it done.

MONTAGNE: Thank you very much for joining us.

Mr. SULLIVAN: Glad to be here, Renee.

MONTAGNE: Paul Sullivan spent six years as the project manager for the Department of Veterans Affairs.

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