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Illinois Issues
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State of the State: Fighting for Veterans' Benefits Includes Struggles with State & Federal Programs

Bethany Jaeger
WUIS/Illinois Issues

This Christmas season marks the third anniversary of the moment when life drastically changed for Marine Corps Sgt. Tyler Ziegel and his family.

"Ty" Ziegel of Washington in north central Illinois was burned beyond recognition, suffered skull and brain damage and lost one of his hands as the result of a suicide bomber attack in Iraq December 22, 2004.

He spent 19 months and survived numerous surgeries in Brooke Army Medical Center in Texas. The rehabilitation didn't prepare him or his family for the whirlwind of media attention that soon documented the soldier's struggle with the federal government's disability rating system, which determines benefits available to wounded veterans and their families.

Featured by such major media as CNN and the Oprah Winfrey Show, Ziegel's case got on the fast track to improved benefits.
"He is satisfied with his VA benefits, now," says his mother, Becky Ziegel of Metamora in Woodford County. "But look at the length he had to go, even being him. He has gotten a lot of exposure, but not all of them get that exposure. Not all of their moms get handed a card from the assistant to the secretary of [Veterans Affairs who] said, 'Here, we want to know how things are going.'"

Ziegel told her son, "If you have a voice, you have to decide what your message is." Ziegel's message is that veterans shouldn't give up navigating the federal benefit system.

That system is overwhelmed, according to Tammy Duckworth, a major in the Illinois Army National Guard who lost both of her legs in a helicopter crash in Iraq three years ago. She's now trying to shape policy at the state level as director of the Illinois Department of Veterans' Affairs.
As the featured speaker at a policy luncheon in Springfield last month, Duckworth described a system that can make veterans wait up to two years for the federal administration to approve their health benefits.

If they're denied, Illinois is one of many states trying to catch them before they fall through the cracks. Yet enrollment in some state programs is low. For instance, Gov. Rod Blagojevich's 2006 Veterans Care program was touted as offering health insurance for up to 7,000 veterans younger than 65 in the first phase. But Duckworth says far fewer — "somewhere over 100" veterans — have signed up.

Reaching more veterans will require the state and the feds to change some strategies and some rules. In the meantime, more veterans wait to receive medical services. Duckworth adds that state taxpayers will certainly shoulder more of the cost.

She says two trends are behind the increased demand: One, Vietnam veterans are retiring and losing their employer-sponsored health insurance, so they want access to health benefits through the federal Veterans Affairs system. And two, more recent veterans of the Middle East conflict are returning home and being encouraged to get federal benefits promised to them when they enlisted.

"Going back to the Revolution, this country has not lived up to that promise," says Duckworth, who spent 13 months in Washington, D.C., at Walter Reed Army Medical Center before trying to get her medical benefits through the federal VA system.

She spoke about the financial and physical costs of the Global War on Terrorism during a policy luncheon sponsored by the Institute of Government and Public Affairs at the University of Illinois and the Center for State Policy and Leadership at the University of Illinois at Springfield. She cited a January 2007 study out of Harvard University (.pdf file) that estimates the cost of providing medical care and disability benefits to all veterans returning from Iraq and Afghanistan is between $350 billion and $700 billion. That varies on the length of the soldiers' deployment, the time it takes for them to receive their federal benefits and health care inflation. At the same time, the report recommends increasing staffing and funding for veterans' medical care, particularly for mental health services.

T
he shift to Illinois taxpayers has already started, Duckworth says, adding that this state spent $50 million last year on programs for new veterans administered by more than a handful of state agencies. "The state of Illinois is going to stand up and make sure that we take care of our veterans, especially when they start falling through the cracks because the federal VA system is simply either unprepared or not sufficiently funded."

The federal VA Department of Public Affairs says the delay in the approval process is rooted in the system's goal, which is to obtain an accurate picture of a veteran's level of disability and how that disability relates to his or her military service, according to an e-mail from spokesman Ryan Steinbach. "This requires requesting pertinent information from veterans in support of their claims, with a mandated 60-day minimum waiting period to submit this evidence," he writes.

 
The U.S. Government Accountability Office issued a report (.pdf file) in September that says staff shortages continue to challenge the Army's efforts to better manage veterans' cases from injury to recovery, including care for such disorders as post-traumatic stress or traumatic brain injuries.
Those are the "hallmark injuries of this war," says Dr. Jeff Murawsky, chief medical officer for the Great Lakes Health Care System. The network includes federal VA clinics for northern Illinois, Michigan's Upper Peninsula and Wisconsin. Murawsky says the entire system is better equipped than three years ago, partially because the experts have a much better understanding of those hallmark injuries.

But post-traumatic stress disorder also afflicts veterans of previous wars, particularly Vietnam vets, whose symptoms have been dormant or buried until now. The federal government's National Center on Posttraumatic Stress Disorder reports that about 30 percent of veterans are likely to have such disorders. The estimate increases by 12 percent and 20 percent when singling out veterans of the Iraq war.
Duckworth says the federal system can't match the need.

"There simply are not enough VA-trained mental health professionals that can deal with post-traumatic stress disorder stemming from combat," she said at the luncheon. "They're just not ready. They're completely overwhelmed."

Murawsky says his network of VA clinics has joined a federal effort over the past 18 months, ramping up mental health services and training all levels of staff to recognize and treat those disorders. He says there is a slight lag in bringing the right people on board, but there are no longer waiting lists for mental health or other services.

"We're growing just as fast as the need is," he says. "And the need is growing, and we're growing." Illinois programs are growing in scope, too.
Lt. Gov. Pat Quinn, who traveled to Iraq and collected anecdotes of Illinois veterans' heroic acts or tragic tales, helped launch Veterans Cash, a scratch-off lottery game, in early 2006. It's estimated the game will generate $3 million a year to provide grants to nonprofit organizations for services for post-traumatic stress disorder, homelessness initiatives, health insurance and disability benefits.

Quinn lists by heart the names of wounded Illinois veterans whom he met in Iraq four years ago or those he has visited in Germany's Landstuhl Regional Medical Center, where he plans to return this month. He also tries to attend every funeral of Illinois veterans killed while serving overseas.
"The everyday heroism of the service members is something you'll never forget," he says.

Once they come home, Quinn says, getting health care is a huge issue. That's why he supports expanding Blagojevich's Veterans Care health insurance program. When it was launched in 2006, the program targeted low-income veterans. But the administration is expected to expand eligibility. (Currently, veterans are eligible if they're between 19 and 64, don't qualify for federal benefits or live 50 miles or an hour away from a federal VA clinic. They pay a monthly premium, $40 or $70 a month, depending on income and region.)

According to the Blagojevich Administration, the Veterans Care program approved 130 applicants. "It is still a young program, and we are actively working to increase outreach efforts to other veterans who may benefit from the program," Jessica Woodward, spokeswoman for the Illinois Department of Veterans Affairs, says in an e-mail.

Duckworth says the health care program is still doing its job of serving as the final safety net for veterans who otherwise wouldn't have health insurance.

Future soldiers also may be more likely to suffer symptoms of post-traumatic stress disorder or traumatic brain injury when returning home. The state Veterans' Affairs Department has allocated about $8 million to a program that will eventually screen all Illinois veterans and national guardsmen returning from the Iraq and Afghanistan. The program is only in its first stage: training the service officers who will screen the soldiers.

The next step, according to Duckworth, is to change administrative rules so more veterans qualify for the state health insurance program. For instance, she says, the administration is looking to:

  • Change the rule that veterans have to go without health insurance for six months before qualifying for Veterans Care.
  • Change the rule that veterans must live at least 50 miles away from a federal VA clinic in order to qualify for Veterans Care.
  • Change the rule that prevents national guardsmen and reservists from qualifying for Veterans Care because they are covered by federal health benefits while they actively serve one weekend a month.

"Whether we like it or not, these veterans are going to access our social services," Duckworth said last month. "Whether they do it under the label of a veterans' program or whether they're just doing it because they're out there and they have the need, we're still going to be paying to take care of them."
See more background on veterans' health care in our April 2006 article, Deeper Scars."

 

Reaching more veterans will require the state and the feds to change some strategies and some rules. In the meantime, more veterans wait to receive medical services.

Bethany Jaeger can be reached at capitolbureau@aol.com.


Illinois Issues, December 2007

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