Grassley Calls for Review of Armed Forces Mental Health Policy

Sen. Chuck Grassley, along with a bipartisan group of Senators, sent a letter to Secretary of Defense Robert Gates, calling for an independent review of the personality disorder discharge process in the Armed Forces. The letter was prompted by a story in the Washington Post titled “The War Inside,” which chronicled the struggles of Army Specialist Jeans Cruz, a soldier suffering from Post Traumatic Stress Disorder.

“Soldiers are putting their lives on the line to protect us. They deserve to know that if they become injured, physically or mentally, while serving our country they will be cared for upon their return,” Grassley said. “We must learn from cases like Specialist Cruz’s and ensure our men and women in uniform receive this care for all ailments, including mental health disorders

Cruz suffered from Post Traumatic Stress Disorder and was given a personality disorder discharge which classified his condition as pre-existing to his combat experience in Iraq This discharge prevents Cruz’s from receiving disability benefits and medical care from the Department of Veterans Affairs. The senators are concerned that this is a widespread problem in the military.

In February of this year, Grassley along with Senator Tom Harkin introduced the Joshua Omvig Veteran Suicide Prevention Act. Omvig was a soldier from Iowa who committed suicide after serving his country in Iraq. The legislation directs the Department of Veterans Affairs to implement a comprehensive program to prevent suicide among veterans. The program will identify symptoms of mental health disorders, encourage veterans to seek help, and train VA employees in the best practices for suicide prevention. The legislation is expected to be considered by the Senate Committee on Veteran’s Affairs.

Here is a copy of the letter sent to Gates:

Dear Secretary Gates:

We urge you to conduct a thorough and independent review of the personality disorder discharge process across the Armed Forces. We are concerned over continuing reports from Veterans’ Service Organizations, the media, and individual U.S. service personnel that personality disorder discharges have been implemented inappropriately and inconsistently. There are indications that personality disorder discharges are being used as a tool to discharge expeditiously U.S. service personnel who have service-connected injuries, such as Post Traumatic Stress Disorder (PTSD) or Traumatic Brain Injury (TBI). Even more troubling is the perception that the U.S. military is using these discharges to avoid disability and medical benefits payments.

The Washington Post deftly illustrated an example of this problem on June 17, 2007, in a piece entitled “The War Inside.” According to the Post—after serving a combat tour in Iraq —Army Specialist Jeans Cruz returned to Ft. Hood, Texas, crippled by the mental anguish of his combat experience. Notes from his medical files indicate “major depression,” and “anger from Iraq, nightmares, flashbacks.” The Army was so concerned that it even went so far as to have Spc. Cruz sign a “Life Maintenance Agreement,” a document stating that he agreed “not to harm himself or anyone else.” But the Army ultimately discharged Spc. Cruz with a “personality disorder,” in essence finding that Spc. Cruz’s medical problems had nothing to do with his service in Iraq

Since personality disorder discharges are considered “pre-existing,” personnel discharged under these provisions cannot collect disability benefits and may not receive medical care from the Department of Veterans Affairs f or these “pre-existing” illnesses. Spc. Cruz experienced this first-hand. On August 16, 2006, Spc. Cruz received a letter from the VA stating that he had been denied disability pay.

To make matters worse, military personnel given a personality disorder discharge who have not fulfilled their service contracts can find themselves forced to repay thousands of dollars in re-enlistment bonuses back to the federal government. This can result in debilitating debt for military personnel and their families—many of whom supported our forces over many years of service and endured significant strain as a result of frequent and protracted combat deployments.

Defense Department records indicate that over 22,500 personality disorder discharges have been processed within the past six years. While this represents a small percentage of overall discharges, their inappropriate use and debilitating impact on personnel once discharged is cause f or grave concern.

Another egregious example of misuse was chronicled by reporter Joshua Korson March 29, 2007, in a piece entitled: “How Specialist Town Lost His Benefits.” A copy of the article is attached for your review. On October 19, 2004, Spc. Jon Town was injured and sustained major loss of hearing in a rocket attack in Ramadi, Iraq. His injuries ultimately resulted in memory loss and depression, ending his military career. But instead of sending Spc. Town through the medical board process—an in-depth medical review of a service member’s fitness that often results in the award of disability payments and allows injured personnel and their families to remain eligible f or medical benefits after active service ends—the command at Ft. Carson, Colorado, elected to give Spc. Town a personality disorder discharge. This action deprived Spc. Town of disability benefits and guaranteed VA care f or his injuries once he was discharged from the Army.

While the Army claims to have thoroughly evaluated and reviewed the Town case, we understand that neither Spc. Town or his fellow soldiers, who were aware of the rocket attack and his resulting injuries, were contacted to discuss the case. Hence in this situation, and we fear potentially in others, the Army review was inadequate and anything but thorough.

Consequently, serious questions remain unanswered about the use, or abuse, of the personality disorder discharge and a chain-of-command that allows the inappropriate use of the discharge to continue even as members of Congress from both parties seek to review the practice and the media points out the glaring inconsistencies in the manner in which the personality discharge is administered.

Like many veterans’ advocates, we are skeptical about an administrative process that suddenly diagnoses military personnel who have long and honorable military careers, such as Spc. Cruz and Spc. Town , with pre-existing personality disorders that reportedly become apparent only after combat service in Iraq and Afghanistan . We are particularly concerned that combat forces at the unit level and above are inadequately equipped to diagnose, treat, and work with personnel assessed with brain-related injuries, and that the mechanisms tasked with handling the discharge process and meeting unit manning requirements are also overwhelmed.

Therefore, we urge you to conduct a thorough and independent review of the personality discharge process and to implement appropriate measures to prevent the repeat of cases like Spc. Cruz’s and Spc. Town’s in the future. We also urge you to support the creation of a Special Discharge Review Board to assist the Board f or Correction of Military Records for each service in reviewing petitions from personnel discharged for personality disorders with honor able service records in Iraq and Afghanistan.

As the Walter Reed Army Medical Center hearings demonstrated, the American people will not tolerate substandard treatment and rehabilitative care for those who have served. As members of the United States Senate, we have an obligation to ensure that our service personnel and their families receive the benefits and care they are entitled to. We are eager to work with the Department of Defense on the issues we have outlined and look forward to hearing from you.

No Exit: The Plight of Veterans’ Health Care

The willingness with which our young people are likely to serve in any war, no matter how justified, shall be directly proportional to how they perceive how the veterans of earlier wars were treated and appreciated by their nation. --George Washington

For presidential hopefuls, Memorial Day serves as an opportunity to participate in memorial services and subsequent photo opportunities, while paying tribute to America’s fallen soldiers. This year was no exception, especially in Iowa, as politicians offered their support of the troops currently serving overseas. Now that the post-Memorial Day political dust has fallen, the question facing American voters is to what extent politicians support our troops, in particular, those veteran soldiers returning from the theaters of war in Iraq and Afghanistan, where over 1.5 million Americans have served thus far.

Among these returning veterans, VA hospitals have seen a surge in health-related issues, both physical and psychological, that have far outpaced the funding provided by the federal government. Consequently, one of the biggest struggles between the Bush administration and veterans has been the fight over veterans’ health care policy. In 2006, Congress had to enact emergency legislation on two occasions to help supplement the VA’s budget by $1.4 billion to help bridge the funding gap. And it appears the 2007 budget is destined to fall short as well. In a study, “The Independent Budget,” coauthored by the DAV, AMVETS, the Paralyzed Veterans of America, and the VFW concluded that:

Congress will need to appropriate $26 billion for veterans’ medical needs just to maintain current service levels. The Administration’s budget for FY 2007 seeks $24.7 billion in appropriations for veterans’ medical services, which falls $1.3 billion short of the IB’s recommendation. The President’s FY 2007 medical care budget slightly increases the mental health services capacity; however, it continues the hiring freeze of all other direct health care providers at a time when an influx of new veterans from the wars in Iraq and Afghanistan will place substantial new demands upon a system already struggling to meet its mission. This budget proposal estimates that only 109,191 veterans of the Iraq and Afghanistan wars will seek treatment in 2007. This reflects a decrease of 1,375 below the number of these new war veterans the VA estimates it will treat in 2006.

This years’ budget for veterans’ health care expenses is optimistic and assumes fewer vets will seek treatment, which puts VA medical facilities in a financial quagmire. While the presidential hopefuls preach platitudes of support for the troops and the wars in Iraq and Afghanistan, voters need to weigh how vigilante they are in supporting the effects these wars are having on the welfare of out troops and their families.

While stumping for veterans in Iowa, Sen. Barack Obama, who voted against the Iraq war supplemental funding bill, faced critics, who charged him with not supporting the troops. Obama responded that the best way to demonstrate support for troops is putting programs in place to support them. "When our veterans come home we want to do more than slap a yellow sticker on the back of an SUV,'' Obama said. “We want to honor their service with health care if they get hurt and support for their families.'' Obama noted in his speech to Iowa veternans that there is no comprehensive plan to prepare for a soldier's return and one-third of the troops returning from Iraq and Afghanistan are suffering from traumatic brain injury, post-traumatic stress disorder and other psychological problems.

Obama’s Democrat rivals, John Edwards and Sen. Hillary Clinton, also stumped for veterans in Iowa last weekend and addressed the need to focus more attention on veterans’ health care. All three of these candidates have addressed veterans’ health care issues on their campaign websites:

Barack Obama: “Honoring Our Veterans”

John Edwards: “Sacred Contract with Our Military and Veterans Community”

Hillary Clinton: “Fulfilling Our Promises to Veterans”

After perusing the rest of the Democratic candidates’ web sites, the only other candidate to specifically address veterans’ health care is Dennis Kucinich.

Of the GOP presidential hopefuls, the only candidate to address veteran’s health care issues on his website is John McCain ( “Commitment to America’s Service Members: Past and Present”), the only veteran among all the candidates running for president. Most of the GOP candidates have taken an aggressive, hawk stance on the war in Iraq thus far, however, only one of them is openly addressing the inevitable consequences of this stance, at least not on their campaign websites. Ironically, it’s these very same candidates who have attacked the Democrat hopefuls for not supporting the troops.

The Bush administration has drawn fire from both sides for not having an “exit strategy” before going to Iraq, and now, four years later, our wounded troops returning from the theaters of war are seeing that the same holds true on the this end as well.

Weinstein: “VA Committed a Crime against Humanity”

Michael “Mikey” Weinstein, the lawyer representing Navy Veteran David Miller, said “What the people are doing at the Veterans Administration Hospital {Iowa City} are committing, quite literally, a felony against Democracy and a crime against humanity.”

Weinstein agreed to take the case, when David Miller, reached out to him screaming: “I am not an animal. I’m not a Jewish animal. I am a human being. I am an American human being.”

“We got a man screaming in pain due to angina,” said Weinstein. “What he’s been through is unimaginable pain, and he’s screaming for the nurses to tell the evangelical VA Chaplain to go away and this is when he began evangelizing him, telling him that Jesus came for him. This is torture.”

This is one of the primary reasons Weinstein decided to take Miller’s case. “It’s simple, I took the case for the humanity,” said Weinstein. “It was off the scale, and I’ve seen just about everything. This was another manifestation of Gitmo, Abu Ghraib, and Walter Reed. It’s as simple as that. We are not a complex meal. We are not hamburger. We’re simply telling the military and the Veterans Administration that you are going to be at least as constrained as a shift manager at Starbucks or at the KFC or Cosco.”

Michael Weinstein, founder and president of the Military Religious Freedom Foundation and an attorney who worked in the White House under President Reagan, is filing a suit against the U.S. Department of Veterans Affairs in federal court over David Miller's treatment, while hospitalized at the VA medical Center in Iowa City. Miller is on full disability for angina, a painful medical condition that causes severe chest pains due to an oxygen shortage to the heart. In the suit, Weinstein claims that David Miller’s constitutional rights have been violated and the VA has overstepped the line separating the church and the state:

“This isn’t a Christian versus Jewish issue; this is a subset of people, who call themselves Dominionist Fundamentalist Evangelical Christians – roughly 12.6 percent of the American population, but still that’s roughly 38 million people. This is the Dominionist Fundamentalist Christians versus the Constitution issue and their revisionist history about the founding father’s intent when they crafted the Constitution.”

Weinstein said David Miller’s case is just the beginning and suspects there are other veterans who have been treated similarly and hopes Miller’s case will be a catalyst for a class-action lawsuit. During a telephone interview, Weinstein said he’s been contacted by over 4200 soldiers and military veterans, who feel they have been victimized by the indoctrination of institutionalized Christianity. Due to fears of a backlash from military leaders for speaking out, only 112 of them will go on the record publicly and voice their complaints. “David Miller is an American hero,” said Weinstein. “He had the courage to speak out about.”

Administrators at the Veterans Affairs Medical Center in Iowa City have gone on the record saying they’re taking Miller’s allegations very seriously. A spokesman, Kirt Sickels, said "We will look into these concerns that Mr. Miller is talking about. The Iowa City VA respects the rights to religious beliefs for every patient. If they have a request for any kind of religious needs, we try to accommodate whatever those needs or beliefs might be."

On of the major complaints cited by David Miller is that the VA hospital neglected to provide a kosher food alternative during all three of his visits to the facility, nor would the facility contact his rabbi to bring him some kosher food.

“We got a man screaming in pain due to angina,” Weinstein claims. “What he’s been through is unimaginable pain, and he’s screaming for the nurses to tell the evangelical VA Chaplain to go away and this is when he began evangelizing him, telling him that Jesus came for him. This is torture. During his last three visits, he wasn’t given food, because they didn’t have kosher food. Look, when you go on cruises they have kosher food. Even high school football players are provided with kosher food options. And the VA by its own accord is supposed to have kosher food.”

“Kosher meals are available to Jewish VA patients in Iowa City,” Sickels said.

Weinstein is confident he has a strong case against the VA: “We put people under oath and they’re swearing to tell the truth and we’re going to provide a number of witnesses that will support David Miller’s account. We’re in it to win it. We have military regulations up and down the line that specifically state you cannot use the Draconian specter of command influence to push anything on anyone, including Mary Kay products.”