Dear VA: Stop kicking veterans with PTSD out of your hospitals

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Imagine getting raped by your commander or shot in the jungles of Vietnam, seeking care at a VA hospital, and being turned away. Told you’re not a veteran. As a veteran attorney, this happened to my clients — many of whom were in crisis — time and again. The VA’s denial of their identity and right to care was devastating.

report released yesterday by Harvard Law School’s Veterans Legal Clinic shows that my clients’ awful experiences are not unique. The VA has done this to many thousands of veterans across the country. And roughly 400,000 more are currently at risk of being denied critical care.

Why in the world is this happening?

It starts with the VA’s definition of “veteran.” Military service isn’t enough. The VA only presumes veteran status for former service members with an Honorable or General discharge. Former servicemembers with “bad paper” — an Other Than Honorable, Bad Conduct, or Dishonorable discharge — must apply for recognition as a veteran.

The VA, however, often doesn’t let them apply. When veterans with bad paper present at a VA hospital, the VA is supposed to tell them about the application process and set it in motion. In reality, the VA doesn’t mention there’s a path to eligibility, let alone initiate it. The VA just slams the door in the veteran’s face.

Is the VA discriminating against veterans with bad paper discharges? Maybe. Though discrimination can be hard to prove, this doesn’t mean it’s not happening.

The report by Harvard Law School makes this much clear: the VA’s mistreatment of veterans with bad paper is mainly due to ineptitude.   

Based on documents obtained from the VA, the report finds that VA employees are poorly trained. Frontline staff at VA hospitals are often not instructed on how to receive veterans with bad paper. For instance, the report notes one employee’s admission that despite working at the VA for over twenty years, they’d never even heard of the veteran status application form.

To make matters worse, when VA staff are given information, it’s legally incorrect. One set of training materials lists a bad paper discharge as categorically “non-qualifying.” Likewise, a staff reference manual contains an eligibility checklist with a thumbs down symbol next to bad paper discharges. This is wrong and promotes bias against veterans with bad paper.

No wonder veterans with bad paper discharges are being summarily thrown out of VA hospitals.  

Ironically, the veterans the VA is excluding are most in need of support. Veterans with bad paper discharges have higher rates of homelessnesssubstance abuse, and suicide than other veterans.

Many are sexual assault survivors. One-third of servicemembers who report being assaulted suffer retaliatory discharges. And they are more likely to receive a bad paper discharge. Others were discharged under the military’s discriminatory sexual orientation policies, or because symptoms of combat PTSD were misinterpreted as misconduct. 

The VA’s exclusion of these veterans is not only unfair — it’s illegal. Under federal law, veterans with bad paper have a right to petition the VA for review of the individual circumstances of their discharge. And the VA is required to sympathetically consider mitigating factors, such as service traumas. While some veterans with bad paper don’t qualify because they committed serious offenses with no excuse, many thousands of veterans do. The VA can’t know the difference unless it listens to veterans’ stories. By ignoring them, the VA is breaking the law.

There’s good news, though. This problem should be easy for the VA to fix. It doesn’t require an act of Congress or the slow agency rulemaking process. The VA has the power to address this internally and quickly. All the VA has to do is revise its training protocols. And ensure its gatekeepers understand that veterans with bad paper are deserving of help, like any other veteran.

The VA also needs to atone for the harm it has done to the tens of thousands of veterans it has already turned away. Burned by rejection, these veterans have no reason to think they can come back to the VA for a fair shot. The solution here is straightforward, too. As the Harvard report notes, the VA can send letters and use social media to give veterans with bad paper their overdue invitation to apply. It can also partner with veterans organizations, to leverage their connections in the community.

Just think: with reforms this simple, the VA could take a bite out of the veterans’ suicide epidemic. Twenty veterans commit suicide every day. And veterans with bad paper are three times more likely to experience suicidal ideation than other veterans. Access to VA care removes this disparity and can be life-saving.

The VA must seize this unique opportunity to save lives with little effort. If the VA doesn’t, it will have veterans’ blood on its hands.   

Rose Carmen Goldberg is a deputy attorney general in the Office of the California Attorney General whose work includes veterans’ rights lawsuits. Previously she represented veterans with bad paper discharges. The views expressed are her own.

Tags Healthcare in the United States United States Department of Veterans Affairs

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