Central Texas veterans face nation's longest wait for VA disability claims
GEORGETOWN — Three decades after he left the jungles of Vietnam, Richard Sivage's life began to unravel around him. The frequent rages snapping car antennas, punching walls were punctuated by uncontrollable crying jags that left him increasingly isolated.
He left the restaurant business and went into home repair, where he wouldn't have to interact with people. He cut himself off from friends and rarely left the house. "The last decade has been hell," he said.
But he didn't connect his debilitating emotional problems to the war until recently. In 2010, he filed a claim with the Department of Veterans Affairs, seeking disability benefits.
That was 684 days ago. Because of a historic backlog of VA claims, Sivage, 70, and nearly a million other veterans have yet to receive a ruling on their claims. The problem is severe across the nation, but it is particularly acute in Texas, which is home to the second-largest veteran population in the country behind California.
The Waco claims processing center, which serves Central Texas veterans, has the nation's longest average wait time for claims processing: roughly 393 days, according to the VA's most recent numbers. That's 139 days longer than the national average and more than three times as long as the nation's fastest claims processing center in St. Paul, Minn. During the claims process, VA officials evaluate medical, service and financial records before determining a disability percentage, or rating.
And over the past 12 months, nearly 1 of every 5 claims processed in Waco has been plagued by errors, which can range from incorrect paperwork to failure to locate records or order medical tests, according to agency numbers. Inaccurate claims often lead veterans into appeals that can last for years. The Waco office's 17.5 percent error rate is the eighth worst among the nation's 56 regional offices.
Lorenzo Zarate, an Army veteran who participated in the initial invasion of Iraq, is among those waiting for a claim to wend its way through the Byzantine appeals process. He's seeking to increase his disability rating from 70 percent to 100 percent, saying that severe post-traumatic stress disorder symptoms make it impossible to hold a job.
"Mentally, I'm not right. I live in paranoia," said Zarate, 28, who cares for a young daughter. "Since I can't hold my job, I have to live in poverty."
Zarate said that receiving a 100 percent disability rating, which would increase his monthly benefits from $1,228 to $2,673 (about $32,000 a year), would help ease his constant money worries and allow him to focus on healing his psychological wounds.
A disability rating can unlock a host of federal and state programs for veterans, from low-interest loans to hiring preferences for federal jobs to free tolls on Houston roads. Perhaps most importantly, some veterans can't access free medical care until their claim is approved.
"I've seen some veterans who have almost lost their homes while they wait for VA claims to be granted," said Donna Harrell, the Williamson County Veterans Service officer. Such service officers, who are mostly county employees and act as veteran advocates, are in counties throughout the state and aid veterans in filing their claims. "The level of frustration is very high out there," she said.
The two VA claims offices in Texas — Waco and Houston — are among the busiest in the nation, each completing more claims than all but a handful of other regional offices. And Central Texas has one of the largest veteran populations in the nation: Bell County, home to Fort Hood, has more disabled veterans than Houston.
But local VA officials say that the Waco and Houston offices are simply feeling the same pressures driving the backlog nationally: a sour economy, aging Vietnam and World War II veterans, an influx of younger veterans from wars in Iraq and Afghanistan and new rules that make it easier to file claims.
"Our employees are anxiously engaged in processing claims as promptly, accurately and compassionately as possible," Waco VA officials said in a written statement. "Our strategic initiatives seek to improve the quality and timeliness of benefits delivery."
U.S. Rep. Bill Flores, R-Waco, said he will visit the Waco regional office this month in hopes of getting a better idea of what is causing the backlog. "We may have a cultural problem and not a systems problem," he said. "It's a huge disappointment for me, especially in light of the huge veteran population in Texas."
Texas legislators have held hearings on the backlog of Texas veteran claims, which have doubled in two years, and state leaders have pledged $1.5 million to help the federal government speed processing of claims in the state, a tactic that has garnered interest from other states such as California. But that state aid, in the form of additional claims counselors, may make only a small dent in the nearly 70,000 severely delayed Texas claims. Nationally, the claims backlog is trending in the wrong direction — while the VA processed a record 1 million claims last year, it received 1.3 million nationwide.
The VA is in the midst of a massive effort to modernize an archaic system that still depends on shuffling huge piles of paper. Through digitizing files and overhauling training, the department is aiming to reduce its average processing time for claims from 254 days to 125 days and bring its error rate down to 2 percent by 2015.
The Veterans Benefits Administration "has made similar promises for decades and failed to deliver," said Paul Sullivan, director of veterans outreach for the Maryland-based law firm Bergmann & Moore and former project manager at the Veterans Benefits Administration. "What's different this time is enormous public attention, congressional interest and the magnitude of the crisis."
Rise in PTSD claims
Despite the surge in claims from younger service members, Vietnam veterans account for 3 of every 10 new claims with the VA and nearly half of all amended claims, according to the VA.
That's partly because rules adopted in 2010 make it easier for Vietnam veterans to file claims based on PTSD and exposure to Agent Orange. Previously, veterans had to prove their conditions were specifically tied to the war; now, their conditions are assumed to be war-related. Waco officials say they have devoted "significant resources" to processing more than 19,000 Agent Orange claims, delaying other claims in the process.
If the experience of Vietnam-era service members is any indicator, the number of current service members developing PTSD and filing claims will grow in future years.
"There is typically a significant delay (in manifestation of PTSD symptoms) in survivors," said Dr. Raymond Scurfield, a Mississippi-based psychiatrist who served in Vietnam and has written several books about PTSD in war veterans. "People can have things so buried, they separate themselves emotionally from experiences to protect themselves from being overwhelmed. ... But after a period of time, you get tired, you get exhausted, and there is an in-rushing of re-experiencing."
Scurfield said old traumas can resurface after a triggering event, and "for Vietnam veterans, the major international events have been the first Persian Gulf war and 9/11."
Memories of Vietnam
Sivage said that after 9/11, his crying fits became more frequent and intense.
"I don't know if it was the current war, seeing all these guys coming back," he said. "I've just isolated myself. No freedom. I don't want any friends; I can't tolerate them."
The seeds were planted in the late 1960s. Sivage, who was born in New Mexico and lives in Georgetown, wasn't a grunt, but he worked on the front lines as a Navy electrician, helping to build camps, runways and bunkers. He wasn't trained for it, but he remembers vividly helping to carry horribly wounded soldiers on stretchers to the hospital.
At the end of 1967 he spent months near the demilitarized zone separating North and South Vietnam, a region of constant battle. His camp came under frequent mortar attacks; one shell landed close enough to give Sivage partial hearing loss. Sivage said the stress was amplified because as a member of a construction battalion, he was ordered not to return fire without permission.
His homecoming was far different than the ones experienced by today's generation of soldiers. After Vietnam, many soldiers returned home individually, not in groups with their units — experts now say that abrupt return, without the safety net of fellow war comrades, exacerbated mental health problems. The term PTSD was not invented until 1980, and screening for it was nonexistent, as were reintegration programs to help them transition to civilian life.
And recent war veterans were thrust into a society that often viewed them with disdain. Sivage tried college for a time, but he dropped out of Eastern New Mexico University shortly after he gave a presentation in speech class about his experience in the hugely unpopular war. His professor pulled him aside after class and asked him not talk about the war anymore.
Then came years of heavy drinking and fighting, before he settled down for a few years and opened a series of fried chicken restaurants in West Texas before marrying in the late 1970s.
Restaurants were something he threw himself into, he says now, in an attempt to escape from his demons.
Along the way, he tried attending church and getting involved with the chamber of commerce but felt alien. "You get out of the service, you come back and you hide it; you suppress it. No one wants to talk about it; no one wants to hear about it," he said. "When I got back from Vietnam, I just never felt like I ever fit in anywhere."
In the early 1990s, the crying began. He's still not sure what triggered it, but it got progressively worse. He says he began seeing a psychiatrist in 2001 but didn't link his emotional state to his war experiences for another decade. That's when he began to see a VA psychiatrist who told him he had the symptoms of PTSD.
"I was thinking you'd need a big trauma (to cause PTSD), like a roadside bomb," said Sivage, who now attends a weekly counseling group for Vietnam veterans. "But come to find out, various people are subject to various things."
Sivage said that during the worst of his emotional spiral, financial help from a brother and his wife's timely inheritance kept his family solvent. "If it hadn't been for that, I would have been on the street, homeless."
Sivage, who has peppered the offices of Texas' two U.S. senators with requests for help, received some good news last month when he was told that his claim had moved past the rating stage, in which federal employees determine how much in disability benefits to give injured veterans. A final decision, he has been told, will come in weeks.
Preparing for the future
Sivage and many of his fellow Vietnam-era fighters have underscored the fact that it can take decades for psychological and emotional injuries to take the form of a disability claim.
Ten years after the Vietnam War ended, one congressionally mandated study found that 15 percent of Vietnam veterans still had PTSD.
Already nearly 400,000 Iraq and Afghanistan veterans have sought mental health help from the VA, according to Veterans for Common Sense, and studies estimate 15 to 30 percent of returning troops have PTSD or other severe psychological problems. It's just the beginning of a wave that officials warn will require funding long after the wars end and recede into memory.
In addition to the digital claims system and enhanced training for claims workers, the VA is adopting a streamlined processing system that channels easier-to-handle claims into a so-called "express lane." The Houston claims office is one of 16 nationwide already using the express lane approach, which is expected to move to all 56 claims offices by the end of 2013.
The VA and Department of Defense also have begun instituting a program to move injured active-duty service members directly into the VA system, avoiding the lengthy delays involved in moving from one bureaucracy to another. VA officials say more than 7,000 Texas veterans have begun receiving disability payments in the program, with VA officials stationed at Texas military installations such as Fort Hood.
But such moves might only help the VA play catch-up, critics warn, and not necessarily address future needs.
"History shows that our requirements in the VA continue to grow a decade after the last combatant comes back," VA Secretary Eric Shinseki recently told a congressional committee. "In this case, while operations will be over and budgets will begin to reflect that, at the VA our requirements will still be growing. It's important to spend the time now to better anticipate the (future) needs for care and benefits."
That is something that up until now, the VA, and its funders in Congress, have been unable to do.