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House lawmakers are considering four bills that could help veterans suffering from the effects of sexual trauma in the military by improving the process for receiving benefits and providing greater support to victims.

House lawmakers are considering four bills that could help veterans suffering from the effects of sexual trauma in the military by improving the process for receiving benefits and providing greater support to victims. (Stars and Stripes)

WASHINGTON — House lawmakers are considering four bills that could help veterans suffering from the effects of sexual trauma in the military by improving the process for receiving benefits and providing greater support to victims.

"From equitable access to health care and benefits to strengthening programs that will help veterans lead a life of meaning and purpose, these bills will help strengthen the institution tasked with serving our increasingly diverse veteran population," said Rep. Mark Takano, D-Calif., chairman of the House Committee on Veterans' Affairs.

Military sexual trauma is a term used to describe sexual assault or sexual harassment that a veteran experienced during their service, accord to the Department of Veterans Affairs. The VA reported in May 2021 that 1 in 3 women and 1 in 50 men said they experienced sexual assault or sexual harassment during their service in the military.

The VA Office of Inspector General investigated denied claims for military sexual trauma and found VA processors didn’t always follow the policies and procedures for them. Leaders of the Veterans Benefits Administration didn’t monitor compliance, and there were ongoing “failures in governance,” according to the IG report.

"As a result, veteran survivors of military sexual trauma remain at risk of not receiving the VA benefits to which they are entitled and experiencing additional distress when claims are improperly handled or denied," the report stated.

The inspector general's office investigated the claims as a follow-up to a 2018 review, during which inspectors found about 49% of rejected claims for military sexual trauma between April 1 and Sept. 30, 2017, were denied without the processors performing their due diligence.

Inspectors conducted a second review to see how the department improved since the 2018 report. They discovered the situation had gotten worse. The office found 57% of the rejected claims for military sexual trauma in the last quarter of 2019 were denied but should not have been.

The VA had not corrected the problems found in 2018, the new report found. Some of the bills being considered by the House committee are, in part, a respond to those IG findings.

The Dignity for (Military Sexual Trauma) Survivors Act focuses on the treatment of military sexual survivors and their trauma. The bill would restore dignity to the claims appeals process by requiring the VA secretary to ensure workers for the Veteran Benefits Administration complete yearly military sexual trauma training to continue hearing appeals. It would also require the VA to review the language in the claims denial letters to ensure they are carefully worded to avoid traumatizing veterans who are already suffering from the effects of sexual assault or sexual harassment.

Moreover, the bill would mandate that contract medical providers conduct military sexual trauma-related examinations in a sensitive trauma-informed manner. The bill will require the VA to confer with stakeholders to identify the appropriate language for inclusion in denial letters.

"While VA has taken steps in the right direction, more must be done to improve the claims appeal experience, show compassion, and safeguard the dignity of [military sexual trauma] survivors," Rep. Frank Mrvan, D-Ind., said last week.

An amendment to the bill would require the VA to apply the same standards to the Veterans Health Administration examiners and outside providers who carry out military sexual trauma-related exams.

"Words have meaning, and power and language we use can itself retraumatize [military sexual trauma] survivors," Takano said. "Therefore, much thought should be given to the way VA corresponds with veterans who have [military sexual trauma] claims."

If board members do not meet the yearly training requirement, they will not be assigned military sexual trauma cases. Moreover, the bill will provide medical providers to use the most up-to-date trauma-informed protocols during their work with veterans seeking military sexual trauma claims.

Another bill to assist sexual trauma victims in the claims process is the VA Peer Support Enhancement for (Military Sexual Trauma) Survivors Act.

First introduced in October, the bill will require the VA to establish a peer support program at the Veterans Benefits Administration for veterans who were sexually assaulted or sexually harassed. The bill will ensure each veteran who files a military sexual trauma claim can have a peer support specialist amid the claims process and will require the peer support specialist to be trained as a victim advocate. The peer support specialist will not be responsible for any part of the adjudication of the veteran's claim.

The Veterans Benefits Administration has military sexual trauma outreach coordinators. However, they assist military sexual trauma claimants with the compensation claims process and accessing care, according to Dr. Nilijah Carter, executive director for pension and fiduciary service at VA's Veterans Benefits Administration.

Carter said each of the administration’s 56 regional offices staffs specially trained military sexual trauma coordinators.

"Veterans who are experiencing distress as a result of the claims process can access treatment through [Veterans Health Administration], whose trained clinicians can provide support, as needed," Carter said. "The VA supports Congress' overall intent to provide increased support to veterans filing claims for [military sexual trauma] and looks forward to working with the committee to address our technical concerns."

However, a VA inspector general report in August based on interviews with 136 of the VA's military sexual trauma coordinators found that more than 60% said they didn't have the administrative support needed to perform their duties, and nearly 30% said they needed more funding for outreach and education.

Takano said the VA has used peer-support specialists for recently discharged veterans to assist with mental health and substance abuse issues and caregivers. Thus, peer support for military sexual trauma victims might prove to be a beneficial tool amid the claims process.

"Now, within the military sexual trauma context, a highly trained peer-support specialist can serve as an advocate who can provide counsel, assistance, and coordination to navigate a process that may be stress-inducing and anxiety-provoking," Takano said. "If the [military sexual trauma] claimant chooses to utilize the services of a peer support specialist, the [military sexual trauma] claims may go more smoothly, potentially reducing the strain on an inherently difficult process."

An amendment to the bill would clarify that the peer-support specialist can provide counseling services to the veteran who might have difficulty coping with recounting their sexual trauma experience during the claims process. Moreover, the amendment clarifies the peer-support specialist cannot provide claims advocacy services such as sharing a veteran's personal story amid a hearing.

Rep. Nancy Mace, R-S.C., who was sexually assaulted, said the military sexual trauma claims process is complicated and traumatic enough.

"It often requires a survivor to retell their story of assault multiple times over, and in some cases actually relive it," she said. "And for some people, it is the worst day of their lives."

The third military sexual trauma-related bill to be considered by the House is the Veteran Benefits Administration/Veteran Health Administration Coordination (or Military Sexual Trauma Claims Coordination) Act.

"Due to the sensitive nature of military sexual trauma claims and the fact that they touch on the responsibilities of both of these administrations, it's imperative that they can coordinate better internally," said Rep. Elaine Luria, D-Va.

The bill also would require the VA to provide more advanced services, including information on the Veterans Crisis Line, accessing counseling and care, and providing additional resources specifically for veterans who have been sexually assaulted or sexually harassed.

“Wherever a veteran makes contact with VA, whether if first through filing a claim or by attempting to receive [Veterans Health Administration] care, there should be pamphlets, signage, contact sheets, and other materials to provide veterans the resources they need to fully engage with VA to have their needs met,” said Kristina Keenan, associate director of the Veteran of Foreign War’s national legislative service.

The last military sexual trauma-related bill to be considered is The VA & NASEM [National Academies of Sciences, Engineering, and Medicine] Agreement for Military Sexual Trauma. The bill would direct VA Secretary Denis McDonough to enter into an agreement with the academy, an independent nonprofit institution that provides policy advice in science, technology, and health.

One element of the bill would have the academy focus on the adequacy of the disability benefits questionnaires related to military sexual trauma. The VA's raters use the questionnaires to determine whether a veteran's condition is service-connected and to provide a rating.

Rep. Troy Nehls, R-Texas, said he had heard concerns from veterans service organizations that the forms are outdated for physical health conditions related to military sexual trauma.

"If the [disability benefits questionnaire] is not sufficient to describe the veterans' disabilities, the veteran may receive an improper denial or incorrect rating, and that is unacceptable and it must be addressed today," he said.

The bill would require the academy provide recommendations for how the VA can improve the disability claims and exam process for military sexual trauma.

Brianne Ogilvie, the assistant undersecretary for policy and oversight at the VA's Veterans Benefits Administration, said the administration has made several efforts to the military sexual trauma claims process. She said the VA has concerns with the bill.

"There's a difference between medical treatment and examinations for disability purposes," Ogilvie said. "While I'm sure [the academy is] very capable of making medical determinations, we are concerned about how they would make a determination of the adequacy of the tools and protocols used when we're talking about what's needed for ratings for disability claims."

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Sara Samora is a Marine Corps veteran and the veterans reporter for Stars and Stripes. A native Texan, she previously worked at the Houston Business Journal and the New Braunfels Herald-Zeitung. She also serves on the boards of Military Veterans in Journalism and the Houston Association of Hispanic Media Professionals.
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