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Veterans claim and health issues that have been posted on various Sites


Veteran News Update!

Concerning VA Doctors giving opinions to help veterans, Mr. Selfon states:  "We have been told that some of these providers have actually been warned of disciplinary action if they elect to assist veterans in this respect." (see complete statement below).
I have been in communications with Mr. Selfon, and he states that The VVA has apprised the VHA Acting Under Secretary Dr. Thomas Garthwaite of the situation, and the VHA will be looking into the matter.  Also Mr. Selfon states that it appears to be isolated situations by some management at VA facilities rather than by VA Directive or letters. 
Mr. Selfon also states that he expects regulations to be implemented which allow VA Doctors to continue providing Statements in support of veterans claims. (Editor's Note: if you have knowledge of this occurring you should contact the VHA and tell them.  Also any VA Doctor who gives opinions for veterans should be given assistance.  The names of anyone threatening a VA Doctor should be given to the VA Inspector General).
When I received Mr. Selfon's email, he also mentioned that the March/April 2000 issue of the VVA Veterans Benefits News has been delayed , but will be published soon, with the June/July issue not to far behind.  These items will be reviewed with links to the various cases, when available.
Your Editor,


Department of Veterans Affairs Selects Magellan Behavioral Health to Manage Mental Health and Substance Abuse Services

COLUMBIA, Md.--(BUSINESS WIRE)--July 24, 2000--The Department of Veterans Affairs has selected Magellan Behavioral Health to manage mental health and substance abuse benefits for its members.

Under the five-year agreement, which takes effect on October 1, 2000, Magellan will manage mental health and substance abuse services for approximately 100,000 beneficiaries in the United States and internationally. The Civilian Health and Medical Program of the Veterans Administration (CHAMPVA) contract is administered through Magellan's Englewood, Colo. service center.

CHAMPVA processes medical claims for surviving spouses and dependents of U.S. military personnel who gave their lives or became permanently disabled while in service to their country.

``We are delighted that the Department of Veterans Affairs has chosen us to manage this contract,'' said Marilyn Gaipa, executive director of Magellan's regional service center in Englewood. ``This contract gives us the opportunity to bring our proven record of success in managing both commercial contracts and TRICARE programs to this very deserving group of beneficiaries.''

Gaipa added, ``We believe we can improve the quality of care received by these beneficiaries, while controlling costs, which makes this a winning situation for the CHAMPVA beneficiaries, for the government, and for the taxpayer.''

Magellan Behavioral Health is the country's leader in managed behavioral health, employee assistance programs and human services, serving individuals across the United States and Canada.

The company specializes in managed mental health and substance abuse services as well as employee assistance/work-life programs, and serves over 3,000 client organizations from health plans, government agencies, unions, and corporations, including more than 20 percent of all Fortune 500 companies.

Its parent organization, Magellan Health Services (NYSE:MGL - news) is a Fortune 1000 company and the country's leading specialty managed care organization.

     Magellan Behavioral Health
     Kevin Helmintoller, 410/953-1218
     Erin Somers, 410/953-2405


War’s Heart of Darkness

Post-Traumatic Stress May Cause Cardiac Disease in Vets

Vietnam veterans with Post-Traumatic Stress Disorder have twice as many heart problems as the U.S. Vietnam vet population as a whole. (

 By Bill Brewster
Nov. 10 — Thursday is Veterans’ Day, the day Americans remember their country’s wars, and the men and women who fought in them.
     Some remember heroism and sacrifice; some remember horror and senseless death. Some swell with pride; some recoil in shame. But everyone remembers something.
     For many former U.S. military personnel who fought in Vietnam in the 1960s and ’70s, the much-reported truth is that they remember all too much. Thousands experienced something so awful in Vietnam that they developed post-traumatic stress disorder, an often-debilitating psychological condition that never lets them forget what they saw and felt.
     In this month’s issue of Annals of Behavioral Medicine, researchers Joseph Boscarino and Jeani Chang establish a direct link between PTSD and coronary heart disease. The news is especially crucial because as Vietnam veterans age, their doctors have an increasing need to know and address their principal disease risks.

Heart Risk Doubles
To be sure, PTSD did not begin in Vietnam. Boscarino, the chief researcher of this study, notes that its symptoms have long been recognized in military hospitals. He says journal entries indicate that the symptoms of PTSD were widespread as far back as the U.S. Civil War.
     PTSD sufferers include those who witness, or are victims of, violent crime; workers in high-risk occupations such as inner-city police or metropolitan firefighters; victims of sexual abuse or domestic battery; victims of natural disasters, and people involved in motor vehicle or airplane accidents.
     But only in the past 20 years has PTSD commanded the attention of psychiatric researchers. And only among war veterans can they find a large group of people approximately the same age, suffering PTSD from a kind of communal experience that is perfect for studying.
     Boscarino looked at more than 4,000 male U.S. Army vets’ electrocardiograms, which were collected by the Centers for Disease Control in the mid-1980s — about 20 years after most of the men had served.
     Boscarino found that while 14.5 percent of the study population had abnormalities in their resting ECG test — that is, they were at serious risk of heart disease or had already suffered a cardiac event — the rate nearly doubled for those currently being treated for PTSD.

Rough Idle
Charles Figley, a Florida State University professor who studies PTSD, says its overarching problem is that “it increases the body’s idle point” because it consumes extra energy and attention. That “takes away from the good things that enable our body and mind to spring back,” says Figley, things such as strengthening the immune system and having pleasant dreams.
     Boscarino says his study is a breakthrough because it presents one of few proven links between PTSD and other diseases as determined by an objective medical test not just by “self-reporting” of symptoms by the study population. He characterizes the ECG tests as “the gold standard for diagnosis of heart disease.”
     He says the study shows that doctors need to consider history of PTSD as an additional risk factor for heart disease. Most researchers agree that this conclusion is intuitive and not surprising, but they also agree that Boscarino’s study delivers the proof.
     Paula Schnurr, a psychiatry professor at Dartmouth Medical School and a researcher at the National Center for PTSD, says she hopes that this week’s results will encourage further research to look for links between PTSD and other illnesses, including gastrointestinal complaints, cancer, stroke, immune problems and a host of other diseases.

Multiple Pathways
Schnurr emphasizes the distinction between stress, which has been well-studied and linked to many illnesses, and PTSD, which has not. While no one denies the weighty impact of events like divorce or job loss that lead to stress, something about suffering a trauma is different.
     She says that while nearly everyone who suffers trauma shows some symptoms like those described below, most do not develop PTSD, which is defined as suffering from such symptoms for more than a month. And it’s the onset of PTSD, not the trauma itself, that is linked with increased disease risk.
     Those who develop PTSD are more likely to use alcohol more, smoke more, use legal and illegal drugs regularly, exercise less, and engage in other health-compromising behavior. That might mean that there are many pathways by which trauma turns into PTSD for some, or several reasons why PTSD sufferers develop serious diseases more often.
     Whatever the case, spare a thought on this week’s day of remembrance for those who are getting sick from memories they cannot escape.

More on PTSD
PTSD experts say that the disorder is different from “stress” in that it’s brought on by a extremely traumatic event.
     Paula Schnurr of the National Center for PTSD says that while the definition is fuzzy, a “traumatic stressor” usually involves a serious injury or threat to your life, seeing those traumas happen to someone else, or knowing someone who’s suffered them.
     Symptoms include:
     Intrusive memories or flashbacks
     Taking pains to avoid physical or emotional reminders of the trauma
     Feeling numb or cut off from society
     Difficulty expressing love
     “Hyper-arousal” (edgy, easily startled), also often irritable or angry
     A 1995 study found that roughly 8 percent of U.S. adults get PTSD at some point during their lives. About 4 percent are suffering it at any given time. Among Vietnam veterans, 30 percent have had it at some point, and about 15 percent are grappling with it at any given time.
     The only known effective treatment is psychosocial intervention that usually involves group therapy.

Vietnam Vets Battle Illness

The Post-Traumatic Stress Connection

New evidence indicates that the severity of Vietnam veterans' later health problems depends on whether they were heavily involved in combat. (PNI/

By John Dudley Miller
Special to
To veterans of Vietnam and other wars, it's a statement of the obvious: the stress of battle can cause serious health problems in soldiers decades after they return home.
    But the search for definitive evidence linking service in Vietnam to later illnesses has stymied researchers over the years and sparked numerous political battles.
     A new study, published in the journal Psychosomatic Medicine, may begin to clear up some of the questions.
    What the research found is that Vietnam veterans who survived heavy combat and were later diagnosed with post-traumatic stress syndrome (PTSD) are much more likely than other vets to suffer from a variety of chronic physical diseases 15 to 20 years later.
     Compared to GIs who saw little of the battlefields in Vietnam and did not develop PTSD, combat vets are 50 to 150 percent more likely to have had heart trouble, weakened immune systems, infections, arthritis and breathing and digestion problems.

Stress Factor
Most or all of those problems may stem directly from PTSD, says study author Joseph Boscarino, an epidemiologist and social psychologist for Catholic Health Initiatives, a national chain of hospitals and nursing homes.
    “It starts off as a psychological phenomenon,” Boscarino explains, “but it eventually affects the whole body system.”
    One of the classic symptoms of PTSD is over-arousal, a state of being “on guard” mentally and physically, and constantly aware of combat memories. This unabated tension apparently causes the endocrine system to pour out a steady stream of hormones and other chemicals, attacking the body over a period of years and wearing it down.

Mind-Body Disconnect
Boscarino concluded that battlefield experience and PTSD were pivotal factors in Vietnam vets’ post-war health after analyzing the results of medical exams done on veterans in the late 1980s. Most were in their late 30s at the time; it’s not known what their health is like today because they haven't been re-examined as a group.
     The original 1988 data was compiled by the U.S. Centers for Disease Control and Prevention, which did detailed physical exams on nearly 4,500 of the 4.9 million people in the military from 1965 to 1971. The original study found that many of the vets had psychological problems, and some had isolated medical problems.
     But, says Boscarino, the CDC researchers never connected the mental and physical problems, probably because the agency’s medical investigators and social scientists worked in separate groups.
     Boscarino contends that the CDC researchers also found fewer physical ailments among the men than really existed, because they didn’t count anything but full-blown illnesses. For instance, for heart disease they counted heart attacks but not other significant problems, such as high blood pressure or abnormal heart rate.
     The problem with that approach, he says, is that “many of these major diseases have not fully manifested themselves yet at the fourth decade of life.”

Same Data, Different Approach
In his reanalysis of the CDC data, Boscarino found that 25 percent of high-combat PTSD-diagnosed veterans had heart and circulatory problems, compared with only 12.9 percent of vets who had served in low- or non-combat areas and did not have PTSD.
     Likewise, 22.9 percent of the high-combat veterans had digestive problems, 21.4 percent had urinary or genital problems, and 15.4 percent had arthritis, all significantly higher figures than for low-combat, non-PTSD vets.
     In previous research, Boscarino found that high-combat Vietnam veterans also had lower levels of the chemical cortisol in their blood streams, a sign of a weakened immune system. They also had abnormally high white-blood-cell counts.
     “When your doctor finds you have (that high) a white blood cell count,” he explains, “they want to take you in for more tests, to find out whether you have a chronic infection or a disease somewhere. It's a hallmark of disease.”

Direct Evidence
Dr. Charles Figley, a professor at Florida State University and a leading PTSD expert, thinks Boscarino's findings are very important. “It clearly supports what those of us who have been rolling around in this field have said for a very long time,” says Figley. “Because of his tenacity, we now have clear and direct evidence.”
     He and other PTSD experts think Vietnam vets should be re-examined now to see if their health has worsened in the last decade. “These guys are 48 to 50 now,” notes Dr. Terence Keane, director of the National Center for Post-Traumatic Stress Disorder at the Boston Veterans Administration Health Center. “This is the point where you're going to start to see some serious diseases develop.”
     But the main organization representing Vietnam veterans isn't ready to accept that PTSD alone has made combat veterans ill. Vietnam Veterans of America (VVA) believes that exposure to the defoliant Agent Orange has caused many physical diseases, especially cancer and birth defects, and it may also have caused the increased instance of illnesses such as heart disease that Boscarino found.
     “It's a very difficult thing to determine,” says Jacqueline Rector, chair of the group's PTSD/Substance Abuse Committee, “because for the most part, they were exposed to both things.”
     According to Boscarino, the effects of Agent Orange are impossible to assess from the data he analyzed, because the military's exposure records are inaccurate.
     “We know that combat veterans tend to report exposure and tend to have PTSD and these medical problems,” he says. But without knowing exactly how much of the chemical each vet got, it's impossible to show whether it caused later problems.
    So Boscarino's study won't provide the final answer for Vietnam veterans who suffer from poorly understood ill health, but it does make an important link that may send other researchers in different, more productive directions.

New Monument to Honor Vets This Veterans Day
War Wounds Without Blood



“You never quite get over the anxiety caused by the trauma and the dangers of war. The willingness to confront it is an important step”
— Dr. Charles Stenger


Click on the buttons to learn more abou
t American veterans.

(; Data from: Department of Defense, Department of Veterans Affairs, National Coalition for Homeless Veterans, National Gulf War Resource Center and Department of Veterans Affairs)

By E.J. Gong Jr.
Neither bullet nor bayonet injured Ron Landsel during his two-year stint in Vietnam but the former Marine came home severely wounded. After two years of combat, it was his spirit that suffered most.
Now, 30 years since he left the jungles of Da Nang, Landsel finally feels emotionally healed. Today, his goal in life is to help other vets do the same.
     In honor of Veterans Day Wednesday, Landsel will unveil a 60-foot-long moveable wall composed of photographs and artwork to honor all U.S. vets suffering from mental and emotional wounds. The wall is made of wood and marble. It includes pictures of smiling children, representing the hope for peace.
     Landsel and fellow vets built the wall in Pittsburgh and brought it by semi truck to Washington, D.C., for an exhibit on the National Mall, just feet from the permanent National Vietnam Veterans Memorial.

War Ended But Pain Did Not
Thousands of veterans from World War I to the Persian Gulf War still cope with depression, alcoholism, homelessness, suicide, drug abuse and post-traumatic stress disorder due to their experiences on the battlefield, says Landsel. Yet so often, these problems aren’t seen as true casualties of war.
     “It’s an opportunity for the human cost of war to be known on Veterans Day,” says Landsel. “I want to bring a deeper awareness of what our soldiers must live with when they come home.”
     Another purpose of the mobile monument is to help vets face up to their pain. Landsel says the longer a vet runs from it, the worse it gets.
     He knows from experience. Landsel refused to confront the pain and anger of his own experiences from the late 1960s, but when he finally did, he freed himself. That experience inspired him to create Operation 11th Hour: Veterans Speak, the group that built the wall. Landsel said several other veterans’ groups are interested in showing the wall in their cities after the D.C. exhibit ends this week.

Vet Groups Praise the Exhibit
The Vietnam Veterans of America Association, a congressionally chartered organization based in D.C., praises Landsel’s work. Spokesman Rick Weidman says the Vietnam Veterans organization was founded 20 years ago to deal precisely with the painful emotional issues arising from the aftermath of war.
     “We were losing guys left and right to the ravages of mental war wounds,” says Weidman. “There are obligations the government still hasn’t met. So anything that increases awareness our pain is important.”
     Psychologist Charles Stenger, an expert in post-traumatic stress disorder, says many veterans come home ashamed of their depression and anxiety. They think it means they’re weak.

Trauma Never Totally Gone
“You never quite get over the anxiety caused by the trauma and the dangers of war,’’ says Stenger, a World War II vet. “The willingness to confront it is an important step.”
     Stenger served as a medic and was a prisoner of war for six months in Germany. He says his role as a caregiver probably kept him from suffering from deep emotional problems.
     “I had a constructive role and it helped my sense of self-esteem,” he says. “When you’re busy helping others you don’t have time to worry about yourself.”
     Still, he doesn’t like revisiting those memories much. He refused to see the movie Saving Private Ryan for fear the first 20 minutes of battle scenes might trigger his emotions, but he was glad to hear about its realism.
     Says Stenger: “People need to see war is a terrible business.” 



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