Being Presumptuous

--Bill Mauldin

Time is on my side, yes it is
Time is on my side, yes it is
--Time is on My Side,
The Rolling Stones

You're in the Army now,
You're not behind a plow;
You'll never get rich,
You son-of-a-bitch
--You're in the Army Now

What am I now that I was then?
Time is the school in which we learn,
Time is the fire in which we burn.
--Calmly We Walk Through This April Day,
Delmore Schwartz
________________

DAV Magazine (May/June) reports, "New 'Presumptive' Illness Proposal for Iraq, Afghanistan Veterans":

"In a long overdue decision affecting veterans of the wars in Iraq and Afghanistan, the Department of Veterans Affairs has moved to grant presumptive service connection [SC] for nine illnesses, making it much easier for those veterans to obtain health care and disability compensation."

"The National Academy of Sciences [NAS] Gulf War and Health report recommended in October 2006 that the VA establish new presumptions of service connection for brucellosis, Campylobacter jejuni, Coxiella burnetti (Q fever), malaria, mycobacterium tuberculosis, non-typhoid Salmonella, shigella, visceral leishmaniasis and West Nile Virus.

"The proposed federal rule authorizing the presumptions cover the nine diseases associated with military in Southwest Asia during the Gulf War, or in Afghanistan on or after 10/19/01. It includes all veterans of Iraq since Operation Desert Shield.Desert Storm in 1990."

The reason for this piece is twofold: To inform former soldiers of these developments and to discuss Black Ops and presumptive ailments. [Previous posts Nuts and Double Jeopardy discussed the CRSC issue.]

The Special operations community takes great pride in being special, but they often forget that even tabbed-up soldiers may find themselves in the beaten zone of the Department of Defense and the Department of Veterans Affairs.

This same DAV issue highlights the fact that the VA routinely takes an adversarial stance in veteran's appeals:

"In recent oral arguments at the Supreme Court, Chief Justice John Roberts expressed shock at the government's admission that in litigating with veterans about their benefits, VA routinely takes a position that is unjustified. In other words, the government sometimes makes veterans jump through hoops to obtain benefits to which they are entitled by virtue of their service" (Some Veterans Given Runaround at BVA and CAVC).

You're in the Army now.

Though the DVA was tasked to help vets prove their claims, the reality is often the opposite. The DVA has historically been a stonewalling agency that blocks veterans efforts to gain compensation for their service connected conditions by requiring them to provide often difficult to obtain medical evidence to prove their claim of service connection.

How do Special Operators prove that they were even on such a mission, in such a country, when all records of the activity are classified and sterilized? Black Ops types are cool, until they must prove their exposure to an illness-causing agent that occurred in that secret realm.

Let us say you were on a Top Secret assignment to Gitmo and you contract mycobacterium TB from a prisoner, or anything else from anywhere else in the Third World. Or your Q fever goes away, but not really, and 20 years later you're facing organ failure? Sand-borne infectious agents abound, many activating only after years of service. What then?

These same soldiers will be facing other compensation issues. They may have to do battle with the DA to receive Combat Related Special Compensation (CRSC), an arcane process with many hoops to jump. What if you are ill and cannot jump very well?

To receive CRSC one must apply through HQDA and have a service connected DVA SC condition that fulfills Army guidelines as Combat Related. This is difficult, as the DVA does not address the concept of "Combat Related", nor are they legally required to do so.

The Army applies a harsh yardstick, and neither gives the applicant any presumptions nor accepts sworn testimony from vets or witnesses. Only official documents are accepted -- a Catch-22 if you were on a mission that didn't exist on the books.

Ranger's case is typical, and involved Lieutenant Colonel Fred Sisson, Officer in Charge of the DA program. The issue was the infamous crushed testicle operated on in theatre at the 24th Evac Hospital, whose records had long since been deep-sixed.

The crushing occurred in a Stabo Rig in RVN, fitting all definitions of combat relatedness. No records, so LTC Sisson refused combat relatedness -- and yet there you have the thing, incurred while SF, Infantry, drawing combat pay and on jump status! Was there another explanation for entering the country with uncrushed testes and leaving with one squashed, and it NOT be combat or training-related? (Ranger was not a bronco-rider.)

Next was my bilateral tinnitus, again denied as being combat-related by Sisson due to lack of documentation. However, ear damage -- and tinnitus, in particular -- are common combat related conditions. One can get tinnitus from high blood pressure, nerve damage or exposure to blast and gunfire, engine noise and all the classic combat arms stuff.

It was incumbent upon me to seek out an audiologist at Shands Hospital specializing in tinnitus to confirm my condition was blast-related. LTC Sisson then conceded the point, assigning combat
relatedness -- but why the exercise in futility? If one has tinnitus and a combat arms background, the DA should presumptively grant the award.

Finally, my neck injury from parachute whiplash. My cervical spinal damage was not accepted as parachute related, though the DVA rated it as SC. Talk about a verbal whiplash! How would one injure one's neck as an airborne infantryman? Duh! Duh to all but LTC Sisson, that is, who refused to accept the damage as combat related/realistic training related.

Fortuitously, I found a sick slip in my records from 1979 indicating an airborne connection, and once again Sisson awarded the correct relatedness adjudication. But why the battle? Who has sick slips from 1979?

If not for the slips of paper and savvy specialists, my word as an officer seems to have no value to the CRSC staff. Benefit decisions do not favor the position of the veteran.

Please don't disregard this as the writings of an old disaffected trooper. Apply my lessons to your life and career. When injured have your medical personnel clearly state that your condition is combat related or from realistic combat-related training.

Do not trust fate or the Army to serve your best interests 25 years down the road. Army loyalty doesn't stretch that far. My experiences with the DVA and DA CRSC are not exceptional but are tediously average. If you don't believe me, talk with another wounded old soldier.

Not only must you be a good soldier, but you must be a good record keeper documenting your career. If you fail to do so, you will pay the price.

Nuts

I hang onto my prejudices,
they are the testicles of my mind
--Eric Hoffer

NUTS!
--General McAuliffe,
on German request for surrender

If your testicles are crushed, or your male member missing,
you must never enter a sanctuary of the Lord
--Deuteronomy 23:1
_______________

So, Ranger could properly quote the Bible if he ever needed to get out of church duty.

In yet another We Support the Troops initiative (Not) comes Undersecretary of Defense for Personnel and Readiness David Chu's rejiggering of the standards for Combat-Related injuries, which disqualifies thousands of disabled veterans from receiving certain benefits, like Combat-Related Special Compensation.

His decision will also require many disabled service members to "repay their military disability severance pay before they could receive disability compensation from the Department of Veterans Affairs." (Pentagon Narrows Combat-Related Definition.) Unsurprisingly, the Department of Defense has adopted Mr. Chu's reconfiguring of the Congressional mandate as it will result in a reduced disability compensation load form the Department of Veterans Affairs.

"Contrary to the 2088 Defense Authorization Act, in which Congress defined disability as combat-related if it resulted from service in a combat zone or performance of duty in combat-realted operations, Chu argued that the DoD 'endorsed the premise that the benefit for those hurt in combat should be more robust than for members with disabilities incurred in other situations (e.g. simulation of war, instrumentality of war or participation in hazards not related to combat).'"

According to Chu, if a disability results not "as a disease or injury incurred in the line of duty as a direct result of armed combat," such affected service members will be remunerated at a considerably "less robust" rate.

The DAV claims Chu has "(D)isregarded the broader intent of Congress," through eliminated disability resulting from hazardous service, duty under conditions simulating war or disability incurred through an instrumentality or war incurred outside of a combat zone as "combat-related" injuries. As a result, these disabled veterans are no longer eligible for their CRSC as mandated by Congress.

This issue affects Ranger, who has been riding the merry-go-round for years with Officer in Charge Fred Sissons of the Army's CRSC determination board. Only after pursuing congressional channels was Ranger able to receive his CRSC.

The administrative battle was distasteful and contrary to the spirit and intent of the law. Congress honored combat-related disabled vets by awarding CRSC, but then the Army creates a jungle-like maze one must wade through in order to receive the special compensation.

The other services have different interpretations of the regulations, resulting in application and qualifying procedures which are more liberal than those of the Army. DoD lacks a comprehensive approach to qualification for these funds, as each branch controls its own program. For instance, Chu's new guidelines for the Army disqualify combat-related training injuries from CRSC application, yet more servicemen are training-injured than combat-wounded.

In Ranger's case, he was injured in the Republic of Vietnam in a STABO rig accident. He suffered a crushed testicular artery and left testicle practicing jungle combat extractions in a 1970 field exercise. This was a practice exercise, in country, and Ranger was Infantry, Special Forces and drawing combat pay. The injury was surgically treated in the 24th evac hospital. But today's CRSC reps say this service-connected disability is not combat-related.

The problem in applying for the CRSC is a Catch-22: CRSC requires "combat-relatedness," however, this term does not exist in the pantheon of DVA terminology. The VA uses only the term "service-connected," as required by law.

38 years ago Ranger lacked the presence of mind and forethought to ask the doctor to put in the medical record, "combat-related." The Army didn't care how Ranger was injured, they simply operated to alleviate the problem. Today, my left nut is service-connected but not combat-related.

Now that's really nuts.