RURAL PROBLEMS 4-CORNERS FACE
We may face different problems from other rural areas face. In addition to being rural, we are in the SW Corner, you know, that place too far to travel, too easy to ignore, except for water and natural gas.

FIRST THE GOOD ?

* Care at our local VA Contracted Clinic with Health Net Federal Services is absolutely outstanding and a standout out in the VA Clinic system.
The health care delivered from the Albuquerque VA Medical Center is outstanding. I receive continuous unsolicited favorable comments at my office from veterans and their families about the quality delivered and caring staffs.
Health Net Federal Services has recognized the Clinic for its service.

? Local assistance through cooperative efforts by the Veteran Service Office LaPlata County, LaPlata County Human Services, Southern Ute Veterans Association, Veterans of Foreign Wars Post 4031 and its Auxiliary, the Durango Army National Guard Family Assistance Center, Durango Blue Star Moms Chapter One, Durango Disabled American Veterans Chapter 48, private citizens and veterans families work together to provide 24/7 support in various ways. This has been on going since January 2002. Resources, while always slim, are now hard to generate to sustain this effort ? the needs have not diminished. I would be remiss not singling out Gina Picolli, owner of Coldwell Banker in Durango. Because of Coldwell Banker we have two DAV Vans due to matching a grant and two electric scooters to assist veterans with an offer of further support.   
LaPlata County, Archuleta County and San Juan County Veterans Offices whose veterans are served out of the same Durango VA Health Care Clinic work together in a cooperative spirit.
Comment:
These successful efforts should be supplements to and not a replacement for VA provided funding to the degree they are now.

? The support we receive through Grants from the Colorado Board of Veterans Affairs from their share of the Tobacco Settlement money is the heart of any transportation success as it stands now.

Comment:
This will change in 2007 when the source of the grant funding, the Tobacco Settlement money runs out.
State Representative Mark Larson is assisting the LaPlata County, CO VSO in presenting a Colorado constitutional amendment as a possible source of replacement funds.

? Veteran's Administration Veterans Service Center in Denver from my
      experience has provided assistance and advice that has made this office efficient
and is part of any success we have had. There is no doubt by the manner in which they conduct themselves that they all are there for the right reason.
Comment:
It would be nice if someone like Senator Salazar would pass on that they
were compliment by a local VSO at your VA Hearing.

? For consideration by the recently created Veterans Disability Benefits Commission. Create a more efficient VA process first before considering decreasing benefits. The work has been done. The savings are worth a serious look. Many hundreds of local veterans services offices still submit hand written claims / forms. Some are barely legible ? creates misinterpretations, rejections, repeat submissions, out of hand rejections ? no fault of the state/regional VA offices.

Comment:
Andy Fautheree, the VSO of Archuleta County, Colorado put together and very easy to use Adobe Electronic Filing CD. Jake Martinez, SFVSO of the New Mexico Department of Veterans' Services prepared a booklet called ?Well-Grounded Claims?. The National Department of Veterans Affairs should give a serious look at these exceptional efforts as training tools nationally. These tools allowed me to be effective within a few weeks instead to the usual year plus, and I was able to generate claims much more efficiently, with fewer mistakes.
[Andy Fautheree can be contacted through: County Board of Commissioners, Archuleta County Courthouse, Box 1507, Pagosa Springs, CO 8147 ?
Jake Martinez can be contacted through: Department of Veterans Affairs, 500 Gold, SW, and Albuquerque, NM.]
THE NOT-SO-GOOD

ALBUQUERQUE OVERNIGHT ACCOMODATIONS VIRTUALLY ELIMINATED:

Comments:

TEMPORARY SOLUTION - Only through the Colorado Board of Veterans Affairs (CBVA) 2005 Grant and local VFW, DAV and private donations are veterans served by the Durango, CO Clinic no longer canceling Compensations Evaluations.

The source of  CBVA Grants end in 2007:
The Colorado Board of Veterans Affairs share of the Tobacco Settlement money that sustains their Grant program ends in 2007.

PERMINANT SOLUTION ? Allow veterans to help veterans. Have a National Program that allows gambling money to be put to good use.

Proposal: Using existing Congressional mandated veterans organization By-Laws for control and inquiring how other existing state programs work, allow veterans organizations with a facility only, by square foot of facility to a maximum of 4 each, gambling machines to generate income of which above costs only 15% is retained and 85% must be donated to ?
State level Board of Veterans Affairs (50%)
State Veterans Nursing Homes (15%)
State Department of that service organization (15%)
VA Medical Center Transportation Program under which local veterans are served (5%)
Required to work -
-State Revenue Department must adjust fees/taxes so as to allow the maximum generation of funds for the purpose intended.
- Veteran organization Post, Chapter, etc must hire independent accountant who sends reports to the organizations Department level. District level can verify independent report during quarterly mandated Post, Chapter audits.

Advantages:
- Veterans organizations federally chartered already have strict controls in place by virtue of their congressionally mandated By-Laws.
- Income allows the equivalent of entitlement for reliable funding.
- Funding is independent of state congressional budgeting.
- Income would essentially stop the loss of veteran's posts with facilities.
Comments:
The Commission should look at what local posts do in the way of community projects by reviewing the Community Service Reports and see how important the affect of the loss of veterans organizations has on the character of the community.
Local VFW, Legion and other veteran organization Posts are a major relied upon source of assistance for the older veteran. They provide understanding, comradeship, moving assistance, home repairs, transportation, job finding, vehicle repair, gas, meals, and all things generally provided by various local human services.
Veteran organizations just having their insurance and operating costs covered are assured continuance of their existence.
Changing time affect veteran's organizations as are other organizations. Older veterans work too and are no longer available to generate the funds needed to keep posts operating. Volunteer hours are at a premium.
For the returning combat veteran Posts are a vital source for reconnecting with their community.

REQUEST

- Allow participating Posts to provide DOD approved memorial services to deceased veterans. This in turn could be a vehicle to relieve local National Guard and Active service units of this duty where applicable. Especially in our nations rural areas.
- Limiting the number of gambling machines removes the ?competition? argument of the gambling industry.
- The veteran as a customer supports the gambling industry. This allows the gambling industry to vicariously support the veteran by cooperating and would be a good advertising tool.

? NEW OPPRESSIVE ?VA QUALIFICATION METHOD? IMPOSED VIRTUALLY SHUT DOWN THE DAV/VA TRANSPORTATION PROGRAM.
New Voluntary Services requirements put in place to qualify voluntary drivers have reduced my driver pool from 22 to 1. In July, the Grant/matching grant $ paid 17 vets to arrange their one transportation to Albuquerque. There was only 1 VA Van trip. Suggestion: Eliminate the funds that support the VA Van Transportation Program and use it to fund your S1191 ?VetsRide Act? Grants.

Details of local affect of unreliable transportation and no accommodations being provided:

* Vets cancel compensation and pension examinations and other appointments due to 14 ? 16 hour round trip days, or could not find a ride ?OR- for lack of personal funds (VA negotiated motel rate now approx. $70.00).

* Only alternate travel is bus ride. Round trip costs $93.00 [verify] return departure time 2:55am ? travel time 5 hours.
Some were asked to stay overnight to complete exams next day, at own cost.
Some give up due either trip too long, complicated or expensive, not including food/drink.

DESERVING OF THANKS ?

It would be nice if the Senator found it proper to recognize these two individuals for their desire to improve the claims and submission process.
The Colorado VA Veterans Service Office personnel give good telephone assistance and class training which in my experience cuts processing time and improves results to the deserving.

WHAT I WOULD LIKE TO SEE:
When you consider the volume in information that guides the claims process, a Forms cover sheet containing simple pertinent processing information would eliminate most vet misinterpretations and reduce waste in terms of time.
No veteran service officer, no mater how he/she tries can impart to every veteran the advice needed to avoid the pitfalls encountered in the submission of claims. Confusion exists as it relates to VA medical services verses the VA claims process.
Simple cover sheets such as what the CVA uses would I believe significantly improve veteran understanding and speed up the process and reduce 800 telephone calls to the VA by the claimant.
Example: Why Compensation over Pension. Why Medicare over Pension.
? There are points of information critical to the ?veteran seeking assistance?. There is repetitive information the local VSO must impart to each category of service provided. For example:
- Explaining the difference between Pension and Compensation, or health care enrollment qualifications.
- What is key for consideration when VA receives a claim in simple terms?
ADVANTAGE:
One VA person provides the informational cover sheets.
Simpler.
Easier.
More effective.
Time saving.
Greater ?Customer satisfaction? results.
Reaches the veteran that comes for assistance.
Can replace the little read and more costly VA Pamphlet 21-00-1 and covers more information.
A standard, short, simple, topical VA generated single ?cover sheet? added to the applicable form would reduce calls to the state Department of VA, shorten local VSO time per veteran, have the positive affect on the veteran seeking assisting.

OTHER PROBLEMS ENCOUNTERED:

~ Inaccuracies in hearing transcriptions.
At same hearing. veteran trusted original records in his possession to Tiger team at their request for them to copy and return (is in transcript). They were never returned. Vet award determination delayed another year. Waiting for another Hearing date to be set.

~Social Security determined vet with amnesia due stroke was a veteran ? VA can't accept Social Securities determination. Vet must have DD-214 ? vet goes without health care.

~Within reason, VA itself should be allowed to satisfy claimant due own mistake. No one is perfect. Example, incorrect information caused widow to remarry after 57 thinking she can retain widows pension. She reported remarriage as instructed and pension was  cancelled. She called three times over a period of four months, the last two to verify before remarrying. Had dates she called. This is rare, but happens.

~ VA establish some uniformity in administering same programs in different VISN's that significantly effect vets.
Example: Albuquerque Medical Center expenditure of funds relating to overnight accommodations differs from Grand Junction Medical Center. Veterans in SW Colorado use both medical centers. Albuquerque has restrictions, Grand Junction does not.

I HAVE SPECIFIC SITUATIONS I BELIEVE NEED TO BE ADDRESSED -

A. Retired veteran with documented service connected injury:

His service medical record clearly indicates service connected injuries and vet has evidence of deterioration of injury affecting employability.

He has income above what is allowable to be enrolled in VA Health Care.

His assets are being depleted at fast rate to pay health care costs.

Military medical facilities do not provide health care to retirees.

He cannot receive medical treatment form the VA Health Care System for that injury until he goes through the lengthy Compensation process.

The VA advises me there is no vehicle that allows them to shorten the process time that could take up to 2 plus years.

Solution ? place these unique cases in the same category as recent returnees form Iraq and Afghanistan ? process in 60 days when documentation exists..

B. Radiation Exposure.

I have two veterans with documented service connection problems due to radiation.

The over exposure of roentgens is known.

One vets exposure is above what was determined to be overexposure in 1958. It is now known that the acceptable level of exposure then is far greater by today's acceptable level.
The evidence is in his favor yet the end of a 2-year study must be completed before a determination will be made and an award considered.

Question

Why is this so when it has already been established he was overexposed by the original standards?

Comment

The new standard will only say his exposure was greater.

What will the difference be in the award process when the result of the overexposure via his medical condition is what determines the award?

How can this delay be justified?

The second veteran with radiation overexposure I fear may have a significantly greater and more urgent problem medically.

C. Other Comments:

NEWLY FORMED VETERANS DISABIITY BENEFITS COMMISSION

I read with interest what Tim Dyhouse reported on in the August 2005 issue of the VFW Magazine about what the Veterans Disability Benefits Commission is considering.

I believe they are initially looking in the wrong direction. Could begin by starting at the source.

Involve the Armed Forces.
- Could have standards for medical staff to make determination and document what veteran/injury does not qualify for VA consideration after discharge.
- Example could be ?detectable prior service medical problems? not eligible. Have prospective service sign a medical waiver. I have a case when a servicemen was a problem from the first day due to non-service life experiences. The service determined he was eligible to apply for VA benefits and included such documentation in his discharge papers.
- There are instances where the service has taken in persons with known medical deficiencies that now contribute to the VA's problem.
- Exempt automobile accidents where serviceman is at fault.
- They could go along way in their efforts to improve the determination of benefits by recommending the imposition of veteran information sessions and health determinations by the VA/Armed Forces at the time of discharge instead of burdening the VA System. -

Benefit
You could probably allocate 5% of the VA Budget, allocate for the services for this purpose while be saving the VA 10 ? 15% cost man-hours for endless appeals and processing.
I honestly feel that if armed forces specialists working with a VA representative at service medical facilities are involved with the service connected disability process at the Discharge Physical level, more could be achieved than by rewriting ?standards? and ?appropriateness? of compensation and ?generosity? of present evaluations.

- offering lump sum payments to 20% and less to vets with disabilities is faulted.
It costs more under Medicare that is more generous.

- At what % level disability payments begin depending on the type of disability is appropriate. Why couldn't 0% and 10% in most cases equal 0 dollars depending on disability? Or payments start at 20%, or at 30% disability or give % of earned income tax-free?

- Anything physical in the service, recreational included benefits service member AND others that rely on his fitness in hazardous situations they encounter on a regular basis. Not just in combat. Fitness is the key to survival ? it should be encouraged and not punitive.
OTHER COMMENTS CONT'D

This rational is equivalent to ?Congressman should be paid on the basis of how much time spent in the office, or on the Senate or House floor.?

- Putting more into a veteran employment situation post service is more cost efficient. Make it easier for a veteran to get his old job back. Help him there. Get rid of the reliability of the VA to survive. My Assistant VSO was denied his jog back when asked if he would remain in the National Guard. He has 9 years active Navy and is now less than 2 years from retirement status in the National Guard after returning 9/2004 from 18 months call-up.

FLAWED RATIONAL

Many veterans feel they did not serve their country to become a burden. They come out and provide for their own health care. Take the Vietnam Veteran. Only %3.5 were unemployed after leaving the service.

Yet they are penalized?

* If a qualified veteran immediately after release from the service enrolls into the VA Health Care System and uses the health care facilities to maintain enrollment, his efforts in regards to claims is an easy process due to VA continuance of health care documentation.

* If a veteran that has not used the VA Health Care System and attempts to decades later when he needs it, it can be a problem due to assets accumulated in that lapsed time.

How can it be justified that the qualified veteran be penalized in any manner for NOT using the VA Health Care System? Most were mustered out without being advised.