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The Veterans Affairs Connecticut Healthcare System in West Haven.
Photo: File PhotoThe Veterans Affairs Connecticut Healthcare System in West Haven.
The Veterans Affairs Connecticut Healthcare System in West Haven.
The Veterans Affairs Connecticut Healthcare System in West Haven.
Chief among the promises the country makes to its veterans is that they will have access to health care following their service. But a new report from the Legal Services Center at Harvard University details how the Department of Veterans Affairs improperly turns away veterans who qualify for care. It is a problem occurring right here in Connecticut.
At the Connecticut Veterans Legal Center, or CVLC, our mission is to help veterans recovering from homelessness and mental illness overcome the legal barriers to housing, health care and income. Often the biggest barrier to health care for veterans is their discharge status.
The military characterizes most discharges occurring after service members’ first six months in five ways: honorable, general (under honorable conditions), other than honorable (OTH), bad conduct and dishonorable. Although Congress has stated that VA benefits are available to veterans as long as they were “discharged or released under conditions other than dishonorable,” the VA presumes “other than honorable” and “bad conduct” discharges to be “dishonorable.” To gain access to health care, veterans with those discharges have two options. They must either prove to the VA that they are “honorable for VA purposes” through a characterization of discharge process or prove that their initial discharge was incorrect by applying for a discharge upgrade with the Department of Defense.
However, even when veterans meet the VA’s stringent guidelines, the VA may still unlawfully turn them away. CVLC represents a small fraction of Connecticut’s veterans, but over the course of four months, we had four different clients unlawfully turned away by VA staff.
John Rios is a Navy veteran who served during the conflict in Bosnia. He struggled for over 20 years with the post-traumatic stress disorder that contributed to his OTH discharge. He was eventually successful in obtaining a discharge upgrade. He went to VA seeking health care, his new honorable discharge papers in hand. His paperwork conflicted with the hospital’s computer system and they turned him away.
William Daigle was repeatedly sexually assaulted by a platoon sergeant. Daigle’s requests for transfer were never responded to and, suffering from trauma, he went AWOL. The Army gave him an OTH discharge and Daigle began a prolonged struggle with substance abuse. Wanting to stabilize his life, he petitioned for a characterization of discharge and the VA officially found him “honorable for VA purposes.” However, when he went to obtain health care from the VA, he was told that his characterization was not listed in the VA’s system. When his attorney presented VA staff with his letter showing his characterization, she was told that she was misreading the letter, and that Mr. Daigle wasn’t eligible for VA care. Another VA employee incorrectly stated that Mr. Daigle needed to apply for a discharge upgrade.
Robert Morales is another OTH veteran who survived sexual assault in the military. Although he would ordinarily not qualify for health care without proving his case in a characterization of discharge, Sen. Chris Murphy’s Honor Our Commitment Act extended behavioral health care to sexual assault survivors and combat veterans regardless of discharge. The eligibility desk correctly told Morales that he could get the mental health care he was seeking. However, when he arrived at “triage,” another employee told him that his discharge barred him from receiving assistance. Morales would have left without the care he needed had his attorney not intervened. Yet few veterans have the benefit of a lawyer.
To some, these incidents might feed the broad anti-VA narrative that arises in public discourse. This takeaway is incorrect. The VA provides incredible care for struggling veterans across the country. Studies have shown that on average VA health care is as good or better than private health care. Every day, CVLC sees the heroic work of VA clinicians.
However, there is a need for widespread reform of the VA’s front door. Not only is health care important by itself, it is one of the social determinants that can greatly reduce the likelihood of veteran suicide. At minimum, VA staffers need to have an expanded understanding of the varied ways that veterans with varying discharge characterizations may qualify for care.
But on a more philosophical level, VA leadership needs to institute a clinician’s mindset in the department’s policies and among its administrative staff. The institutional mindset that expects veterans to first prove that they are worthy of care directly results in overly guarded gatekeepers that err on the side of excluding needy veterans. Instead, the VA leadership should adopt a culture that trains its administrative staff to approach veterans with an attitude of assistance — disposed to search every avenue to provide care, rather than searching for the first disqualifying factor. Veterans have given their physical and mental well-being to the country; they deserve to access the health care they were promised.
Liam Brennan is executive director of the Connecticut Veterans Legal Center in West Haven.
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March 12, 2020 at 11:00AM
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