Author’s Note: This letter was originally sent to the Sec of the VA, the author’s state and federal Congressmen, and to committees on both levels associated with VA issues. The statements made do not reflect the entirety of the veteran community but are an expression of my personal experiences and those shared with me by other veterans. The use of collective terms such as “we,” “us,” and “they” are based on this premise. This letter has been redacted to remove personal identifying information.
Politicians wage war, and soldiers fight them, whether they agree or not. They sacrifice youth, body, innocence, life, and friends. They come home to a pat on the back, a “good job,” a stack of papers, and a DD214. Veterans have endless amounts of resources, but no real way to know they exist, and have to fight for every benefit they are owed.
The VA call system is overcrowded, and ever-changing, with button after button just to arrive at the wrong location. We are left with piles of paperwork to file and they must ensure they cross every T, dot every I, check all the right boxes, and say all the right things. The Department of Veterans Affairs (VA) has long failed those who sacrifice for the very freedoms you, I, and the entire country enjoy. This country owes each and every veteran dignity and respect. It does not take but a simple Google search for one to find the failings of the VA plastered across headlines.
The former Director of the VA, Shulkin, has released a recent book describing the massive failures of the VA (Wentling, N., 21 Oct 2019; Wentling, N., 22 Oct 2019). The book describes the culture within the VA as “Toxic. Chaotic. Subversive” (Wentling, N., 21 Oct 2019). I could not agree more with those three profound words. This letter is but a drop in the ocean. My personal and family battle for treatment, obtaining simple records, and dignity is nothing compared to so many others. My words are nothing more than an anecdote to the broken system which fails those who have sacrificed in the name of this country.
The issues begin at the end. The issues start when a veteran begins the “expiration- term of service” process, better known among veterans as the ETS process. The process is a series of classes, paperwork, checklists, and obtaining records. I could not possibly encapsulate how confusing and unorganized this process is. One must stop by “shop” after “shop” to obtain this record or that record, fill out his form or that form, and answer questions with limited information. It is just as confusing as the entry process.
The process is not a complete wash, many of the classes provide veterans with critical information needed for success in the “real world,” but they have no idea they actually need it. They are the same young 18 to 20-year-olds that enlisted to avoid college, jail, or had no other prospects. They are the same lower-income patriotic adolescent who signed on the line and raised their hand after a slick-tongued recruiter spun a world of lies. To many veterans, it is nothing more than another “death by PowerPoint.” One of the final stops in the process is filing for disability. To many veterans, pain and suffering have long been the name of the game. Sacrifice is synonymous with duty, and veterans do not see their pain as anything less than reality. Those around us were also in pain, and, oftentimes, their pain was far worse than ours. “Sick call” was for extreme injuries or “shammers,” one who uses a fake or minor ailment to avoid physical duties.
I arrived in that office on my final days, the retired Vietnam veteran looked at my skimpy folder. I arrived wearing civilian clothes, without patches or beret. He glanced at my folder and says, “You must have been a Ranger.” I inquire why and he informs me after four years at Ft. Benning as a forward observer, my injuries are undoubtedly more extensive than my folder captured. Sometimes hindsight is 20/20. I refuted, but he convinced me to file for disability anyway, something I am eternally grateful for. I fought among great legends like SFC Kapacziewski, who had doctors remove his own leg so he could fight again. My pain was insignificant in my mind, all my peers who were in chronic pain, it was the name of the game…
Seven years later the process is ever familiar. It begins with an expression of pain and ends with quiet solemn suffering. It is attempting to navigate a bureaucracy so vast it is incomprehensible. It is the familiar voice dictating which number will transfer you where, but not before it tells you what to do in case of an emergency or who to contact if thoughts of suicide. The latter is a reminder of the silent killer which strips away the strongest of warriors. With each press of a number you are transferred, again the familiar voice tells you what to do in case of an emergency or thoughts of suicide. The subsection of the overarching department is selected. Often what follows is a familiar voice telling you what to do in case of an emergency or thoughts of suicide.
If one is lucky, two selections will bring you to your desired destination, though this is often a hopeful wish. The reality is it often takes 4-5 selections. Once you arrive at your destination, one of two things often happens, it is the wrong department for what you are needing, or there is no answer and you leave a message and pray you receive a callback. After the callback, which may take more than one message, you must make selection after selection, listening to the familiar voice telling you what to do in case of an emergency or thoughts of suicide. An appointment is scheduled, and the process begins. Before the phone calls, a familiar voice tells you what to do in case of an emergency or thoughts of suicide. The selections, familiar voice telling you what to do in case of an emergency or thoughts of suicide, messages, and callbacks, there is the driving force.
This is often the pain. It is the ever-present and persistent pain most veterans live with. These pains can be physical, emotional, and/or psychological. For most of us, the pain must become unbearable to make the call, to reach out for help, or arrive at the emergency room, the rapid alternative recommended by your friendly VA doctor if you need help before your appointment. The doctor is no fool, they have lived within this behemoth for far too long. They know and understand that an “emergency” room means getting treatment faster than the weeks it will take to see your overworked and over-scheduled doctor. They know going to the ER will get the tests ordered faster and the process started long before they can.
The pain that starts the whole process is often persistent in the life of a veteran. It is the reminder of the things carried, the friends lost, the firefights, the combat tours, the time away from friends and family, and all that lies in between. It is the innocence and youth lost. It is ever-present. The pain never really goes away, it just fluctuates. Some days it is almost forgotten, other days it is crippling. By the time one hears that familiar voice telling you what to do in case of an emergency or thoughts of suicide, the pain is unbearable.
A veteran waits for many different reasons, but three stand alone. A veteran waits because they are warriors, they have lived with pain for so long its absence would be abnormal. A warrior shows no weakness, they just “take a knee, drink water, and face out,” then they pick back up and keep going. A veteran waits because the process ends just as it began, quiet solemn suffering.
Walking the halls of the VA hospital I feel as though my simple pain and suffering is but a drop in the ocean to so many others. I pass the finest men and women this country has to offer in those halls. The pain is visible in their faces, in their words, and, most notably, in their eyes. The cramped quarters and labyrinth of hallways is enough to make one’s head spin. As if the halls were not enough to drive one crazy, elevators only access this part or this floor, or this part of this floor… At each elevator exit, there are always a handful of perplexed and frustrated veterans trying to navigate the building after having to navigate the phones. Luckily there are always friendly and helpful VA staff walking about to explain the directions that are like a Grand Theft Auto cheat code, left, right, right, left, up, left, right, down…
Knowing the directions will do no good. These busy, overworked, over-scheduled employees will happily walk you to your destination as if an usher escorting you to the minotaur’s wedding. These overworked and over-scheduled employees are the only saving grace to the massive behemoth that is the VA hospital. Veteran or non-veteran, doctor or custodian, they are quick with a smile, a quippy joke, or much-needed assistance. If they do not know, they find someone who does.
I have suffered from back pain for ten years. I was 19 when it started, only a year into my military experience. I joined the Army at 17 and went to basic between my junior and senior year of high school. I finished my last year of school and a month later I was in AIT, followed by Airborne School, RIP, and then the perpetual cycle of training and deploying. The pain did not just start after one single incident, but it came on quickly and with a furry. This was nothing new in my unit, we all had back pain and I know not a single lineman who escaped that world without it. There was no single fall, or, if there was, I was never able to determine which one of the never-ending fast roping, airborne jumps, bounding, or other falls that caused the injury. I let it go for years, after all, it is what a warrior does. I was 21 when I was walking, yes, just walking, in shorts and a t-shirt across a parking lot when it all changed. I managed to catch myself with my hands before my knees hit the concrete. For a moment in time, my back had just given up. At 21 it just gave out. It was scary. What if it did that while on target? What if I was on a mountain? What about fast roping?
The doctor tried everything. Physical therapy, x-rays, adjusted workouts, chiropractor, acupuncture, shock therapy, and the list went on. He tried it all but was unable to establish what exactly caused the pain. Sure, my X-ray had some abnormalities, but nothing to cause the pain I had experienced. Two doctors and three physical therapists would submit multiple requests to the main hospital for an MRI. Each time I was outright denied. X-rays show nothing, so MRI would be useless. It was one of the most absurd things I have ever heard in my life. Once I was actually scheduled to get one, but it was nothing more than a slip into the crack. They quickly called back and said upon further review there was no need for an MRI. An out-of-military pain clinic was used in an attempt to just relieve some pain before I got out. I only obtained one of three treatments before I separated, meaning it did little to nothing. Despite the best attempts of the physicians around me, I was passed along to the Department of Veterans Affairs.
My experience with the VA has been lovely employees within a chaotic and unorganized system. It is a system that is easy to get lost in. When I got out, I did not want to claim any disability, but the aforementioned smarter and more experienced Vietnam veteran all but forced me to. At 22 I figured living in pain every day was normal, after all, my peers all lived in the same state of pain. I thought struggling to reach and tie one’s own shoes was normal. I thought shoulders sounding like popping popcorn was normal. I thought the high pitch noise in my ears that came and went was normal. I thought a lot of things that were not true, one of which was the VA would take care of me. I could go on about how it took almost a year before someone even told me I was supposed to have a VA ID card. How fighting for my tinnitus has been such a hassle I have all but given up. How I was offered morphine patches instead of identifying and fixing my pain. The list could go on.
I called, that familiar voice telling you what to do in case of an emergency or thoughts of suicide came and went. I selected a number, that familiar voice telling you what to do in case of an emergency or thoughts of suicide came and went. I selected another number… I left a message. I was contacted and an appointment was made. I was informed if I needed any help prior, to go to the ER. I went to the elevator that gives me access to the labs because remember, it is a labyrinth with limited access from each elevator. I was contacted by the nurse who tells me, for once in seven years, they are actually ahead, and I can check in ASAP. I go up, go in, get my vitals, no wait, straight to the doctor, and then the rigmarole. While he agrees I have pain and need to figure out what is going on, he is just a case manager more than anything.
My pain has escalated over the past six months. After six months of headaches, low energy, lack of concentration, difficulty sleeping, and struggling to complete daily tasks, I had enough. While the pain is ever present, it often flares up for a week or two and subsides for a few months, but not this time. After six months enough was enough. I already knew the process, the doctor sends me to physical therapy, physical therapy then assesses, sends findings to the doctor, the doctor then submits for test A-B-C, that department calls me, we make an appointment, they send findings and suggestions to the doctor, the doctor sends me to a specialist or whoever… I think the point is made.
Well, physical therapy is to the VA what Saint Peter is to heaven. PT is the first step to the next stop or stagnation. In the seven years I have “navigated” the VA, I have been to PT countless amounts times. I have been so often and implemented what they have asked into my physical regimen that they often review my workout book and tell me they have nothing to offer. I have obviously made every attempt to rehabilitate the injury. I am given some extra meds, maybe some steroids, a pat on the back, and off to quiet solemn suffering.
This time I had had enough. I wanted answers and thought I might get them. My PT spoke with me in person and instantly asked why in 10 years I never received an MRI. He said we would conduct PT for a month to see if it helped at all and check the box, then submit for an MRI. My follow-up was not with my PT however, it was with his assistant. The PT was a veteran who knew what it was all like, the assistant was a fresh young girl, devoid of any military experience. Our first visit summed it all up, the entire VA experience. She told me the goal was to “manage/reduce the pain.” She told me we all have pain sometimes, that even she had back pain, and told me to reduce/manage my stress, stretch, and keep coming back until the pain goes down.
There it was, the epitome of the VA experience, “manage the pain.” There I was in physical therapy without even the slightest explanation as to why my back persistently hurt for ten years. Yet, there I was receiving “treatment.” It is hard to express how baffling this is to me. When in science and medicine are a treatment prescribed before ever establishing, or even actively seeking, a cause? I bit my tongue and maintained pleasantries, but it ate at me for almost two weeks. After making two calls and leaving two messages, she called back. When asked how it was going, I informed her nothing had changed. She wanted to schedule not one, but two follow-ups… It is not working, so let’s keep doing it, the definition of insanity at its finest.
Another week went by, it continued to eat me up. I left a message, canceling my appointment. I contemplated what to say when she called back. Maybe I should be brutally honest to the innocent and well-intended, though obviously culturally unaware, assistant. For ten years my every move has been dictated by my back. How I sleep, how long I sleep, what I sleep on. I have changed my entire sleeping position, my pillows, my bed, and everything possible to help my back. What I do from the moment I wake up to the moment I lay back down is dictated by my back. How much I sit, how much I stand, how I work out or even if I work out. My day is filled with running tallies. When I wake up my back quickly lets me know how it feels. Every action and inaction is calculated to manage my daily activity to pain level. The reality of the conversation was just short of the complete truth. While the conversation only caused further irritation, it’s content irrelevant to this letter, but after ten years, I finally have an MRI scheduled.
The process begins with unbearable pain, a pain that is ever-present. It begins with this pain and ends in quiet solemn suffering. The daily pain becomes persistently overbearing. The call is made. The familiar voice telling you what to do in case of an emergency or thoughts of suicide, a selection is made, a familiar voice tells you what to do in case of an emergency or thoughts of suicide, a selection is made, a familiar voice telling you what to do in case of an emergency or thoughts of suicide, lather, rinse, repeat. The doctor/case manager sends you to PT. PT sends you medicine and pats you on the back. Even when one is able to get the tests, the VA sends you home with a bag full of unwanted medicine because it seems easier than treatment. Bag after bag because it is the easy “fix.” Bag after bag to dull the quiet solemn suffering. If one were to wander the labyrinth of the VA, one could see a building over-filled with veterans managing their pain. The very veterans we sent out to fight our wars are the very same veterans we force to fight for their own dignity. Overwhelmed by the bureaucracy of the VA, they quietly suffer, bag in hand, pills in mouth.
The process for obtaining military medical records is much the same. The archives website lists two different locations for obtaining records based on the discharge dates. Mine falls into the VA category. The website lacks all information on how to submit a request, but a quick YouTube search provided me the answer… so I thought. I submitted an online request and mailed in my signed portion to the address listed at the bottom of the request printout. I received a prompt reply that it was the wrong office. So, I submitted it all again, mailing it to the VA address. I received a notice a few weeks later that they never received a completed request and closed the inquisition. I submitted yet another request just prior to writing this letter.
I called to ensure I had all my T’s crossed and my I’s dotted. After the typical long-winded prompt and selections, I was finally connected to the operator line. The prompt notified me they were experiencing high call volume, nothing new with the VA system. Most offices have you leave a voicemail, as discussed previously or submit/schedule a callback. I was angry and surprised when the prompt notified me they were not taking additional calls, and to call back later. My current signed request now includes a short statement, all the information the online request asked for spelled out in plain text, as well as a number of profane words requesting all of my service records.
I have been “navigating” the VA system since 2012. The system has left me frustrated and apathetic. Those around me have long described me as someone who vocally stands up for what I believe in, but the VA system has all but broken my resolve. That is the day a close family member passed away. I could not begin to express their true value to my life
After they were originally diagnosed with cancer, the doctor had to beg and convince them to come home for treatment, they were that loyal to their soldiers. The loss was difficult for each of us in the family. We were left with a struggle over the death certificate, which has since been rectified, a packet of paperwork, and confusion. The funeral home provided a single form and informed us they were no longer allowed to fill any VA paperwork out due to VA policies. While completing the packet I called the hotline for assistance, at which point a lovely lady informed me there was an entire packet. This packet would allow my family to file for a series of benefits.
I cannot thank this lovely woman enough. She walked us through the process, filed as much as she could, and then provided us a digital copy so we might begin the process post haste. Following the funeral, a representative from a nearby base called and inform us they were sending us prepopulated forms so we might file for additional benefits. The packet included only two of the forms. The packet provided by the lovely lady included over five different benefit forms. Even with the packet provided, the “instructions” are limited, confusing, and difficult to comprehend, even for someone, like myself, who is far too familiar with the VA system.
I must also acknowledge all that the VA has provided for myself and my family. Following my separation from the Army, I was able to obtain a bachelor’s and master’s degree debt-free using my GI Bill. Multiple family members were able to obtain different levels of degrees. As a police officer, I have witnessed the VA benefits provide homes for homeless veterans and mental health treatment for those in need. In reference to the latter two, I must also concede these processes are plagued with delays and difficulties expressed in my personal anecdote above.
The VA currently serves over nine million veterans through its 1,243 facilities (The Department, 2018; The Department, 2019), a task that is unarguably daunting. Our country has long thrived on the backs of the average .05% of the population who have served in the military (Parker, K., Cilluffo, A., & Stepler, R., 2017). These soldiers have stood ready to serve in wars waged by the powers that be in Washington DC. These soldiers have waded through the blood, sweat, and tears of the fallen. They have journeyed down the river Styx, fought in the belly of Hades’ underworld, and have treaded the river back, battle-hardened, and often tattered.
Their lives forever changed and shaped by an experience that escapes all words. Veterans have fought in foreign wars and returned home only to fight for what they have earned. They must fight for their very dignity and respect as they are shuffled and shooed away, pills in hand, off to a quiet solemn suffering. Veterans have higher rates of homelessness, mental illness, and substance abuse compared to the general population (Perl & Libby, 2015; Slate, Buffington-Vollum, & Johnson, 2013). It is no surprise when the very system that is supposed to assist them is maddening. It is filled with a labyrinth of hallways, that familiar voice telling you what to do in case of an emergency or thoughts of suicide, and stacks of confusingly redundant paperwork. Veterans become nothing more than forgotten names among the numbers. They shuffle on, fighting toward apathy. The final outcome is a folded flag and a packet of paperwork on the lap of their next of kin if they are lucky enough to get the packet.
I am not asking for personal favors, I am asking for the dignity and respect EVERY veteran has earned. I am asking that this country simply fights for those who have long fought for it. I do not have the answers. I do not have the insight to provide a solution, but I have a voice to beg for assistance. In almost thirty years of life, I have never knelt before a single soul, but I would place both of my crackling and popping knees on the floors of Congress to beg and grovel. I would go against every warrior’s ethos, fall to my knees, and ask that someone do something. I write this letter because you are the people who can do something. I write this letter because I have nothing but my words left.
The Department of Veterans Affairs (23 Jan 2018). Veteran’s health administration. Retrieved on 22 Oct 2019 from https://www.va.gov/health/FindCare.asp
The Department of Veterans Affairs (24 May 2019). National center for veterans analysis and statistics. Retrieved on 22 Oct 2019 from https://www.va.gov/vetdata/Veteran_Population.asp
Parker, K, Cilluffo, A, & Stepler, R (13 Apr 2017). 6 Facts about the U.S. military and its changing demographics. Pew Research Center. Retrieved on 22 Oct 2019 from https://www.pewresearch.org/fact-tank/2017/04/13/6-facts-about-the-u-s-military-and-its-changing-demographics/
Perl, L. (2015). Veterans and homelessness (CRS Report RL34024). Washington, DC: Congressional Research Service
Slate, R., Buffington-Vollum, J., & Johnson, W. (2013). The criminalization of mental illness. 2nd ed. Durham, NC: Carolina Academic Press.
Wentling, N. (21 Oct 2019). Shulkin warns ‘subversive’ culture at VA is leading department to ‘grave danger.’ Stars and Stripes. Retrieved on 22 Oct 2019 from https://www.stripes.com/news/us/shulkin-warns-subversive-culture-at-va-is-leading-department-toward-grave-danger-1.604020
Wentling, N. (22 Oct 2019).Shulkin: ‘We need a reset in the way that things work in Washington.’ Stars and Stripes. Retrieved on 22 Oct 2019 from https://www.va.gov/health/FindCare.asp
Jake Smith is a law enforcement officer and former Army Ranger with four deployments to Afghanistan.
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