If you are a military retiree and eligible for both CRDP and CRSC, you may elect to change which compensation you receive during the CRDP/CRSC Open Season.  This annual Open Season election period is Jan. 1 thru 31 JAN 09, and allows the retiree to choose which payment is preferred.  You may receive one or the other but not both.

 In late DEC 08, eligible retirees will be mailed a CRDP/CRSC Open Season Election Form.  The retiree needs to return the form only if making a change from CRDP to CRSC or vice versa.  If the retiree prefers to keep things the way they are, do nothing.  The payments the retiree now receives will continue uninterrupted.

To help the retiree make a more informed decision, the form will include a comparison of the CRSC and CRDP entitlement amounts as well as information about the collection actions and taxes to which each type of payment is subject.

If the retiree wants to change from CRDP to CRSC or vice versa, the form must be postmarked by 31 JAN 09.  If the form is dated after this date, it will not be processed and the current payments will continue uninterrupted.

The change in the payment will be effective with the first business day of FEB 09.  Due to a 30-day processing timeframe, the retiree may not receive their first payment until the first business day of MAR 09, including a retroactive adjustment for the payment that would have been paid on the first business day of February.

 [Source:  NAUS Weekly Update for 26 Nov 08 ++]

 A key lawmaker is urging President-elect Barack Obama to move slowly and cautiously on his pledge to grant all veterans medical attention at Veterans Affairs Department facilities, or else risk clogging they system and harming quality. Obama said repeatedly during the campaign that one of his first acts as president would be to sign an executive order permitting veterans with non-service-related disabilities to seek medical care within the VA system. These so-called “Priority Group 8” veterans make up the lion’s share of living American veterans. Vets are designated as Priority 8 when their income exceeds a pre-set threshold, which varies from county to county based on the level of affluence in a given location. They are the most affluent category of vets, but some earn as little as $28,430 a year. Until 2003, these veterans were permitted to seek treatment at VA health facilities, but the department announced a freeze on new Priority 8 enrollments that year to alleviate a 300,000-plus patient backlog and quell a funding crisis. Chet Edwards, chairman of the House Appropriations Military Construction, Veterans’ Affairs and Related Agencies Subcommittee, says that he will fight to fund VA health care for Priority 8 veterans but that he wishes to do so at a gradual pace. “Even if we had unlimited dollars, it would take time to hire all the doctors and nurses,” said Edwards, D-Texas. “We don’t want to double, triple, quadruple the wait times. I would urge the administration to maintain the goal but spread it out equally.”

         This approach would involve continuing to raise the Priority 8 income threshold over a number of years to gradually include more and more veterans. Congress authorized $375 million in the fiscal 2009 Military Construction and Veterans Affairs spending measure (PL 110-329) to raise the Priority 8 income threshold and bring more of these veterans into health-care-eligible categories. But it is unlikely that the amount appropriated will do much to move the threshold to a significantly higher income level, according to a Senate Veterans’ Affairs Committee aide. So far, the Obama presidential transition team has declined to disclose details on the implementation of his campaign promise, but it is certain to be expensive, however the new administration decides to do it. If Obama orders a plan to gradually raise the threshold to eventually cover all veterans, it would require Congress to continue to increase record funding for the VA year after year. Aides note that if he wants to make all Priority 8 veterans eligible at the same time, it would likely require an emergency supplemental spending bill that would total billions of dollars. With Congress already providing $700 billion to help bail out failing banks and other businesses, the government’s capacity to provide another supplemental spending measure is questionable.

         Obama will have plenty of backers on Capitol Hill for his VA medical coverage plans. Rep. Bob Filner, chairman of the House Veterans’ Affairs Committee, contends that there are actions Congress can take to bring all Priority 8 veterans into the VA health care system at once. For example, the VA currently has an inefficient system for recouping money from private health insurance companies when covered veterans go to the VA for treatment, said Filner (D-CA). Installing more effective tracking technology would reward the VA with billions of dollars, he added. “I have talked to people who have systems to do this, and they are telling me about several billion dollars, easy,” Filner said. “I have seen $3 billion or $4 billion estimated.” Filner also said Medicare should reimburse the department when Medicare-eligible veterans get treatment at the VA. “We are saving them money,” he said. Sen. Patty Murra (D-WA), a potential chairwoman of the Veterans’ Affairs Committee in the 111th Congress and a member of the Military Construction and Veterans’ Affairs Appropriations Subcommittee, is also a strong proponent of giving Priority 8 veterans full VA health care eligibility. “While the VA health care system certainly has its share of problems, closing its doors to thousands of veterans who have served us is not the answer to fixing them,” Murray said. “That means expanding access, but it also means providing the funding and resources to hire doctors and staff, invest in VA infrastructure, do research, and decrease the wait on benefit claims. We make a promise to all veterans when they sign up to serve that, regardless of their future income or health needs, they will receive VA medical care.”

         Like Edwards, veterans’ advocacy groups favor a more gradual approach. Their main concern is that opening up the VA’s health facilities to at least 400,000 new patients could put the VA on the same faulty financial footing that plagued the department before 2003. They also say it is not just a matter of securing funding; they say the VA would need time to put the money to use by hiring new doctors and clinical staffers, building and leasing new facilities, and procuring new equipment. “If he just opens the gates wide open and says everyone is eligible now to enroll for VA health care, then we would find ourselves back in that same situation again,” said Joseph Violante, national legislative director for Disabled American Veterans. "While the VA has gotten nice budgets the last two years, it will not be in a position to care for a large influx of new veterans,” Violante said. “We would wind up getting rationed care for all the veterans that are in the system, including the service-connected disabled.” Rationed care is a large concern at a time when thousands of service members are returning home from Iraq and Afghanistan with severe injuries. “We are concerned that adding more veterans into the system may take away priority for the service-connected wounded, especially the most severe service-connected,” said Bob Wallace, executive director at Veterans of Foreign Wars. “They need to be taken care of before anybody else.” [Source: CQ  Veterans' Affairs Matthew M. Johnson article 18 Nov 08 ++]

The concurrent retirement and disability pay (CRDP) retro payments being paid to retirees rated with “individual unemployability” (IU) by the VA are taxable in the year received. CRDP always has been taxable income, as it is a restoration of taxable military retired pay. According to the Internal Revenue Service (IRS), income is considered taxable in the year it is received. This is the case even though the retro payment is to make you whole from an earlier time. Many have asked about the ability to file an amended tax return. It is not an option. Amended returns are for correcting a past mistake, or for when you paid taxes in the past that you didn’t need to pay. The CRDP retro payments for IU don’t apply to either of these situations because you were paid in accordance with the laws and policies at those times. The laws changed in 2008 to make things different, so the payment is considered a current year income payment.  [Source: MOAA News Exchange 18 Nov 08 ++]

With a 5.8% COLA in the bank for 2009, the Consumer Price Index (CPI) promptly tanked to start the new fiscal year. The October CPI dropped 1.3% compared to the September number - the biggest October decline in 61 years.  And because the September number, in turn, was lower than the July-to-September average that's the starting point for the 2010 COLA, we start the first month of the COLA year in a 1.5% hole. And with gas prices continuing their steep fall off into November, it looks like inflation will start off FY2009 in an even deeper hole than it did in 2007, when we ended up the year with a 2.3% COLA.

[Source: MOAA Leg Up 21 Nov 08 ++]

 Tricare officials remind overseas providers and beneficiaries that they have limited time left to file claims that have not already been processed. Tricare Management Activity (TMA) has extended a “timely filing waiver” through 31 DEC 08 for Tricare Overseas claims. The extension accommodates providers, beneficiaries and others living overseas who have not filed claims within one year of the “date of service.”

One year is the limit normally allowed by Tricare policy. However, according to Tricare officials, late filing overseas sometimes occurs due to local statutes, which often give healthcare professionals up to three years to file claims for reimbursement. The filing extension through 31 DEC 08 allows extra time for Tricare area offices overseas to educate providers, beneficiaries and others about Tricare’s claims filing policies. To be eligible for this limited timely filing waiver, overseas Tricare service centers, military treatment facilities, remote points of contact, providers and beneficiaries who have outstanding healthcare bills with dates of service before 31 DEC 07 must submit their claims no later than 31 DEC 08 to Wisconsin Physicians Service (WPS), the overseas claims processor for Tricare.

Beneficiaries can file claims by mailing a completed DD Form 2642 with a copy of the itemized bill and receipts to the appropriate WPS address found on the contact page at http://tricare4u.com. If WPS initially denies a claim filed more than a year from the date of service, the filer can then request the limited timely filing waiver. However, after the 31 DECF 08 deadline, new claims will be denied if not filed within one-year from the date of service.

Contact a local overseas Tricare area office for assistance or WPS overseas at 1-608-301-2310. 

Area office contact information is available at the beneficiary portal at http://www.tricare.mil. [Source: Tricare News release 08-117 dtd 28 Nov 08 ++]

   A Certificate Of Creditable Coverage (CoCC) is usually required when changing from one health insurance plan to another and serves as evidence of prior health care coverage to reduce how much or how long a health care plan can exclude a person from coverage for a pre-existing health condition.  The certificate shows the new insurance carrier that a beneficiary had Tricare coverage for the period noted on the certificate. 

Certificates identify the name of the sponsor and/or family member for whom it is issued, the dates Tricare coverage began and ended, and the certificate issue date. Those issued upon request of a beneficiary will reflect each period of continuous coverage under Tricare that ended within 24 months prior to the date of loss of eligibility. The Defense Manpower Data Center Support Office (DSO), as the custodian of the defense enrollment eligibility reporting system, is the issuing authority. They issue a certificate to sponsors and family members upon loss of eligibility, including active duty members who separate from service. An active duty member who retires does not lose eligibility and is not automatically issued a CoCC. However, when retired member needs a certificate to present to a new employer for health plan coverage, he/she should request one in writing. Examples of when certificates may be issued include:

    •    Upon separation of the sponsor from active duty, a certificate will be issued to the sponsor listing all eligible family members.
    •    Upon the loss of eligibility for a dependent child (age 21, or 23 if a full-time student), a certificate will be issued to dependent child.
    •    Upon loss of coverage after divorce, a certificate will be issued to the former spouse.

    By law, if an individual incurs a 63-day break in coverage, all previous creditable coverage before the break is disregarded (meaning the beneficiary does not show as Tricare eligible during that 63-day period) which may reduce any future pre-existing condition exclusion period. Guard/reserve members on active duty orders for 30 days or less are not issued CoCC’s because they are not Tricare eligible and that time is not considered when calculating the length of coverage. Eligible retirees or those who may have lost their certificate may submit a written request for a CoCC, which will be mailed to the sponsor or family member without charge. Certificates cannot be requested by phone from the DSO. Written requests for a CoCC must include the sponsor's name and social security number, name of person for whom the certificate is requested, reason for the request, name and address to whom and where the certificate should be sent, and signature of the requester.

The mailing address for a CoCC request is: Defense Manpower Data Center Support Office (DSO), Attn: Certificate Of Creditable Coverage, 400 Gigling Road, Seaside, Ca 93955-6771. If there is an urgent need for a CoCC, a beneficiary can fax his/her request to the DSO at (831) 655-8317 or request (via mail or fax) that the DSO fax it to a particular number.  Note:  Tricare does not exclude preexisting conditions, so there is no need for a CoCC from a previous plan when a beneficiary becomes Tricare eligible.

         Content of CoCCs for members of the guard and reserve called to several periods of active duty depends on how long the member was mobilized, whether he/she was eligible for transitional assistance management program benefits, and whether the member had a break in health care coverage of 63 days or more. Some possible scenarios for issuance are:

    •    Member mobilized for 45 days, but not eligible for TAMP (such as RC members called to active duty for special work or a similar non-contingency period of active duty). The certificate issued covers the initial 45-day period. Thirty days later, the member is mobilized for 60 days (again not eligible for TAMP), and the break in coverage is less than 63 days. The second certificate will cover the 60-day period. The member may then present these collective certificates to a health plan and receive credit for the total coverage time.
    •    A guard/reserve member is mobilized for 45 days but eligible for 180 days of TAMP coverage.   The certificate is issued at the end of the 225-day period, indicating continuous coverage for 225 days.
    •    A guard/reserve member was covered for 18 months, which is followed by a break in coverage of 63 days or more. The 18-month period that occurred prior to the 63-day break in coverage will not be credited on the certificate of creditable coverage. By law, if an individual incurs a 63-day break in coverage, all previous creditable coverage prior to the break are disregarded (meaning you were not Tricare eligible during this period) and reduces any future preexisting condition exclusion period. Also, since rc members on active duty orders for 30 days or less are excluded, these periods of active duty service will not be considered when calculating your length of coverage.

    For questions regarding the Certificate Of Creditable Coverage, sponsors and family members may contact the DSO at (800) 538-9552. For TTY/TDD, dial (866) 363-2883. Questions also may be sent via e-mail to the Tricare Management Activity HIPAA program office at hipaamail@tma.osd.mil .  Additional CoCC information is available on the Tricare web site at www.tricare.mil/hipaa/downloads/cocc.pdf.  [Source: CoCC Fact Sheet www.tricare.mil/Factsheets/print.cfm?id=247. 17 Nov 08 ++]

    ===============================

You cannot file with both the Physical Disability Board of Review (PDBR) and Board for Correction of Military (or Naval) Records (BCMR/BCNR) asking both to review the issue of whether you should have received a higher rating. Assuming you do file in both places at the same time, the BCMR/BCNR case may be placed in administrative hold until the PDBR application is decided. When a case is placed on administrative hold, the case is not closed, but no action is taken on the case. The applicant will be notified in writing when the case is placed in this status. If you ask the PDBR to review that rating you may not subsequently ask your service BCMR to review that rating, but you can ask your service BCMR/ to review other issues such as whether you should have been rated for additional medical conditions. If you do not go to the PDBR, you can ask the BCMR/BCNR to consider all of the issues relevant to your separation including the rating awarded for your unfit condition.

         As an example assume you were found unfit for a back problem and separated at 10% for this condition. You also had asthma problems but they were not found to be unfitting and thus were not part of your disability rating. You may only ask the PDBR to re-evaluate your back injury rating. In contrast, you could ask a BCMR/BCNR to change your record to show you were found unfit for both conditions. If you do not go to the PDBR, you could ask the BCMR/BCNR to do both; if you have been to the PDBR, the BCMR/BCNR will not review the rating for the back, but will consider whether you should have been found unfit (and received an additional rating) for the asthma or any other medical condition.

        There is no easy or clear-cut answer as to which one to choose. Nor is there any government organization available to help you make the choice and the government will not pay for an attorney to assist you in your decision.. The choice is important and highly dependent upon the facts and circumstances of your case. The applicant should weigh all the factors and make a choice only after careful consideration.  You can contact your local veterans’ service organizations several of which provide excellent advice and service on these issues. If you filed with the BCMR/BCNR prior to 27 JUN 08 (effective date of the DoDI), you will not have to choose between the BCMR/BCNR and the PDBR review. You should understand there are several differences between the scope and the consequences of the two rating reviews. These differences are:

    •    Panel Composition:  BCMR/BCNR panel is 3 civilians in grade of GS-15 and above wheras PDBR panel consist of 3 military officers in grade of 05/06 (or civilian equivalents); Board president 06 or civilian equivalent.
    •    Review Authority:  Veteran may apply to BCMR/BCNR  for review of military record within three years of error/injustice (may be waived in the interest of justice) whereas with PDBR veteran can only apply with a  medical separation 20% or less where member did not retire finalized between 11 SEP 01 and 31 DEC 09.
    •    Review Process:  With BCMR/BCNR once application is submitted, medical, personnel or legal advisories are prepared and served on applicant who has a chance to comment before panel review and vote wheras with PDBR once application is submitted the case is summarized by PDBR medical member (or other experts) for presentation to PDBR before vote. Applicant can submit records from non DOD sources. Thus, the PDBR is a much more limited review than a BCMR/BCNR review.
    •    Panel Outcome:  With BCMR/BCNR you receive a recommendation or decision whereas with PDBR you receive a recommendation only.
    •    Decision Authority: With BCMR/BCNR Director, Review Boards Agencies (Army, Air Force, Assistant Secretary of the Navy (M&RA) or Assistant General Counsel (M&RA) (Navy) whereas with PDBR Director, Review Boards Agencies (Army, Air Force), Assistant Secretary of the Navy (M&RA) or Assistant General Counsel (M&RA) (Navy).
    •    Burden of Proof:  With BCMR/BCNR veteran has the burden of proof to establish error or injustice. There is a presumption of regularity whereas with PDBR veteran need not allege anything, review is accomplished upon request.
    •    Effective Date of Correction and Benefits Computation: With BCMR/BCNR benefits are retroactive to date of separation whereas with PDBR benefits forward only as of date of final decision.
    •    Standards: With BCMR/BCNR panel will correct errors in records and/or remove an injustice whereas with PDBR your rating is reviewed for fairness and accuracy only.
    •    Impact of Subsequent VA Rating: With BCMR/BCNR within discretion of the Board Will whereas the PDBR will compare VA rating with particular attention to one given within 12 months of separation.
    [Source:  DoD Military Health System News 3 Nov 08 ++]

The Disabled American Veterans (DAV) organization has issued a call to all service members and veterans who think they may have illnesses related to burn pits in Afghanistan and Iraq: “Anyone out there who thinks they may have had a long-term health effect ... needs to file a complaint” with the Department of Veterans Affairs, said Kerry Baker, DAV’s associate national legislative director. They should also Contact DAV so they can collect data and look for trends. Noting that it took Vietnam veterans 20 years to gain benefits for exposure to the defoliant Agent Orange, Baker said, “We don’t want to see these guys have to wait 20 years. We want to see Congress act right away.” Service members/veterans should be alert for respiratory-related problems, such as allergies, sleep apnea, trouble breathing, asthma and lymphocytic leukemia, as well as skin diseases. Of the 300 to 400 disability cases Baker said he has personally reviewed since the wars in Iraq and Afghanistan began, he said 30%t potentially could be linked to the burn pits. He said he’s amazed by the numbers of troops reporting sleep apnea.

         Sen. Russ Feingold (D-WI) also has demanded an investigation in a 31 OCT letter to Army Gen. David Petraeus, the new chief of U.S. Central Command. “After years of helping veterans of the Vietnam and Gulf Wars cope with the health effects of toxic battlefields, we have learned that we must take exposures to toxins seriously,” Feingold wrote. He asked Petraeus to inform him of pending investigations into the “prevalence of health care conditions among those potentially exposed to toxins and particulates,” as well as why more incinerators are not taking the place of burn pits in Iraq. Pentagon officials say no long-term illnesses are associated with the burn pits. But Military Times has received more than 50 letters from troops responding to a 3 NOV story, expressing concern about the time they spent near the billowing black clouds emitted by open pits where the military has burned its waste — everything from plastic bottles, which emit dioxins when burned at low temperatures, to petroleum products that emit benzene.

         One Air Force bioenvironmental engineer, Lt. Col. Darrin Curtis, was so worried by the chemicals he thought were being released into service members’ living and work spaces at Joint Base Balad, Iraq, that he warned: “In my professional opinion, the known carcinogens and respiratory sensitizers released into the atmosphere by the burn pit present both an acute and chronic health hazard to our troops and the local population.” Troops say they coughed their way through their deployments; several said respiratory problems and headaches continued long after their deployments ended. Air Force officials say they had cleaned up the Balad burn pit as of JUN 08 by using two incinerators and recycling plastic bottles. A report shows that tests in 2007 reflected an “acceptable risk” for cancer-causing and other poisonous toxins from the pit. “It’s a fantastic before-and-after story,” said Army Capt. Lynn Thompson, waste management officer for Balad from March to October. “The contractor who runs the place is planning to build a tennis court about 100 meters west of the trenches.” The burn pits are now “trench burners,” which burn hotter and produce less smoke. Still, he said, “Trench burners are no substitute for zero-emission incinerators. They are not intended to be a permanent solution. It is the best we can do with the funding available.” While that’s good news for troops on future deployments, the burn pits in Balad and across Iraq and Afghanistan have burned since the beginning of the wars — initially managed by troops working directly inside the pits to keep them burning.

         Service members told Military Times that they have asthma that was diagnosed after they left Balad; that they have allergy-like symptoms for the first time in their lives; that an unusual number of people in their units have developed cancer; that they are failing the runs on their physical fitness tests because of breathing problems; and that their headaches still haven’t gone away months after returning home. One Army officer reported a brain tumor. “The fact that DoD says it’s safe just makes no sense at all,” Baker said. “Dioxin was used in herbicides in Vietnam. Now it’s a byproduct of the burn pits. But you don’t just have dioxin — you have a list of other chemicals. We need to look at the combined effect of all these chemicals.” John Bradley, a legislative consultant for DAV, said the group can look to see whether there is a positive association between a deployment and disease, and that can lead VA to presume those diseases were caused by this war. The proof shouldn’t rest on the veteran, he said.

        Army Staff Sgt. Danielle Nienajadlo said her time in Balad led to a nightmare that will haunt her for the rest of her life. As a vehicle mechanic, she spent much of her time at the motor pool near the burn pit. Her living quarters, she said, were within a couple of miles of the pit, and when they ran for physical fitness training, they inhaled the fumes as they passed the plume. She said the smoke constantly hung over her living quarters. “We were always covered in ash and dirt,” she said. “People got bloody noses and headaches.” Before she arrived, she had a full physical, including a blood workup, because she wanted to become a helicopter pilot. But upon arrival at Balad, she started coughing and blowing out black stuff. Soon, she lost her appetite. She felt nauseated, was constantly tired and had trouble breathing. She went to sick call several times, only to be told she might be stressed out. One night, she stayed up all night with hot sweats and a fever; she went to the emergency room and begged doctors to draw her blood. They did. Her white blood cell count was over the top: She had leukemia. She believes the burn pit served as a catalyst for her cancer. “I know I got it out there,” she said. The cancer took over her lungs, and she couldn’t breathe. After a full course of chemotherapy at Walter Reed Army Medical Center, Washington, D.C., where she remains, she said she’s doing better, though she will be checked every three weeks for the next five years to make sure it doesn’t come back. “I’m in remission,” she said. “I know I’m blessed. If I’d waited another day, I would’ve died.” [Source: NavyTimes Kelly Kennedy article 14 Nov 08 ++]

Washington, DC – More Service Members may now qualify for Traumatic Servicemembers’ Group Life Insurance (TSGLI), because of newly expanded benefits that are a result of a review conducted by The Department of Veterans Affairs (VA). The purpose of the review was to ascertain whether additional injuries/losses should be covered, whether the program was operating effectively, and whether other improvements could be made that would allow more Service Members to benefit from TSGLI.

 

Through the review’s findings, the TSGLI Schedule of Losses was simplified, making it more usable for each branch of service and allowing for easier interpretation by the general public. Existing TSGLI qualifying loss definitions on the schedule, such as those for sight, burns and amputations were expanded and additional qualifying losses including uniplegia, limb salvage, facial reconstruction, and a 15-day hospital stay were added as well.

 

“The TSGLI benefit expansion helps us further the mission and spirit of the program – help traumatically injured Service Members at their greatest time of need,” says COL John F. Sackett, Chief of the Army’s TSGLI Branch.  “As stated by our prior Vice Chief of Staff, we need to ‘do what is right for the Soldier’. With these changes we can offer assistance to even more men and women who have so bravely served our country.” members whously qualifyy the general public and more usable for each b

 

Service Members that have already submitted a claim in the past do not need to resubmit. The VA and TSGLI offices for each service will conduct a reachback of previously denied claims to see if they qualify for payment under the new guidance. Notifications will be sent to the Service Member if an additional award is due.

 

TSGLI is a Congressionally-mandated program that applies to members of all branches of Service and all components—Active, Guard, or Reserve, who incur a traumatic, physical injury based on an external force of violence.  TSGLI provides tax-free payments between $25,000 and $100,000 per traumatic event, which can be used to help with unseen expenses or provide a financial start on life after recovery.

 

The TSGLI program began on December 1, 2005, as a non-option selection attached to Servicemembers’ Group Life Insurance (SGLI). All Service Members from that point forward who elected SGLI benefits pay $1 towards this coverage each month.  In addition, Service Members who incurred a qualifying traumatic injury from 7 October 2001 through 30 November 2005 while on orders outside the United States in support of Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF), or serving in a Combat Zone Tax Exclusion (CZTE) area are covered by TSGLI, regardless of whether they elected SGLI coverage or not.

 

For more information about TSGLI, including a complete list of the new schedule of losses, eligibility requirements, and claim submission instructions, Service Members should contact their branch of service using the contact information below:

 

ARMY

Army Human Resources Command

Attn: TSGLI

200 Stovall Street,

Alexandria, VA 22332

Phone: 1-800-237-1336

Website: www.tsgli.army.mil

 

NAVY

Navy Personnel Command

Attn: PERS-62

5720 Integrity Drive

Millington, TN 38055

Phone: 800-368-3202

Website: www.npc.navy.mil/CommandSupport/CasualtyAssistance/TSGLI

 

MARINE CORPS

HQ, Marine Corps

Attn: WWR-TSGLI

3280 Russell Road

Quantico, VA 22134

Phone: 877-216-0825

Website: https://www.manpower.usmc.mil/pls/portal/url/page/m_ra_home/wwr/wwr_a_command_element/wwr_d_regimental_staff/3_s3/wwr_tsgli

 

AIR FORCE

AFPC/DPWC

550 C Street West

Randolph AFB, TX  78150
Phone: 1-800-433-0048

Website: www.ask.afpc.randolph.af.mil

 

COAST GUARD

COMDT (CG-1222)

2100 2^nd Street SW

Washington, DC 20593

Phone: 202-475-5391

To view and download VA news release, please visit the following
Internet address:
http://www.va.gov/opa/pressrel

WASHINGTON (Dec. 4, 2008) - Veterans will have easier access to
world-class health care under a Department of Veterans Affairs (VA) plan
to open 31 new outpatient clinics in 16 states.

Secretary of Veterans Affairs Dr. James B. Peake today announced VA will
establish new clinics in Alabama, Arkansas, California, Florida,
Georgia, Hawaii, Illinois, Iowa, Maryland, Michigan, Minnesota,
Mississippi, Missouri, North Carolina, Pennsylvania and Vermont.

"VA is committed to providing world-class health care to the men and
women who have served this nation," Peake said. "These new clinics will
bring VA's top-notch care closer to the veterans who have earned it."

With 153 hospitals and about 745 community-based clinics, VA operates
the largest integrated health care system in the country.  VA's medical
care budget of more than $41 billion this year will provide health care
to about 5.8 million people during nearly 600,000 hospitalizations and
more than 62 million outpatient visits.

"Community-based medicine is better medicine," said Dr. Michael Kussman,
VA's Under Secretary for Health. "It makes preventative care easier for
patients, helps health care professionals have closer relationships with
their patients and permits easier follow-ups for patients with chronic
health problems."

The community-based outpatient clinics, or CBOCs, will become
operational by late 2010, with some opening in 2009.  Local VA officials
will keep communities and their veterans informed of milestones in the
creation of the new CBOCs.

VA's Proposed Sites for New Outpatient Clinics
Alabama - Monroe County (2010)

Arkansas - Faulkner County (2010), Pope County (2010)

California - Lake County (2010), Oakhurst (2010), Susanville (2010),
Yuba County (2010)

Florida - Brandon (2010), Clermont (2010)

Georgia -- Blairsville (2010)

Hawaii - Leeward (Honolulu, 2010)

Illinois - Carbondale (2009), Harrisburg (2010), Sterling (2010)

Iowa -- Decorah (2010)

Maryland - Fort Meade (2010), Montgomery County (2010)

Michigan - Bad Axe (2010), Cadillac (2010), Cheboygan (2010), Grayling
(2010)

Minnesota - Southern central border (2010), Southwest metro area (exact
locations to be determined, 2010)

Mississippi - Pike County (2010)

Missouri - Excelsior Springs (2009), Sikeston (2009), Sedalia (2010)

North Carolina - Edenton-Elizabeth City (2010), Goldsboro (2010)

Pennsylvania - Cranberry Township (2009)

Vermont - Brattleboro (2010)

The military keeps track of folks who are currently receiving military pay. That means they know the location of individuals who are currently on active duty, in the National Guard and Reserves, and those who are retired from the military. If you're looking for someone who spent a few years in the military, and then separated, the military is not going to know where they are. Even if the people you are looking for are currently on active duty, in the Guard or Reserves, or are retired, whether or not the military will release information they do have on file is dependent upon the circumstances. For example, the military generally does not release information about individuals who are deployed. Following are some guidelines on where you can look:

    Base Locators:  If the person you're trying to find is currently on active duty, and you know their rank, name, and where they are stationed, finding them is pretty easy. Every military base has a "base locator." You can usually locate the military member you're looking for with a simple phone call. To contact the base locator, call long distance information, and ask them to connect you to the base operator for the military base where the member is stationed. When the base operator comes on the line, ask to be connected to the base locator. The base locator can give you the duty phone number and duty address of any active duty person stationed on that base. Unless the individual has asked to keep the information private, the locator can also give you their home phone number and home address.

    World-Wide Locators:  If you don't know where the member is stationed, you'll need to contact the specific service's world-wide locator service. Each military branch has their own:

    •    Air Force. The Air Force World-Wide Locator is based at the Air Force Personnel Headquarters in Texas. It handles requests for Air Force active duty, Air Force reserves, the Air National Guard, and retired Air Force members. There are two types of requests: official requests and unofficial requests. Official requests are defined as requests received from any government agency and the Department of Defense. All other requests are considered unofficial. All unofficial requests must be made in writing. In order for the Air Force to properly locate the correct individual, your request must contain as much of the following information as possible: Full name to include a middle initial; Rank; Social Security number; Date of birth; Any known assignment information (places/dates). A fee of $3.50, per individual request, is required for all unofficial requests. The fee must be paid by check or money order made out to "DAO-DE RAFB." Requestors who are on active duty, National Guard, Reserves, or military retired are exempt from paying the fee. Your written request needs to include your name, address, and phone number. Put your written request in an unsealed envelope with a return address, proper postage affixed and the individual's (the person you're looking for) name in the addressee portion of the envelope. Place this envelope in a larger envelope with your check or money and mail to the locator address at: HQ AFPC/DPDXIDL, 550 C St West Ste 50, Randolph AFB, TX 78150-4752. Your request constitutes permission for the Air Force to release your name, phone number, and address to the military member.

    •    Army. Due to security reasons, the Army has closed their World-Wide Locator Service to the general public. To access the Army locator, you now need an Army Knowledge Online account (that means you need to be a member of the Army, Army National Guard, Army Reserves, Army Retired member, or an Army Dependent). Other requests to locate active duty Army members are handled on a case-by-case basis. Send your written requests to: Commander,  U.S. Army Enlisted Records & Evaluation Center, ATTN: Locator, 8899 East 56th Street, Fort Benjamin Harrison, IN 46249-5301 Tel:1-866-771-6357.


    •    Navy. The Navy World Wide Locator helps locate individuals on active duty and those who have been recently discharged (within one year). The Navy also has a current address for retired Navy service members. Retiree addresses and addresses for those who have recently separated, however, are protected under the provisions of the Privacy Act and cannot be released. In these cases, however, the locator can forward mail. Give as much identifying information as possible about the person you wish to locate such as full name, rank (rate), last duty assignment/last known military address, service number, and Social Security number. You can call the locator service at 1-866-827-5672 or 1-901-874-3388, DSN 882-3388. Unless you are calling on official business or a family member or active duty member, the fee for researching an address is $3.50 per address made payable by check or money order to the U.S. TREASURER. Fees are retained in cases resulting in an unsuccessful search. Mail your correspondence with your fee to: Navy World Wide Locator, Navy Personnel Command, PERS 312E2, 5720 Integrity Drive Millington, TN 38055-3120.

    •    Marine Corps. The Marine Corps can provide the duty station for active duty personnel and reservists. For retired individuals, the locator service can provide the city and state, but not an address. The service will provide the service member's current rank and unit address; however, due to the locator's staffing, the office cannot forward mail except in special cases. Telephonic requests to 1-703-640-3942/3943 are no charge to immediate family members and government officials calling on official business. In addition, telephonic service will be provided at no cost to any individual, business or organization, if the Marine locator decides the information would benefit the individual. Other requests cost $3.50, made payable by check or money order to the U.S. TREASURER. Send written locator requests to: Commandant of the Marine Corps, Headquarters, USMC Code MMSB-10, Quantico, VA 22134-5030.


    •    Coast Guard. The Coast Guard World Wide Locator has duty stations for active duty personnel. They do not maintain listings for CG reserve or retired personnel. To locate an active duty Coast Guard member, you can send an email to: ARL-PF-CGPCCGlocator@uscg.mil. You can also write to: Coast Guard Personnel Command (CGPC-adm-3), 2100 Second St, SW.,Washington, DC 20593-0001 Tel: (202) 267-0581

    Other: Military members are people, just like any other folks. They can often be found by employing methods you would use to try and locate anyone. For example, a private detective agency may be able to assist. They usually have access to resources and databases which can search driver's license records, utility records, mortgage and deed documents, etc. There are web sites that allow former military members and former military members to enter their contact information, so that it is available to people who wish to find them. The disadvantage is that the member will not be listed there, unless he/she specifically requested that their information be listed. Some of these web sites are:
    •    www.militarylocator.com. You have to join this site to use their locator.
    •    www.militaryconnections.com. Database with over 450,000 names.
    •    www.gisearch.com. Database with information from many current and former military members.
    •    www.usaf-locator.com. More than 32,000 email addresses of current and former Air Force members.
    •    www.classmates.com. Classmates.com has a special section for current and former military members. You have to join in order to use their services.

    [Source:  About.com U.S. Military Rod Powers article Nov 08 ++]

To view and download VA news release, please visit the following
Internet address:
http://www.va.gov/opa/pressrel

WASHINGTON (Dec. 1, 2008) -- The Department of Veterans Affairs (VA) has
sent the October 2008 report from the VA Research Advisory Committee on
Gulf War Veterans' Illnesses to the National Academy of Sciences'
Institute of Medicine (IOM) for review and recommendations.

The October report from the advisory committee identified potential
causes for -- and asserted that research supports the existence of -- a
multi-symptom condition resulting from service in the 1990 - 1991 Gulf
War, which the committee identified as Gulf War Illness (GWI).

Because VA has traditionally and by law relied upon IOM for independent
and credible reviews of the science behind these particular veterans'
health issues, Secretary of Veterans Affairs Dr. James B. Peake has
asked IOM to review the advisory committee's report before VA officially
responds to the report's conclusions.

"I appreciate the committee's work on this report, and I am eager to see
the results of further independent study into their findings," Peake
said. "Of course, VA will continue to provide the care and benefits our
Gulf War veterans have earned through their service, as we have for more
than a decade."

VA has long recognized conditions, granted benefits and provided health
care to Gulf War veterans suffering from a broad range of symptoms, even
though these conditions have not been scientifically recognized as a
specific disease or injury or GWI.

These include chronic fatigue, persistent rashes, hair loss, headaches,
muscle pain, joint pain, neurologic symptoms, neuropsychological
symptoms (such as memory loss), respiratory system symptoms, sleep
disturbances, gastrointestinal symptoms, cardiovascular symptoms,
abnormal weight loss and menstrual disorders.

  The Marine Corps is searching for at least 500,000 people who have visited Camp Lejeune, NC, and could be at risk for health problems due to the drinking water on base.  Chemicals from a building used to wash clothes for dry cleaning and de-greasing were found in the water system.  More than 80,000 people have registered, which is only a fraction of the veterans and visitors who could be affected.  Those who have visited or lived on the base between 1957 and 1987 should register by visiting the Marine Corps' Camp Lejeune Water Study website https://clnr.hqi.usmc.mil/clsurvey/ or by calling (877) 261-9782.

 [Source:  NAUS Weekly Update 26 Nov 08 ++]

All bills introduced in the 110th Congress that have not been passed into law are void unless they are reintroduced into the 111th Congress.  Congress will convene the 111th Congress on JAN 09. Refer to the Bulletin’s House & Senate attachments for or a listing of Congressional bills of interest to the veteran community that have been introduced in the 110th Congress. Support of these bills through cosponsorship by other legislators is critical if they are ever going to move through the legislative process for a floor vote to become law.  A good indication on that likelihood is the number of cosponsors who have signed onto the bill. A cosponsor is a member of Congress who has joined one or more other members in his/her chamber (i.e. House or Senate) to sponsor a bill or amendment. The member who introduces the bill is considered the sponsor.  Members subsequently signing on are called cosponsors. Any number of members may cosponsor a bill in the House or Senate. At http://thomas.loc.gov you can also review a copy of each bill’s content, determine its current status, the committee it has been assigned to, and if your legislator is a sponsor or cosponsor of it.  To determine what bills, amendments your representative has sponsored, cosponsored, or dropped sponsorship on refer to http://thomas.loc.gov/bss/d110/sponlst.html.  The key to increasing cosponsorship on veteran related bills and subsequent passage into law is letting our representatives know of veteran’s feelings on issues.  At the end of some listed bills is a web link that can be used to do that. You can also reach his/her Washington via the Capital Operator direct at (866) 272-6622, (800) 828-0498, or (866) 340-9281 to express your views. Otherwise, you can locate on http://thomas.loc.gov who your representative is and his/her phone number, mailing address, or email/website to communicate with a message or letter of your own making.  Refer to http://www.thecapitol.net/FAQ/cong_schedule.html for future times that you can access your representatives on their home turf.  [Source: RAO Bulletin Attachment 13 Nov 08 ++]

 Defense Secretary Robert Gates has issued a policy stating that the military will follow a new law requiring that service members being medically retired for post-traumatic stress disorder be rated at least 50% disabled, a provision of the 2008 Defense Authorization Act. But the Pentagon is ignoring another provision of the Act that requires a review board to be set up for medical evaluation cases, and has even added some pain to service members who feel they have been wronged: Decisions by the board, whenever it is formed, will not be retroactive. The Physical Disability Board of Review was mandated by Congress to check the fairness and accuracy of troops’ disability cases. The Defense Department decided that the board will review only conditions found unfitting — which advocates for service members say leaves out any diagnosis that should have been included but wasn’t. They say it also excludes cases in which lower-rated conditions were found unfitting while higher-rated conditions were found fitting — allowing the military to spend less money on medical separation cases. Now a new memo states that decisions of the board, which was supposed to be set up in April, will not be retroactive. The memo, posted on the Military Health System Web site, states: “Any change to the rating is effective on the date of final decision by the service secretary.”

In other words, service members will not receive back pay for incorrect ratings.

         Retired Army Lt. Col. Mike Parker, who has worked as an advocate for troops going through the medical retirement system, said the situation is maddening because the longer the Defense Department takes to set up the new board, the less back pay it will have to hand out. Parker said the new memo on PTSD ratings is better news. According to the 2008 Defense Authorization Act, all the services are required to follow the rules of the Veterans Affairs Schedule for Rating Disabilities. According to those rules, anyone being medically discharged with a diagnosis of PTSD must receive a disability rating of 50% and then be re-examined six months later. In the past, according to Army documents, many soldiers with PTSD have been found unfit for service, rated 10% disabled and immediately booted out. Not long ago, rumors were rampant that defense officials soon would issue guidance stating that this was, in fact, how those cases should be handled. But after the threat of a lawsuit and calls from veterans’ groups for the Pentagon to obey the letter of the law, a 14 OCT policy was incorporated into Defense Department Instruction 1332.38, stating that the military will abide by the VASRD rules. The rules state: “When a mental disorder that develops on active duty as a result of a highly stressful event is severe enough to bring about release from active military service, the rating agency shall assign an evaluation of not less than 50% and schedule an examination within the six-month period following discharge to determine whether a change in rating and disposition is warranted.” The only exceptions will be those found to have a permanent and stable condition and a rating of 80% or higher, who will be permanently retired.

         The memo, signed by David Chu, undersecretary of defense for personnel and readiness and effective immediately, also states that troops in the Disability Evaluation System may request an impartial physician or other health care professional not involved in his or her case to review the medical evidence for a Medical Evaluation Board. That was also mandated by Congress in the 2008 Defense Authorization Act. The memo states: “In most cases, this impartial health professional should be the service member’s primary care manager,” and adds that the adviser has five days to review the evidence. The new guidance also:

    •    Lays out time limits for how long each task should take to perform. For example, the entire process, from the date of the first medical summary for the Medical Evaluation Board to the final review board, excluding appeals review, “should not exceed” 70 days for active-duty members and 130 days for reserve-component members. Each appeal should take no longer than 30 days from the day the final Formal Physical Evaluation Board is completed.
    •    Asks the services to create a new Medical Evaluation Board or Physical Evaluation Board to process cases if they encounter backlogs.
    •    States that Physical Evaluation Board legal counselors will consult with the service members they counsel “at least one day in advance of the scheduled formal hearing.” Troops have complained that their counseling came just hours before their hearings, and often took place by phone.
    [Source:  NavyTimes Kelly Kennedy article 22 Nov 08 ++]

    ===============================

    DOD DISABILITY EVALUATION SYSTEM UPDATE 13:    Marine Cpl. James Dixon was wounded twice in Iraq -- by a roadside bomb and a land mine. He suffered a traumatic brain injury, a concussion, a dislocated hip and hearing loss. He was diagnosed with post-traumatic stress disorder. Army Sgt. Lori Meshell shattered a hip and crushed her back and knees while diving for cover during a mortar attack in Iraq. She has undergone a hip replacement and knee reconstruction and needs at least three more surgeries. In each case, the Pentagon ruled that their disabilities were not combat-related. In a little-noticed regulation change in MAR 08, the military's definition of combat-related disabilities was narrowed, costing some injured veterans thousands of dollars in lost benefits -- and triggering outrage from veterans' advocacy groups. The Pentagon said the change was consistent with Congress' intent when it passed a "wounded warrior" law in January. Narrowing the combat-related definition was necessary to preserve the "special distinction for those who incur disabilities while participating in the risk of combat, in contrast with those injured otherwise," William J. Carr, deputy undersecretary of Defense, wrote in a letter to the 1.3-million-member Disabled American Veterans. The group, which has called the policy revision a "shocking level of disrespect for those who stood in harm's way," is lobbying to have the change rescinded.

         Sen. Carl Levin (D-MI), chairman of the Armed Services Committee, said the Pentagon's "more conservative definition" limited benefits for some veterans. "That was not our intent," Levin said in a statement. He added: "When the disability is the same, the impact on the service member should be the same no matter whether the disability was incurred while training for combat at Ft. Hood or participating in actual combat in Iraq or Afghanistan." Pentagon officials argue that benefits should be greater for veterans wounded in combat than for "members with disabilities incurred in other situations (e.g., simulation of war, instrumentality of war, or participation in hazardous duties, not related to combat)," Carr wrote. But veterans like Dixon and Meshell said their disabilities were a direct result of wounds suffered in combat. Dixon said he was denied at least $16,000 in benefits before he fought the Pentagon and won a reversal of his noncombat-related designation. "I was blown up twice in Iraq, and my injuries weren't combat-related?" Dixon said. "It's the most imbecile thing I've ever seen." Meshell, who is appealing her status, estimates she is losing at least $1,200 a month in benefits. Despite being injured in a combat zone during an enemy mortar attack, she said, her wounds would be considered combat-related only if she had been struck by shrapnel. Meshell said the military had suggested that at least some of her disability was caused by preexisting joint deterioration. "Before I went over there, I was fine -- I was perfectly healthy," Meshell said. "This whole thing is causing me a lot of heartache."

         Kerry Baker, associate legislative director of DAV, has accused the Pentagon of narrowing the definition of combat-related disabilities to save money. He said the change would reduce payments for tens of thousands of veterans -- those already wounded and those injured in the future. "This is going to hurt a lot of people," Baker said. "It's one of those things that when you first look at it, you think: 'Wow. How can this be?'  In a letter to members of Congress, the Disabled American Veterans accused the Pentagon of "mutilating" the statutory definitions of combat-related disabilities as part of a "deliberate manipulation of the law." The January legislation was aimed at allowing troops wounded in combat and combat-related operations to collect disability severance from the military and disability compensation from the Department of Veterans Affairs. Disability severance is based on past service. Disability compensation is based on future loss of earning potential. Previously, veterans with combat-related disabilities received reduced monthly VA compensation until their severance money was recouped. That is still the case for those whose injuries are not deemed combat-related. Years ago, Congress adopted a detailed definition of combat-related disabilities. It included such criteria as hazardous service, conditions simulating war and disability caused by an "instrumentality of war." Those criteria were not altered in the January legislation. The Pentagon, in establishing an internal policy based on the legislation, in March unlawfully stripped those criteria from the legislation, the Disabled American Veterans said. "We do not view this as an oversight," Baker testified before Congress in June. "We view this as an intentional effort to conserve monetary resources at the expense of disabled veterans."

         The Pentagon changes focused on "tip of the spear" fighters, or those "in the line of duty in a combat zone," said Eileen Lainez, a Pentagon spokeswoman. They comprise "a very special, yet limited, subset of those who matriculate through the Disability Evaluation System," Lainez wrote in an e-mail response to a request for comment. In many cases, veterans say, they are not told why their disabilities are not considered combat-related. Dixon said he did not realize he had been put in a noncombat-related category until he began questioning his disability payments. It took more than six months of phone calls, letters and appeals -- plus help from the Disabled American Veterans and a member of Congress -- to overturn his designation. Navigating the Pentagon's bureaucracy was made more difficult because Dixon's brain injury resulted in short-term memory loss. He had to write everything down in notebooks and calendars. "It was a nightmare," Dixon said. "Most veterans don't know how the system works, or how to fight it. They don't realize all the obstacles they put in your way to keep you from getting what you deserve." Meshell said the military disability system was so complex that few veterans were equipped to navigate it. "I'm a college graduate. I'm not a dumb person. But honestly, I can't begin to explain some of this stuff," she said. After five years of active duty, a combat tour in Iraq and 12 years in the National Guard and Reserves, she thinks she deserves the full disability benefits authorized by Congress for veterans injured in combat. "I earned them," she said. "I went to Iraq. I was in combat. I got injured."

[Source: Los Angeles Times David Zucchino article 25 Nov 08 ++]

 In NOV 08 over 75 health advocacy organizations launched the Coalition to End the Two-Year Wait for Medicare, sending a letter to health leaders in the House and Senate demanding that next year’s health reform efforts make a priority of covering people with disabilities who are struggling to survive as they wait for Medicare coverage.

Close to 1.5 million people are stuck in this waiting period annually. ”Nearly 40% of these individuals are without health insurance coverage at some point during their wait for Medicare; 24% have no health insurance during this entire period.

Many cannot afford to pay COBRA premiums to maintain coverage from their former employer, and private coverage on the individual market is unavailable or too expensive for this high-cost population. The economic downturn makes it difficult for states to extend Medicaid coverage beyond the most impoverished people with disabilities,” the coalition letter reads. “No one with disabilities severe enough to qualify for SSDI should be without health insurance.”

The coalition includes organizations such as the American Cancer Society – Cancer Action Network, Amputee Coalition of America, Alzheimer’s Association, Easter Seals and the Medicare Rights Center. In 1972, when Congress expanded Medicare to include people with disabilities, it created a “waiting period” that requires people to wait 24 months from when they begin receiving their Social Security Disability Insurance (SSDI) payments before they can receive health care through Medicare.

Costs for the elimination of the waiting period are estimated to be around $9 billion annually. These costs would be offset by about $4 billion in Medicaid savings. In the 110th congress Senate bill S.2102 sponsored by Senator Jeff Bingaman (D-NM), wioth 23 sponsor (including President-elect Barack Obama) and House bill H.R. 154 sponsored by Representative Gene Green (D-TX) with 103 cosponsors.

This legislation would eliminate the waiting period through a ten-year phase out.

 [Source:  Medicare Watch 25 Nov 08 ++]

   The U.S. Department of Veterans Affairs is being blamed for the suicide of a 24-year-old Michigan man who served with the Marines in Iraq. A lawsuit filed 25 NOV accuses government doctors of failing to keep Randen Harvey in a hospital or commit him to a mental-health facility in 2006. Harvey died of a drug overdose at his father’s home in Farmington Hills in JUN 06.

The lawsuit says he suffered from post-traumatic stress disorder after two tours in Iraq. The lawsuit says Harvey was found on the roof of the VA Medical Center in Ann Arbor, three days before his death. He was discharged and told to wait for substance-abuse treatment. The lawsuit in federal court in Detroit seeks $600,000. A message seeking comment was left with the VA.

The VA made a financial offer before the lawsuit was filed “but it was too low,” lawyer Thomas Campbell said.

[Source: MarineCorpsTimes AP article 25 Nov 08 ++]

The Army, Air Force and Marine Corps announced the current number of reservists on active duty as of 25 NOV 08 in support of the partial mobilization.

The net collective result is 349 more reservists mobilized than last reported in the Bulletin for 15 NOV 08.

At any given time, services may mobilize some units and individuals while demobilizing others, making it possible for these figures to either increase or decrease. The total number currently on active duty in support of the partial mobilization of the

• Army National Guard and Army Reserve is 96,345;
• Navy Reserve, 5,803;
• Air National Guard and Air Force Reserve, 10,741;
• Marine Corps Reserve, 6,859;
• and the Coast Guard Reserve, 858.

This brings the total National Guard and Reserve personnel who have been mobilized to 120,606 including both units and individual augmentees. A cumulative roster of all National Guard and Reserve personnel, who are currently mobilized, can be found at http://www.defenselink.mil/news/Nov2008/d20081125ngr.pdf . [Source: DoD News Release 984-08 26 NOV 08 ++]

An Associated Press analysis of federal data has found taxpayers have shelled out at least $200 million since 2004 for medications that have never been reviewed by the government for safety and effectiveness but are still covered under Medicaid. Millions of private patients are taking such drugs, as well. The availability of unapproved prescription drugs to the public may create a dangerous false sense of security. Dozens of deaths have been linked to them. The medications date back decades, before the Food and Drug Administration tightened its review of drugs in the early 1960s. The FDA says it is trying to squeeze them from the market, but conflicting federal laws allow the Medicaid health program for low-income people to pay for them. The AP analysis found that Medicaid paid nearly $198 million from 2004 to 2007 for more than 100 unapproved drugs, mostly for common conditions such as colds and pain. Data for 2008 were not available but unapproved drugs still are being sold. The AP checked the medications against FDA databases, using agency guidelines to determine if they were unapproved. The FDA says there may be thousands of such drugs on the market. Medicaid officials acknowledge the problem, but say they need help from Congress to fix it. The FDA and Medicaid are part of the Health and Human Services Department, but the FDA has yet to compile a master list of unapproved drugs, and Medicaid — which may be the biggest purchaser — keeps paying.

         At a time when families, businesses and government are struggling with health care costs and 46 million people are uninsured, payments for questionable medications amount to an unplugged leak in the system. Sen. Charles Grassley (R-IA) has asked the HHS inspector general to investigate. That unapproved prescription drugs can be sold in the United States surprises even doctors and pharmacists. But the FDA estimates they account for 2% of all prescriptions filled by U.S. pharmacies, about 72 million scripts a year. Private insurance plans also cover them. The roots of the problem go back in time, tangled in layers of legalese. It wasn't until 1962 that Congress ordered the FDA to review all new medications for effectiveness. Thousands of drugs already on the market were also supposed to be evaluated. But some manufacturers claimed their medications were "grandfathered" under earlier laws, and even under the 1962 bill. Then, in the early 1980s, a safety scandal erupted over one of those medications. E-Ferol, a high potency vitamin E injection, was linked to serious reactions in some 100 premature babies, 40 of whom died. In response, the FDA started a program to weed out drugs it had never reviewed scientifically. Yet some medications continued to escape scrutiny. Sometimes, the medications do not help patients. In other cases, the FDA says, they have made people sicker, maybe even killed them. This year, for example, the FDA banned injectable versions of a gout drug called colchicine after receiving reports of 23 deaths. Investigators found the unapproved drug had a very narrow margin of safety, and patients easily could receive a toxic dose leading to complications such as organ failure.

         Critics say the FDA's case-by-case enforcement approach is not working. In most cases, doctors, pharmacists and patients are not aware the drugs are unapproved. Tackling the problem is made harder by confusing — and sometimes conflicting — laws, regulations and responsibilities that pertain to different government agencies. Medicaid officials said their program, which serves the poor and disabled, is allowed to pay for unapproved drugs until the FDA orders a specific medication off the market. But that can take years. Compare that with Medicare, the health care program for older people.  Medicare's prescription program is not supposed to cover unapproved drugs. Medicare has purged hundreds of such medications from its coverage lists, but continues to find others. It might be easier to sort things out if the FDA compiled a master list of unapproved drugs, but the agency hasn't. FDA officials say that would be difficult because many manufacturers do not list unapproved products with the agency. Yet, the AP found many that were listed — a possible starting point for a list. Among the drugs the AP's research identified were Carbofed, for colds and flu; Hylira, a dry skin ointment; Andehist, a decongestant, and ICAR Prenatal, a vitamin tablet. Medicaid data show the program paid $7.3 million for Carbofed products from 2004 to 2007; $146,000 for Hylira; $4.8 million for Andehist products, and $900,000 for ICAR.

        FDA officials say they tell Medicaid and Medicare when the agency moves to ban an unapproved drug, so the programs can stop paying. The FDA began its latest crackdown on unapproved drugs two years ago and has taken action against nine types of medications and dozens of companies. Typically, the agency orders manufacturers to stop making and shipping drugs, and it also has seized millions of dollars' worth of medications. But federal law does not provide fines for selling unapproved drugs, and criminal prosecutions are rare. Some manufacturers of unapproved drugs say their products predate FDA regulation and are grandfathered in.  The FDA is skeptical that any drugs now being sold are entitled to "grandfather" status. To qualify, they would have to be identical to medications sold decades ago in formulation and other important aspects. The agency is targeting drugs linked to fraud, ones that do not work and, above all, those with safety risks.


While the crackdown has helped, it does not appear to have solved the problem. The gout drug banned by the FDA this February is not the only recent case involving safety problems. Last year, the FDA banned unapproved cough medicines containing hydrocodone, a potent narcotic. Some had directions for medicating children as young as age 2, although no hydrocodone cough products have been shown to be safe and effective for children under 6. In a 2006 case, the agency received 21 reports of children younger than 2 who died after taking unapproved cold and allergy medications containing carbinoxamine, an allergy drug that also acts as a powerful sedative. Regulators banned all products that contained carbinoxamine in combination with other cold medicines.

[Source: AP Ricardo Alonso-Zaldivar and Frank Bass article 24 Nov 08 ++]

An Army Reserve colonel and Iraq war veteran could become the next secretary of Veterans’ Affairs. Anthony Brown, Maryland’s lieutenant governor, is getting attention because he is on President-elect Barack Obama’s transition team as co-chair of the group studying priorities for the Veterans Affairs Department — and because, like Obama, he is a Harvard Law School graduate. Brown had been a member of Veterans for Clinton, a group that supported Sen. Hillary Rodham Clinton (D-NY) for the Democratic presidential nomination.That he was named to the transition team appears to show that early support for an Obama rival has not worked against him. Brown also helped draft the 2008 Democratic Party national platform last summer. Brown’s name, hotly circulating 21 NOV among people advising the Obama transition, comes after speculation had centered on two other people to take over the VA, both disabled veterans.
    -    Former Sen. Max Cleland, a 67-year-old Vietnam veteran who lost both legs and an arm in that conflict, served as head of the then-Veterans Administration during the Carter administration and campaigned hard for Obama in the recent election campaign.
    -    Tammy Duckworth, a 41-year-old Iraq war veteran who lost both legs when her helicopter was hit by a rocket-propelled grenade, has served as the head of the Illinois Department of Veterans Affairs since she lost a 2006 race for Congress. Duckworth, a major in the Illinois National Guard, has been mentioned as a possible successor to Obama’s U.S. Senate seat, which he resigned after being elected president.

    Obama aides did not respond to questions about the VA nomination. Although there has been speculation about several cabinet posts, no formal announcements have been made about nominees. Brown was commissioned in the Army in 1984 and spent five years on active duty as a helicopter pilot with the 4th Combat Aviation Brigade, 3rd Infantry Division. He entered law school after leaving active duty. After getting his law degree, he spent two years as a clerk for the U.S. Court of Military Appeals. Brown deployed to Iraq in 2004 as part of the 353rd Civil Affairs Command, and since 2007 has commanded the Army Reserve’s Pennsylvania-based 153rd Legal Support Organization. He served as a Maryland state delegate from 1999 until his election as the state’s lieutenant governor in 2006. Since then, he has worked on a variety of military and veterans projects, serving as chairman of the Maryland Veterans Behavioral Health Advisory Board that oversees efforts to provide and improve direct mental health services to returning veterans and working to expand services for veterans in rural areas.“We will provide the services when they are not available to veterans,” Brown said in an interview with Military Times earlier this year about Maryland’s initiatives for returning veterans. When Brown and Gov. Martin O’Malley looked at what they could do for returning veterans, Brown said, “The glaring area is in mental health, … the inability of VA to care for veterans.” To those who contend that this is a federal responsibility, Brown said that when he looks at someone, he doesn’t see a federal worker or civilian worker, but a Maryland resident. “When they come home and take off the uniform, they are our neighbors,” he said.

[Source: ArmyTimes Rick Maze article 23 nov 08 ++]