Getting the Facts Straight on VA’s Leadership

Folks looking for military, foreign policy, and Veteran news, often turn to TIME’s Battleland, a blog with an impressive cast of talented writers, many of them with military experience. They were even so kind as to publish something I wrote for Veterans Day last year. Usually the writing at Battleland is crisp and the facts are right on target.

So I found it puzzling to read Nate Rawlings’ piece on Wednesday that puts forth the idea that VA Secretary Eric Shinseki isn’t a visible advocate for Veterans. It’s especially confounding since the Secretary raced from the VFW National Convention on Tuesday to be in Washington, DC to answer questions on VA’s progress and responsibilities for nearly three hours before Wednesday’s joint VA/ Department of Defense hearing, which was promoted through VA’s Twitter feed for Veterans to follow. And that’s just this week.

So let’s unpack Mr. Rawling’s criticism. I take issue with the idea from several viewpoints: As a VA employee who has seen him in direct, personal discussions with Veterans, as a public Veteran advocate who also acts as an internal and external critic of VA when necessary, and as a student of journalism, where I have grown to understand—and look for—a few crucial conventions of the trade that Mr. Rawlings failed to utilized in his critique.

First, let’s examine the foundation of his argument:

But since taking over the VA, Shinseki has been “AWOL” as a veterans group leader told Joe Klein back in June. “He’s been a quiet disaster at the VA…and I mean quiet,” the man told Joe.

I don’t really have to debunk this from a VA standpoint. The New York Times addressed and debunked similar criticism earlier this month. Most folks in the Veterans space know the Secretary has a monthly breakfast with Veteran group leaders where they discuss the pressing issues their members face, and as the Times notes, “Mr. Shinseki has delivered more than 250 speeches since taking office in 2009, testified before Congress 21 times and conducted nearly 60 news conferences in the past 18 months.” And later this month, he will have completed his goal to visit 50 states in over 140 trips, engaging directly with Veterans on each one.

That level of access was highlighted by two Vets group leaders:

“Overall, he’s been a very accessible secretary,” said Peter Gaytan, executive director of American Legion, noting that Mr. Shinseki had been interviewed at least twice for the Legion’s magazine and had appeared at its national convention every year since taking office.

Similarly, Michael Dakduk, executive director of Student Veterans of America, said Mr. Shinseki had visited many of the group’s chapters at universities around the country, meeting scores of student veterans, most in their 20s.

“I can tell you that I’ve seen this man make the rounds,” Mr. Dakduk said.

Of course, some folks will disagree. So back to Rawlings’ piece. We’re told that the Secretary is “AWOL.” But who thinks that? Is it a consensus or a lone dissenting opinion? How many Veterans groups—or the Veterans they represent—agree the Secretary isn’t visible enough?

Surely Rawlings, a fellow Iraq War Veteran, knows more than a few Veterans to quote. He could also use his credibility as a TIME journalist to gain access to Veteran organization leaders and ask himself. But he didn’t do that. Instead, he cited a coworker, Joe Klein, and his bizarre quote from an anonymous “leader of a veterans group,” with no indication of who it is, why they’re speaking anonymously, or how widespread that opinion is.

For leaders who want to transform VA for the better, an anonymous tipster leaving quotes behind an “off-the-record” shield, isn’t the best way to advocate. It’s telling that Mr. Klein (or Rawlings) could not (or would not) find a single Veterans group leader with enough conviction to put a name to a quote like that.

Doubling down on anonymous, axe-grinding sources and failing to solicit more than one viewpoint would make any intro to journalism professor cringe, but it goes beyond that. Rawlings moves on to the continuing issue with VA’s claims backlog (which, we are the first to admit, has grown too large and Veterans wait far too long). What’s missing here is context—a lot of it.

It’s intellectually (and journalistically) lazy to declare, “The VA is an antiquated bureaucracy in desperate need of an overhaul” as a catchall reason for the existence of the claims backlog without giving the context of many reasons the backlog has grown, some of which are in VA’s control—and some of which are not.

The Associated Press gave a straightforward rundown of the circumstances, none of which are as simple as slow-moving bureaucrats. One pretty complex reason is that Secretary Shinseki declared a series of illnesses presumptively connected to Agent Orange, in a long overdue move, that put nearly a quarter of a million claims into the system and took 37 percent of the raters off their normal duties to complete.

Not to mention that claims soar under economic uncertainty, or that Veterans of modern wars (like Rawlings and myself) are filing claims at twice the rate of Veterans from other eras, and for up to seven times as many conditions—including connected injuries like traumatic brain injury and amputations that are unfortunate consequences of modern warfare. That kind of complexity demands greater attention, which unfortunately means longer wait times.  And that’s why we have a plan to automate the system so those wait times are a thing of the past.

This could’ve been explained to Rawlings by any number folks at VA who work on this issue. We have over a dozen friends in common on Twitter, so it’s easy to say we swim in the same pond of Veterans and advocates, which should make him comfortable enough to reach out. I regularly help connect reporters with VA experts, and would’ve been happy to do so for someone who chewed the same terrain in Iraq.

Now, I’m not certain Rawlings reached out to anyone at VA, or if he felt he knew enough information to forgo historical facts and projections for the piece, but it appears diligence was left at the door.

This is where context becomes pretty crucial. No one will deny that Veterans wait too long to receive a decision on their disability claims. That’s understood. But Rawlings goes as far to suggest that VA’s goal—a decision made by 125 days—is somehow not good enough:

Yes, 125 days. That’s over 4 months. That means that three years from now, a veteran filing a claim might still have to wait more than a third of a year. This is an absurd vision.

We already know the national average of 241 days is far too long, but is half that number still too long? What would an acceptable number be? Is there an amount of time that allows for evidence to build, appointments and evaluations made, and decisions sent that strikes a balance between due diligence, legality, and speed? Is 125 days that number, or can we do better? Again, this would be a good time for Rawlings to ask someone.

The process is still governed by laws established by Congress, and they must gather enough evidence to make a fair assessment. It’s an assessment that will potentially pay Veterans every month and affect the health care they receive for the rest of their lives.

So, what kind of timeframe should we set for that? Disability compensation isn’t Amazon, or Zappos, or on-demand cable. There’s a reason filing a claim isn’t like ordering fast food. It’s serious business that we have to get faster and better at, but that we absolutely must get right. But with a lack of situational awareness from folks like Mr. Rawlings, it’s difficult for Veterans to judge whether our goal is the best possible, good enough, or unacceptable.

Criticism is my thing. I got my job here by being vocal about VA’s shortcomings when it came to education benefits. And since starting at VA, I’ve been an internal critic with an external microphone, looking to start a conversation about the things we need to improve. So it’s not about sensitivity to criticism, but rather the pursuit of honest and informed dialogue.

With Secretary Shinseki’s leadership, we’ve had the ability to push the envelope with citizen engagement arguably more than any other government agency. It wasn’t possible before his tenure, and he has helped build a philosophy that has led to a very public discussion on the issues Veterans face.

And there’s no hiding from that.

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21 Comments to “Getting the Facts Straight on VA’s Leadership”

  1. RamadiSapper says:

    There seems to be a great number of “leaders” often from one of the many supposed Veterans Service Organizations that attempt to perpetuate the divide between Veterans and the VA for their own benefit. It’s easy to point out what someone is doing wrong, but when they criticize and don’t offer any constructive solution it’s all just talk. The VA is not the enemy, we are all on the same team and need to work together to make things right. Don’t come to the table with accusations and empty rhetoric, offer a viable solution so we may move progressively forward as a community, not allowing our past frustrations to shadow the work that has already been accomplished. I applaud the steps the VA has taken to make things right and I hope at the very least we as Veterans take into consideration how difficult and challenging it is to fix a system that was broken for so long. Nothing happens overnight. We must be patient, do what we can to be part of the solution and keep pressing forward.

  2. Horton is at the plate. Rawlings is on the mound. He pitches… and Horton hits it out of the park! The ball goes center field directly into the nuts of a “veterans group leader” and the crowd goes wild!

    This brings the final score to VA=1 Unproductive Douches=0

    What a game! See you next week folks.

    *I know this won’t get posted but hopefully it brings you all a good Friday laugh. Well done and keep up the good fight.

  3. BrokenSkull says:

    Lets not forget one big thing. Secretary Shinseki has transformed the VA into a system that veterans actually want to use. Veterans nowadays see that the VA is a high quality, high tech and forward leaning medical system and they want to be a part of that. When I got out I was told by many people that the VA is only for poor, homeless or really really broken veterans and to not even bother using it if I didn’t need a wheelchair or I couldn’t find any other options. Vets also see increased education benefits and a vast array of services that they didn’t know exited. This Secretary is a big part of that.

    I admit that VA is not perfect, but show me a perfect system. I tried non-va health care. No one I saw from regular family docs to specialists had any idea how to treat things like TBI or PTSD. They all said the same thing…”Go to the VA, it’s much better than you think.”

  4. AFB says:

    Your loyalty is admirable.

    And let’s just say that Mr. Shinseki is an honorable man who leads an antiquated bureaucracy full of dunces and fools. Most who work at the VA HQ aren’t even Vets.

    Mr. Peake and Mr. Nicholson had to try to get the same (“you can’t fire me and you can’t make me work”) slugs to actually give a damn about their customers. (The Veterans)

    Mr. Shinseki may be the one-eyed man in the land of the blind (DC VA HQ).

  5. Tim Gang says:

    General Shinseci, The word is out there that the VA is looking to hire veterans but I am at a loss when I can’t get the right time of day when it comes to getting correct and honest hiring practices at the Northport VA ,NY. I am service connected 30% or higher and have been given run around that my application was lost and a non veteran was hired . How can I speak to someone who I can trust to get a straight answer. I believe it is making the Generals words look false?

  6. I have been unsuccessful in getting past SEC Shinseki’s gatekeepers in order to ask him to engage industry leaders in ALS treatment research to encourage their effort and appeal for large group expanded access once safety and effectiveness is demonstrated. Have been told it wasn’t worthy of his effort.

    The VA needs leadership and to lead in the ALS fight in three areas

    1. The VA needs to partner or reach out to leaders in research on ALS treatment such as BRAINSTORM and Neuralstem, and others as they emerge.

    2. The VA needs to publish guidance on expanded access funding for Veterans with ALS to expedite approvals and treatments.

    3. SEC Shinseki needs to engage industry leaders in ALS treatment and research to encourage their efforts, and appeal for large group expanded access once safety and effectiveness is demonstrated.

    What really brings this home is the fact that 1,400 of the 3,600 Veterans with ALS received care from VHA during the past 4 fiscal years (FYs) died because there is no treatment or cure – yet. Sitting back and waiting is what we have been doing..

  7. SCOTT JOHNSON says:

    I have been unsuccessful in getting past SEC Shinseki’s gatekeepers in order to ask him to engage industry leaders in ALS treatment research to encourage their effort and appeal for large group expanded access once safety and effectiveness is demonstrated. The VA needs to lead and a leader to in the fight against ALS.

    1. The VA needs to partner or reach out to leaders in research on ALS treatment such as BRAINSTORM and Neuralstem, and others as they emerge.

    2. The VA needs to publish guidance on expanded access funding for Veterans with ALS to expedite approvals and treatments.

    3. SEC Shinseki needs to engage industry leaders in ALS treatment and research to encourage their efforts, and appeal for large group expanded access once safety and effectiveness is demonstrated.

    What really brings this home is the fact that 1,400 of the 3,600 Veterans with ALS received care from VHA during the past 4 fiscal years (FYs) died because there is no treatment or cure – yet.

    • SCOTT JOHNSON says:

      Please let me know if you do not post. I would at least like to get the message passed up the chain.

  8. AllEn Hope says:

    The VA does not serve its veterans! It serves the VA and the rich contractors that service it! Shut the entire VA system down! This is every useless office and person drawing good wages while veterans struggle! Give each and every veteran $5,000 a month and tell them to get their own health care. For those traumatic cases a financial review would be in order. What this does is put the veteran at the forefront, and not the VA!

  9. SCOTT JOHNSON says:

    SEC Shinseki’s decision to make ALS 100 percent sevice connected vice a minimum of 30 percent in JAN 2012 was great. In terms of long term commitment to an individual Veteran with ALS, it means little since most Veterans with ALS only live between 3-5 years from diagnosis.

    Did he work with Congress to ensure spouses of post-911 Veterans with ALS were included in the full Family Caregiver Program and received the same stipend spouses of severely disabled injured post-911 Soldiers? NO. Has he gone to Congress and asked them to change the law to include spouses of post-911 Veterans with ALS? NO. Has he requested any funding from Congress to conduct research into actual ALS treatment since being appointed? NO. Has he established an overarching ALS care protocol to standardize care across the VA for Veterans with ALS? NO.

  10. SCOTT JOHNSON says:

    Excert from email conversation with SEC’s special assistant regarding ALS support from MAR 2012. We also discussed the Family Caregiver Program, and the response was the law was the law..

    “There is a group of folks with ALS working to get some drug companies to release their new drugs to ALS patients before final FDA approval. FDA has indicated they would support in the same manner they do it for HIV and cancer drugs. The challenge has been getting the companies to play ball. CEOs have been saying no despite some pretty desperate and compelling pleas. Do you think it would be possible for the Task Force and/or the Secretary to engage on behalf of veterans with ALS? Simple letter or phone call encouraging them to allow expanded access as soon as possible. I have plenty of background data and can provide FDA/company POCs, etc…”

    SCOTT JOHNSON
    COL (R), US ARMY
    EVANS, GA

    “As to the new question about a letter of support, I am not sure how to proceed. I am willing to look at whatever you have and see what folks here think. I expect that asking the Secretary to do this sort of thing is a pretty big ask. I will talk to some of the folks in VHA and see if they have any ideas. ”

    Special Assistant to the Secretary
    Office of the Secretary
    Department of Veteran Affairs

  11. SCOTT JOHNSON says:

    ALS treatment has never has never been a topic/subject in any of the three VA INDUSTRY INNOVATION COMPETETIONS. See this years announcement below:

    On March 29, 2012, Secretary Shinseki announced the opening of VA’s third Industry Innovation Competition with four new topics and up to $50 million in potential awards.
    Each Industry Innovation Competition focuses on several unique topics. The topics for 2012 are:

    Maternity Continuity of Care

    Redesign of the PTSD Treatment Experience

    Mobile Applications for eBenefits

    Innovations in Prevention and Treatment of Pressure Ulcers

    • SCOTT JOHNSON says:

      Brainstorm just attempted to raise $ 7 million in order to take their NUROWN patient provided adult stem cell treatment through a PH II FDA Trial in the USA this fall. PH I/II Trials in Isreal have exceeded expectations in terms of safety and effectiveness, and compassionate use in Isreal has produced amazing remissions. Yet, the VA produces a draft AMYOTROPIC LATERAL SCLEROSIS (ALS) SYSTEM OF CARE PROCEDURES that emphasizes hospice and pallative care in lieu of research to find treatments or a cure.

      • spouse of a veteran says:

        My husband is a very sick 90% service connected disabled vietnam veteran from complications/secondary diseases conected with agent orange and every single day of his life all his medical problems are getting worse. After doing my own research i came across ALS and my husband has almost every single symptom it list. His vascular doctor never once mention he might have ALS, since our last appt. she has referred him to a nuerologist to see what he thinks is going on. I am knew to the understandings of this terrible disease but im not a doctor either, but im sure most all doctors are familiar with this disease. I would think that this vascular doctor could have put his symptoms with this ALS. We are still waiting for the letter to arrive in the mail to see when his appt. will be with the nuerologist and i can only hope and pray that this doctor figures out what is going on. God bless all our veterans and families.

  12. John Ledingham says:

    I think anyone who serves earns the right to be as a “negative” as they want if they see something that is not working right. It’s one of the freedoms you serve to defend. What good is freedom if you don’t ever use it? To keep your mouth shut and look the other way or try to be “positive” is exactly the attitude that a number of guys took in 1967 when I joined the Marines and they were heading to Europe, Canada, etc., or staying in college till they were sure it was all over. The VA does have some problems. I know from personal experience. They see a veteran as a potential expense. I think you could walk in for a physical on all fours and the evaluator would tell you that you’re “looking strong.” Some of the staff give you the impression that it is a private club and you are just passing through. Maybe it’s like that in any large organization. But it shouldn’t be like that at the VA.

    • RC says:

      John, i think the VA has come along way due to Eric Shinseki but i will say that alot of the service i have received from the VA has been very poor. When a VA vascular doctor knows you have several agent orange related medical conditions caused from diabetes, one being severe PAD tells you that they never do stenting proceeders because they dont work,and i respond with i had a private MD who wanted to do stenting , the response was OH they alway make things out worse then what they really are and they are out for the money. Then responds with the only time we do anything would be a bypass proceeder and thats if you cant walk at all. Then when i asked about my occlusion by the colon, the response was we only worry about it if you havent had a bowel movement in ONE month. Then i respond with i have lost 40lbs in the last 7mths and i havent changed my diet , and the response was , pointed to a intern who was very small and weight was about 140lbs, well if i got down to 140 i probably wouldnt be living. Weight loss is weight loss, doesnt matter how much you weigh, if your losing it for no reasons. So, all i can say is hopefully the VA continues to move forward and take care of these veterans.

  13. vietnam vet says:

    Can someone help me with a question i have. I received a Honorable discharge after my doing 2 tours in nam. I wanted to remain there but they would not allow me to due to mental problems. They wrote a letter stating that vietnam messed my mind up and I couldnt go back. I told them thats where i belonged and still they denied me to go back. I have been being treated for PTSD by a private MD, whom has been treating me with meds and counseling. A few years ago I requested copies of my medical records, there was a X mental() personality disorder. My question is how do i get a copy of this letter stating vietnam messed my mind up and the mental health records. Do i have to request those seperately are should they have been in with the rest of my medical records.Any help would be greatly appreciated. Thanks

  14. spouse of a veteran says:

    I commented on ALS yesterday and it never got posted and i have seen things being posted since then. Is there a reason why mine is not posted yet??? I have some concern about my husband who is very ill and i did some research myself after reading these comment about ALS. My husband is a service connected vietnam vet who is suffering terribly and he is diabetic with secondary problems but i dont know alot about this ALS but my husband has just about all the symptoms they listed and yet none of these VA doctors have put the symptoms with this ALS. He is suppose to be getting a notice in the mail about his next appt. with a neurologist, is this the type of doctor who would know alot about this ALS??? Any help would be greatly appreciated

    • SCOTT JOHNSON says:

      The short answer is yes, a neurologist is exactly the right specialist to diagnose ALS. No, many doctors haven’t a clue regarding symptoms which results in late diagnosis. Its unlikely anyone at the VA will respond to either your or my posts. God bless you.

      • spouse of a veteran says:

        Thank you Scott for your response. It does seem from what ive researched that by the time a doctor diagnosis you with ALS, its in the later stages, so i guess we will have to wait and see when we get this appt. with the VA neurologist and see what he has to say. The problem that we see is, alot of these Va doctors dont seem to address alot of medical issues until its in the later stages and has advanced where treatment wont work. I guess if we dont get any results from this doctor , ill try seeking out help in the private sector, while we still have private medical insurance which wont be much longer, so i hope i get to the bottom of it soon. Thanks again and god bless you also.

  15. SCOTT JOHNSON says:

    The disheartening response of the VA’s Scientific Program Manager, Office of Research and Development to our inquiry regarding proactive integration of emerging ALS treatments that could extend or save lives. Essentially, its up to the Veteran not the VA…

    “Short answer, we do NOT have a means to track all regenerative cell therapy progress by industry. The majority of these therapies are still
    in clinical trials and therefore not available at VAMCs. It is up to the individual to pursue such therapies when it is still in the clinical trial phase. That being said, it is up to the industry sponsor to contact us if they want to include the VA as part of their trials. Please note that each therapy must be approved by the FDA prior to use in humans. All clinical trials are listed at the http://www.clinicaltrials.gov public site so anyone can obtain more information regarding a specific therapy.

    Once a therapy becomes accepted as a standard of care (following a decisive phase 3 clinical trial), it would have to be adopted by our health services and patient care services branches.”