Veterans are naturally drawn to communities. We’re closer than brothers and sisters in the military, and we’re more than a family in combat. But once we leave a cohesive unit, a community is voluntary. Organizations like Team Rubicon and Team Red, White and Blue have coalesced Veterans into groups in order to strengthen them individually and on the whole.

Yet even with support networks in place, some Vets in crisis unfortunately take their lives. In war, many lives are saved in the golden hour—the small window of time someone can survive serious wounds if they get immediate medical help. But there isn’t anything like that for Veterans who receive mental health wounds from combat.

The tragic suicides of Team Rubicon members Clay Hunt in 2011 and Neil Landsberg earlier this month remind us that we must keep a golden hour with each other, a pact to help look after each other and get help to those who need it fast.

Here are a few things you can do as a member of the Veterans community to recognize both yourself or your buddies in crisis, and what to do about it to receive help immediately.

Know what suicidal behavior looks like

The awful thing about a mental health crisis is there’s not always some grand gesture or clear sign that someone is thinking about harming themselves. Folks often hide their issues for a number of reasons, and signs of struggle are not as apparent. Additionally, there are a number of suicide risk factors, like a family history of suicide, relationship and financial problems, among others. That being said, signs can subtly creep up. If you notice a string of hopelessness, rage, a boost in alcohol or drug use, withdrawing from family, and other factors, do not hesitate to get yourself, your buddy, or your loved one immediate assistance.

The Veterans Crisis Line offers immediate support

The Veterans Crisis Line is staffed 24/7/365 by professional responders to immediately connect Veterans and family members with mental health resources. The number is 1-800-273-8255 (press 1 for Veterans or their families or friends). Folks can also text 838255, or chat online. Save the number into your phone, write it down and stick it on the fridge, post the link on Facebook—do everything you can to get it out there. It should be a reflexive action to whip the number out if you catch even an inkling of a Veteran in crisis. More than 28,000 rescues have been made since 2007, so it works.

Get the help at a Vet Center

Vet Centers are a unique support system for combat Veterans and their families. More than 300 non-descript offices around the country are staffed by mental health and family professionals like psychologists and social workers to deal with challenges associated with combat Veterans, like post traumatic stress disorder.  They also offer services for families of war Vets.  All this is done in an environment that is as welcoming and non-clinical as possible. Vet Centers often have extended and weekend hours to accommodate busy schedules. Also, Vet Centers are often staffed by fellow war Vets—to extend the feeling of community even more. Check out Vet Center services and find one in your community, and make sure to save your local one in Google Maps.

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The burden of war on the mind eases over time for most, but it never fades, and sometimes it can be difficult to shoulder it—even with the help of a community. While it’s a promising sign that we’re continuing to hire more mental health clinicians, we have a long way to go on two fronts: spreading awareness of VA mental health care services, and breaking down the stigma of seeking the care in the first place. So let’s normalize outreach in our community. Make it an SOP in your local or national group to go over suicide signs and mental health resources. Call your buddies and check to see how they’re doing. Just remember one thing: the golden hour may have arrived for someone you know, and there are no second chances to get it back.

The job market for Veterans has shown some promising signs of strength, but that doesn’t mean we’re letting up now. Instead, we’re piling on—focusing on securing the gains in veteran employment this summer with two important events.

The first is the National Veterans Small Business Conference, which is hitting St. Louis August 6-8. The conference will bring the top entrepreneurial talent to instruct Veteran business-owners on best practices and give the low-down on complex operations like federal contract procurement. Veteran business owners bring in $1.6 billion in revenue and employ 1.3 million Americans, so this event is a huge boon to not only Veteran entrepreneurs, but for the country as well.

The second event is a considerable showing of Hiring Our Heroes in the middle of the conference, hosted by the U.S. Chamber of Commerce. The Chamber will be out in full force on Tuesday, August 6, at the America’s Center with dozens of employers looking to hire Veterans in the public and private sectors.

The event is part of a larger effort led by the Chamber to inject momentum into the national Veteran hiring movement. There have been more than 500 job fairs to date across the country, leading to nearly 20,000 jobs for Veterans and military spouses. If you can’t make it to St. Louis this summer, there might be one near you.

As I’ve traveled across America, I meet Veterans who are motivated to get in the arena and revitalize the nation, from students graduating on the GI Bill to entrepreneurs on the cusp of launching the next Fortune 500 Company. They are more than capable of success, and these events will provide them with the tools to get them there so that they can flourish—give back when we need them the most.

Photo courtesy U.S. Chamber of Commerce

Many changes at the VA in the past few years have focused on improving the quality of care for Veterans and better management of limited resources, such as money, facility space, and health care provider time. VACI is currently sponsoring the VA Nutritional Study Design (VANS-D) Project, an undertaking anticipated to serve both goals.

Overweight, obesity, and diabetes are among the most critical health issues confronting Veterans today. Nearly 75 percent of Veterans are overweight and close to 40 percent are obese; 20 percent of Veterans seen as patients in the VA Medical Centers have diabetes. It’s well known that interventions for treating obesity and other cardiovascular risk factors have many features in common with those used to prevent and treat diabetes.

Complications of diabetes can be devastating and expensive. Poorly-managed diabetes results in increased risk of heart attack and stroke and is the leading cause of blindness, end-stage renal disease, and amputations. Better blood sugar control through lifestyle modification translates into fewer medications, physician visits, and hospitalizations, all of which means increased healthcare savings.  More importantly, fewer complications mean an improved quality of life for Veterans with diabetes.

As the VANS-D Project team, we believe that nutritional intervention holds the promise of providing a simple, inexpensive, effective, and evidence-based approach that can not only save resources, but eyes, limbs, and lives.

A variety of dietary approaches have been shown to lead to better health, but reduced-carbohydrate and Mediterranean diets seem to have unique features that are particularly beneficial to individuals affected by obesity or at risk for diabetes.

Over the past decade, clinical trials have demonstrated repeatedly that dietary modification to either a Mediterranean-type diet relatively rich in monounsaturated fats or a carbohydrate-restricted diet that also improves the quality of carbohydrates consumed are both promising approaches for addressing obesity as well as diabetes. Researchers and clinicians within the VA are already exploring the use of these diets to improve health outcomes and treatment options for Veterans. The VANS-D Project builds on the programs currently in place to include longer-term and larger-scale investigations.  Rigorously testing the long-term benefits of these dietary approaches will help to inform preventative medicine approaches within the VA for decades to come.

Gary Taubes, MS – VANS-D Co-Technical Director, “Author of Good Calories, Bad Calories”

Jeff S. Volek PhD, RD – VANS-D Co-Technical Director, Associate Professor, Department of Kinesiology, University of Connecticut

Adele Hite, MPH, RD, MAT – Research Assistant, Principal Author, University of North Carolina at Chapel Hill

Brittanie Volk, MA, RD – Research Assistant, University of Connecticut

Catherine Chenard, MS, RD, LD – Research Assistant, University of Iowa

Laura Kunces, MS, MS, RD – Research Assistant, University of Connecticut

Marin Thompson, MS – Research Assistant

Listen to the chatter in a VA medical center waiting room or scroll our Facebook page, and you’ll get a sense of one of the biggest issues affecting Veterans: the disability claims backlog. The problem did not begin overnight, and as a result, the solutions won’t arrive that quickly either. But VA took another step to square away the backlog once and for all.

In partnership with the American Legion and Disabled American Veterans, VA will ramp up its Fully Developed Claims output in an effort to cut down on the backlog. From Military.com:

“We have been working with VA since last December on its fully developed claims process,” [American Legion National Commander] Koutz said. “Teams of our experts have already gone to VA regional offices in Denver, Pittsburgh, Baltimore and other cities to help identify best practices for FDCs, and to further train our own service officers.”

FDCs—claims with all the necessary evidence that can be processed in half the time of normal claims, with better accuracy—are a key part of the solution. A great deal of time spent on a claim is simply waiting for evidence to be submitted and collected. FDCs strip away that antiquated method in order to reach claims decisions much faster.

The Legion and DAV have keyed on a vital aspect of their relationship with VA. Their members are a sounding board for issues affecting Veterans, and their policy experts can channel their experiences into strong, common sense solutions that VA can implement. The two-way communication also helps us to amplify our initiatives to VSO members—which has always been a challenge. So if you know someone about to file a claim, have them look into FDCs along with a Legion or DAV representative, often found right in a VA medical center.

This partnership is just one of the ways VA is tackling the issue. In recent weeks, mandatory overtime has gone into effect for 10,000 claims raters in the agency through the fiscal year, along with a decision to assign provisional ratings to claims older than a year to get Veterans their benefits more quickly.

Photo courtesy of American Legion.

There are many ways you can get involved and help fellow Veterans through VA’s Voluntary Service Program. VAVS volunteers have the opportunity to work at hospitals, outpatient clinics, readjustment counseling centers, VA regional offices, and cemeteries.

Some volunteers also provide in-home companionship to homebound Veterans. For example, the Southern Arizona VA Health Care System recruits volunteers to provide a much needed break for primary caregivers. Check out how Caregiver Support Volunteers Karissa Trimpe, Barbara Carling and Richard Hambacher make a difference in the lives of the Veterans and caregivers they help.

Students can also volunteer through the Student Volunteer Program and gain valuable experience and training. Student volunteers can explore their health care career options and gain experience in a health care environment while learning new skills and making new friends. There are also scholarship opportunities for student volunteers through VAVS and veterans service organizations, such as the James H. Parke Memorial Youth Scholarship Award.

Becoming a VAVS volunteer is simple. Click here to fill out a volunteer form and a local VAVS representative will contact you to provide further information and set up an appointment for an interview. Or you can contact your local VA facility and let them know your interest in the volunteer program. Learn more about the program here, and join the VAVS family to make a difference in the lives of our Veterans.

The VA home loan guaranty program is one of VA’s most utilized benefits. VA guaranteed more than 530,000 home loans last year, helping those Veterans and Service members across the country – from Guam in the Pacific to Puerto Rico in the Atlantic – find a place to call home. In 2012, VA guaranteed its 20 millionth home loan and 2013 is on track to be the biggest year in the history of the program dating back to 1944.

Here are a few things to keep in mind when using your VA Home Loan benefit:

Work with your Realtor

Most American families purchase only a few homes in their lifetimes. Your Realtor is an expert on finding and purchasing a home in your local area. VA has worked closely with realtors since the home loan program started in 1944. Use them as a resource to help you navigate the entire process, including accessing your VA home loan benefit.

What does the VA home loan guaranty benefit include?

Most VA Home Loans are handled entirely by private lenders. VA establishes minimum guidelines in order for Lenders to offer the program. VA guarantees a portion of the loan, which allows lenders to provide VA Home Loans to as many Veterans as possible with some of the most attractive terms in the industry. These terms include:

• A little or no down payment as long as the sales price doesn’t exceed the appraised value. In 2012, 89 percent of all VA loans had no down payment.
• No private mortgage insurance premium requirement. This saved Veterans who obtained VA loans last year $19 Billion over the life of their loan.
• VA rules limit the amount and type of charges that a Veteran will pay for closing costs. In addition, there are no prepayment penalties.
• VA maintains minimum property requirements that protect Veterans to help ensure the dwelling is safe, sound, and sanitary. An example of this requirement would be “no exposed wiring” in the home.

Where do I start?

1) Determine your eligibility in the program by getting your Certificate of Eligibility (COE), VA’s validation to the mortgage lender that you are eligible to receive the VA Home Loan benefit. You can yet yours one of three ways:

• eBenefits.va.gov – Veterans registered on eBenefits may log on and request their COE online, 24/7.
• Mortgage Lender – with this option, a lender requests a borrower’s COE from the VA directly using our Automated Certificate of Eligibility system.
• Eligibility Center – Veterans may mail applications for a COE to the Atlanta Eligibility Center or call toll-free at 1-888-768-2132.

2) Check out our Home Loans website to learn more.
3) Connect with a local realtor to help you navigate the home buying process from start to finish
4) Speak with several lenders to find one that offers a loan product that best meets your needs

We are here to help

You are not alone. A third of VA’s Home Loan program staff assist Veterans who have a VA-guaranteed loan and are experiencing financial hardship. These employees are based in offices across the country and serve as liaisons between Veteran borrowers and their mortgage servicers. If you need help – call 1-877-827-3702 and we will assign an individual loan technician to help you understand your current situation and work with your loan provider to explore potential options that may allow you to keep your home.

Adapting a home for your use

For certain severely disabled Veterans, VA offers grant funds to ensure independent living through modification, purchase, or home construction. Specially Adapted Housing grants can be used for renovations including: ramps, walkways, bathrooms, kitchens, handrails, grab bars and sliding doors.

For more information on VA’s home loan benefit, watch the recent Google+ Hangout with Mike Frueh, director of VA’s home loan program.

Samantha O’Neil is a communications specialist with the Veterans Benefits Administration.

VRAP is a joint program between VA and Department of Labor. However, the successful outreach of VRAP was a much larger community endeavor. Many individuals who represent our stakeholders, community partners, and Veterans Service Organizations helped us reach out to this deserving population. We thank them for helping us and supporting our outreach efforts. We could not have achieved this without them.

Our challenge now is ensuring that Veterans who have received notification of approval, a COE, start their training as soon as feasible. According to the law that established VRAP, the program expires March 31, 2014, so it’s important that training is initiated and completed by that date.

Please help us get that word out. We do not want any of the 99,000 slots to go unused. The program is only two years long. Unless the program is extended by Congress, we can only accept applications until September 30, 2013, and the last payment can be made through March 31, 2014. The urgency should be conveyed: Apply, use the benefit as soon as feasible, or notify us to cancel the Certificate of Eligibility so that another Vet can potentially use the benefit.

Curtis Coy is VA’s Deputy Undersecretary for Economic Opportunity and a U.S. Navy and U.S. Air Force Veteran.

If you thought Veterans were only accustomed to taking orders and not giving them, you might find this surprising: nearly 14 percent of the 26 million small businesses in the United States are operated by Veterans. And later this fall, VA will inject this community with tools and resources to help them succeed.

Today, VA announced the National Veterans Small Business Conference is setting up shop at the St. Louis America’s Center in St. Louis, Missouri August 6-8. For three days, Veterans either looking to start or expand their small business will attend more than 200 breakout sessions, with a focus on how to successfully compete for federal contracts. Key federal government and private sector officials will be on hand to discuss and troubleshoot contracting issues and other business issues Veterans may have experienced.

The process to get Veteran-owned businesses certified can be complex, so information sessions on how to get set up and running will be provided, along with outreach strategies to the larger Veteran community.

This conference will mark the third for Veteran business owners. When I went last year, several Veterans told me networking with other businesses was just as crucial as attending classes. Deals were made and business relationships flourished. It cannot be understated how vital Veteran-owned businesses are to the economy; they employ 1.8 million Americans and generate more than $1.6 trillion dollars in annual revenue. With this conference, hopefully we can see the needle on both numbers move a bit.

If you’re interested in attending this year, sign up for updates on the conference page, follow along on Facebook and Twitter, and watch for more information in the coming weeks.

What does it all mean?

Why is exercise important?
If your doctor told you that doing one thing for approximately 30 minutes per day, 5 days per week would significantly reduce your risk of:

Early death, coronary heart disease, stroke, high blood pressure, type 2 diabetes, breast and colon cancer, falls, depression.

Would you consider incorporating it into your life? It would cause no harm, only benefits, including health and financial gains. Would you do it? By now it is no surprise that this 30-minute per day “thing” is Physical Activity!

Watch this video, it is worth every minute:

How much?

Some physical activity is better than none.  For major health benefits the CDC , the American College of Sports Medicine, the U.S. Dept of Health & Human Services, and the American Heart Association recommend that adults:

• Engage in at least 150 minutes per week (i.e. 30 minutes, 5 days per week) of moderate-intensity aerobic activity.  Moderate-intensity is a level that elevates the heart rate, one becomes breathy (able to talk, but not necessarily sing a favorite song), and sweaty.

• Participate in strength training at least 2 days per week.  Strength training uses weights, or one’s own body weight, to exercise the major muscles of the body (legs, hips, back, chest, abdomen, shoulders, and arms).

New to exercise?  That is okay!  Gradual progression of exercise frequency, total time, and intensity is recommended to reduce risk of injury.  Start small, perhaps 5 minutes per day, and work up towards a new goal each week.

What?

A gym membership is not required for physical activity.  Vigorous walking is considered moderate intensity, as is heavy gardening (shoveling, raking), bike riding, water aerobics, or pushing a lawn mower.  Chair exercises can also be done energetically enough to get one’s heart pumping. 

Strength training includes lifting weights, working with resistance bands, using one’s own body weight (sit ups, push ups, squats, lunges), and yoga.

Older adults should also incorporate balance activities into their routine to reduce risk of falls.  Examples of balance activities include: standing on one leg (with something nearby to grab for steadiness), walking backward or sideways, or standing from a sitting position repeatedly.

When?

Anytime!  30 minutes per day can be a big commitment, but this can be broken down into smaller 10 minute segments, 3 times per day.  Simply becoming more active, even if less than 10 minutes at a time, can yield benefits.  Use simple tactics such as parking at the back of the parking lot, skipping the elevator and taking the stairs, and speaking in person to a colleague instead of email or phone call.

Remember!

Anyone and everyone can be more physically active, and can improve their health.  If you are an adult with a disability, regular physical activity can provide you with the same important health benefits.  The National Center on Physical Activity and Disability  can provide additional information and guidance.  

The VA offers the MOVE! Weight Management Program  to all Veterans who want to improve their health through weight loss; speak with your PCP for more information, or to join the program.  Visit with a Registered Dietitian to discuss nutrition and exercise help and goal setting.  Speak with your healthcare provider before beginning any new physical activity routine for guidance and clearance. 

Jessie Furman is currently a dietetic intern at the Memphis VA Medical Center.

But it’s important for the American public to know that those Servicemembers who are separating from the military for wounds, injuries or illnesses have their own VA benefits process, and on average receive their disability compensation within three months of leaving the military.

This process, called the Integrated Disability Evaluation System (IDES), started in 2007 when the Department of Defense (DOD) and VA collaborated to design a more seamless transition specifically for Servicemembers who could no longer continue with their military careers for medical reasons—which includes PTSD.

To support IDES, VA has dedicated staff to work exclusively on disability claims for this population. Because of this DOD/VA cooperation, VA can begin working the necessary documentation for disability compensation before a wounded, ill or injured Servicemember leaves the military—and provide benefits much faster. It’s also important to know that for severely wounded Servicemembers, the system provides case managers to work one-on-one to ensure all the transition needs are met—especially those of the family.

So if combat wounded, ill and injured Servicemembers are being taken care of within IDES, who is in the current claims inventory and backlog that we hear so much about? Basically, the inventory is made of up people who separated or retired from the military when their time was up. And now that they are in a Veteran status, they are claiming disability compensation for medical conditions incurred or aggravated while serving. This ranges from young troops getting out now to guys who served in World War II. There’s no time limit for filing, and there’s no limit on the number of claims you can file.

In fact, about 60% of the 845,000 pending disability claims are from Veterans for whom VA has already completed at least one claim. About 78% of those Veterans are already receiving monetary compensation at some level—and about half of those are rated with at least a 50% disability, receiving $1000 or more monthly. The other 40% of the total inventory are from Veterans filing for the first time. This 60/40 percent split is roughly the same proportion for claims that have been pending more than 125 days—i.e. the backlog. Also, many people—including reporters covering the story—attribute the growing number of claims to the wind-down of current conflicts.

In reality, only one in five claims in the inventory come from Iraq and Afghanistan Veterans. The largest portion is actually from Vietnam-era Veterans. That makes sense when you think about the fact that this cohort is now reaching the age where health conditions are worsening. Also, VA’s decision to presume service connection for a variety of medical conditions related to exposure to the herbicide Agent Orange, which was used in Vietnam, accounts for many of the claims in the current inventory. What is true about Veterans of Iraq and Afghanistan is that they are filing more complex claims than their predecessors—meaning each claim has many more medical conditions that VA needs to adjudicate. That’s understandable too, since this relatively small, all-volunteer force has undergone multiple deployments, with more wear and tear on their bodies.

The reality is that, for a variety of reasons, VA is receiving a lot more claims work now than it did in the past. And given the legal requirements VA has to substantiate the claims, the work is outpacing the capacity to process in a timely manner. That’s why it made the investment in new technology, processes and training that will result in a system that can accommodate a higher demand. A change of this magnitude takes time, but it is being built to last—and once it is fully up and running, it will change the way Veterans receive benefits for generations to come.

Patrick Mackin is the director of the Office of Corporate Communications at the Veterans Benefits Administration. He is also a retired U.S. Army colonel.