VA Seeks to Deny Care to Veterans at Significant Risk of Suicide
By: Swords To Plowshares
Tags: Veterans, Mental Health, Suicide Prevention, Veterans Affairs, PTSD

September is National Suicide Prevention Awareness Month, and with an unconscionable suicide rate of nearly 20 veterans per day, it is hard to conceive of a greater priority for the Department of Veterans Affairs. In its latest report on the subject, the VA found that veterans enrolled in VA mental health treatment are at a much lower risk of dying by suicide than those receiving non-VA treatment. As a result of these findings, the VA vowed to create “universal strategies [which] aim to reach all Veterans.”

Yet, the VA recently proposed regulations which seek to exclude hundreds of thousands of veterans from VA care due to minor infractions in their military record. If finalized, these veterans — many of whom have Post-Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI) — will be denied mental health treatment by the VA and will be at greater risk of suicide.

Congress never intended to leave these veterans out in the cold. When drafting the 1944 G.I. Bill, Congress defined the term “veteran” as those who served on active duty and were discharged “under conditions other than dishonorable.” Only those who meet this definition are entitled to VA benefits. In drafting that definition, the legislative record shows Congress intended to exclude only veterans whose misconduct would have, or did, result in a Dishonorable Discharge — the most severe punitive discharge status which requires a General Court Martial criminal conviction.

However, today, the VA regularly denies VA care to veterans for minor misconduct and the new regulations could make it even harder for these veterans to get the treatment they need. Currently, the VA rejects 90% of eligibility claims from veterans with less than honorable, or “bad paper”, discharges, including three out of four combat veterans with PTSD. At Swords to Plowshares, we have represented hundreds of veterans with bad paper discharges in their VA eligibility cases. While each client’s story is unique, in many ways they are all the same. The veteran enters the service hoping to be part of something greater than themselves, follow in a parent’s footsteps, or begin a military career. Then, at some point on active duty, something terrible happens. They experience combat. They are raped. They witness something horrific. And their brain and their body do exactly what they are designed to do to help them survive.

What does this look like? They develop hypervigilance, mood dysregulation, sleep disturbance. The panic becomes overwhelming, and they flee or they suppress it with alcohol or marijuana. The motivation they once had to excel, and the pride they once had in their military service diminishes. These symptoms of PTSD constitute misconduct that can get someone kicked out of the military. Of the service members who are clinically diagnosed with PTSD or TBI while on active duty, nearly a quarter of them are separated with a discharge status that effectively renders them ineligible for VA care. Marine Corps veterans with PTSD are eleven times more likely to have a bad paper discharge than those without PTSD.

Furthermore, veterans of color are at greater risk of being issued a bad paper discharge. Black Airman and Black Soldiers are 71% and 61% more likely respectively to face Court Martial and non-judicial punishment than their white comrades. This increases their chances of having a discharge status that would preclude them from obtaining VA healthcare.

Five years ago, Swords to Plowshares and the National Veterans Legal Services Program (NVLSP) petitioned the VA to revise it regulations to match Congress’s intent. Two months ago, the VA finally responded, but the proposed regulations still presume bad paper veterans to be ineligible for treatment. Under the proposed rules, a veteran could be denied VA benefits for showing up late to work twice during a four-year enlistment. While Congress intended those with felony-level criminal convictions to be barred, the VA seeks to exclude veterans for misconduct that could still warrant an Honorable discharge. This is an overreach of the VA’s statutory authority and is, frankly, terrible policy given the higher rate of suicide among veterans with bad paper discharges.

Thankfully, the VA’s proposed regulations are not yet final. Swords and NVLSP, along with many other veterans advocates, submitted public comment criticizing the VA’s proposal and asking the VA to create a more just, inclusive system. The VA now has an opportunity to respond to these comments and finalize regulations that could succeed in significantly reducing veteran suicide.

Let’s hope they seize it — veterans’ lives depend on it.

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Maureen “Mo” Siedor directs Swords to Plowshares’ Legal Services Unit which provides assistance and legal representation to homeless and low-income veterans on their veterans’ benefits and military discharge upgrade cases.