Barack Obama

Transcript of Veterans Town Hall Meeting with Secretary Nicholson, Sen. Obama, and Sen. Durbin

Monday, May 23, 2005

Printable Format

TOWN HALL MEETING
HELD AT WRIGHT, JR. COLLEGE
4300 NORTH NARRAGANSETT
CHICAGO, ILLINOIS 60634
MAY 20, 2005
COMMENCING AT 2:45 P.M.

REPORT OF PROCEEDINGS at the Town Hall Meeting before Moderator Phil Ponce; the Honorable Senator Richard Durbin; the Honorable Senator Barack Obama; the Honorable R. James Nicholson, Secretary, Department of Veterans Affairs; Admiral Daniel L. Cooper, VA Undersecretary for VA Benefits; and Richard J. Griffin, VA Inspector General, taken by Lisa M. Grau, License Number 084 003658, Certified Shorthand Reporter, taken this 20th day of May, 2005, at the hour of 2:45 p.m.

MODERATOR PONCE: Ladies and gentlemen, Veterans, honored guests, welcome. My name is Phil Ponce, and I'm the anchor for News Analysis from Chicago Tonight, and I willing be serving as your moderator for today's event.
Senator Richard Durbin and Senator Barack Obama has asked the Secretary of the U.S. Department of Veterans Affairs, the Honorable R. James Nicholson to join them here to hear from you and address your questions.
First of all, can everyone hear me?
AUDIENCE MEMBER: No, not in the back.
MODERATOR PONCE: People can't hear, you can't hear so well in the back. Okay. I'm going to count to 20, and whoever is doing the audio, maybe you could tweak it a little bit so that everybody could hear. One, two, three, four, five, six, seven, eight, nine, ten.
Is that better in the back?
AUDIENCE MEMBER: Yeah.
MODERATOR PONCE: You can hear all right. Good.
Before we begin, I would like everyone, please, to turn off or mute your cell phones to prevent any disruptions.
At this point I would like to invite a veteran to lead us in the Pledge of Allegiance. Would Al Lynch please come up? Al Lynch, retired First Sergeant, U.S. Army.
(Pledge of Allegiance cited.)
MODERATOR PONCE: Thank you. And before we get started, I would like to acknowledge some of the guests who are here tonight. This afternoon joining us is Congresswoman Jan Schakowsky. Congresswoman, stand up and give
(Applause from the audience.)
MODERATOR PONCE: We also have with us Lieutenant Governor Pat Quinn.
(Applause from the audience.)
MODERATOR PONCE: Joining us is Alderman Tom Allen. We are in the alderman's ward. Alderman.
(Applause from the audience.)
MODERATOR PONCE: And also joining us is Alderman Jim Balcer. Please stand.
(Applause from the audience.)
MODERATOR PONCE: And I would like to acknowledge Mark and Marie Schulman of Eli's cheesecake. They provided the cheesecake for everybody here.
(Applause from the audience.)
MODERATOR PONCE: Our format today will include some brief opening remarks from each of our speakers, and we will then move to the questions you have provided on the three by five cards, which have been made available to you. And as there are many of you here today, this, the time that we're going to have, and we're going to have about an hour for the questions, we will get through as many questions as possible during the available time. And I as the moderator will read the questions as you have written them in your own words, and then the appropriate official will respond.
I remind you that if you are here for your own individual specific claims, that there are benefit advisors here to serve you at the tables in the entrance area, the lobby where we walked in. And they will be here not just for the duration of the meeting, but they're going to be here afterwards. Anybody who turns in a three by five card, even if your question even if we're not able to get to your question during the time that we have for it, it will be answered. Just make sure you leave your contact information. So if you submit one of these three by five cards, you will get a response, even if we don't get to it in today's session.
Also, if a question comes up as a result of another question that is asked during the course of this hour, you want to submit it, again, drop it off afterwards, and you will get a response.
I would like to say that here supporting the Town Hall meeting today are members of the local VA leadership, along with senior VA leaders. I would like to introduce Admiral Daniel L. Cooper. He is the VA Undersecretary for Benefits. Admirable Cooper.
(Applause from the audience.)
MODERATOR PONCE: And the Honorable Richard J. Griffin. He is the Inspector General for the VA. Mr. Griffin.
(Applause from the audience.)
MODERATOR PONCE: And it is now my pleasure to introduce Senator Richard Durbin.
(Applause from the audience.)
SENATOR DURBIN: My thanks to Phil Ponce, to Wright College and Secretary Nicholson.
First, let me thank the veterans. Once again, we are gathering together to honor what you have given to America, to make certain that it goes beyond the speeches of Memorial Day and the speeches you will hear at the campaigns to show our commitment to you by what we do, rather than what we say.
Thank you for what you gave to this country, and what you continue to give, and we'll continue to stand by you and make sure that you're treated fairly. Thank you so much for being here today.
Let me say to Secretary Nicholson, thank you. Thank you for keeping your word for coming to Chicago, as you promised Senator Obama and me several months ago to meet with the veterans of the Chicagoland area to talk about the challenges we face.
Secretary Nicholson, it wasn't your leadership that brought us to this point today, but it is your leadership that can lead us from this point forward to make certain that we treat veterans fairly in every region of the country, certainly in the area of Chicago.
Let me also say about those who work for the Veterans Administration. There are many conscientious, hard working, good people working for the VA at the hospitals, at the clinics, at the offices. We salute them. We thank them. If there is room for improvement, we want to work with them to make certain that the VA continues to be an agency that serves our veterans so well.
So now a thanks to their report of the Inspector General, we come together today armed with the facts, armed with information, and the information that has been given to us unfortunately is disappointing.
Too many times Illinois vets were denied disability claims and compensation unfairly not one year, not for five years, but for 20 years Illinois ranked dead last in the United States of America compensating its victims. We can talk about demographics and trends, but it won't explain the fact that we were last in the nation 20 straight years.
There is more to the story. And when you look closely at the IG's report, you can see it. If a veteran came in to pursue a claim and didn't bring a VSO or an attorney with him, he was likely to receive maybe only half of what he was entitled to. We also know that the worst experience dealt with claims where there was some subjective judgment. It wasn't an amputation. It was a question of how much of a loss. In those cases, IG's report tells us there was a wide disparity.
For posttraumatic stress disorder, 100 percent, it turns out in New Mexico, you were five times more likely to receive it than the State of Illinois. When it comes to individual unemployability, it turns out if you were in one of the high states that the IG's report analyzed, you were three times more likely to receive it than in the states of the low states, like Illinois.
The conclusion for decades: Illinois veterans pursuing a claim without an attorney came up with a about half of what they were entitled to, and if the claim involved a subjective decision, they may have received as little at 20 cents on the dollar compared to other states.
Let me see we have to also take a look at the Chicago Regional Office. The report of our veterans on that Regional Office is a call for leadership and a call for change in that office.
(Applause from the audience.)
SENATOR DURBIN: We have to make certain that the veterans coming to that office do not leave disappointed, feeling that they didn't receive a timely, fair, prompt and thorough decision.
I think things are getting better. The report indicates they are. But we can improve even more, and we have to strive to do that.
Secondly, we have to make sure that when it comes to resources, we provide them. When you do a survey across America and have almost 2,000 people working in VA office surveyed, and two thirds of them say there just aren't enough people working here to keep up with the case load to treat the veterans fairly, that is a call to arms not just for the Secretary, but for members of Congress to appropriate the money to put it in the Veterans Administration system.
Let me close by saying this.
(Applause from the audience.)
SENATOR DURBIN: Let me close by saying this. We need to make sure that we don't fight a war on the cheap, and we've got to make certain that we don't serve our veterans on the cheap. We have to say to veterans, soldiers of today and the young men and women we are trying to recruit that we will stand behind you.
When it comes to posttraumatic stress disorder, we have to acknowledge the obvious. There is a wave of challenges coming at us. We haven't dealt with this issue as seriously and completely as we should have.
I thank you for gathering today, for adding your voices in this meeting to tell us what our challenge will be. I thank you for your leadership and making America safer. And now let's work together to make veterans across Illinois fairly compensated and respected for what they gave to our country.
(Applause from the audience.)
MODERATOR PONCE: Thank you, Senator Durbin. And now it is my pleasure to introduce Senator Barack Obama.
(Applause from the audience.)
SENATOR OBAMA: Thank you so much. Thank you, everybody. It is wonderful to see this great turnout. Many of you participated in some Town Hall meetings that we had when I was first elected, and one of my first priorities was obtaining a seat on the Veterans Committee, because as I traveled across the state, the thing I consistently saw was that our best and our brightest, having fought for in wars, having provided that enormous devotion to their country were coming back and feeling neglected, feeling mistreated, feeling ignored.
And the thing that I pledged when I was sworn in as the Senator was that if nothing else in the first couple of years in the Senate, I could make absolutely certain that there would have been a strong advocate in the United States Senate.
(Applause from the audience.)
SENATOR OBAMA: It so happened, it so happened that as I was joining the Veterans Committee, that a story broke in the Sun Times indicating that there was a huge discrepancy between disability payments for Illinois veterans relative to veterans in other states. These were not small discrepancies. We're talking about discrepancies on the magnitude of $5,000. And immediately we requested, Senator Durbin and myself, meeting with Secretary Nicholson, to not only find out why this had occurred, but more importantly how we were going to solve it.
I am grateful for Secretary Nicholson on following through on his pledge to come and report directly to Illinois veterans. And I am grateful to the IG's office for conducting their report in a timely fashion. But the purpose of the meeting today is not only to go over what has happened in the past, it is to make absolutely certain that it never happens again.
(Applause from the audience.)
SENATOR OBAMA: That's going to be our top priority. I just want to I have a visual here, just to underscore what Senator Durbin talked about. This is a chart that was included in the report, Review of State Variances in VA Disability Compensation Payments. This is contained in the report prepared by the IG.
The first year, 1985, go back all the way up to 2000. If you look from 1985 to 2004, Illinois ranks 50th every single year, each and every year. It is not 49 some years, it is not 42nd some years, it is every single year it is number 50.
Now, as Senator Durbin indicated, it appears that there have been some improvements in terms of new claims. If you were lucky enough to file your claim in the last year or the last two years or the last three years, then it appears based on the report prepared by the IG that you have a good likelihood of doing relatively well if you're an Illinois veteran.
But one of the critical issues that I think, Mr. Secretary, we're going to need to talk about today is what happens to all the veterans who filed their claims during this 20 year period.
(Applause from the audience.)
SENATOR OBAMA: How can we make them whole. I know based on some of the statements that were made yesterday that the Veterans Administration has as a matter of policy the ability of every veteran to appeal their claims. But from my perspective, at least, and I think Senator Durbin shares this view, it is not sufficient to say to veterans who may have been shortchanged for 20 years, well, you can go through the same process all over again, wait for the same number of years as you went through before, and potentially get the same results.
It strikes me that there should be some way to expedite and review what happened during this 20 year period in order to make certain that people are treated fairly, and they don't have to wait.
Let me just close by saying this, because we want to leave sufficient time for the Secretary and for your questions. If you look structurally at what is happening in the Office here in Chicago and in Illinois, what is clear is that despite the fine work of many officers who are working within Veterans Affairs, they are understaffed, they are not able to produce timely and accurate reports, they are not able to do the job that needs to be done on behalf of veterans.
Now, the President issued the budget in which he said we don't need more money for the VA. And you know, as Senator Durbin said, this is not something that you caused. You just came in. And so I'm not holding you responsible for what has happened in the past, but my understanding at least was, and you testified before my Committee, I was sitting there, that we have adequate resources to meet the challenges.
I guess my point is that if we've got the majority of your own employees indicating that we are not sufficiently staffed in order to provide timely service to these veterans, then it seems to me that we've got to come up with the resources to make sure that we fix that system.
(Applause from the audience.)
SENATOR OBAMA: If we don't, if we don't, then what I fear will happen is that we will have some nice words at this meeting today, but three years, four years when the cameras aren't here and the newspapers aren't around, we start slipping back into the same situation that we have had for the last two decades, and that's what I want to prevent.
So I hope that there is going to be in your responses some structural issues that are addressed in terms of how we can improve what happens in Chicago, what happens in Illinois, to make certain that our veterans, who have done such great service for all of us, that we are repaying the debt that we owe each and everyone of them.
Thank you very much, everybody.
(Applause from the audience.)
MODERATOR PONCE: Thank you, Senator. Thank you, Senator Obama.
Our next speaker grew up on a tenant farm in Iowa. He is one of seven children. He is a 1961 graduate of the United States Military Academy at West Point. He served eight years on active duty as a paratrooper and Ranger qualified Army Officer. He served 22 years in the Army Reserve, and retired as a Colonel. While serving in Vietnam, he earned the Bronze Star Medal, Combat Infantryman Badge, the Meritorious Service Medal, the Republic of Vietnam Cross of Gallantry and two Air Medals.
Please join me in welcoming the Honorable R. James Nicholson, Secretary to the United States Department of Veterans Affairs.
(Applause from the audience.)
SECRETARY NICHOLSON: Good afternoon, everyone. Thank you for this opportunity of being here. I want to thank particularly Senator Durbin, Senator Obama for inviting me to come and giving me the opportunity to be here with you and to be heard. I want to send my greetings to the Lieutenant Governor of the State, Mr. Quinn, and I also want to thank the many colleagues that I have here from the VA.
I was very happy to get this invitation to come here, and doubly happy that our Inspector General really accelerated his place so that we could have his report, his study completed, and informed so that we could make it public, which we will do here today with copies for you, if you want to take one with you.
Just before coming here today, it was my pleasure to be out at the Hines VA Hospital campus where we dedicated a new spinal cord injury clinic and a new blind rehabilitation center out there, which so far as I know, the first tangible results of our new CARES or asset realignment process in the VA where we're trying to have VA services the closest and most convenient that we can to where the veterans are.
A lot of facilities were built during or just after the war. We've had great demographic shifts since then, and some facilities need to be closed, others need to be expanded, like we've just done, which we were able to do because we consolidated some other facilities.
For nearly 75 years, I say nearly, in July, it will be 75 years, that's our 75th Birthday. The Department of Veterans Affairs has honored this nation's commitment to our veterans. It is a commitment rooted in the values that we Americans place on those of you who have worn our nation's uniform.
I have a special perspective on this, because four months ago, I was an Ambassador in Italy at the Vatican when I was asked to come back to take this job. And the other ambassadors from all over the world said what is it you're going to do; you are going to be a minister, as they say in new government. What will you do. I said if confirmed by the Senate, I will be the Secretary of the Department of Veterans Affairs.
None of them knew what I was talking about. They had a vacuous look on their face. There is no other country in the world that has something like we have in our VA, and it speaks to the value that we have for the veterans.
This Town Hall communicates yet another important message I think. There is a question concerning the process by which the VA has provided, and continues to provide benefits and services to our veterans. And this has come to the light of day here and we are addressing it.
Late last year, when press reports questioned the fairness of our claims process, the Inspector General, who is an independent agency of our Department, was asked by my predecessor to do a system wide review of our claims and benefits process to see what problems there are or might be. After all, our long standing commitment is that every veteran's claim will be treated fairly and equitably no matter where that veteran might live.
As many of you know, the Inspector General released his report yesterday, along with eight recommendations. They are good recommendations I think, and we are taking them seriously, and we are taking them on board, and we're going to take action.
In fact, seated at this table right down here to the right of Senator Durbin is our VA Inspector General, Richard Griffin, who has come here today to answer questions on his report if so appropriate.
Seated right beside him is a gentleman that has already been introduced, that's the Undersecretary for Benefits for the VA, Admiral Dan Cooper. His charge to me is to make sure that those recommendations become reality.
And let me conclude by saying something as clearly and sincerely as I can. We are committed to doing what is right for our veterans. If that entails that we have to set up a special operation here in Illinois to review your claims or to look at new claims that you as an eligible veteran want to make, we will do that. We want each of you to feel that you have been treated fairly and equitably by your VA, because you deserve that.
The past is past, but as I have been charged by both of these Senators, the future is now, and we are going to make a special effort to see if we can have you feel sure that you have been treated fairly and equitably by the VA so that you will have a chance if you so choose to have a review of that, or you can bring the new information to us, and we will make every effort to see that that is reviewed, and reviewed fairly and equitably for you.
Thank you.
(Applause from the audience.)
MODERATOR PONCE: Thank you, Mr. Secretary.
At this point I will be reading questions from the audience, and when I read the question, I am going to read the name of the person who submitted the question, and I would invite you to stand or raise your hand as your question is being answered.
The first question comes from John Donnegan of Chicago, U.S. Army. The question is for Secretary Nicholson. Mr. Donnegan, would you care to indicate where you are?
MR. DONNEGAN: Right here.
MODERATOR PONCE: Thank you. And the question is for Secretary: Why does a veteran need representation in order to get benefits?
SECRETARY NICHOLSON: Can you hear me? Is it working?
Well, the short answer is that you don't. But the veteran service organizations, American Legion, VFW, et cetera, have people that are trained, and they can make available to become advocates for a veteran in filling out a claim, and so it is up to the veteran about whether or not he or she wants to make use of these veteran service representative organizations.
SENATOR OBAMA: Can I just make a comment on that? The Secretary Nicholson is correct that it is not required, but and perhaps the Inspector General wants to comment on this as well. This study shows that those who use VSO advocates tend to receive substantially higher benefits than those who do not.
So my first piece of advice to everybody, every veteran here, work with your VSO, because it makes a difference.
(Applause from the audience.)
SENATOR OBAMA: If I'm not mistaken, Mr. Secretary or Inspector General, the difference is as much as $1,700.
SENATOR DURBIN: 62.
SENATOR OBAMA: Excuse me. $6,200 if you use one of these advocates as opposed to when you didn't. And I think that part of my understanding in terms of some of the variables that create discrepancies between states is that some states have higher utilization of these VSOs than others do. Is that correct?
MR. GRIFFIN: If I may, we have placed 300 copies of the executive summary of our report on a table in the hallway so that you could pick the report up, take a look at it. If you have questions that don't get addressed today that you would like to ask me about, please call us. The entire report, which is 200 pages, is available on our website, which is identified inside the cover.
Just a point of clarification about how these different numbers are over the years. The first numbers that triggered the local interest in the payments that we received in Illinois represented the average payment that was the result of ratings done in Illinois for the past 60 years, and it was an average payment. So if you had a rating done in 1946, and it hasn't changed, your rating is part of that average.
What we did is we looked at more current data, because to go back to '45 and '46, first of all, we didn't have time to do that, and secondly, we wanted to see what has been happening lately.
And in looking at the data for the last six years, for the first half of fiscal year '05, the Chicago office ranks fifth in the country for new and reopened claims, just so you are aware of that.
As far as the 6,225 goes, that number came from our examination of the 60 years worth of data. The $1,700 that the Senator referred to initially refers to the delta for ratings done in 2004. So it has shrunk, perhaps it has shrunk because of legislation that created Duty to Assist by VBA. And the fact is that if you are strapped from a human resources standpoint, if you have VSOs who are familiar with the system, who can work in support of the VBA employees.
SECRETARY NICHOLSON: Say what VBA is.
MR. GRIFFIN: I'm sorry. Veterans Benefits Administration. That's like a fourth multiplier for them, and they also know how it is done, and that results in these higher numbers.
MODERATOR PONCE: The next question comes from Tom Brophy, U.S. Army from Oswego. Mr. Brophy, if you care to stand or indicate.
MR. BROPHY: Here you go.
MODERATOR PONCE: Thank you. This is his question is for the Secretary, and the question is: Considering that half of the reasons for Illinois' low ranking deal with demographics that can't be changed, how do you account for Illinois raising average benefits in the last two years, aside from rater subjectivity? Mr. Secretary.
SECRETARY NICHOLSON: I think that's a real good question, and the technical expertise that we have here resides in Undersecretary for Benefits and the IG who did this research study. So I will ask first for Admiral Cooper to respond, and then if you have anything to add, please do, Mr. Griffin.
ADMIRAL COOPER: I would say the major factors are the changes that we started making three years ago. Four years ago the Secretary of the VA asked that a study be done, and I was asked to chair that study. I came in and got some very knowledgeable people, and realized that across VA, we were doing things in disparate ways; each RO was operating differently. And so as a result, we set up some very specific rules as to how it is organized, how the IT applications are done, how the processes are set up. We then set up better specialized training. We also set up very specific oversight from Headquarters where I have people who will go out and visit the regional offices to make sure they're doing much better.
So I think everybody was raised. I also think that the Regional Office Director that went in about the year 2000 and other people that we have put in there who are very talented have helped to a great degree.
MODERATOR PONCE: The next question was submitted without a name. The question is: It is my understanding that it takes 300 days to certify an appeal. What are you doing to reduce the backlog? Mr. Secretary.
SECRETARY NICHOLSON: I don't know if it is 300, and Admirable Cooper can respond to that more specifically, but the appeals do take time. They're appealed initially to the Board of Veterans Appeals, which is an independent, quasi independent board that reviews the decision of our claim adjudicator, and they will typically ask for more data from the hospitals and from the doctors that made the examination, and they may need to see more things from the veteran's record.
And so there is, there is pervasive time, a drag in there, if you will, where that data has to be gotten where those reviews have to be accomplished.
I will ask Admiral Cooper if he has anything he would like to add.
ADMIRAL COOPER: First I would like to say that yes, it is 300 days to date. Two years ago, it was 400 some days. That is not much relief, but that at least explains that we are trying to make progress.
Secondly, I would say to you this. Veterans Claims Assistance Act that came into effect in late 2001 laid down very specific time requirements, and one of those is whenever we send you a letter and say we need some information, you have at least 60 days to answer that letter. And every time we find a new fact and we need to get new information from you or ask for an explanation, that is another 60 days that is allowed. So let me say the time is too long. We're working very hard on it.
The final point I would make to you is we are today getting about 800,000 claims a year into the VBA. So all those things are factors. They are too long. We're working on it very hard.
MODERATOR PONCE: Senator Durbin.
SENATOR DURBIN: If I could just follow up on that. It was an excellent question, and here is some information that I would like to ask the Secretary or Admiral or someone to respond to.
Currently it takes the Chicago VA office 206 days from receipt of a claim until final decision. That's 39 days more than the national average of 167 days. We've also learned that the office, Chicago office sends almost one out of four claims, 23 percent, to Cleveland, St. Louis, Muskogee, Oklahoma, or Milwaukee to be processed.
We also find out that when it comes to appeals, that in this situation, Chicago had 56 percent of its appeals cases kicked back for more information last year. This year so far, 182 cases out of 376, almost half decided by the Board of Veterans Appeals, have been remanded back to the Chicago VA for more documents. It takes two years to reach the point where it is remanded. It can be doubled that time once it is sent back.
So I think what this tells us is, and what you just said, we need more people. We need more people processing these claims.
(Applause from the audience.)
SENATOR DURBIN: And I I know having worked in Washington for a while and members and delegates, and I think Senator Obama raised the fact, but I have to ask you, Mr. Secretary, how can we make good on our promise to do a timely review of these claims and appeals without more people to get the job done?
SECRETARY NICHOLSON: That's a fair question and fair comment. If, if we need more people in this office, I think we've added some already, we will add them.
But let me just point out, because there is in this appeals process, as Admiral Cooper just said, there are statutory time plugs in there of 60 days every time something new is needed from you, you have 60 days to respond.
So I would say if you come in and we're working with you, give your information back to us just as quickly as you can.
AUDIENCE MEMBER: How is that going to get more people?
SECRETARY NICHOLSON: If we need more people here, we're going to get them. And as I said when I spoke earlier, this is a it looks like, you know, we could make a special effort for you to come in and have a review or come in with a new claim, and we're going to have people there to process it and do it just as timely as we can.
AUDIENCE MEMBER: Are you going to get more people?
SECRETARY NICHOLSON: I would I would say yes, we are, because it is
(Applause from the audience.)
SECRETARY NICHOLSON: We're probably going to need
MODERATOR PONCE: The next question comes from Mr. John Piciolo. He is from Lockport, Illinois, and Mr. Piciolo, would you like to raise your hand or stand, sir?
He has a two part question. Do the proposed funding levels for '06 reflect the anticipated need of vets returning from Iraq, number one?
And number two, will vets currently in the system have benefits reduced to accommodate the new vets? Mr. Secretary.
SECRETARY NICHOLSON: Good question. The answer is yes. The budget that has been submitted by the President to the Congress is a record budget. The VA budgets have gone up 47 percent in the last four years. This record is a record budget if its approved at that level, and it anticipates our needs of our returning heroes from Iraq and Afghanistan.
And as to the second part of your question, sir, by having them being a priority in our treatment will not diminish the care that we give to our existing veterans.
SENATOR OBAMA: Mr. Piciolo, I just want to comment. You know, the Secretary presented the President's budget, and you know, I have utmost respect for the Secretary being here, being willing to talk to the veterans directly, but I do have to say that the initial budget presented by the President, if I'm not mistaken, called for a one half of one percent increase over previous years, not sufficient to cover the anticipated return of the significant number of Iraqi and Afghani troops.
Senator Durbin has done some terrific work documenting the incidents of posttraumatic stress disorder that in previous years often times went undiagnosed. If we're doing our job well, it will be diagnosed this time. All that seems to point to a need for significant additional resources if we're not going to have a situation in which either the timetables get stretched out further for claims, or the amount of time that it takes for veterans to receive services is prolonged.
And so I guess I'm just wondering, just if you can amplify a little bit on the question, are you currently reviewing next year's budget to accommodate for this growth from what we anticipate to be more veterans coming into the system?
SECRETARY NICHOLSON: You're talking about the '06?
SENATOR OBAMA: The '06 budget.
SECRETARY NICHOLSON: Yes, we are looking at that. That's a dynamic process, and it is
AUDIENCE MEMBER: What about the $100 billion to treat illegal immigrants.
SENATOR OBAMA: Hold on a second.
SECRETARY NICHOLSON: We are I also want to point out, Senator, is that in that budget, we do have $100 million requested increases for PTSD, research and frequency.
SENATOR OBAMA: Okay.
MODERATOR PONCE: The next question is from George Fraser. Mr. Fraser, if you care to stand or raise your hand. The question is: Hines doctors are very good, as well as assistants, but delays in treatment and mistakes with paperwork and determinations are the norm.
Secretary Nicholson, would you please respond to this observation?
SECRETARY NICHOLSON: Well, if they're making mistakes or delays, I'm sorry to hear that. I will tell you that I've been in this job now almost four months and have visited many of our hospitals, including Hines today, and I'm extremely proud as an American and as a veteran and as a Secretary of the job of what the people are doing at our hospitals, I have been extremely impressed.
And even more importantly than what I think of them probably is what third party evaluators do. And recently we had an article in the Annals of Internal Medicine that said the VA Integrated Health Delivery System is the best there is. It said that about the VA. And I can brag about that, because I didn't make it that way, but I'm very proud and grateful that it is.
Is it perfect, probably not. But the staff that I have met in these hospitals, most of whom can make more money elsewhere, work there, and the common denominator in their response to me when I say how can we keep you, how do we keep you at the VA, they said I get to take care of veterans. So they really believe in what they're doing.
If there is a chronic case of mistakes or delays, I would like to know more about it individually, because I'm sure we can correct that.
AUDIENCE MEMBER: Why is there no nurse's aides on the second and third shift at Hines? Nurses have to
(Inaudible comment made in the
audience.)
MODERATOR PONCE: The question was, and then we will stick to the cards, the question has to do with why there are no nurses on the second or third floor
AUDIENCE MEMBER: Nurse's aides.
MODERATOR PONCE: The nurses have to take care of everyone.
AUDIENCE MEMBER: On the second and third shifts, nurses that are on shifts now have no one else to help them. They cover all of the things that happen on the ward.
MODERATOR PONCE: So the question is
AUDIENCE MEMBER: They have to take care of all the patients, if there is any kind of accidents, if they soil their beds, if they soil the floor, they have to come and take care of it. When you ring your buzzer and ask why, you have some need for yourself, you are lucky if someone comes within an hour.
Before, it used to be, and even three or four years ago, if you would ring that buzzer and somebody would be there within ten minutes.
MODERATOR PONCE: All right. Let's get a response to that, and then we will stick with the cards. Secretary.
SECRETARY NICHOLSON: I'm not able to respond to this in the detail, but I will, if we get your name and so forth, I will find out and get you an answer.
MODERATOR PONCE: I am reminded that there are specific health officials here in the lobby area who can respond to specific kinds of concerns, so if you have any more questions along those lines, there are people to respond to your questions.
The next question comes from Ben Dock Wagner. Mr. Wagner, if you want to raise your hand.
MR. WAGNER: Right here.
MODERATOR PONCE: The question is according to the error rate for 2003, why are 27 percent of disability claims in Illinois decided incorrectly?
SECRETARY NICHOLSON: Do you have a response to that Admiral?
ADMIRAL COOPER: I will merely say that we are continuing to look at it, we continually look at it. And the report I have as of three days ago that the error rate is about 10 to 11 percent, which is still not good enough.
I don't know the 27 percent of three years ago. I know we have tried to work very hard and beat people down to get these thing right.
AUDIENCE MEMBER: Could I get a mike over here?
MODERATOR PONCE: Real quickly, yes, sir. And sir, I would say if you have a follow up question, get to the question so we can get to other questions too, please. Thank you.
AUDIENCE MEMBER: My follow up question would be another question.
MODERATOR PONCE: Go ahead.
AUDIENCE MEMBER: The VA is telling me, what I know about this, I have been involved with as an Airmen officer, and they are telling us, they say a severed leg is worth more in Montana than it is in Illinois, and it just doesn't make sense.
(Applause from the audience.)
AUDIENCE MEMBER: I will give you one example. I have a friend in Texas, who was at the same battle of the Chosen as I was. My buddy that was in the Battle of the Chosen Reservoir lives in Texas. We have the same 85 percent disability from frostbite where we lost part of our toes and our ears, and he I get $1,400 less a month than he does.
One more point. On my $1,400, I'm supposed to be getting 2,250, and I'm retired, and they take it out of my Navy retirement, and we fought that. President Bush did sign a law to drop concurrent receipt, and the VA turned around, and here is what they did, boys and girls, they phased it over a ten year period. I will be dead and buried before I ever get my money. Thank you very much.
(Applause from the audience.)
MODERATOR PONCE: Mr. Secretary, before we answer that, we are going to be sticking to the cards after that, because I would like to get to those of you who submitted the cards. Unfortunately we are going to have to have to limit the impromptu questions from the audience, as legitimate as they are.
Mr. Secretary.
SECRETARY NICHOLSON: First of all, thank you for your service. I will tell you that the loss of a limb is the same everywhere.
AUDIENCE MEMBER: No, it isn't. Cost more to live in Texas.
SECRETARY NICHOLSON: I'm going to refer to our Inspector General, if he wants to elaborate a bit on that answer, and then I can take up or have one of our people talk to you individually. I have people here that they will be here all day and into the evening for those of you who want to talk with them about your specific case, sir.
AUDIENCE MEMBER: All right. Thanks a lot.
(Inaudible comments made from the
audience.)
MODERATOR PONCE: Excuse me. We really have to take the cards.
MR. GRIFFIN: May I respond to that?
MODERATOR PONCE: Thank you.
MR. GRIFFIN: In the course of our review, we reviewed 270,000 cases involving below the knee amputation, above the knee amputation can I just. These are real examples, just so you have the benefit of the information, and deafness, and we checked by diagnostic code for those things. Because it was suggested during the course of our review that a below the knee amputee in Chicago ought to get the same money as a below the knee amputee in another part of the country.
So we specifically pulled that data, and for the 270,000 cases that we looked it that four categories, we had about a 99 percent consistency rating. The ones that were not consistent, we referred to VBA.
And we're finding out some of them, the reason they were different than the assigned rating is that they had a secondary condition that caused them to get more.
I would think, as the Secretary said, I would take your case to the Regional Office people here and have them review it.
(Inaudible comments made by the
audience.)
SENATOR OBAMA: Sir.
AUDIENCE MEMBER: I have been there many times.
SENATOR OBAMA: Mr. Inspector General, this might be a good time to amplify for the veterans the point that seems to be made in the report, that is, if there is inconsistencies when it is an identifiable physical disability, but it does appear that there are huge discrepancies when it comes to ailments like posttraumatic stress disorder, in which some states are receiving significantly higher than others.
Part of the concern, Senator Durbin and I spoke yesterday and talked to your assistant, was that our understanding, and maybe you can explain this to me, is that the criteria by which you evaluate and rate these disabilities was first designed in the 1940s when my grandfather, a WW II vet was first leaving Patton's Army, and it strikes me that there has been a lot of medical advances since that time. We have a lot more information about the difficulties that many veterans face.
I'm wondering what systematic steps we can start taking to update that system to start achieving more consistency across states.
MR. GRIFFIN: As indicated in our report, using the disability such as PTSD, which involves obviously mental conditions, which are not easily measured, there is a wide discrepancy or variance depending on where you're located. Some of that variance may be due to the fact that the stressor event to which the PTSD benefit is tied is not present, and therefore, it brings into question that rating.
Let me say this. We reviewed 2,100 PTSD files in seven different regional offices. We looked at two in what we call the high cluster in states that had the highest average payment, and we looked at two at the bottom, and we looked at three in the middle. In looking at those cases, my audit staff used the protocol that Veterans Benefits Administration has in their manual for rating PTSD cases.
In the cases we reviewed, in two of those seven regional offices, one office had a 40 percent error rate, and I defined that by saying that when we looked in that case file, there was nothing in the file that would support the stressor event that their claim was tied to. That's a problem.
And Admiral Cooper has agreed that they will take a second look at those. Another office was at 36.7 percent. Illinois was at 21.7 percent of the PTS of the 300 files we looked at here, where we couldn't locate in the file what the stressor event was.
So it is a problem. There is variance. It needs some work. It is 45 year old rating schedule. It doesn't reflect the technology of today, or the employment opportunities of today. Because right after World War II, there are different opportunities today, and although the schedule and the system has been increased over the years, it needs to be given a thorough going over.
If you have never seen that rating schedule, it is about the size of the Chicago yellow pages. The raters have been trying to go through that sometimes with only very general terms to describe the condition, such as mild, moderate, severe, pronounced. It doesn't give them a lot of help to try and determine which of those ratings is most appropriate.
SENATOR DURBIN: I would like to say one word on this. I want to say a word about this posttraumatic stress disorder, and I want to salute Lieutenant Governor Pat Quinn on this. We've been working together. I think this is a huge growing problem that we're going to face in the Veterans Administration.
(Applause from the audience.)
SENATOR DURBIN: I just we have had, Lieutenant Governor Quinn and I had have town meetings where vets coming back from Iraq and Afghanistan. You Vietnam vets know what I'm talking about. If they don't get a helping hand quickly, things can go down fast in their lives.
Mr. Inspector General, when I read the summary, page seven, here is what you write, talking about 100 percent disability related to PTSD, and here is what you write:
For example, New Mexico has the highest payment average of $12,004, and 12.6 of its veterans are in this group. Illinois has the lowest average payment of $6,961, and only 2.8 percent of its compensation recipients are rated 100 percent.
So it is not only the fact that almost five times as many veterans are receiving compensation for this problem in New Mexico, the payment that they're receiving is almost twice as much.
(Applause from the audience.)
SENATOR DURBIN: So if you could could you address that particular issue? This goes beyond subjectivity as I see it, if I read your figures correctly.
MR. GRIFFIN: New Mexico is one of the states that we reviewed PTSD cases in. We had a problem with 35 percent of the 300 cases we reviewed. Again, we used the same protocol in all seven offices. When we finished, we sat down with the three Regional Office directors at all seven locations, and although as you would expect, there was some push back on some of the cases that we challenged. More than half of them they agreed on, and in one office they agreed with 94 percent of our conclusions.
You are right. It is a growing problem. It is a real condition. Please don't misunderstand. I know that. I also know, though, that at the end of fiscal year 1998, VBA was paying $1.7 billion a year for posttraumatic stress compensation. And at the end of fiscal year 2004, they're paying $4.3 billion. So it has gone up 2.6 billion.
And you should know that the cases that my people reviewed, and we just review them and report what we find, we reviewed the cases in Illinois. Illinois was one of the regional offices we came to, and the fact is we had on average 25 percent over the seven locations that were not supported by a stressor event in the file.
So it has grown. No question. There are other denominators that are attached to it. We found that upon achieving 100 percent ratings, 39 percent of the 92 that we looked at for this circumstance ceased coming in for mental health treatment. They continued to come to the VA for other treatment, but 39 percent of them, their mental health treatments went away by 82 percent, and some of them never came back.
So we have to realistically look at this and determine, you know, what's going on, and I think that's what is going to happen.
AUDIENCE MEMBER: Part of those are 18,000 homeless guys.
MODERATOR PONCE: Our next excuse me. Excuse me. We need to move on, because time is limited.
Our next question, Mr. Secretary, comes from David Rogers. Mr. Rogers, would you care to Mr. Rogers.
The question is, Mr. Secretary, what can you do, what will you do to bring emergency relief to homeless and disenfranchised vets?
(Applause from the audience.)
SECRETARY NICHOLSON: That's a very important question, and we are working on that diligently. In fact, I was here in Chicago, now I think maybe it has been four weeks ago, to break ground for a 131 bed shelter facility in conjunction with the Archdiocese of Chicago and Catholic Charities on the old St. Leo parish in South Chicago. That's going to be a beautiful facility, and we, the VA are going to co position a community based outpatient clinic right there with it, and a vocational rehabilitation training facility. So we've made a major commitment to that.
This is a big problem for our country. There are we think over 300,000 homeless veterans in America, and as far as I'm concerned, there shouldn't be any. And we, the President, the President has thrown down a gauntlet when he came into office that in ten years, we want to end chronic homelessness for veterans, and we are making strives towards that.
I chair the Intergovernmental Task Force on Housing with some other cabinet officers. We have a meeting coming up I think the week after next. It is a priority of the government, and we need to do these public/private partnerships with faith based organizations, lever all we can so that we can, number one, find facilities for our homeless veterans, and then two, do the therapeutic programs that it takes to help them break barriers, their addictions, their chronic conditions, and give them hope and self value so we could get them back to being the productive people that they once were.
(Inaudible comment from the
audience.)
AUDIENCE MEMBER: I have not had the biggest snow job (inaudible.) Thank God I met you in Skokie at the Lithuanian American Post. I've got two letters, one for you and one for Senator Durbin and Senator Obama, because I know something will be taken care of. These are for you.
SENATOR DURBIN: One of my staff people, Christina, if she's still around.
MODERATOR PONCE: This is a question from Katie Boisie of Chatham, Illinois. Ms. Boisie, would you care to stand.
The question is to Senator Obama. Senator Obama, what opportunities are there for personnel returning from OIF to support the veterans, especially those injured or needing further assistance?
I'm not sure, could you explain what the OIF is?
AUDIENCE MEMBER: Operation Iraqi Freedom.
MODERATOR PONCE: Thank you.
SENATOR OBAMA: Well, you know, I think this is a wonderful question, and that is how can we utilize our veterans to help veterans, because I know that in some of the Town Hall meetings that we've had, a lot of times there is an emphasis on fact that there aren't enough veterans working in VA, that particularly when it comes to some of the homeless issues that I think Secretary Nicholson sincerely wants to deal with it, it is much more effective if somebody who has been in the field is reaching out and can relate to some of the issues that some of these folks are going through.
So I don't have clear answers right now in terms of what those opportunities are, but I would love to talk to you and other individuals that are interested, and one of the things that we might be able to do is set up some organizational structures or institutions here in the State working with the VSOs, working with the VA, to potentially do some of work. And it sounds like there may already be some systems that are in place, Secretary. Are you aware of
SECRETARY NICHOLSON: Yeah.
SENATOR OBAMA: some mechanisms that we can plug in for persons like this young woman?
SECRETARY NICHOLSON: Yeah. I would like to amplify that, because that is a very important question. In fact, you know, I am the Secretary of Veterans Affairs, and I consider it almost anything it affects a veteran, an affair of the veteran, and employment is certainly one of them.
I have learned that among our age cohort of veterans of 20 to 24 years old, 20.3 percent of them are unemployed. That's five times the national unemployment rate. That's unacceptable. These are people who signed up, did the training, performed their job in the military, got an honorable discharge, and one of five of them are unemployed.
So I'm taking steps. I have had a meeting now with people from the Department of Labor. I have gotten into the National Governors Association to commit to us that we are going have a big conference in Washington next month to develop a program to reach out to employers through the governors, through the major trade associations, and have them make an extra effort to find our veterans and to hire them. One, because they make great employees, and they've gone through all of this stuff I've told you, and two, because they deserve it. And if we can forge this linkage, I think we can make great strives in employing our veterans. Thank you.
SENATOR OBAMA: Ms. Boise, I will have my staff get in touch with you after the meeting so we can make sure we get your contact information.
MODERATOR PONCE: I'm afraid this is going to have to be the last question. You know, I wish we had more time.
This is from Andre Carter of Chicago, and the question: Mr. Secretary, what is going to come out of this meeting?
SECRETARY NICHOLSON: I'm glad you asked that question. Where is he? Because that's I was hoping I would have a chance to summarize what is going to come out of this, because we are making ourselves available starting right now. Where are your people?
AUDIENCE MEMBER: In the lobby.
SECRETARY NICHOLSON: People are in that lobby now. If you want now to go and leave your name, social security number, talk to them, whatever you want to do today, they will stay there until the last person leaves. We are going to make a special mobilization commitment to review those of you that want to be reviewed. If you have new information, new claims that you want to make, we are going to make an extra effort to serve you here in
MODERATOR PONCE: Secretary.
SECRETARY NICHOLSON: In Illinois. Thank you very much.
MODERATOR PONCE: And I understand the Secretary is on a very tight schedule, but Senator Obama, Senator Durbin, we have very brief closing statements.
SENATOR OBAMA: First, the only thing I want to say is I am so grateful to all the veterans for the great questions. They were all on point. Give yourselves a round of applause.
(Applause from the audience.)
SENATOR OBAMA: For those of you who are interested in staying and talking to our staff or the VA staff, just make sure myself and Senator Durbin will be around a little bit longer to talk to you and respond to some of your questions more directly.
SENATOR DURBIN: I just want to say thank you. I also want to thank the Secretary. It wasn't easy for him to take these questions. He did it. You hold us accountable. We will hold him accountable, and we are all accountable to you. Let's make sure the veterans end up the winners.
MODERATOR PONCE: As the meeting is breaking up real quickly, I would like to note some people who have not previously been
(Inaudible remarks made by
Moderator Ponce, due to the
audience leaving.)
STATE OF ILLINOIS )
) SS:
COUNTY OF DuPAGE )

Lisa M. Grau, being first duly sworn,
on oath says that she is a court reporter doing business in the State of Illinois; and that she reported in shorthand the proceedings of said Town Hall Meeting, and that the foregoing is a true and correct transcript of her shorthand notes so taken as aforesaid, and contains the proceedings given at said Meeting.

______________________________
Certified Shorthand Reporter