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RAO Bulletin
1 November 2008

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THIS BULLETIN CONTAINS THE FOLLOWING ARTICLES
== Military History Anniversaries ---------------------- (November)
== Daylight Saving Time [01] ---------------------- (Why & When)
== Votes Count ------------------------------- (Make Sure You Vote)
== LTC Catch 22 ----------------------------- (Middle Class Plight)
== Mobilized Reserve 28 OCT 08 ----------------- (882 Decrease)
== VA Nursing [01] ------------------------------- (In Short Supply)
== VA Blue Water Claims [04] --------------- (Writ of Certiorari)
== SSA Disability Claims [01] -------- (760,000 Pending Review)
== Uniform Wearing ---------------------------------- (Federal Law)
== Prostate Cancer [07] ------------------- (Vitamin E & Selenium)
== SSA Compassionate Allowances ---------- (Diseases Covered)
== Veteran Travel Opportunities ----- (Barking Sands, Kauai HI)
== Medicare Part D [29] ----------- (Hospital Medical Errors)
== Medicare Part D [30] ---------------- (Advantage Commissions)
== VA Means Test -------------------------------- (How Conducted)
== Flu Shots [02] ----------------------- (Best Protection Available)
== RC Disability Claims --------------- (Disproportional Denials)
== VA Retro Pay Project [15] ------------- ($12 Million in Errors)
== Pneumonia ---------------------------------------------- (Overview)
== Pneumonia [01] ------------------------------------ (Smoker Risk)
== Patient Privacy Rules --------------------- (HIPPA Regulations)
== TFL Appointments -------------------------------- (How to make)
== VA Home Loan [14] ----------- (Enhanced Options Available)
== Diabetes [01] ------------------------- (Drug Spending Doubles)
== VA Mobil Counseling Centers ----------- (50 Motor Coaches)
== Multiple Sclerosis [01] --------------- (Leukemia Drug Impact)
== ID Card Expiration Date -------------------------------- (Ignore)
== Saluting the Flag [03] ------------------------ (National Anthem)
== VA Fraud [13] --------------------------- (Arlington County VA)
== PA Vet Cemetery [03] ------------ (Accepting Interment Apps)
== Back Pay Interest --------------------------------- (Now Allowed)
== Veterans Day --------------------------------------------- (History)
== CRDP [43] ------------------------------------ (Back Pay for IU's)
== Golden Corral Military Buffet ------ (Complementary Dinner)
== McCormick & Schmick's Vet Tribute --------------------- ( " )
== Nebraska Vet Cemetery [01] ----------------- (Ground Broken)
== Gulf War Syndrome [04] --------------------- (Rumor's Impact)
== VA Credibility ------------------- (Key lawmaker Losing Faith)
== Tricare/Medicare Combined Benefit --------------- (Under 65)
== Overseas Holiday Mail 2008 ----------------------- (Deadlines)
== VA Claim Shredding -------------------- (Under Investigation)
== Filipino Vet Inequities [11] ------------ (Sen. Burr Comments)
== Kentucky State Park Discount ------------ (Veterans Eligible)
== COLA 2009 [05] -------------------------------- (Final Figures)
== SSA COLA 2009 [01] ----------------------------- (5.8 Percent)
== VA Presumptive Gulf War Vet Diseases [01] - (Current list )
== Veteran Legislation Status 29 OCT 08 ---- (Where we Stand)


MILITARY HISTORY ANNIVERSARIES:   Significant November Events in
 Military History are:
1775 - Continental Congress establishes two battalions of Marines.
 Samuel Nicholas was appointed "Captain of Marines" on 28 November 1775, and
 promoted to major on June 25, 1776. Because of his senior status among
 other Marine officers of the Revolution, he is numbered as the first
 Commandant.
1775 - Americans under General Richard Montgomery capture the British
 fort of Saint Johns. (War of Independence)
1861 - The Confederate raider Nashville captured and burned the Union
 clipper ship Harvey Birch in the Atlantic Ocean. (Civil War)
1864 - Union General W.T. Sherman began his march to the sea from
 Atlanta, GA, in an effort to cut the Confederacy in two. (Civil War
1865 - Dr. Mary E. Walker, the first female surgeon in the Union Army,
 is presented with the Medal of Honor, the first woman to receive that
 award.
1910 - First airplane flight from the deck of a ship.
1917 - American troops were first engaged in fighting attacking German
 troops near the Rhine-Marne Canal in France. (World War I)
1918 - World War I ends at the eleventh hour of the eleventh day of the
 eleventh month with the signing of an Armistice. (World War I)
1942 - Operation Torch begins with Allied landings in northwest Africa
 (World War II).
1943 - U.S. Marines landed on Tarawa in the Gilbert Islands, one of the
 bloodiest campaigns waged by American forces against the Japanese in
 the Pacific (World War II).
1965 - Battle of Chu Pon-ia Drang River, Vietnam. U.S. 1st Calvary
 fought North Vietnamese regulars for four days (Vietnam War).
1967 - American troops broke a North Vietnamese assault at Loc Ninh,
 near the Cambodian border (Vietnam War).
1968 - Battle of Nui Chom Mountain. The 4th Bn, 31st Infantry, 196th
 Inf Bde fought and destroyed the 21st NVA Regiment on Nui Chom Mountain
 southwest of Da Nang, Vietnam in a fierce six day battle. Cpl Michael
 Crescenz received the Medal of Honor as they fought inch by inch up the
 steep mountain. (Vietnam War)
1979 - Iranian militants seized the US Embassy in Tehran, held 65
 Americans hostage.
1999 - VetJobs goes live on the Internet.
[Source:  VetJobs Veteran Eagle Nov 08 ++]


DAYLIGHT SAVING TIME UPDATE 01:    The prominent English builder and
 outdoorsman William Willett conceived Daylight Savings Time in 1905
 during a pre-breakfast ride, when he observed with dismay how many Londoners
 slept through a large part of a summer day. An avid golfer, he also
 disliked cutting short his round at dusk. His solution was to advance the
 clock during the summer months, a proposal he published two years
 later. He lobbied unsuccessfully for the proposal until his death in 1915.
 Germany, its World War I allies, and their occupied zones were the
 first European nations to use Willett's invention, starting 30 APR 16.
 Britain, most of its allies, and many European neutrals soon followed suit.
 Russia and a few other countries waited until the next year.  In 1918,
 the United States came to the same realization and enacted a law to
 both preserve daylight and provide standard time for the nation.. It was
 an unpopular law, and in 1919 was repealed over President Wilson's
 veto. However, some localities liked the DST concept and continued it.
 During WWII, the nation, for the years of 1942 - 1945 went under DST year
 around, which was called "War Time". Since then, the world has seen many
 enactments, adjustments, and repeals. In 1966, 1972, and 1986,
 Congress passed various laws concerning the issues of time and daylight
 savings.

     Most of the United States begins Daylight Saving Time at 2:00 a.m.
 on the second Sunday in March and reverts to standard time on the
 first Sunday in November. In the U.S., each time zone switches at a
 different time. This began in 2007.  The 2007 U.S. change was part of the
 Energy Policy Act of 2005; previously, from 1987 through 2006, the start
 and end dates were the first Sunday in April and the last Sunday in
 October, and Congress retains the right to go back to the previous dates
 once an energy-consumption study is done. In the U.S., 2:00 a.m. was
 originally chosen as the changeover time because it was practical and
 minimized disruption. Most people were at home and this was the time when the
 fewest trains were running. It is late enough to minimally affect bars
 and restaurants, and it prevents the day from switching to yesterday,
 which would be confusing. It is early enough that the entire
 continental U.S. switches by daybreak, and the changeover occurs before most
 early shift workers and early churchgoers are affected. For the U.S. and
 its territories, Daylight Saving Time is NOT observed in Hawaii, American
 Samoa, Guam, Puerto Rico, the Virgin Islands, the Commonwealth of
 Northern Mariana Islands, and Arizona. The Navajo Nation participates in
 the Daylight Saving Time policy, even in Arizona, due to its large size
 and location in three states. To keep track just remember Spring (i.e.
 MAR) forward & Fall (i.e NOV) back. [Source: [Source: EANGUS Minuteman
 Update 30 Oct 08 ++]


VOTES COUNT:    Almost 125 million people voted in the 2004
 presidential election. In case your wondering if your vote really counts here's a
 smattering of close elections:
 
o In 1972, Dorothy Wilson was re-elected as a Nevada justice of peace
 by the flip of a coin.
o Campaigning for a seat on the Massachusetts Governor's Council on the
 day of the primary election in 1988, Herbert Connolly lost track of
 time - and got to his polling place too late to vote. The polls had
 closed just minutes before. When the ballots were counted later that night,
 he'd lost by one vote.
o In 2000, the Presidential election was decided by 537 votes, between
 George Bush and Al Gore.
o In 2002, in a Congressional race in the 7th District of Colorado,
 only 121 votes separated the top two candidates, Bob Beauprez and Mike
 Feeney.
o In 2004, the Washington state governor's race came down to 133
 important voters who favored Christine Gregoire over Dino Rossi.
o In 2006, Connecticut's 2nd Congressional District was decided by only
 83 votes, giving Joe Courtney the seat over Rob Simmons.
[Source: EANGUS Minuteman Update 30 Oct 08 ++]


LTC CATCH 22:   The phenomenon of middle-class, middle-aged Americans
 stretched to their emotional and financial limits caring for sick
 spouses or parents is one that's already widespread and likely to get worse,
 experts say. Once private insurance benefits end, the only option for
 most Americans is Medicaid, which requires that recipients have less
 than $5,000 in assets. This means that couples are elders must exhaust
 most of their remaining assets to qualify.  In the case of couples one
 option is divorce.  Some statistics that support a worsening situation
 are:

o U.S. Census figures project that the number of Americans 65 or over
 will double by 2030, and that two-thirds of today's 65-year-olds will
 require some period of long-term care later in their lives.
o According to one recent study, the number of geriatricians has
 actually declined in recent years, to about 7,750: that translates to one
 for every 4,254 older Americans.
o It's projected that the country will face a shortage of more than
 800,000 nurses by 2020.
o According to U.S. government surveys, in 2004, there were 2.5 million
 Americans living in either nursing homes or assisted living
 facilities. The average cost of a private room in a nursing home, according to a
 recent MetLife study: $75,000 per year.
o The AARP notes that two-thirds of older Americans who needed
 long-term care now rely completely on unpaid help -- in most cases, family.

Carol Raphael, president of the Visiting Nurse Service of New York, who
 joined other experts at a recent media briefing in New York City on
 eldercare said, "The trouble is, caregivers just feel utterly unprepared
 for their role.  Many of the family caregivers VNS staffers encounter
 feel left out of crucial decisions concerning their loved one's care.
 They are often on the border -- they aren't even included in thinking
 about how care will be provided." Another big challenge -- caregivers are
 often confronted with an array of doctors, procedures, paperwork and
 facilities, with no one to help pull it all together. In the current
 system, there's no one accountable.  Raphael said, "That's why it can cost
 you $125 an hour [for a geriatric care manager], because you're trying
 to fill that hole." Too often, chronically ill patients and their
 families simply lurch from one crisis to the next, with no continuity of
 care to make sure that once patients leave the hospital; they aren't
 getting readmitted a few weeks later. AARP president Jennie Chin Hansen, who
 has 40 years of experience as a nurse said, "Care has to be
 coordinated and supported. We have to be preventing things from happening because
 there are things that we know cause you to go to the hospital again:
 taking the wrong medications while you're back home, for example." Chin
 and other experts focused especially on the crucial 30 days after a
 hospital discharge. Close monitoring and follow-up during that month can
 greatly reduce unnecessary suffering and cost, they said.

     Across America, much of the in-home care that is provided is
 carried out by home health care aides, who are often woefully under-trained,
 the experts said. "They are the glue that is holding the home health
 care system together," said Raphael. But, she added, she is shocked that
 in most states we have very minimum training requirements for these
 para-professional workers who are handling very complex cases." In New
 York State, for example, home health care workers are required to undergo
 120 hours of training before getting certification. That might sound
 OK, until you realize that finger-nail technicians in California need to
 have 350 hours of training to be certified to work in a salon.. "The
 pay scale [for home health aides] is also relatively low, and they don't
 have health care benefits, on top of that," Chin added. Wage issues
 are keeping the number of geriatricians at an all-time low, as well.
 Geriatricians are crucial, the experts said, because they look not at a
 particular disease or body site, but at the older person as a whole.
 However, a recent U.S. Institute of Medicine report found that geriatricians
 remain the lowest paid medical specialty of all. Boosting the number
 of geriatricians, nurses and well-trained home health care aides will be
 a top priority in easing the eldercare "squeeze," the experts agreed.

     The same can be said for recent moves by government and medical
 institutions to cut down on red tape and better coordinate care,
 especially between the hospital and home. In the meantime, aging Americans
 should plan wisely, especially since resources vary widely state by state.
 One good resource: The National Association of Area Agencies on Aging
 (www.n4a.org), found in every state, can give details on what's
 available to you locally. It also pays to think about how you will pay for
 long-term care, since Medicaid only kicks in after personal finances are
 exhausted -- something Raphael labeled a policy of pauperization. In the
 end, it will be middle-income Americans who feel the squeeze most,
 according to journalist Gail Sheehy, who is currently writing a book about
 her care-giving spouse experience. "For people who are very wealthy, if
 the family cares about the loved one, they'll be able to provide this
 care. And the poor finally get a break, because they can get on
 Medicaid," she said. "But it's the vast lower-middle to upper-middle class
 that is really getting the shaft."  [Source: Helath Day E.J. Mundell
 article 29 Oct 08 ++]


MOBILIZED RESERVE 28 OCT 08:   The Army, Air Force and Marine Corps
 announced the current number of reservists on active duty as of 28 OCT 08
 in support of the partial mobilization. The net collective result is
 882 fewer reservists mobilized than last reported in the Bulletin for 15
 OCT 08. At any given time, services may mobilize some units and
 individuals while demobilizing others, making it possible for these figures to
 either increase or decrease. The total number currently on active duty
 in support of the partial mobilization of the Army National Guard and
 Army Reserve is 95,327; Navy Reserve, 6,177; Air National Guard and Air
 Force Reserve, 10,606; Marine Corps Reserve, 7,197; and the Coast
 Guard Reserve, 758. This brings the total National Guard and Reserve
 personnel who have been mobilized to 120,065including both units and
 individual augmentees. A cumulative roster of all National Guard and Reserve
 personnel, who are currently mobilized, can be found at
 http://www.defenselink.mil/News/Oct2008/d20081028ngr.pdf . [Source: DoD
 News Release 857-08 28 Oct 08 ++]


VA NURSING UPDATE 01:    Nurses are the largest group of health care
 providers employed by the Veterans Affairs Department, but its medical
 centers face significant hurdles in recruiting and retaining them,
 according to a new report. The Government Accountability Office (GAO)
 recommended that VA implement a new staffing system and assess the barriers to
 alternative work schedules to improve the situation. According to VA
 nursing officials, retention problems stem from nurses spending too much
 time performing non-nursing duties such as housekeeping and clerical
 tasks, GAO said. Also, while the department's medical centers were
 authorized in 2004 to offer RNs alternative work schedules, such as three
 12-hour shifts within a week to be considered full-time for pay and
 benefits purposes, few nurse executives reported offering such schedules.
 Nursing officials and RNs noted that retention problems also result from
 relying on supplemental staffing strategies, such as overtime, and
 insufficient professional development opportunities.

     Maintaining the nurse workforce at VA is critical to the care of
 the veteran population since studies have shown that a shortage of
 nurses, especially when combined with a greater workload, can adversely
 affect patients and the care they receive. For example, hospitals with
 fewer nurses have demonstrated higher rates of problems such as urinary
 tract infections and pneumonia, the report said. "Conversely, an increase
 in RN staffing has been associated with a reduction in adverse patient
 care events and with better quality outcomes such as fewer infections,"
 GAO noted. Additionally, the agency found that VA did not have an
 adequate staffing plan for nurses, largely because a patient classification
 system the medical centers used to determine staffing included
 outdated and inaccurate data. As a result, nurse managers do not rely on that
 data to help set nurse staffing levels, but on information from a
 variety of sources, including historical data or workforce data from other
 hospitals. While VA said it intends to develop a new nurse staffing
 system, GAO noted that the department has not developed a detailed action
 plan that includes a timetable for building, testing and implementing
 such a system.

     Meanwhile, VA nurse executives also identified limitations on the
 department's ability to hire new nurses. For example, VA-imposed hiring
 freezes and delays discourage potential candidates from seeking
 employment or following through on applications at its medical centers.
 Although VA has taken steps to address some of the factors that contribute
 to hiring delays, GAO found, "it is too early to determine the extent to
 which these steps have been effective in reducing hiring delays." GAO
 recommended that VA develop a specific plan that includes a timetable
 for developing a process that provides nurse staffing estimates that
 accurately account for the severity of patients' illnesses, the current
 nursing tasks performed in inpatient units and the level of nursing
 support available. GAO also recommended that the department assess the
 obstacles to alternative and flexible work schedules for nurses and explore
 ways to overcome those barriers. VA agreed with GAO's findings and
 recommendations, noting that it plans to develop a new nurse staffing
 system. The Office of Nursing Service also plans to create a special task
 force to identify options for expanding alternative and flexible work
 schedules. [Source: GovExec.com newsletter Brittany R. Ballenstedt article
 28 Oct 08 ++]


VA BLUE WATER CLAIMS UPDATE 04:    The American Legions Veteran Affairs
 and Rehabilitation (VA&R) Commission tracks and provides Bulletins on
 Blue Water Claims   They have had a longstanding position (resolution)
 supporting the premise that shipboard service in Vietnam's territorial
 waters constitutes service in the Republic of Vietnam for the purpose
 of presumption of exposure to herbicides (Agent Orange) during the
 Vietnam War. Following is a summary of legal actions to date in efforts by
 the American Legion and the National Veterans Legal Services Program
 (NVLSP) to get the VA to accept Agent Orange related claims from "Blue
 Water" Navy veterans:

o August 16, 2006, the United States Court of Appeals for Veterans
 Claims (CAVC) held in Haas v. Nicholson (now Haas v. Peake) that Vietnam
 veterans who served in the waters off Vietnam ("Blue Water" Navy
 veterans) are entitled to disability benefits for diseases related to exposure
 to Agent Orange.
o May 12, 2008, the Department of Veterans Affairs (VA) appealed the
 CAVC's decision to United States Court of Appeals for the Federal
 Circuit.
o May 8, 2008, the Federal Circuit issued a decision reversing the
 decision of the CAVC in Haas v. Peake.
o June 23, 2008, the attorneys for Mr. Haas, the National Veterans
 Legal Services Program (NVLSP), filed a Combined Petition for Panel
 Rehearing or Rehearing En Banc.
o June 30, 2008, The American Legion, Military Order of the Purple
 Heart, and United Spinal Association filed an Amici Curiae Brief in support
 of Mr. Haas' petition for rehearing.
o September 12, 2008 VA filed its opposition to the petition for
 rehearing.
o October 9, 2008, the Federal Circuit denied the petition for
 rehearing.
o October 17, 2008, Mr. Haas' attorneys filed a Petition for a Writ of
 Certiorari in the U.S. Supreme Court asking the Court to overturn the
 Federal Circuit's decision in Haas that denied Agent Orange-related VA
 benefits to Blue Water Vietnam Veterans. 
o November 21, 2008 due date for VA's response to the petition. The
 Supreme Court only grants certiorari in about one percent of cases and,
 even if they agree to hear the case, there is no guarantee that Mr. Haas
 would win on the merits.
[Source: VA&R Bulletin 34-08 dtd 28 Oct 08 ++]


SSA DISABILITY CLAIMS UPDATE 01:   Despite hiring new judges with an
 additional $150 million in funding, the Social Security Administration's
 massive backlog of years-old disability claims has not been appreciably
 reduced over the last year, although the agency has processed most
 cases that have been in the pipeline the longest. A person claiming
 disability benefits must prove to the Social Security Administration (SSA)
 that she or he is unable to perform any degree of work in order to begin
 receiving Social Security Disability Insurance. Initial applications
 are often denied, leading to an appeal to an administrative law judge
 (ALJ) for reconsideration. More than 760,000 cases were pending review
 from an ALJ at the end of September. This is 14,000 more cases than were
 pending in SEP 07, and shows that growth in the backlog had slowed
 significantly. Previously, SSA had added about 70,000 cases to its backlog
 annually. According to agency data, the average wait for a decision in
 SEP 08 was 509 days. This is slightly longer than the average wait one
 year ago. During fiscal year 2008, SSA hired 190 new ALJs, opened a
 National Hearing Center (NHC), and eliminated virtually the entire backlog
 of over 135,000 cases that had been waiting over 900 days for a hearing
 decision. SSA notes that the hiring of new ALJs was critical, but it
 will take a number of months before they become fully productive. The
 NHC will give SSA the capability of conducting video hearings in cities
 with the worst backlogs. The agency is also working with the Government
 Services Administration to establish new hearing offices. [Source:
 Medicare Watch 28 Oct 08 ++]


UNIFORM WEARING:    Federal laws concerning the wear of the United
 States Military uniforms by people not on active duty are published in the
 United States Code (USC). Specifically, 10 USC, Subtitle A, Part II,
 Chapter 45, Sections 771 and 772 state.:

- Section 771: Except as otherwise provided by law, no person except a
 member of the Army, Navy, Air Force, or Marine Corps, as the case may
 be, may wear - (1) the uniform, or a distinctive part of the uniform, of
 the Army, Navy, Air Force, or Marine Corps; or (2) a uniform any part
 of which is similar to a distinctive part of the uniform of the Army,
 Navy, Air Force, or Marine Corps
- Section 772 lists some exceptions:
(a) A member of the Army National Guard or the Air National Guard may
 wear the uniform prescribed for the Army National Guard or the Air
 National Guard, as the case may be.
(b) A member of the Naval Militia may wear the uniform prescribed for
 the Naval Militia.
(c) A retired officer of the Army, Navy, Air Force, or Marine Corps
 may bear the title and wear the uniform of his retired grade.
(d) A person who is discharged honorably or under honorable conditions
 from the Army, Navy, Air Force, or Marine Corps may wear his uniform
 while going from the place of discharge to his home, within three months
 after his discharge.
(e) A person not on active duty who served honorably in time of war in
 the Army, Navy, Air Force, or Marine Corps may bear the title, and,
 when authorized by regulations prescribed by the President, wear the
 uniform, of the highest grade held by him during that war.
(f) While portraying a member of the Army, Navy, Air Force, or Marine
 Corps, an actor in a theatrical or motion-picture production may wear
 the uniform of that armed force if the portrayal does not tend to
 discredit that armed force.
(g) An officer or resident of a veterans' home administered by the
 Department of Veterans Affairs may wear such uniform as the Secretary of
 the military department concerned may prescribe.
(h) While attending a course of military instruction conducted by the
 Army, Navy, Air Force, or Marine Corps, a civilian may wear the uniform
 prescribed by that armed force if the wear of such uniform is
 specifically authorized under regulations prescribed by the Secretary of the
 military department concerned.
(i) Under such regulations as the Secretary of the Air Force may
 prescribe, a citizen of a foreign country who graduates from an Air Force
 school may wear the appropriate aviation badges of the Air Force.
(j) A person in any of the following categories may wear the uniform
 prescribed for that category: (1) Members of the Boy Scouts of America.
 (2) Members of any other organization designated by the Secretary of a
 military
[Source:  About.com: US military 28 Oct 08 ++]


PROSTATE CANCER UPDATE 07:   A large government study of whether
 Vitamin E and selenium protect men against prostate cancer has been
 suspended, federal health officials announced 29 OCT 08, after an independent
 analysis determined that the nutrients did not reduce the risk for the
 common malignancy. The $119 million study, involving more than 35,000
 men, also found hints that the nutrients might increase the risk for
 prostate cancer and diabetes, although officials stressed that those
 findings may be a coincidence. Nevertheless, the study's organizers had begun
 notifying participants to stop taking the pills they were receiving,
 and offered to tell them whether they were taking the nutrients or
 placebos. All the participants will continue to have their health monitored
 for about three years. The announcement marks the latest in a series of
 disappointing findings about the potential health benefits of vitamins
 and other nutritional supplements, which earlier studies had indicated
 could have a host of advantages. One theory was that antioxidants could
 mop up damaging free radicals, which are a natural byproduct of
 cellular processes in the body. But subsequent studies testing antioxidants
 and other nutritional supplements have not confirmed the benefits, and
 several have even been alarming. For example, beta carotene increased,
 rather than decreased, the risk of lung cancer among smokers, and
 Vitamin E -- also touted as helping to prevent heart disease -- appeared to
 boost the overall risk.

     The new study was funded by the National Institutes of Health
 after earlier studies indicated the nutrients may protect against prostate
 cancer, the most common cancer in men after skin cancer. Men age 50 and
 older received one or both of the nutrients or placebos at 400 sites
 in the United States, Puerto Rico and Canada. An independent panel of
 experts monitoring the study discovered, after men had been taking the
 supplements for about five years, that there was no benefit but that
 there were suggestions of possible harm, prompting officials to stop the
 project. "The important message for consumers is that taking supplements,
 whether antioxidants or others, is not necessarily beneficial and
 could be harmful," said Eric Klein of the Cleveland Clinic, a study
 coordinator. "You should not be taking them unless there is a rigorous
 scientific study that shows a benefit. Andrew Shao of the Council for
 Responsible Nutrition, an industry group, said in a statement that the findings
 did not "discount the value of taking vitamin E and selenium for other
 general benefits."  [Source: Washington Post Rob Stein article 28 Oct
 08 ++]


SSA COMPASSIONATE ALLOWANCES:    Social Security has an obligation to
 provide benefits quickly to applicants whose medical conditions are so
 serious that their conditions obviously meet disability standards.
 Compassionate allowances are a way of quickly identifying diseases and other
 medical conditions that invariably qualify under the Listing of
 Impairments based on minimal objective medical information. The Compassionate
 allowances initiative will allow Social Security to quickly target the
 most obviously disabled individuals for allowances based on objective
 medical information that they can obtain quickly. Commissioner Astrue
 has held two Compassionate Allowance public outreach hearings. The first
 was on rare diseases and the second was on cancers. A third hearing on
 brain injuries is planned for 18 NOV 08. The initial list of
 Compassionate Allowance conditions was developed as a result of information
 received at public outreach hearings, public comment on an Advance Notice
 of Proposed Rulemaking, comments received from the Social Security and
 Disability Determination Service communities, and the counsel of medical
 and scientific experts. Also, SSA considered which conditions are most
 likely to meet their current definition of disability. For additional
 info on how the allowances are processed refer to
  https://secure.ssa.gov/apps10/poms.nsf/lnx/0423022000!opendocument.
  The list of 25 rare diseases and 25 cancers which follows have been
 selected for the initiative's rollout and may expand over time:

1. Acute Leukemia
2. Adrenal Cancer - with distant metastases or inoperable, unresectable
 or recurrent
3. Alexander Disease (ALX) - Neonatal and Infantile
4. Amyotrophic Lateral Sclerosis (ALS)
5. Anaplastic Adrenal Cancer - with distant metastases or inoperable,
 unresectable or recurrent
6. Astrocytoma - Grade III and IV
7. Bladder Cancer - with distant metastases or inoperable or
 unresectable
8. Bone Cancer - with distant metastases or inoperable or unresectable
9. Breast Cancer - with distant metastases or inoperable or
 unresectable
10. Canavan Disease (CD)
11. Cerebro Oculo Facio Skeletal (COFS) Syndrome
12. Chronic Myelogenous Leukemia (CML) - Blast Phase
13. Creutzfeldt-Jakob Disease (CJD) - Adult
14. Ependymoblastoma (Child Brain Tumor)
15. Esophageal Cancer
16. Farber's Disease (FD) - Infantile
17. Friedreichs Ataxia (FRDA)
18. Frontotemporal Dementia (FTD), Picks Disease -Type A - Adult
19. Gallbladder Cancer
20. Gaucher Disease (GD) - Type 2
21. Glioblastoma Multiforme (Brain Tumor)
22. Head and Neck Cancers - with distant metastasis or inoperable or
 uresectable
23. Infantile Neuroaxonal Dystrophy (INAD)
24. Inflammatory Breast Cancer (IBC)
25. Kidney Cancer - inoperable or unresectable
26. Krabbe Disease (KD) - Infantile
27. Large Intestine Cancer - with distant metastasis or inoperable,
 unresectable or recurrent
28. Lesch-Nyhan Syndrome (LNS)
29. Liver Cancer
30. Mantle Cell Lymphoma (MCL)
31. Metachromatic Leukodystrophy (MLD) - Late Infantile
32. Niemann-Pick Disease (NPD) - Type A
33. Non-Small Cell Lung Cancer - with metastases to or beyond the hilar
 nodes or inoperable, unresectable or recurrent
34. Ornithine Transcarbamylase (OTC) Deficiency
35. Osteogenesis Imperfecta (OI) - Type II
36. Ovarian Cancer - with distant metastases or inoperable or
 unresectable
37. Pancreatic Cancer
38. Peritoneal Mesothelioma
39. Pleural Mesothelioma
40. Pompe Disease - Infantile
41. Rett (RTT) Syndrome
42. Salivary Tumors
43. Sandhoff Disease
44. Small Cell Cancer (of the Large Intestine, Ovary, Prostate, or
 Uterus)
45. Small Cell Lung Cancer
46. Small Intestine Cancer - with distant metastases or inoperable,
 unresectable or recurrent
47. Spinal Muscular Atrophy (SMA) - Types 0 And 1
48. Stomach Cancer - with distant metastases or inoperable,
 unresectable or recurrent
49. Thyroid Cancer
50. Ureter Cancer - with distant metastases or inoperable, unresectable
 or recurrent
[Source:  NORD Press Release 27 Oct 08 ++]


VETERAN TRAVEL OPPORTUNITIES:    The Pacific Missile Range Facility
 (PMRF) MWR offers beach cottage accommodations at Barking Sands, Kauai HI
 to active duty, reservists, and retirees at bargain prices.  Also
 eligible to use the facilities are:

a. Ex-POW; Medal of Honor recipients; Honorably discharged veterans
 with 100% service connected disability; Involuntarily separated service
 members under the Transition Assistance Management Program (TAMP);
 Voluntary Separation under the Voluntary Separation Incentive (VSI); and
 Special Separation Benefit (SSB) programs for two years after separation.
b. Family members to include spouse and children (21 years or older) of
 those category (a) eligible patrons who possess a spouse/dependant
 I.D.
c. Department of Defense (DoD) Civilians and MWR/NEX/AFEES NAF
 employees.
d. Contractors working on board the installation who have been
 authorized use of MWR programs by the Commanding Officer

Available are 18 two bedroom cottages and a VIP three bedroom cottage
 right on the water.  They are well maintained and come with all
 amenities including a washer & dryer.  The site also has a well stocked
 exchange, gym, pool, gas station, an all hands club, a dining hall (open to
 retirees) and a tour booking & equipment rental office.  Rates vary by
 rank and are subject to change.  Presently they are $70 to $90/night for
 the 2-bedroom and $90 to $95 for the 3-bedroom cottages. The maximum
 stay is two weeks, but may be extended based on availability upon
 check-in. Occupancy is limited to a maximum of six (6) people per two-bedroom
 unit and 8 people per three-bedroom unit.  Pets are prohibited inside
 and outside the beach cottages. You will need to rent a car.  The
 advance reservation categories for eligible patrons are:

Category 1: Includes active duty Navy and their family members residing
 in Hawaii. Reservations may be made up to six (6) months in advance to
 the date.
Category 2: Includes active duty Navy (outside of Hawaii), Marine and
 Coast Guard personnel and their family members. Reservations may be made
 up to five (5) months in advance to the date.
Category 3: Includes active duty members of other services, reservists,
 retirees, Ex-POW and Medal of Honor recipients, and their family
 members; Reservations may be
made up to four (4) months in advance to the date.
Category 4: Includes Navy DoD civilians, MWR/NEX NAF employees;
 Reservations may be made up to three (3) months in advance to the date.
Category 5: Includes other service DoD civilians, AFEES employees.
 Reservations may be made up to two (2) months in advance to the date.
Category 6: Includes contract employees working on the installation.
 Reservations may be made up to one (1)
month in advance to the date.

Reservations are made by contacting Central Cottage Reservation Office
 at COM (808) 335-4752 or DSN 471-6752. To confirm a reservation, a
 credit card deposit of 50% is required. If submitting a reservation by
 check or cash, it must be received at the time the reservation is placed.
 The 50% deposit will be applied to the total amount due. Cancellation
 more than 45 days prior to the reservation will result in a full refund.
 NO REFUND will be issued if cancellation is within 45 days of the
 reservation date. The MWR Director may review special circumstances for
 possible exceptions to this policy. For more info, contact the Navy Region
 Hawaii Quality of Life website at www.greatlifehawaii.com or email to:
 erika.burton@navy.mil.  [Source:
  http://www.greatlifehawaii.com/docs/PMRF_Beach_Cottage_policyMay2006.pdf
 Oct 08 ++]


MEDICARE PART D UPDATE 29:   The Centers for Medicare & Medicaid
 Services (CMS) will no longer reimburse hospitals for ten categories of
 preventable medical errors that result in serious risk of injury to
 patients. CMS prohibits hospitals to charge people with Medicare for the
 additional costs associated with treating these conditions. Hospitals will
 now assume the costs of procedures associated with "never events," so
 called because they should never occur. While Medicare will save $21
 million as a result of the new policy, the primary purpose of the rule is to
 improve quality of care for people with Medicare by creating greater
 incentives for doctors and hospitals to avoid preventable errors. The
 expectation is that if these errors affect hospitals' overall budgets,
 doctors and hospitals will take more aggressive measures to prevent these
 errors. The ten categories of "never events" Medicare no longer covers
 include remedial treatments related to foreign objects retained by
 patients after surgery; transfusion of incompatible blood; falls and
 traumas during a hospital stay; manifestations of poor glycemic controls;
 catheter-associated urinary tract infections; surgical site infection
 following a coronary artery bypass graft or orthopedic surgery; and deep
 vein thrombosis/pulmonary embolism. [Source: Medicare Watch Newsletter
 of the Medicare Rights Center 14 Oct 08 ++]


MEDICARE PART D UPDATE 30:   Recent reports indicate that some of the
 major national Medicare private health plans are going to pay
 independent agents $500-plus per year over five years--$2,500 in total--for every
 new enrollee they sign up for  their "Medicare Advantage" plans. The
 new totals are at least double the top commissions typically paid over
 the last couple of years--a period when people with Medicare were
 regularly victimized by predatory agents looking to make a quick buck. Older
 adults and people with disabilities were bullied or tricked into
 Medicare private health plans that no longer allowed them to see their
 doctors or that stuck them with high out-of-pocket costs when they fell ill.
 These new commissions are an attempt by some of the major plans to
 undermine efforts by the Centers for Medicare & Medicaid Services (CMS) to
 restrain commissions and in particular to eliminate incentives for
 agents to "churn"--move customers from plan to plan just to earn
 commissions. Many agents believe that these higher commissions actually increase
 incentives to churn.
      CMS should not allow Medicare Advantage plans to pay these
 commissions. The agency has broad authority, under the Medicare Improvements
 for Patients and Providers Act, to establish commission guidelines that
 create "incentives for agents and brokers to enroll individuals in the
 Medicare Advantage plan that is intended to best meet their health
 care needs."  Asclepios contends:
- There should be no incentive to move someone from one Medicare
 Advantage plan to another just to earn a higher commission.
- There should be no incentive to move someone from a Medigap
 supplemental plan to a Medicare Advantage plan just to earn a higher commission.

With those twin goals in mind, CMS should establish a cap on
 commissions consistent with existing requirements to pay level commissions over 5
 years, starting with the 2009 plan year. The cap should be set at a
 level that approximates current renewal rates for Medicare Advantage
 enrollments made in 2007 and 2008. And it should approximate Medigap
 renewal rates for a healthy 66-year-old, the low-cost consumer that Medicare
 Advantage plans target for enrollment. With those parameters,
 commissions would be capped at well under half the rates Medicare Advantage
 plans are now proposing to pay. Remember, Medicare Advantage plans are
 paying these commissions out of subsidies they receive from taxpayers. It
 is outrageous that any of these subsidies, which are supposed to pay for
 the health care of older adults and people with disabilities, are
 diverted to pay commissions to enroll people with Medicare in plans that
 cost taxpayers more money--$150 billion over the next ten years--than it
 costs to provide care under Original Medicare. Unfortunately, there is
 zero chance that the current administration will ban Medicare private
 health plans from paying commissions, just as it has opposed any effort
 by Congress to reduce the excessive subsidies these plans receive. For
 that, more comprehensive solution, we will have to wait until after the
 election.  [Source: Asclepios Weekly Medicare Consumer Advocacy Update
 23 Oct 08 ++]


VA MEANS TEST:   By law VA is required to verify the self-reported
 gross household income (veteran, spouse and dependents, if any) of certain
 nonservice-connected or noncompensable 0% service-connected veterans to
 confirm the accuracy of their Eligibility for VA health care,  Copay
 status, and Enrollment priority group assignment.  VA verifies veterans'
 gross household income (spouse and dependents, if any) provided by the
 veteran on the financial assessment (means test). This financial
 information is verified by matching financial records maintained by the
 Internal Revenue Service (IRS) and the Social Security Administration
 (SSA). If the result of the income match reveals that the veteran's gross
 household income is higher than the established VA national means test
 threshold, the veteran will be contacted via mail to help resolve the
 income discrepancy. These contacts from VA gives the veteran and spouse
 the opportunity to dispute income as reported by IRS and SSA and/or
 reduce the total gross household income by providing proof of allowable
 deductible expenses

     VA requires most veterans not receiving VA disability compensation
 or pension payments to provide information on their annual gross
 household income and net worth to determine whether they are below the
 annually-adjusted VA national means test threshold (income threshold), in
 order to qualify for exemption from outpatient, inpatient and medication
 copays. The financial assessment includes all gross household income
 and net worth, including Social Security, retirement pay, unemployment
 insurance, interest and dividends, workers' compensation, black lung
 benefits and any other gross household income. Also considered are assets
 such as the market value of property that is NOT the primary residence,
 stocks, bonds, notes, individual retirement accounts, bank deposits,
 savings accounts and cash. VA also compares veterans' financial
 assessments with geographically based income thresholds. If the veteran's income
 is above the VA national means test threshold and below the geographic
 means test (GMT) thresholds where the veteran lives, they are eligible
 for an 80% reduction in inpatient co-pay rates. For more information
 about geographically based income thresholds, go to the GMT eligibility
 page.

     The veteran (and spouse if applicable) will be provided an
 opportunity to review the discrepancy between their reported income and the
 IRS and SSA data. If there is an error or other explanation for the
 discrepancy this information is provided by the veteran to VA for review. If
 we have not received a response from the veteran with 45 days, we will
 attempt to independently verify the total gross household income. This
 process entails us contacting all employers and financial institutions
 that reported income to the Internal Revenue Service and Social
 Security Administration. If no response is received from the veteran within
 75 days, VA considers that due process requirements have been met and
 action is initiated to make appropriate eligibility, copay and enrollment
 status changes. Veterans subject to this process are individually
 notified by mail and provided with all related information.  At the end of
 the income verification process, if it is determined that the veteran's
 gross household income is higher than the VA national means test
 income threshold:

- The veteran's priority group assignment will be changed.
- The veteran will be required to pay health care and medication
 copayments.
- VA health care facilities that provided care to the veteran will be
 notified to bill the veteran for services provided for their
 nonservice-connected conditions during the period covered by the income
 assessment.
- The veteran will be provided with due process/appeal rights

If the veteran is financially unable to pay the assessed copay charges,
 there are three options available:

1.  Request a Waiver of Debt for the past debts you owe. A Waiver of
 Debt can be granted when there has been a significant change in income
 and the veteran has experienced significant expenses for medical care for
 the veteran or other family members, funeral arrangements or veteran
 educational expenses. A Waiver of Debt excuses all existing bills, but
 does not prevent future charges. A waiver must be requested in writing
 and by completing VA Form 5655, Financial Status Report. The request
 must specify each copayment for which a waiver is being requested. There
 is no limit on the amount that the veteran can request to be waived. The
 veteran must request a waiver in writing within 180 days from the date
 on the bill. To request a waiver, and for more information, contact
 the Revenue Coordinator at the VA health care facility where the veteran
 receives their care.

2.  Request a Hardship Determination to prevent future billing. A
 Hardship Determination is an exemption from copay for a determined period of
 time. If a veteran's current year income is substantially reduced from
 the prior year, a veteran may request a Hardship Determination.
  Hardship Determination must be requested in writing. To request a Hardship
 Determination, contact the Enrollment Coordinator at the VA Medical
 Center where the veteran receives their care.

3.  Request an Offer in Compromise. An Offer in Compromise is an offer
 for past debts only and acceptance of a partial payment in settlement
 and full satisfaction of the debt at the time the offer is made. VA will
 consider both the current and anticipated future income in making
 these determinations. Most Offers in Compromise that are accepted must be
 for a lump sum payment payable in full 30 days from the date of
 acceptance of the offer.
Offers in Compromise must be requested in writing and by completing VA
 Form 5655, Financial Status Report. There is no limit on the amount
 that the veteran can request for the Offer in Compromise. To request an
 Offer in Compromise, contact the Revenue Office at the VA Medical Center
 where the veteran receives their care.
[Source: http://www.va.gov/healtheligibility/iv/ Oct 08 ++]


FLU SHOTS UPDATE 02:   Experts are making their annual plea for people
 50-plus and other at-risk groups to get their shots. Public health
 officials say a new vaccine from five different manufacturers has been
 shipped to clinics and doctors' offices around the country. There should be
 enough to go around. According to Julie Gerberding, M.D., director of
 the U.S. Centers for Disease Control and Prevention (CDC), between 143
 million and 146 million doses are available, ruling out any shortage
 like the one that occurred in 2004, when the vaccine supply was cut in
 half. Influenza--the fancy word for the flu--is an infectious respiratory
 disease, caused by a virus which can be really dangerous to at-risk
 groups, including the older people, infants and people with chronic
 diseases. Flu and bacterial pneumonia--a common complication of flu--each
 year send 200,000 people to hospitals in the United States and cause on
 average 36,000 deaths. Immunizations usually help individuals avoid the
 flu, but public health officials are concerned that this season, people
 may be reluctant to be inoculated. That's because last year's
 circulating virus strains did not match up with the vaccine, so more people
 came down with the flu. Vaccine formulations are determined each year by
 scientists who look at the dominant strains in the Southern Hemisphere.
 In February they recommend the three viruses that are most likely to
 strike the United States in the next flu season.

         Usually one or two strains are used from the previous year's
 vaccine. But this year's formulation is "unprecedented," says Anthony S.
 Fauci, M.D., director of the National Institute of Allergy and
 Infectious Diseases (NIAID), because the vaccine has been manufactured with
 three new strains. In 16 of the last 19 years, the vaccine has been a
 good match with prevailing viruses, says Joe Bresee, M.D., head of the
 CDC's flu prevention effort. Normally, a shot works for 70 to 90% of those
 immunized, he says, but last year only 44% were protected. The vaccine
 has come under scrutiny from various sources. In fact, some doctors
 don't think it prevents disease in the older population. They point to a
 study published in the British medical journal the Lancet on 2 AUG,
 which found that the vaccine didn't lower the risk of pneumonia.
 Researchers at the Group Health Center for Health Studies in Seattle found that
 older people who are the most likely to get a flu shot are generally
 healthy and the least likely to get pneumonia, while those too weak or
 frail to get to the doctor's office for a vaccination are the most
 vulnerable. Factoring in the variations in health status, the vaccine
 appeared to make little difference in pneumonia risk. The findings were based
 on a review of thousands of medical charts of older members of a
 Seattle HMO.

     A new CDC report shows that in 2006, 72% of those older than 65
 were vaccinated, but only 42% of individuals ages 50 to 64 and 35% of 18-
 to 49-year-olds were immunized. Just 42% of health workers got the
 shots. And a new consumer survey commissioned by the National Foundation
 for Infectious Diseases (NFID) shows that four in 10 patients say
 they've never even talked with their doctors about being vaccinated. What's
 likely to get more people to roll up their sleeves is a longer-lasting
 vaccine that confers immunity from year to year. "I think that's the
 ultimate endgame and endpoint, but we're not there yet, obviously," says
 Fauci. Currently, NIAID is spending about $94 million on developing
 vaccines for different types of flu, up from just $3.6 million in 2000,
 before the 9/11 attacks, the anthrax scare and worries about avian flu.
 "People may question whether the vaccine is effective," adds the CDC's
 Bresee, "but they need to remember it's still the best protection we have
 year in and year out."  You do not need a doctor's prescription to
 obtain a flu shot. Three types of vaccines are available with various
 means to access them:
o Traditional flu shot consisting of a "killed" virus for healthy
 people older than six months.
o Nose spray consisting of a weakened live virus for healthy people
 ages 2 to 49 years (but not pregnant women).
o A one-time vaccination against bacterial pneumonia, a common
 complication of flu, for those 65 and older and nursing home residents.
o Flu shots generally cost between $15 and $30, but check hospitals,
 senior centers, pharmacies (i.e. Rite Aid, CVC, etc.) and public clinics
 in your community for free or low-cost shots.
o Some polling places are offering flu shots on Election Day through
 the Vote and Vax program.
o Medicare pays for the total cost of flu and pneumonia vaccinations,
 and so do many private health plans.

Pneumococcal disease (such as meningitis) and other bacterial
 infections can follow flu and cause secondary infections that worsen flu
 symptoms and increase the risk of flu-related death. For example, it's
 believed that bacterial infections caused almost half of the deaths of young
 soldiers during the 1918 worldwide flu pandemic, according to background
 information in an Emory University news release. Keith P. Klugman,
 professor of global health at Emory's Rollins School of Public Health,
 created a predictive model to estimate the public health and economic
 effect current influenza vaccination practices would have on children
 younger than two years old during a flu pandemic.  The model showed that
 current PCV vaccination practices lower costs in a typical flu season by
 $1.4 billion and would cut costs by $7 billion in a pandemic. It also
 predicted that PCV vaccination would prevent 1.24 million cases of
 pneumonia and 357,000 pneumococcal-related deaths in a pandemic. [Source:
 AARP Bulletin Today Jeff Levine article 10 Oct 08 ++]


RC DISABILITY CLAIMS:   The head of the Reserve Officers Association
 said he hopes a study ordered by Congress will explain the big
 discrepancies in veterans' disability benefits awarded to active and reserve
 component (RC) forces. Retired Marine Lt. Gen. Dennis McCarthy, ROA's
 executive director, said 22 OCT that there may be good reasons why National
 Guard and reserve members are more likely to have their veterans'
 claims denied and to receive lower disability ratings -- but those reasons
 are not immediately clear, and the Department of Veterans Affairs does
 not have a good explanation. "We really need to keep on them until this
 study is done," McCarthy said, noting that veterans must have
 confidence that the disability system is fair. Retired Rear Adm. Patrick Dunne,
 VA's undersecretary for benefits, met with McCarthy to discuss the
 discrepancies in disability compensation, which were first reported earlier
 this month by Military Times. The report, based on information
 obtained by Veterans for Common Sense, showed that 45%t of active-duty
 veterans of operations in Afghanistan and Iraq had filed disability claims,
 compared with 23% of Guard and reserve members who deployed to the war
 zones. Just 4% of claims by active-duty veterans were denied by VA, while
 11% of claims from Guard and reserve members were denied.

     Dunne did not dispute the report, McCarthy said, and said VA is
 trying to determine why there is such a big difference. Dunne suggested
 that one possible explanation might be that active-duty veterans
 accumulate more service-connected disabilities over a career than Guard and
 reserve members. McCarthy said Dunne tried to assure ROA that there is no
 outright discrimination against Guard or reserve members. "That they
 are going to do a study is a good sign," McCarthy said. "This is a
 difficult time for VA and they have a lot of big issues facing them." The
 demographic study of disability claims promised by Dunne was ordered by
 Congress, and VA is looking for a private company to study the
 differences between active and reserve veterans by age, locations where claims
 are filed and where veterans live to determine why there are differences
 and whether some people are being treated unfairly. The study will
 take more than a year to complete. [Source: ArmyTimes Rick Maze article 24
 Oct 08 ++]


VA RETRO PAY PROJECT UPDATE 15:    A Pentagon financing office said 23
 OCT it has begun a review of a veterans' claims program that a House
 lawmaker says has made payment errors reaching millions of dollars. Tom
 LaRock, spokesman for the Defense Finance and Accounting Service (DFAS),
 said the office's director, Teresa McKay, "has expressed her
 commitment to ensure that the veterans receive the benefits they are due. If
 mistakes were made, we will take appropriate steps to correct them." On 22
 OCT, Rep. Dennis Kucinich (D-OH) wrote McKay, saying his office had
 calculated that nearly 2,000 severely disabled veterans were wrongly
 denied payments under a program that extends retroactive benefits for
 retired veterans whose disabilities were linked to combat or military
 service. He said there were also inaccuracies -- both overpayments and
 underpayments -- for an additional 2,500 veterans who received benefits in
 excess of $2,500. Kucinich said the total cost of the errors in the VA
 Retro program was about $20 million. On 23 OCT, he revised that figure to
 about $12 million but said the number of affected veterans was
 unchanged. He urged McKay to recalculate all claims made under the program.
 Kucinich blamed the errors on a weakening of quality control checks
 prompted by a rush to shrink a backlog of unprocessed claims. LaRock said
 his office started a review of the program after the House Oversight
 subcommittee on domestic policy that Kucinich chairs held hearings on the
 issue last July. He said they have reprocessed about 10% of the 133,000
 claims originally considered eligible for the program and hoped to
 complete the review by early spring next year. [Source: NavyTimes AP
 article 24 Oct 08 ++]


PNEUMONIA:    Pneumonia is an infection of one or both lungs which is
 usually caused by bacteria, viruses, or fungi. Prior to the discovery of
 antibiotics, one-third of all people who developed pneumonia
 subsequently died from the infection. Currently, over 3 million people develop
 pneumonia each year in the United States. Over a half a million of these
 people are admitted to a hospital for treatment. Although most of
 these people recover, approximately 5% will die from pneumonia. Pneumonia
 is the sixth leading cause of death in the United States. Some cases of
 pneumonia are contracted by breathing in small droplets that contain
 the organisms that can cause pneumonia. These droplets get into the air
 when a person infected with these germs coughs or sneezes. In other
 cases, pneumonia is caused when bacteria or viruses that are normally
 present in the mouth, throat, or nose inadvertently enter the lung. During
 sleep, it is quite common for people to aspirate secretions from the
 mouth, throat, or nose. Normally, the body's reflex response (coughing
 back up the secretions) and immune system will prevent the aspirated
 organisms from causing pneumonia. However, if a person is in a weakened
 condition from another illness, a severe pneumonia can develop. People with
 recent viral infections, lung disease, heart disease, and swallowing
 problems, as well as alcoholics, drug users, and those who have suffered
 a stroke or seizure are at higher risk for developing pneumonia than
 the general population. Once organisms enter the lungs, they usually
 settle in the air sacs of the lung where they rapidly grow in number. This
 area of the lung then becomes filled with fluid and pus as the body
 attempts to fight off the infection.
What are pneumonia symptoms and signs?

     Most people who develop pneumonia initially have symptoms of a
 cold which are then followed by a high fever (sometimes as high as 104
 degrees Fahrenheit), shaking chills, and a cough with sputum production.
 The sputum is usually discolored and sometimes bloody. People with
 pneumonia may become short of breath. The only pain fibers in the lung are
 on the surface of the lung, in the area known as the pleura. Chest pain
 may develop if the outer pleural aspects of the lung are involved. This
 pain is usually sharp and worsens when taking a deep breath, known as
 pleuritic pain. In other cases of pneumonia, there can be a slow onset
 of symptoms. A worsening cough, headaches, and muscle aches may be the
 only symptoms. In some people with pneumonia, coughing is not a major
 symptom because the infection is located in areas of the lung away from
 the larger airways. At times, the individual's skin color may change
 and become dusky or purplish (a condition known as "cyanosis") due to
 their blood being poorly oxygenated. Children and babies who develop
 pneumonia often do not have any specific signs of a chest infection but
 develop a fever, appear quite ill, and can become lethargic. Elderly people
 may also have few symptoms with pneumonia.
 
   Two vaccines are available to prevent pneumococcal disease; the
 pneumococcal conjugate vaccine (PCV7; Prevnar) and the pneumococcal
 polysaccharide vaccine (PPV23; Pneumovax). The pneumococcal conjugate vaccine
 is part of the routine infant immunization schedule in the U.S. and is
 recommended for all children less than 2 years of age and children 2-4
 years of age who have certain medical conditions. The pneumococcal
 polysaccharide vaccine is recommended for adults at increased risk for
 developing pneumococcal pneumonia including the elderly, people who have
 diabetes, chronic heart, lung, or kidney disease, those with alcoholism,
 cigarette smokers, and in those people who have had their spleen
 removed. VA will provide the PPV23 shot to vets 65and older upon request if
 approved by their VA physician. Antibiotics often used in the treatment
 of this type of pneumonia include penicillin, amoxicillin and
 clavulanic acid (Augmentin, Augmentin XR), and macrolide antibiotics including
 erythromycin, azithromycin (Zithromax, Zmax), and clarithromycin
 (Biaxin). Penicillin was formerly the antibiotic of choice in treating this
 infection. With the advent and widespread use of broader-spectrum
 antibiotics, significant drug resistance has developed. Penicillin may still
 be effective in treatment of pneumococcal pneumonia, but it should only
 be used after cultures of the bacteria confirm their sensitivity to
 this antibiotic.  [Source:
  http://www.medicinenet.com/pneumonia/article.htm Oct 08 ++]


PNEUMONIA UPDATE 01:   For the first time, an influential government
 panel is recommending a vaccination specifically for smokers. The panel
 decided 22 OCT 08 that adult smokers under 65 should get pneumococcal
 vaccine. The shot already recommended for anyone 65 or older protects
 against bacteria that cause pneumonia, meningitis and other illnesses.
 Federal officials usually adopt recommendations made by the panel, the
 Advisory Committee on Immunization Practices. The vote means more than 31
 million adult smokers probably will soon be called on to get the shot.
 Studies have shown that smokers are about four times more likely than
 nonsmokers to suffer pneumococcal disease. Also, the more cigarettes
 someone smokes each day, the higher the odds they'll develop the
 illnesses. Why smokers are more susceptible is not known for sure, but some
 scientists believe it has to do with smoking-caused damage that allows the
 bacteria to more easily attach to the lungs and windpipe, said Dr.
 Pekka Nuorti, a medical epidemiologist with the Centers for Disease Control
 and Prevention. Pneumococcal infections are considered the top killer
 among vaccine-preventable diseases. It's a common complication of
 influenza, especially in the elderly, and is considered responsible for many
 of the 36,000 annual deaths attributed to flu.
 
    The committee voted 11 to 3 to pass the recommendation, with one
 member abstaining. The panel also added a call for smoking cessation
 counseling. Some members said it might be more cost effective to recommend
 the vaccine for smokers who were at least age 40, because pneumococcal
 disease is relatively uncommon in younger smokers. Others at the
 meeting made the same argument. Dr. James Turner, who oversees student health
 programs at the University of Virginia, said about one in five college
 students smoke but he has never seen a case of serious pneumococcal
 disease in a student body. The shot is less than perfect. First licensed
 in 1983, it is designed to protect against 23 strains of pneumococcal
 bacteria. But it hasn't proved very effective against pneumonia, and
 hasn't been very effective in warding off other pneumococcal illnesses in
 people with weakened immune systems and people age 80 or older. It's to
 be given to smokers as a one-time dose with no booster, but its
 protection drops off after five to 10 years. Made by Merck & Co., it's sold
 under the trade name Pneumovax and costs about $30 a dose. A different
 vaccine Wyeth's Prevnar, which came on the market in 2000 is recommended
 for children under age 2, and for kids 2 to 5 with certain chronic
 conditions or who are at higher risk for illness. That vaccine costs about
 $84 per dose. Prevnar protects against seven strains of bacteria that
 were the most common causes of pneumococcal diseases at the time the
 vaccine was developed. But lately, those strains have stopped being
 important causes of illness. Experts have become concerned about dozens of
 other strains, including some that have flourished and become resistant
 to antibiotics. Wyeth has been developing a new vaccine. It is expected
 to present study data on it at a scientific meeting later this month,
 and to apply for government licensing approval early next year.
 [Source: AP Mike Stobbe article 22 Oct 08 ++]


PATIENT PRIVACY RULES:   The U.S. Department of Health and Human
 Services (HHS) enforces the Federal privacy regulations commonly known as the
 HIPAA Privacy Rule (HIPAA). HIPAA requires most doctors, nurses,
 pharmacies, hospitals, nursing homes, and other health care providers to
 protect the privacy of your health information. Here is a list of common
 questions about HIPAA and when health care providers may discuss or
 share your health information with your family members, friends, or others
 involved in your care or payment for care.

1.  If I do not object, can my health care provider share or discuss my
 health information with my family, friends, or others involved in my
 care or payment for my care?
Yes. As long as you do not object, your health care provider is allowed
 to share or discuss your health information with your family, friends,
 or others involved in your care or payment for your care. Your
 provider may ask your permission, may tell you he or she plans to discuss the
 information and give you an opportunity to object, or may decide, using
 his or her professional judgment, that you do not object. In any of
 these cases, your health care provider may discuss only the information
 that the person involved needs to know about your care or payment for
 your care. Here are some examples:
- An emergency room doctor may discuss your treatment in front of your
 friend when you ask that your friend come into the treatment room.
- Your hospital may discuss your bill with your daughter who is with
 you at the hospital and has questions about the charges.
- Your doctor may talk to your sister who is driving you home from the
 hospital about your keeping your foot raised during the ride home.
- Your doctor may discuss the drugs you need to take with your health
 aide who has come with you to your appointment.
- Your nurse may tell you that she is going to tell your brother how
 you are doing, and then she may discuss your health status with your
 brother if you did not say that she should not. BUT:
- Your nurse may not discuss your condition with your brother if you
 tell her not to.

2.  If I am unconscious or not around, can my health care provider
 still share or discuss my health information with my family, friends, or
 others involved in my care or payment for my care?
Yes. If you are not around or cannot give permission, your health care
 provider may share or discuss your health information with family,
 friends, or others involved in your care or payment for your care if he or
 she believes, in his or her professional judgment that it is in your
 best interest. When someone other than a friend or family member is
 asking about you, your health care provider must be reasonably sure that you
 asked the person to be involved in your care or payment for your care.
 Your health care provider may share your information face to face,
 over the phone, or in writing, but may only share the information that the
 family member, friend, or other person needs to know about your care
 or payment for your care. Here are some examples:
o A surgeon who did emergency surgery on you may tell your spouse about
 your condition, either in person or by phone, while you are
 unconscious.
o A pharmacist may give your prescription to a friend you send to pick
 it up.
o A doctor may discuss your drugs with your caregiver who calls your
 doctor with a question about the right dosage. BUT:
o A nurse may not tell your friend about a past medical problem that is
 unrelated to your current condition.

3.  Do I have to give my health care provider written permission to
 share or discuss my health information with my family members, friends, or
 others involved in my care or payment for my care?  HIPAA does not
 require that you give your health care provider written permission.
 However, your provider may prefer or require that you give written
 permission. You may want to ask about your provider's requirements.

4.  If my family or friends call my health care provider to ask about
 my condition, will they have to give my provider proof of who they are?
 
HIPAA does not require proof of identity in these cases. However, your
 health care provider may have his or her own rules for verifying who is
 on the phone. You may want to ask about your provider's rules.

5.  Can I have another person pick up my prescription drugs, medical
 supplies, or X-rays?
Yes. HIPAA allows health care providers (such as pharmacists) to give
 prescription drugs, medical supplies, X-rays, and other health care
 items to a family member, friend, or other person you send to pick them up.
 

6.  Can my health care provider discuss my health information with an
 interpreter?
Yes. HIPAA allows your health care provider to share your health
 information with an interpreter who works for the provider to help
 communicate with you or your family, friends, or others involved in your care. If
 the interpreter is someone who does not work for your health care
 provider, HIPAA also allows your provider to discuss your health
 information with the interpreter so long as you do not object.

7.  How can I help make sure my health care providers share my health
 information with my family, friends, or others involved in my care or
 payment for my care when I want them to?
Print a copy of this document and discuss it with your health care
 provider at your next appointment. You may also want to share this
 information with your family members, friends, or others involved in your care
 or payment for your care.

8.  Where can I get more information about HIPAA?
The HHS Office for Civil Rights Web site at
 http://www.hhs.gov/ocr/hipaa/ has a variety of resources to help you
 understand HIPAA.
[Source: http://www.hhs.gov/ocr/hipaa/consumer_ffg.pdf 24 Oct 08 ++]


TFL APPOINTMENTS:     With Tricare for Life (TFL) you can manage your
 own health care. There are no special rules for accessing certain types
 of care such as urgent, routine, specialty or preventive care.  While
 you'll never require referrals for any type of care, some services may
 require prior authorization. A prior authorization is a review of the
 requested health care service to determine if it is medically necessary
 at the requested level of care. You will not require prior authorization
 from Tricare unless the covered services have been exhausted under
 Medicare. If needed contact your Tricare for Life contractor for more
 information.
     Make your appointment with your Medicare provider.  Depending on
 the type of care you need, there may be slight differences in how
 Tricare for Life works.

- For Medicare and Tricare-covered services, Medicare pays first and
 TFL pays your remaining coinsurance for Tricare-covered services.
- For services covered by Tricare but not by Medicare, such as care
 received overseas, TFL pays first and Medicare pays nothing.  You must
 pay the Tricare fiscal year deductible and cost shares.  
- For services covered by Medicare but not by Tricare, such as
 chiropractic services, Medicare pays first and TFL pays nothing.  You must pay
 the Medicare deductible and coinsurance.
- For services not covered by Medicare or Tricare, such as cosmetic
 surgery, Medicare and Tricare pay nothing and you must pay the entire
 bill. 
[Source:
 http://tricare.mil/mybenefit/home/Medical/GettingCare/Appointment 24
 Oct 08 ++]


VA HOME LOAN UPDATE 14:    Veterans with conventional home loans now
 have new options for refinancing to a Department of Veterans Affairs (VA)
 guaranteed home loan. These new options are available as a result of
 the Veterans' Benefits Improvement Act of 2008, which the President
 signed into law on 10 OCT 08. "These changes will allow VA to assist a
 substantial number of veterans with subprime mortgages refinance into a
 safer, more affordable, VA guaranteed loan," said Secretary of Veterans
 Affairs Dr. James B. Peake. "Veterans in financial distress due to high
 rate subprime mortgages are potentially the greatest beneficiaries." VA
 has never guaranteed subprime loans. However, as a result of the new
 law VA can now help many more veterans who currently have subprime loans.
 The new law makes changes to VA's home loan refinancing program.
 Veterans who wish to refinance their subprime or conventional mortgage may
 now do so for up to 100% of  the value of the property. These types of
 loans were previously limited to 90% of the value.  Additionally,
 Congress raised VA's maximum loan amount for these types of refinancing
 loans. Previously, these refinancing loans were capped at $144,000. With the
 new legislation, such loans may be made up to $729,750 depending on
 where the property is located.

     Increasing the loan-to-value ratio and raising the maximum loan
 amount will allow more qualified veterans to refinance through VA,
 allowing for savings on interest costs or even potentially avoiding
 foreclosure. Originally set to expire at the end of this month, VA's authority
 to guaranty Adjustable Rate Mortgages (ARMs) and Hybrid ARMs was also
 extended under this new law through 30 SEP 12. Unlike conventional ARMs
 and hybrid ARMs, VA limits interest rate increases on these loans from
 year to year, as well as over the life of the loans. Since 1944, when
 home loan guaranties were offered with the original GI Bill, VA has
 guaranteed more than 18 million home loans worth over $911 billion. This
 year, about 180,000 veterans, active duty servicemembers, and survivors
 received loans valued at about $36 billion. For more information, or to
 obtain help from a VA Loan Specialist, veterans may call VA at
 1-877-827-3702 or visit www.homeloans.va.gov.  [Source: VA News Release 24 Oct
 08 ++]


DIABETES UPDATE 01:   Americans with diabetes nearly doubled their
 spending on drugs for the disease in just six years, with the bill last
 year climbing to an eye-popping $12.5 billion. Newer, more costly drugs
 are driving the increase, said researchers, despite a lack of strong
 evidence for the new drugs' greater benefits and safety. And there are more
 people being treated for diabetes. The new study follows updated
 treatment advice for Type 2 diabetes, issued last week. In those
 recommendations, an expert panel told doctors to use older, cheaper drugs first.
 And a second study, also out on 27 OCT 08, adds to evidence that
 metformin -- an inexpensive generic used reliably for decades -- may prevent
 deaths from heart disease while the newer, more expensive Avandia didn't
 show that benefit. "We need to pay attention to this," said Dr. David
 Nathan, diabetes chief at Boston's Massachusetts General Hospital, who
 wrote an editorial but wasn't involved in the new studies. "If you can
 achieve the same glucose control at lower cost and lower side effects,
 that's what you want to do."

     The studies, appearing in the 27 OCT 08 Archives of Internal
 Medicine, were both funded by federal grants. In one, researchers from
 University of Chicago and Stanford University looked at which pills and
 insulin doctors' prescribed and total medication costs. Diabetes drug
 spending rose from $6.7 billion in 2001 to $12.5 billion in 2007, a period
 when costs dropped for metformin. More patients got multiple
 prescriptions as new classes of drugs came on the market. And more patients with
 diabetes were seeing doctors, increasing from 14 million patients in
 2000 to 19 million in 2007. "There's been a remarkable change in diabetes
 treatments and remarkable increases in the cost of treatments over the
 past several years," said study co-author Dr. Caleb Alexander,
 assistant professor of medicine at the University of Chicago. "We were
 surprised by the magnitude of the changes and the rapid increase in the cost of
 diabetes care." Nearly 24 million Americans, 8% of the population,
 have Type 2 diabetes, which can lead to kidney failure, blindness and
 heart disease. Current guidelines say doctors should prescribe metformin
 (about $30 a month) to lower blood sugar in newly diagnosed patients and
 urge them to eat healthy food and get more exercise. Other drugs can be
 added later, on top of metformin, to help patients who don't meet
 blood sugar goals. The updated guidelines don't include Avandia, which
 costs about $225 a month.

    In the other study, Johns Hopkins University researchers analyzed
 findings from 40 published trials of diabetes pills that measured heart
 risks. Compared to other diabetes drugs or placebo, metformin was
 linked to a lower risk of death from heart problems. The findings hint that
 Avandia has a possible increased risk for heart disease death, but that
 increase wasn't statistically significant, meaning it could have been
 the result of chance. Few of the studies lasted longer than six months.
 The researchers cited a "critical need" for long-term studies of
 diabetes pills and heart risks. Last year, the Food and Drug Administration
 issued a safety alert on Avandia, made by British-based GlaxoSmithKline
 PLC, after another pooled analysis of studies found a risk of heart
 attacks. And in July of this year, FDA advisers said the agency should
 require drugmakers to show new diabetes drugs don't increase heart risks.
 GlaxoSmithKline spokeswoman Mary Anne Rhyne said FDA-approved labeling
 for Avandia says available data on the risk of heart attack are
 inconclusive. The medication, approved in 1999, has been used by well more
 than 7 million patients, she said.  [Source: AP article 27 Oct 08 ++]


VA MOBIL COUNSELING CENTERS:   The first of a fleet of 50 new mobile
 counseling centers for the Department of Veterans Affairs (VA) Vet Center
 program was put into service 22 OCT with the remainder scheduled to be
 activated over the next three months. Each vehicle will be assigned to
 one of VA's existing Vet Centers, enabling the center to improve
 access to counseling by bringing services closer to veterans. The 38-foot
 motor coaches, which have spaces for confidential counseling, will carry
 Vet Center counselors and outreach workers to events and activities to
 reach veterans in broad geographic areas, supplementing VA's 232
 current Vet Centers, which are scheduled to increase to 271 facilities by the
 end of 2009. Vet Centers, operated by VA's Readjustment Counseling
 Service, provide non-medical readjustment counseling in easily accessible,
 consumer-oriented facilities, addressing the social and economic
 dimensions of post-war needs.  This includes psychological counseling for
 traumatic military-related experiences and family counseling when needed
 for the veteran's readjustment. The team leader at each Vet Center will
 develop an outreach plan for use of the vehicle within that region,
 not being limited to the traditional catchment area of a particular Vet
 Center. These vehicles will be used to provide outreach and direct
 readjustment counseling at active-duty, reserve and National Guard
 activities, including post-deployment health reassessments for returning combat
 service members. The vehicles will also be used to visit events
 typically staffed by local Vet Center staff, including homeless "stand downs,"
 veteran community events, county fairs, and unit reunions at sites
 ranging from Native American reservations to colleges. While most of their
 use will be in Vet Centers' delivery of readjustment counseling
 services, the local manager may arrange with VA hospitals or clinics in the
 region to provide occasional support for health promotion activities
 such as health screenings. The normal counseling layout can be converted
 to support emergency medical missions, such as hurricanes and other
 natural disasters. The 50 vehicles are being manufactured for VA by Farber
 Specialty Vehicles of Columbus OH. Home bases of planned vet center
 vehicles will be:

Alabama - Birmingham
Arizona - Chinle & Prescott
Arkansas - Fayetteville
California - Corona, Fresno, Santa Cruz, and Eureka
Colorado - Colorado Springs
Florida - Pensacola
Georgia - Savannah & Macon
Idaho - Boise
Kansas - Wichita
Kentucky - Lexington
Illinois - Springfield
Louisiana - New Orleans
Maine - Caribou & Lewiston
Massachusetts - Springfield
Michigan - Escanaba
Minnesota - St. Paul
Montana - Missoula & Billings
Nebraska - Lincoln
New Mexico -  Sante Fe &  Las Cruces
New York - Watertown
North Carolina - Greenville
North Dakota - Minot &Fargo
Ohio - Dayton
Oregon - Eugene
Pennsylvania - Erie & Scranton
South Carolina - Columbia
South Dakota - Rapid City
Tennessee - Johnson City & Memphis
Texas - Amarillo, Midland, and San Antonio
Utah - Salt Lake City
Vermont - White River Junction
Virginia - Richmond
Washington - Spokane & Tacoma
West Virginia - Morgantown & Beckley
Wyoming - Casper
[Source:    VA Media Relations 22 Oct 08 ++]


MULTIPLE SCLEROSIS UPDATE 01:   Researchers at the University of
 Cambridge in London said 23 OCT they have found that a drug originally
 developed to treat leukemia can halt and even reverse the debilitating
 effects of multiple sclerosis (MS). In trials, alemtuzumab reduced the number
 of attacks in sufferers and also helped them recover lost functions,
 apparently allowing damaged brain tissue to repair so that individuals
 were less disabled than at the start of the study. "The ability of an MS
 drug to promote brain repair is unprecedented," said Dr Alasdair
 Coles, a lecturer at Cambridge university's department of clinical
 neurosciences, who coordinated many aspects of the study. "We are witnessing a
 drug which, if given early enough, might effectively stop the
 advancement of the disease and also restore lost function by promoting repair of
 the damaged brain tissue." The MS Society, Britain's largest support
 charity for those affected by the condition, said it was delighted at the
 trial's results, which must be followed up with more research before
 the drug can be licensed. "This is the first drug that has shown the
 potential to halt and even reverse the debilitating effects of MS and this
 news will rightly bring hope to people living with the condition day
 in, day out," said head of research Lee Dunster.

     MS is an auto-immune disease that affects millions of people
 worldwide, including almost 100,000 in Britain and 400,000 in the United
 States. It is caused by the body's immune system attacking nerve fibres in
 the central nervous system, and can lead to loss of sight and
 mobility, depression, fatigue and cognitive problems. There is no cure, and few
 effective treatments. In the trial, 334 patients diagnosed with
 early-stage relapsing-remitting MS who had not previously been treated were
 given alemtuzumab or interferon beta-1a, one of the most effective
 licensed therapies for similar MS cases. After three years, alemtuzumab was
 found to reduce the number of attacks the patients suffered by 74% over
 the other treatment, and reduce the risk of sustained accumulation of
 disability by 71% over interferon beta-1a. Many individuals who took
 alemtuzumab also recovered some of their lost functions, becoming less
 disabled by the end, while the disabilities of the other patients
 worsened, the study in the New England Journal of Medicine said. Alastair
 Compston, professor of neurology and head of the clinical neurosciences
 department at Cambridge, said alemtuzumab was the "most promising"
 experimental drug for the treatment of MS. He expressed hope that further
 trials "will confirm that it can both stabilise and allow some recovery of
 what had previously been assumed to be irreversible disabilities".
 Alemtuzumab was developed in Cambridge and has been licensed for the
 treatment of chronic lymphocytic leukaemia. [Source: Yahoo Health Alice
 Ritchie article 23 Oct 08 ++]


ID CARD EXPIRATION DATE:    Before Tricare For Life (TFL) was enacted
 in 2001, the military ID card expiration date indicated when you dropped
 off the Tricare Prime or Standard rolls upon turning age 65. Card
 holders age 65 and older with TFL will continue to see the expiration date
 on the back of their card in the medical block, under "EXP DATE". The
 processes used for issuing military ID cards do not allow for an
 "indefinite" or blank input in the expiration block. At present costs for
 changing the systems are prohibitive. So a date will continue to be printed
 for the foreseeable future as DoD hashes out the options. DoD Tricare
 Management Activity is aware of the issue and has passed the word to
 all contracted health providers and military treatment facilities. These
 agencies have been told to not pay as much attention to the ID card as
 to their online information in the Defense Enrollment Eligibility
 Reporting System (DEERS). DEERS has your most current eligibility
 information. Of course, as with most large organizations like the health service
 community, someone will not get the news and occasionally deny a
 retiree health service based on the expired ID card date. If this should
 happen to you, ask the service provider to perform an interactive DEERS
 query rather than rely on the ID card information. And have your Medicare
 Part A and B card ready.  [Source: MOAA News Exchange 22 Oct 08 ++]


SALUTING the FLAG UPDATE 03:    The 2009 NDAA clarified actions to be
 taken during the playing of the National Anthem.  It authorizes
 individuals in uniform to give the military salute at the first note of the
 anthem and maintain that position until the last note. Members of the
 Armed Forces and veterans who are present but not in uniform may render the
 military salute in the manner provided for individuals in uniform; and
 all other persons present should face the flag and stand at attention
 with their right hand over the heart, and men not in uniform, if
 applicable, should remove their headdress with their right hand and hold it
 at the left shoulder, the hand being over the heart. 

     On 29 JAN 08, President Bush signed a law amending federal code to
 allow a veteran to salute the U.S. flag while not in uniform in
 certain, but not all, situations. The amended federal code addresses actions
 for a viewer of the U.S. flag during its hoisting, lowering or passing.
 In these instances, the law allows a veteran in civilian attire to
 salute the flag. All other persons present should face the flag, or if
 applicable, remove their headdress with their right hand and hold it at
 the left shoulder, the hand being over the heart. Citizens of other
 countries present should stand at attention. All such conduct toward the
 flag in a moving column should be rendered at the moment the flag passes.
 However, another section of federal code that specifically relates to
 actions of those reciting the Pledge of Allegiance was not amended. In
 this case, a veteran in civilian attire is not specifically authorized
 to render a hand salute during the Pledge. In any case, a veteran in
 civilian clothes is authorized to place their right hand over their heart
 as has been tradition. [Source: NCOA Leg Actions 22 Oct 08 ++]


VA FRAUD UPDATE 13:   An Arlington County man has pleaded guilty to
 swindling the U.S. Department of Veterans Affairs Department for more than
 $60,000 over a four-year period, federal court documents said. Willie
 Brian Williams pleaded guilty 17 OCT after a Veterans Affairs
 investigator learned late last year that Williams had been employed between APR
 00 and OCT 04 while still collecting $61,190 in unemployment benefits
 from the department, court documents said. During those four years,
 Williams earned about $185,000 as an employee of Sterling, Va.-based
 ABBTECH Staffing Services, court records said. While employed by the
 temporary staffing firm, Williams worked as a "help desk manager" at Lockheed
 Martin Federal Systems in Springfield. According to court records,
 Williams reportedly told investigators he intentionally did not report the
 income to Veterans Affairs in order to keep his unemployment benefits.
 In a JUN 05 handwritten letter, Williams continued the ruse, telling
 Veterans Affairs officials he had "not worked in a very long time." He
 faces up to five years in prison and a $250,000 fine.  [Source: D.C.
 Examiner Freeman Klopott article 16 Oct 08 ++]


PENNSYLVANIA VET CEMETERY UPDATE 03:   The Department of Veterans
 Affairs had announced its decision to accept applications for interment of
 deceased military veterans at the Washington Crossing National Cemetery.
 According to a statement released by the VA, families who are
 temporarily keeping the remains of loved ones in cremation urns or in other
 cemeteries should call the National Cemetery Scheduling Office in St.
 Louis at 800-535-1117 for more information. The first phase of construction
 for the 205-acre cemetery is expected to start in the spring, with
 burials expected to begin late next year, VA officials said. VA
 spokesperson Jo Schuda said that, like all veterans cemeteries, Washington
 Crossing will not accept plot reservations. "The process is different than it
 is with cemeteries in the private sector," she said. "We only accept
 applications after the passing. Hopefully this will bring some peace of
 mind to the families of veterans who have been holding onto cremated
 remains." Schuda also confirmed that spouses and dependent children of
 veterans may also be laid to rest at the cemetery.  [Source: Bucks County
 Courier Times Christian Menno article 16 Oct 08 ++]


BACK PAY INTEREST:    Black World War II soldiers wrongly convicted of
 murder and inciting a riot at Fort Lawton, Wash., are entitled to
 receive back pay with interest after having their paychecks cut as
 punishment in 1945. Rep. Jim McDermott, D-Wash., announced that President Bush
 had signed a bill 14 OCT that would award back pay plus interest to any
 service member who was owed back pay due to a correction of military
 records. The bill came after Jack Hamann wrote a book called "On American
 Soil" detailing the killing of an Italian prisoner of war by a white
 American soldier because the Italian had been flirting with American
 women on post. Italian prisoners of war were allowed to roam freely at the
 time. The American soldier tried to cover up the murder -- the Italian
 was hung from a tree -- by starting a fight between other Italian POWs
 and black American soldiers who were in a barracks adjacent to where
 the prisoners were being held. In a quick trial, three black soldiers
 were convicted of murder and 40 were convicted of rioting. Many were sent
 to prison, and most were dishonorably discharged. Hamann's book showed
 the men were innocent and that the evidence against them was flimsy at
 best. "Justice has prevailed, but more than that, the dignity, courage
 and honor lived by Samuel Snow, Booker Townsell and other
 African-American soldiers throughout a half century of racial injustice will write
 a new chapter in American history that children will learn about for
 generations to come," McDermott said.

     "While no amount of money can ever repay the lost opportunities
 endured by these African-American soldiers, they would be the first to
 say it was never about money; it was always about equal protection under
 the law for everyone in America." The new bill allows the secretary of
 defense to pay interest on back pay, which had previously been illegal.
 Samuel Snow of Leesburg FL was among the 28 black soldiers falsely
 convicted. Snow, a teenager at the time, served almost 12 months in a
 military prison and then was dishonorably discharged from the Army. Snow
 died last July at age 83 only hours after receiving an honorable
 discharge and an Army apology during a ceremony in Seattle. Snow always said
 that he had nothing to do with the riot. Last year, the Army overturned
 Snow's conviction and he was sent a check for $725. But the amount was
 not adjusted for inflation. That led Nelson to take up Snow's cause and
 pressure the Army to include the interest. He joined U.S. Rep. Jim
 McDermott, D-Seattle, to place legislation in a military appropriations
 bill that awards back pay plus interest to veterans who have had their
 convictions overturned. Now that the bill has been signed into law Snow's
 family has received another check for $28,305 which is the $725
 compounded over 60 years at 6% interest. [Source: ArmyTimes Kelly Kennedy
 article 19 Oct 08 ++]


VETERANS DAY:   World War I - known at the time as "The Great War" -
 officially ended when the Treaty of Versailles was signed on 28 JUN 19 ,
 in the Palace of Versailles outside the town of Versailles , France.
 However, fighting ceased seven months earlier when an armistice or
 temporary cessation of hostilities, between the Allied nations and Germany
 went into effect on the eleventh hour of the eleventh day of the eleventh
 month. For that reason, 11 NOV 18, is generally regarded as the end of
 "the war to end all wars."  In November 1919, President Wilson
 proclaimed 11 NOV as the first commemoration of Armistice Day. 

     The original concept for the celebration was for a day observed
 with parades and public meetings and a brief suspension of business
 beginning at 11 a.m.  Congress officially recognized the end of World War I
 when it passed a concurrent resolution on 4 JUN 26, with these words:
Whereas the 11th of November 1918, marked the cessation of the most
 destructive, sanguinary, and far reaching war in human annals and the
 resumption by the people of the United States of peaceful relations with
 other nations, which we hope may never again be severed, and
Whereas it is fitting that the recurring anniversary of this date
 should be commemorated with thanksgiving and prayer and exercises designed
 to perpetuate peace through good will and mutual understanding between
 nations; and
Whereas the legislatures of twenty-seven of our States have already
 declared November 11 to be a legal holiday: Therefore be it Resolved by
 the Senate (the House of Representatives concurring), that the President
 of the United States is requested to issue a proclamation calling upon
 the officials to display the flag of the United States on all
 Government buildings on November 11 and inviting the people of the United States
 to observe the day in schools and churches, or other suitable places,
 with appropriate ceremonies of friendly relations with all other
 peoples.

     An Act approved 13 MAY 38, made the 11NOV of each year a legal
 holiday - - a day to be dedicated to the cause of world peace and to be
 thereafter celebrated and known as "Armistice Day." This was primarily a
 day set aside to honor veterans of World War I, but in 1954, the 83rd
 Congress, at the urging of the veterans service organizations, amended
 the Act of 1938 by striking out the word "Armistice" and inserting in
 its place the word "Veterans." With the approval of this legislation
 (Public Law 380) on 1 JUN 54, November 11th became a day to honor American
 veterans of all wars. Later that same year, on 8 OCT President
 Eisenhower issued the first "Veterans Day Proclamation" which stated: "In order
 to insure proper and widespread observance of this anniversary, all
 veterans, all veterans' organizations, and the entire citizenry will wish
 to join hands in the common purpose. Toward this end, I am designating
 the Administrator of Veterans' Affairs as Chairman of a Veterans Day
 National Committee, which shall include such other persons as the
 Chairman may select, and which will coordinate at the national level
 necessary planning for the observance. I am also requesting the heads of all
 departments and agencies of the Executive branch of the Government to
 assist the National Committee in every way possible." 

     In 1958, the White House advised VA's General Counsel that the
 1954 designation of the VA Administrator as Chairman of the Veterans Day
 National Committee applied to all subsequent VA Administrators. Since
 MAR 89 when VA was elevated to a cabinet level department, the Secretary
 of Veterans Affairs has served as the committee's chairman.  The
 Uniforms Holiday Bill (Public Law 90-363)) was signed on 28 JUN 68, and was
 intended to insure three-day weekends for Federal employees by
 celebrating four national holidays on Mondays: Washington's Birthday, Memorial
 Day, Veterans Day, and Columbus Day. It was thought that these extended
 weekends would encourage travel, recreational and cultural activities
 and stimulate greater industrial and commercial production. Many states
 did not agree with this decision and continued to celebrate the
 holidays on their original dates.

     The first Veterans Day under the new law was observed with much
 confusion on 25 OCT 71. It was apparent that the commemoration of this
 day was a matter of historic and patriotic significance to a great number
 of our citizens, and so on 20 SEP 75 President Ford signed Public Law
 94-97 which returned the annual observance of Veterans Day to its
 original date of 11 NOV, beginning in 1978. This action supported the
 desires of the overwhelming majority of state legislatures, all major
 veterans service organizations and the American people. Veterans Day continues
 to be observed on 11 NOV, regardless of what day of the week on which
 it falls. The restoration of the observance to 11 NOV not only
 preserves the historical significance of the date, but helps focus attention on
 the important purpose of Veterans Day: A celebration to honor
 America's veterans for their patriotism, love of country, and willingness to
 serve and sacrifice for the common good. [Source:
 http://www1.va.gov/opa/vetsday/ NOV 05]


CRDP UPDATE 43:   Section 642 of the 2008 National Defense
 Authorization Act expanded the eligibility requirements for the Concurrent
 Retirement Disability Payment (CRDP), beginning on 1 OCT. Retirees who were
 rated by the VA as individually unemployable (IU) and are receiving VA
 disability compensation as a result of IU status, are eligible to receive
 full concurrent receipt of both their VA compensation and retired pay.
  This section of the 2008 NDAA is retroactive to 1 JAN 05. The Defense
 Accounting and Finance Center (DFAS) will begin paying approximately
 40,000 veterans their fully restored retired pay beginning 3 NOV.  The
 November payday reflects their October entitlement.  Eligible retirees
 will see their fully restored retired pay reflected on their Retired
 Account Statements which will be available on myPay. The law also provided
 for a retroactive payment back to January 2005, if applicable.  DFAS
 is beginning payment of these retroactive payments.  Cases that are less
 complicated, such as straight CRDP and certain blended cases, will be
 paid first as these are capable of being automatically computed.
  Approximately 20,000 cases fall in this category.  Retirees should begin
 seeing this one-time payment in November. The more complicated cases, for
 example garnishments and former spouse payments, require more in-depth
 adjudication.  DFAS workers will compute these cases as quickly as
 possible while ensuring accurate payments, said officials.  The goal is to
 have all retroactive payments under this section of the law completed
 by MAR 09. Retirees can log on to the DFAS Web site under "Retired Pay"
 at http://www.dfas.mil/retiredpay.html  to find out more information on
 Section 642 such as viewing frequently asked questions, eligibility
 criteria, and the current adjudication status.  [Source: NAUS weekly
 update 17 Oct 08 ++]


GOLDEN CORRAL MILITARY BUFFET:   On Monday 17 NOV 08 from 5 to 9 pm,
 all 485 Golden Corral restaurants across America will offer any person
 who has served in the United States Military (including National Guard
 and Reserves) a "thank you" dinner buffet and beverage on the house - no
 identification required.  This will be the eighth annual "thank you"
 dinner for our nation's heroes from Golden Corral restaurants, who have
 provided over 1,835,000 complimentary meals to military personnel over
 the history of the event and contributed over $2.53 million to the
 Disabled American Veterans organization. For the second year, Golden
 Corral's guests and restaurant teams may send personal greetings to America's
 military personnel on active duty overseas.   From 1 SEP through 17 NOV
 08, special postcards will be available at all Golden Corral
 restaurants for sending messages of thanks and encouragement to the troops
 overseas. They will be delivered to our troops prior to the Holidays.   In
 2007, over 55,000 Military Appreciation post cards were delivered to
 military troops stationed overseas. To locate a restaurant near you refer
 to http://www.goldencorral.net/ and enter your zip code. [Source:
 www.goldencorral.net 21 Oct 08 ++]


MCCORMICK & SCHMICK'S VET TRIBUTE:  Sunday, 9 NOV is the date that
 McCormick and Schmick's Seafood Restaurants around the country will salute
 veterans.  They will be offering a complimentary entrée from a special
 menu.  Veterans are encouraged to make reservations and bring proper ID
 to present to your server.  Proper ID includes retired military ID
 cards, membership card in a veterans organization like NAUS or a copy of
 your DD-214 discharge papers.  Most restaurants will not be able to seat
 parties over six people in order to accommodate more veterans.  To
 find the participating McCormick & Schmick's restaurant nearest to you
 refer to
 http://www.mccormickandschmicks.com/index.cfm?fuseaction=content.display&pageID=263.
  [Source: NAUS Weekly Update 24 Oct 08 ++]


NEBRASKA VET CEMETERY UPDATE 01:   Ground was broken 17 OCT southeast
 of Alliance for the first Nebraska Veterans Cemetery. The property,
 consisting of 20 acres, was donated by the City of Alliance and was once
 farmland until 1942 when it was converted to the Alliance Army Air Field
 to train paratroopers for World War II. The U.S. Department of Veterans
 Affairs will provide $2.9 million for the first phase of construction
 on a 12-acre area. It will include more than 2,500 burial sites,
 roadways, walking paths and an entry monument. When complete, the cemetery is
 expected to accommodate 8,500 burial sites. The VA has committed
 approximately $5 million for the project. The site will be open to veterans,
 their spouses and dependent children. The legislation to create the
 Nebraska State Veterans Cemetery was passed during the 2006 legislative
 session, 10 years after the High Plains Cemetery Task Force formed to
 spearhead the project. The project will involve two phases. Phase 1A will
 consist of 2,549 burial sites, roadways, entry monument, memorial
 walk, fencing and landscaping. Phase 1B will include an administrative and
 maintenance building, committal shelter with plaza, an avenue of flags
 and scattering garden. [Source: Star-Herald Reporter Tonya Wieser
 article 17 Oct 08 ++]


GULF WAR SYNDROME UPDATE 04:   A new study concludes that informal
 communication among British veterans of the first Iraq war may have shaped
 the vets' characterization of Gulf War Syndrome. After the bullets
 stopped flying, the rumors took off among British veterans of the 1991 Gulf
 War. Early accounts of physical and emotional reactions to wartime
 experiences spread from one person to another through networks of
 veterans. Within a few years, these former soldiers had decided among
 themselves that many of them suffered from the controversial illness known as
 Gulf War Syndrome, Simon Wessely of King's College London and his
 colleagues analyzed extensive written accounts provided in 1996, five years
 after the Gulf War, by 1,100 British Gulf War vets participating in a
 larger survey of veterans' health. Vets described their wartime
 experiences and related what had happened in the conflict to their later health
 and illness. The research team doesn't regard rumor as necessarily
 untrue or misleading. Rumor proved to be critical among the British Gulf War
 vets because it counteracted a lack of communication from military and
 government authorities regarding possible wartime health risks,
 Wessely says. Scared and confused vets turned to their own social grapevine
 for answers, Wessely's group reports in an upcoming Social Science &
 Medicine. Out of their shared stories and explanations grew a collective
 conviction that Gulf War Syndrome existed as a unitary illness with
 elusive causes.

     "The nature of Gulf War Syndrome in the years after the conflict
 was keenly shaped by these early rumors, which entangled specific ideas
 about the illness with feelings of betrayal, distrust and ambiguity,"
 said Wessely. Symptoms attributed to Gulf War Syndrome include joint and
 muscle pain, bouts of depression or violent behavior and cancers of
 various types. Some researchers regard the condition as a psychological
 disorder related to the stress of combat. Others, as well as many vets,
 contend that it's a physical disorder caused by exposure to toxic
 substances shortly before or during the war. By 2001, an estimated 15% to
 20% of those who served in the Gulf War believed that they suffered from
 Gulf War Syndrome. Current medical consensus holds that Gulf War
 veterans indeed display unusually high rates of various health problems, but
 that these conditions don't constitute a discrete illness or syndrome,
 Wessely says. Research on this issue remains contentious. In a
 commentary slated to be published with the new study, Thomas Shriver of
 Oklahoma State University in Stillwater and Sherry Cable of the University of
 Tennessee in Knoxville say that Wessely's team appears to regard
 veterans' symptoms as purely psychological and perhaps partly invented out of
 rumor. "The authors come perilously close to blaming the victims," the
 two sociologists contend. U.S. Gulf War vets used rumors early after
 their return to define collective grievances and develop a plan to press
 authorities for medical treatment and compensation, Shriver and Cable
 say. But, Wessely responds, "Far from blaming vets, we are shifting the
 spotlight to the role of governments in allowing an information vacuum
 to develop regarding potential health risks, which allowed rumors to
 spread and gain currency after the war."

     Military authorities in the United States and England have learned
 a hard lesson from that experience, he says. Consider that the anthrax
 vaccine was administered to U.S. and British soldiers entering the
 Gulf War, but that the vaccine was given under a code name. Rumors about
 the vaccine spread quickly, including one that soldiers were being
 injected with an experimental AIDS vaccine. Before the 2003 invasion of
 Iraq, U.S and British soldiers were told upfront that they were receiving
 the anthrax vaccine. The new study confirms that rumors about health
 risks, especially from vaccinations and pills, spread rapidly among troops
 just before, during and after the war. About 90% of the survey
 participants listed one or more personal problems, including anger,
 depression, forgetfulness, lumps, rashes, seizures, post-traumatic stress
 disorder, brain lesions, incontinence and self-enforced isolation. More than
 one-third of vets worried about unknown pollutants that had somehow
 entered their bodies. Concern focused on exposure to depleted uranium used
 during the war by U.S. and British forces, tablets and vaccinations
 provided to protect against Iraqi biological and chemical warfare and
 smoke from oil fires set by Iraqi forces as they retreated from Kuwait.
 About two-thirds of vets said that they did not, at the time of the
 survey, suffer from any full-blown illness but still felt susceptible to
 developing Gulf War Syndrome. Most participants also cited a lack of
 confidence in their leaders, from commanders of military units to government
 officials. Frustration over military secrecy and over not knowing whom
 to trust was common. After the war, rumors reaffirmed the social bond
 among returning vets and helped them to shape a bewildering array of
 physical and psychological symptoms into the common burden of Gulf War
 Syndrome, the scientists propose. [Source: Science News Bruce Bower
 article17 Oct 08 ++]


VA CREDIBILITY:    The chairman of the House Veterans' Affairs
 Committee says he completely understands why many veterans have lost confidence
 in the Department of Veterans Affairs. "I am sure there are good
 people working there who are trying very hard and have the best of
 intentions, but they are bunglers," said Rep. Bob Filner (D-CA). "You lose
 confidence in these people by watching them." Filner, a frequent critic of
 VA, cited two examples: the department's abandoned plans to use a
 private contractor to help launch the new GI Bill benefits program next year,
 and VA's order 16 OCT to its 57 regional offices to stop shredding
 documents after veterans' claims materials were found in piles of paper
 waiting to be destroyed. "This is an insult to veterans," Filner said.
 Last week's announcement that VA would implement the Post-9/11 GI Bill by
 next August using in-house resources came after department officials
 spent weeks telling lawmakers they could meet that deadline only with
 outside help, Filner said. "After arguing for months and months that they
 could only do this with a contractor, you have to be concerned about
 whether VA can do it," he said. "This is so important, and people are
 betting on it. VA better get this done." The 16 OCT announcement that VA
 had ordered a system wide freeze on destroying documents came after
 auditors discovered claims and potentially irreplaceable paperwork tagged
 for shredding at four regional offices. Shredding is suspended until
 new paper management procedures are in place. Filner said veterans have
 long complained about claims getting lost in VA bureaucracy. "You are
 supposed to have a sense they may be slow, but at least they will
 eventually do the right thing," he said. Now, he said, the possibility that
 records vital to approving a claim might be destroyed fuels complaints
 that VA is trying to prevent claims from being awarded at all. [Source:
 AirForceTimes Rick Maze article 20 Oct 08 ++]


TRICARE/MEDICARE COMBINED BENEFIT:    Officials want to ensure that
 Tricare beneficiaries who receive a Social Security disability check
 receive the Tricare coverage to which they are entitled. In general, most
 beneficiaries become eligible for Medicare at age 65.  However, many
 beneficiaries under age 65 also qualify for Medicare and there is one
 critical fact they need to know. "Most Tricare beneficiaries who are
 eligible for premium-free Medicare Part A are required under federal law to
 enroll in Medicare Part B to keep Tricare benefits. Medicare Part A
 covers inpatient care in hospitals and skilled nursing facilities. It also
 covers hospice and some home health care. Medicare Part B is medical
 insurance. It helps cover outpatient and physician services as well as
 some physical and occupational therapies and home health care. The
 Medicare Part B monthly premium is currently $96.40 and will remain the same
 for 2009.  Individual premiums could be higher, based on income.
 
          When Medicare coverage is effective, it becomes the primary
 insurance, while Tricare becomes the secondary. Beneficiaries who take
 appropriate steps to maintain their Tricare eligibility will often have
 no out-of-pocket expenses for health care services covered by Medicare
 and Tricare.  Generally, beneficiaries who receive social security
 disability benefits begin receiving Medicare benefits after two years and
 they may choose between options such as Tricare Prime or Tricare for
 Life.  Most will need to have Medicare Part B, although there are some
 exceptions. Whatever they choose, it cannot be emphasized enough that
 beneficiaries need to look carefully at their options before making
 decisions that could result in a loss of Tricare coverage. Factors
 beneficiaries must take into consideration before making a decision when it comes
 to Medicare and Tricare include:
-  Whether their spouse is on active duty;
-  If they are disabled due to injuries while serving on active duty;
-  If they have other health insurance; or
-  If they are enrolled in the uniformed services family health plan or
 Tricare Reserve Select. 

Other factors may also apply, but help is available to understand the
 complexities of this benefit. Detailed information on how Medicare and
 TRICARE work together for eligible beneficiaries under 65 is available
 through the TRICARE Web site at http://www.tricare.mil/medicare , where
 users can also download a new "Using TRICARE and Medicare" flyer.
 Additional resources for Medicare, TRICARE and Social Security information
 are: FAQs at http://www.tricare.mil/faqs/  (select the TRICARE For Life
 category); http://www.medicare.gov  or call 1-800-633-4227;
  http://www.ssa.gov  or call 1-800-772-1213; or contact Wisconsin
 Physicians Service at 1-866-773-0404. [Source: Tricare Press Release 08-105
 dtd 21 Oct 08 ++]


OVERSEAS HOLIDAY MAIL 2008:    The 2008 Christmas holiday mailing
 deadlines have just been announced. If you want your cards, letters, and
 packages to arrive to a military member overseas, or deployed on a Navy
 ship by Christmas, be sure to mail them by the following dates:

For military mail addressed to APO/FPO AE zips 090-098 (except 093); AA
 zips 340; and AP zips 962-966:
* Express Mail: Dec. 18
* First-Class Mail (letters/cards and priority mail): Dec. 11
* Parcel Airlift Mail: Dec. 4
* Parcel Post: Nov. 13

For military mail addressed to APO/FPO AE ZIP 093:
* Express mail Military Service: N/A
* First-Class Letters/Cards/Priority Mail: Dec. 4
* Parcel Airlift Mail: Dec. 1
* Space Available Mail: Nov. 21
* Parcel Post: Nov. 13
[Source: About.com Rod Powers article 19 Oct 08 ++]


VA CLAIM SHREDDING:    Veterans Affairs officials have ordered a halt
 to all document shredding after a routine check found unprocessed
 benefits applications tossed into disposal piles at four regional offices. In
 a conference call with veterans groups 16 OCT, VA officials said the
 department's inspector general found five unprocessed documents waiting
 to be shredded in the Detroit regional office. Three more were found in
 the St. Louis office, two more in Waco, Texas. Officials said more
 were found in a Florida regional office but could not specify how many.
 Leaders at the Veterans of Foreign Wars of the U.S. called the revelation
 a "disgraceful management failure" and called for better enforcement
 of the department's own paperwork safeguards. VFW national commander
 Glen Gardner said in a statement, "With almost 850,000 VA claims in the
 backlog, the question that begs to be asked and answered is how many
 veterans had their disability and compensation claims disappear down a
 paper shredder." The department has 56 regional offices handling benefits
 claims for disability pay, pensions, tuition assistance, home loans and
 other financial issues. The VA would not specify what types of
 documents were found in the shred piles.

     In a statement Secretary of Veterans Affairs James Peake
 acknowledged the misplaced paperwork could have affected some veterans'
 eligibility for the financial aid. "It is unacceptable that documents important
 to a veteran's claim for benefits should be misplaced or destroyed,"
 he said. VA undersecretary for benefits Patrick Dunne ordered the
 regional offices to suspend all document shredding as of 16 OCT until a
 broader investigation into the problem is completed. While the inspector
 general investigation continued, the VA's separate inquiry found nearly
 500 documents improperly placed in shredder bins in about two-thirds of
 the agency's 57 benefits offices. Peake promised any employees found
 improperly disposing of documents would be held accountable and said
 regional directors will now have to certify that no original copies of key
 documents are being destroyed in their offices. Under department rules,
 original copies of military discharge orders, marriage and death
 certificates, and other essential paperwork are returned to veterans or
 families after benefits processors can verify them. Duplicate copies of
 those papers are destroyed after the claims are processed to protect
 veterans' privacy.

     A House committee overseeing the Department of Veterans Affairs
 will hold hearings next month to question VA leaders about documents
 improperly marked for shredding at agency offices around the nation. Rep.
 Bob Filner, (D-CA) chairman of the House Committee on Veterans Affairs,
 said he was outraged by revelations that papers crucial to deciding
 veteran disability and pension claims were being destroyed by VA workers.
 "These guys remind me of the Keystone Kops," Filner said. "This
 completely shatters confidence in the whole VA system. These documents are
 matters of life and death for some of these veterans." Rep. C.W. Bill
 Young, (R-FL) is not on the committee but supports having hearings and
 suggested the problem might be widespread. Some VA employees could face
 legal problems, he said. Filner said he will hold the hearings the week of
 Nov. 17, when a lame-duck session of Congress is expected to convene
 to consider an economic stimulus package. Among those he will call to
 testify are VA Secretary James Peake and investigators for the agency's
 independent watchdog, the inspector general. Rick Weidman, director of
 government relations for the Vietnam Veterans of America, said his group
 has complained to the VA for years about mishandling of documents at
 the regional offices. "I wish we could say we're surprised by this, but
 the only real surprise is that they admitted it," he said. "We told
 (Dunne's) predecessors about this, but nothing has really happened. "We
 can keep holding hearings and filing lawsuits, but I don't know what it's
 going to take to get them to obey the law." [Source: Stars and Stripes
 Leo Shane article 10 Oct 08 ++]


FILIPINO VET INEQUITIES UPDATE 11:   U.S. Senator Daniel K. Akaka
 (D-HI), Chairman of the Veterans' Affairs Committee, responded 20 OCT to
 comments made by the Committee's Ranking Minority Member, Senator Richard
 Burr (R-NC) regarding provisions in S. 1315 that would provide equity
 to Filipino veterans who served under U.S. command during WWII. The
 American Coalition for Filipino Veterans (ACFV) posted a video of Senator
 Burr's comments on YouTube www.youtube.com/watch?v=DNNWTtvQi2Q  in which
 Burr expresses his willingness to negotiate a limited pension for
 Filipino World War II veterans.  According to ACFV, Burr's comments came in
 response to a question from 91-year-old WWII veteran Celestina Almeda,
 who travelled to attend the public event at Davidson College in North
 Carolina on October 9. Akaka responded directly to Burr by letter,
 stating: "I am eager to work with you and hear what level of pension and
 compensation you would be willing to support.  The veterans waiting for
 passage of the equity provisions in S. 1315 are not someone else's
 veterans - they are our veterans.  I am willing to negotiate the extent of
 those benefits with you if you are prepared to recognize them as U.S.
 veterans."  Akaka encouraged immediate discussions in hopes of reaching
 an agreement before the Senate reconvenes as expected following the
 November elections. S. 1315 is the Veterans' Benefits Enhancement Act of
 2007, an omnibus veterans' benefits bill that includes provisions
 providing recognition and benefits for Filipino veterans of World War II who
 served under U.S. military command.  S. 1315 passed the Senate by a vote
 of 96-1, and an amended version later passed the House.  Chairman
 Akaka's motion for a conference between the House and Senate on a final
 version of the bill was then objected to by Senator Burr. [Source: Sen.
 Akaka Press Release 20 Oct 08 ++]


KENTUCKY STATE PARK DISCOUNT:   Active and retired members of the
 military and veterans can take advantage of discount rates at Kentucky's
 state parks with the Kentucky State Parks "USA Military Pass" program from
 2 NOV 08 to 31 MAR 09. The program is available to those on active
 military duty, retired members of the military, veterans, members of the
 National Guard and reservists. Proof of military service is required at
 check-in. With the USA Military Pass, lodge rooms are available for
 $44.95 a night plus tax. The Kentucky State Parks have 17 resorts that
 offer golf, fishing, hiking on scenic trails, beautiful scenery and full
 service restaurants. For more information refer to the Kentucky State
 Parks website www.parks.ky.gov/ or call 1-800-255-7275. [Source: Military
 Report 20 Oct 08 ++]


COLA 2009 UPDATE 05:    The 2009 cost-of-living adjustment (COLA) for
 military retired pay will be the highest seen in over 15 years at 5.8%.
  The increase, which goes into effect on 1 DEC 08, also applies to SBP
 annuities, Social Security checks, and VA disability and survivor
 benefits. Retirees will see the increase in their JAN 09 checks.  The
 annual Cost-of-Living-Adjustment is not in any way related to the annual
 military pay raise for active duty and reserve servicemembers which this
 year was 3.9%. All retirees who retired before 1 JAN 08 will receive the
 5.8% Cost-of-Living-Adjustment. Retirees who first became members of
 the uniformed services on or after 1 AUG 86 and elected to receive a
 Career Status Bonus at 15 years, and retired on or before 1 JASN 08, will
 receive an increase of only 4.8%.  Retirees who first became a member
 of the uniformed services on or after Sept. 8, 1980, and retired in 2008
 will receive a Partial COLA on a prorated basis as follows:
o Jan. 1, 2008, and March 31, 2008, will receive 5.0%
o April 1 - June 30, 2008 will receive 3.8%
o July 1 - Sept. 30, 2008 will receive 1.2%
o Those who retired after Oct. 1, 2008, will see no COLA this year.

This is the third year in the last four that the retiree COLA has been
 higher than the pay raise for currently serving troops. The two are
 never the same because they are based on different things and have
 different purposes. Military pay raises are based on private sector pay
 growth, as measured by the Bureau of Labor Statistics' Employment Cost Index
 (ECI). Their intent is to ensure military pay is kept reasonably
 comparable to private sector pay, to allow the services to compete
 successfully for manpower over time. Retired pay COLAs, on the other hand, are
 cost-of-living adjustments that track to inflation, as measured by the
 Consumer Price Index (CPI). Their purpose is to ensure that whatever
 purchasing power a member's retired pay represented on the date he or she
 left service isn't eroded by inflation over time. Over time, the two
 tend to even out. During the 1970s, COLAs were higher in 5 years and pay
 raises won out for the other five. In the '80s, pay raises beat COLAs (6
 - 4); in the '90s, it was 50-50 split (5 - 5). The first half of this
 decade, pay raises were higher, but with COLAs higher for three of the
 last 4 years, the pendulum seems to be swinging the other way again.
  [Source: MOAA Leg Up 17 Oct & Military Report 20 Oct 08 ++]


SSA COLA 2009 UPDATE 01:   Social Security Announces 5.8 Percent
 Benefit Increase for 2009 Monthly Social Security and Supplemental Security
 Income benefits for more than 55 million Americans will increase 5.8% in
 2009, the Social Security Administration announced.  The 5.8 percent
 increase is the largest since 1982. Social Security and Supplemental
 Security Income benefits increase automatically each year based on the
 rise in the Bureau of Labor Statistics' Consumer Price Index for Urban
 Wage Earners and Clerical Workers (CPI-W), from the third quarter of the
 prior year to the corresponding period of the current year.  This year's
 increase in the CPI-W was 5.8%.  The Cost-of-Living Adjustment (COLA)
 will begin with benefits that over 50 million Social Security
 beneficiaries receive in JAN 09. Increased payments to more than 7 million
 Supplemental Security Income beneficiaries will begin on 31 DEC. Some other
 changes that take effect in January of each year are based on the
 increase in average wages.  Based on that increase, the maximum amount of
 earnings subject to the Social Security tax (taxable maximum) will
 increase to $106,800 from $102,000.  Of the estimated 164 million workers who
 will pay Social Security taxes in 2009, about 11 million will pay
 higher taxes as a result of the increase in the taxable maximum. 
 Information about Medicare changes for 2009 can be found at www.medicare.gov.
 [Source: SSDA Press Release 16 Oct 08 ++]


VA PRESUMPTIVE GULF WAR VET DISEASES UPDATE 01:   The Department of
 Veterans Affairs presumes that specific disabilities diagnosed in certain
 veterans were caused by their military service. If one of these
 conditions is diagnosed in Vietnam Vet, VA presumes that the circumstances of
 his/her service (i.e. exposure to Agent Orange) caused the condition,
 and disability compensation can be awarded. This includes DIC education
 and CHAMPVA for spouses of veterans rated 100% or surviving spouses
 late-veterans that died from discussed medical problems. The following
 disabilities may be presumed for those who served in the Southwest Asia
 Theater of Operations during the Gulf War with condition at least 10%
 disabling by 12/31/11.  Included are medically unexplained chronic
 multi-symptom illnesses defined by a cluster of signs or symptoms that have
 existed for six months or more, such as:
o chronic fatigue syndrome
o fibromyalgia
o irritable bowel syndrome
o amyotrophic lateral sclerosis (ALS)
o any diagnosed or undiagnosed illness that the Secretary of Veterans
 Affairs determines warrants a presumption of service connection

Signs or symptoms of an undiagnosed illness include:  fatigue, skin
 symptoms, headaches, muscle pain, joint pain, neurological symptoms,
 respiratory symptoms, sleep disturbance, GI symptoms, cardiovascular
 symptoms, weight loss, and menstrual disorders. [Source: County of Humboldt
 Veterans Service office 12 Oct 08 ++]


HAVE YOU HEARD:  On some bases the Air Force is on one side of the
 field and civilian aircraft use the other side of the field, with the
 control tower in the middle.  One day the tower received a call from an
 aircraft asking, 'What time is it?' 

The tower responded, 'Who is calling?' 
The aircraft replied, 'What difference does it make?' 
The tower replied, 'It makes a lot of difference........
If it is an American Airlines flight, it is 3 o'clock.
If it is an Air Force plane, it is 1500 hours.
If it is a Navy aircraft, it is 6 bells.
If it is an Army aircraft, the big hand is on the 12 and the little
 hand is on the 3.
If it is a Marine Corps aircraft, it's Thursday afternoon and 120
 minutes to 'Happy Hour.'


VETERAN LEGISLATION STATUS 29 OCT 08:   Refer to the Bulletin's House &
 Senate attachments for or a listing of Congressional bills of interest
 to the veteran community that have been introduced in the 110th
 Congress. Support of these bills through cosponsorship by other legislators
 is critical if they are ever going to move through the legislative
 process for a floor vote to become law.  A good indication on that
 likelihood is the number of cosponsors who have signed onto the bill. A
 cosponsor is a member of Congress who has joined one or more other members in
 his/her chamber (i.e. House or Senate) to sponsor a bill or amendment.
 The member who introduces the bill is considered the sponsor.  Members
 subsequently signing on are called cosponsors. Any number of members may
 cosponsor a bill in the House or Senate. At http://thomas.loc.gov you
 can also review a copy of each bill's content, determine its current
 status, the committee it has been assigned to, and if your legislator is
 a sponsor or cosponsor of it.  To determine what bills, amendments your
 representative has sponsored, cosponsored, or dropped sponsorship on
 refer to http://thomas.loc.gov/bss/d110/sponlst.html.  The key to
 increasing cosponsorship on veteran related bills and subsequent passage into
 law is letting our representatives know of veteran's feelings on
 issues.  At the end of some listed bills is a web link that can be used to
 do that. You can also reach his/her Washington via the Capital Operator
 direct at (866) 272-6622, (800) 828-0498,  or (866) 340-9281 to express
 your views. Otherwise, you can locate on http://thomas.loc.gov who
 your representative is and his/her phone number, mailing address, or
 email/website to communicate with a message or letter of your own making.
  Refer to http://www.thecapitol.net/FAQ/cong_schedule.html for future
 times that you can access your representatives on their home turf.
  [Source: RAO Bulletin Attachment 13 Oct 08 ++] 


Lt. James "EMO" Tichacek, USN (Ret)
Director, Retiree Assistance Office, U.S. Embassy Warden & IRS VITA
 Baguio City RP
PSC 517 Box RCB, FPO AP 96517
Tel: (951) 238-1246 in U.S. or Cell: 0915-361-3503 in the Philippines.
Email: raoemo@sbcglobal.net Web:
 http://post_119_gulfport_ms.tripod.com/rao1.html
AL/AMVETS/DAV/FRA/NAUS/NCOA/MOAA/USDR/VFW/VVA/CG33/DD890/AD37 member

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