PurpleheartOklahoma (scroll down)

OEF and OIF website: http://ptsd.about.com/gi/dynamic/offsite.htm?zi=1/XJ&sdn=ptsd&cdn=health&tm=44&gps=346_120_1023_510&f=10&su=p736.8.336.ip_&tt=6&bt=0&bts=0&zu=http://www.oefoif.va.gov/

VA OEF and OIF Review DECEMBER 2010 •VOl 6| NO 1

http://www.publichealth.va.gov/exposures/oefoif/resources.asp
http://www.publichealth.va.gov/docs/oefoif/oefoif-newsletter-dec2010.pdf

Operation Enduring Freedom and Operation Iraqi Freedom
INFORMATION FOR VETERANS WHO SERVED IN IRAQ AND AFGHANISTAN AND THEIR FAMILIES

VA to Cover New Illnesses for OEF/OIF and Gulf War Veterans
a new VA regulation now makes it easier for Veterans to obtain disability compensation for certain diseases associated with service in Iraq and Afghanistan, as well as the Gulf War.
The final regulation, announced in September 2010, establishes presumptive service-connection for nine specific infectious diseases associated with military service in Southwest Asia during the Gulf War and other conflicts in Iraq from August 2, 1990 to the present; and in Afghanistan on or after September 19, 2001.
“This is part of historic changes in how VA considers Gulf War veterans' illnesses,” said Secretary of Veterans affairs, Eric K.Shinseki. “By setting up scientifically based presumptions of service connection, we give these deserving Veterans a simple way to obtain the medical and compensation benefits they earned in service to our country.”
the regulation affects claims involving the nine diseases listed on page 3. Most of these diseases must be diagnosed within one year of return from service, though some conditions may manifest at a later time. continued on page 3 below.
 
New Research will Increase Understanding of OEF/OIFVeteran health
The national Health Study for a new generation of u.S.Veterans is a 10-year investigation by Va to study the health of oeF/oiF Veterans. the study will look at chronic and acute medical conditions, post-traumatic stress disorder (ptSd), traumatic brain injury (tBi), general health perceptions, reproductive health, pregnancy outcomes, use of health care, behavioral risk factors (e.g., smoking, drinking, sexual behavior,and risky driving), and VA disability compensation.
Launched in 2009, the study has already reached out to assess the health status of a sample of 60,000 Veterans through voluntary surveys and interviews. of this number, 30,000 were deployed to oeF/oiF and 30,000 served elsewhere during the same time period. the study includes Veterans from all branches of service, representing active duty, Reserve, and national guard members.
Twenty percent of the 60,000 Veterans contacted are women.
Over the 10 years of the study, Veterans will be asked to complete surveys about every three years and additional studies may be included in this initiative. the research will help VA plan more effectively to provide the best care possible for thenation’s newest generation of Veterans.
as a follow up within this study, the Mind study (Markers forthe identification, norming, and differentiation of tBi and ptSd)continued on page 2

VA launches IOM study of BurnPit Illnesses in Veterans
Va has commissioned an 18-month study by the National Academy of Sciences institute of Medicine (ioM) to investigate any association between exposure to burn pit smoke in iraq and Afghanistan and illnesses reported by oeF/oiF Veterans.
By mid-2011, the ioM will provide a report of any evidence-based association between exposure to burn pit smoke and long term health effects. Va will then convene a task force to review the ioM report and recommend any updates or changes to benefits and treatment based on the findings.continued on page 2

FEatUREs Va connects Veterans to Benefits and care......................3Va expands efforts to address environmental exposures....4new Benefits available for caregivers................................4Fast Facts: environmental exposures.................................5comprehensive Health care for Women Veterans...........6Va Reaches out via Web and Social Media.........................6Va Simplifies access to ptSd Benefits...............................7WRiiScs provide Specialized Health care..........................7new Hotline for Homeless Veterans...................................8www.publichealth.va.gov/exposures/oefoif2
 
About the OEF/OIF Review
the oeF/oiF Review is produced by Va’s environmental agents Service (eaS) to provide information on health issues and other concerns of operation enduring Freedom and operation iraqi Freedom Veterans, their families, and others interested in possible long-term health effectsof military service in Southwest asia. the Review provides updates on a wide range of Va programs and other Federal resources for Veterans.
This issue was completed in december 2010, and does not include developments that occurred after that time.
For past issues of the newsletter and related informa-tion, see the Web site at www.publichealth.va.gov/exposures/oefoif
.
Questions, comments, and suggestions for future issuesare encouraged and can be sent to: editor, oeF/oiF Review,environmental agents Service (131), u.S. department ofVeterans affairs, 810 Vermont avenue, nW, Washington, dc 20420.

CONtINUED FROM PagE 1 New Research will Increase Understanding of OEF/OIF Veteran Health
will focus on helping clinicians more easily and accurately diagnose tBi and ptSd. traumatic brain injuries are caused byimpacts to the head, which may occur during a fall, motor vehicle crash, or when the brain is shaken during a blast. ptSd is an anxiety disorder that can develop after a person has beenthrough a traumatic event. the symptoms of tBi and ptSd are often similar, affecting how a person thinks and acts.

By closely examining Veterans with tBi and/or ptSd symptoms and comparing them to Veterans without these symptoms, the Mind study will explore the differences betweenthe two conditions and develop more accurate tools for diagnosis and treatment.
For more information, go to www.publichealth.va.gov/newgenerationstudy
or www.publichealth.va.gov/research/epidemiology/research_studies.asp#MIND.

CONtINUED FROM PagE 1 VA Launches IOM Study of Burn Pit Illnesses in Veterans
one of a range of possible benefit changes could include a presumption of service-connection between burn pit exposure and related illnesses. currently, when Veterans apply for benefits,they must provide documentation of their exposure and establish a connection to a particular condition. Such a presumptionwould relieve the Veteran of the burden of proving a connectionbetween burn pit exposure and related illnesses.
Burn pits are areas in which jet fuel is used to burn refuse. Sometimes, especially early in the conflict, the refuse included plastics, metals, rubber, chemicals, petroleum, medical, and human waste.Burn pits and incinerators have been used at u.S. military bases throughout iraq and afghanistan. Smoke from these pits can blow over bases and into living areas.

Short term health effects commonly related to smoke from burn pits include burning eyes, nose, and throat irritation, cough,short-term nausea, headaches, and skin rash. the long term health effects of exposure to burn pit smoke are unknown. the ioM study will assist Va in determining any long term health effects.
Va believes that further scientific investigation will help ensure that Veterans receive appropriate benefits and health care. For more information about potential exposure to toxins fromburn pits, possible health-related problems, and Va benefits, go to www.publichealth.va.gov/exposures/burnpits
.
In Every Issue disability compensation from Va.............................................8Free oiF Health Registry ............................................................9news Briefs–Benefits and care for oeF/oiF Veterans...........9Health conditions Recognized.................................................10Where to get Help and additional information....................11
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the oeF/oiF Review is often posted online before print copies arrive in the mail. Sign up at www.easmailcall.aac.va.gov
to receive noticevia e-mail that the latest newsletter is available.www.publichealth.va.gov/exposures/oefoif3
 

VA Offers “seven touches of Outreach” to Connect OEF/OIF/New DawnVeterans to Va Benefits and Care
 
Va’s outreach efforts connect returning Service members with the various health care, education, and other benefits they have earned in service to the nation.
using in-person outreach events as well as Web and phone-based resources available around the clock, Va works to enroll and register Veterans for their benefits as soon as they are eligible. getting enrolled quickly is critical to accessing important benefits. For instance,guard and Reserve members returningfrom combat are entitled to five years of free Va health care and have 180 days to obtain a one-time dental evaluation and treatment.
Veterans can connect with specially trained Va outreach staff or oeF/oiF program Managers at any–or all–of the following touchpoint opportunities designed to reach Service members at least seven times from the time they deploy through their first six months back home.
touch point 1is Va's Reserve component demobilization initiative where oeF/oiF Veterans returning from the combat zone are introduced to Va services during out-processing at the 61 demobilization sites.
touch point 2is Va's individual Ready Reserve Muster (iRR),where iRR reservists are informed of their enhanced Va health and dental benefits.
touch point 3is Va's combat Veteran call center, which contacts oeF/oiF Veterans to ensure they are aware of Va services and benefits. Veterans may also contact the call center at 866-606-8216.
touch point 4is dod's Yellow Ribbon program (YRp), where Va staff provides "boots on the ground" for Yellow Ribbon events hosted by each of the services during the 30-60-90 days post-deployment cycle. to learn about local YRp events, go towww.jointservicessupport.org/OSD
.
touch point 5is dod's post-deployment Health Reassessment (pdHRa), where Va supports the dod health assessment and is able to link Veterans with appointments for mental health or other follow-up needs.
touch point 6is Va's partnership with the national guard and the training of transition assistance advisors (taas), who work for the adjutant general in each state. taas work to reach out to Veterans and refer them to Va services or benefits.contact information for each state’s taa is available online atwww.vet-trans.org/TAA/SearchTAA.asp
.
touch point 7is the www.oefoif.va.gov
 
Web site that offers in-formation on benefits, answers to questions, a blog community,twitter feeds, and links to hot topics. there is also a section onthe Web site for women Veterans and family members.
in addition to the opportunities noted above, Veterans canconnect to Va benefits and services any time by visiting theirlocal Va Medical center (VaMc) and asking for the oeF/oiFprogram Manager. a directory of VaMcs is available online atwww.va.gov/directory
.

CONtINUED FROM PagE 1 VA to Cover New Illnesses for OEF/OIF and Gulf War Veterans
 
to obtain disability benefits under the new rule, Veterans only have to show service in Southwest asia or afghanistan, and a diagnosis of one of the nine diseases within the designated time period after service. this will reduce the amount of paperworkneeded to apply for benefits and the amount of time required to process claims.
the conditions covered by the ruling are:

• Brucellosis
• campylobacter jejuni
• coxiella burnetii (Q fever)
• Malaria
• Mycobacterium tuberculosis
• nontyphoid Salmonella
• Shigella
• Visceral leishmaniasis
• West Nile Virus

in the past, a Veteran was required to establish through medical evidence an actual connection between military servicein Southwest asia or in afghanistan, and any one of these diseases.
eligible Veterans are encouraged to apply for benefits athttp://vabenefits.vba.va.gov/vonapp
so that claims may beprocessed. information is also available at www.publichealth.va.gov/exposures/gulfwar/compensation_benefits.asp
.
For more information about health problems associated with military service during operations desert Shield, desert
Storm, enduring Freedom and iraqi Freedom, as well information about disability compensation and other Va benefits, go to www.publichealth.va.gov/exposures/oefoif

VA Expands Efforts to address Environmental Exposures: working with DoD to Identify and Contact affected Veterans
 
Va monitors numerous hazards in iraq, afghanistan, and othermilitary installations that could potentially present health risksto Service members and Veterans.
in a letter to Va Regional offices (VaRos) in april 2010, Va noted that “it is imperative that regional office personnelare aware of these environmental health hazards and are well-trained to handle disability claims from Veterans based on exposure to them.”
Recognizing that not all Veterans may be aware of their exposure during service, Va is also providing information to clinicians about which Veterans may have been affected andwhen to ask about exposures.
potential exposures for Veterans of iraq and afghanistan include burn pits; particulate matter; sulfur fires; and hexavalentchromium exposure at Qarmat ali Water treatment plant in Basrah, iraq in 2003. other potential exposures include contaminated drinking water at camp Lejeune between 1953 to 1987 and Veterans exposed to pollutants from a waste incinerator near the naval air Facility in atsugi, Japan, from the early 1980s to 2001.
Va is working with the department of defense to identifyand contact individuals who may have been exposed to specific
environmental hazards while serving in the military. However,it may not be possible to identify all individuals because someexposures, such as burn pits, are widespread. Veterans who believe they may have been exposed to one or more of thesehazards are encouraged to contact their local Va environmentalHealth coordinator www.publichealth.va.gov/exposures/coordinators.asp
.
Potential Environmental Exposures in Iraq andAfghanistan
• Burn pits:areas used to burn waste products at most forward operating bases.
• Particulate matter:extremely small particles and droplets in the air, such as those from dust storms and emissions from local industries.
• Sulfur fire:Sulfur dioxide and hydrogen sulfide releasedduring the June 2003 fire at Mishraq State Sulfur Minenear Mosul, iraq.

New Benefits available for OEF-OIF Veteran Caregivers
 
a new law will allow Va to provide primary caregivers of Veterans of all eras with increased support and resources.caregivers play a vital role in the lives of Veterans, especially as a new era of younger, severely injured Service members return from iraq andafghanistan.
"caregivers are the family members and loved ones who take care of the severely injured Veterans who need assistance on a daily basis," said Va Secretary eric K. Shinseki. "these mothers, wives, fathers, husbands, and other loved ones make tremendous sacrifices to be there every day for the Veterans who served
this nation. they are our partners in Veteran health care andthey deserve our support."
Va is rolling out a variety of programs for Veteran caregiversin 2011. these include a caregiver Helpline, a comprehensive caregiver Web site, and a variety of caregiver support and training programs. Va has been consulting with Veterans organizations,as well as individual Veterans and their family members, to ensure
these new programs are implemented to provide the best possible support for those who have sacrificed so much.
the law authorizes Va to provide primary caregivers ofoeF/oiF Veterans with training, support, and access to healthcare coverage, including mental health counseling. it will also allow eligible caregiversto receive stipends, travel assistance to attend appointments, family assistance, and respitecare when appropriate.
these benefits will add to the range of compassionate and practical programs forVeteran caregivers currently available from Va, including in-home and community–basedcare, respite care, education and training, and family supportservices. For more information, go to www.caregiver.va.gov
.
to access these caregiver programs, contact the caregiver Support coordinator at the nearest Va Medicalcenter (VaMc). a directory of VaMcs is available online at www.va.gov/directory
.
“Caregivers… are our partners in Veteran health care and theydeserve our support.”www.publichealth.va.gov/exposures/oefoif45
 
Fast Facts: Environmental Exposures
toxic Embedded Fragments
an embedded fragment (also called ‘shrapnel’) is a pieceof metal or other material that stays in the body afterexposure to a blast or other similar traumatic incident.the word “toxic” pertains to fragments from potentiallyharmful materials.
Va’s toxic embedded Fragment Surveillance center(teFSc) in Baltimore, Md provides special testing forchemicals that may be released by the fragments andmaintains a health registry of Veterans with fragmentsin their bodies.
oeF/oiF Veterans who believe they may be affected by toxic embedded fragments and who would like anevaluation can contact the environmental Health (eH)coordinator at their local Va Medical center. the eH coordinator may refer Veterans to the teFSc.
For more information, go to www.publichealth.va.gov/exposures/toxic_fragments /surv_center.asp
.
Depleted Uranium
depleted uranium (du) has been used in u.S. militarytank armor and some bullets since the early 1990s.
exposure to depleted uranium is a potential health hazard if it enters the body, such as through embedded fragments(shrapnel), contaminated wounds, and inhalation or ingestion. Soldiers who were on, in, or near vehicles hit with "friendly fire;” rescuers entering burning vehicles,and those near burning vehicles; soldiers who served near fires involving du munition; and those salvaging damaged vehicles are among those who may have been exposed to depleted uranium. Simply riding in a vehicle with du weapons or du shielding will not expose a servicemember to significant amounts of du or external radiation.
to date, no health problems have been found to be associated with du exposure, however Va researchers andclinicians continue to monitor the health of these Veterans.
For more information, go to www.publichealth. va.gov/exposures/depleted_uranium/index.asp.

Exposures in qarmat ali
approximately 830 Servicemembers including nationalguard, active component, and Reserve troops, whoworked at the Qarmat ali water treatment plant in Basrah, iraq, in the spring or summer of 2003 mayhave been exposed to sodium dichromate, containingthe hexavalent chromium. Many of the guard/Reservemembers were from indiana, South carolina, WestVirginia, and oregon.
the chemical was used as an anti-corrosion agent by previous workers at the plant and was found on the groundafter bags of the chemical were opened at the site. Short-term health effects can include respiratory problems, skinrashes, eye irritation, nasal sores, and other health effects.Long-term exposure can cause lung cancer. Va has developed a medical surveillance program to track possiblehealth concerns among these Veterans.
For more information, go to www.publichealth.va.gov/ exposures/oefoif/qarmat-ali
.
Veterans concerned about health problems associatedwith toxic embedded fragments, depleted uranium, exposure to hexavalent chromium, or other environmentalhealth concerns may contact the oeF/oiF programManager or environmental Health (eH) coordinator attheir nearest Va Medical center.
a listing of Eh Coordinators is available online atwww.publichealth.va.gov/exposures/coordinators.asp
and a list of Va medical facilities is located atwww.va.gov/directory
Information is also available through Va’s health Resource Center helpline at1-866-606-8216+
Va Reaches Out to OEF/OIF Vets via web and social Media
 
the oeF/oiF Web site—www.oefoif.va.gov
—welcomes homeVeterans of the iraq and afghanistan conflicts with a social, informative Web site focused on their needs and questions. Va seeks to make the site a helpful and engaging resource for returning Veterans. the Web site features videos, Veteran stories, Q&as, and information on Va benefits and resources.
Va is also reaching out via Facebook and twitter, engagingVeterans in social networking communities and via micro-blogging. these sites allow Va to update Veterans onnew health and benefits information, as well as open a dialogue between Veterans and Va.
Va’s Facebook page, www.facebook.com/Veteransaffairs
, has over 80,000 fans and provides a forum for Veterans to share experiences and information. the twitter page,@deptVetaffairs or http://twitter.com/deptVetaffairs
, has over 10,000 followers and publicizes a steady flow of “tweets” about Va initiatives, news, health tips, benefits, profiles of Veterans, and events.
in addition to the main Va pages, several other Va departments maintain Facebook and twitter pages, includingthe Veterans Health administration, Veterans Benefitsadministration, and national cemetery administration. ManyMedical centers across the country have also launched theirown pages with information about local resources and events.
stay in touch with Va Online
Twitter: Follow @deptVetaffairs @VaVetBenefits
@VeteransHealth @Vanatcemeteries
Facebook: Become a fan atwww.facebook.com/Veteransaffairswww.facebook.com/VeteransHealthwww.facebook.com/VeteransBenefits www.facebook.com/nationalcemeteries
YouTube: Watch videos atwww.youtube.com/user/deptVetaffairswww.youtube.com/user/VeteransHealthadmin
Blogs: Read and comment at www.blogs.va.gov/Vantage
Mobile Web site: Keep up with news on the go at m.va.gov
OEF/OIF Web site: Find information at www.oefoif.va.gov
 

Comprehensive health Care for women Veterans: You served, You Deserve the Best Care anywhere
 
as the frontlines of battle and the rules of warfare havechanged dramatically in the last 50 years, so has the face of the u.S. military and the Veteran population.
Va now treats more women Veterans thanever before. Women make up more than 11percent of the Veterans who served in thecurrent conflicts in iraq and afghanistan.almost half of these female oeF/oiF Veteranshave enrolled in Va health care, and it is expected that these numbers will continue to increase over the next few years.
Va is committed to providing a comprehen-sive approach to women Veterans’ health care needs, including primary care, preventive care screenings for breast andcervical cancer, gender-specific mental health care, and beyond.
to better serve women Veterans’ needs, Va is launching a number of programs to address provider education and has increased access through clinic enhancements and hometele-health. they have also begun to focus on the developmentand improvement of clinical services andcreated a system-wide focus on continuity of care.
at each Va Medical center (VaMc) nationwide, a Women Veterans programManager is designated to help provide thequality care women Veterans need and deserve. the program Manager can help coordinate the range of available services,from primary care to medical services toMental Health and Sexual abuse counseling.
contact the Women Veterans program Manager at any VaMc or call 1-877-222-8387to find the nearest Va facility.Learn more about Women Veterans Health care online atwww.publichealth.va.gov/womenshealth
. www.publichealth.va.gov/exposures/oefoif6
Va simplifies access to health Care and Benefits for Veterans with PTSD
 
Va streamlined its process to provide health care and disability compensation for Veterans with post-traumatic stressdisorder (ptSd), with the publication of a final regulation in theFederal Register in July 2010.
the rule, which applies to Veterans of all eras, will simplify the process for a Veteran to establish service-connection forptSd by reducing the evidence needed to support a claim.
While each claim will be evaluated and require confirmation by a Va psychiatrist or psychologist, the new process is
expected to allow for faster and more accurate decisions to help connect Veterans to medical care and other benefits available through Va.
More than 400,000 Veterans with ptSd currently receive Va compensation benefits. ptSd is an anxiety disorder withsymptoms that include recurrent thoughts of a traumatic event,emotional numbing, hyperalertness, anxiety, and irritability.
For more information, go to www.va.gov
or call 1-800-827-1000.

wRIIsCs Provide specialized healthCare for Combat Veterans
When Charonda Taylor was in the Air Force, she received numerous awards and decorations for outstanding performance.But when she returned to civilian life, she faced several unexpected challenges with her health and well-being.
Taylor enlisted in the Air Force in 1999 because she wanted to give back to her country. She was deployed twice, working as an intelligence analyst in Qatar and Iraq.
When she returned home, readjustment to civilian life was difficult. Taylor’s back and joint pain, which began when she was deployed in iraq, continued to get worse. “My family was the first to recognize that I was not the same person. I was flying off the handle, yelling at the tv or crying over silly things,” she said.
Taylor made the decision to reach out and ask for the help she needed. With the support of her family, she contacted the Operation Enduring Freedom/Operation Iraqi Freedom (oeF/oiF)program Manager at the Wilmington, De, VA Medical Center.
Putting the Puzzle Back Together
She received a referral to the WRiiSc in East Orange, NJ, where she was struck by the comprehensiveness of her evaluation and that the team of clinicians looked at “the whole picture,”

By asking questions about her entire medical history. Taylor appreciated getting specific recommendations on what she could do to improve her quality of life.
She recalled, “i really liked getting the WRiiSc ‘roadmap,’which included tips on exerciseincluding aqua aerobics, along with healthy eating and stress reduction techniques.
I felt like i was able to put the pieces of the puzzle together.”
that roadmap has also helpedtaylor follow through and implement a number of changesthat have helped improve heroverall quality of life.

Enjoying Life Again
today, taylor still has her good days and bad days, but her health is much improved. She now serves as a military and Veteran constituent advocate for u.S. Senator ted Kaufmann of delaware.
When asked what advice she would give to Veterans about lifeafter deployment, she advises, “deal with whatever issues you have, no matter how difficult they are to confront. there are re-sources out there, and it’s up to you to take advantage of them.do whatever you have to do to advocate for yourself. approachthe mission to be healthy with the same energy you approached your military life and combat.”
the War Related illness and injury Study center (WRiiSc) is a Va national program that specializes in post-deployment care for Veterans with difficult todiagnose illnesses and deployment related exposure concerns.
For more information, go to www.WarRelatedIllness.va.gov
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