September is National Suicide Prevention month. Accordingly, as it does nearly every year, the U.S. Department of Veterans Affairs (VA) issued its National Veteran Suicide Prevention Annual Report this month.
The report contains startling statistics, such as the fact that, in 2017, 45,390 adults in the U.S. died by suicide, including 6,139 veterans. This means that the national suicide rate is 1.5 times higher for veterans than it is for non-veterans, after adjusting or population differences in age and sex.
In addition to statistics, the report goes on to discuss the usual factors, such as suicide as national problem not just a veterans problem, and understanding the cultural context of suicide in the U.S. It also reiterates that suicide prevention remains a top national priority for the VA.
Buried inside the report, however, is an important point that not enough stakeholders are talking about: that “[Veterans Healthcare Administration] patients with military service-connected disability status may have lower risk of suicide than other VHA patients.”
Service-connected disability compensation is authorized “for disability resulting from personal injury suffered or disease contracted in line of duty . . . in the active military, naval, or air service.” Within the VA-structure, the Veterans Benefits Administration (VBA) is responsible for making service-connected eligibility determinations, and the Board of Veterans’ Appeals (the board) is responsible for reviewing appealed claims.
As such, improving performance and accountability within VBA and the board through the issuances of timely, quality decisions must be part of VA’s overall suicide prevention strategy.
Despite the fact that an award of service-connected disability compensation may literally be the difference between life and death for some veterans, most conversations about the veterans’ suicide epidemic focus solely on the role of healthcare, and specifically the work of VHA.
Getting service-connected decisions right for veterans is an important factor in preventing suicide, and one that stakeholders need to pay more attention to going forward.
First, an award of service-connected disability compensation is often how veterans gain access and awareness to other VA services. As noted in the 2019 report, “[t]he majority of [v]eterans do not use VHA services, and the majority of [v]eteran suicides occur among [v]eterans who have not recently received VHA services.”
However, many veterans do not use VHA services simply because they are either unaware or not eligible to do so. Service-connected disabilities are how many veterans gain their eligibility for VA healthcare. Moreover, veterans applying for service-connected disability benefits are often represented by an accredited Veterans Service Officer or attorney, who is knowledgeable not only about the specific disability benefits sought, but also how to enroll in other VA programs.
Second, an award of service-connection results in monthly compensation to the veteran. These disability payments can often alleviate economic distress and, in the most severe cases, even prevent homelessness. These factors – economic distress and homelessness – are both identified by VA as common risk-factors afflicting veterans who die by suicide.
Unfortunately, however, rating decisions issued by VBA often take months to issue, or are plagued with errors resulting in not only a denial of needed monthly compensation, but a lengthy appeals process at a VA regional office or the board that than can take years, thus exacerbating a veteran’s risk-factors for suicide.
Indeed, according to a VA Office of the Inspector General Report released in March 2018 regarding the timeliness of the VBA appeals process, it takes an average of seven years for a veteran’s appeal to be decided. What’s worse, is that seven percent of VBA cases were deemed “resolved” because the veteran had died while waiting for a decision.
Although the report did not clarify how many of those veterans had died by suicide, given the overall statistics, it is extremely likely that a number of veterans who died by suicide are included in this number.
“An accurate and timely VA decision is often critical for a veteran’s mental health recovery and financial well-being,” said Glenn Bergmann, an attorney and partner at Bergmann & Moore, a national law firm focusing only on VA disability claim appeals.
Bergmann added that, for example, “in 2018, VA’s Inspector General found unacceptably high rates of VA errors in PTSD claims based on military sexual trauma (MST). VA is urged to provide better training and oversight of PTSD/MST claim processing so the claims are granted quickly. VA must decide the claims properly the first time and thus reduce the stress placed on veterans who would otherwise face years of VA paperwork and appeals.”
As noted in President Trump’s March 2019 executive order on a National Roadmap to Empower Veterans and End Suicide, the veterans’ suicide epidemic is not due to a lack of resources, but rather, by a lack of coordination. This includes lack of coordination between VBA services and VHA services for some veterans.
The executive order goes on to state that, to reduce veterans suicides, the federal government must work side-by-side with community partners to provide veterans with the service they need.
As we, unfortunately, continue the painful yet necessary conversations on how to prevent veterans suicide, we must make greater effort to include organizations devoted to helping veterans obtain service-connected disability benefits, such as veterans law school clinics.
As the VA’s 2019 annual report concludes, there is much more that must be urgently done to help veterans who may be at-risk for suicide. Ensuring the issuance of timely and accurate disability determinations from VBA is one factor that can go a long way toward the end of goal of preventing veteran’s suicides.
Rory E. Riley-Topping served as a litigation staff attorney for the National Veterans Legal Services Program (NVLSP), where she represented veterans and their survivors before the U.S. Court of Appeals for Veterans Claims. She also served as the staff director and counsel for the House Committee on Veterans’ Affairs, Subcommittee on Disability Assistance and Memorial Affairs for former Chairman Jeff Miller (R-Fla.). You can find her on Twitter: @RileyTopping.
If you or someone you know is having thoughts of suicide, contact the Veterans Crisis Line to receive free, confidential support and crisis intervention available 24 hours a day, 7 days a week, 365 days a year. Call 1-800-273-8255 and Press 1, text to 838255, or chat online at VeteransCrisisLine.net/Chat.