U.S. Department of Veteran Affairs

Carlos Figueroa monoskis in Aspen Snowmass on Thursday as part of a VA sports clinic for disabled veterans.

An Iraq war veteran who yearns to snowboard next March at the Sochi Paralympics recently told a priest he would give his left leg to compete for his country. And then, he did.

Six weeks ago, retired Army Sgt. Carlos Figueroa allowed a surgeon to amputate below his left knee — 10 years after an IED blast rendered the limb nearly useless. The decision was surprisingly simple, he said, because it sliced away a decade of mounting pain. Yet he also acknowledged: “I did give it up because I want to get into the Paralympics.”

“When I went in, my doctor asked me: ‘What’s your biggest goal?’ I told him: ‘Be on my board within three months.’ He just said, ‘Dude, most people aren’t walking within three months,’ ” Figueroa recalled. 

Walking will come. What he can do — already — is carve down a mountain, the lone place Figueroa, 34, feels at peace: “Up there, I’m no different from anybody. No PTSD. I’m at my happiest.” On Thursday, Figueroa beamed while manhandling an Aspen, Colo., slope atop a monoski at a sports clinic for disabled veterans. As a familiar, cool breeze brushed his face, he also dreamed about racing in Russia.

“My love for snowboarding is about loss, the loss of what I had in the military, where you’re used to being on the move, on patrols, on raids. That’s how I treat my races. The moment that gate drops, it’s like the door opening on a raid. I go full blast. I’m able to get something back that I felt was taken away. That rush. I love it.”

U.S. Department of Veteran Affairs

"Up there, I'm no different from anybody. No PTSD. I'm at my happiest," said Carlos Figueroa of the feeling of carving down slopes.

The wars in Iraq and Afghanistan have borne a bittersweet byproduct: scores of American Paralympic hopefuls. The Sochi Paralympics, to be held just after the 2014 Winter Games in that city, marks the inaugural Paralympic snowboarding event for disabled athletes. The U.S. men’s Paralympic snowboarding squad will consist of five members.

'Slim chance'
Figueroa (and those close to him) knows he’s the longest of long shots. His own coach, Mike Shea, estimates he took two years to, literally, make the leap from his own leg amputation to landing jumps. The raw nerve endings in an amputated limb must become desensitized to the harsh pounding. When the board hits the snow, the stump pushes into the prosthetic leg, “sending chills up your spine,” Shea said. “It doesn’t feel good.”

Then there’s the calendar. If Figueroa is indeed back on his board by autumn, he’ll have a limited number of sanctioned races — beginning in January 2014 — to rack up enough points to rank among the top five American men. And the U.S. Paralympic snowboarders, including Shea, compose the world’s deepest talent pool in that sport. The roster likely will be named in February.

“It’s a slim chance, a super, super small window,” Figueroa said, “but we’re still going to push.”

He needs only a sliver of possibility to kindle his hope — or better yet, someone telling him he can’t. He certainly doesn’t need two legs.

The Feb. 15 amputation came 10 years after a bomb detonated beneath his armored vehicle, ejecting him through an open roof hatch. A decade spent lugging a useless left limb (with no heel), suffering increasing back and knee pain, instantly convinced him to say “Let’s do it,” when an orthopedic surgeon in San Diego suggested, “Let’s cut.” He was done, he said, wasting another day “in a bubble” due to his injury, calling the operation “liberating.”

'Go fast and have fun'
Nobody who has heard that account is betting against Figueroa.

“With any military athlete, you can definitely see that sense of pride and determination above and beyond what you see with other athletes. Part of it is just a chance to represent their county again,” said Kevin Jardine, high performance director of Parlaympic alpine skiing and snowboarding for the U.S. Olympic Committee. “They’re willing to sacrifice a lot.”

Added Shea, who lost his leg in a 2002 wake-boarding accident: “Anything you tell Carlos, he’ll get it done. He always seems to find a way. He has no fear up there. He has passion. And I’ve learned from him the smiling gets you a long way in life.”

This week at the National Disabled Veterans Winter Sports Clinic in Aspen, organized by the Department of Veterans Affairs, Figueroa has been tempted to grab a board and shred. This is his fourth year attending. As a testament to his disregard for other people’s timelines, he couldn’t even stand on a snowboard four years ago due to his injury, yet he competed in a World Cup event for disabled snowboarders not long after that.

Until his prosthetic leg arrives, he’ll stick to monoskiing, during which he sits in a “bucket” atop one ski, using his arms to hold smaller, balancing skis.

“The first run, I took it slow. After that, I opened it up,” Figueroa said. “I just want to go fast and have fun.”

When the instructor noticed his raw speed, he warned Figueroa: “You do realize if you go down, you may peel off half your face.”

Figueroa simply grinned: “That’s alright.”

Related: 

• 365 days after blindness, swimming sailor claims gold
• 'Vet ink' shares tales of battle, loss and life-long pride
• Home from war, troops face 'white knuckled' first month

Jim Seida / NBC News

"I had seen some stuff that I probably would have never seen before in life had I not been in Marine Corps, some good stuff and some stuff I just don't care to think about anymore," said Iraq War veteran Eric Swinney, seen here outside his room at Grand Veterans Village in Phoenix.

By Bill Briggs, NBC News contributor

Despite funding that has reached $5.8 billion annually and a slew of innovative community partnerships, the Obama administration is lagging in its goal to end homelessness among veterans – or, as federal veterans' leaders like to say, “drive to zero” – by the end of 2015.

If the current rate of progress is maintained, roughly 45,000 veterans would still be without homes when the deadline passes -- a big improvement since the drive was launched but also evidence of how difficult it is to eradicate the problem.

"I don’t truly think you can end homelessness,” said John Scott, who heads the Phoenix office of U.S. Vets, a national, nonprofit service provider to homeless and at-risk veterans that receives some federal funding. “Things happen that can precipitate homelessness for anyone, and it can happen quite rapidly. However, we can effect change in veterans who have been chronically homeless.”

Scott, a former Marine Corps sergeant, was a keynote speaker at the November 2009 summit where Veterans Administration Secretary Eric Shinseki proclaimed that he and President Obama were "personally committed to ending homelessness among veterans within the next five years.” (The VA now cites the end of 2015 as its target.)

That crusade thus far has housed 12,990 veterans, an average of 361 per month. At the last count, which took place in January 2012 and was released in December, some 62,000 veterans still were homeless, meaning the campaign would need to average about 1,300 per month to meet its mark.

“While there may have been those who did not think ending veteran homelessness was possible (when Shinseki made his 2009 vow), it brought much needed attention to the matter," Scott said. “And it has, in turn, created many new funding opportunities for veterans experiencing homelessness.”

Scott hammers at the problem in a state VA officials hold out as a shining prototype, where in 2012 veterans accounted for just 13 percent of the adult homeless population — down from 20 percent in 2011. He oversees a tangible symbol of that drive, a former Howard Johnson hotel refurbished into apartments meant to shelter more than 130 homeless veterans. It’s called Grand Veterans Village.

Flashbacks, panic attacks
Manning the community’s gas grill most days is Iraq veteran Eric Swinney, who arrived there in early March. Originally from Mississippi, the former Marine’s barbecued specialties include ribs, chicken and pork chops. He doesn’t talk much about his brief homeless stretch. But his spiral seems fueled by what he saw in Iraq — and what he sees in his nightmares.

“I picked up heads, legs. I picked up blown-up hips from two blocks away, from the roofs of houses. Numerous, numerous occasions. Iraqi people parts,” said Swinney, 26. The human pieces were ripped away and strewn during firefights or suicide-bomber blasts.

Jim Seida / NBC News

Smoking and joking on the second floor of what used to be a Howard Johnson's in Phoenix, Iraq War vets Zeb Alford, left, Trent Stubbs, center, and Swinney pass the time at Grand Veterans Village.

“I have this one image, every time I sleep, of picking up the head of an Iraqi.” In his room at Grand Veterans Village, the flashback wakes him often, he said, leaving him soaked in perspiration.

Nothing new, though. Swinney began feeling what he calls “mental anguish” before leaving Iraq in 2008. From there, his descent reads like a manual on post-traumatic stress disorder: foreboding and booze and bad luck. “Every time something happened that reminded me of Iraq, I would just go get me a bottle and start drinking.” Then, a DUI arrest in Georgia. Then, panic attacks, which left him unable to hold any of his six or so post-war jobs.

He tried to physically flee that internal storm, moving to Phoenix last June: “A new change, a new climate.” He got an apartment. He got a job as a security guard. But when his car was stolen on Super Bowl Sunday, he had no ride to work. The rent money ran dry. He lost his room. “Ever since I left the Marine Corps, stuff just keeps happening.”

During his eight months in Phoenix, however, Swinney also had been visiting the local VA center, meeting with caseworkers. When he became homeless, they steered him to U.S. Vets, to Scott and to Grand Avenue. There, his rent is covered by U.S. Vets. Next, Swinney will be paired with local experts who "are going to assist him with some of the trauma he's brought back from war," Scott said.

The plan is to have Swinney find his financial footing and, eventually, move into a more permanent apartment where he will be responsible for the lease.

'Daunting challenge'
That federal-community safety net — housing wrapped around social services, in dozens of cities — is precisely why VA officials remain outwardly confident they can meet Shinseki's 2015 objective.

"Yes, we know it’s an aggressive goal. But we work hard at this every day to try to achieve it. Because for us, it’s really just not acceptable to have anybody on the streets with the capabilities and the opportunities that are around now," said Vincent Kane, director of the VA National Center on Homelessness Among Veterans.

"With the focus, the attention and the commitment we're putting to this as a health-care system, [VA has] the best opportunity now than at any other point in the history of our program" to hit that mark, Kane said.

One program making a dent is HUD-VASH, run jointly by the VA and the U.S. Department of Housing and Urban Development. Under that plan, veterans receive housing vouchers and access to case management and clinical services. Since 2008, Congress has appropriated $350 million to HUD-VASH, which has handed housing vouchers to more than 47,000 veterans and their families, according to HUD.

Armed with such initiatives, "we believe we are going to quicken the pace" to house all veterans, Kane said. "We know it’s a daunting challenge.

Nightmares and all, Swinney plans to be one of the success stories in that intended final tally of zero. He is a proud man, and thankful for his service, no matter where it has taken him five years after leaving Iraq.

"I hate when people feel entitled to stuff. Being a Marine helped me in a lot of ways. Yes, it had its drawbacks. But what it all boils down to is we’re average Americans, like everybody else. We just had more dangerous jobs," he said. "Nobody owes me anything."

Related: 

Has disability become a 'de facto welfare program'?

Broke and ashamed: Many won't take handouts despite need

'By the Grace of God:' How workers survive on $7.25 an hour

This story was originally published on Fri Mar 29, 2013 3:16 PM EDT

VA Secretary Eric Shinseki's chief of staff will leave that post Sunday, saying "my wife and I decided it was time to retire," but the Department of Veterans Affairs honcho exits amid the sound of Capitol Hill criticism. 

John Gingrich, a retired Army colonel who commanded a field artillery battalion during the Gulf War, told VA staffers in a note that after 37 years of combined military and federal service, he had discussed his "transition" with Shinseki earlier this year, as the Obama administration began its second term. During that conversation, Gingrich and Shinseki "agreed to ensure a smooth transition and to set the conditions for an interim chief of staff, which will be completed by March 31," he wrote. 

"Over the last four years, I have had the tremendous honor to serve the Nation's Veterans, their families, and survivors as VA's Chief of Staff," Gingrich wrote to VA employees. "I will always be grateful for the opportunity that the Secretary afforded me. After a long career in the Army, and after four years of balancing my dedication to the department with my other responsibilities, it is time for me to shift my focus."

Word of his departure comes six days after members of Iraq and Afghanistan Veterans of America met with White House Chief of Staff Denis McDonough about the chronically long claims-benefits backlog, which is managed by VA. The leader of that veteran's group, Paul Rieckhoff, called on President Obama to find an immediate fix for the backlog, adding the time had come "to go above the VA" on the problem. 

'Lack of judgement'
Also last week, Rep. Jeff Miller, R-Fla., chairman of the House Committee on Veterans’ Affairs, told NBC News "the president needs to take a personal interest" in the backlog. Miller, additionally, had called for Gingrich to resign in October after revelations surfaced detailing improper VA spending. Last fall, Miller condemned Gingrich’s approval of an $8 million budget for a pair of VA human resources conferences held in Florida during 2011. 

“Even though I deeply respect John Gingrich’s time in uniform and public service, the fact remains that his lack of judgment in approving a number of lavish VA events cost taxpayers more than $6 million and cast a lingering shadow over the department’s reputation," Miller said Tuesday in a statement.

"The task at hand for the department is finding a replacement who will avoid repeating Gingrich’s past mistakes," Miller said. "In addition to being a good steward of taxpayer dollars, Gingrich’s successor must be willing to have an honest conversation about the challenges VA faces and its ability to overcome those challenges — qualities that are absolutely essential for every VA leader to have.” 

Related

• DOD, VA sluggish helping returning veterans, study says
• Hunt for bogus war heroes uncovers thousands of hoaxers
• Obama urged to step in to fix VA backlog

Nearly half of the 2.2 million U.S. troops who served in Iraq and Afghanistan have struggled to readjust to American life in part because the Departments of Defense and Veterans Affairs have been sluggish in helping those coming home in droves, according to a sweeping report released today.

After examining veteran suicides and unemployment as well as the military’s handling of sex assaults, women in uniform and same-sex family issues, the Institute of Medicine said returning service members deserve “timely and adequate care,” yet it cited cases in which the DOD and VA are using unproven diagnostic and therapy tools.

"The (federal) response has been slow and has not matched the magnitude of this population's requirements as many cope with a complex set of health, economic, and other challenges," said co-author Dr. George Rutherford. He chairs the IOM’s committee on the assessment of readjustment needs of military personnel, veterans, and their families. The IOM, an independent nonprofit, is the health arm of the National Academy of Sciences. 

"The number of people affected, the influx of returning personnel as the conflicts wind down, and the potential long-term consequences of their service heighten the urgency of putting the appropriate knowledge and resources in place to make re-entry into post-deployment life as easy as possible,” added Rutherford, head of preventive medicine and public health at the University of California, San Francisco School of Medicine.

Another 34,000 U.S. service members will be flown home from Afghanistan during the next 12 months. The high suicide toll among veterans (22 per day) has drawn recent Congressional scrutiny as have the elevated veteran-unemployment rate and access limits to VA mental health care. Congress requested the IOM study. 

Among the recommendations within the 500-plus page report:

• DOD and VA must “boost efforts to reduce the stigma” associated with service members or veterans simply asking for help to deal with mental-health issues or with substance-abuse problems.
• The tool DOD uses to assess cognitive function following a head injury – Automated Neuropsychological Assessment Metrics (ANAM) — carries “no clear scientific evidence” to show that it works. That’s key because more than 200,000 U.S. troops have sustained traumatic brain injuries since 2000 — most non-combat-related. On March 5, Congressional members sent a letter to the chiefs of DOD and VA seeking data to investigate a new theory linking TBIs with the military’s suicide crisis.
• One of the VA’s “first-line treatments for depression” — Acceptance and Commitment Therapy — similarly “lacks sufficient evidence” to show its efficacy.
• Research has found that curbing access to lethal weapons prevents suicides, however, “DOD policy prohibits restricting that individual's access to privately owned weapons” — even if a service member is known to be at risk for suicide.
• DOD and VA should link their databases so that the health records of all service members are available to track their medical conditions from the moment they enter the service through the day any future treatment is eventually rendered by a VA facility. 

"These (recommendations) are meant to be helpful, meant to be more of a roadmap of how to pursue” these issues, Rutherford said. “These are extraordinary challenges that the systems are facing and they’ve gone to extraordinary efforts to try and work with them.

'Demand is large'
“Yeah, it can all be streamlined. Yeah, (the available help) can be matched better to the demands. Yeah, you can improve this stuff. But they are trying like crazy to make it match the demand,” he added. “The demand is large, and it’s growing.”

Compared to past post-war generations, a higher percentage of returning Iraq and Afghanistan Veterans are using the VA for their health care — 56 percent of that population, according to the VA.

"This report provides VA a better understanding of the difficulties some Veterans face as they readjust to home, reconnect with family members, find employment and return to school," read an email from Josh Taylor, a VA spokesman. "Greater collaboration with the Department of Defense (DoD) in the areas of research, treatment and clinical outcomes will further enhance continuity of care as service members transition from active to veteran status."

Pentagon officials will examine the IOM’s suggestions, said Cynthia O. Smith, a DoD spokeswoman.

“DoD appreciates IOM's hard work and will thoughtfully consider the study's key findings and recommendations,” Smith wrote in an email. She added that the agency’s Deployment Health Clinical Center “will work collectively with the VA to provide a joint response to Congress no later than June 2013.” 

The IOM study reports that 44 percent of veterans have had "readjustment difficulties," 48 percent have dealt with "strains on family life," 49 percent have experienced post-traumatic stress, and 32 percent have felt "an occasional loss of interest in daily activities." Those figures were plucked from an earlier Pew Research Center survey. 

"I’m not surprised (by those numbers), talking to my other buddies that have gotten out. I’ve got several buddies that still can’t find jobs but, to be honest with you, I think it's a factor of (their) motivation" to hunt for work, said Ryan Kriesel, 24, an Army tank operator who served two tours in Iraq. He's now a student at the University of Minnesota. He described his own transition as "pretty smooth." 

When it comes to those younger veterans who report a flagging interest in daily life, Kriesel believes some of that may be due to the loss of the emotional rush that once came with combat. 

"Part of it is being back in the civilian world," he said. "There’s not as much adrenaline going on as when you were overseas, out on combat missions several times a day."

Related:

• Hunt for bogus war heroes uncovers thousands of hoaxers
• Obama urged to step in to fix VA backlog

The benefit-claims backlog that has ensnared nearly 600,000 younger veterans — many with war wounds — has reached a crisis point inside the Department of Veterans Affairs, and the hour has come for President Barack Obama to become personally involved in unclogging the quagmire, two of the nation's leading veterans advocates told NBC News Thursday. 

"It’s time to go above the VA. If you think of VA as a broken down car, it’s hard for us to know how to fix it if we can’t see under the hood. The president can see under the hood. And the president can send people in to fix it," said Paul Rieckhoff, an Iraq War veteran and CEO of Iraq and Afghanistan Veterans of America, which represents more than 200,000 people.

"When you have so many men and women that are waiting years to see their claims adjudicated, there is a problem and it's somewhere within VA. And the president needs to take a personal interest," said Rep. Jeff Miller, R-Fla., chairman of the House Veterans' Affairs Committee. 

Rieckhoff contends that Obama must answer a key question: With the overall claims tally surpassing 900,000 cases earlier this year and with 34,000 troops soon returning from Afghanistan, should VA Secretary Eric Shinseki be replaced? 

In a meeting Wednesday with White House Chief of Staff Denis McDonough, Rieckhoff said he told Obama's top advisor: "We need to hear it from the president" as to whether Shinseki should remain atop the VA.

During a press briefing Wednesday, White House spokesman Jay Carney said: "It is absolutely the president’s position that we need to aggressively address this problem, and he has made clear to Secretary Shinseki that he wants this addressed. He is getting weekly updates on the backlog."

Responded Rieckhoff: "We’re focused on ending the backlog. What we need from the president is a plan to end the backlog. If (Shinseki's removal) is a part of that plan, we’d love to hear about it. The easy thing to do is fire some people. But that won’t necessarily fix things.

"Yes, we need a cultural transformation (at the VA). We need new blood, new ideas," Rieckhoff added. "But three VA secretaries have been there and three VA secretaries have failed. That’s why we’re focused on the president. This is bigger than Shinseki."

IAVA file

"The backlog is the place where veterans end up feeling betrayed. When your claim is delayed 600 days, which is the case if you live in New York or L.A., you feel like your president and your country are letting you down," said IAVA's Paul Rieckhoff, photographed Thursday speaking to reporters in Washington, D.C.

VA official urged to step down
On Tuesday, Miller called for the resignation of Allison Hickey, the VA's under secretary of benefits. Miller is frustrated with Hickey, in part,  because she can not project where the backlog will stand in 12 months while she is simultaneously promising that no veterans will be waiting 125 days or more for their benefits by 2015. Miller said he fears that high-ranking VA officials have failed to reveal to Shinseki the real depth of the claims challenge and the scope of the financial hardships faced by hundreds of thousands of Iraq and Afghanistan veterans — many who are unable to work due to battle injuries.

Asked Thursday if he believes Shinseki should resign, Miller said: "I am not prepared to ask the same of the secretary. He has a strong desire to do what is right. My fear is his leadership (team) has not been transparent with him to the point that he knows the true picture that exists out there." 

This week, four other prominent veterans' groups — Student Veterans of America, The American Legion, Veterans of Foreign Wars and Disabled American Veterans (DAV) all voiced support for Shinseki and for the work being done by the VA's Veterans Benefits Administration (VBA), which has handled claims for millions of veterans. Those groups argue that the VA's plan to cut the backlog should be given a chance to work.

"DAV believes that VBA is on the right path, that they have set the right goals and that they have leadership committed to transforming and institutionalizing a new claims processing system to better serve veterans," DAV national legislative director Joe Violante testified Wednesday before a Senate panel examining veterans issues. 

During 2012, the VA paid $58.6 billion in benefits to 4.3 million veterans or their survivors, according to the VA. The agency reported Thursday that its total "claims inventory" stands at 859,396. The VA defines its "backlog" as claims that have been pending for more than 125 days — that number stands at 592,222, according to the VA. 

"Secretary Shinseki believes it is unacceptable that veterans are waiting too long to get the benefits they have earned," read a statement emailed by Josh Taylor, a VA spokesman. "That is why VA is implementing an aggressive plan that will solve this decades old problem for good and transform how VA processes claims for decades to come."

But according to Miller, one factor fueling the backlog is that VA claims handlers are not working as efficiently as they did before the wars in Iraq and Afghanistan. In 1997, the average VA field officer processed 138 claims a year while, in 2011, with three times as many overall employees, the average VA field officer processed 73 claims a year, Miller said. 

"I have confidence at this time that (Shinseki) has a desire to move in the right direction. He leads an organization of 300,000 people that delivers some of the best health care in the world as well as educational benefits," Miller said. "But this benefits backlog, unfortunately, is going to be a stain that will stay with VA for years to come."

Related:

• Epic waits, 'gaming' the books at some VA hospitals, testimony reveals
• As VA backlog grows, Congress, veterans grow weary of excuses
• Disability-compensation claims for veterans lag as 'VA backlog' worsens
• Home from war, troops face 'white knuckled' first month

Some veterans are waiting six months to see VA doctors to fix their broken dentures or artificial knees and at least two veterans died last year from diseases “due to delay in care” at their local VA hospitals, according congressional testimony delivered Thursday.

Meanwhile, staffers at several Veterans Affairs medical centers were found to have rigged computer records to make it appear as though there are little or no wait times for ex-service members when, in reality, backlogs for veterans needing exams and treatment can span six to eight weeks, additional testimony revealed.

“Delayed care is denied care,” said Rep. Ann Kirkpatrick, D-Ariz., during a House oversight hearing held to investigate why most veterans must wait 50 days on average to schedule initial exams with VA doctors. Kirkpatrick spoke of one Iraq veteran in her district who required more than six months to book his initial consultation with a VA mental health provider.

“Veterans should not have yet another hoop to jump though. Access to health care should be easy to schedule,” Kirkpatrick said.

With the Department of Veterans Affairs already nine months behind in meeting disability claims, the fresh anecdotal evidence of long veteran-patient waits prompted Rep. Mike Coffman, R-Colo., to chastise the VA Deputy Under Secretary William Schoenhard: “You’ve been here, in this position since 2009. You came in (and) the system was in chaos and not serving the veterans community. You’ve been there. You haven’t made a difference. And I have no reason to think that under your leadership, unfortunately, this job is going to get done.”

Coffman also waved a handful of VA records documenting the deaths in May of 2012 of two veterans, one in Georgia and one in South Carolina — both of whom were ill and awaiting consultations with VA doctors. “So by your own internal documents there are issues concerning the quality of care related to timeliness and, unfortunately, the loss of life unnecessarily of veterans. That’s particularly alarming,” Coffman said.

Earlier in the hearing, Schoenhard expressed his regret over any reported “breakdown in care,” adding that “any veteran who goes without timely care is one veteran too many in terms of our commitment to serve those who served us.” He testified that the VA is working to tighten its appointment system by better meshing its administrative and clinical functions and ensuring “more robust training of our staff who schedule these patients.”

But equally troubling to members of the House Veterans’ Affairs subcommittee: reports of VA employees who — as Coffman described — “game the numbers” to deceptively make VA patient-wait times appear shorter. The Government Accountability Office discovered such altered computer records during recent inspections at four VA medical centers, a GAO official testified Thursday.

“Some staff told us they changed medical-appointment desired dates so that the wait times aligned with VA’s related performance goals ... We heard this across several facilities,” testified Debra A. Draper, director of health care at the GAO.

Draper testified that at one primary VA clinic, GAO investigators learned that a scheduler had changed dates (in a computer) “to show there were no long wait times. At another specialty care clinic, we heard providers were changing (appointment) dates to make sure their data showed they were within the (desired) 14-day timeline of the VA. We also went to one specialty clinic (where) it showed a zero-day wait time (when) ... in reality there was a six-to-eight week backlog, at least.”  

Asked by Kirkpatrick whether those VA schedulers “were unduly influenced” by VA brass to purposely tweak the appointment records, Draper replied: “We weren’t specifically told they were directed by management. The current (software) situation provides ample opportunity to change dates, whether intentional or not, to reflect the results you want to achieve.

“(However), these measures are included in VA’s budget submissions and in VA’s annual performance and accountability report,” Draper added. “So there’s a lot of incentive around these measures.”

Related: 

• As VA backlog grows, Congress, veterans grow weary of excuses
• Disability-compensation claims for veterans lag as 'VA backlog' worsens
• Home from war, troops face 'white knuckled' first month

With most veterans waiting nine months for the Department of Veterans Affairs to process disability claims, a congressional panel Wednesday chastised the VA and the Department of Defense for each breaking four years of vows to merge all troops’ medical records into a single electronic system to help crack that backlog. 

A senior defense official admitted to the House Committee on Veterans' Affairs that while “looking down the barrel” of Friday’s sequestration-mandated budget cuts, DOD recently opted not to simply link with the VA’s existing electronic health-record system but to instead seek a more cost-effective computerized tool to catalog and track its service members' medical files.

That explanation, however, sparked committee members to slam both agencies for protecting their individual turfs rather than fixing the lengthening wait for troops' claims to be seen and for disability checks to be cut. Further complicating that human math: Another 34,000 service members will return from Afghanistan during the next 12 months. 

“Dammit, it’s time to get over the excuses and get this fixed!” said Rep. Jeff Denham, R-Calif., a veteran of Operation Desert Storm. “We have brave men and women that are coming home in huge numbers right now. We don’t want to see these backlogs of benefits continue to escalate. What we need is you guys (VA and DOD) to work together.

“You’ve been given a directive by your President to get this done. My belief is you don’t have the will to do it,” Denham said. “Those who have volunteered at a time of war ... if they come home tomorrow, they ought to be in the (electronic-record) system tomorrow, knowing what benefits they will receive ... and that it doesn’t take a 5-day or a 50-day system. Get it right or we’re going to force you to get it right.” 

On Tuesday, VA Secretary Eric Shinseki acknowledged in a speech to the American Legion that effectively slashing its ballooning benefits backlog hinges, in part, on the full installation of an electronic record system. As of December, that backlog had reached more than 270 days, according to a VA website. 

In a separate but related move, Rep. Jeff Miller, R.-Fla., chair of the House Veterans’ Affairs Committee, urged VA leaders to fire “problematic employees” rather than to continually transfer them from one regional VA office to another — a bureaucratic shell game that “has contributed to major benefits backlogs at a number of VA regional offices across the country.” 

“It’s time to end that culture of complacency that has developed among some VA employees and replace it with a culture of accountability,” Miller told Shinseki and others Tuesday at the same American Legion gathering in Washington, D.C. “If a VA employee doesn’t want to do their job, the answer isn’t to move them to another VA office. The answer is to remove them from VA altogether.”

The committee hearing Wednesday was held to ask the two largest federal agencies to explain why they are — according to Miller, "doing a U-turn" — failing to honor a promise made to Congress as recently as last July to build a single, universal, electronic health-record system.

VA leaders testified they prefer their current electronic system, called VistA — on which, according to Congress, the VA already has spent hundreds of millions of dollars to install, and potentially billions more to improve. VA has been using VistA for decades. Miller said military “doctors in theater” have told him they prefer using the VA’s electronic-health-record system. In addition, more than 100 non-VA hospitals have implemented that technology.

Following the hearing, VA officials emailed a statement to NBC News reaffirming that the Department of Veterans Affairs and DOD remain “committed to a single, joint, electronic health record.” They also revealed that Shinseki on Tuesday called new Defense Secretary Chuck Hagel to congratulate him on his Senate confirmation and that during the phone chat “both leaders emphasized their desire to meet soon and build on the strong partnership between the two departments on common priorities for troops, veterans, and military families.”

“In short, VA and DoD are seeking to achieve the same program goals: common data, common applications, and a common user interface, but we look to achieve them with less cost and less risk and accelerate the availability of needed functionality,” read the VA’s emailed statement. 

DOD chiefs, meanwhile, testified they are exploring several electronic health-record options — including "commercial" systems — to replace its current set-up, called Ahlta. And while the Defense Department said it is considering VistA as one option, its assessment found that system may be too clunky and costly to build across the entire armed services. 

"There is no infrastructure really right now for us to bring VistaA into 56 hospitals and 700 clinics and be able to configure it," testified Jonathan A. Woodson, assistant secretary of defense for health affairs and director of TRICARE Management Activity. "The good news about VistA is it was ahead of its time ...

"(But) it's important for this program to skate to where the puck will be. What I mean by that is: The current VistA system is a generation 1-plus-2, in terms of how we look at electronic health records. Industry is already at a generation 3 and moving to a generation 4," Woodson said. "We would need to assess what's required for us to bring VistA over, modernize it, and (calculate) what the total cost of ownership would be over time." 

One veteran, who listened Wednesday to the techno-speak and budget explanations offered by the VA and DOD, urged the two agencies to find common ground fast.  

"Veterans are not getting the single system they were promised. As long as VA and DOD remain in separate camps, pursuing their own individual systems, it's the veterans that will be short-changed," said Jacob Gadd, deputy director for health care at the American Legion. 

"Getting all the information into one place can be the key to finally breaking the back of the backlog. But we don't have it," added Gadd, a former Navy hospital corpsman. "VA and DOD have spent four years and close to a billion dollars to develop this and we're in the same place we were in four years ago ... Until they fulfill the promise made to veterans of a single, seamless, unified record, the veterans of this country will remain skeptical of their government's ability to deliver on all of the promises made to them."  

Related: 

• Disability-compensation claims for veterans lag as 'VA backlog' worsens
• Home from war, troops face 'white knuckled' first month

Eighty percent of veterans who attempted suicide and survived had received mental health care one month earlier from the Department of Veterans Affairs, underscoring the potential peril of 50-day average wait times they face in trying to access VA treatment, a suicide expert told a Congressional committee Wednesday.

“When they had contact a month prior, the question I ask is: How long was it until their next (VA) appointment? Was it scheduled six weeks out? Is that the problem? Or was it scheduled one week out?” David Rudd, head of the National Center for Veteran Studies, testified before the House Committee on Veterans’ Affairs.

“My concern is — from the individuals I talk with that we treat to surviving family members of those who have died — often times, it’s an issue of the (VA) system getting in the way to keep an appointment, to get an appointment, or to get to an appointment,” Rudd said. 

According to a VA report released earlier this month, 18 to 22 veterans commit suicide each day. And that rate “has remained steady” since the Iraq and Afghanistan wars began 12 years ago, said Veterans' Committee chairman Rep. Jeff Miller, R-Fla., who noted that during that same span the VA has increased its budget by 39 percent and its staffing by 41 percent.

“When a veteran is in need of care, the difference of a day or a week or a month can be the difference between life and death,” Miller said. “ ... Something somewhere is clearly missing.”

In his State of the Union address Tuesday night, President Barack Obama announced that 34,000 U.S. troops would head home from Afghanistan during the next year.

Given that mammoth flow of young veterans into an already-backlogged VA system, Miller questioned whether the agency’s “one-size-fits all approach” will leave thousands of ex-service members mired in a bureaucracy that “fails to recognize that addressing mental-health needs ... is a task that the VA cannot handle by themselves.”

“We’ve improved our services for veterans but we know there’s a lot more work to be done,” testified Dr. Robert A. Petzel, the VA’s undersecretary for health.

In 2012, for example, the VA’s 24-hour crisis line fielded 193,000 phone calls that resulted in more than 6,400 “rescues” of veterans who were threatening to hurt themselves or their family members, Petzel said.

While the volume of calls to the hotline is increasing, fewer of those calls are “acute” — or people making an imminent threat — “demonstrating that VA’s early intervention appears to be working,” Petzel added.

What’s more, in the past year, VA has hired 1,058 new mental-health providers and the agency expects to meet its hiring goal of 1,600 extra clinicians by June, Petzel testified, adding that last year 1.3 million veterans received mental-health care from the VA, up from 927,000 in 2006. That increase, he contends, shows that “proactive screening” is working to find and treat veterans for Post Traumatic Stress Disorder, depression, substance abuse issues, and the effects of military sexual trauma.

“Your focus is on the process, the number of people hired. Numbers, numbers, numbers,” Miller responded. “The most important number is the number of veterans getting healthy, healthier or helped.”

“It’s time for us not to do the same thing,” Rudd agreed. “More of the same thing isn’t working ... The way we’ve (tried to address these problems) over the years since the start of these wars is we’ve made the VA larger. I think the evidence would suggest the VA does not need to be larger. I was not encouraged when I heard they’re hiring over 1,000 individuals.”

Instead, Rudd testified, VA should partner with the Department of Defense’s health system TRICARE “because their providers are already in those small communities and available."

“That means shifting money to a non-traditional model,” he added. “But that’s how you connect people to people” instead of linking individual veterans into a vast system.

Related: 

• Soldier Hard's hip-hop lyrics reveal PTSD's rough edges
• 22 veterans commit suicide each day: VA report
• Concern grows about military suicides spreading within families

An estimated 22 veterans committed suicide in America each day in 2010, according to a report released Friday by the U.S Department of Veterans Affairs.

That rate has edged higher from 1999 when an estimated 20 veterans took their lives every day, the report noted. In 2007, the veteran suicide pace temporarily dipped to 18 per day. 

Nearly 70 percent of all veteran suicides were among men and women aged 50 or older, the VA said.

"The mental health and well-being of our courageous men and women who have served the nation is the highest priority for VA, and even one suicide is one too many,” VA Secretary Eric K. Shinseki said in a news release. “We have more work to do and we will use this data to continue to strengthen our suicide prevention efforts and ensure all Veterans receive the care they have earned and deserve.”

The report notes that while the numbers of veterans who die by suicide each day "has remained relatively stable over the past 12 years," the overall percentage of people who die by suicide in America who are veterans has decreased slightly. The share of all suicides reported as "veterans" on state-issued death certificates was 25 percent in 1999 versus slightly more than 20 percent in 2010, according to VA researchers. 

"This provides preliminary evidence that the programs initiated by VA are improving outcomes," read an accompanying "executive summary" signed by Dr. Robert A. Petzel, the VA's under secretary for health. "As long as veterans die by suicide, we must continue to improve and provide even better services and care."

Also Friday, the U.S. Army released its monthly suicide report, offering a preliminary tally for 2012 in that branch: 325 "potential" suicides among active and reserve troops — the highest number in history, Army officials noted. More than 50 of those deaths remain "under investigation," awaiting a final ruling. If that bleak total remains at 325, the toll in 2012 would have risen by 15 percent over 2011 when the Army sustained 283 suicides. 

Meanwhile, Iraq and Afghanistan Veterans of America, a nonprofit advocacy group representing more than 200,000 members, said the nation should be "outraged" by rate of veterans who are taking their own lives — nearly one per hour. 

“This VA suicide report is the most important piece of data to be released since 2007,” said IAVA founder and CEO Paul Rieckhoff. “Our leaders in Washington need to accelerate efforts to shrink wait times for mental health care and find more creative solutions like the Veteran Crisis Line" — 800-273-TALK. 

"The country should be outraged that we are allowing this tragedy to continue The trends are headed in the wrong direction,” Rieckhoff added. “As veterans, we at IAVA understand the spectrum of challenges facing veterans transitioning home, including the struggle with invisible wounds. One thing is clear, we need more research and more collaboration.”

VA leaders vowed "immediate actions" to curb the suicide rate among former service members. The top strategy on the agency's list: A task force — already established — that will "provide recommendations for innovating mental health care" within the VA system," VA officials said. 

That panel also has been tasked with "reassessing the value of traditional suicide risk assessments at screening" and "adding ways to identify life stressors and concerns earlier," read Petzel's summary. 

Friday's report also identified female veterans and Vietnam-era veterans as two demographic groups that require extra urgency when it comes to suicidal behaviors. VA officials said they will be developing "additional training programs" to help better target those segments of the U.S. veteran population. 

The veteran-suicide statistics are likely to become a topic on Feb. 13 when the U.S. House Committee on Veterans' Affairs holds a hearing to explore whether veterans are "overcoming barriers to quality mental health care." 

Related: 

• Concern grows about military suicides spreading within families
• Military suicide rate set record high in 2012
• The enemy within: Soldier suicides outpace combat deaths in 2012
• Some wounded vets shine on 'Alive Day,' others wear black 

Nearly half of eligible ex-service members who served in Iraq or Afghanistan are snubbing free, federal health care they earned in uniform because many harbor “huge mistrust” of the U.S. Department of Veterans Affairs, contends a leading veterans advocacy group.

About 1.5 million men and women who served in those wars have since separated from the U.S. military. Among those eligible to access VA medical help, only 55 percent of veterans have done so through the third quarter of 2012, VA figures show.

“It’s because the VA has a branding problem, an image problem,” said Tom Tarantino, chief policy officer for Iraq and Afghanistan Veterans of American (IAVA), which has more than 200,000 members.

For many younger veterans, Tarantino said, the issue that has most sullied the VA’s reputation is the average time it takes to complete the disability-compensation claims submitted by wounded veterans. The average wait for that money has grown to 272.3 days, or about nine months, a 10-day increase from early December, according a federal website.

VA Secretary Eric Shinseki last year vowed to shrink the so-called “VA backlog” to 125 days by 2015 as the agency finishes transitioning to a digital processing system.

“Any time we ever hear about the VA, what do we hear? That the backlog is astronomically high. Or, that the VA is late in providing GI Bill (tuition) checks. It’s not an antagonistic relationship. It’s: ‘Oh, there goes the VA again; they still don’t have it together.’ Meanwhile, the VA is pathologically incapable of telling its own story,” said Tarantino, who uses a VA medical center. The former Army captain spent time in Iraq, earning the Bronze Star. “The problem is there is a huge mistrust of the VA.

“And what’s unsettling is the VA is an outstanding health care system. But they have not done a good job to explain to the American people what it is they do or offer,” Tarantino added. “This is business 101. You can have the greatest product in the world but if people don’t know about or trust your product, you have a bad product.”

Asked if Tarantino’s assessment is fair, a VA spokesman responded to NBC News with an email listing the agency’s latest work: bolstering mental-health staffers by 49 percent, opening 80 additional clinics, enticing clients through social media, and launching initiatives that allow ex-troops to chat with doctors online or talk with “peer-to-peer specialists” with combat experience.

“Although we have made many improvements, there is still work to do,” read a response emailed by Mark Ballesteros, a VA spokesman. He also cited the VA’s shift to “a new model of health care” called Patient Aligned Care Teams (PACT), a “patient-centered, team-based” and “data-driven” system.

Advanced tactics, modern buildings and clever acronyms aside, the VA faces a long, tough sell with its youngest audience, according to interviews with several post-9/11 veterans. 

Pete Chinnici, 26, personifies the type of a public-relations damage VA officials must patch before forging deeper inroads within the Iraq and Afghanistan veteran communities.

After completing Marine Corps duty in Iraq from 2005 to 2007, Chinnici applied for VA health care in Phoenix. He’d been diagnosed with post-combat stress and hearing loss. But six months after stepping inside the pipeline, Chinnici said a VA employee told him his entire medical file was missing and that he’d need to start over.

“After having two friends who went through the VA process – it took one 9 months and the other almost a year (to gain entry) – and then being told they’d lost the paperwork, I never went back,” Chinnici said.

Three time zones east, another Marine, Alex Hill, visited the VA medical center in Brockton, Mass. after exiting Iraq in 2009, he said, “without a scratch.”

“The VA just wasn’t for me: the unmotivated staff members, the piles of bureaucracy,” said Hill, 26. “I also have objections with how they treat veterans by solving every problem they come across with a bottle of pills.”

The VA hopes to win back veterans like Hill and Chinnici, in part, via its 151 Facebook pages (which have more than 623,000 combined “likes”), its 581 posted YouTube videos, its 75 Twitter feeds, and its VAntage Point blog, which offers 500-plus articles authored by VA employees, veterans and family members, said VA spokesman Ballesteros.

“We’re reaching out to provide veterans with more options for care and more access to health care providers than ever,” Ballesteros wrote in the emailed statement. “Now patients can choose to come in for a face-to-face appointment with their doctor or avoid driving long distances, and instead interact with a provider through our (secure, online) telehealth programs.”

More than 380,000 veterans received “telehealth” services during the 2011 fiscal, he added.

But on the primary VA Facebook page that Ballesteros touted, there are many unhappy hints of the agency’s steep climb to win fresh hearts. On Jan. 19, Janet Woodworth Jennings posted there: “Hire VA doctors who actually care and know what they are doing.” Her comment was promptly “liked” by Luanne Pruesner-Van De Velde, who added: “I AGREE...Hire EMPLOYEES that care about Vets - Period!!!”

Related: Army spouses club offers 'special guest membership' for same-sex wife
Related: Military suicide rate hit record high in 2012
Related: Wal-Mart plans to hire 100,000 veterans