Joint Hearing of the Committee on Homeland Security and Governmental Affairs of the U.S. Senate and the Committee on Veterans’ Affairs of the U.S. House of Representatives at 1:00 p.m. CDT.
Submission For The Record of The American Legion
Tim Hecker joined the Army at 18 and soon decided to make a career of it. He served 22 years in all, in and out of combat, rising to the rank of master sergeant. In the summer of 1990, he married his high‑school sweetheart, Tina, and the couple had three children.
Then Tim couldn’t remember having married Tina. He couldn’t tell his sons apart. Their names escaped him. Injuries suffered in two separate roadside-bomb explosions in a span of two months in Iraq in early 2008 left him with a traumatic brain injury and severe post-traumatic stress. He was no longer the man Tina had married.
Frustrated with her husband’s descent and the lack of progress with traditional care, Tina went online and found information about hyperbaric medicine. Following a phone call and an initial interview, Tim was selected to be part of a pilot study on the use of hyperbaric oxygen therapy (HBOT) for Traumatic Brain Injury (TBI) and Posttraumatic Stress Disorder (PTSD). He claims the treatments have given him back most of his pre-injury life.
“By the fourth treatment, I started feeling like a new person,” he says at his home in West Edmeston, N.Y. “I was more aware. I could see things. The deeper I got into the treatments, my cognition started to come back – my motor skills and my balance. My vision started to improve. The biggest benefit was my emotional control.”
“We’re talking a 180-degree turn around,” Tina says. “There are days when he’s almost back to normal with his personality.”
The preceding story is a condensed version of one of the many veteran stories The American Legion encountered while researching and compiling The War Within, a landmark report published by The American Legion to highlight the findings of the TBI and PTSD Committee founded in 2010. It is illustrative of the possibilities presented by one of many potential alternative therapies for some of the emerging wounds of modern warfare, TBI and PTSD. As veterans struggle to cope with these conditions, sometimes alternative therapies offer solutions traditional therapies cannot provide. For this reason The American Legion believes the Department of Veterans Affairs (VA) must be at the forefront of cutting edge care, to include alternative therapies, if they are to truly serve the veterans who suffer from the modern wounds of war.
The American Legion has continued to be concerned with the unprecedented numbers of veterans returning from the wars in Iraq and Afghanistan suffering from TBI and PTSD, categorized as the “signature wounds” of these conflicts. The American Legion believed that all possibilities should be explored and considered in an attempt to finding treatments, therapies, and cures for TBI and PTSD to include alternative treatments and therapies and they need to make them accessible to all veterans. If these alternative treatments and therapies are deemed effective they should be made available and integrated into the veterans’ current health care model of care.
As a result The American Legion established the TBI and PTSD Committee in 2010 comprised of American Legion Past National Commanders, Commission Chairmen, respected academic figures, and national American Legion staff. The committee is focused on investigating existing science and procedures as well as alternative methods for treating TBI and PTSD that are not being employed by the Department of Defense (DOD) and VA for the purpose of determining if such alternative treatments are practical and efficacious.
During a three year study the committee met with leading authorities in the DOD, VA, academia, veterans, private sector mental health experts, and caregivers about treatments and therapies veterans have received or are currently receiving for their TBI and PTSD symptoms. As a result of the study, the committee released their findings and recommendations in a report titled “The War Within.” “The War Within” report highlights these treatments and therapies and also identifies findings and recommendations to the DOD and VA.
Key Highlights and Findings of the Report:
Some of the critical findings of The War Within included:
- Most of the existing research for the last several years has only validated the current treatments that already exist – VA and DOD research is not pushing the boundaries of what can be done with new therapies, merely staying within an environment of self-confirmation bias.
- There seems to be a lack of fast track mechanisms within DOD and VA to employ innovative or novel therapies – a standardized approach to these therapies could help service members and veterans gain access to care that could help them.
- While some VA Medical Centers (VAMCs) do offer complementary alternative medicine (CAM) therapies, they are not offered in a consistent or uniform manner across all 152 VAMCs nationwide – VA struggles with consistency and needs better guidance.
In addition to those findings, the TBI and PTSD Committee made some recommendations for the way forward:
- Congress needs to provide oversight and funding to DOD and the VA for innovative TBI and PTSD research that is being used successfully in the private sector healthcare systems such as hyperbaric oxygen therapy, virtual reality exposure therapy, and non-pharmacological treatments and therapies.
- Congress needs to increase DOD and the VA research and treatment budgets in order to improve the research, screening, diagnosis, and treatments for TBI and PTSD.
- DOD and VA need to accelerate their research efforts in order to effectively and efficiently diagnose and develop evidence-based TBI and PTSD treatments.
The American Legion’s efforts to assess the care and treatments available for veterans suffering from TBI and PTSD are not limited to the efforts of the TBI and PTSD Committee. In 2003, The American Legion established the System Worth Saving Task Force to conduct ongoing, on-site evaluations of the Veterans Health Administration (VHA) medical system. Annually, System Worth Saving visits provide Legionnaires, Congress and the public with an in-depth, boots on the ground view of how veterans are receiving their healthcare across the country.
Over the last several years, the System Worth Saving reports have examined the full spectrum of VHA care, but specifically have noted several things about how VHA delivers on complementary and alternative medicine (CAM) in their facilities.
VA medical centers throughout the VA healthcare system are committed, dedicated, and compassionate about treating veterans with TBI. Many medical centers throughout the country have found successful complementary and alternative methods for the treatment of TBI and PTSD such as hiking, canoeing, nature trips, equine, and music therapy. While some systems like the El Paso VA Healthcare System offer several CAM solutions, such as yoga, guitar lesions, sleep hygiene and other practices, other locations such as the Pittsburgh VA and Roseburg VA Healthcare System are more limited, offering only acupuncture in Pittsburgh, and acupuncture for pain management through the fee basis program in Roseburg.
In addition to the ongoing System Worth Saving Task Force visits, The American Legion is taking the lead for veterans by aggressively pursuing the best possible treatment options for veterans on multiple fronts.
Hearing from Veterans About their Treatment:
On February 3, 2014, The American Legion launched a TBI and PTSD survey online in order to evaluate the efficacy of the veterans’ TBI and PTSD care, treatments, and therapies and to inquire if they are receiving and benefiting from CAM treatment offered by the DOD and VA. The survey will assist The American Legion to better understand the experiences of veterans who receive care throughout the VA healthcare system.
William Detweiler, Past National Commander and Chairman of the TBI and PTSD Committee stated, “The American Legion is very concerned by the unprecedented number of veterans who suffer from these two conditions…We firmly believe that both VA and DOD need to act aggressively in adopting all effective treatments and cures, including alternatives being used in the private sector, and make them available to our veterans nationwide…By completing this survey, veterans across America will have the opportunity to tell the true story of the types of care and treatments that they are actually receiving for PTSD and TBI. The survey will greatly help The American Legion in its efforts to advise the Administration, Congress, DOD, VA on the best possible care and treatments for these injuries.”
The survey is available online at: www.legion.org
On May 21, 2014, The American Legion is hosting a TBI and PTSD Symposium entitled “Advancing the Care and Treatment of Veterans with TBI and PTSD.” The symposium aims to discuss the findings and recommendations from the TBI and PTSD veteran’s survey, hear directly from service members, veterans, and caregivers on their TBI and PTSD experiences, treatments and care, and determine how the Administration, Congress, DOD and VA are integrating complementary and alternative treatments and therapies into current models of veterans’ health care.
As America progressed through the first decade of the 21st century as a nation at war, an evolving understanding of the nature of the wounds of warfare emerged. As understanding of the wounds of war continues to emerge, veterans must be reassured that the care they receive, whether serving on active duty in the military, or through the VA Healthcare system in their home town, is the best treatment available in the world. To combat the physical and psychological wounds of war, sometimes the old treatments are not going to be the most efficacious.
Just as new understanding about the nature of these wounds emerges, so too must the new understanding about the best way to treat these wounds continue to adapt and evolve. Veterans are fortunate to have access to a healthcare system designed to treat their wounds, but that system must recognize that different treatments will have differing levels of effectiveness depending on the individual needs of the wounded veteran. There is no silver bullet. There is no single treatment guaranteed to cure all ailments. With a national policy that respects and encourages alternative therapies and cutting edge medicine, veterans have the best possible shot to get the treatment they need to continue being the productive backbone of society their discipline and training prepares them to be.
The American Legion looks forward to working with the Committee, as well as VA, to find solutions that work for America’s veterans. For additional information regarding this testimony, please contact Mr. Ian de Planque at The American Legion’s Legislative Division, (202) 861-2700 or firstname.lastname@example.org.
 Resolution #108: Request Congress Provide the Department of Veterans Affairs Adequate Funding for Medical and Prosthetic Research
 2011 SWS – “Transition of Care from DOD to VA”
 2014 SWS – “Past, Present and Future of VA Health Care”