Good morning Chairman Bob Filner, Ranking Member Steve Buyer, and Members of the Committee. Thank you for the opportunity to share my personal experience with the Military and the Department of Veterans Affairs. The following details my family’s experiences with Ryan’s journey and the significant role that the nonprofit communities played in helping my injured soldier regain his independence.
My name is Lorrie Knight-Major. I am the mother of Sergeant Ryan Christian Major. On November 5, 2003, Ryan enlisted in the US Army for a three year term, which was later extended for an additional five months. On November 10, 2006 at 0300, five days after his original discharge date and two months prior to his redeployment from Iraq to the US, Ryan was critically wounded as a result of an improvised explosive device (IED) blast while on a mission with his unit on a foot patrol in Ramadi. The device was hidden under ground. As a result of the blast, Ryan sustained multiple massive injuries including:
- Both legs were amputated above the knee;
- Both arms were broken with multiple fractures;
- Extensive peritoneum injuries;
- Severe right pelvic fracture; and
- Traumatic Brain Injury and post traumatic stress disorder
As I recall the events following the blast as a mother and a caregiver, I am reminded of the pledge that soldiers take when they enlist, the Soldier’s Creed. I ask that each one of you listen closely and reflect on America’s solemn oath to providing the necessary resources to our military.
A Soldier’s Creed
I am an American Soldier. I am a Warrior and a member of a team.
I serve the people of the United States, and live the Army Values.
I will always place the mission first. I will never accept defeat.
I will never quit. I will never leave a fallen comrade.
I am disciplined, physically and mentally tough, trained and proficient in my warrior tasks and drills.
I always maintain my arms, my equipment and myself.
I am an expert and I am a professional.
I stand ready to deploy, engage, and destroy, the enemies of the United States of America in close combat.
I am a guardian of freedom and the American way of life.
I am an American Soldier.
I met Ryan at his bedside in the intensive care unit in Landstuhl, Germany, three days after I had received the news. He was barely hanging on. I was frightened beyond description. But as bad as Ryan looked, I knew in my heart, he was a fighter. As a child, he had challenged every line I had drawn in the sand. Now I was certain that his determination would save his life. Although he lay there helpless, I believed that if given a fighting chance and the best possible medical care available, Ryan would persevere.
Within twenty-four hours of our arrival in Landstuhl, doctors had stabilized Ryan for transport to Walter Reed Army Medical Center. Ryan underwent multiple surgeries while at Walter Reed. On January 3, 2007, Ryan was moved by ambulance to the R Adams Cowley Shock Trauma Center at the University of Maryland Medical Center (Shock Trauma). Shock Trauma is world renown for managing difficult traumas and complicated infections and is the only free standing hospital center in the world dedicated to trauma.
Within hours of Ryan’s admission to Shock Trauma, the Pain Team was on board employing its unique holistic approach to treatment. The team used a host of tools including narcotics, Reiki therapy, massage therapy and, later, acupuncture. For the first time in three weeks, Ryan was able to sleep through the night peacefully, as the staff turned him every two hours.
On January 31, 2007, Ryan was transferred to National Rehabilitation Hospital (NRH) where he spent the next seven months. But getting Ryan into NRH wasn’t easy because he was an enlisted soldier. It took multiple meetings with military staff, but ultimately they granted permission. I convinced them that NRH had a proven track record and that Ryan’s family and friends could routinely visit — support I felt would be critical to his successful recovery.
Before going to NRH, we were given four options of VA polytrauma hospitals in the U.S., but none were close to home. Ryan’s transfer to any of them would have required me to travel out of state and live for many months far from home, without social support and away from my job, while leaving my minor child at home. Our veterans should have access to Regional Trauma Hospitals and nationally recognized rehabilitation facilities that possess expertise on polytrauma that are located near their homes. Our family was very fortunate to live in the national capital region, home of two of the finest medical facilities, R Adams Cowley Shock Trauma Center at the University of Maryland Medical Center and National Rehabilitation Hospital. Most families I have met or talked to don’t live in close proximity to hospitals such as these in their home towns. Most families of severely injured soldiers travel across state lines and live in hospital and hotel rooms to be near their injured soldiers for many months placing additional burdens on an already emotionally fraught time period.
For the first two months after Ryan’s injuries, we were not certain if he would survive. He was in a coma fighting for his life. He battled serious infections and underwent surgeries daily. Once we crossed those bridges and it appeared very likely that he would survive; I started to plan for his return home.
Because of the wheelchair, I knew that major structural changes to our house were needed to accommodate him. Two separate architects examined our home and determined that a stair lift wasn’t feasible. They both said that we needed an elevator. I didn’t know how I would accomplish the huge task of making our home wheelchair accessible.
Through the VA, there are three grants available for constructing an adapted home or modifying an existing home to meet veterans with service connected disabilities’ adaptive needs: the Specially Adapted Housing Grant, The Special Home Adaptation Grant and the Home Improvements and Structural Alterations Grant (HISA), which require separate applications to the Veterans Health and Benefits Administrations. HISA does not require a service connected disability. To access the maximum funding through these grants, veterans have to own the homes where the modifications will be done. Up to half of the injured soldiers are single and they return home to live with their parents, other family members, or friends. Therefore, access to funding through the VA is limited to fourteen thousand dollars ($14,000.00) for work done on someone else’s home where the veteran will live.
In 2007, when I was looking for available housing resources, the grant provided fifty thousand dollars ($50,000). Now the grant provides sixty thousand dollars ($60,000). For the modifications that our home required, it wasn’t enough money. The grant would have only paid for the elevator to be installed which would have carried him from the garage into the first floor of the house. But the bedrooms were located on the second floor.
Fortunately, by word of mouth, I was informed about Rebuilding Together, a national non-profit organization that provides home rehabilitation and modification services to homeowners in need. In 2005, Rebuilding Together launched its Veterans Housing Program to address the needs of soldiers returning from Iraq and Afghanistan. This program has been expanded to help veterans of all wars, and is now sponsored by Sears Holdings Corporation.
Rebuilding Together’s Veterans Housing program to date has rehabilitated and modified the homes of 725 veterans and 25 veterans’ centers. Their overall mission is homeownership preservation for those in need, and their 200 affiliates nationwide rehab 10,000 houses a year, at no cost to the homeowner, thanks to the work of thousands of skilled and unskilled volunteers and the support of national and local sponsors.
Rebuilding Together immediately committed to the project upon receipt of my application. An evaluation of our house was performed. Their staff and architect met with Ryan’s medical team at NRH to thoroughly assess Ryan’s needs.
The renovations were completed within four months. The work that was done by Rebuilding Together included: an elevator, the conversion of our first floor family room into Ryan’s bedroom with an accessible bathroom, a new deck addition for his egress, a new separate central air and heating system for his bedroom, and an in-ground generator for emergency purposes and escape. The value of these renovations is estimated at $150,000 which, thanks to Rebuilding Together, didn’t cost our family anything. This project was not just about installing an elevator or renovating the bathroom or adding a new deck. It was a life changing experience. Without the modifications, Ryan would have been confined to the basement - apart from his family or dependent on his brothers and friends to carry him up and down the stairs. The elevator and handicap accessibility renovations gave Ryan the freedom and the independence to move around his home and insured that he was an integral part of our home and our family.
If these services had not been provided by Rebuilding Together, over 725 veterans and their family members would not have the quality of life they now enjoy since VA does not fully accommodate all of their needs through its grant programs. Sometimes that is because the veteran is unaware of the benefit, ineligible, or it’s simply not enough as in our case. Ryan’s dream to come home could not have been fulfilled without the generosity of many other members in our community.
In 2008, Ryan received an IBOT wheelchair from the Independence Fund. This chair can climb stairs and rises in the air raising the seat height. Ryan’s IBOT gives him the ability to reach upper kitchen cabinets in our home and allows him to visit friends where climbing stairs is necessary to enter their home. Independence Fund is a small nonprofit that was established in 2004. Independence Fund has donated twenty IBOTs to wounded soldiers and veterans totaling $500,000. Again, the VA did not have the ability to provide Ryan with this level of specialized equipment.
In August 2009, Ryan received Theodore from Paws for Liberty. Theodore is a three year old Belgian Shepherd and has truly made the biggest impact on Ryan’s independence. Theodore helps Ryan with retrieving dropped items, helps him navigate crowded areas, and helps relieve and mitigate his PTSD symptoms. Once Theodore came home with Ryan, Ryan no longer required someone at his bedside so that he could sleep. Paws for Liberty is a five year old organization based out of Lake Worth, Florida. They have donated four service dogs to veterans and six service dogs to individuals with disabilities. These dogs cost on average of $15,000 - $20,000 to train. Again, a resource not offered to Ryan by the VA.
I am reminded of the ancient African proverb, “It takes a village to raise a child” because, “It takes a community to bring a soldier home”. Thanks to all of the support that we have received, Ryan is embracing his challenges, and is moving forward with his life. He has completed both the New York Marathon and the Boston Marathon on a hand crank bicycle, skied in Aspen Colorado, kayaked on the Colorado River, and is driving his own car. He began attending college this semester pursuing a degree in Business Administration with the assistance of Sentinels of Freedom, a nonprofit organization.
I have had to reach outside the system and rely on the nonprofit community for assistance throughout this ordeal. This support should have been provided by the government. It is because of the nonprofits that have provided Ryan with the resources for him to live at home with his family, take charge of his own care, and allow him to feel safe and sleep at night. In light of this, there should be better collaboration between the Department of Defense, VA and nonprofit organizations.
Unlike many other soldiers transitioning out of the military, Ryan’s transition into the VA system went smoothly. I credit this success to Ryan’s Federal Recovery Coordinator. She laid the groundwork in planning Ryan’s transition into the VA a year in advance by beginning the communication between Walter Reed and the Baltimore VA. Ryan’s medical board process with the VA was a simple process. All of the VA staff that dealt with Ryan’s medical board and disability rating provided outstanding services. I could not have asked for a more straight forward process. However, in hindsight, now that Ryan is enrolled in college, I wish that a vocational rehabilitation assessment was mandatory as part of his disability evaluation process before he separated from the Army. This would have provided vital information on his aptitude and functioning and would have informed his college course choices. He has still not had a VA Vocational Rehabilitation and Employment assessment.
The one item that I feel has been overlooked in the VA Disability Rating is the disability’s impact on a veteran’s quality of life. And based on its impact, a corresponding dollar value should be assigned and paid to the veteran as part of the monthly disability compensation as a special monthly compensation.
From the moment that Ryan was injured, his clothes required alterations due to surgeries, arm and hand splints, bilateral lower extremity amputations and the use of medical creams and ointment frequently soiled and ruined clothes. The clothing allowance available to veterans is not permitted under the law to active duty service members with the same injuries or conditions. This benefit should be treated equally with the other benefits available to active duty wounded warriors, such as the auto and housing allowances.
Our journey has been fraught with various obstacles that serve as barriers to access to quality care. Navigating the complex maze of treatment options and benefits is a job in and of itself. But, we remain determined that Ryan receives the quality care that he was promised when he enlisted to serve in the United States Army should he become injured. Advocating for this quality medical care and the coordination of services has been my mission. But this level of care and advocacy comes at a price. The cost has been my family’s financial security. As a result of caring for my Ryan, and the emotional toll it has taken on our family, I had to leave my job to provide the necessary level of medical care and advocacy that my son required. This led to a significant financial hardship for our family because of my living on credit cards and a home equity line of credit, which have all been exhausted. When I gave up my job, I also gave up my health insurance that covered me and my minor child, shifting that additional monthly expenditure to my out of pocket expenses. Families should not have to sacrifice and bear the burden of advocacy, and compromise their own financial stability and wellness to ensure that their soldiers’ receive the appropriate and necessary services from the government.
I recognize that progress has been made in the caring of our injured soldiers. We still have a ways to go.
Recommendations in Moving Forward
Here are the things that I would recommend to improve the lives of wounded warriors and veterans:
- Increase the amount of VA Housing Grants and the establishment of a competitive fund for national housing organizations to compete for housing dollars to better enable them to provide housing modifications for veterans.
- VA Service Dogs are made available to veterans with service connected disabilities to include challenges with mobility and mental health issues as are done with Guide Dogs.
- Increase in the VA Automobile Grant.
- Increase in the number of authorized electric wheelchairs based on changing needs and a program for veterans to return wheelchairs that no longer meet their needs.
- Vocational Rehabilitation Assessments are made mandatory during the Disability Evaluation System process before a veteran with service connected disabilities separates from the military; and
- Authorize a clothing allowance that is available for veterans to be available to service members with similar injuries and conditions
As a mother, here are the things that I would recommend that would have made my life easier if they were in place:
- Health insurance allowance for my minor son and me; and
- Non-medical attendant allowance that is provided by DoD to caregivers of veterans that receive medical care greater than fifty miles from their residence. Since I lived within the fifty mile radius, I didn’t qualify for the DoD benefit, but VA could have filled the gap.
As an observer with a window seat, here are my recommendations for the providers of care:
- Improved communication between all of the providers regardless if VA, DoD or private;
- Better collaboration between all of the medical policy leaders, both in the government and civilian population. Allow private providers and facilities to fill in the gaps when a VA facility is not in the veteran’s community. Additionally, the sharing of best practices between all medical providers would improve the medical care provided to both the military and civilian populations; and
- Require a multidisciplinary medical team approach in providing care in military and VA hospitals to include the Pain Team and Infectious Disease specialty.
Ryan loved being in the Army until the day he separated on May 20, 2010. He loves the military. He never quit. He never once complained about getting hurt. The men in his Unit never quit. The medical teams that saved him in theater never quit. I ask this Congress to not only honor this country’s solemn oath to care for our veterans, but I urge you to work towards the United States being proactive in making funding available for our wounded soldiers and veterans. If the United States can set aside funds for an unexpected oil spill, surely America can put aside monies at the time a war is authorized, to take care of our military that continues to take care of us preserving our freedoms. We owe a tremendous debt to our veterans for their services and sacrifices. It is our social, moral, and ethical responsibility to provide them with the appropriate resources, and the tools and support that are necessary for them to live longer, fuller, and healthier lives.
Now that the Caregiver Bill has been signed by the President, I would like to know how it would address the concerns that I have shared on the record. Will the VA pay retroactive compensation to caregivers of OEF/OIF veterans? If so, will there be a lump sum payment to these caregivers?
If the nonprofit organizations had not provided assistance, would it have been acceptable to the government for my son to have been placed in a nursing home? Would it have been acceptable to the government for my son to have lived isolated in a basement because he didn’t have a means to be transported to the main areas of the house? Would it have been acceptable for my son to require sleep medications or someone in his room nightly for him to sleep? Is this what the government considers to be the cost of the war?
Ryan couldn’t be here today because he is attending classes. Therefore, I included a picture of him and his service dog, Theodore.
Again, thank you Mr. Chairman for the opportunity to share my personal experience in accessing care and resources within the Department of Defense and the Department of Veterans Affairs.
(Courtesy of b free daily)