EXCERPTS - THE GHOSTS OF WAR

FROM the Introduction by Allen Hassan, M.D., J.D.

        As a medical doctor and an attorney, I am often asked to evaluate our veterans for disability benefits. As a former proud US Marine whose experience includes two tours as a civilian doctor during the Vietnam War, I have a special sympathy for our American veterans. With my early training in psychiatry and my own experience in Vietnam, I have a well-grounded understanding of what the chaos and horror of war can do to people who must experience it.
        As a medical doctor, in 1970 I was first approved by the Veterans Administration to evaluate veterans with what has since been labeled Post-Traumatic Stress Syndrome or PTSD. Over the years, performing mental and physical evaluations of military veterans has become a sub-specialty for me. Becoming an attorney greatly deepened my understanding of the legal dimension of many of these claims. As the Veterans Administration will not pay the cost of having any veteran represented by a lawyer, I have occasionally used my legal training to maximum advantage.
        Since 1970 I have conducted mental/physical evaluations for the Veterans Administration on behalf of more than 3,000 former soldiers, sailors, airmen, Marines, and National Guardsmen. Although I may have lost one or two cases of which I am not aware, I believe all my recommendations eventually prevailed with the VA. However, these claims do not move quickly through the system. Many cases take several letters and much time, perseverance, and patience on the part of the veteran claimants themselves.
        I am writing this book because many other medical doctors have told me they have no idea how to approach the writing of letters such as these. In writing The Ghosts of War, I hope to show other physicians, lawyers, and the veterans they serve, how to present a claim for disability benefits, and how to write effective, winning evaluations. 
        To qualify for veterans’ benefits, of course, the veteran’s claim must establish three things. First and foremost, it must establish that the medical or psychological problem began or originated while the veteran was in the service. It must establish that the problem has been chronic or developing from that time. And finally, it must establish that the problem seriously affects the veteran at the time of the claim, and also establish the degree of affliction. The VA rates these claims in increments of 10 percent, with established guidelines for rating veterans with particular mental or physical problems....CONTINUED IN THE GHOSTS OF WAR

from Chapter 2. OUT OF CONTROL SOLDIERS IN VIETNAM
        Sylvester, a black man, was a soldier in Korea and Vietnam who wanted to do a good job. He was well-spoken, with a distinct military bearing after many years of service. In the Air Force during the Vietnam years, his job was to get the barracks prepared for an enemy attack, and his troops were unruly, smoking marijuana in the barracks, unconcerned and not prepared for a possible attack. As he conscientiously tried to do his job, Sylvester was worried he’d be fragged, or killed by his own men. By one estimate, 278 officers were fragged in Vietnam, and perhaps 10 times more than that were attempted. He was often asked to deal with young black soldiers who were out of control, adding to the stress of war a concern that his own people not kill each other. Sylvester lived through nine rocket attacks in Vietnam.

October 27, 2005
Department of Veterans Affairs, Regional Office

RE: Sylvester D. (Regular Air Force)
Dates of enlistment in combat
1953, Wan Ju and We Jon Bu, Korea
1970-71, Da Nang, South Vietnam

        This letter is written in response to my patient’s request for assistance in obtaining veterans benefits for combat-related Post-Traumatic Stress Disorder.
        While this patient was stationed in Korea, it was enemy territory and although the war had supposedly been concluded, there were still missions to be done and enemies to be intercepted. The patient was a young airmen third class at the time he was on frequent patrol and at one point intercepting a Korean who had stolen an electric code sender from the ACNW aircraft and control center. The patient recalls that he had apprehended the individual because he saw suspicious materials hanging underneath his trench coat. For his interception, the patient had to “rough up and disarm” this particular Korean. He still remembers the blood coming out of the Korean’s ears....CONTINUED IN THE GHOSTS OF WAR

from Chapter 3. RAPED IN THE NATIONAL GUARD
        Linda was a black lady who had an obvious problem with self-esteem. Underneath that, she was angry that nobody had ever listened to her complaints. She was somewhat reticent to tell her story, which involved more acting out behavior and drugs than when I was in the service. In my office, it took three hours to hear her story and to write the letter to the VA. Linda was sitting in the room as I dictated the letter to the Veterans Administration, as all my veterans are. After I finished the dictation and she heard her story spelled out in detail for the first time, she stood up and thanked me profusely. I knew from my own experience that there could be bad apples in the military....CONTINUED IN THE GHOSTS OF WAR

from Chapter 4. TERRORIST BOMBING IN GERMANY
        Stephen was a military police patrol supervisor when he was caught in the middle of a terrorist bomb attack in a PX in Frankfort, Germany, in which 34 people were injured. Although he was off-duty at the time, this veteran felt he should have done more to help the victims of the bombing. His experiences resulted in constant mental stress which affected him in civilian life to the extent that we recommended a 40% disability for PTSD....CONTINUED IN THE GHOSTS OF WAR

from Chapter 5. RADIATION EXPOSURE LEADS TO CANCER 
        Roger was a medium-sized man with a very rare form of cancer. He had been exposed to radiation several times in the service in 1956, but the Veterans Administration continued to maintain that radiation was not a factor in his cancer. It is a fact that there is no true measure of the amount of radiation exposure necessary to cause cancer. However, we worked out the amount of radiation exposure he had suffered, and then researched the issue as to cause and effect. There were several studies that showed that medical personnel who worked around radiation had higher incidences of several types of cancer, no matter what precautions were taken to protect them. Since he had been denied on the basis of exposure to radiation, we went to the idea of chronic disease, and used their own medical statutory language to get benefits for this deserving man. Questions remain in this area. How do you measure radiation exposure? How much radiation exposure causes cancer? Does mere exposure qualify a person for disability benefits?...CONTINUED IN THE GHOSTS OF WAR

from Chapter 6. AGENT ORANGE LEADS TO LEUKEMIA 
        This veteran served in the Air Force for 20 years. He came into my office suffering from chronic lymphocytic leukemia. The VA denied him benefits for this fatal disease, alleging no service connection. As a general rule, once any doctor sees a veteran with this or other rare cancers, he should look at the entire experience of the patient including the Armed Forces records to see if chemical exposure occurred. He should also generally understand the types of exposure people had during various wars. If you are treating the patient for heart problems, you shouldn’t overlook leukemia which could come from exposure to Agent Orange. When this letter was written, in 2004, Cambodia, Laos and Thailand were not included in the countries where soldiers were presumed to be exposed to Agent Orange but in 2006 these three countries were given equal status for Agent Orange exposure benefits. This soldier worked in Southeast Asia for two years, mostly in Thailand, but also in Cambodia, loading and unloading and repairing airplanes and equipment which came out caked with dust and dirt from Vietnam. He had frequent respiratory infections during this time, possibly from exposure to Agent Orange and other chemicals used during the Vietnam War and this exposure had dire consequences later in his life....CONTINUED IN THE GHOSTS OF WAR

from Chapter 7. DEPLETED URANIUM LEADS TO CANCER
        The U.S. Army charged this soldier with exploding depleted uranium ordinance in Bosnia Herzegovina, which led to his developing testicular cancer. Uranium is an obvious carcinogen. At issue was a urine sample taken eight years after his exposure, which showed a significant level of uranium in his body. VA evaluators wished to read test results as showing levels were harmless, but to be fully accurate we pointed out the test should be given soon after exposure -- not eight years later when uranium levels had surely fallen....CONTINUED IN THE GHOSTS OF WAR


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