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State News

State of New Mexico

Department of the Disabled American Veterans



New Mexico VA Health Care System

Department of Veterans Affairs



Contact:     Michael P. Kleiman                                                    For Immediate Release

                   Public Affairs Officer                                                  July 15, 2003

                         (505) 256-2843


Interim Director Appointed to Lead the New Mexico Veterans Affairs Health Care System


Albuquerque, N.M. – The Department of Veterans Affairs has appointed Kurt W. Schlegelmilch, M.D., as interim director, New Mexico Veterans Affairs Health Care System, effective July 14. 


Dr. Schlegelmilch serves in his new position for the next three months while the organization’s director remains on leave due to a family illness.  


Since September 1997, he has worked as director, Grand Junction, Colo., Veterans Affairs Medical Center.  Under his leadership, the facility received the 2001 Presidential Award for Quality and the Veterans Health Administration’s highest honor, the Robert W. Carey Quality Award, in 1999.  During the preceding three years, Dr. Schlegelmilch was employed as chief of staff, Anchorage, Alaska, Veterans Affairs Medical Center.  From November 1990 to July 1994, he held the position of associate chief of staff, Ambulatory Care, Reno, Nev., Veterans Affairs Medical Center.  After serving three years on active duty with the Air Force, he joined the Department of Veterans Affairs in July 1989 as the chief medical officer for an outpatient clinic in Toledo, Ohio.  Regarding his new opportunity, Dr Schlegelmilch said, “I know that we can achieve much in the advancement of veteran care and service.  The organization’s best days are yet ahead!”


He earned a medical doctorate in 1983 from the State University of New York at Buffalo School of Medicine.  Dr. Schlegelmilch is an active member of the American College of Physicians, the American College of Physician Executives and a diplomat of the American College of Healthcare Executives.



Date: Wed, 16 Jul 2003


Subject: [Veteran Issues] corrected units, AO in Korea

  Fw: Agent Orange in Korean DMZ




During the March 2003 VSCM call, we provided information regarding the use of Agent Orange in Korea along the DMZ, including the units in the area during the period in which Agent Orange was sprayed.  DoD has provided a correction to two of the cited units.  Previously reported as the 109th and 209th Infantry, those units were actually the 1/9th and 2/9th Infantry.  A corrected listing of units follows:


 The four combat brigades of the 2nd Infantry Division:


1/38th Infantry

2/38th Infantry

1/23rd Infantry

2/23rd Infantry

3/23rd Infantry

3/32nd Infantry

1/9th Infantry

2/9th Infantry

1/72nd Armor

2/72nd Armor

4th/7th Cavalry


3rd Brigade of the 7th Infantry Division:


1/17th Infantry

2/17th Infantry

1/73rd Armor

2/10th Cavalry


If you receive a claim from a veteran who alleges service at the DMZ during the period April 1968 to July 1969, and who was assigned to one of the above units, please concede exposure to herbicides.  Therefore, there is no need to contact C&P Service in these cases.


For all other claims of herbicide exposure, ask the claimant for a detailed description of the exposure, including the location, approximate date(s) and nature of the exposure.  You should also ask the claimant for proof of exposure, such as "buddy" statements, photographs taken during service or letters written during service.  Once the detailed exposure information is obtained and there is no evidence of exposure, provide this information to Cheryl Konieczny via email.  We will then consult DoD's Agent Orange listing of use, test and disposal of Agent Orange.  (Note:  I did note that no MP units are listed by themselves--yet they are/were on the DMZ.)



Date:      Tue, 15 Jul 2003

Subject: Rating Process for PTSD & PSYCHIATRIC CONDITIONS


The below info comes from M21-1 - Adjudication Procedures VA manual






 a. Reductions.  Do not make drastic reductions in evaluations in ratings for psychiatric conditions if a reduction to an intermediate rate is more in agreement with the degree of disability.  See also 38 CFR 3.344.  The general policy to be observed is a gradual reduction in evaluation to afford the veteran all possible opportunities of adjustment.


 b. Attempted Suicide.  A finding of "mental unsoundness" under the provisions of 38 CFR 3.302, in the absence of any underlying psychiatric disability subject to service connection, does not in itself constitute a service-connectable disability.  See Elkins v. Derwinski, 8 Vet. App. 391 (1995).




Service connection for PTSD requires medical evidence establishing a clear diagnosis of the condition, credible supporting evidence that the claimed in-service stressor actually occurred, and a link, established by medical evidence, between current symptomatology and the claimed in-service stressor (38 CFR 3.304(f)).  The issue of service connection for PTSD is the sole responsibility of the rating specialist at the local level.  Central Office opinion or guidance may be requested on complex cases.


 a. Stressors.  In making a decision, exercise fair, impartial, and reasonable judgment in determining whether a specific case of PTSD is service connected.  Some relevant considerations are:


 (1)  PTSD does not need to have its onset during combat.  For example, vehicular or airplane crashes, large fires, flood, earthquakes, and other disasters would evoke significant distress in most involved persons.  The trauma may be experienced alone (rape or assault) or in the company of groups of people (military combat).


 (2)  A stressor is not to be limited to just one single episode.  A group of experiences also may affect an individual, leading to a diagnosis of PTSD.  In some circumstances, for example, assignment to a grave registration unit, burn care unit, or liberation of internment camps could have a cumulative effect of powerful, distressing experiences essential to a diagnosis of PTSD.


 (3)  PTSD can be caused by events which occur before, during or after service.  The relationship between stressors during military service and current problems/symptoms will govern the question of service connection. Symptoms must have a clear relationship to the military stressor as described in the medical reports.


 (4)  PTSD can occur hours, months, or years after a military stressor. Despite this long period, service-connected PTSD may be recognizable by a relevant association between the stressor and the current presentation of symptoms.  This association between stressor and symptoms must be specifically addressed in the VA examination report and to a practical extent supported by documentation.


 (5)  Every decision involving the issue of service connection for PTSD alleged to have occurred as a result of combat must include a factual determination as to whether or not the veteran was engaged in combat, including the reasons or bases for that finding.  (See Gaines v. West, 11 Vet. App. 113 (1998).)


 b. Evidence of Stressors in Service


 (1)  Conclusive Evidence.  Any evidence available from the service department indicating that the veteran served in the area in which the stressful event is alleged to have occurred and any evidence supporting the description of the event are to be made part of the record.  Corroborating evidence of a stressor is not restricted to service records, but may be obtained from other sources (see Doran v. Brown, 6 Vet. App. 283 (1994)). If the claimed stressor is related to combat, in the absence of information to the contrary, receipt of any of the following individual decorations will be considered evidence that the veteran engaged in combat:


Air Force Cross

Air Medal with "V" Device

Army Commendation Medal with "V" Device

Bronze Star Medal with "V" Device

Combat Action Ribbon

Combat Infantryman Badge

Combat Medical Badge

Distinguished Flying Cross

Distinguished Service Cross

Joint Service Commendation Medal with "V" Device

Medal of Honor

Navy Commendation Medal with "V" Device

Navy Cross

Purple Heart

Silver Star


Other supportive evidence includes, but is not limited to, plane crash, ship sinking, explosion, rape or assault, duty on a burn ward or in graves registration unit.  POW status which satisfies the requirements of 38 CFR 3.1(y) will also be considered conclusive evidence of an in-service stressor.


 (2)  Evidence of Personal Assault.  Personal assault is an event of human design that threatens or inflicts harm.  Examples of this are rape, physical assault, domestic battering, robbery, mugging, and stalking.


 (a)  Alternative Evidence.  If the military record contains no documentation that a personal assault occurred, alternative evidence might still establish an in-service stressful incident.  Examples of such evidence include, (but are not limited to):


· Records from law enforcement authorities

· Records from rape crisis centers, hospitals, or physicians

· Pregnancy tests or tests for sexually transmitted diseases, and

· Statements from family members, roommates, fellow service members or clergy.


 (b)  Behavior Changes.  Behavior changes that occurred at the time of the incident may indicate the occurrence of an in-service stressor.  Examples of such changes include (but are not limited to):


· Visits to a medical or counseling clinic or dispensary without a specific diagnosis or specific ailment

· Sudden requests for a change in occupational series or duty assignment without other justification

· Increased use or abuse of leave without an apparent reason, such as family obligations or family illness

· Changes in performance and performance evaluations

· Episodes of depression, panic attacks, or anxiety but no identifiable reasons for the episodes

· Increased or decreased use of prescription medications

· Increased use of over-the-counter medications

· Substance abuse such as alcohol or drugs

· Increased disregard for military or civilian authority

· Obsessive behavior such as overeating or under eating

· Unexplained economic or social behavior changes, and

· Breakup of a primary relationship.


 (c)  Development Requirements.  Do not deny a post-traumatic stress disorder claim that is based on in-service personal assault without first advising the claimant that evidence from sources other than service medical records, including evidence of behavior changes, may constitute credible supporting evidence of the stressor.  Allow the veteran the opportunity to furnish this type of evidence or indicate its potential sources.


 (d)  Interpretation of Secondary Evidence.  In personal assault claims, secondary evidence may need interpretation by a clinician, especially if it involves behavior changes.  Evidence that documents such behavior changes may require interpretation in relationship to the medical diagnosis or an opinion by an appropriate medical or mental health professional as to whether it indicates that a personal assault occurred.


 (3)  Credible Supporting Evidence.  A combat veteran's lay testimony alone may establish an in-service stressor for purposes of service connecting PTSD (Cohen v. Brown, 94-661 (U.S. Ct. Vet. App. March 7, 1997)).  However, a noncombat veteran's testimony alone does not qualify as "credible supporting evidence" of the occurrence of an in-service stressor as required by 38 CFR 3.304(f).  After-the-fact psychiatric analyses which infer a traumatic event are likewise insufficient in this regard (Moreau v. Brown, 9 Vet. App. 389 (1996)).


 c. Development


 (1)  For instructions regarding development of service records, medical treatment and evidence of stressor or personal assault, refer to Part III, subparagraphs 5.14b and 5.14c.


 (2)  Unless medical evidence adequate for rating purposes is already of record, request an immediate examination.  When requesting an examination, state in the remarks section of VA Form 21-2507, "Request for Physical Examination," "Claims folder to be made available to examiner upon request."


d. Incomplete Examinations and/or Reconciliation of Diagnosis.  If an examination is received with the diagnosis of PTSD which does not contain the above essentials of diagnosis, return the examination as incomplete for rating purposes, note the deficiencies, and request reexamination.


 (1)  Examples of an unacceptable diagnosis include not only insufficient symptomatology, but failure to identify or to adequately describe the stressor, or failure to consider prior reports demonstrating a mental disorder which could not support a diagnosis of PTSD.  Conflicting diagnoses of record must be acknowledged and reconciled.


 (2)  Exercise caution to assure that situational disturbances containing adjustment reaction of adult life which subside when the situational disturbance no longer exists, or is withdrawn, and the reactions of those without neurosis who have "dropped out" and have become alienated are not built into a diagnosis of PTSD.


 e. Link Between In-service Stressor and Diagnosis.  Relevant specific information concerning what happened must be described along with as much detailed information as the veteran can provide to the examiner regarding time of the event (year, month, day), geographical location (corps, province, town or other landmark feature such as a river or mountain), and the names of others who may have been involved in the incident.  The examining psychiatrist or psychologist should comment on the presence or absence of other traumatic events and their relevance to the current symptoms.  Service connection for PTSD will not be established either on the basis of a diagnosis of PTSD unsupported by the type of history and description or where the examination and supporting material fail to indicate a link between current symptoms and an in-service stressful event(s).


 f. Review of Evidence


 (1)  If a VA medical examination fails to establish a diagnosis of PTSD, the claim will be immediately denied on that basis.  If no determination regarding the existence of a stressor has been made, a discussion of the alleged stressor need not be included in the rating decision.


 (2)  If the claimant has failed to provide a minimal description of the stressor (i.e., no indication of the time or place of a stressful event), the claim may be denied on that basis.  The rating should specify the previous request for information.


 (3)  If a VA examination or other medical evidence establishes a valid diagnosis of PTSD, and development is complete in every respect but for confirmation of the in-service stressor, request additional evidence from either the Center for Unit Records Research (CURR) or Marine Corps.  (See Part III, paragraph 5.14.)


 (4)  Do not send a case to the CURR or Marine Corps unless there is a confirmed diagnosis of PTSD adequate to establish entitlement to service connection.  Correspondingly, always send an inquiry in instances in which the only obstacle to service connection is confirmation of an alleged stressor.  A denial solely because of an unconfirmed stressor is improper unless it has first been reviewed by the CURR or Marine Corps.


If the CURR or the Marine Corps requests a more specific description of the stressor in question, immediately request the veteran to provide the necessary information.  If the veteran provides a reasonably responsive reply, forward it to the requesting agency.  Failure by the veteran to respond substantively to the request for information will be grounds to deny the claim based on unconfirmed stressor.  (See Part III, paragraph 5.14.)



Date:       Mon, 14 Jul 2003

Subject: Veterans Benefits Act of 2003 (H.R. 2297) passes VA Committee


The House Veterans Affairs committee passed several bills at the end of June including a bill (H.R. 1720) to authorize $1.1 billion in new VA health care construction projects. The Committee also passed the Veterans Benefits Act of 2003 (H.R. 2297) that would add cirrhosis of the liver as a presumed service-connected disability for former POWs, increase certain grants awards, and expand the Montgomery GI bill program for self-employment training programs. ( The Committee also passed a bill that would establish standards for veterans' access to medical care provided by VA.


All bills can be searched for by number at .



VA-HUD Spending Bill Includes Higher Medical Costs for Veterans:
Despite opposition from FRA and other organizations, the House Appropriations VA-HUD Subcommittee included a provision that established an annual $250 health care enrollment fee for some veterans; raised their co-pay for medicine from $7 to $15 and boosted their co-pay for outpatient services from $15 to $20 in its version of the FY 2004 VA-HUD spending bill on Wednesday.

The Department of Veterans Affairs has evaluated the extension of these fees to Category 8 veterans, those who have no service-connected disabilities and have income levels that exceed
geographically determined thresholds.  Along with The Military Coalition (TMC), FRA is urging House Appropriators to remove these provisions from the spending bill.


FRA Opposed Byrd Amendment:
FRA strongly opposed an amendment by Sen. Robert Byrd (W.V.) to the FY 2004 Defense Appropriations Bill, which the Senate passed late last night.  Byrd's amendment would have limited the President's ability to deploy reservists in response to global threats by limiting the funding needed to deploy reserve personnel overseas for longer than 180 days, or more than once in a 360-day period.  FRA maintains that hindering the Reserve Component's ability to deploy is not the answer to ensuring that our nation's growing operational commitments do not overextend the troops.  The Association supports an increase in manpower levels as a more appropriate solution.  FRA National Executive Secretary Joe Barnes has written Sen. Christopher Bond (
Mo.), who also publicly opposed the amendment, thanking him for speaking out against this provision.  The amendment was not included in the final version of the legislation.


Secretary Rumsfeld Threatens HASC over Concurrent Receipt:

In letters to the chairman and ranking member of the House Armed Services Committee (HASC),  Secretary of Defense Donald Rumsfeld wrote, "If the President is presented with a bill that . . . authorizes concurrent receipt of military retirement pay and veterans' disability compensation benefits or expands [the TRICARE benefit to reservists], then I would join other senior advisors to the President in recommending that he veto the bill." 

The letter detailed this and other Administration concerns regarding provisions in the House and Senate FY 2004 Defense Authorization Bills that await conference committee deliberations.  This response is consistent with the Administration's position on these provisions in last year's Defense Authorization.  Conference action on the defense bills is stalled, and no action is expected until after the August recess.


FRA Commends the Salute to Veterans and Armed Forces Act:
In a letter to Rep. Chet Edwards (Texas), FRA commended his leadership in introducing The Salute to Veterans and Armed Forces Act of 2003 (H.R. 2569).  Edwards' bill includes a discharge petition that would force House leadership to bring concurrent receipt legislation (H.R. 303) directly to the floor for a vote.  Lawmakers from both parties have repeatedly cosponsored
concurrent receipt legislation, and the petition has 201 of the 218 votes needed for action.  The list of signatures can be viewed on the Association's web site

(  Shipmates whose representatives' names are not on the list should send an electronic letter, via the Association's Action Center (, to their elected officials in the House urging support for the concurrent receipt discharge petition.  (Note that this campaign has also been covered in past issues of News Bytes.)

H.R. 2569 would also repeal the dependency and indemnity compensation (DIC) offset from the Survivor Benefit Plan annuities; increase education assistance for members of the Selected Reserve; provide a one time bonus for those service-members who participated in Operation Iraqi Freedom and Operation Enduring Freedom, and present additional funding to improve access to veteran's medical care.



Mobilized Reservists Are Securing `Veteran' Status:


For first-time activated reservists in the war on terrorism, there is a silver lining behind the cloud of a long, disruptive and often dangerous mobilization. The call-up will ensure their status as ``veterans'' and their eligibility for a full range of benefits from the Department of Veterans Affairs.


A fact still not well known among reservists and National Guard personnel is that those who first entered service after Sept. 7, 1980, which includes many of 294,000 members mobilized since 9-11, face a higher threshold than previous generations to qualify for VA healthcare benefits.


The impact of this change is only now becoming clear to some Selected Reservists and National Guardsmen completing careers that followed a once-traditional path. That is, they did their initial training, attended monthly drills and spent enough time on active-duty-for-training to earn 20 ``good'' years of reserve service. Now they can retire and, at age 60, will begin receiving a reserve retirement check.


But as they investigate VA benefits, some reserve retirees are surprised to learn they are not ``veterans.'' Others discover they have only limited veteran status, by virtue of minimal active service, but are ineligible for a full range of VA benefits.


To gain full veteran status, including eligibility for VA health care, reservists who entered the military after Sept. 7, 1980, must serve 24 continuous months of active service, or be called to active duty under a federal mobilization order, like the one President Bush signed after 9-11.


William West, a benefits expert at the VA, said that minimum active duty requirements impact eligibility for VA benefits including guaranteed home loans and education benefits. But today, thanks to easing by Congress, the 24-month rule only impacts VA healthcare.


And thanks to the massive call-up over the last two years, the biggest since World War II, many reserve and National Guard members are earning full veteran status through their mobilization, thus avoiding benefit disappointments that have touched some retiring colleagues.


In 2000, the VA adopted a broader definition of ``veteran'' for data collection to try to get give a more precise picture of the overall veteran population. This broader definition included 1.1 million separated reservists who failed to meet the 24-month rule on VA health care eligibility. They comprised only 4.4 percent of 25.5 billion veteran population overall but a large percentage of younger veterans.


For example, as of Sept. 30, 2000, no measurable percentage of veterans older than 55 was affected by the 24-month rule. Most entered service before the 1980 date. Among 3.2 million veterans age 50 to 54, only a tenth of one percent were ineligible for VA health care because they had less than two years of continuous active service. The VA calls this group the ``L2s''.


The number and proportion of L2s rose sharply as ages fell. Among 754,000 veterans age 25 to 29, more than 31 percent had less than the required two years of continuous active service. Among 264,000 veterans ages 20 to 24, more than half, 51 percent, were L2s.


If these veterans never serve 24 straight months on active duty, or if they aren't mobilized by federal authorities, VA health care won't be an option. In that light, the massive call-up over the last two years would appear to be reserving that trend, ensuring that many more reserve and National Guard members earn full veteran status.


The call-up affects other VA benefits. For example, it accelerates a reservists' eligibility for VA-guaranteed home loans. Typically, the home loan benefit is available to reservists only after they serve six years in the Selected Reserve or National Guard; they also need an honorable discharge. Members called to active duty don't have to complete the six years of drill to gain VA home loan eligibility.


A call-up also affects eligibility for 1) VA disability pensions, an important benefit for veterans who fall on hard times, 2) a death pension for low income widows and dependents, and 3) education benefits for spouses and children of veterans with permanent disability ratings of 100 percent.


Not all mobilizations affect VA benefits. To do that it must be ``federal,'' that is, ordered by the president. If a state governor calls up the National Guard, to fight a fire or protect an airport, it does not impact veteran status.


The rule of thumb for VA benefits of Selected Reservists and National Guard members serving on active duty is that they can earn the same benefits as other veterans, if they meet the same length-of-service requirements.


Reservists who haven't served on active duty receive fewer benefits but they aren't shut out by any measure. For example, they do get medical care for service-connected disabilities, VA compensation for injuries that occur while on active or inactive duty for training and Montgomery GI Bill for Selected Reserves.


Readers can find a robust list of VA benefit fact sheets on line at: .


Comments and suggestions welcomed. Write to Military Update, P.O. Box 231111, Centreville, Va. 20120-1111, e-mail to Tom Philpott or visit Philpott's website at: .




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