The Department of Veterans Affairs is being criticized for the shortfall in care for almost a million veterans who can't get timely compensation and have been waiting hundreds of days for help, often to no avail.
Frustration with the agency came to a head last Thursday when VA Secretary Eric Shinseki was called before a closed-door meeting of the House Appropriations Committee.
"We are aggressively executing a plan that we have put together to fix this decades-old problem and eliminate the backlog, as we have indicated, in 2015," Shinseki said after the meeting.
That's a long time for people in crisis to wait.
Coming Home Hurt
Glenn Smith, a 28-year-old Army veteran from St. Louis, joined the military in 2004.
"I joined because I loved tanks, believe it or not," Smith tells Jacki Lyden, host of weekends on All Things Considered.
Smith was deployed to Iraq twice between 2006 and 2010; he spent most of four years in combat. He now has an irregular heartbeat, and attributes it to one of the many IED blasts he went through. The irregular heartbeat, discovered during a routine training exercise, led to him being discharged last spring.
Smith described an anxiety attack in March in which "things just [closed] in" on him. It's even happened while he was driving.
"I didn't feel like I had any release or way to break free of it," he says. "I've had memories and nightmares of my experiences while I was in Iraq. Any all that just came rushing to the surface."
Smith also says he has a bad case of PTSD.
His PTSD has been so debilitating, he needs help navigating the VA. He submitted his initial claim about a year ago, but still lacks regular treatment for the disorder.
"Once I got back home to St. Louis, I've been trying to push with the VA here ... [and] trying to get my compensation and also trying to get therapy for my PTSD," he says. "Recently ... I was told my case wouldn't be looked at for another year or so because they're backlogged two years right now."
While he waits, Smith is patching together medical care for his PTSD. His heart condition is getting better, but he's in limbo, waiting for his benefits while he attempts to carry on.
"For the immediate horizon, I'm just trying to find a job so I can feel like I have a sense of moving forward and healing," he says. "And for the fall, I'm actually getting myself into college."
A Backlog Of Assistance
There are almost 900,000 VA benefits claims pending, says Quil Lawrence, NPR's veterans affairs correspondent. He tells Lyden that VA has set a goal that it should only take 125 days to process each claim.
"Currently, almost 600,000 of them are 125 days old or more," Lawrence says. "In some major cities, it's taking 300 days, even 600 days to get your claim taken care of."
The VA is updating its electronic medical software, and says delays are expected when moving from a paper system to one that is digital. But there is still the issue of moving medical information from military records to the VA's system.
"Despite a billion dollars that has been spent to get these two systems to unify, the Pentagon is still deciding to adopt the VA's software model," Lawrence says.
Tales of VA red tape range from the tragic to the comic, Lawrence says, citing one example where a double-amputee veteran was told his condition wasn't "chronic."
Criticism of VA secretary Shinseki's handling of the problem has come from both sides of the aisle, and some question whether his 2015 goal is even possible, Lawrence says.
"There's a strange conflict within the VA's mission," he says. "They're trying to get care to as many deserving veterans as possible, but the more successful they are at finding those veterans and signing them up, the bigger their backlog gets."
One of the people looking for those veterans is Tommy Sowers, the assistant secretary of public and intergovernmental affairs at the VA. He says the battle the agency is fighting is not an easy one.
"Some of the decisions here have been tough decisions, but right decisions," Sowers says.
He says the VA has expanded access to veterans related to Agent Orange, who have waited four decades for justice. The agency did the same thing for PTSD, he says, and expanded the number of people being treated for military sexual trauma.
"This is a challenge [and] we're making tough decisions that make it possible for more people to apply for and receive benefits," he says.
The agency is actively addressing the paperwork issue, Sowers says, and is in the process of implementing a paperless system this year. He stresses it is decades of paperwork that has piled up, and that they are essentially transitioning from a 19th century system to a 21st century system.
"Six months ago, only about 3 percent of our claims were electronic; today, nationwide that's about 18 percent," he says. "The backlog today is less than it was a year ago ... and in the past two months we've seen the backlog reduce by about 50,000 claims. We're all impatient and we're all driven to fix this."
In the meantime, Sowers says the VA does take care of emergency health care, and 56 percent of vets have used it.