Tech For Justice Hackathon Veterans Problem Set

Christy Leos edited this page Feb 27, 2017 · 15 revisions

PROBLEM SETS AND SOLUTION DESIGN

THE GOAL OF THIS DOCUMENT: Collaboration for use as a foundation for event design, participation, and expert recruitment.

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TECH FOR JUSTICE HACKATHON+ VETERANS GOAL: Develop community models and technology tools to improve access to justice for veterans and those who aim to support them.

WHAT ARE PROBLEM SETS? Problem sets identify and explain specific issues that participants will seek to solve. Problem sets are important because they help attendees from multiple sectors focus on one issue and better understand one another.


The problem set was constructed from four focus group sessions and from interviews with veterans, advocacy groups, agency workers. All personal accounts are anonymous.

1. Military Sexual Trauma (MST)

"I was raped by another officer and hospitalized for two weeks with broken ribs, shoulder, arm, lacerations, dislocated jaw, and concussions. My last memory was the sound of the surgical tray and instruments hitting the floor as I was slammed to the wall. The Army quickly separated me, my life fell apart and now I have no home."

Problem: MST is under reported due to stigma, myths and feelings of helplessness. It is a particular problem with female homeless veterans, with 75 percent being identified as victims of MST. These women have greater incidents of PTSD than other female combat veterans and are less likely to get help. The number of female homeless veterans doubled during the first decade of Operation Enduring Freedom.

Current Solution: There are many efforts among agencies, to promote prevention, response and screening for MST. The Department of Veterans Affairs (VA) views MST as “an experience” rather than a “diagnosis” and offer free treatment of medical conditions resulting from MST, regardless of service-connection, for those victims who come forward. Also, virtual reality is being used to treat MST victims.

Need: Online interactive process to anonymously explore reporting options, case reception, validity, targeted resources, obtain counselling, join support groups, build confidence and consider the pros/cons of moving past anonymity to unrestricted reporting.

2. Undesirable discharge characterizations (e.g. General and lower)

“Three months into my tour in Afghanistan, my lieutenant was killed by an Afghan soldier. I didn’t handle it well and the Army kicked me out. I knew I had PTSD but I did not tell them because of the stigma.”

Problem: 872,0000 of veterans may be blocked from receiving valuable treatment and compensation benefits, to which they would otherwise be entitled. PTSD was not recognized at the time they separated from military service, and its resulting symptoms and behaviors were viewed as performance and disciplinary violations, which led to undesirable discharges. Policy in 2014 allows this to be remedied. However, Discharge Review Boards (DRB) are nearly exclusively held in Washington D.C. at the member’s own travel and lodging expense if they desire a personal appearance, and can be cost-prohibitive.

Current solution: Since 2014, policy has allowed veterans to apply to the Discharge Review Board (DRB) for upgrades, but the program is not well known. Applications can be by document submission or by a personal appearance (usually more favorable for the veteran) at the DRB. Army and Air Force DRBs occasionally travel the US, but Navy, Marine and Coast Guard DRBs do not. Further, many veterans live abroad.

Need: A need exists for an online process for remote personal appearances that would allow veterans who cannot afford to travel an opportunity to personally address DRBs.

3. Veterans Treatment Courts (VTC)

“We go into the service vetted, drug free and healthy. We carry our experiences back into the civilian world. Some adjust and some can’t.”

A. Problem: Mental health disorders and Traumatic Brain Injuries (TBI) can lead to poor outcomes for veterans and their communities. VTCs recognize and address needs that are often unique to veterans, yet some courts are challenged to cover multiple counties and states. These courts could benefit from an online process to increase coverage, albeit at a loss of face-to-face time with the court.

Current solution: Court teams travel to cover multiple geographical areas.

Need: Online process for VTCs. Perhaps with “a single jurisdiction as the pilot project since each jurisdiction will have it’s own menu of forms, services, intake options, staffing levels, etc” (Dr. Zemmelman).

4. Veterans access to their VA Claims Folder (C-File) to determine VA Benefits

“It’s one thing to have to go fight for your country; it’s another to have to come home and fight your country.”

Problem: The records in a veteran’s Claims Folder are essential to the VA claims process. The file is difficult for the veteran to obtain, which hinders their access to records that the VA is using to decide upon the veteran’s claim for compensation, treatment, or health care.

Current solution: A veteran must request the file from their regional VA office, and often must also submit a Freedom of Information Act request or employ the assistance of an attorney to do so.

Need: A timely and accurate way for veterans to obtain their VA records, which determine a veteran’s service-connected injuries and establish a veteran’s entitlement for compensation and treatment.

5. Geographically-separated disputes

A. Problem: Families that are geographically separated and have family disputes such as divorce, child custody, contact, and maintenance. These issues can be very complex, expensive, and disadvantage service members, families, and veterans in other states or working abroad.

Current solution: A service member, veteran, or their families must travel to other courts or hire legal representation there.

Need: Service members and veterans, who are geographically separated from their families (e.g. soldiers deployed while undergoing divorce, or veterans employed as as DoD civilians and ex-pats) would benefit from an alternative dispute process that allows remote participation.

B. Problem: Civil/small claims disputes in heavy military/veteran populations, which are prone to frequent geographical separation (or travel challenges due to disability), can be difficult to resolve.

Current Solution: CourtCall exist for some participating courts.

Need: An online dispute process for remote participation from anywhere.

6. Veterans deemed unemployable by VA denied Social Security benefits

“The VA says I can’t work. Social Security says I can. It is a dilemma, because if I do, I will lose VA benefits and make my health even worse.”

A. Problem: Veterans who are rated by the VA as Individual Unemployability (IU) and unable to engage in substantial gainful employment (SGE) due to their service-connected disabilities are being denied Social Security Administration (SSA) disability benefits (SSDI) because SSA considers the unemployable veteran to be capable of substantial gainful activity (SGA) under their agency’s rules. This inconsistency across agencies is because the VA uses a greater number of impairment codes to detail service-connected disabilities than the SSA does (e.g. SSA has no separate diagnosis of PTSD). Veterans rated IU who engage in SGE to make ends meet risk losing their service-connected disability status, any related benefits, and incurring financial hardship.

Current solution: The VA provides compensation for service-connected disabilities, while the SSDI program’s purpose is to provide income replacement for disability. SSA published a report in 2014 examining the relationship of VA and SSA disability compensation. The VA program intended to compensate veterans for their service-incurred injuries and illness is in effect being repurposed to replace income that rightfully should be provided by the SSDI program, which the veteran has paid into.

Need: A tool to best articulate the veterans VA-rated impairments in a way that aligns to SSA’s listing of impairments and meets their evidentiary requirements.

B. Problem: Total Disability based on Individual Unemployability (TDIU) veterans who apply for SSDI must undergo examinations for service-connected conditions that have already been clinically diagnosed and determined to be disabling by the VA. This redundancy slows the application process to allow examinations to be scheduled and performed for those conditions. Importantly, it also risks psychological harm to TDIU veterans when diagnosis of service-connected injuries and illness that are determined to be disabling by the VA are not supported by SSDI doctors and examiners; in effect doubting the integrity of a veteran’s injuries or illness, its true impact on their employability or ability to contribute to society, and upsets any confidence that the veteran has in their treating physicians and existing diagnosis.

Current Solution: “Because this involves an entirely separate federal agency, this one might be challenging” (Dr. Zemmelman).

Need: An expedited SSDI application process, that waives redundant exams for TDIU veterans with existing VA medical diagnoses for service-connected disability.

7. Will preparation

“I appreciate that my children will be able to prepare their own wills online for free after I die. But it is baffling that I, the veteran, do not have that benefit.”

Problem: The US Dept of Veteran Affairs provides a no-cost online will preparation service for beneficiaries of certain Servicemember Group Life Insurance (SGLI) and Veterans Group Life Insurance (VGLI) plans in order “to quickly and easily prepare a will without an attorney,” but does not extend the benefit to the actual veteran.

Current Solution: After answering a series of straightforward questions, the beneficiary will receive a legal will, valid in all states, ready to print and sign. The service is handled by FinancialPointPlus.com, and requires an 8-digit insurance claim number to access the service. However, claim numbers are not issued until the servicemember or veteran dies. Effectively, the veteran’s death unlocks the VA benefit of a free online will preparation service for the veteran’s beneficiaries, but the benefit is never made available for the actual veteran, nor their beneficiaries, while the veteran is living.

Need: A free online will preparation service for veterans.

8. Post-Separation Transition

“It takes 90 days to forge a soldier. We need a reverse boot camp for when soldiers return.”

Problem: Challenges to returning vets is also a robust topic in our focus groups. It seems not much has changed in how veterans feel about civilian and stateside transition; from our Vietnam vets to our Afghanistan vets; especially lack of access to information when transitioning out of the service back into civilian life. Transition Assistance Programs are sometimes too late (i.e. close to the member’s separation date) to be practical, do not have the information desired by the separating member, and are not available as a resource after separation.

Current Solution: There are many endeavors to bring together resources into one-stop-shop kind of websites, including the DoD/DoL/VA comprehensive National Resource Directory. Also TAP programs may be available long before separation, but members’ approval for timely attendance is often trumped by mission needs.

Need: A virtual post-separation assistant to better present the vast array of detailed and complex transition resources together in an easy to understand way that can be intuitively navigated and actioned.

9. Appealing VHA clinical decisions

“I went to the emergency room for kidney stones and was committed to the psych ward for three days. They accused me of using MST to get ahead on the waiting list for surgery. I had to obtain surgery privately.”

Problem: “Develop a process for appealing clinical decisions that provides veterans protections at least comparable to those afforded patients under other federally-supported programs” - Commission on Care Final Report

Current Solution: The commission found that the Veterans Health Administration (VHA) clinical appeals process lacks a defined process for the veteran to have their case heard in person, provisions for an expedited review and a right to an external review. In October 2016, VHA directive 1041 encouraged “mediation” as the first level of a clinical decision appeal, but no other guidance exist as to implementation. This, and a later “submission of supporting arguments” are veterans’ only opportunities to be heard in the 4-stage process.

Need: A mediation process for patients and their treatment teams, that supports an expedited review, and promotes a mutual interest path to an external review when needed. An online process would save travel time for veterans living far from VHA facilities and potentially save time for VHA staff. An asynchronous process would allow time for thoughtful and deliberate communication, and likely be more conducive to clinical staff schedules.

10. Mobile Technology for Homeless Veterans

“When we go for help, we just get stonewalled and lied to. Make info available to help them and make it simple for us to understand.”

Problem: Homeless veterans need timely and relevant information to aid in accessing health care, food, shelter, weather warnings, donation distributions, mobile and similar community services.

Current Solution: “Many homeless veterans have mobile phones and regularly access the internet.” Currently, there are no active national mobile phone apps that are designed for use by homeless veterans.

Need: Create app or SMS text messaging capability for homeless vets who want to know when and where resources are available. Since the need to connect to a crisis hotline and healthcare alerts are being covered by other groups (see below), it may be useful to focus on shelter, food, VA events, job fairs, as well as provide alerts for events such as unfavorable weather or mobile clinical services.

11. Targeted Financial/Legal Help for Veterans Facing Imminent Homelessness

“I have always been self-sufficient. I accomplished my missions. I helped others. I have raised kids. I have never felt as helpless as I do now. I need help but the number of resources are overwhelming. I don’t know where to start.”

Problem: Critical tough legal and financial decisions must be made when avoiding, or transitioning, into homelessness. Help is needed to prioritize debt, discover life-sustaining resources, access essential services, and identify applicable veterans benefits in a way that helps to avoid or expedite recovery from homelessness.

Current Solution: Decisions regarding food, shelter, healthcare, financial obligations, benefits eligibility, storage, phone service, sanitation, and many other critical decisions are often made during times of crippling stress, and with no idea of how to function within a new unfamiliar reality. The vast array of resources can overwhelm and frustrate good decision making.

Need: An interactive tool for veterans that will aid decision making on which financial obligations to maintain, and which to let go, for the best possible outcome; to identify survival and other essential resources; and to screen for available veteran-specific assistance, such as debt relief organizations.

12. Annual Point-in-Time homeless Count

“Some of us prefer displacement...In the street we know our purpose, to survive, that is our comfort zone.”

Problem: Annual point-in-time (PIT) homeless counts contribute to our understanding of the extent, nature and trends of homelessness, which counted 40,000 homeless veterans in Jan 2016, of which 13,000 were unsheltered that night.

Current Solution: Collect data on paper forms and enter the data manually.

Need: The process might be improved by a tool to automate or assist the annual national count. An optical character reader can convert text into digital data saving hours of manual data entry.

###13. Veteran employment

“We need work. We need a mission.”

Problem: We have nearly 500,000 unemployed veterans in the US.

Current Solution: Many efforts exist to connect veterans with employers such as Hire Heros, the VA’s Vets.gov, and VetJobs.com. Federal job seekers using USAjobs.gov which gives hiring preferences to veterans. However, federal job seekers are frustrated with arduous processes, broken links, and low success rates. Also, employers who are federal contractors subject to the Vietnam Era Veterans' Readjustment Assistance Act (VEVRAA) of 1974, as amended by the Jobs for Veterans Act of 2002, 38 U.S.C. 4212 (VEVRAAA), are is required to take affirmative action to employ and advance in employment: (1) Disabled veterans; (2) Recently separated veterans; (3) Active duty wartime or campaign badge veterans; and (4) Armed forces service medal veterans. Veterans are trained to serve their country, complete missions and work as a team. Many companies and governments can benefit from that training if the right mindset is put in place at a local, national and global level. Veterans can be redeployed to meet mission critical objectives that are now plentiful in civilian and NGO settings.

Need: Find jobs for veterans that employ their military leadership skills

To see our list of current projects, click here.

###Bibliography### *Currently being updated

1.MILITARY SEXUAL TRAUMA

Journalism

The Path Home for Women Veterans (Feb 21, 2017)

Camaraderie Offsets Trauma for Women Veterans (Feb 14, 2017)

What Happens When a Rape Goes Unreported (Feb 4, 2017)

G.I. Jane Needs a Place to Sleep (Feb 1, 2017)

‘It Savaged My Life’: Military Sexual Assault Survivors Fighting to Become Visible (Oct 11, 2016)

Taking Military Sexual Trauma Seriously (Sep 13, 2016)

Academic Publications & Blogs

Differential Risk for Homelessness for Male and Female Veterans With a Positive Screen for Military Sexual Trauma (June 2016)

Military Sexual Trauma: Prevalent and Undertreated (Nov 3, 2015)

Researchers Study Virtual Reality Exposure Therapy to Treat Military Sexual Trauma-Related PTSD (June 24, 2015)

Mindfulness-Based Stress Reduction for Veterans Exposed to Military Sexual Trauma: Rationale and Implementation Considerations (June 2015)

Government and Policy Institute Resources

Do You Really Expect Me to Get MST Care in a VA Where Everyone is Male? Innovative Delivery of Evidence-Based Psychotherapy to Women with Military Sexual Trauma

Websites

Military Sexual Trauma: An Uphill Battle for VA Disability Compensation

Infographics, Maps, & Statistics

Coming Out of the Shadows -- U.S. Women Veterans and Periods of Homelessness After Military Service

Facts on United States Military Sexual Violence

Videos

The Invisible War (PBS - Independent Lens, 2012)

Service: When Women Come Marching Home (2011)

2.UNDESIRABLE DISCHARGE CHARACTERIZATIONS

Connecticut to Help PTSD Vets Upgrade ‘Bad Paper’ Discharges (Nov 16, 2016)

3.VETERANS TREATMENT COURTS

Veterans Treatment Courts: A Second Chance for Vets Who Have Lost Their Way

4.VETERANS ACCESS TO THEIR VA CLAIMS FOLDER (C-FILE) TO DETERMINE BENEFITS

Requesting A Copy of Your VA Claims Folder (C-File)

5.GEOGRAPHICALLY-SEPARATED DISPUTES

Court Call - Remote Appearance Platform

6.VETERANS DEEMED UNEMPLOYABLE BY VA DENIED SOCIAL SECURITY BENEFITS

Veterans Who Apply for Social Security Disabled-Worker Benefits After Receiving a Department of Veterans Affairs Rating of “Total Disability” for Service-Connected Impairments: Characteristics and Outcomes

7.WILL PREPARATION

8.POST-SEPARATION TRANSITION

National Resource Directory

9.APPEALING VHA CLINICAL DECISIONS

Commission on Care: Final Report

VHA Directive 1041

10.MOBILE TECHNOLOGY FOR HOMELESS VETERANS

Preliminary needs assessment of mobile technology use for healthcare among homeless veterans

11.TARGETED FINANCIAL/LEGAL HELP FOR VETERANS FACING IMMINENT HOMELESSNESS

12.ANNUAL POINT-IN-TIME HOMELESS COUNT

Homeless Veterans Point in Time (PIT) Count

13.VETERAN EMPLOYMENT

Bogus Benefit? Frustration With USAJOBS

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