Frequently Asked Questions
How do I know if I am eligible to be seen at WRIISC?
Any veteran who served in a theater of combat operations from World War
II through Operations Enduring Freedom and Iraqi Freedom and received
the corresponding campaign medal is eligible to be seen at WRIISC. Specific
eligibility criteria for the National Referral Program are described in
the VA
Undersecretary for Health’s Information Letter.
How do I obtain a referral if I am interested in the WRIISC clinical
program?
- Veterans must be referred to WRIISC by their VA primary care provider.
- Clinicians interested in making referrals to the National Referral
Program should contact Helen Malaskiewicz at 202-273-8463.
- A prescreening WRIISC referral application must be completed to confirm
combat eligibility status and sent to Helen Malaskiewicz either by fax
(202-273-9080) or by e-mail to helen.malaskiewicz@med.va.gov.
- Once eligibility is established, the referring physician is asked
to complete the electronic WRIISC referral template in CPRS to provide
background medical information. The title of this CPRS note is WRIISC
Assessment and was distributed in patch TIU*1.0*159.
The WRIISC evaluation is a fairly intense 5-day program. Consequently,
referring physicians need to verify in the electronic CPRS WRIISC referral
note that the veteran is physically and mentally stable for travel and
participation in the program. Once this template is completed, Ms. Malaskiewicz
will forward the referral to either the East Orange, NJ, or Washington,
DC, WRIISC based on geographical location. The WRIISC clinical team that
receives the application will conduct a thorough review to determine whether
the veteran is likely to benefit from an inpatient WRIISC evaluation or
if some other mechanism, such as a Telehealth Consult, would be more appropriate.
Seriously ill patients with well-established diagnoses, even if they are
not responding to recommended therapy, usually are not appropriate candidates
for WRIISC referral. Once a veteran has been approved for the WRIISC National
Referral Program, an evaluation date will be finalized and confirmed with
the veteran and referring provider. Additionally, detailed logistical
information (to include contact information, maps, and a program description)
will be mailed to the veteran.
How do I find out more information on depleted uranium and its
health effects?
In 1998, the Institute of Medicine (IOM) began a series of congressionally-mandated
studies to examine the scientific and medical literature on the potential
health effects of chemical and biological agents related to the Gulf War.
The first study reviewed the scientific literature on depleted uranium,
chemical warfare agents (sarin and cyclosarin), pyridostigmine bromide,
and vaccines (anthrax and botulinum toxoid) and published their findings
in the report, Gulf War and Health Volume I: Depleted Uranium, Pyridostigimine
Bromide, Sarin, Vaccines. The report is available from the IOM
Web site.
For VA clinicians, Veterans Health Administration (VHA) Directive (VHA
HANDBOOK 1303.1) outlines the procedures for evaluating Gulf War veterans
with possible exposure to depleted uranium (DU).
How do I find out if the illness that I have is related to Agent
Orange exposure?
(Note: The following information is provided in Agent
Orange General Information Brochure, July 2003.) The number of diseases
that the VA has recognized as associated with (but not necessarily caused
by) Agent Orange exposure has expanded considerably during the 1990s.
The following conditions are recognized for service connection for veterans:
Agent Orange (a skin disorder), chloracne (a skin disorder), porphyria
cutanea tarda, acute or subacute peripheral neuropathy (a nerve disorder),
type 2 diabetes, and numerous cancers (non-Hodgkin’s lymphoma, soft
tissue sarcoma, Hodgkin’s disease, multiple myeloma, prostate cancer,
respiratory cancers [including cancers of the lung, larynx, trachea, and
bronchus]) and chronic lymphocytic leukemia. Several time-limited conditions
are recognized as associated with Agent Orange exposure. These conditions
are chloracne (must occur within 1 year of exposure to Agent Orange),
prophyria cutanea tarda (must occur within 1 year of exposure), and acute
and subacute transient peripheral neuropathy (must appear within 1 year
of exposure and resolve within 2 years of date of onset). In addition,
Vietnam veterans’ children with the birth defect spina bifida are
eligible for certain benefits and services. Furthermore, VA now provides
certain benefits, including health care, for children with birth defects
who were born to female Vietnam veterans.
Are there services available for combat veterans who experience
symptoms of posttraumatic stress disorder (PTSD)?
(Note: The following information is provided in A National Center for
PTSD Factsheet)
The Department of Veterans Affairs Medical Centers provide a network
of more than 100 specialized programs for veterans with PTSD and work
closely with the Vet Centers operated
by VA's Readjustment Counseling Service. Each specialized PTSD
program offers veterans education, evaluation, and treatment conducted
by mental health professionals from a variety of disciplines (such as
psychiatry, psychology, social work, counseling, and nursing).
Outpatient PTSD programs include three basic types of clinics in which
veterans meet with a PTSD specialist for regularly scheduled appointments.
PTSD Clinical Teams (PCTs) provide group and one-to-one evaluation, education,
counseling, and psychotherapy. Substance Use PTSD Teams (SUPTs) offer
outpatient education, evaluation, and counseling for the combined problems
of PTSD and substance abuse. Women's Stress Disorder Treatment Teams (WSDTTs)
provide women veterans with group and one-to-one evaluation, counseling,
and psychotherapy.
Day Hospital PTSD programs include two basic approaches to providing
a "therapeutic community." Veterans with PTSD can attend these
community programs several times a week for social, recreational, and
vocational activities as well as for counseling. Day Treatment PTSD Units
provide one-to-one case management and counseling, group therapy, education,
and activities in order to help clients live successfully with PTSD. Treatment
and socialization activities are scheduled for several hours each day
during the day and evening hours. Residential (Lodger) PTSD Units also
offer one-to-one case management and counseling, group therapy, education,
and activities for several hours each day. While enrolled in daytime and
evening PTSD treatment, lodger clients may live temporarily in secure
quarters that do not have 24-hour nursing supervision.
Inpatient PTSD programs include four basic types of service and are conducted
while veterans reside in hospital units that provide 24-hour nursing and
psychiatric care. Specialized Inpatient PTSD Units (SIPUs) provide trauma-focused
evaluation, education, and psychotherapy for a period of 28 to 90 days
of hospital admission. Evaluation and Brief Treatment of PTSD Units (EBTPUs)
provide PTSD evaluation, education, and psychotherapy for a briefer period
ranging from 14 to 28 days. PTSD Residential Rehabilitation Programs (PRRPs)
provide PTSD evaluation, education, counseling, and case management that
focus on helping the survivor resume a productive involvement in community
life. PRRP admissions tend to range from 28 to 90 days. PTSD Substance
Use Programs (PSUs) provide combined evaluation, education, and counseling
for substance use problems and PTSD. PSU admissions range from 14 to 90
days.
Are there suggestions for simple steps that veterans and their
loved ones can take to make readjusting to life after a combat experience
easier?
There are a number of tips that counselors, family, and friends can
take to ease the readjustment process. Capt.
Hugh Reusser offers his suggestions in a recent edition of Vet
Center Voice, a publication of the Readjustment Counseling Service.
I have a medical problem that is due to my military service.
What compensation and benefits am I entitled to?
VA benefits and services fall into these major categories:
- Education and Training Benefits
- Vocational Rehabilitation and Employment
- Dependents’ and Survivors’ Benefits
The mission of the Veterans
Benefits Administration is to provide benefits and services to the
veterans and their families in a responsive, timely, and compassionate
manner in recognition of their service to the Nation.
The WRIISC program is not directly involved in the compensation and pension
program for combat service veterans. However, the WRIISC-DC program will
provide veterans with information on available resources that may help
to answer questions regarding compensation and pension.
Where can clinicians go to learn more about caring for combat
veterans?
The Veterans Affairs Employee Education System and the Office of Public
Health and Environmental Hazards sponsored an independent study module,
"Caring for War Wounded," as a part of the Veterans
Health Initiative (VHI). The VHI is a comprehensive program of continuing
education that recognizes the connection between certain health effects
and military service and emphasizes better military medical histories
for those wounded during Gulf War II.
Learning objectives of the independent study include
- Define the VA/DoD Contingency Back-Up System
- List the environmental and endemic hazards of deployment to Southwest
Asia
- Explain the purpose of DoD predeployment screening and the Force Health
Protection Program
- List the VA healthcare benefits after combat deployment
- Describe the specific combat-related injuries, including wounds from
traditional weapons and high-velocity weapons
- Identify injuries associated with chemical warfare agents
- Identify injuries associated with pesticide agents
- Identify injuries associated with biological warfare agents
- Identify injuries associated with radiological warfare
- Explain the effect of combat on mental health
- Describe the family support programs for veterans and their families
This independent study is primarily designed for Department of Veterans
Affairs clinicians and other interested VA staff. Other healthcare providers,
especially those in VA healthcare facilities, also are encouraged to complete
the study. This program is available in booklet form and on the Web at
http://www.va.gov/vhi. CEUs and CME credit is available.
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