How Health Care Providers Can Help Military Veterans
Step One: Have the Conversation
Step One: Have the Conversation
Imagine this scenario: A 70-year-old Vietnam combat veteran is diagnosed with prostate cancer. Apprehensive about seeking VA care and benefits because he wasn’t fond of his time in service and feels there are more deserving veterans out there, he receives care outside of the VA system. He doesn’t imagine his health concerns could have anything to do with his time in service nearly 50 years prior.
However, he was exposed to agent orange in Vietnam. This makes his cancer a “presumptive condition” — that is, presumed to have been caused by his service and, therefore, covered by VA health insurance. Because he didn’t file a claim with the VA for his treatment, he ends up losing out on $19,365 in service-connected compensation, along with full coverage for the treatment of the service-connected condition.
Any of his health care providers along the way might have prevented this outcome by starting a conversation with one question: “Would it be OK if I talked with you about your military experience?”
For health care providers, this opener is not only a way to acknowledge and honor a patient’s military service, but also an avenue for getting a more complete health history. “We don’t know about a patient’s military service if we don’t ask,” says Andrea Hodges, a U.S. Navy veteran who served as a Veterans’ Service Officer in Livingston County and recently offered a presentation through the Office of Patient Experience Learning Forum on “Serving Those Who Have Served.”
Michigan has the 11th largest veteran population in the U.S.: 8.2% of the adult population in Michigan are veterans. Of the 529,368 veterans in Michigan, 357,366 are not enrolled in the VA health care system. Many of them will receive care at Michigan Medicine, where providers “are really front line for diagnosing veterans for these health care conditions [that may be covered by the Veterans Benefits Administration],” says Hodges.
As with Hodges’ example of the Vietnam vet with prostate cancer, some veterans are not aware of the ways their health problems may be related to their service. That’s why it’s important for providers to initiate the conversation. And providers need not be experts on topics such as presumptive conditions. All of the information they need to help their veteran patients, including that initial question, is on the Military Health History pocket card (both print- and mobile-friendly versions are available to download). Beyond a list of opening questions, the pocket card also includes health risks broken down by eras of service (Vietnam, Cold War, WWII, etc.), how to talk about unwanted sexual experiences in the military, and specific questions to ask about chemical, biological, and psychological exposure concerns.
In addition to getting a health history related to a veterans’ service, providers can also help veterans get the health care benefits they’re entitled to. Contrary to common belief, not all veterans are entitled to free VA Healthcare, so it’s important that providers not assume the VA will be the best source of care and support for veteran patients. Simply asking the patients if they’ve touched base with their Veteran Service Officer (VSO) can be a good starting point for a conversation about benefits.
Linking veterans to their VSO “is super important,” says Michael Mendez, M.D., an associate professor of internal medicine who participated in a panel discussion after Hodges’ presentation. “Knowing to connect [them to an] officer in [their] county is gold, so they don’t have to make a longer trip to their home VA if it’s outside their county.” It’s also important to remind patients that their diagnoses may be related to military service, even if it isn’t obvious. Patients can check michiganveterans.com to find their nearest VSO, who can help them understand their benefits and even file claims on their behalf.
Some health care providers wonder if they should thank their veteran patients for their military service. Hodges and Mendez both say it’s a good thing to do. “It’s very well received,” says Mendez. “I’ve always seen a smile of appreciation.”
For more detailed information on how to help veteran patients, view the full presentation and panel discussion. Also, this U-M Health Blog post gives practical advice for anyone on “How to Support Military Veterans Every Day.”