Transition and Care Management
for Returning Combat Veterans

HANDBOOK

Index

INTRODUCTION

Why You Should Read This Guide

Letter from a Combat Vet

Dear Veteran,
Welcome home! You served this country honorably and we are truly grateful for your service. There are many benefits you are now eligible to receive. You've earned all of these benefits, which include health care, education, readjustment assistance, and a whole list of others, which are explained in this guide.
When I separated from the U.S. Army after two consecutive tours in Afghanistan, I went through a readjustment from military to civilian life. Every Service Member will go through some type of readjustment. For some, the transition is smoother than others. The good news is that there's help. There are many dedicated people in the VA who care about you and want to make sure you have the smoothest readjustment possible.
I also encourage you to explore all of your benefits. While some follow you for the rest of your life, some do not. Keep this guide handy as a reference and reminder of what is available to you. And again, Welcome Home.
–Raf Raza
OEF/OIF/OND Program Manager
Orlando, VAMC

Combat Veteran Eligibility

Five Years of Enhanced Health Care

Most Veterans, including National Guard and Reservists, who served in a theater of combat operations after November 11, 1998, and were discharged under other than dishonorable conditions, are eligible to receive cost-free VA health care for combat-related conditions and enhanced enrollment priority for five years after separation from active duty. After five years, services are still available; however, services that are not related to a defined service-connected disability will be assessed a co-pay, based on income.

Health Care Benefits Under the "Combat Veteran" Authority

Priority Goups:
During enrollment, each Veteran is assigned to a priority group. VA uses priority groups to balance demand for VA health care enrollment with resources.

How to Enroll

To take advantage of these health care benefits, you must enroll in the Veterans Health Administration (VHA) Health Care system within five years of separation. Do this in person at any VHA facility or complete VA 10-10EZ, "Application for Health Benefits" at: www.va.gov/healthbenefits/apply
You can also mail the application to the VHA facility where you'd like to receive your care. Include your DD-214 (separation document). For a list of VA facilities nearest you, refer to the "POCs" tab.

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HEALTH CARE

Guard and Reserve Eligibility

Five Years of Enhanced Health Care

National Guardsmen and women and Reservists currently constitute 50% of returning Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF)/Operation New Dawn (OND) Veterans who use VA services.
Like the regular active duty, mobilized Guard and Reservists called to active duty and serving in a theater of combat operations after November 11, 1998, are eligible to receive cost-free VA health care for combat-related conditions and enhanced enrollment priority for five years after separation from active duty.
Combat Veterans not previously enrolled, but who separated from active duty before January 28, 2003, are eligible for enhanced benefits until January 27, 2011, after which time they might incur a co-pay.

Eligibility and Contacts

To determine your eligibility for health care benefits call
1-800-827-1000 or visit: www.va.gov/healthbenefits
You can also download a very useful guide to VA benefits for National Guard and Reserve personnel at:
www.benefits.va.gov/guardreserve/index.asp
Additionally, every VA Medical Center and Clinic has a team
standing by ready to welcome OEF/OIF/OND Service members and
Veterans, and help coordinate their health care. Call or e-mail the VA facility nearest you. A list of contacts can be found on the "POCs" tab.

Other Helpful Websites

For Service members leaving active-duty status:
www.dodtap.mil/transition_gps.html
Naval Reserve:
www.navy.com/advisors/navy-family.html
Employer Support of the Guard and Reserve: www.esgr.mil

VA Health Care Services

VA provides general and specialized health care services to meet the unique needs of Veterans returning from combat deployments. When you establish care at your local VA Medical Center or Clinic, you will be teamed up with a primary care provider. That provider is part of a team that can help you meet your post-
combat health care needs, including specialized services for:

Services may include specialty medical or surgical care; rehabilitative services including vocational rehabilitation, prosthetics, social work and family services; benefits counseling; community resource information; and referral assistance. There is also hospital, outpatient medical, community living center and community-based residential care.

OEF/OIF/OND Veterans: Where to Get Help

Each VA Hospital has a special program designed to meet the specific needs of Veterans returning from OEF/OIF/OND. To contact a Transition and Care Management Coordinator at your nearest VA Hospital or Clinic, see the "POCs" tab in this QuickSeries guide.

For information on VA enrollment, health and dental benefits, call 1-877-222-8387 or visit: www.va.gov/healthbenefits

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COMBAT STRESS / C & P

Recovering from Combat Stress

Service members respond to war zone experiences in different ways. Some report feeling upset or keyed up even after returning home. Some continue to think about events that happened in combat, sometimes even acting like they were back in a combat situation. These are common combat stress reactions that can last for days or weeks, and are normal reactions to combat experiences. Below is a list of common reactions:

Behavioral Reactions Physical Reactions Emotional Reactions
Trouble concentrating Trouble sleeping, overly tired Feeling nervous, helpless or fearful
Jumpy or easily startled Stomach upset, trouble eating Sad, guilty, rejected or abandoned
Being on guard, always alert Headaches and sweating when thinking of war Edginess, easily upset and annoyed
Bad dreams or flashbacks Lack of exercise, poor diet or health care Experiencing shock, being numb, unable to feel happy
Avoiding people or places related to the trauma Rapid heartbeat or breathing Feeling hopeless about the future
Work or school problems Too much drinking, smoking or drug use Irritable or angry
Loss of intimacy or feeling withdrawn, detached and disconnected Other health problems becoming worse Not trusting others, being over-controlling, having lots of conflicts

Most who experience combat stress reactions like those listed above will recover naturally over time. Others may continue to struggle with memories of their combat experiences and their reactions. These reactions may create problems that could become post-traumatic stress disorder (PTSD). If you recognize any of these reactions, getting help is very important.

Every VA Medical Center has a team ready to help. Call a Transition and Care Management Coordinator at the VA facility nearest you (see the "POCs" tab). Vet Centers are another great place to get help. Find the nearest Vet Center at:
www.vetcenter.va.gov or call 1-800-827-1000.

Veterans Crisis Line

1-800-273-TALK (8255) (Press 1)
www.suicidepreventionlifeline.org

VA Disability Compensation

Disability compensation is a tax-free benefit paid to a Veteran for disabilities that are a result of or made worse by injuries or diseases that happen while on active duty, active duty for training or inactive duty training. Disability compensation is also paid to certain Veterans disabled from VA health care.

Eligibility and Payments

If you have a service-related disability and you were discharged under other than dishonorable conditions, you could be eligible for basic benefits ranging from $133.17 to $2,906.80 per month, depending on how disabled you are.

How to Apply

You can apply by filling out VA Form 21-526, "Veterans Application for Compensation and/or Pension." You can also apply online at: http://vabenefits.vba.va.gov/vonapp or by calling 1-800-827-1000 for more information.

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PTSD

What Is PTSD?

Post-traumatic stress disorder (PTSD) is an anxiety disorder resulting from an intense or traumatic situation like that experienced in combat. PTSD varies widely in its severity – from mild and short-lasting, to severe and chronic. Recognizing the symptoms, promptly being evaluated and getting treatment are key to
overcoming PTSD.

Symptoms of PTSD

Treating PTSD

Combat stress reactions usually go away over time, but if they don't, there are effective treatments for PTSD and other problems. Cognitive-behavioral therapy (CBT) has been shown to be the most effective treatment for PTSD. It involves working with cognitions, or thoughts, to change emotions, thoughts and behaviors. Treatment usually focuses on the following:

Medication

Medication is another treatment option. It can reduce PTSD symptoms through anxiety-reduction techniques, teaching coping skills and correcting inaccurate thoughts related to the trauma.

Many VA health care centers have experts in PTSD and related problems. Contact the VA facility nearest you (flip to the "POCs" tab). More PTSD resources can be found at:
www.ptsd.va.gov

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PTBI / Dental Treatment

Traumatic Brain Injury

Traumatic brain injury (TBI) is caused by a blow or jolt to the head or by a penetrating head injury that disrupts the brain's normal function. Those returning from combat areas like Iraq and Afghanistan may have suffered a brain injury – some without even realizing it. TBIs can range from mild to severe and can result in short-term problems with independent function.

Signs and Symptoms of a Head Injury

The signs and symptoms of TBI can be subtle. Symptoms may not appear until days or weeks following the injury or may even be missed as returning Veterans may look fine even though they may act or feel differently. Some signs and symptoms of TBI are:

Getting Help

If you suspect that you or a loved one has TBI, it's important to get help as soon as possible. Contact the VA nearest you. Flip to the "POCs" tab.

Additional resources on TBI are available at:
www.qsp.mobi/link.VISN8tbi

Dental Treatment

Veterans are eligible for outpatient dental treatment if VA determines they meet one of the following criteria:

Those having a service-connected, non-compensable dental disability or condition.
Were Prisoners of War (POWs) and those whose service-connected disabilities rated at 100% or who are receiving the 100% rate by reason of individual unemployability.
Those who are participating in a VA vocational rehabilitation program under 38 U.S.C. Chapter 31 with certain conditions.
Veterans enrolled in a VA homeless program, under certain conditions.

One-Time Treatment for Dental Conditions

Effective January 28, 2008, recently discharged Veterans with a service-connected, non-compensable dental condition or disability who served on active duty 90 days or more, and who apply for VA dental care within 180 days of separation from active duty, may receive one-time treatment for dental conditions if the condition exists at the time of discharge and the Veteran's certificate of discharge doesn't indicate he/she received necessary care within a 90-day period before discharge.

For more information about eligibility for VA dental and other benefits, call 1-800-827-1000 or visit: www.oefoif.va.gov/dental.asp

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Women VETS / POCS

Programs for Women Veterans

Each VA Medical Center has a Women Veterans Program Manager (WVPM) who can help women Veterans establish their eligibility, understand their benefits and obtain their health care in the VA system. The Women Veterans Heath Program provides a full range of medical and mental health services, including:

For more information, call a member of the Transition and Care Management Program Office at the VA Medical Center nearest you.

Points of Contact

Every VA Medical Center has a team ready to welcome OEF/OIF/OND Service members and help coordinate their care. Call the VA facility nearest you:

VISN 8 Facilities

C.W. Bill Young VAMC:
10000 Bay Pines Blvd., Bay Pines FL 33744
Transition and Care Management (TCM) Office:
727-398-6661, Ext. 10776 / 15893
www.baypines.va.gov

Bruce W. Carter Department of VAMC-Miami:
1201 N.W. 16th St, Miami, FL 33125
TCM Office: 305-575-7000, Ext. 6252
www.miami.va.gov

James A. Haley Veterans' Hospital:
13000 Bruce B. Downs Blvd., Tampa FL 33612
TCM Office: 813-972-2000, Ext. 3825/6396/5370
www.tampa.va.gov

West Palm Beach VAMC:
7305 North Military Trail, West Palm Beach, FL 33410
TCM Office: 561-422-7223
www.westpalmbeach.va.gov

Orlando VAMC:
13800 Veterans Way Orlando, FL 32827
5201 Raymond St, Orlando, FL 32803
TCM Office: 321-397-6272
www.orlando.va.gov

Malcolm Randall VAMC:
1601 SW Archer Rd., Gainesville, FL 32608
TCM Office: 352-376-1611, Ext. 5510
www.northflorida.va.gov

Lake City VAMC:
619 South Marion Ave., Lake City, FL 32025
TCM Office: 352-376-1611, Ext. 5510
www.northflorida.va.gov

Caribbean Health Care System (VACHS):
10 Casia St San Juan, PR 00921-3201
TCM Office: 787-641-7582, Exts. 11366/11368/11369
toll-free: 1-800-449-8729
www.caribbean.va.gov

The VA Sunshine Healthcare Network, also know as Veterans Integrated Services Network (VISN) 8, is an integrated system of hospitals, multispecialty outpatient clinics and community-
based primary care clinics in Florida, Southern Georgia, Puerto Rico and the U.S. Virgin Islands. For a complete list of VISN 8 Facilities: www1.va.gov/directory/guide/region.asp?ID=1008

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VR & E

Vet Centers

Vet Centers are a great place to get help after returning home. They are located throughout the country and are focused on helping Veterans readjust to life after deployment and providing outreach. Many Vet Center counselors are Veterans themselves who have recently returned from combat areas. They offer readjustment and mental health counseling, providing Veterans and their families with resources to handle post-deployment issues.

To find the nearest Vet Center, go to www.vetcenter.va.gov

Veteran Service Organizations

Another great resource for individuals returning from a war zone is Veteran Service Organizations or VSOs. They provide resources and help to military members following deployment as well as help to bring individuals with similar experiences together. They also help with paperwork required for VA benefits. They are often organized by branch of service, religion, ethnicity, war zone theater, purpose and many other categories. Large organizations like the American Legion or Veterans of Foreign Wars (VFW) are focused on the needs of Veterans in general.

For a list of VSOs, go to www.va.gov/vso

Vocational Rehabilitation & Employment (VR&E)

VR&E is an employment-oriented program that helps Veterans with service-connected disabilities prepare for, find and keep suitable employment. The goal of these services is to locate suitable employment consistent with their aptitudes and interests, or help Veterans achieve independence in their daily living. For Veterans with service-connected disabilities so severe they cannot immediately consider work, VR&E offers services to improve their ability to live as independently as possible.

Vocational Rehabilitation and Employment Services (VR&E)

Who's Eligible?

To receive an evaluation for VR&E services, a Veteran must:

VR&E services may be used 12 years from the latter of the following:

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Employment / Education & Training

Employment

The VA is always seeking to hire Veterans of all eras. To view the latest information on VA job openings, go to VA Jobs at:
www.va.gov/jobs

Department of Labor (VETS) Job Information

The Department of Labor (DOL) is a job and job counseling service, employment placement service and job training service for eligible Veterans. To view the latest information on services and programs offered by the DOL, visit:
www.dol.gov/vets/programs/empserv

Other Websites

Employer Support of the Guard and Reserves: www.esgr.mil
USA Jobs: www.usajobs.gov
Social Security Office Locator: www.ssa.gov or call 1-800-772-1213

Education & Training

GI Bill® 1

Montgomery GI Bills are available for many different types of education and training programs including institutions of higher learning (four-year universities, community colleges, advanced degrees), non-college degree programs, on-the-job & apprenticeship training, flight training, distance learning & Internet training, correspondence training, National Testing Program, licensing & certification, entrepreneurship training and others.

New Post-9/11 GI Bill

A new Post-9/11 GI Bill approved by President Bush in 2008 provides enhanced benefits to Veterans pursuing graduate and undergraduate degrees, and vocational/technical training. The new bill goes beyond helping to pay for tuition. Many Veterans who served on or after Sept. 11, 2001 will get full tuition and fees, a monthly housing payment and an annual $1,000 stipend for books and supplies. The new bill also gives activated Reserves and Guard members access to the same GI Bill benefits.

Eligibility

Veterans who have served at least 90 days of active duty service after Sept. 10, 2001 and received an honorable discharge will qualify at least in part of the Post-9/11 GI Bill. To be eligible for the full benefit, you must have three years of active duty service after 9/11 or have been discharged due to a service-connected disability. Veterans who qualify for the Active Duty GI Bill, the Reserve GI Bill or the Reserve Educational Assistance Program (REAP) will have the option to choose which benefit best suits their needs.

1 GI Bill is a registered trademark of the U.S. Department of Veterans Affairs (VA). More information about education benefits offered by VA is available at the official U.S. Government website at:
www.benefits.va.gov/gibill

For more information on the GI Bill, visit:
www.benefits.va.gov/gibill/ or call: 1-888-442-4551

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Home Loans / Resources

Home Loans

VA home loan guaranties help eligible Veterans obtain homes, condominiums, residential cooperative housing units, manufactured homes and to refinance loans. The VA guaranty varies with the size of the loan, and is issued to protect the lenders so they can make loans to eligible borrowers. Because the lenders are able to obtain this guaranty from the VA, borrowers do not need to make a down payment, provided they have enough home loan entitlement.

Eligibility

Besides the periods of eligibility and conditions of service requirements, VA home loan applicants must have a good credit rating, sufficient income, a valid Certificate of Eligibility (COE), and agree to live in the property in order to be approved by the lender. To obtain a COE, complete VA Form 26-1880, "Request for a Certificate of Eligibility." Then, provide your lender with the certificate.

For more information on the VA Home Loan Guaranty, visit:
www.benefits.va.gov/homeloans

Resources

Military OneSource
Offers a wide variety of support from education and transition to employment and financial matters.
www.militaryonesource.mil

DoD TAP
Veterans transitioning from military to civilian life can access resources through the TAP portal.
www.dodtap.mil

Links and resources for military families
www.survivingdeployment.com/links.html

State Veterans Affairs Offices
www.va.gov/statedva.htm

Tricare Military Healthcare System
www.tricare.mil

Women Veterans
www.va.gov/womenvet

Vet Centers
www.vetcenter.va.gov

National Center for PTSD
www.ptsd.va.gov

VA's National Suicide
Prevention Lifeline
1-800-273-TALK
www.suicidepreventionlifeline.org

VA Polytrauma System of Care
www.polytrauma.va.gov

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