From: Director, RAO Baguio []

Sent: Thursday, August 31, 2006 6:17 AM

Subject: RAO Bulletin Update 1 September 2006


RAO Bulletin Update

1 September 2006





== Agent Orange Lawsuits [04] -------------- (Offshore Eligibility)

== VA Presumptive AO Illnesses [Vets] ---- (AO Impact on Vets)

== VA Presumptive AO Illnesses [Kids] ---- (AO Impact on Kids)

== Alzheimer’s [01]  --------------------------- (Early Treatment)

== TFL Claim Processing [02] ---------------- (Opt-out Providers)

== Recruiters ----------------------------- (Increase in Wrongdoing)

== Recruiters [01] ------------------------ (Sexual Misconduct)

== Social Security Name Change ------------  (New Rules)

== DFAS Contact Info [01] -------------------- (Keep Current)

== Computer Tip -------------------------------- (Email Print Size)

== American Amicable Refunds -------------- (70,000+ Vets Due)

== Expeditionary Warfare Pin [USN]  ------- (Approved 31 JUL 06)

== Air Force Enlistment -------------------- (Recruits Still Needed)

== Service Members’ Rights Website  ------ (New Website)

== Walter Reed Army Medical Center  ------ (Closing in 2011)

== Medicare Part D [07] ----------------- (TFL Mistaken Enrollment)

== Medicare Part D [08] ----------------------- (Excluded Medicines)

== VA New York Hospitals:  ---------------- (Will Remain Open)

== COLA 2007 [05] ---------------------------- (3.4% to Date)

== TMOP [05] ------------------------- (Prescription Savings)

== Captioned Telephone:  ------------- (Hearing Impaired Vets)

== VA Claim Representation [03] ----------- (DAV Opposes S.2694)

== VA Data Privacy Breach [24] ------------- (Data to be Encrypted)

== FDA Assessment --------------------------- (Lower Enforcement)

== SBP Open Season [03] -------------------- (Last Chance)

== Tricare Allowable Charges:  -------------- (New Executive Order)

== Disabled Retiree Back Pay [02]----------- (Some in OCT)

== Medicare Physical Therapy Payments --- (Limited in 2007)

== Health Care Quality and Price ------------ (Medical Data Sharing)

== USMC Involuntary Recall --------- (Individual Ready Reserve)

== AHLTA Update [01] ---------------------- (Problem for VA)

== Beer Belly Control ------------------------- (1-2 beers a day OK)

== PI Tricare Provider Certification --------- (How to)

== Military Legislation Status ---------------- (Where we stand)



AGENT ORANGE LAWSUITS UPDATE 04:  Veterans who patrolled the waters

off Vietnam can now claim disability benefits for exposure to Agent

Orange under an appeals court ruling that opens the door for

thousands of servicemen to seek medical coverage. The ruling was

handed down by the U.S. Court of Appeals for Veterans Claims in the

case of Haas v. VADC-Nicholson by a former sailor who served on an

ammunition ship during the Vietnam War but never stepped foot on

land. The court’s order, issued 16 AUG, reverses the Veterans Affairs

Department’s denial of benefits for Jonathan L. Haas, who blamed his

diabetes, nerve damage and loss of eyesight on exposure to Agent

Orange. Haas, represented by the National Veterans Legal Services

(NVLS) argued that clouds of the toxic defoliate, which the U.S.

sprayed on Vietnamese jungles, drifted out to sea, englfing his ship

and landing on his skin. Veterans officials said that to qualify for

coverage, Haas was required to have docked in Vietnam and come



     The three-judge panel said regulations governing the benefits

were unclear. The court said it made no sense for veterans who

patrolled Vietnam’s inland waterways and those simply passing through

the country to receive medical coverage while those serving at sea do

not. “Veterans serving on vessels in close proximity to land would

have the same risk of exposure to the herbicide Agent Orange as

veterans serving on adjacent land, or an even greater risk than that

borne by those veterans who may have visited and set foot on the land

of the Republic of Vietnam only briefly,” Judge William A. Moorman

wrote. The Court did not actually award a disability to Haas, but

sent his case back to the Board for that determination.  If the Board

rules in his favor, the Court directed that his other Agent

Orange-related medical conditions also must be compensated.  The

Veterans Affairs Department said Friday that it was reviewing the

opinion and was not sure how many veterans would be affected or how

much the added coverage would cost.


     This VCAA decision could eventually expand to cover more

veterans than the decision appears to now cover.    During Vietnam

was a short time frame where military service within the Theater of

Operations within the Vietnam War justified the Vietnam Service

Medal. This included waters off the coast {so called brown water},

deep waters for air operations {so called blue water operations},

Thailand based Operations for USAF and other types of operations

which included loading the Agent Orange aircraft.  Most Vietnam

combat veterans receive some medical benefits, but if their illnesses

are related to their service, they could receive full coverage and

their families might be eligible for benefits. David Houppert,

director of veteran’s benefits for the Vietnam Veterans of America,

said the ruling could allow thousands of veterans to seek coverage

for service-related illnesses. Most are Navy veterans, he said, but

some Marines and Army veterans could be affected. Houppert said his

group was encouraging these veterans to seek coverage quickly because

the ruling left it up to government officials whether to change

federal regulations in a way that could deny coverage.  Vets can

refer to to review

what benefits they could be eligible for.


     As of 20 AUG the VADC-legal office had not filed a request for a

stay order pending an appeal to the Supreme Court.  The Board of

Veterans' Appeals is sitting at the Phoenix VARO.  The senior judge

has agreed to contact his office in Washington DC to get current

guidance on implementation of this decision.  The VCAA ruling over

turned a BVA decision on Haas.  If the VADC-Sec Nicholson's office

does not appeal they have no choice but to grant service connected

for Agent Orange Presumptive Disabilities with military service with

in the theater of Vietnam war for those with the Vietnam Service

Medal.  This decision will mean a potential liability of millions of

dollars to the VA Medical budget and VA Administrative budget.

Potential claims from the wives of already deceased Vietnam veterans

could also mean considerable liability.  This helps explain why the

VADC has been slow to provide positive guidance about this VCAA

decision.  Haas is now the law of the land and therefore VA must

abide by it. However, it is possible that VA may amend their

regulations in such a way that it is adverse to veterans who

otherwise would have benefited from the court’s decision.  Service

organizations are recommending that other veterans like Mr. Haas who

served offshore but did not set foot in Vietnam, and who suffer from

diseases or conditions that they believe to be caused by exposure to

Agent Orange should consider filing a claim for disability.  Members

who have had such claims denied may wish to re-file based on the

Court's decision.  Veterans are encouraged to seek the advice and

assistance of an experienced veterans' service organization before

proceeding. [Source: Associated Press article 18 Aug  & Arizona

Department of Veterans' Services msg 23 Aug 06 ++]



VA PRESUMPTIVE AO ILLNESSES [VETS]:  The following health conditions

are presumptively recognized for service connection. Vietnam vets

with any of these conditions do not have to show that the illness is

related to their military service to get disability compensation. A

current medical diagnosis of the condition and a DD Form 214 showing

Vietnam Service is normally all that is needed to accompany a

completed Veterans Application For Compensation or Pension VA Form

Number 21-526.


1. Chloracne (must occur within 1 year of exposure to Agent Orange).

Chloracne is a skin condition that looks like common forms of acne

seen in teenagers. The first sign may be excessive oiliness of the

skin. This is accompanied or followed by numerous blackheads. In mild

cases, the blackheads may be limited to the areas around the eyes

extending to the temples. In more severe cases, blackheads may appear

in many places, especially over the cheekbone and other facial areas,

behind the ears, and along the arms.

2. Non-Hodgkin’s lymphoma. A group of malignant tumors (cancers) that

affect the lymph glands and other lymphatic tissue. These tumors are

relatively rare compared to other types of cancer, and although

survival rates have improved during the past two decades, these

diseases tend to be fatal.

3. Hodgkin’s disease.  A malignant lymphoma characterized by

progressive enlargement of the lymph nodes, liver, and spleen, and by

progressive anemia.

4. Kaposi's sarcoma or mesothelioma

5. Soft tissue sarcoma other than osteosarcoma and chondrosarcoma. A

group of different types of malignant tumors (cancers) that arise

from body tissues such as muscle, fat, blood and lymph vessels, and

connective tissues (not in hard tissue such as bone or cartilage).

These cancers are in the soft tissue that occurs within and between

organs.  The following conditions fall under the term "soft-tissue


           a. Adult fibrosarcoma

b. Dermatofibrosacoma protuberans

c. Malignant fibrous histicytoma

d. Liposarcoma

e. Leiomyosarcoma

f. Malignant granular cell tumor

g. Alveolar soft part sarcoma

h. Rhabdomysarcoma

i. Ectomesenchymoma

j. Malignant glomus tumor

k. Malignant hemangiopericytoma

l. Malignant Schwannoma

m. Malignant mesenchymoma

n. Epithelioid sarcoma

o. Extraskeletal Ewing's sarcoma

          p. Congenital and infantile fibrosarcoma

       q. Malignant ganglioneuroma

       r.  Epitheloid Leiomysarcoma (malignant meiomyblastoma)

       s. Angiosarcoma (hemangiosarcoma and lymphagiosarcoma)

       t.  Proliferating (systemic) angioendotheliomatosis

       u. Clear cell sarcoma of tendons and aponeuroses

       v. Synovial sarcoma (malignant synovioma)

       w. Malignant giant cell tumor of tendon sheath

6. Porphyria cutanea tarda (must occur within 1 year of exposure.)

Porphyria cutanea tarda is a

   disorder characterized by liver dysfunction and by thinning and

blistering of the skin in sun-exposed areas.

7. Multiple myeloma.  A cancer of specific bone marrow cells that is

characterized by bone marrow

   tumors in various bones of the body.

8. Respiratory cancers, including cancers of the lung, larynx,

trachea, and bronchus. (Previously

   these conditions must have manifested within 30 years of the

veteran's departure from Vietnam to qualify but this 30 year time

limit has now been eliminated.

9. Prostate cancer. A cancer of the prostate and one of the most

common cancers among men.

10.   Peripheral neuropathy (transient acute or subacute. It must

appear within 1 year of exposure and

   resolve within 2-years of date of onset.) A nervous system condition

that causes numbness, tingling, and muscle weakness. This condition

affects only the peripheral nervous system, that is, only the nervous

system outside the brain and spinal cord. Only the transient acute

(short-term) and subacute forms of this condition (not the chronic

persistent form) have been associated with herbicide exposure.

11.   Diabetes mellitus: Often referred to as Type 2 diabetes: A

condition characterized by high blood

   sugar levels resulting from the body’s inability to respond properly

to the hormone insulin.

12.   Chronic lymphocytic leukemia (Final rule and regulations

pending). A disease that progresses

slowly with increasing production of and older) who live in areas

where it’s offered.



VA health care providers occasionally see combat veterans with

multiple unexplained symptoms or difficult-to-diagnose illnesses that

can cause significant disability. Two VA centers offer specialized

evaluations for combat veterans with disabilities related to these

difficult-to-diagnose illnesses. The War Related Illness and Injury

Study Centers - WRIISCs (pronounced “risks”) are at the VA Medical

Centers in Washington, DC, and East Orange, NJ. Veterans who were

deployed to combat zones, served in areas where hostilities occurred,

or were exposed to environmental hazards while on duty may be eligible

for services. [Source: NAUS Weekly Update for 22 AUG 03 & POVA VSO msg

28 JUL 04]



VA PRESUMPTIVE AO CONDITIONS [KIDS]:  The following health conditions

are presumptively recognized in children of veterans for service

connection. Vietnam veteran’s children with any of these conditions

do not have to show that their illness is related to their parent’s

military service to get disability compensation. A current medical

diagnosis of the condition and a DD Form 214 showing the parent’s

Vietnam Service is normally all that is needed to accompany a

completed Veterans Application For Compensation or Pension VA Form

Number 21-526.

  Spina bifida (except spina bifida occulta): A neural tube birth

defect that results from the failure of the bony portion of the spine

to close properly in the developing fetus during early pregnancy.

  Other (than spinal bifida) disabilities in the children of women

Vietnam veterans. Covered birth defects” means any birth defect

identified by VA as a birth defect associated with the service of

women Vietnam veterans in Vietnam from 28 FEB 61 to 7 MAY 75, and

that has resulted, or may result, in permanent physical or mental

disability. However, the term does not include a condition due to a

familial (this is, inherited) disorder; birth-related injury; or

fetal or neonatal infirmity with other well-established causes.


Covered birth defects include, but are not limited to, the following


1) achondroplasia,

2) cleft lip and cleft palate,

3) congenital heart disease,

4) congenital talipes equinovarus (clubfoot),

5) esophageal and intestinal atresia,

6) Hallerman-Streiff syndrome,

7) hip dysplasia,

8) Hirschprung’s disease (congenital megacolon),

9) hydrocephalus due to aqueductal stenosis,

10)   hypospadias,

11)   imperforate anus,

12)   neural tube defects,

13)   Poland syndrome,

14)   pyloric stenosis,

15)   syndactyly (fused digits),

16)   tracheoesophageal fistula,

17)   undescended testicle, and

18)   Williams syndrome.

** Not covered are conditions that are congenital malignant

neoplasms, chromosomal disorders, or developmental disorders. In

addition, conditions that do not result in permanent physical or

mental disability are not covered birth defects. All birth defects

that are not excluded under the language above are covered birth

defects. (Source: Extracted from Agent Orange Review, Vol. 19, No 2,

Dated July 2003)



ALZHEIMER’S UPDATE 01:  If treatment to prevent Alzheimer's disease

is going to work, it may have to begin in middle age — or even

younger, new research by Seattle scientists suggests. The researchers

found that in people genetically prone to Alzheimer's, significant

amounts of a brain-clogging protein start moving from the spinal

fluid to the brain at about age 50 or younger.  Previous research has

indicated that Alzheimer's begins years before symptoms appear. But

this latest work by Dr. Elaine Peskind, associate director of the

University of Washington Alzheimer's Disease Research Center at the

VA Puget Sound Health Care System in Seattle and her colleagues is

the first to look at early signs across a wide range of ages — from

21 to 88. The research is particularly significant because scientists

predict a dramatic increase in Alzheimer's in the decades ahead. About

4.5 million people in the United States have the disease, and

researchers say that could increase to 16 million by 2050.


    Peskind and scientists from five other medical centers analyzed

the effects of aging and the presence of a gene connected to

Alzheimer's, APOE4, on 184 adult volunteers with an average age of 50

and all mentally normal. People with the APOE4 gene have a higher

Alzheimer's risk because it produces a sticky protein, called beta

amyloid, in the form of a plaque that is thought to damage brain

cells.  Among the volunteers with the gene, the level of one

important form of the protein in the spinal fluid was dramatically

lower in participants 50 and older than in the younger ones. The

decline in levels possibly begins in young adulthood in those with

the gene, the scientists report in the July edition of the Archives

of Neurology. Among the volunteers without the gene, the protein

levels dropped slowly into old age. About a quarter of the population

has the APOE4 gene, though there are other physical factors that also

influence whether a person develops the disease.


     Peskind said more research is needed to confirm the study's

findings. As part of that effort, the scientists will follow about

half of the participants, those older than 60, to see which ones

develop Alzheimer's and to analyze more spinal-fluid samples. She

predicts that spinal-fluid tests someday could help identify who will

develop Alzheimer's. Because there is no cure or vaccine for

Alzheimer's, such tests would be unwise now, because they could

affect whether someone could obtain health insurance or

long-term-care insurance, she said. The four prescription drugs now

available for Alzheimer's merely ease the symptoms for a few years.

Other drugs are under investigation, including two at the UW. One is

to remove the plaque. The other is to prevent its production. But

Peskind predicts it will be many years before a major drug will be

available to prevent or control the disease but believes that within

10 years, it will definitely be possible. [Source:  Seattle Times

medical reporter Warren King 11 JUL 06] 




are strongly encouraged to find out what type of Medicare provider

they have prior to making an appointment with their health care

professional. If you don't, you may wind up paying more than you

think. Medicare currently has three types of providers:


-  Opt-out providers:  Opt-out providers have chosen to not see

Medicare patients and cannot submit claims to the Medicare program.

They are considered nonauthorized and nonparticipating. If you use a

nonauthorized provider, you will be responsible for the full bill,

including the portion TRICARE would have paid.

-  Participating providers:  Participating providers are

Medicare-authorized providers who agree to accept the

Medicare-allowable charge as payment in full, and who agree to file


-  Nonparticipating providers: A nonparticipating provider does not

agree to accept the allowable charge as payment in full, and may or

may not file claims.


Beginning 5 JUN 06, a small number of TFL beneficiaries who were

treated by providers who "opted-out" saw their claims denied by both

Medicare and Tricare. This was incorrect. The TFL claims processor

will automatically reprocess those claims that were improperly

denied. No action by the beneficiary is necessary. Tricare will

continue to pay claims at the Tricare Standard rate for any

Medicare-eligible beneficiary who is treated by a provider who has

opted-out of Medicare only until 30 SEP 06. After that date, a TFL or

Dual Eligible beneficiary who seeks care from a provider who has opted

out of Medicare will be responsible for the entire bill.


     About 93% of all doctors accept Medicare patients (and therefore

also accept Tricare for Life). Although your present providers might

be participating at the moment, come 1 JAN 07 many could decide to

opt out of Medicare because of the scheduled 5.1% reduction in fees

to be paid by Medicare after that date. When Medicare fees are cut,

TFL payments are also reduced thus making it less desirable for

providers to see a military retiree/spouse/surviving spouse. An AMA

survey of providers in early 2006 indicated that if the payment cuts

kick in, 45% of physicians plan to either stop accepting or decrease

the number of new Medicare patients and 43% will either stop

accepting or decrease the number of new Tricare patients. This

government action and the recently implemented Tricare third tier

pharmaceutical copay upgrades is making the lifetime medical care

benefit of retirees much more restrictive and costly to users. To

find out what type of health care provider you have, call Medicare

toll-free at 1(800) 633-4227. The November elections will give

veterans an opportunity to show Congressional incumbents what they

think of their actions that have allowed this erosion of our health

care benefit. [Source: MOAA News Exchange 16 Aug 06 ++]



RECRUITERS:  As the military struggled to attract new troops to fill

its billets, instances of wrongdoing by recruiters skyrocketed

between fiscal 2004 and fiscal 2005, Government Accountability Office

(GAO) investigators concluded in a report released 14 AUG.  Ongoing

operations in Iraq and Afghanistan, coupled with low U.S.

unemployment rates, have made lining up new enlistments a challenging

duty, compelling some recruiters to employ illegal or unethical

tactics to meet their quotas.  Cases of wrongdoing vary widely,

ranging from paperwork errors to serious allegations, such as sexual

harassment, falsifying documents and concealing serious medical

conditions. In May, for instance, The Oregonian reported that the

Army had accepted an autistic recruit and signed him up to become a

cavalry scout. The recruit has since been discharged.  The GAO

reported last year, allegations of wrongdoing among the military's

22,000 recruiters grew by 50% over fiscal 2004 claims, while

substantiated cases increased by more than 50%. Criminal violations,

meanwhile, jumped by more than 100%,


      The actual number of cases of wrongdoing may be even higher

than the number provided by GAO, whose investigators concluded that

many of the services do not have an effective way to track complaints

and allegations. They contend DoD is not in a sound position to assure

the general public that it knows the full extent to which recruiter

irregularities are occurring.  Its investigation follows two other

reports in 1997 and 1998 that recommended the military improve

performance among recruiters and reduce the number of violations by

rewarding recruiters for every enlistee's successful completion of

basic training rather than the number of enlistment contracts written

for applicants they attracted.


     Rep. Fortney Stark (D-CA) said in a statement 14 AUG that, “DoD

has twice ignored GAO recommendations on how best to account for and

limit recruiters' violations. This third inquiry confirms the two

prior reports' findings and demands immediate action."  Stark, who

requested the report with House Armed Services Personnel Subcommittee

ranking member Vic Snyder (D-AR) urged the military to take overdue

steps to enforce the Uniformed Code of Military Justice and called on

the House Armed Services Committee to increase oversight on the

matter. In 2005, the Army, Army Reserve and Navy Reserve failed to

meet recruiting goals, however DoD reported last week that all

services met or exceeded their recruiting targets for JUL 06.

[Source: Daily Briefing 14 Aug 06 ++]



RECRUITER MISCONDUCT UPDATE 01:  More than 100 young women who

expressed interest in joining the military in the past year were

preyed upon sexually by their recruiters. Women were raped on

recruiting office couches, assaulted in government cars and groped en

route to entrance exams. A six-month Associated Press investigation

found that more than 80 military recruiters were disciplined last

year for sexual misconduct with potential enlistees. The cases

occurred across all branches of the military and in all regions of

the country.  At least 35 Army recruiters, 18 Marine Corps

recruiters, 18 Navy recruiters and 12 Air Force recruiters were

disciplined for sexual misconduct or other inappropriate behavior

with potential enlistees in 2005, according to records obtained by

the AP under dozens of Freedom of Information Act requests. That’s

significantly more than the handful of cases disclosed in the past

decade. The AP also found:

  The Army, which accounts for almost half of the military, has had

722 recruiters accused of rape and sexual misconduct since 1996.

  Across all services, one out of 200 frontline recruiters - the ones

who deal directly with young people - was disciplined for sexual

misconduct last year.

  Some cases of improper behavior involved romantic relationships,

and sometimes those relationships were initiated by the women.

  Most recruiters found guilty of sexual misconduct are disciplined

administratively, facing a reduction in rank or forfeiture of pay;

military and civilian prosecutions are rare.

  The increase in sexual misconduct incidents is consistent with

overall recruiter wrongdoing, which has increased from just over 400

cases in 2004 to 630 cases in 2005, according to a General Accounting

Office report released this week.


     The Pentagon has committed more than $1.5 billion to recruiting

efforts this year. Defense Department spokeswoman Lt. Col. Ellen

Krenke insisted that each of the services takes the issue of sexual

misconduct by recruiters very seriously and has processes in place to

identify and deal with those members who act inappropriately. In the

Army 53 of 8000 recruiters were charged with misconduct last year.

Recruiting spokesman S. Douglas Smith said the Army has put much

energy into training its staff to avoid these problems.


     For this story, the AP interviewed victims in their homes and

perpetrators in jail, read police and court accounts of assaults and

in one case portions of a victim’s journal. A pattern emerged. The

sexual misconduct almost always takes place in recruiting stations,

recruiters apartments or government vehicles. The victims are

typically between 16 and 18 years old, and they usually are thinking

about enlisting. They usually meet the recruiters at their high

schools, but sometimes at malls or recruiting offices. Not all of the

victims are young women. A former Former Navy recruiter is serving a

12-year sentence for molesting three male recruits. One of the

victims is suing him and the Navy for $1.25 million. The trial is

scheduled for next spring. All of the recruiters the AP spoke with

said they were routinely alone in their offices and cars with girls.



     Although the Uniform Code of Military Justice bars recruiters

from having sex with potential recruits, it also states that age 16

is the legal age of consent. This means that if a recruiter is caught

having sex with a 16-year-old, and he can prove it was consensual, he

will likely only face an administrative reprimand. But not under new

rules set by the Indiana Army National Guard. There, a much stricter

policy, apparently the first of its kind in the country, was

instituted last year after seven victims came forward to charge a

National Guard recruiter with rape and assault. Now, the 164 Army

National Guard recruiters in Indiana follow a “No One Alone” policy.

Male recruiters cannot be alone in offices, cars, or anywhere else

with a female enlistee. If they are, they risk immediate disciplinary

action. Recruiters also face discipline if they hear of another

recruiter’s misconduct and don’t report it. At their first meeting,

National Guard applicants, their parents and school officials are

given wallet-sized “Guard Cards” advising them of the rules. It

includes a telephone number to call if they experience anything

unsafe or improper. [Source: AP article 21 Aug 06 ++]



SOCIAL SECURITY NAME CHANGE:  A new law, the Intelligence Reform and

Terrorism Prevention Act, includes several provisions that change

rules for assigning a Social Security number and issuing a Social

Security card. This Social Security changes became effective 17 DEC

05. It is important to know the rules for getting a replacement

Social Security card before you apply. If you need to change your

name on your Social Security card, you must show proof of your legal

name change. SSA can accept the following documents as proof of the

legal name change: marriage document, divorce decree stating you may

change your name, Certificate of Naturalization showing your new

name, or a court order for a name change.


     In the past, you could change the name by showing your driver's

license with the old name and the document giving the reason for the

name change.  The change now requires an extra step. You must change

your name on your driver's license first so that SSA can see a

document with the new name already on it. You can then use your old

license, the new license (not the temporary license), and the

document authorizing the name change.  If the document authorizing a

name change has enough information on it to identify you, then you

can get the name changed on your Social Security card without having

to change it on your driver's license first. Proof of identification

must include the applicant’s name and date of birth, Social Security

number, age, parents’ names, or a photograph. Some name change

documents do not contain this information, so people will have to

change the name on their driver's license before changing it on their

Social Security card. SSA must see original or certified copies of

your documents. Photocopies are not accepted.


     These new rules help ensure that only those who should receive a

Social Security number do so.  They make Social Security numbers less

accessible to those with criminal intent and prevent individuals from

using false or stolen birth records or immigration documents to obtain

a Social Security number. SSNs have never been reissued after their

owner’s death even though over 420 million SSNs have been issued to

date.  The current numbering system will provide enough new numbers

for several generations into the future with no changes in the

numbering system. [Source: 14 Aug 06]



DFAS CONTACT INFO UPDATE 01:  The Defense Accounting and Finance

Service (DFAS) reminds all military retirees and annuitants to review

their retirement or annuitant pay account status to ensure all

information is up-to-date. DFAS relies on current personal

information to provide their customer service. Officials emphasize

that it’s imperative that retirees notify the agency as soon as

possible about any change in marital or family status, beneficiaries,

mailing address and bank account information.  This ensures that the

individual’s retirement pay is processed correctly and on time. If

beneficiary information needs to be updated, customers can access the

new Designation of Beneficiary form online at Changes to

much of a retiree’s pay account can be made via myPay AT

http:/ or by calling the Retired/Annuitant Pay Customer

Service Center at 1(800) 321-1080.  Retirees may also send an e-mail

via myPay or by regular mail to: DFAS, U. S. Military Retirement Pay,

 P. O. Box 7130, London, KY 40742-7130. Any account changes must be

completed and submitted by the end of November 2006 in order to be

effective for the end-of-year processing (1099R’s, RAS’s, etc.). This

includes both retired and annuitant pay accounts. [Source: Air Force

Retiree News Service 17 Aug 06]



COMPUTER TIP:  Having trouble reading the small print in the text of

your oncoming messages.  If so, hold down the Ctrl key on your key

board and turn the small wheel in the middle of your mouse.  This

will change the print size to either larger or smaller depending on

which way you turn the wheel.  [Source Tom Kelly, Las Vegas msg 14

Aug 06]



AMERICAN AMICABLE REFUNDS:  More than 70,000 service members and

former service members are due some $70 million in refunds or policy

upgrades based on a settlement between American Amicable Insurance

Co. on one side and the Justice Department, insurance commissioners

from 42 states, Washington, D.C., and Guam, and the Securities and

Exchange Commission on the other. American Amicable does not have to

admit to or deny allegations that it improperly marketed and sold

insurance to junior ranking service members.  However, American

Amicable may not do business on U.S. military bases for five years.

In addition, the company is barred from:

-  Using allotment or MyPay forms for insurance premium funding;

-  Accepting applications from soldiers in pay grades E-1 through E-3

without proof they have been counseled according to Army regulations;


-  Offering gifts worth more than $5 to those with direct authority

over service members in pay grades E-1 through E-4.

[Source: Armed Forces News 18 Aug 06 & ]



EXPEDITIONARY WARFARE PIN:  The Navy’s Enlisted Expeditionary Warfare

(EXW) Specialist qualification program and pin were approved 31 JUL

06. The pin, which will be equivalent to the Navy’s other warfare

qualification designations, could be initially awarded to as many as

40,000 Sailors within six months. The EXW pin will be available to

Sailors assigned to SEAL units under Navy Special Operations Command

if the units institute a qualification program to be mandated by a

pending Navy instruction. According to Command Master Chief (EWS/SW)

of the Naval Expeditionary Combat Command (NECC). the pin will not be

available initially to Sailors on individual augmentee (IA) tours with

the Army because it is being established for Sailors qualifying with

expeditionary skills involved with maritime security. That exclusion

could change if the IA program moves to the NECC.  [Source: Armed

Forces News 18 Aug 06]



AIR FORCE ENLISTMENT:  The Air Force says that, despite rumors to the

contrary, the service is still recruiting. Next year’s recruiting

goals have been reduced by nine percent in comparison to the numbers

sought in 2006. Nevertheless, according to the Air Force Recruiting

Service Operations Division superintendent, the Air Force is still

hiring a mix of people in all of its career fields.  The service is

seeking 27,760 high school graduates or the equivalent, ages 17-28,

to join its enlisted ranks from October to September 2007. The Air

Force is also looking for 482 college graduates to join its officer

corps. The most available positions are pilot, combat systems officer

(navigator), air battle management and electrical engineering. After

the 482 Officer Training School positions are filled, additional

applications will move out to fill the following year’s jobs. For

more information about Air Force careers, visit

[Source: Armed Forces News 18 Aug 06]




Gonzalez announced 14 AUG a new Web site that would help the Justice

Department keep civil rights laws for American service members a

priority.  The Justice Department Web site,,

outlines the rights service members have under the Uniformed Services

Employment and Reemployment Rights Act, the Uniformed and Overseas

Citizens Absentee Voting Act and the Service Members Civil Relief

Act.  The attorney general said these are not just “pie in the sky”

rights, but issues that directly affect people. Mr. Gonzales urged

any service member with questions to go to the Justice Department Web

site. Military lawyers can help service members and their families

navigate through the laws. [Source: NGAUS NOTES 18 Aug 06]



WALTER REED ARMY MEDICAL CENTER:  Officials at Walter Reed Army

Medical Center announced 16 AUG the construction of a temporary

medical annex at the hospital to provide better facilities for

wounded troops undergoing post-amputation care. The

30,000-square-foot addition is being built onto Walter Reed’s general

medical facility building and will be called the U.S. Army Amputee

Patient Care Center. According to retired Col. Charles Scoville, the

future director of the annex upon completion will improve the

capabilities to return soldiers to the highest level of function. The

annex will provide better facilities and equipment as well as

additional room. Groundbreaking for the facility has been initiated

with completion slated by OCT 07.  Walter Reed’s amputee care

facility mostly treats wounded soldiers since the war on terror

began, as well as some Marines transferred from the National Naval

Medical Center, in Bethesda, MD. The daily amputee care caseload

averages eight to 10 inpatients and around 75 to 100 outpatients.

The facility admits 10 to 15 new patients each month. Walter Reed

will close in 2011 as part of the 2005 Base Realignment and Closure

Act. Amputee recovery services at Walter Reed will be moved into a

new joint medical facility to be built in Bethesda, and other

patients will be moved to Fort Belvoir VA. [Source: NGAUS NOTES 18

Aug 06]



MEDICARE PART D UPDATE 07: Per Express Scripts, some people that are

Tricare For Life members were automatically enrolled in Part D and

are now experiencing difficulties getting their prescriptions. The

number automatically enrolled is unknown but there are 129,000

Tricare beneficiaries that are enrolled in Part D. Very few actually

benefit from Part D unless they qualify for Part D with no premiums.

Express Scripts is recommending the pharmacy process the Rx under

Part D and then it will go to Tricare for the balance.  Beneficiaries

are told to contact Medicare to disenroll from Part D and obtain a

letter from Medicare. The letter then should be faxed to (831) 583

2340 Defense Manpower Data Center (DMDC) (formerly DSO) and the Part

D will be removed from DEERS within 24 hours. DMDC can also

accommodate DEERs change of address inputs at  Express Scripts is

working with TMA to determine the best resolution of the inadvertent

TFL user’s automatic Part D signup. [Source: NAUS Weekly Update 18

Aug 06 ++]



MEDICARE PART D UPDATE 08: Under the 2003 Medicare drug legislation,

coverage was provided for most medically necessary drugs.  Yet

millions of seniors are learning which prescription medications are

covered under their drug plans and which are not.  Considerable

attention has been devoted to the fact that Part D plans are

permitted to limit the coverage of drugs through the use of

formularies, “step therapy” (requiring that patients first try less

expensive drugs), prior authorization, and quantity limits. Less well

known, however, is the fact that nine entire categories of drugs were

excluded under the Medicare Modernization Act of 2003 Part D

legislation.  Medicare will not cover them under any circumstance.

These excluded drugs include:

1. Agents when used for anorexia, weight loss, or weight gain

2. Agents when used to promote fertility

3. Agents when used for cosmetic purposes or hair growth

4. Agents when used for the symptomatic relief of cough and colds

5. Prescription vitamins and mineral products, except prenatal

vitamins and fluoride preparations

6. Nonprescription drugs

7. Outpatient drugs for which the manufacturer seeks to require

associated tests or monitoring services be purchased exclusively from

the manufacturer or its designee as a condition of sale

8. Barbiturates

9. Benzodiazepines


Some of the drugs have been the subject of controversy for years, and

this no doubt led to their exclusion.  Those drugs have significant

side effects that may be exacerbated in older patients, such as

over-sedation causing falls and hip fractures, and addiction.  In

addition, when Congress considered legislation to add a prescription

drug benefit, many of the major bills advanced by both Democrats and

Republicans adopted some or all of the categories of drugs that are

excluded under state Medicaid programs, and excluded them from

coverage under Medicare.  The TRAS Senior citizens League (TSCL)

questions some of the exclusions.  Particularly those of drugs that

are currently covered under most state Medicaid programs.  The

blanket exclusion of medically necessary drugs could result in

serious harm to Medicare beneficiaries who really need them.  TSCL is

studying the issue and believes that certain categories could be

legitimately modified by the Secretary of the Department of Health

and Human Services, for coverage under Part D.  [Source: TSCL Social

Security Advisor 26 Aug 06]



VA NEW YORK HOSPITALS:  VA Secretary Nicholson announced that the VA

will keep both the Manhattan and the Brooklyn VA medical centers open

and will make major renovations and improvements at the St. Albans VA

Medical Center in Queens. There has been an ongoing 2 year analysis

studying if the centers should be consolidated. The decision was

based both for the convenience of the veterans and the VA’s desire to

continue retain its close ties with NYU’s Medical School and the

medical school of the State University of New York. The Secretary

also said he wanted to personally thank the local advisory panels for

the Manhattan/Brooklyn study and the St. Albans study, along with many

others, including the New York congressional delegation, veterans

groups, city and state leaders, other stakeholders and VA employees

which have guided VA in these decisions [Source:  TREA Leg Up 18 Aug




COLA 2007 UPDATE 05:. In mid-August, the Bureau of Labor Statistics

announced the JUL 06 monthly Consumer Price Index (CPI), which is

used to calculate the annual cost-of-living adjustment (COLA) for

military retired pay, VA disability compensation, survivor annuities,

and Social Security. The CPI continued its upward trend, rising

another 0.3% in July -- for a cumulative increase of 3.4% so far this

fiscal year.  Once again, a large share of the increase was due to a

jump in energy prices. The July CPI-W contained a 3.1% increase in

energy costs and a 1.8% increase in transportation costs which

influenced the increase in inflation. Last year, the CPI had risen

3.2% through the month of July and ended up the year at 4.1%. With

inflation running slightly ahead of last year's pace so far, it would

seem likely that we'll end this year in the same ballpark. We can

still hope that inflation in the last two months of this year may not

match last year's experience, when Hurricane Katrina sent energy

prices soaring. For more information, For more information, visit

[Source: MOAA Leg Up 18 Aug 06]



TMOP UPDATE 05:  Tricare's mail-order pharmacy (TMOP) is getting a

lot of legislative attention, and military beneficiaries would do

well to pay attention.  Each prescription dispensed through the

mail-order system saves the Pentagon an average of $50 to $150

dollars, depending on what's counted.  Also, those who use TMOP save

67% because they get a three-month supply for the same copayment that

buys only a one-month supply in a retail pharmacy. But for whatever

reason, only 6% of prescriptions are currently filled through the

mail-order system, and the most rapid growth is in the retail system

– the one that's most expensive for both the government and


MOAA believes there are several reasons for underutilization of the

TMOP, including a lack of publicity about it by the Defense

Department and beneficiaries' reluctance to change what has worked

for them in the past, even if the change would save them a modest

amount of money.


     The cost difference is a big deal for the government, and

Congress is determined to do all it can to encourage use of the

much-cheaper mail-order program. One way is to significantly sweeten

the program for beneficiaries, and both the House and the Senate put

provisions in the FY2007 Defense Authorization Bill that will

eliminate any copayment for most drugs obtained through the

mail-order system. That should make using the mail-order system a

no-brainer for the vast majority of people who use long-term

maintenance medications.  Why pay a copayment or make an extended

trip to a military installation if you can get the same medications

delivered right to your doorstep -- for free? But some in Congress

aren't convinced that voluntary incentives will generate enough

migration to TMOP.  So the Senate also passed a provision that would

require military beneficiaries to obtain all refill prescriptions of

maintenance medications through TMOP.  The Military Coalition (TMC)

thinks that's going too far.  There are some instances when the

mail-order system isn't appropriate or efficient - such as when the

doctor changes the dosage or when replacing lost medication.


       Another way to reduce government costs is to require drug

companies to provide the defense department the same prices through

the retail system that it charges for drugs dispensed through

military and VA facilities.  The Senate version of the defense bill

would do that, but the Administration's Office of Management and

Budget is opposing that provision - seemingly putting the interests

of the drug companies ahead of the Defense Department's. TMC supports

the Senate provision requiring reduced retail drug prices and heartily

endorses elimination of any beneficiary copayments for drugs obtained

through the mail-order system.  TMC opposes mandatory refills of

maintenance medications through the mail-order system.  That doesn't

allow enough latitude for individual circumstances - especially when

White House budgeteers are taking the drug companies’ side in

opposing consistent price discounts for all military-purchased drugs.

Our legislators need to be told by their constituents how they feel

about the NDAA proposed changes.  It is not too late to influence the

Compromise Committee’s vote on the 2007 NDAA content.  [Source: MOAA

Leg Up 18Aug 06]



CAPTIONED TELEPHONE:  Captioned Telephone (CapTel) service is

available in the vast majority of states, for the hearing impaired.

This is a new telephone technology that allows people to receive

word-for-word captions of their telephone conversations. It is

similar in concept to Captioned Television, where spoken words appear

as written text for viewers to read. The CapTel phone looks and works

like any traditional phone, with callers talking and listening to

each other, but with one very significant difference of captions

being provided live for every phone call. The captions are displayed

on the phone's built-in screen so the user can read the words while

listening to the voice of the other party.  Thus, if the CapTel phone

user has difficulty hearing what the caller says, he can read the

captions for clarification. In many states, CapTel equipment is

provided free or at a reduced rate to people with hearing loss. You

can check the specifics of your state at There is no cost for

using the CapTel captioning service which is provided free as part of

your state's relay service. Veterans and retired federal (civilian &

military) employees can qualify for a free CapTel phone if they:

-  Have a hearing loss; and

-  Complete an application form availble at; and

-  Submit offical verification of their retirement status (i.e.

DD-214, SF50 or other official verification)


Signed applications should be mailed to: Sprint-Federal Relay, Attn:

Free CapTel Phone, 401Ninth St., NW, Ste 400, Washington DC or via

Fax to (202) 585-1841.  Federally recognized U.S. Tribal member are

also eligible. For additional information refer to  [Source: Paul Hart msg 15 Aug 06]



VA CLAIM REPRESENTATION UPDATE 03:  According to Disabled American

Veterans National Commander Bradley S. Barton, federal legislation

that would allow lawyers to charge veterans for helping them file a

claim for benefits from the Department of Veterans Affairs is

unnecessary and would increase costs to veterans.  Barton, who is

himself an attorney and a veteran’s advocate, said veterans should

not have to hire and pay a lawyer to help them with the largely

administrative claims process which is designed to be open, informal

and helpful to veterans.  He disagrees with what the Senate passed

Veterans’ Choice of Representation Act would do because:

-  Involvement of lawyers would increase costs to veterans and to the

VA without significantly improving the process.

-  The VA is required to assist veterans in completing and filing the

relatively informal application for benefits and then takes the

initiative to advance the claim through the appropriate steps.

-  Veterans can get free help from the DAV’s professionally trained

National Service Officers or other organizations in navigating the VA

claims process.


     The VA is also opposed to the legislation, noting that attorney

fees would consume significant amounts of payments under programs

meant to benefit veterans.  If enacted the VA would have to create a

substantial new bureaucracy to perform the additional accreditation

and oversight responsibilities. Instead the VA should use its scarce

resources to hire more claims adjudicators and provide them with the

training needed to improve the quality as well as timeliness of

decisions.  Unfortunately there has been no indication that the VA

would take this tack and the backlog of claims continues to grow.

Congress placed the duty on the VA to ensure all alternative theories

of entitlement are exhausted and all laws and regulations pertinent to

the case are considered and applied. Under present regulations

veterans may hire an attorney for advice and counseling prior to

filing a claim for benefits or after the VA administrative

proceedings have been completed.


     There does not appear to be any evidence that attorneys would

provide service superior to that rendered by veterans service

organization (VSO) representatives. In fiscal year 2005, the Board of

Veterans’ Appeals granted one or more of the benefits sought in 21.3%

of the appeals in which claimants were represented by attorneys, who

have the luxury of hand picking their clients. The board granted one

or more of the benefits sought in 22.3% of the cases in which a

claimant was represented by a veterans’ service organization.  The

1.3 million-member Disabled American Veterans, a non-profit

organization founded in 1920 and chartered by the U.S. Congress in

1932, represents this nation’s disabled veterans. Its sole purpose is

building better lives for our nation’s disabled veterans and their

families.  [Source: DAV News Release 18 Aug 06 ++]



VA DATA PRIVACY BREACH UPDATE 24:  Although some might think of it as

locking the barn door after the horse got out, the VA announced 14 AUG

it will be improving data encryption on its computer systems to make

it harder to copy or misuse personal information. VA Secretary R.

James Nicholson announced a $3.7 million contract was signed 1 AUG

with a Syracuse, N.Y., business, SMS Inc., which is a small business

owned by a disabled veteran.   Under the contract, all computers will

receive encryption programs, starting with laptops and then desktops.

Devices that transfer data, such as compact discs, portable hard

drives and flash drives, also will have security encryption. The VA

announcement said. two software programs will be used which are now

undergoing final tests. Program installation on laptops could start

as early as 18 AUG. The statement estimates it will take four weeks

for installation on all VA laptop computers. [Source: NavyTimes staff

writer Rick Maze article 14 Aug 06 ++]



FDA ASSESSMENT:  Timed to coincide with the Food and Drug

Administration’s (FDA) 100th anniversary, a new report by Rep. Henry

A. Waxman (D-CA) examines how the Bush Administration has carried out

FDA’s enforcement responsibilities.  The report is based on a 15-month

investigation that included a review of thousands of pages of internal

agency records. Concluding that FDA enforcement has dropped

precipitously over the last five years, the report states:


**The number of warning letters issued by the agency for violations

of federal requirements has fallen by over 50%, from 1,154 in 2000 to

535 in 2005, a 15-year low. During the same period, the number of

seizures of mislabeled, defective, and dangerous products has

declined by 44%.

**In at least 138 cases over the last five years involving drugs and

biological products, FDA failed to take enforcement actions despite

receiving recommendations from agency field inspectors describing

violations of FDA requirements.

**Although the Federal Records Act and internal agency procedures

require FDA to keep records that document agency enforcement

decisions, FDA does not appear to comply with these requirements.

FDA’s response to Committee requests for relevant enforcement

documents was haphazard, incomplete, and untimely.


     FDA officials explained that FDA could not provide prompt and

complete responses because the agency lacks a system that enables it

to track enforcement recommendations from field offices. The report

entitled Prescription for Harm: The Decline in FDA Enforcement

Activity. U.S.  House of Representatives Committee on Government

Reform Minority Staff Special Investigations Division, June 2006  can

be viewed at .

For additional documents, refer to

.  [Source: Consumer Health Digest Weekly Update 22 Aug 06]



SBP OPEN SEASON UPDATE 03:  SBP Open Enrollment period signup for

increased SBP coverage terminates 30 SEP 06 and none of the services

have experienced any great influx of applications.  T he less than

staggering numbers is attributed to the significant buy-in costs

faced by retired members who have been retired a long time. Even with

large buy-in costs mandated by Congress to ensure the integrity of the

fund is maintained, officials still feel that the SBP is a tremendous

bargain.  To match the SBP would take a high-dollar insurance policy

with premiums beyond the reach of most. In addition, retired members

don’t have to take physical exams to get into the SBP. Two provisions

enacted in recent years make the SBP even more attractive:

1. Phased in elimination of the Social Security offset, which

previously meant a widow’s annuity payment dropped from 55% of the

selected base amount to 35% when the surviving spouse reached the age

of 62. Payments to surviving spouses increased to 40% on the base

amount on 1 OCT 05 and to 45% 1 APR 06 SBP payments will go to 50% on

` APR 07 and 55% on 1 APR 08.

2. Enactment of a paid-up provision which means that beginning 1 OCT

08, retired members who are age 70 and older and who have paid into

the SBP for 30 years will no longer have to pay premiums.  Retired

members, who buy-in during the current SBP enrollment period, GAIN


COVERAGE, meaning that some will pay monthly premiums for just over

two more years.


     Those who took SBP coverage and later elected to terminate that

coverage are not eligible to make an open enrollment election. Open

enrollment elections require a lump sum buy-in premium as well as

future monthly premiums.  The lump sum equates to all back premiums,

plus interest, from the date of original eligibility to make an

election plus any amount needed to protect the Military Retirement

Fund.  The latter amount applies almost exclusively to those paying

fewer than seven years of back payments. The lump sum buy-in premium

can be paid over a two-year period.  Monthly premiums for spouse or

former spouse coverage will be 6.5% of the coverage elected, the same

premium paid by those currently enrolled. Reserve component members

under age 60 and not yet eligible for retired pay do not pay back

premiums or interest, but must pay a monthly SBP premium “add-on”

once their retired pay starts. Elections are effective the first day

of the month after the election is received.


     To make an open enrollment election, a retiree must complete and

submit a DD Form 2656-9, “Survivor Benefit Plan (SBP) and Reserve

Component Survivor Benefit Plan (RCSBP) Open Enrollment Election.”

available at For

assistance with the form, retired members should contact the office

managing the SBP for their Service. Air Force retirees should call 1

(800) 531-7502 anytime between 0730 & 1630 CST, M-F except holidays.

Those residing outside the CONUS may need to obtain an AT&T direct

access number to call the SBP toll-free number. If someone other than

the retired member calls for information, that person should have the

retiree’s most recent retiree pay statement available.  Privacy Act

restrictions do not permit SBP counselors to access the retiree’s

account for a second party. Mail the completed form to the address

specified on the form.  Applicants will be formally notified of their

cost and have 30 days from the date of the notice to cancel the

election by notifying the Defense Finance and Accounting Service or

the reserve component, as applicable, in writing. [Source:

Afterburner  Aug 06 ++]



TRICARE ALLOWABLE CHARGES:  President Bush signed an Executive Order

on 22 AUG titled “Promoting Quality and Efficient Health Care in

Federal Government Administered and Sponsored Health Care Programs,”

directing federal agencies that administer health care programs to

take steps to promote quality care. It also states that agencies must

do these three things: create incentives for beneficiaries to care

about the quality and price of their health programs; address

interoperability of health information technology products; and make

health information more transparent to consumers.  To support this

and other health initiatives in the President’s Management Agenda,

the Department of Defense has initiated several activities intended

to realize the promise of improved and more efficient health care for

all beneficiaries of the Military Health System (MHS).


     In one initiative, Tricare is partnering with industry, current

health managers and providers, who contract with DoD in developing

robust measures of quality health care that can be consistently

applied by the MHS as a unified effort. These ongoing “data quality

summits” are developing a core set of metrics that will enable both

MHS leaders and beneficiaries in making sound decisions about health

choices.  In another initiative, the MHS is actively engaged in

strategic partnerships with both the public and private sectors to

advance health care information science and to promote and define

standards for health information technology systems interoperability.

DoD has made significant progress advancing health care information

technology through large-scale adoption and deployment of AHLTA which

is nearing full implementation


    In still another initiative to promote transparency of health

care pricing and quality, TRICARE has posted its allowable charges on

an easy-to-use  site at The cost

of medical care varies widely across the country. Neither hospitals

nor doctors’ offices typically post their charges for various

procedures, making it hard for patients to judge if they are being

charged a reasonable amount for operations or examinations. By making

its charges easily available to the public, Tricare is leveling the

playing field between medical service providers and users. The new

Web site shows the Tricare maximum allowable charge tables, listing

the most frequently used procedures - more than 300 of them - and the

amount Tricare is legally allowed to pay for them. These charges are

tied to Medicare allowable charges, effectively making them a federal

standard for health care costs.  [Source: DoD News Release 22 Aug 06]



DISABLED RETIREE BACK PAY UPDATE 02:  If all goes as planned some

disabled retirees due retroactive pay could start to see their

payments in mid-October according to DoD and VA (VA) sources.  A

small number may see payments before that; however, VA officials

caution that, if any unexpected glitches crop up, the payments will

be delayed until the second half of January.  That's because they'll

have their hands full at the end of the year reprogramming and

implementing new pay rates for 2007.

Over 100,000 retirees now drawing either Combat Related Special

Compensation (CRSC) or Concurrent Retirement and Disability Pay

(CRDP) ultimately will receive back payments and that number is

growing daily with new awards.  Because of the complexity of

calculating who is due how much the majority of the payments will

likely be phased in from January through next summer. This is because

individual circumstances vary widely and many cases require manual



     Why is retroactive pay due?  While the VA disability award

letter usually establishes a retroactive effective date, the VA

doesn't initially make retroactive payments for retirees with less

than a 100% disability rating.  That's because there's usually at

least some offset required for retired pay already received.  If the

VA paid all retroactive awards immediately, it would cause major

headaches for many disabled retirees, who would then have to pay back

large amounts of their military retired pay.  Only if and when a

disabled retiree is awarded CRDP or CRSC can the VA find out whether

back disability pay is due – but it needs a ton of data from the

Defense Department to figure out how much.  On the other hand,

retirees who experience changes in their disability awards may also

be due retroactive CRSC/CRDP payments from the Defense Department.


     The bottom line is that the new and complicated CRSC and CRDP

programs have created major administrative and budgetary headaches

for Pentagon and VA administrators.  Their first priority has been to

get the pays started while minimizing confusion or aggravation for

disabled retirees.  Now, they've invested months of combined effort

to change their policies, systems, and budgets to finish the hard

part – figuring out who is due how much in retroactive payments.

Defense Finance and Accounting Service (DFAS) sources say the

affected retirees will receive specific details at the time their

retroactive payment is made.  DFAS expects to publish a detailed news

release later this month.  [Source: MOAA Leg Up 25 Aug 06]



MEDICARE PHYSICAL THERAPY PAYMENTS:  Barring congressional action

before the end of 2006, Medicare payments for outpatient physical

therapy will be limited to a flat $1,740 a year, starting in JAN 07.

But a bipartisan effort is underway in the House to change the law and

suspend the payment cap. 

The cap on outpatient physical, speech-language and occupational

therapy services by any providers other than hospital outpatient

departments was put in law by the Balanced Budget Act of 1997.   That

law required a combined cap for physical therapy and speech-language

pathology, and a separate cap for occupational therapy, but Congress

delayed its implementation for several years. The $1,740 annual cap

went into affect in JAN 06, but Congress authorized an exception if

such services are determined to be "medically necessary" -- which

most certainly are.  But this exception is due to expire at the end

of 2006.


     In May, Reps. Benjamin Cardin (D-MD) and Philip English (R-PA)

authored a bipartisan letter urging the leaders of the Ways and Means

and Energy and Commerce Committees, which oversee the Medicare payment

issue, to repeal the cap.  At the very least, the letter said, the

medical necessity exception should be extended through 2007.  177

representatives joined Cardin and English in signing the letter.

Absent a repeal of the cap or extension of the exception, Tricare For

Life (TFL) beneficiaries will experience more out-of-pocket expenses

and may have to seek these services in a hospital setting.  Military

eligibles will have some protection in that TFL will become primary

payer after the Medicare cap is reached, but Tricare deductibles and

copays apply after that point. H.R.916 & S.438 have been introduced

in Congress to repeal the increase. To support these bills refer to to contact your

Representative or to to contact your

Senator. [Source: MOAA Leg Up 25 Aug 06]



HEALTH CARE QUALITY AND PRICE:  On 22 AUG President Bush signed an

Executive Order designed to promote more efficient sharing of medical

data between government agencies. In the executive order, the

President said, “It is the purpose of this order to ensure that

health care programs administered or sponsored by the federal

government promote quality and efficient delivery of health care

through the use of health information technology, transparency

regarding health care quality and price, and better incentives for

program beneficiaries, enrollees and providers.” In effect, the

President tells providers in order to do business with the federal

government have to show the government their prices.  It requires

that four major government agencies, DoD, Department of Health and

Human Services, OPM and the VA, gather and share information about

the quality and price of medical care.  These four agencies provide

coverage to nearly 25 percent of all Americans with health



     The agencies covered by the order must establish programs

designed to measure quality of care. The beneficiaries must also be

able to see the prices these agencies pay for common medical

procedures, to develop and identify practices that encourage high

quality care, and whenever possible, use compatible computer systems

and electronic health records to help track a beneficiary’s medical

care and condition.  These changes and new procedures must be

underway by 1 JAN 07. The Executive Order should have the effect of

improving quality and efficiency and ensure “Seamless Transition”

from active to inactive service is given a higher priority than it

currently enjoys. The entire Executive Order may be seen on the web

at [Source:

NAUS Weekly Update 25 Aug 06]



USMC INVOLUNTARY RECALL:  Due to projected shortages in some

specialties such as engineers, intelligence, military police and

communications, the Marine Corps on 22 AUG announced that they will

shortly begin involuntary recalls. They will begin by calling up 2500

members at a time, of the Individual Ready Reserve. They have decided

to exempt those who are either in the first or last year of their

reserve status. Marines can expect to be deployed for an average of

12-18 months but could be for as long as two years. They will receive

five months to prepare before having to report for duty. [Source: NAUS

Weekly Update 25 Aug 06]



AHLTA UPDATE 01: William Winkenwerder Jr., assistant secretary of

defense for health affairs, took time during a 23 AUG teleconference

with journalists to tout his department’s ability to transfer

electronically the medical records of separating service members to

the VA.  His comments came in unveiling a new DoD instruction on

deployment health which is a compilation of policy decisions taken

over the last four years to enhance force health protection

dramatically. Two of the initiatives are new. 

-  First, DoD is committed, as capabilities allow, to collecting data

daily on the location of every service member deployed.  This will

allow officials to link environmental monitoring data to individual

deployments and, over time, correlate exposure data to veterans’


-  Second, DoD will extend all health protection measures to deployed

DoD civilian employees and contractors as well as service members.


In praising DoD’s system, Winkenwerder ignored a rising chorus of

critics who say AHLTA, the Department of Defense’s digitalized

medical record system, is a problem for the VA and for veterans

because, in fact, it doesn’t allow electronic record transfers

outside the military network. The critics include the Government

Accountability Office, senior VA officials and, most recently, the

chairmen of the both the House and Senate veterans’ affairs

committees. GAO reported last month that the biggest obstacle

remaining for severely wounded troops to experience “seamless

transition” from military care to VA trauma centers is the inability

to transfer AHLTA records.


     Through June, more than 19,000 service members had been wounded

in Iraq and Afghanistan.  Sixty-five percent had blast injuries,

which often result in trauma requiring comprehensive rehabilitation.

GAO said that nearly 200 severely wounded members, while still on

active duty, have been transferred to a VA poly-trauma centers for

care and rehabilitation.  Most of these cases involve brain injury,

missing limbs and spinal cord injuries. GAO acknowledges that VA and

DoD have strengthened procedures for transferring war-injured members

and veterans. Their joint programs have eased hassles for patients and

families. VA social workers are assigned to large military treatment

facilities to coordinate transfers.  Military liaisons have been

added to VA staff at poly-trauma centers to handle transition issues

raised there. But GAO said there are problems electronically sharing

the medical records VA needs to determine whether service members are

medically stable enough to participate in vigorous rehabilitation

activities. DoD radiological images, vision and hearing tests, and

anesthesia notes cannot be transferred electronically.  Also, DOD has

no system-wide approach to electronic medical record management..

Information is maintained and stored at individual treatment

facilities or in networks of facilities rather than system wide. GAO

noted, for example, that health care providers at Walter Reed Army

Medical Center and the National Naval Medical Center can access each

other’s electronic medical records but cannot access medical records

from Landstuhl Regional Medical Center in Germany.


     Perhaps the most obvious weakness of AHLTA, said GAO, is it

captures outpatient records only.  VA needs inpatient records to

provide follow-care and rehabilitation.  As of APR 06, Walter Reed

Army Medical Center still had to fax records to VA poly-trauma

centers. Rear Adm. John M. Mateczun, Navy’s deputy surgeon general,

said military patients transferred to the VA can arrive with a

digitized medical record.  It must be brought over on a computer disk

and read by an offline computer. But the record can’t be transmitted

by AHLTA nor can it be integrated into the VA’s VISTA record system.

Winkenwerder suggested AHLTA is the more sophisticated system. Asked

to reconcile his rosy view of AHLTA with such criticism, Winkenwerder

said DoD is working with VA to be able to share images of x-rays, MRIs

and CAT scans electronically.  That might happen within 18 months, he

said.  Next year, work will begin on closing other gaps in electronic

transfer capability raised by GAO.


     Sen. Larry Craig (R-ID), chairman of the Senate Veterans’ Affair

Committee, told Government Health IT that the VA has an award-winning,

highly touted electronic health records system while the DoD is still

talking about requirements.  This leaves him wondering whether DoD is

just trying to justify building its own system. Rep. Steve Buyer

(R-Ind.), Craig’s counterpart in the House, also complained to the IT

industry newsletter.  He said AHLTA is less capable than VISTA in its

ability to share data between its own hospitals. VISTA’s architecture

and software do not meet the requirements of DoD. It’s sort of a

hospital by hospital system and DoD’s need was to be able to move the

information globally, from the battlefield of Iraq or Afghanistan to

Landstuhl, Germany to anywhere in the world. The Senate

appropriations committee has urged DoD to switch to VA’s record

system.  However, Defense officials say VISTA would need significant

modification to meet military needs and the switch would be long and

costly. [Source: Military Update Tom Philpott article 24 Aug 06 ++]



BEER BELLY CONTROL:  Over 90 million Americans enjoy drinking beer!

Drinking moderately has been proven by many doctors, as well as the

New England Journal of Medicine, to be a healthy component of

longevity. In fact, moderate consumption of alcohol, including beer,

has been proven to reduce the effects of high cholesterol, heart

disease, some forms of cancer and even impotence. Anything done in

excess is naturally unhealthy. Moderation is defined by most doctors

as 1-2 beers a day. And NO, you cannot save up through the week and

catch up on the weekend drinking 10-12 beers in an evening. That is

NOT moderation. There is even a U.S. Beer Drinking Team

( that links beer enthusiasts and promotes moderation,

responsibility, and healthy living.


     The average can of beer has over 100 calories. Drinking one beer

is equivalent to eating a chocolate chip cookie. Drinking four is

equal to eating a Big Mac Hamburger. In order to lose weight, you

have to burn off these extra calories as well as the other calories

that you ate for breakfast, lunch and dinner. Even the lightest of

beers has the empty calories of alcohol, which is the cause of poor

health if done in excess and without a regular exercise routine.

Unfortunately, too many Americans live under one of the worst

stereotypes placed on a human being - the BEER BELLY. This is caused

by excess calories in your diet and lack of activity to burn the

extra calories. The solution to lose your beer belly is as simple as

calories in must be less than calories out or  Calories IN < Calories

Out (burned thru exercise) = Weight Loss.  If you can add exercise

into your schedule for 20-30 minutes a day, your daily consumption of

alcohol (1-2 beers) will not have any additional impact on your gut.

To lose your beer belly, you REALLY have to watch your food and

beverage intake, drink 2-4 quarts of water a day, and fit fitness

into your world. There is no other healthy answer!  The exercise and

workout ideas below can get you started on your calorie burning plan.

For more tips on burning calories refer to,13190,Smith_Index,00.html:


1.  Workout #1: This is a great full body calorie burner: Walk, run

or for 5 minuted +  20 squats + 10-20 Pushups +  20 situps or

crunches.  Repeat 3-5 times.

2.  Workout #2: Swimming and elliptical gliding (cross country

skiing) burn the most calories per hour (This workout can burn up to

1000 calories in one hour). Swim 20-30 minutes non-stop or elliptical

glide 20-30 minutes.

[Source: Weekly News 21 Aug 06]



PI TRICARE PROVIDER CERTIFICATION:  There are two types of provider

certification. The first is an “institutional” certification for

hospital, clinics, pharmacy, etc., and the second is for

“non-institutional” providers, which are essentially independent

doctors and specialists. Those already certifiedin the Philippines

can be found at by clicking the

Tricare in the Philippines button and then the Philippine Provider

Listing button. If the provider, either institutional or

non-institutional, has not been previously certified, the first claim

filed for health services rendered to a Tricare-eligible beneficiary

by either the beneficiary or provider initiates the certification

process.  If an institution (hospital, clinic, pharmacy, etc.) that

is a certified Tricare provider employs a provider, that provider may

or may not be certified. It depends on the arrangement between the

institution and the providers. Since the institution has been

certified, the cost of care including the professional fees can be

filed using the institution’s certified credentials and provider

number. The institution can then pay the provider for his/her

professional fees once reimbursement is received from Tricare. If a

provider, however, wants to file directly to Tricare for his/her

professional fee and not through the institution, then he/she should

request to be certified separately from the institution to obtain

his/her own provider number.


     A beneficiary can file a claim on a non-certified provider but

this may require the provider to issue a letter stating they wish to

be certified by Tricare. This may result in significant delays in the

processing of your claim(s), or possible denial of your claim if the

provider declines certification or cannot be certified. When you

submit a claim for service provided by a non-certified provider, the

Tricare overseas claims processor places a hold on the claim and

sends a request to the Tricare-contracted certifying agent to

initiate a certification action. The provider is approached and asked

if they are willing to participate in being certified by Tricare. If

your claim was denied because the provider was not Tricare certified,

it usually means that the provider either declined Tricare’s request,

or could not be certified for other reasons. Unless a provider agrees

to be certified no claims filed for services obtained from that

provider can be reimbursed by Tricare.


     If the provider was initially unwilling to be certified and you

can convince the provider to change their mind, then you can have the

provider submit a letter requesting to be added to the Tricare

Provider Network to the following address:  International SOS, Inc.,

Suite 1205/6, One Magnificent Mile Bldg, San Miguel Avenue, Ortigas

Center, Pasig City, Metro Manila, Philippines, 1600 Tel: (63) (2)

637-0700  or Fax: (63) (2) 637-4872. Keep in mind that you have one

year from the date of service to resubmit a claim previously denied

due to a then-uncertified provider. In some cases, a provider does

not meet the requirements for certification; i.e., the provider does

not have proper credentialing, or does not have a valid physical

location that matches the address given for the provider. If the

provider cannot be certified, then you will not be reimbursed for any

out-of-pocket expenses you may have incurred with this provider. That

is why it is highly recommend by TAO-P that you always seek care from

a provider who has already been Tricare certified.  [Source: Aug 06 ++]



MILITARY LEGISLATION STATUS UPDATE:  Following is current status on

some Congressional bills of interest to the military community.

Support of these bills through cosponsorship by other legislators is

critical if they are ever going to move through the legislative

process for a floor vote. At you can determine

the current status of each bill and if your legislator is a sponsor

of the bill you are concerned with. The key to increasing

cosponsorship is letting your representative know of your feelings on

these issues.  At the end of most of the below listed bills is a web

link that can be used to do that:


H.R.303:  The ‘Retired Pay Restoration Act of 2005’ To amend title

10, United States Code, to permit certain additional retired members

of the Armed Forces who have a service-connected disability to

receive both disability compensation from the Department of Veterans

Affairs for their disability and either retired pay by reason of

their years of military service or Combat-Related Special

Compensation and to eliminate the phase-in period under current law

with respect to such concurrent receipt.  No new sponsors were added

to this bill which has a total of 237. To support this bill and/or

contact your Representative refer to 


H.R.602:  The ‘Keep Our Promise to America's Military Retirees Act’

to restore health care coverage to retired members of the uniformed

services and their eligible dependents. House version of  S.407.  No

new sponsors were added to this bill which has a total of 249.


H.R.808:  The ‘Military Surviving Spouses Equity Act’ to amend title

10, United States Code, to repeal the offset from surviving spouse

annuities under the military Survivor Benefit Plan for amounts paid

by the Secretary of Veterans Affairs as dependency and indemnity

compensation (DIC).  A motion was filed to discharge the Rules

Committee from consideration of H.RES 271 on 16 NOV 05.  This

resolution provides for the consideration of H.R.808 and requires 218

signatures for further action. No new sponsors were added to this bill

which has a total of 207. To support this bill and/or contact your

Representative refer to

To support the discharge petition and/or contact your Representative

refer to


H.R.916: The ‘Medicare Access to Rehabilitation Services Act of 2005’

To amend title XVIII of the Social Security Act to repeal the Medicare

outpatient rehabilitation therapy caps. Referred to the House

Subcommittee on Health 14 MAR 05. House version of  S.438. No new

sponsors were added to this bill which has a total of 237. To support

this bill and/or contact your Representative refer to &


H.R.968: To amend title 10, United States Code, to change the

effective date for paid-up coverage under the military Survivor

Benefit Plan from October 1, 2008, to October 1, 2005. No new

sponsors were added to this bill which has a total of 143. To support

this bill and/or contact your Representative refer to


H.R.994:  To amend the Internal Revenue Code of 1986 to allow Federal

civilian and military retirees to pay health insurance premiums on a

pretax basis and to allow a deduction for TRICARE supplemental

premiums.  No new sponsors were added to this bill which has a total

of 335. This is the House version of S.484. To support this bill

and/or send a message to your Representative refer to


H.R.995: The ‘Combat Military Medically Retired Veteran's Fairness

Act of 2005’ to amend title 10, United States Code, to provide for

the payment of Combat-Related Special Compensation under that title

to members of the Armed Forces retired for disability with less than

20 years of active military service who were awarded the Purple

Heart. No new sponsors were added to this bill which has a total of

31. To support this bill and/or send a message to your Representative

refer to


H.R.1366:  The Combat-Related Special Compensation Act of 2005 to

amend title 10, United States Code, to expand eligibility for

Combat-Related Special Compensation paid by the uniformed services in

order to permit certain additional retired members who have a

service-connected disability to receive both disability compensation

from the Department of Veterans Affairs for that disability and

Combat-Related Special Compensation by reason of that disability.  No

new sponsors were added to this bill which has a total of 51.  There

are no related bills.  To support this bill send a message to your

Representative refer to

To support Sen. Reid’s amendment to the 2007 NDAA bill S.2766 send a

message to your Representative refer to


H.R.2076: The ‘Retired Pay Restoration Act of 2005’ To amend title

10, United States Code, to permit certain retired members of the

uniformed services who have a service-connected disability to receive

both disability compensation from the Department of Veterans Affairs

for their disability and either retired pay by reason of their years

of military service or Combat-Related Special Compensation.  No new

sponsors were added to this bill which has a total of 28. Related

bills are H.R.303, S.558, S.845. To support this bill and/or send a

message to your Representative refer to


H.R.2356:  The ‘Preserving Patient Access to Physicians Act of 2005’

to amend title XVIII of the Social Security Act to reform the

Medicare physician payment update system through repeal of the

sustainable growth rate (SGR) payment update system. No new sponsors

were added to this bill which has a total of 173.  Related bills are

S.1081. To support this bill and/or send a message to your

Representative refer to


H.R.2962: The ‘Atomic Veterans Relief Act’ to amend title 38, United

States Code, to revise the eligibility criteria for presumption of

service-connection of certain diseases and disabilities for veterans

exposed to ionizing radiation during military service, and for other

purposes.  No new sponsors were added to this bill which has a total

of 52.  There are no other related bills. To support this bill and/or

send a message to your Representative refer to


H.R.4914: The ‘Veterans right to Know Act’ to establish a Commission

to investigate chemical or biological warfare tests or projects,

especially such projects carried out between 1954 and 1973, placing

particular emphasis on actions or conditions associated with such

projects that could have contributed to health risks or been harmful

to any United States civilian personnel or member of the United

States Armed Forces who participated in such a project or who was

otherwise potentially exposed to any biological or chemical agent,

simulant, tracer, decontaminant, or herbicide as a result of such

projects; and to submit a report to Congress of its findings and

recommendations. No new sponsors were added to this bill which has a

total of 40. There are no other related bills. Referred to the House

Subcommittee on Military Personnel 30 NOV 05.


H.R.4914: The ‘Veterans' Choice of Representation Act’ to amend title

38, United States Code, to remove certain limitations on attorney

representation of claimants for veterans benefits in administrative

proceedings before the Department of Veterans Affairs, and for other

purposes.  No new sponsors were added to this bill which has a total

of 8. There are no other related bills.  To support this bill and/or

send a message to your Representative refer to


H.R.4949: The ‘Military Retirees Health Care Protection Act’ to amend

title 10, United States Code, to prohibit increases in fees for

military health care.  No new sponsors were added to this bill which

has a total of 160. There are no other related bills.  To support

this bill and/or send a message to your Representative refer to


H.R.4992: The ‘Veterans Medicare Assistance Act of 2006’ to provide

for Medicare reimbursement for health care services provided to

Medicare-eligible veterans in facilities of the Department of

Veterans Affairs.  No new sponsors were added to this bill which has

a total of 20. There are no other related bills.  To support this

bill and/or send a message to your Representative refer to



H.R.5881: The ‘Disabled Veterans Tax Termination Act’ to amend title

10, United States Code, to eliminate the offset between military

retired pay and veterans service-connected disability compensation

for certain retired members of the Armed Forces who have a

service-connected disability, and for other purposes. Introduced 26

JUL 06 by Rep Marshall, Jim (GA-03) the bill has no cosponsors. There

are no other related bills. To support this bill and/or send a message

to your Representative refer to[capwiz:queue_id]


S.185:  The ‘Military Retiree Survivor Benefit Equity Act of 2005’ to

amend title 10, United States Code, to repeal the requirement for the

reduction of certain Survivor Benefit Plan annuities by the amount of

dependency and indemnity compensation and to modify the effective date

for paid-up coverage under the Survivor Benefit Plan. No new sponsors

were added to this bill which has a total of 35. There are no other

related bills.  To support this bill and/or send a message to your

Senator refer to


S.407:  The ‘Keep Our Promise to America's Military Retirees Act’ to

restore health care coverage to retired members of the uniformed

services and their eligible dependents. No new sponsors were added to

this bill which has a total of 14. A related bill is H.R.602.  To

support this bill and/or send a message to your Senator refer to


S.484: To amend the Internal Revenue Code of 1986 to allow Federal

civilian and military retirees to pay health insurance premiums on a

pretax basis and to allow a deduction for Tricare supplemental

premiums. No new sponsors were added to this bill which has a total

of 63. A related bill is H.R.994. To support this bill and/or send a

message to your Senator refer to


S.2147: The ‘Multiple Sclerosis’ bill to extend the 7 year time

period during which a veteran's multiple sclerosis is to be

considered to have been incurred in, or aggravated by, military

service during a period of war. Referred to the Senate Committee on

Veterans' Affairs 20 DEC 05.  The bill has no cosponsors and there is

no related legislation in the House.  


S.2617: The ‘Military Retirees Health Care Protection Act’ to amend

title 10, United States Code, to limit increases in the costs to

retired members of the Armed Forces of health care services under the

TRICARE program, and for other purposes.  No new sponsors were added

to this bill which has a total of 9. There are no other related

bills. To support this bill and/or send a message to your Senator

refer to


S.2658:  The ‘National Defense Enhancement and National Guard

Empowerment Act of 2006’ to amend title 10, United States Code, to

enhance the national defense through empowerment of the Chief of the

National Guard Bureau and the enhancement of the functions of the

National Guard Bureau, and for other purposes. No new sponsors were

added to this bill which has a total of 39. A related bill is

H.R.5200.  To support this bill send a preformatted or edited message

to your Senator by using the “Write to Congress” feature refer to


S.2694:  The ‘Veterans' Choice of Representation and Benefits

Enhancement Act of 2006’ to amend title 38, United States Code, to

remove certain limitation on attorney representation of claimants for

veterans’ benefits in administrative proceedings before the DVA, and

for other purposes.  This bill was passed/agreed to in Senate 3 AUG

06 by unanimous consent.  To support this bill and/or send a message

to your Senator refer to


Note:  The House of Representatives is out of session 31 July thru 3

Sept.  The Senate is out of session 7 AUG thru 3 SEP.  There are only

68 days until Election Day.  Be sure you are registered to vote and

make your vote count. . [Source: USDR Action Alerts 15-31 Aug 06 ++]




Lt. James “EMO” Tichacek, USN (Ret)

Director, Retiree Assistance Office, U.S. Embassy Warden & VITA

Baguio City RP

PSC 517 Box RCB, FPO AP 96517

Tel: (760) 839-9003 or FAX 1(801) 760-2430; When in RP: (74) 442-7135

or FAX 1(801) 760-2430

Email:  When in Philippines




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