Authorizing Council's Committee on Global Opportunities and the Creative/Innovative Economy to hold hearings investigating whether the Philadelphia area's VA Medical Centers are properly screening and treating returning Veterans for brain injuries.

WHEREAS, Traumatic brain injury (TBI) is a significant health issue which affects military service members and veterans. The Defense and Veterans Brain Injury Center (DVBIC) defines TBI as “a blow or jolt to the head that disrupts the normal function of the brain.” The leading causes of TBI for service members are blasts and explosions. TBI can be classified as mild, moderate, severe, or penetrating, and the severity is determined based on symptoms at the time of injury; and

WHEREAS, There is also growing evidence that a physical injury to the brain can make people susceptible to post-traumatic stress disorder (PTSD), a condition that can cause flashbacks, nightmares, and severe anxiety for years after a traumatic event. Studies of troops who deployed to Iraq and Afghanistan have found that service members who have suffered a concussion or mild traumatic brain injury are far more likely to develop PTSD; and

WHEREAS, According to the DVBIC, the Department of Defense’s office of responsibility for tracking TBI data in the U.S. military, 352,619 service members have been diagnosed with TBI since 2000. This figure includes 9,214 TBI diagnoses between January 1 and June 30, 2016; and

WHEREAS, The Department of Veterans Affairs (VA) reports that between 11-20% of Operations Iraqi Freedom and Operation Enduring Freedom veterans have PTSD in a given year. About 12% of Gulf War veterans have PTSD in a given year, and it is estimated that about 30% of Vietnam War veterans have had PTSD in their lifetime; and

WHEREAS, Concerns have arisen that the VA has not been appropriately screening veterans for TBI. The VA has admitted that many veterans were examined by medical providers who were not qualified to diagnose TBI. Only neurosurgeons, neurologists, physiatrists, and psychiatrists are able to properly recognize and diagnose TBI. The VA explained that it “issued a series of guidance documents that created confusion regarding the policy.” This confusion led to almost 25,000 veterans to be screened for TBI by unqualified medical practitioners; and

WHEREAS, The VA’s medical staff often attributes residual symptoms of possible TBI to PTSD and related mental health disorders without fully ruling out the possibility of TBI. Critics allege that this may be because screening for TBI can be more expensive and time consuming for the VA; and

WHEREAS, Veterans are also given a percent disability rating, which is higher and does not change over time for cases of TBI. For PTSD, this percent disability rating can be lowered over time to indicate that a veteran is recovering from his or her symptoms and therefore needs less long-term medical care. Many veterans are being denied benefits and the appropriate medical care to address their TBI because they are not properly diagnosed and/or their symptoms are being attributed to PTSD; and

WHEREAS, Representative Jeff Miller (R-FL), Chairman of the House Committee on Veterans’ Affairs, said he “[looked] forward to hearing from VA officials regarding the steps they are taking to hold those responsible for VA’s TBI struggles accountable, as this is the only way to prevent similar problems in the future”; and

WHEREAS, In April 2014, Council’s Committee on Global Opportunities and the Creative/Innovative Economy held a hearing on the state of affairs of veterans in the City of Philadelphia in accordance with Resolution No. 130791. Veterans deserve access to the full range of benefits, services, and economic opportunities that they have earned; now, therefore, be it

RESOLVED, BY THE COUNCIL OF THE CITY OF PHILADELPHIA, That we hereby authorize Council’s Committee on Global Opportunities and the Creative/Innovative Economy to hold hearings to investigate whether the Philadelphia area’s VA Medical Centers are properly screening and treating returning veterans for brain injuries.

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