Advocating for a Better Veteran Administration
“To care for him who shall have born the battle and for his widow, and his orphan.” -A. Lincoln
Advocating for a Better Veteran Administration
“There are an estimated 22 million veterans of the U.S.
military and an additional 1.4 million active duty service
members who will eventually transition to veteran status (Jahnke
et al., 2014, p.1331).” Acknowledging the lack of appropriate
management and accountability throughout the United States
Department of Veteran Affairs may be the first step for Social
Workers to advocate for Veterans and their families to receive
appropriate medical and holistic support throughout one’s
transition and overall Veteran Administration(VA) experience. Not
only may the issue impact Veterans and their families, but the
roles of Social Workers as well as several other stakeholders.
The surface of this issue may be represented better below as Army
Veteran, Dennis Magnasco, attempts to make an appointment with
the Veteran Administration via telephone. Consider how Dennis’
apparent frustration with the VA may not be the only concern for
him and many other Veterans alike left wondering, “What is wrong
with the VA System?”
Understanding organizational structure and history of the
U.S. Veteran Administration may help one to understand modern
issues associated with Veterans receiving the best service
possible, or lack thereof. The Department of Veteran Affairs
introduced the Veteran Health Administration in the 1800’s
nearing the end of the Civil War (U.S. Department of Veteran
Affairs, 2015). With prior issues of backed up disability claims,
former VA Secretary, Eric Shiseki, advocated for a paperless system
in hopes to address the issue (Brewin, 2013, p. 33). However, this
may not be the case today for the Veteran Health Administration
resulting in Veterans and their families, as well as other
stakeholders, to face weakened or broken policies.
Altogether, considering the level of dysfunction throughout
the Veteran Health Administration may raise concerns for the
various roles and responsibilities of Social Workers. The
importance of maintaining professionalism and compassion in
accordance with the National Association of Social Work Code of
Ethics is crucial as ethics are constantly being challenged.
“Militarization has created new demands for services and
challenges for progressive practice. Veterans and soldiers’
families need more and more services even as military budgets
drain public coffers (Bricker-Jenkins & Randal Joseph, 2008, p.
5).” Being able to recognize such dysfunction may help Social
Workers analyze and provide the best overall service to Veterans
and their families through a more user-friendly and accountable
system; A Veteran Administration they can count on.
Population/Stakeholders and Current Policies
-(1917) Congress created
a new system of
programs for disability
for service personnel,
rehabilitation for the
-(1930) Herbert Hoover
signs executive order
5398, consolidating three
agencies into one.(VA)
Benefits created the GI
Bill which gave Veterans
unemployment benefits of
$20 per week for 52 weeks
-(1973) The VA takes over the National Cemetery
System from the Department of Army preserving
-(1989) The Veterans Administration was renamed The
Department of Veteran Affairs created under the
presidency of George H W Bush(41).
Current Problems With VA System
Supply and Demand
-Controlled @ Federal
-VA is essentially
Socialized which produces
a lower quality standard
of care for our Veterans.
-Like all single-payer health systems around the world, the VA
controls costs by imposing a “global budget” — a limit to how
much it can spend on care.Thus year-to-year funding varies
according to the whims of Congress, not according to what
consumers want or are willing to spend (Tanner, M.D., 2014).
Can Technology Help Improve System
-Technology can help improve the system, by giving those who are
unable to be seen a better chance of being seen. Technology can
certainly help shape the way we provide healthcare. This does not
stem away from the big problem and that is the VA system is
currently a single-payer healthcare system controlled by the
federal government, which drives down the quality of care due to
supply and demand. In 2016, The President proposed a budget of
182.3 billion dollars for the fiscal year 2017, this is according
to the U.S. Department of Veteran Affairs. On March 08, 2016 The
VA received 22.3 billion dollars to upgrade information
technology infrastructure improvements, cyber security, and
operations and network management. This is a great short term
solution but what will be the demand 3, 4, or even 5 years down
the road when there is going to be a need for technological
Areas Of Improvement
-VA Health Care Reform which is currently on the table now in the
Senate, to provide more access/choices to public or private
health care for Veterans.
-Provide Veterans who need immediate relief vouchers to see
doctors of their choosing.
-Updated/Improved Medical Records (Technology) This is one area
that is really hurting but needs to be addressed.
Military Ethics and Social Work Ethics
At first glance, it can be difficult to
distinguish the difference between the
military ethics and the social worker
ethics . However, when it comes to the two
professions, they fall on opposite ends on
the value of social justice. Ethical
dilemmas arise for military social workers,
as they are expected to adhere to both sets of core values and
Social Work Ethics
The NASW Code of Ethics outlines social work’s core values
as service, social justice, dignity and worth of tile person,
importance of human relationships, integrity, and competence.
NASW code of ethics are based on the needs of the individual
right to personal autonomy.
The basic ethical values for all service members as honesty,
integrity, loyalty, accountability, fairness, caring, respect,
promise keeping, responsible citizenship, and pursuit of
“In addition, ethical principles of autonomy, self-
determination, privacy/ confidentiality, quality of life,
and even the right to life takes on a different meaning in
the military, where the Uniformed Code of Military Justice
and the needs of the military missions prevail” (Simmons &
Rycraft, 2010, p. 9).
Within the military, social justice is about “sacrificing
individual freedom for the greater good of society” (Simmons &
Ethical Dilemma: A predicament in which the decision-maker must choose between two options of near or equal value.
Military Social Worker
The military social worker is committed to serving the needs
of veterans while adhering to two code of ethics. The social
will find ethical dilemmas occur when the military values and
regulations over ride the needs of the client.
“The foundation of the system of social work care in the VA
system reflects basic social work principles, which utilize a
rehabilitative and health recovery model based within a
biopsychosocial perspective”(Beder & Postiglione, 2013).
Using a biopsychosocial model requires the social worker to work
with a “multidisciplinary team of professionals to address
medical problems and concerns” (Beder & Postiglione, 2013). When
working with other military professionals and Veterans, military
social workers have to consider how diagnoses can affect medical
Within the military the right to confidentiality has
limitations. The military has their own mandated reporting
system for service members that include domestic violence,
harassment, criminal activity, and substance abuse. The
commanding officer, along with other military personnel, is
authorized to see assessment results on service members.
Assessments are necessary to determine “fitness for duty” and
course of treatments. “Military members may serve multiple tours
of combat duty; therefore, the definition of veterans now
includes active-duty personnel”(Prosek & Holm, 2014). Social
Workers must be thoroughly knowledgeable of the limitations of
confidentiality within the military and be aware of who has
access to their records and documentation.
With the number of Military Veterans currently in the United
States and with that number anticipated to rise due to the number
of active duty service members currently serving, it is vital
that as social workers we look beyond the individual veteran and
the struggles that they are facing and look systematically as to
how it is that the VA can help to support the veterans and
provide optimal level of care.
In a system where just scheduling an appointment is
frustrating it can only get worse. Social workers struggle to
meet the needs of veterans and their families due to an increase
in red-tape and a decrease in strong policies that are meant to
benefit the veteran. Although veterans utilize the VA for both
physical and mental health services, the quality and
continued care is not necessarily based
on the veteran’s best interest but on the available funding that
is determined by the federal budget.
There are also some ethical challenges that come into play
when looking to advocate for the systemic change of the use of
technology within the VA system. Due to the number of active
duty service members who have served multiple deployments, many
seek treatment from the VA for medical and mental health care.
This can pose challenges by making it easier to access a
soldier’s file to review certain information to determine
“fitness for duty.”
By advocating for systematic changes within the VA, veterans
will benefit more than just having access to free health care.
By updating and improving things such as the scheduling system,
veterans will be able to schedule appointments with greater ease
and less frustration, making the VA a more welcoming place. With
updates to the VA medical records system veterans can then travel
anywhere in the country and easily receive care at a VA without
any hassle (this is currently not possible as the VA’s are not an
interconnected computer system) while also putting in protections
to limit what commanding officers have access to within a
veteran/soldiers medical record. Without social workers willing
to fight the larger battle then we can only hope to continue to
continue to win small battles but we will never win the war in
terms of taking care of and supporting our troops the way they
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Services Organizations: A Content Analysis and Review for
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