Understanding the Warfighter

1. Understanding the Warfighter 24 October 2013 Bobby Walden, LCSW HUD-VASH Social Worker Dept. Veterans Affairs Capt. USAFR, BSC

2. Disclaimer • This presentation does not reflect the opinions or views of the United States Air Force nor the Department of Veterans Affairs.

4. Overview • PRESENTATION 1.  Eligibility for VA Healthcare.    a. Overview of services available     b. Service Connected condition    c. Eligible Reserve/National Guard2. The Culture of the Military    a. Differences among the branches and their specific cultures.     b. Core Values

5. Overview 3. Deployment.     a. Emotional reactions    b. Management strategies 4. Combat Stress Facility a. Treatment concepts 5. Discharge     a. Returning Home     b. Identity Issues.      c. Common struggles.

6. Veterans Benefits We will not be discussing claims benefits. For purposes of this presentation we will only be discussing medical benefits

7. Basic Eligibility • Active Duty • Reserves/National Guard • Most Veterans who enlisted after September 7, 1980, or entered active duty after October 16, 1981, must have served 24 continuous months or the full period for which they were called to active duty in order to be eligible.

8. Means Tested • Examination of somebody's income: an examination of somebody's income and savings, carried out in order to determine whether the criteria for a type of assistance or financial aid are met.

9. Service Connected Disability • Veterans who are disabled by an injury or illness that was incurred or aggravated during active military service. These disabilities are considered to be service-connected.

10. Priority Groups • Priority Group 1 • Priority Group 2 • Priority Group 3 • Priority Group 4 • Priority Group 5 • Priority Group 6 • Priority Group 7 • Priority Group 8

11. Priority Group 1 • Veterans with VA Service-connected disabilities rated 50% or more. • Veterans assigned a total disability rating for compensation based on unemployability.

12. Priority Group 2 • Veterans with VA Service-connected disabilities rated 30% or 40%.

13. Priority Group 3 • Veterans who are former POWs. • Veterans awarded the Purple Heart Medal. • Veterans awarded the Medal of Honor. • Veterans whose discharge was for a disability incurred or aggravated in the line of duty. • Veterans with VA Service-connected disabilities rated 10% or 20%. • Veterans awarded special eligibility classification under Title 38, U.S.C., § 1151, “benefits for individuals disabled by treatment or vocational rehabilitation.”

14. Priority Group 4 • Veterans receiving increased compensation or pension based on their need for regular Aid and Attendance or by reason of being permanently Housebound. • Veterans determined by VA to be catastrophically disabled.

15. Priority Group 5 • Nonservice-connected Veterans and noncompensable Service-connected Veterans rated 0%, whose annual income and/or net worth are not greater than the VA financial thresholds. • Veterans receiving VA Pension benefits. • Veterans eligible for Medicaid benefits.

16. Priority Group 6 • Compensable 0% Service-connected Veterans. • Veterans exposed to ionizing radiation during atmospheric testing or during the occupation of Hiroshima and Nagasaki. • Project 112/SHAD participants. • Veterans who served in the Republic of Vietnam between January 9, 1962 and May 7, 1975. • Veterans who served in the Southwest Asia theater of operations from August 2, 1990, through November 11, 1998. • Veterans who served in a theater of combat operations after November 11, 1998, as follows: • Veterans discharged from active duty on or after January 28, 2003, for five years post discharge

17. Priority Group 7 • Veterans with incomes below the geographic means test (GMT) income thresholds and who agree to pay the applicable copayment.

18. Priority Group 8 • Veterans with gross household incomes above the VA national income threshold and the geographically-adjusted income threshold for their resident location and who agrees to pay copays.

19. The Culture of the Military What counts is not necessarily the size of the dog in the fight - it's the size of the fight in the dog. - Dwight D. Eisenhower

20. Icebreaker

24. Why is it important to be Culturally Competent? What is Military Culture? Understanding military culture can: Result in improved abilities to understand, communicate, and effectively interact with service members/veterans and their families. Having basic knowledge regarding the values, structure, policies, can promote a stronger client-provider alliance and help develop skills to provide more effective clinical care.

25. A 20 year old male self refers to you for feeling "on edge", "pissed off," and having difficulty sleeping. He tells you that he is a SPC in the Army National Guard who returned about 4 months ago from a 15 month deployment to Afganastan. In your first meeting he tells you he is a gunner attached to Bravo Company, 2nd Battalion, 7th Infantry Regiment, First Brigade Combat Team 3ID. He's coming to see you because his First Sergeant expressed concern over his irritability during their last drill. He reports that he is still angry with everyone from his Company Commander down to his Platoon Leader for many decisions made down range. He is married with 2 children under the age of 4, one of whom was born during his deployment. He reports a strained relationship with is spouse who he says "doesn't get" what he went through during his deployment. He also indicates that he plans to volunteer to deploy again as soon as possible.

26. Questions • What does it mean that he is in the “Army National Guard?” • What is a SPC? A gunner? • What does it mean that he is from the First Brigade Combat team 3ID? • What does "down range" mean?

27. Military Rank Structure • Enlisted • Warrant Officer • Commissioned Officer

28. Military Rank Structure • See Handout • Note the Navy and Coast Guard has a different Officer Rank titles

29. Enlisted • Majority of military personnel approx 84% • As members progress in rank, leadership responsibilities increase significantly specifically at the NCO level. • Typically have specific job functions similar to employees at a company • NCO – Noncommissioned officer • Enlisted members may also refer to their pay grade E-1 through E-6

30. Role of NCO’s • NCO = Noncommissioned officer. • Traditionally the 1st formal role in leadership. It is said among Marines “No plan survives contact with the enemy” so the Marine Corps places heavy value on small unit leadership to its lowest level. • Marine NCO at an E-4 • Other Branches typically E-5

31. Warrant Officers • Experts at in their field. • Primary task Technical expert • Trainers • Advisors • Coaches • Although above all enlisted ranks they are still below Commissioned officer grades • Make up approximately 2% of the military There are no Warrant Officers in the Air force.

32. Commissioned Officers • Commissioned ranks are the highest in the military • Similar to managers and leaders in a company • Commissions are by order of the President of the United States • Typically seen as generalist in nature, with the ultimate goal to take command over more and more personnel. • Minimum of a four year Bachelors Degree. • Make up approximately 14 % of the military

33. Uniformed Services • United States Army • United States Navy • United States Marine Corps • United States Air Force • United States Coast Guard. • United States Public Health Service

34. United States Army • Motto: This We’ll Defend. • Army's Mission: “To fight and win our Nation’s wars by providing prompt, sustained land dominance across the full range of military operations and spectrum of conflict in support of combatant commanders.”

35. United States Army • The Army is the oldest and largest of the military services and represents the main ground force for the United States. The Continental Army was formed on June 14th 1775 to meet the demands of the Revolutionary War and was subsequently replaced by the United States Army which was created by Congress on June 14, 1784. The Army is comprised of an Active component and two Reserve components, the Army National Guard and the Army Reserves.

36. Army Core Values These core values are intended to guide service members throughout their careers and day to day life. • 1. Loyalty • 2. Duty • 3. Respect • 4. Selfless Service • 5. Honor • 6. Integrity • 7. Personal Courage

37. United States Navy (USN) • Motto: "Non sibi sed patriae" (unofficial) "Not for self but for country“ The Navy has not Motto because they don’t need one! • Navy Mission: “To maintain, train and equip combat-ready Naval forces capable of winning wars, deterring aggression and maintaining freedom of the seas.”

38. United States Navy • The Navy is the second largest branch of service. The U.S. Navy was founded on 13 October 1775, and the Department of the Navy was established on 30 April 1798. The Navy is comprised of an Active and Reserve component but does not have a National Guard. In addition, the Navy also plays an essential role in augmenting air power and transporting Marines to areas of conflict.

39. Navy Core Values • 1. Honor • 2. Courage • 3. Commitment

40. United States Marine Corps • Motto: SemperFidelis, “Always Faithful” Marine Corps Mission: • The seizure or defense of advanced naval bases and other land operations to support naval campaigns. • The development of tactics, techniques, and equipment used by amphibious landing forces. • Such other duties as the President may direct. (National Security Act of 1947)

41. United States Marine Corps • Smallest of the armed forces. Is a Department of the Navy but operationally is a separate branch. The USMC was originally organized as the Continental Marines on Nov 10, 1775 and served as naval infantry. The Continental Marines were disbanded by the end of the revolutionary war and then reestablished as the United States Marine Corps by Congress in 1798. • Similar to the Navy, the Marine Corps is comprised of an Active and Reserve component but does not have a National Guard

42. Marine Corps Values • 1. Honor • 2. Courage • 3. Commitment

43. United States Air Force • Motto: “Fly- Fight- Win” • Air Force Mission: “To deliver sovereign options for the defense of the United States of America and its global interests to fly and fight in air, space and cyberspace.”

44. United States Air Force • The Air Force is the youngest of all the military services and represents the aerial warfare branch of the armed forces. The USAF was formed as a separate branch of the military on 18 Sept 1947 and was known prior to that as the Army Air Corps. The USAF is comprised of an active component and two reserve components, the Air Force Reserve and the Air National Guard. While the Army, Navy and Marines all have and utilize aircraft, it remains the mission of the Air Force to “deliver sovereign options for the defense of the United States of America and its global interests, to fly and fight in air, space and cyberspace.”

45. Air Force Core Values • 1. Integrity First • 2. Service Before Self • 3. Excellence In All We Do

46. United States Coast Guard • Motto: SemperParatus, "Always Ready" • Coast Guard Mission: “To protect the public, the environment, and the United States economic and security interests in any maritime region in which those interests may be at risk, including international waters and America's coasts, ports, and inland waterways.”

47. United States Coast Guard • The United States Coast Guard is an armed force but differs from the rest as it is not a part of the Department of Defense but instead falls within the Department of Homeland Security. Its fundamental roles include maritime safety, maritime security, maritime mobility, national defense, and protection of natural resources. The USCG’s mission is to “protect the public, the environment, and the United States economic and security interests in any maritime region in which those interests may be at risk, including international waters and America's coasts, ports, and inland waterways.” • The Coast Guard can operate under the DoD as a service in the Dept of the Navy if Congress declares war or at the request of the President.

48. Coast Guard Core Values • 1. Honor • 2. Respect • 3. Devotion to Duty

49. Inter Branch Rivalry – A misunderstanding of the mission • Navy & Air Force • Traditionally process driven – highly repetitive, exercise and mission remains the same differ little. • Process failures – Cause loss of life or millions or dollars in equipment due to loss of aircraft shipboard disasters. • Marine Corps & Army • Operate in environments by their very nature are unpredictable and are not controllable - Again see the importance of small unit leadership

50. Inter Branch Rivalry The flexible side views the process driven side as irrelevant the disparity of values is created which leads to cynicism It is important for you to see this distinction so that you understand your bravado veterans are not judgmental rather a product of the environment they served in.