Blog Archives
The Missing Millions: Why So Many Veterans Still Lack Disability Ratings
In the United States today, a significant portion of the veteran population remains without a service-connected disability rating—even though many receive ongoing care from the Department of Veterans Affairs (VA). This gap affects millions and stems from long-standing structural issues and common misunderstandings.
How Many Veterans Are Unrated?
Recent federal data shows:
17.8 million veterans currently live in the U.S.
Only 5.2 million (about 30%) have a service-connected disability rating.
That leaves roughly 12.5 million veterans without a rating, including an estimated 6 million who separated before disability assessments became part of the mandatory out-processing process.
Before the mid-1990s and early 2000s reforms, the DoD did not require a disability evaluation as part of separation or retirement. Millions of veterans left service with no assessment and never filed later simply because the process was unclear or unknown.
Two VA Systems — and They Don’t Communicate
A critical fact many veterans do not know:
VA Healthcare and VA Disability Compensation are completely separate systems.
Receiving VA medical care does not create or update a disability rating.
Diagnoses, imaging, or treatment inside VA healthcare records are not reviewed for disability compensation unless a veteran files a claim.
No condition—primary or secondary—moves into the disability system automatically.
Many veterans assume that being treated for chronic pain, orthopedic injuries, sleep issues, or mental health conditions means their disability file is being updated. It isn’t. Only a formal claim triggers review.
The Impact on Veterans
Millions of veterans who never filed a claim at all.
Veterans with worsening conditions who never requested rating increases.
VA healthcare patients with serious diagnoses that were never evaluated for service-connection.
Missed compensation, lost benefits, and reduced access to programs tied to rating thresholds.
A single misconception—“VA healthcare updates my disability rating”—can cost a veteran years of deserved benefits.
What Every Veteran Should Do Now
To ensure disability benefits reflect current health conditions, veterans should:
1. Review their conditions regularly
Check for new diagnoses, worsening symptoms, or secondary conditions.
2. File new or supplemental claims
Use VA.gov, mail, or accredited submission channels to request evaluation.
3. Understand the system
VA healthcare records do not update disability ratings. A claim must be submitted.
4. Track secondary conditions
Issues like sleep apnea, depression, migraines, radiculopathy, GERD, or joint degeneration often stem from service-connected primaries.
Veterans who separated before mandatory disability evaluations around 2010 are especially vulnerable because many were never informed of the modern process.
Closing the Gap
With only ~30% of veterans holding a disability rating—and millions eligible but unrated—awareness is essential. Understanding that VA healthcare and VA disability compensation operate independently is the first step toward ensuring every veteran receives the benefits they earned through service.
Need Help Understanding Your Claim Path?
If you or a veteran you know is unsure about eligibility, secondary conditions, or how to properly file, guidance is available. Filing a claim is not automatic—but it can be straightforward when you understand the rules and requirements.
A Journey to Acceptance: My Eye-Opening Experience with Medical Marijuana
I was born and raised in Miami, Florida — in the middle of chaos and change. The city I grew up in during the 70s and 80s was a powder keg of race riots, refugees, and drugs. Miami was overrun — and that’s putting it kindly. Cocaine, marijuana, and the war on drugs were everywhere.
I never touched any of it. Not once.
It was a badge of honor, a personal vow. My father was a judge, and I took pride in the discipline that kept me away from substances that, to me, represented weakness and failure. I saw alcohol as adult, social, and controlled. Marijuana? That was for the lost.
For most of my life, I never questioned that belief.
But life has a way of testing the walls we build around our certainty.
When my wife’s illness began to take over our nights, sleep became hard. She was in constant pain, and nothing — not the pills, not the prescriptions, not the endless “next options” — brought her relief without a cost. Then one night, she tried a simple gummy. She slept through the night.
That experience made me aware — painfully so — of my own hypocrisy. While she found healing through a plant I had long dismissed, I was numbing myself each night with alcohol — not to enjoy, but to stop feeling, to force sleep. I told myself it was normal, acceptable, even earned. But it wasn’t helping.
It wasn’t until I was helping a client — a veteran — through her VA disability claim that the truth caught up with me. She confided in me about her fear of admitting she used marijuana to manage anxiety and sleep. I told her what I believed: that she shouldn’t be ashamed, that seeking help isn’t weakness, and that medical care, when legal and responsible, is private and protected.
Then it hit me like a mirror.
How could I coach her toward honesty and healing while denying myself the same?
That same day, I called my wife’s physician, scheduled an appointment, and applied for my medical marijuana card. Since then, I take a gummy every night. I sleep. I think more clearly. I drink less. I feel present.
My view has changed completely — not because of politics or persuasion, but because of experience. What I once called weakness, I now see as wisdom. The real weakness was refusing to see past my own judgment.
In Florida, medical marijuana has been lawful since 2016. But for me, it only became personal when life humbled me enough to listen.
The more I experience life, the more I understand that nothing truly changes until we become aware. Awareness brings empathy, and empathy brings wisdom. And wisdom — I’ve learned — is not the privilege of youth, but the product of life lived honestly.
What will my life be like in 3 years?
I dare not answer the question.
That was my first response when someone asked where I see myself in three years. Without hesitation, fear stepped in — not fear of failure, but fear of imagining life beyond now. Beyond her.
Yesterday, my wife finalized her cremation plans. I’ve done this before — for my sister, for my father. Each time, it became a necessary transaction. Paperwork, signatures, polite condolences exchanged over a table that felt too small for the weight in the room. The funeral director came to the house. We completed the forms. She paid for her services. Efficient. Respectful. Businesslike.
It’s best to do this before it happens, they say — so there’s one less thing to cause anxiety and pain.
But is that really true? Or is it that I just didn’t want to do this again?
Because the truth is, no matter how many times I’ve faced loss, I still don’t know how to prepare for it. I can manage logistics, but not emotions. I can sign the papers, but not the permission slip to move forward.
When I think about the future — traveling, my children, my new grandbaby — I feel guilty. There’s a horrible tension between the yearning to be free and the desperate wish for this stage of life to never end. How do you reconcile wanting relief and wanting permanence at the same time?
Maybe that’s what being human really is — living inside the contradiction.
We spend our lives trying to control time, plan for tomorrow, build systems, write goals. But life keeps reminding us it doesn’t belong to us. It moves with or without our consent.
Three years from now, I don’t know where I’ll be. Maybe I’ll be standing somewhere new, lighter but not the same. Maybe I’ll still wake up some mornings expecting to hear her voice. Maybe I’ll finally find a kind of peace in the not-knowing.
Because the truth is, none of us can control life. We can only honor it
Where will I be in 3 years…..
It Takes a Village: The Realities of End-of-Life Care
Yesterday was one of the hardest days yet. My wife, Sherri, whispered that she wished for death. Her pain was unbearable, even through layers of medication. Her bed sore reopened, two abscesses formed in her mouth, and the ache from her brittle bones and unhealed surgical site—after eight surgeries, two wound vacuums, and countless antibiotics—was relentless.
We took her to the dentist, who could do little more than write a referral to an oral surgeon. In that moment, I realized what Sherri already knew: sometimes, the course of care no longer offers a path worth taking. The procedures, the pain, the waiting—none promise comfort or meaningful recovery.
Yet, it takes a village. Her sister, her cousin, and her circle of friends have become our lifeline. Their presence gives her strength. She lights up when they visit, laughs, and feels alive again. But the cost is steep—those moments of joy are followed by hours of exhaustion and pain. Now, every visit, every appointment must be weighed against what it will take from her.
I see couples in the hospital—older than us—one sick, one trying to navigate the maze of care while barely able to support themselves. Too often, they end up alone in nursing homes, fading quietly. I’m grateful I’m still strong enough to help Sherri, even if I know there will be a toll later.
End-of-life care isn’t about heroics or procedures—it’s about presence. It’s about conserving what’s left of the body’s strength and surrounding the spirit with love. The truth is, medical science can extend life, but only community—family, faith, and friendship—can make it worth living.
When Love Meets the Machine
Day eight of what was supposed to be a three-day stay.
That sentence alone tells you everything about the state of modern healthcare.
As the disease progresses, it creates complications. Those complications summon specialists—each skilled, each confident, each siloed. They gather to form what they call a “care team,” but to the family it feels more like a committee meeting in slow motion.
Every decision takes time.
Every delay steals time.
Consensus becomes a currency that the patient can no longer afford to spend.
To them, this is process.
To us, it is life slipping away.
I find myself fighting thoughts I wish I didn’t have—the kind that whisper that the longer they keep her, the more they bill. That every new consult means another code, another line item, another form. I hate thinking that way. But when you’ve seen the system from the inside, you know how profit hides behind protocol.
Now, her body bears the evidence of the wait—bedsores, failed IVs, and pain so sharp it carves through every ounce of composure. Even the specialists with ultrasound guidance can’t find a vein. The solution: another procedure, another trip to the OR for a Hickman line. More anesthesia. More risk. More time.
And through it all, one question hangs in the air like a prayer caught in the static of bureaucracy: Can she just come home?
But to come home requires insurance approval, a signature in a portal, a code entered correctly. Somewhere between the nurse’s station and the insurance carrier, humanity gets lost. They don’t see her tears or hear her moans—they see a “case.” A “chart.” A “treatment plan.” While we watch the clock, waiting for Dilaudid that’s overdue and for someone—anyone—to notice that time is the one thing she doesn’t have.
This is what it feels like when love collides with a machine.
Profits Over Patients: Why the Insurance System is Failing Families
The health insurance industry has mastered one thing above all else: delay. What should be a simple claim submission turns into months of bureaucratic limbo, hidden behind jargon like “not yet built” or “waiting for processing.” These phrases disguise the truth—that while families wait for critical financial support, corporations sit comfortably on record-breaking profits.
We are told to expect 15 business days just for a claim to be reviewed, then another 30 to 60 days for processing. In the meantime, representatives admit that claims often sit in inboxes, unseen, until patients themselves call to shake the system awake. And yet these same companies proudly announce hundreds of millions in net income, raising their performance outlooks. The disconnect could not be starker: efficiency for shareholders, inefficiency for patients.
This is not a matter of capability. If profits can soar, systems can be fixed. More staff can be hired. Processes can be modernized. But the lack of urgency shows where priorities lie. Patients and families are left to wait, wonder, and absorb the financial strain—all while the corporations built to serve them choose margin over mission.
And this isn’t an abstract critique. This is personal. The claim in question was for my wife’s electric wheelchair—a necessity, not a luxury—purchased on June 9th. It cost more than $2,000. I wrote about it on June 23rd in my blog post “In the Blink of an Eye: Grace in the Midst of the Unthinkable”, where I shared how something as simple as mobility could restore dignity in the midst of suffering. Months later, the claim has still not been processed. Letters arrive contradicting what agents say, and the only reason any progress happens is because I chase it down.
For families like mine, these delays aren’t just numbers on a balance sheet. They are nights spent worrying, bills that pile up, and faith that slowly erodes. Representatives on the front line may show compassion, but they are trapped in a system designed to stall. Until the industry prioritizes people over profit, these “micro” frustrations will continue to echo the much larger, systemic failure of our healthcare system.
You can read the June 23rd post here: In the Blink of an Eye: Grace in the Midst of the Unthinkable
The Power of Presence: How to Support Caregivers
When someone you love is gravely ill or bedridden, the world becomes very small. The walls of the home close in. Time slows. Days blur together. Both the person being cared for—and the caregiver—begin to live in a kind of suspended animation, where joy, spontaneity, and connection are replaced by routine, worry, and waiting.
People often ask, “What can I do?”
And it’s a sincere question. They want to help. So they send flowers. Cards. Food. Gift cards. And all of those are kind gestures. All of them are appreciated.
But if you really want to help a caregiver—and the person they’re caring for—be present. Show up.
Caregiving is not just physically exhausting. It’s emotionally isolating. The one who is ill is often trapped in their body, in their symptoms, in a bed they can’t escape. The caregiver, meanwhile, is trapped in responsibility, routine, and quiet desperation.
Isolation is the great thief.
It steals joy, perspective, and sometimes even hope. But when someone walks through the door just to be there, everything changes—even if only for a little while.
Here’s what you may not see:
When visitors come over, something shifts.
The house feels lighter.
The person being cared for suddenly wants to sit up straighter, to smile, to tell stories—even if they can’t move or speak much.
The caregiver may finally exhale, just a little.
You don’t need to bring anything. Just your presence. A shared moment. A hand held. A joke told. A prayer whispered.
It’s not about what you do. It’s about that you came.
We often overcomplicate compassion. We think we need the “right” thing, the perfect timing, or something polished and proper.
But love isn’t complicated.
Compassion shows up unannounced and says, “I’m here.”
It’s the ministry of presence.
So, if you’re wondering how to help:
- Visit. Even 15 minutes can be sacred.
- Sit. Watch a show, listen to music, share a memory.
- Talk. About something—anything—besides illness.
- Listen. Sometimes just being a witness to the struggle is a gift.
- Stay connected. Don’t let their world shrink without a fight.
Because at the end of the day, love looks like presence. And presence heals in ways medicine can’t.
VA Claims Processing: Success or Hidden Challenges?
In the July 2025 newsletter, the Department of Veterans Affairs proudly announced that it had “processed” over 2 million disability claims—faster than ever before. At first glance, this milestone sounds like a tremendous success. But for veterans who have lived at the intersection of military service and medical hardship, there’s a deeper story behind the headlines.
As a veteran and someone who assists others in navigating the VA claims process, I’ve learned to read between the lines. The newsletter fails to disclose how many of those 2 million claims were denied—a critical omission that affects real lives. A high throughput of claim processing does not necessarily equate to high-quality or just outcomes for veterans.
At the same time, the VA linked to its public repository of Disability Benefits Questionnaires (DBQs) available here. These are detailed, medically technical forms that the VA encourages veterans to bring to their private providers to “expedite” claims—allegedly reducing costs and time associated with VA-conducted exams.
On the surface, this sounds like a win-win. But if you’ve filled out one of these forms or asked a doctor to complete one, you know that each DBQ is 12 to 16 pages long, highly technical, and time-consuming. It could take an experienced clinician over an hour—per form—with no reimbursement provided by the VA.
Let’s pause there: the government is asking veterans to pay out of pocket or call in favors from already overburdened civilian providers, many of whom are unfamiliar with VA language, legal thresholds, or the 38 CFR standards. These forms may reduce government costs, but they shift that burden onto the backs of those who served.
And what’s more concerning is this: Is this an unspoken gatekeeping tactic? Is the sheer complexity of DBQs and the absence of compensation for providers quietly slowing down or stalling new claims from older-era veterans—those who served between 1965 and 2015—who didn’t benefit from the digital medical records era?
As someone working daily with veterans—at the proverbial GEMBA or “point of the spear”—I’ve witnessed firsthand how the standard of approval appears to have shifted. In the first few months of this administration, P&E exams were paused for over three months. Now, adjudications seem stricter than ever. Subjective? Perhaps. But for many veterans, this feels like a regression, not progress.
Questions We Should Be Asking the VA:
- What percentage of the 2 million “processed” claims were denied, granted, or partially awarded?
- Why are providers not compensated for the time it takes to complete detailed DBQs?
- Has the standard of adjudication shifted from the traditional “at least as likely as not” (51%) burden of proof?
- Why are we not leveraging modern AI and automation tools to reduce claim burden for the veteran?
- How does the VA plan to assist older veterans—whose medical records are often incomplete or paper-based—in navigating these requirements?
Pills, Pills, and More Pills: The Hidden Burden of Complex Caregiving
One of the most overwhelming challenges in being a caregiver to a loved one with complex health needs is managing medications. It’s not just about handing over a pillbox. It’s navigating a labyrinth of prescriptions from multiple providers—some within the same healthcare system, others outside it, and even some who are technically in the system but don’t have credentials to see each other’s records. The result? A fragmented network of well-meaning professionals relying on the patient or caregiver to connect the dots.
Every outpatient visit starts with the same question: “Are you still taking…?” And if your loved one isn’t completely lucid or you’re not fully dialed in 24/7, the answer might not be accurate. That’s when the real risk begins. Medications get missed, taken at the wrong time, or worse—interact dangerously. Even with tools like MyChart and pharmacy alerts, medication management for multi-disciplinary patients is a full-time job that demands vigilance and coordination.
Thankfully, my wife has what many don’t: an extended family care team. Her sister—a brilliant organizer—maintains a shared medication log with active and retired prescriptions. Her cousin, a provider based in California, monitors her records through MyChart and flags potential issues or treatment recommendations. Their support has been nothing short of lifesaving.
As her primary caregiver, I also leaned into my background in healthcare and team leadership. I applied principles I once used to support the care for wounded or sick soldiers returning from Iraq at Fort Moore (then Fort Benning), where we built systems but more importantly had people to prevent our service members from getting lost in the shuffle. It’s painful to see that the civilian system still struggles with the same problem.
Where is the care manager? Aren’t they the quarterback? I once asked that question myself—only to be told their panel included 250 complex cases. No human can meaningfully manage that many lives. It was a sobering reminder that “the system” is overloaded, and for those without advocates, the consequences can be tragic.
Having a palliative care physician onboard has been critical. Contrary to common perception, they don’t just deal with end-of-life care. They focus on quality of life—managing pain, coordinating care, and yes, reconciling all those pills. My wife currently has more than 10 providers involved in her care. That number doesn’t include staff, specialists, or the relentless demands of insurance approvals.
Medication management isn’t glamorous, but it’s a battlefield—and like all battlefields, it requires a team, a plan, and an unwavering commitment to the person you’re fighting for. I bring my military mindset to this mission every day. And while I can’t stop the tide of prescriptions or the systemic gaps in care, I can make sure my wife never faces them alone.
The Art of Caregiving: Strategies for Support
“You have to go for a walk. Take a hot shower. Make sure you hit the rack every night early. I mean like 2000 hours at the latest. Every day is just like the military. You’re preparing for the next day.”
That’s what my buddy—another veteran who recently lost his wife to pancreatic cancer—told me. It stuck. Not because it was profound (although it is), but because it was familiar. It’s the kind of advice you’d hear before a deployment. Only now the mission is different. It’s longer. Harder in ways I never expected. And it’s personal.
My wife Sherri is currently watching a movie in our EV, having lunch with our fur babies. It’s a simple solution to a hard problem: it spares her the pain of getting out of the car, into the electric wheelchair, into the house—only to turn around and do it all again in 35 minutes. During that time, my sister-in-law (who’s been a godsend) and I tag-teamed lunch prep, charged the chair, rotated the laundry, and coaxed our teenager into eating something besides cereal. That’s the rhythm. That’s the operation.
It’s funny how much this mirrors the military. In downtime, you prep for the next mission. That’s what caregiving is: a constant cycle of readiness. Because when your loved one is in pain, even helping them move can feel like a landmine of unintended harm. You don’t get to wing it. You plan, prep, adapt, and repeat.
And here’s the kicker: you can’t pour from an empty canteen.
My friend reminded me—like a good NCO would—that I need rest. That I need to recoup. That doing “me time” isn’t selfish; it’s strategic. And yet it’s one of the hardest things to do. How do you step away when the person you love is hurting? But if you don’t, you break down. And when you’re broken, you’re no good to them.
For me, that “me time” is Orange Theory Fitness. It’s more than a workout—it’s my decompression chamber. The people there know my story. They don’t flinch when I show up in a weird mood or vent a little too hard. They get it. It’s a release valve.
But caregiving can’t be done alone. It requires an extended care circle, and let me tell you—building that after the crisis hits is like trying to patch the roof in a thunderstorm. As JFK said, “Fix the roof when the sun is shining.” He wasn’t wrong. Having my sister-in-law here has changed everything. And when she’s not, our neighborhood friends step up in ways that humble me. They’re part of the circle now. I’ve learned that asking for help doesn’t make you weak—it lets people love you in real, tangible ways.
There’s something beautiful about how people show up when you let them. It reaffirms your faith in humanity, even on the hardest days. And if you’re lucky—like I am—you see that caregiving, as hard as it is, is also a sacred kind of service. One where love, not rank, leads the charge.
So here’s what I’ll leave you with:
Build your circle when the skies are clear.
Rest like it’s your responsibility—because it is.
And never underestimate the power of kindness, sweat equity, and a hot shower.
Because when it’s raining, all of that matters more than you’ll ever know.
