The Miami VA facility, the University of Central Florida (UCF) PTSD Clinic and the University of Southern California Institute for Creative Technologies are among those who use VR systems. As VR systems become more affordable, a growing number of health care facilities may choose to incorporate them into their treatment options for PTSD.

The free, three-week UCF Restores program uses a combination of group counseling and VR therapy to transport veterans to the traumatic, life-changing experiences that induced their PTSD. VR therapy uses video googles, headphones and even smells to recreate a particular scenario.

According to research by UCF Restores founder Dr. Deborah Beidel, 66 percent of patients have experienced successful outcomes with the program. For example, one Iraq veteran claimed the process helped reduce his anxiety and paranoia.

Although Beidel described the VR experience as “intense,” she said, “The advantage is that we can really take care of this disorder and treat this disorder thoroughly and effectively in a short period of time.” While it may not be possible to eliminate the traumatic memory completely, the program aims to reduce its accompanying stress and anxiety.

The University of Southern California also runs a VR therapy system called Bravemind. The VR session involves a therapist guiding the veteran through virtual scenarios that resemble their traumatic experience. Patients discuss their fears and anxieties while the therapist helps them process the traumatic memory. The goal is to enable patients to alter their perception and responses to PTSD symptoms.

Researchers wanted to know whether service members become more susceptible to PTSD due to the emotional trauma of combat, or because a concussion physically alters the brain in a way that intensifies anxiety and fear. Potentially thousands of Iraq and Afghanistan veterans may have developed PTSD after sustaining a concussion from a bomb blast on the battlefield.

Researchers assessed more than 1,600 Iraq and Afghanistan troops both prior to deployment and three months after their return. Service members who sustained brain trauma while deployed were twice as likely to develop PTSD in comparison to uninjured veterans.

According to the findings published in the Journal of the American Medical Association, concussions and other brain injuries can change the way the brain reacts to a frightening situation. The injury disturbs the electrical activity in parts of the brain that normally regulate emotional reactions such as tempering responses to fear.

“The result is like a car with no brake,” said biomedical physicist Mingxiong Huang, of the University of California, San Diego. Researchers plan to continue investigating the brain circuitry involved in both TBI and PTSD in order to gain a better understanding of their connection.

A new study shows mindfulness training may serve as a promising way for veterans with PTSD to manage their thoughts. Mindfulness is an alternative therapy that focuses the mind on being aware and in the present. University of Michigan Medical School researchers noted significant improvements in veterans who participated in mindfulness training as part of a study.

Out of 23 Iraq and Afghanistan veterans with PTSD, nine underwent regular group therapy while 14 received sessions that included mindfulness training. Veterans in the latter group were encouraged to meditate on their sensations and surroundings in order to prevent their mind from drifting back to traumatic events. After four months of weekly sessions, the veterans who were given mindfulness training experienced more relief from their PTSD symptoms.

The researchers found surprising results when they compared the veterans’ brain activity prior to the mindfulness sessions and after them. In an MRI conducted after the training, they noted stronger links between different areas of the brain related to shifting attention and processing thoughts.

Lead study author Anthony King said, “The brain findings suggest that mindfulness training may have helped the veterans develop more capacity to shift their attention and get themselves out of being ‘stuck’ in painful cycles of thoughts.”

The researchers suggested their study should be repeated with a larger group of veterans. They also emphasized that mindfulness should not be used as the only treatment for PTSD. In addition, it is essential for veterans with PTSD to receive help from a trained professional.

While PTS symptoms increased the most during the first six months after the service members returned home, they tended to subside after a year. However, researchers were most surprised by the prominence of PTS and severity of symptoms five years after the veterans’ return.

One possible explanation they offered for PTS re-emerging after a long time was that many service members rely on the support of a military group in the early stages to cope with traumatic events. However, such bonding with former peers tends to decrease with time, leading to a delayed stress reaction.

According to the Department of Veterans Affairs, 11 to 20 percent of Iraq veterans in the United States suffer PTS symptoms each year. These symptoms can include nightmares, flashbacks, nervousness, fear, guilt, depression and difficulty concentrating.

Lead study author Iris Eekhout of VU University Medical Center in Amsterdam said there is a lack of research into the long-term mental health effects that veterans experience. The findings suggest screening for PTS symptoms should continue for more than just a year after veterans return home. Doing so would ensure the condition does not go undiagnosed as new or recurrent cases could emerge.

Eekhout emphasized that it is crucial for veterans to have easy access to mental health care. “It is important to monitor their psychological health for a long time after deployment, because early detection of symptoms is essential to early treatment, which is related to positive outcome,” Eekhout said. The findings were published in the journal The Lancet Psychiatry.

Tyler Skluzacek, a senior at Macalester College in Saint Paul, Minnesota, was inspired to create the app due to his personal connection to PTSD. His father, an Iraq veteran, suffers from PTSD and has trouble sleeping due to night terrors which involve screaming, flailing and experiencing fear while sleeping.

Skluzacek and his team won the top prize of $1,500 at HackDC, a computer programming contest in Washington, D.C., in September. They spent 36 hours creating a mobile app for PTSD. The app is called myBivy. It refers to bivouac, a military term for a safe place to sleep such as a temporary camp or shelter.

Using smartphone technology, the app monitors a veteran’s heart rate and movements while they are asleep. It also tracks their sleeping patterns and remains alert for symptoms indicating the onset of panic attacks. The goal of the app is to predict when veterans experience night terrors. It then uses sounds or vibrations to disrupt deep sleep without waking the veteran up, therefore preventing night terrors.

Skluzacek and his team are raising money on Kickstarter to develop the app for wider use across different types of devices. A functional prototype is currently available on the Pebble Time smartwatch and Android smartphone. They plan to start clinical trials in early 2016 and officially launch by May.

Legal Help for Veterans, PLLC fights for veterans rights. We fight to make sure you get the benefits you deserve from the Department of Veterans Affairs. To learn more or contact an attorney about your Post Traumatic Stress, Traumatic Brain Injury, Mental Health, Sexual Assault, Hearing Loss and Tinnitus, Total Disability Based on Individual Unemployability, Medical Malpractice, or Aid and Attendance claim, visit http://www.legalhelpforveterans.com/ or call 800.693.4800

Tyler Skluzacek, a senior at Macalester College in Saint Paul, Minnesota, was inspired to create the app due to his personal connection to PTSD. His father, an Iraq veteran, suffers from PTSD and has trouble sleeping due to night terrors which involve screaming, flailing and experiencing fear while sleeping.

Skluzacek and his team won the top prize of $1,500 at HackDC, a computer programming contest in Washington, D.C., in September. They spent 36 hours creating a mobile app for PTSD. The app is called myBivy. It refers to bivouac, a military term for a safe place to sleep such as a temporary camp or shelter.

Using smartphone technology, the app monitors a veteran’s heart rate and movements while they are asleep. It also tracks their sleeping patterns and remains alert for symptoms indicating the onset of panic attacks. The goal of the app is to predict when veterans experience night terrors. It then uses sounds or vibrations to disrupt deep sleep without waking the veteran up, therefore preventing night terrors.

Skluzacek and his team are raising money on Kickstarter to develop the app for wider use across different types of devices. A functional prototype is currently available on the Pebble Time smartwatch and Android smartphone. They plan to start clinical trials in early 2016 and officially launch by May.

Legal Help for Veterans, PLLC fights for veterans rights. We fight to make sure you get the benefits you deserve from the Department of Veterans Affairs. To learn more or contact an attorney about your Post Traumatic Stress, Traumatic Brain Injury, Mental Health, Sexual Assault, Hearing Loss and Tinnitus, Total Disability Based on Individual Unemployability, Medical Malpractice, or Aid and Attendance claim, visit http://www.legalhelpforveterans.com/ or call 800.693.4800

HR 156 bars visa waiver country citizens from using the vis waiver program if they have traveled to Iraq or Syria within the last 5 years.

In the EB-5 area, there are 5 different, proposed legislative changes to the program which address many components of the EB-5 program, including increases in the minimum investment amount, making the program permanent, changing job creation methodology, changing TEA designations and definitions, and addressing means to reduce and identify fraud in Regional Centers and regional center projects.

Stay tuned for an update for news about Congressional decisions on these issues.

The study was carried out at the VA Medical Center in Minneapolis, Minnesota, where researchers randomly assigned 116 veterans with PTSD to receive one of two types of therapy. One group participated in eight weekly 2.5-hour sessions and a daylong retreat that focused on stress reduction though mindfulness and meditation. The other group underwent nine weekly 1.5-hour sessions of present-centered group therapy that emphasized coping mechanisms for PTSD symptoms in daily life.

According to the findings reported on Aug. 4, 49 percent of veterans who received mindfulness-based therapy reported a significant reduction in their PTSD symptoms, compared with 28 percent of those who received standard group therapy. Veterans from the first group also reported a greater improvement in quality of life after two months.

An estimated 23 percent of Iraq and Afghanistan veterans are affected by PTSD. Mindfulness training is part of a growing wave of alternative therapies in mainstream medicine. It involves teaching veterans take-home techniques for confronting memories from war that they would otherwise try to avoid. The breathing and calming exercises of meditation help veterans focus on the present and cultivate awareness during everyday activities.

Mindfulness training could work as an alternative or addition to standard PTSD treatments such as prolonged exposure and cognitive processing therapy, said researchers. However, follow-up research into the long-term benefits of the therapy and its future applications in VA PTSD programs is still needed. The findings were published in the Journal of the American Medical Association.

Legal Help for Veterans, PLLC fights for veterans rights. We fight to make sure you get the benefits you deserve from the Department of Veterans Affairs. To learn more or contact an attorney about your Post Traumatic Stress, Traumatic Brain Injury, Mental Health, Sexual Assault, Hearing Loss and Tinnitus, Total Disability Based on Individual Unemployability, Medical Malpractice, or Aid and Attendance claim, visit http://www.legalhelpforveterans.com/ or call 800.693.4800

The study was carried out at the VA Medical Center in Minneapolis, Minnesota, where researchers randomly assigned 116 veterans with PTSD to receive one of two types of therapy. One group participated in eight weekly 2.5-hour sessions and a daylong retreat that focused on stress reduction though mindfulness and meditation. The other group underwent nine weekly 1.5-hour sessions of present-centered group therapy that emphasized coping mechanisms for PTSD symptoms in daily life.

According to the findings reported on Aug. 4, 49 percent of veterans who received mindfulness-based therapy reported a significant reduction in their PTSD symptoms, compared with 28 percent of those who received standard group therapy. Veterans from the first group also reported a greater improvement in quality of life after two months.

An estimated 23 percent of Iraq and Afghanistan veterans are affected by PTSD. Mindfulness training is part of a growing wave of alternative therapies in mainstream medicine. It involves teaching veterans take-home techniques for confronting memories from war that they would otherwise try to avoid. The breathing and calming exercises of meditation help veterans focus on the present and cultivate awareness during everyday activities.

Mindfulness training could work as an alternative or addition to standard PTSD treatments such as prolonged exposure and cognitive processing therapy, said researchers. However, follow-up research into the long-term benefits of the therapy and its future applications in VA PTSD programs is still needed. The findings were published in the Journal of the American Medical Association.

Legal Help for Veterans, PLLC fights for veterans rights. We fight to make sure you get the benefits you deserve from the Department of Veterans Affairs. To learn more or contact an attorney about your Post Traumatic Stress, Traumatic Brain Injury, Mental Health, Sexual Assault, Hearing Loss and Tinnitus, Total Disability Based on Individual Unemployability, Medical Malpractice, or Aid and Attendance claim, visit http://www.legalhelpforveterans.com/ or call 800.693.4800

The resolution recognizes that PTSD is undertreated and underreported due to stigma and a lack of awareness. Iraq and Afghanistan Veterans of America says the disorder affects an estimated 20 percent of post-9/11 veterans, while the VA reports that Vietnam veterans have “high lifetime rates of PTSD ranging from 10 to 31 percent.”

The goal of this year’s campaign is to help veterans, their caregivers, families and members of the veteran and military community to learn about the PTSD treatment options available to help improve and save lives. The campaign also emphasizes the importance of recognizing the signs and symptoms of PTSD, which can sometimes be hard to detect. If left untreated, PTSD can lead to homelessness, depression and even suicide.

“Raising PTSD awareness is essential to overcoming the myth, misinformation and stigma that too often prevents veterans from seeking help . . . We encourage everyone to join us in this important effort to share important information about PTSD and help veterans receive care they need,” said VA secretary Robert A. McDonald.

Online resources for raising PTSD awareness are a major focus of the 2015 campaign. The VA runs the National Center for PTSD, which has a website that offers access to the PTSD Coach Online, PTSD Coach mobile app, an online video gallery of veterans discussing the disorder and its treatments and continuing education opportunities for health care providers, among other useful materials.

Legal Help for Veterans, PLLC fights for veterans rights. We fight to make sure you get the benefits you deserve from the Department of Veterans Affairs. To learn more or contact a veterans lawyer, visit http://www.legalhelpforveterans.com/ or call 800.693.4800

The resolution recognizes that PTSD is undertreated and underreported due to stigma and a lack of awareness. Iraq and Afghanistan Veterans of America says the disorder affects an estimated 20 percent of post-9/11 veterans, while the VA reports that Vietnam veterans have “high lifetime rates of PTSD ranging from 10 to 31 percent.”

The goal of this year’s campaign is to help veterans, their caregivers, families and members of the veteran and military community to learn about the PTSD treatment options available to help improve and save lives. The campaign also emphasizes the importance of recognizing the signs and symptoms of PTSD, which can sometimes be hard to detect. If left untreated, PTSD can lead to homelessness, depression and even suicide.

“Raising PTSD awareness is essential to overcoming the myth, misinformation and stigma that too often prevents veterans from seeking help . . . We encourage everyone to join us in this important effort to share important information about PTSD and help veterans receive care they need,” said VA secretary Robert A. McDonald.

Online resources for raising PTSD awareness are a major focus of the 2015 campaign. The VA runs the National Center for PTSD, which has a website that offers access to the PTSD Coach Online, PTSD Coach mobile app, an online video gallery of veterans discussing the disorder and its treatments and continuing education opportunities for health care providers, among other useful materials.

Legal Help for Veterans, PLLC fights for veterans rights. We fight to make sure you get the benefits you deserve from the Department of Veterans Affairs. To learn more or contact a veterans lawyer, visit http://www.legalhelpforveterans.com or call 800.693.4800

Included in the legislative package is one measure that would establish a volunteer application process through the Michigan Department of Civil Rights. That protocol would permit veterans to obtain state-issued identification, dog tags and service dog vests.

Knezek, who served in Iraq, says that many veterans return home with what he calls “invisible wounds,” including PTSD and traumatic brain injury. Knezek explains that many of these veterans find solace and comfort through the presence of a service animal.

Unfortunately, Knezek says, some people question whether a veteran who appears healthy by all outward appearances has a legitimate need for a service animal.

Sen. Margaret O’Brien, R-Portage, one of the package’s four co-sponsors, adds that it will help educate businesses about the special needs of veterans with service dogs.

Legal Help for Veterans, PLLC fights for veterans rights. We fight to make sure you get the benefits you deserve from the Department of Veterans Affairs. To learn more or contact a veterans attorney, visit http://www.legalhelpforveterans.com/ or call 800.693.4800

Family members stated that the patient was Roland Mayo, 65. Mayo was a Vietnam veteran and a former Riverside County deputy sheriff and marshal.

According to Mayo’s daughter, he was admitted to the hospital on October 8 to have a stent replaced in his carotid artery. Complications from prior cancer surgery required a second operation.

Following the surgery, Mayo seemed to be doing well. However, he later began vomiting, then choked on the vomit, resulting in his death.

Following an anonymous tip to Sacramento’s News10, the VA confirmed that a DNR band was incorrectly placed on Mayo’s arm. The VA stated when the patient went into distress, the code response team reviewed the chart and found that Mayo was not actually DNR. According to the VA, the incorrectly placed armband did not impact the response, and Mayo received appropriate resuscitative efforts.

The incident comes after an onslaught of VA scandals this year, including the revelation that thousands of veterans have faced months-long waits for their medical care.

According to a recent report by Senator Tom Coburn of Oklahoma, poor care in the VA system is deadly. Up to 1,000 veterans have lost their lives because of VA treatment since the beginning of the wars in Iraq and Afghanistan. The pervasive malpractice also takes an economic toll and has cost taxpayers close to $1 billion in settlements.

Legal Help for Veterans, PLLC fights for veterans rights. We fight to make sure you get the benefits you deserve from the Department of Veterans Affairs. To learn more or contact a veterans lawyer, visit http://www.legalhelpforveterans.com/ or call 800.693.4800

According to the report, female veterans are more likely to be unemployed than male veterans or non-veteran women. They are more likely to be homeless than non-veteran women. In addition, fewer resources are available to women who need basic health care, PTSD treatment or treatment for military sexual trauma.

Nearly 300,000 women served in the Afghanistan and Iraq wars after 9/11. In 2014, women represented 14.5 percent of active duty service members and 18 percent of reserve members, rates which are expected to increase in the future. Currently, 10.3 percent of all veterans are women.

The study found that female veterans received only 6 percent of domiciliary homeless care for veterans and of grant and per diem programs. They received only 4.4 percent of healthcare support for homeless veterans.

For female veterans, even basic medical care can be a challenge. A third of all Veterans Affairs (VA) medical centers do not employ a gynecologist.

A large proportion of women in the military experience sexual trauma — up to 20 percent of women receiving VA healthcare. However, research shows that many veterans have their military sexual trauma claims denied. Meanwhile, there is a shortage of staff trained to treat this pervasive problem.

At the same time, women also suffer from issues that are common to all veterans, such as increased rates of mental health problems and systemic difficulties in receiving much-needed services.

Legal Help for Veterans, PLLC fights for veterans rights. We fight to make sure you get the benefits you deserve from the Department of Veterans Affairs. To learn more or contact a veterans lawyer, visit http://www.legalhelpforveterans.com/ or call 800.693.4800

The study examined the effects of Sudarshan Kriya yoga on PTSD patients over the course of one year. Sudarshan Kriya focuses on breathing-based meditation. Twenty-one male Iraq/Afghanistan veterans diagnosed with PTSD participated in the study. Eleven participated in a seven-day program that included Sudarshan Kriya, meditation and group discussions, while 10 participants were used as a control group.

Up to 20 percent of America’s 2.3 million Iraq and Afghanistan war veterans suffer from PTSD. The effects are deadly: according to the Department of Veterans Affairs, at least 22 American veterans commit suicide each day.

Individuals suffering from PTSD suffer from anxiety, personality changes and flashbacks. They often feel jumpy and constantly on guard, a phenomenon known as hyper-arousal. Traditional treatment includes antidepressants and psychotherapy.

The veterans’ symptoms were evaluated one week prior to the program, followed by one week, one month and one year after the program. Of the veterans involved in the active program, seven continued to practice yoga afterwards.

The study found that the group that did yoga had fewer PTSD symptoms, and symptoms that did occur were less severe. They had lower anxiety, a lower respiratory rate and showed less hyper-arousal and greater regulation of emotions. The participants in the yoga group reported fewer intrusive memories, and most patients reported that while they experienced trauma during the yoga practice, the impact of the memories was lessened.

In the past, yoga has been demonstrated to be effective in reducing PTSD in tsunami survivors, as well as in the treatment of anxiety, depression and alcoholism.

The practice of yoga is founded in focusing on breathing and remaining in the present moment. Yoga practitioners are also trained in “intraception,” the practice of observing and understanding one’s internal state. In conjunction with other treatments, these tools may help individuals with PTSD to move away from negative thoughts.

Legal Help for Veterans, PLLC fights for veterans rights. We fight to make sure you get the benefits you deserve from the Department of Veterans Affairs. To learn more or contact an attorney about your PTSD, TBI, Mental Health, Sexual Assault, Hearing Loss and Tinnitus, TDIU, Medical Malpractice, or Aid and Attendance claim, visit http://www.legalhelpforveterans.com/ or call 800.693.4800

But less than a week later, a sole U.S. senator, Tom Coburn of Oklahoma, placed a hold on the bill, stopping further progress of the bill until after the beginning of the new session of Congress in 2015.

Veterans groups such as Iraq and Afghanistan Veterans of America (IAVA) have expressed outrage over the delay. IAVA points out that on average, 22 veterans commit suicide each day, and that any delay in improving suicide prevention cost lives.

One Michigan veteran, Nicholas Hunt, published an editorial in the Lansing State Journal underlining the need for more suicide prevention resources in Michigan and exhorting Michigan legislators to do more.

In his editorial, Hunt pointed out that in Battle Creek, veterans endure wait time of up to five weeks to see a mental health professional. Hunt argues that all over the state of Michigan, more resources are needed to get psychological support to veterans faster.

Hunt chided Michigan Senator Debbie Stabenow and Representative Tim Walberg for not co-sponsoring the bill. He calls on them both to pursue whatever actions they can to ensure that the bill is passed expediently in 2015.

The act is named for Clay Hunt, a veteran who committed suicide at the age of 28. Hunt, a veteran of Iraq and a Purple Heart recipient, struggled to receive appropriate service connections or care for his post-traumatic stress disorder (PTSD) from the Department of Veterans Affairs (VA). According to IAVA, he was unable to receive personal counseling. And it took 18 months for VA to respond to his appeal of his PTSD rating. VA finally accorded Hunt a 100 percent rating for his PTSD five weeks after he took his own life.

Legal Help for Veterans, PLLC fights for veterans rights. We fight to make sure you get the benefits you deserve from the Department of Veterans Affairs. To learn more or contact a veterans lawyer, visit http://www.legalhelpforveterans.com/ or call 800.693.4800

Positive reports surfaced last year on the significant reduction of the Department of Veterans Affairs (VA) backlog in benefits claims – VA workers slashed the backlog by over half to 245,000. VA officials were optimistic on cutting that number to zero by the end of 2015…but now that appears out of reach.

Army Times reports that VA will likely not reach a backlog of zero by the end of 2015, as was their goal. VA workers did set a record of completing over 1.3 million claims last year, but with new claims only continuing to increase it appears zeroing-out the entire backlog in the next eleven months or so is unlikely.

“I think they can get close, but I don’t think they can get to zero,” Jackie Maffucci, the research director for Iraq and Afghanistan Veterans of America, told Army Times last week. “Just looking at the numbers, it’s doubtful.”

To Congress’s credit, they did lend a helping hand to the tune of an additional $40 million in the budget to slash the backlog with digital scanning, more claims processors, and other efforts.

However, Army Times also reported that a new backlog is just around the corner. Appeals have risen steadily from about 245,000 in March 2013 to about 287,000 today. Congress gave VA $11 million to address the increasing appeals as well.

The backlog is based on the number of claims pending for more than 125 days. Last year, VA Undersecretary Allison Hickey indicated that the funding from Congress, which provided for new paperless systems, better training of claims processors, and improved communication systems, did contribute to the decrease from 2013-2014.

In 2014, the backlog reduction was welcome news. It represented a ray of hope that one promise from government – to eliminate the backlog before 2016 – was on track to be fulfilled. Despite this news, that promise still matters.

In comparison to years past, veterans are getting better and faster service (which was a low benchmark to improve upon). If the backlog can’t be cut to zero by the end of the year, let’s hope VA comes close – 125-plus days is a long time to wait for critical health care. And let’s not forget that the service our veterans deserve for sacrificing so much is still not where it needs to be.

Legal Help for Veterans, PLLC fights for veterans rights. We fight to make sure you get the benefits you deserve from the Department of Veterans Affairs. To learn more or contact a veterans attorney, visit http://www.legalhelpforveterans.com/ or call 800.693.4800

In standard medical procedure, the ringing in the ears caused by tinnitus can only be covered by machines that produced broadband sound, better known as white noise. The S-tone approach, however, targets an exact pitch of the tinnitus in the sufferer, and then produces just the right tone to counteract that pitch.

The study showed that more than half of the tinnitus sufferers in the study found the S-tones to be more effective at reducing the volume of their tinnitus.

Tinnitus is a condition that can significantly affect a sufferer’s health and quality of life. For some, the ringing in the ears is so loud that it impedes sleep and creates difficulty concentrating, which can lead to a host of physical, psychological, economic and social problems.

The Hearing Health Foundation estimates that 60 percent of Iraq and Afghanistan veterans return home with some form of hearing loss or tinnitus.

SoundCure, a Silicon Valley startup, is dedicated to creating a state-of-the-art S-tone device for tinnitus sufferers. Serenade, its current device, can be programmed by audiologists to the exact frequency and sound type needed by the patient. It can also be programmed for different times of day.

Jeff Carroll, Ph.D., who works for SoundCure, told ABC News that the best part about S-tone therapy is that it can work at much lower volumes than traditional white noise therapy. Because more than three quarters of participants in the AJA study indicated that the S-tones worked at least as well as white noise, a majority of tinnitus sufferers may prefer S-tone therapy simply because it is quieter.

Both the AJA study and the Serenade device have been endorsed by the American Tinnitus Association.

Legal Help for Veterans, PLLC fights for veterans rights. We fight to make sure you get the benefits you deserve from the Department of Veterans Affairs. To learn more or contact a veterans lawyer, visit http://www.legalhelpforveterans.com/ or call 800.693.4800

Unfortunately, I might have had my hopes too high.  Over the weekend, the Austin American Statesman ran a wonderful project by Jeremy Schwartz that outlined many of the problems facing researchers who tried to launch an expensive brain injury research program in Waco.

If you’re interested at all in brain injuries and brain injury research, I urge you to spend some time with the resources at the project.

Even if you’re not particularly interested in brain injuries, I think the project is still a good example of what journalism could be.  In addition to his written articles, which also appeared in the paper, the project includes video stories and links to the actual documents used to substantiate the article.  It is extremely well done.

And now, the U.S. defense industry is adapting to a national military strategy more reliant on technological superiority than on amassed hardware or troops. As defense professionals at the Pentagon and beyond revise their military plans, they are seeing an increasingly acute need for these talented STEM workers.

The importance of keeping foreign-born, graduating STEM students in this country cannot be overestimated.

Part of the need for foreign-born STEM workers is driven by a simple principle of supply-and-demand economics. The number of available H-1B visas is limited, and many of these STEM workers need the visas to immigrate to the United States. Currently, only 85,000 visas are granted each year. Many foreign-born, would-be STEM professionals come to the United States to study on student visas, but when they graduate, those who cannot obtain an H-1B visa must return to their respective home countries.

The recent budget-driven sequester cut spending in all federal departments, and those cuts have impacted the outlook for future defense strategy. The Obama administration has already reduced military outlays in Iraq and Afghanistan. Now, it seeks ways to cut back troop levels and jettison unnecessary, expensive weapons systems in order to maintain an efficiently lean, economical military.

As part of that strategy, the Defense Department has placed a premium on technological advances. But restrictive policies on immigration limit the number of H-1B visas to a total that does not meet the existing demand. The shortage of visas may crimp the Pentagon’s objectives.

Immigration policy troubles the Pentagon, but it is not their only quandary. Competition also affects requiting: many foreign-born STEM graduate students primarily seek a career in Silicon Valley or Austin, Texas. Employment with the defense establishment is often less tempting and, even more often, less lucrative.

A bill that would grant U.S. citizenship to immigrants with advanced STEM degrees passed the U.S. Senate last year, but it has sputtered in the House. Meanwhile, Defense Department officials have publicly emphasized the need for new technologies.

“We must maintain our technological edge over potential adversaries,” said Defense Secretary Chuck Hagel.

A. Banerjee is a Houston immigration attorney in Texas. Before selecting an lawyer, contact the Law Offices of Annie Banerjee by visiting their website at http://www.visatous.com.

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Former President George W. Bush offered an interesting take on erasing the stigma that comes along with Post Traumatic Stress Disorder (PTSD) for military veterans: drop the “D” in PTSD.

At a summit convened on veterans’ issues, the former President said that the condition has been mislabeled a “disorder” and that simply calling it “post-traumatic stress” would go a long way toward removing the stigma for veterans coming home from Iraq and Afghanistan.

The summit was organized by the George W. Bush Institute — the former President’s policy think tank — to highlight how Americans can more effectively help the 2.5 million post-9/11 veterans move to civilian life.

It’s estimated that 11-20% of Veterans coming home from Iraq and Afghanistan suffer from PTSD, in addition to about 10% of Gulf War (Operation Desert Storm) vets, and about 30% of Vietnam vets. The condition has serious consequences beyond that of veterans’ health, especially their ability to find a job when returning home.

“Employers would not hesitate to hire an employee being treated for a medical condition like diabetes or high blood pressure,” said Bush. “And they should not hesitate to hire veterans with post-traumatic stress.”

While others, including high-ranking military officials have previously called for such a change, Bush is the most prominent individual to suggest that PTSD be viewed from a different angle.

Due to the stigma of the condition being a “disorder” – which makes it seem permanent – some veterans are reluctant to get help, while others are unaware of treatment options. Doctors who have been pushing for a name change — perhaps to “post-traumatic stress injury” — praised Bush’s stand as major progress.

PTSD can develop after a trauma in which an individual is harmed or feels the threat of physical harm – which can be triggered by events such as combat or by sexual harassment. Key aspects of the condition are recurring symptoms, such as reliving the event or avoiding situations reminiscent of the event.

Bush was also joined by Jill Biden, wife of vice president Joe Biden, as well as high-ranking military officials, non-profits and representatives from businesses such as Bank of America and 7-Eleven. Hopefully this push to erase the “D” from PTSD will continue and yield results – our veterans deserve it, and we owe it to them.

Read more on former-President Bush’s speech here: http://www.dallasnews.com/news/metro/20140219-bush-wants-change-in-how-ptsd-is-handled.ece?nclick_check=1

For an overview of PTSD basics, check out the VA’s PTSD informational page: http://www.ptsd.va.gov/public/PTSD-overview/basics/how-common-is-ptsd.asp

Legal Help for Veterans, PLLC fights for veterans rights. We fight to make sure you get the benefits you deserve from the Department of Veterans Affairs. To learn more or contact an attorney about your Post Traumatic Stress, Traumatic Brain Injury, Mental Health, Sexual Assault, Hearing Loss and Tinnitus, Total Disability Based on Individual Unemployability, Medical Malpractice, or Aid and Attendance claim, visit http://www.legalhelpforveterans.com/ or call 800.693.4800

Statistics estimate that tinnitus, which strikes young and old alike, affects 10 percent to 15 percent of the U.S. population. But rates among combat veterans are much higher. A recent U.S. Army study concluded that 25 percent of all soldiers return from service in Iraq and Afghanistan with the compromised hearing that results in tinnitus.

There are multiple causes of tinnitus, including noise-induced hearing loss, obstruction of the ear canal, damage to the inner ear and even tumors. Some theories posit that the brain creates the ringing associated with tinnitus as a means of replacing the sounds the ear once heard.

Imagine the environment in which soldiers work. Sudden, loud noises and explosions are a routine occupational hazard to both hearing and life. Unfortunately, the use of hearing protection is rarely practical in combat circumstances.

Tinnitus has also been associated with psychological factors, including fear and memory. Veterans face the possible dimension of this complicating factor both on the battlefield and after the return home, especially in cases involved post-traumatic stress disorder.

When a veteran seeks disability compensation for hearing loss and/or tinnitus, it is important that the claim provide as much information as possible on the likely source of the hearing damage, the duration of exposure and any hearing protection that was employed. A medical opinion from an ear specialist will also help expedite such a claim through the Department of Veterans Affairs.

Legal Help for Veterans, PLLC fights for veterans rights. We fight to make sure you get the benefits you deserve from the Department of Veterans Affairs. To learn more or contact an attorney about your PTSD, TBI, Mental Health, Sexual Assault, Hearing Loss and Tinnitus, TDIU, Medical Malpractice, or Aid and Attendance claim, visit http://www.legalhelpforveterans.com/ or call 800.693.4800

Dr. Melanie Rosenblatt is director of pain management at Broward Health North in Deerfield Beach. In the hour-long documentary “Pain Matters,” she explains that understanding addiction is crucial to pain management. She says that doctors need to consider all options when treating pain patients, not just high doses of opiates, which can actually make pain worse in the long run.

Alternative and complementary treatments include nerve blockers, surgery, behavioral and psychological therapy, spinal cord stimulators, physical therapy, exercise, topical treatments, and non-opiate medications like muscle relaxers and anti-inflammatories.

The documentary covers six patients who struggled with and overcame chronic pain, including a two-time Stanley Cup-winning hockey player and an injured Iraq war veteran.

Before the state’s pill mill crackdown, Florida was home to clinics dispensing astronomical amounts of of pain pills—to legitimate patients, addicts, and drug dealers from all over the country. Their numbers have dwindled, but Rosenblatt points out that some doctors still prescribe addictive narcotics such as oxycodone in amounts she calls “egregious.”

Chronic pain can be devastating to patients and their loved ones. Increased awareness of alternative treatments and the dangers of addiction hopefully will lead to less need for narcotic painkillers.

If you need to speak with a personal injury lawyer, Call Joyce & Reyes at 1.888.771.1529 or visit more of http://www.joyceandreyespa.com/.

Non-U.S. citizens are precluded from bringing claims against the United States involving military operations on foreign territories. In this specific instance, the incident occurred during a time of war and in a foreign country. (1) The Federal Torts Claims Act does not waive sovereign immunity for such claims; (2) The Military Claims Act only applies to U.S. citizens; and (3) the Alien Torts Statute only creates jurisdiction for aliens raising civil actions related to a violation of the law of the nations or a treaty.

There is case law that supports these findings.  For example, in Koohi v. U.S., 976 F.2d 1328, 1994 A.M.C. 1514 (9th Cir. 1992), a case holding that 28 U.S.C.A. § 2680(j) applied to prevent survivors of passengers on board an Iranian commercial airliner shot down by a U.S. Navy vessel during the 1986-1988 Iran-Iraq “tanker war” from suing the United States under the Federal Tort Claims Act, the court stated that the result in the case would be no different if the downing of the civilian plane had been deliberate, rather than the result of error. The court explained that the combatant activities exception applies whether U.S. military forces hit a prescribed or an unintended target; whether those selecting the target have acted wisely or foolishly; whether the missiles employed turn out to be “smart” or dumb; and whether the target chosen performs the function it was believed to perform, or whether the choice of an object for destruction is a result of error or miscalculation. The court added that, in other words, it does not matter for purposes of applying the exception whether the military makes or executes the decision carefully or negligently, properly or improperly, but that it is the nature of the act and not the manner of its performance that counts. The court therefore found that in the case before it, it was of no significance whether a plane that was shot down was civilian or military so long as the person giving the order or firing the weapon did so for the purpose of furthering the United States’ military objectives or of defending lives, property, or other interests. 23 A.L.R. Fed. 2d 489 (Originally published in 2007).

As often stated, war is a terrible thing.  Since the dawn of time, groups of men have been waging war on each other.  Unfortunately, the innocent civilians also suffer.

Legal Help for Veterans, PLLC fights for veterans rights. We fight to make sure you get the benefits you deserve from the Department of Veterans Affairs. To learn more or contact an attorney about your Post Traumatic Stress, Traumatic Brain Injury, Mental Health, Sexual Assault, Hearing Loss and Tinnitus, Total Disability Based on Individual Unemployability, Medical Malpractice, or Aid and Attendance claim, visit http://www.legalhelpforveterans.com/ or call 800.693.4800

Almost one out of every five suicides in the U.S. is a veteran, though veterans only make up about 10 percent of the U.S. population.

The latest numbers indicate that there may be as many as 22 veterans committing suicide each day, or one suicide every 65 minutes. Former defense secretary Leon Panetta says the service member suicide rate is “an epidemic.”

A report by the Department of Veterans Affairs released in February 2013 looked at data reported from 21 states between 1999 and the end of 2011. But the numbers may be even higher, as many vets are missing from the official reports of vet suicides. There is no uniform reporting system of which veteran deaths were suicide-related in the U.S. A coroner or funeral director typically enters the veteran status of the deceased and that the manner of death was suicide on the death certificate. If a veteran dies in a manner that may nor may not be suicide, the incident may go under accidental death. Additionally, when a homeless person commits suicide, his or her veterans status might not be known in that community, and the stigma of suicide in some families and some communities may mean that the manner of death is not divulged or the coroner may be pressured to not list the cause of death as suicide. Veteran status is not verified or followed up by the VA or the Defense Department. Capturing accurate information is an ongoing issue.

A report released by a journalism student program, News21, states that the suicide rate for veterans annually is approximately 30 per 100,000, more than twice the rate of the civilian population (14 per 100,000), and it was also increasing at an accelerated rate compared to civilian suicides. From the 48 states they studied, they found that the suicide rate for vets was increasing an average of 2.6 percent each year, from 2005 to 2011, twice the rate of civilian suicide increase.

Though veteran suicides are happening among men and women, older vets and those who have just returned from Iraq and Afghanistan, almost 70 percent of vet suicides are being committed by those who were 50 and older. Vet mental health advocates currently think that the high levels for that cohort is a combination of Vietnam vets with ongoing combat stress who did not receive adequate support when they returned home, and men who have raised their children to adulthood.

Legal Help for Veterans, PLLC fights for veterans rights. We fight to make sure you get the benefits you deserve from the Department of Veterans Affairs. To learn more or contact an attorney about your Post Traumatic Stress, Traumatic Brain Injury, Mental Health, Sexual Assault, Hearing Loss and Tinnitus, Total Disability Based on Individual Unemployability, Medical Malpractice, or Aid and Attendance claim, visit http://www.legalhelpforveterans.com/ or call 800.693.4800

Unfortunately, post-traumatic stress disorder (PTSD) is an all too common condition for soldiers returning home after serving in Iraq and Afghanistan.  Many veterans choose to seek counseling to cope with this and other effects of their service overseas.

Recently, the Department of Veterans Affairs (VA) began a program by which these therapy sessions are conducted over the internet.  The veterans can see and interact with their counselor through a video-chat program such as Skype or Cisco Jabber.

In the long term, veterans using this “Skype therapy” progressed at the same rate as veterans receiving traditional face-to-face therapy.  Traditional therapy is never going away – but this new online therapy is only going to get bigger.

Of course, there can be technical problems with online therapy such as pixilation, choppiness, and freezing.  If the internet connection is lost, that will end the session.  In one case, a study found that a therapist did not notice for three sessions that his patient was in a wheelchair.  Some also believe that this new approach will decrease empathy because the therapist is unable to shake the patient’s hand, hand tissue to a crying patient, or otherwise physically interact with the patient.

Even with the drawbacks, this new approach is certainly a blessing for veterans who do not live near a VA hospital or clinic.  These veterans will now have the ability to get the treatment they need from the comfort of their own home.

If you have questions about PTSD or benefits for veterans, contact Legal Help For Veterans, a practice group of Fausone Bohn, LLP, at 800-693-4800 or online at www.legalhelpforveterans.com.

To learn more about the VA’s new online therapy program, please visit: http://www.stripes.com/news/veterans/skype-therapy-it-s-working-for-veterans-1.229089#.Udg7dhg-uZk.gmail

Legal Help for Veterans, PLLC fights for veterans rights. We fight to make sure you get the benefits you deserve from the Department of Veterans Affairs. To learn more or contact a veterans lawyer, visit http://www.legalhelpforveterans.com/ or call 800.693.4800

Claims raters working with the VA have been combing through the oldest claims in the system to allow those vets to get their benefits, if eligible. The Veterans Administration has announced that vets who are waiting for their claim to be processed are able to submit additional materials as evidence up to one full year after their provisional rating and prior to the VA issuing its final decision on their claim. Provisional decisions are intended to provide vets with their benefits faster and also will allow them the safety of an additional year to submit additional evidence if necessary. Those cases will be “fast-traced,” said the Undersecretary for Benefits, Allison Hickey.

In tandem with this initiative, VA has announced that it still intends to prioritize the benefits claims of veterans who are homeless as well as the benefits claims for former prisoners of war, terminally ill vets, vets who claim financial hardship, and recipients of the Medal of Honor.

Decisions on benefit claims will be predicated on the evidence submitted, if needed, medical exams will be ordered and processed expeditiously. If an increase of a benefit is determined after additional evidence is submitted, those benefit payment will be paid retroactively to the initial claim file date.

This new initiative is also designed to allow a vet to appeal a decision, including lower benefits than expected, a denial of claim or another issue. The vet will have one full year to submit additional evidence, after which, the VBA will contact the vet to inform them that their rating has been determined and will provide standard appeal information.

The plan is that, as the oldest claims are processed, the average claim competition time through the VA’s system will improve and the average number of days a claim is in the benefits inventory will dramatically decrease.

During the pending phase of compensation claims, vets who are eligible can receive their healthcare benefits from the VA. Vets from recent conflicts are currently eligible for as many as five years of VA healthcare for free. More than 55 percent of vets who have returned from Iraq and Afghanistan are now using VA health care.

Wounded Warrior claims, meanwhile, are continuing to be processed separately with Department of Defense via the Integrated Disability Evaluation System (IDES). Vets designated as “Wounded Warriors” are receiving their VA compensation benefits just 61 days, on average, after separating from military service.

Legal Help for Veterans, PLLC fights for veterans rights. We fight to make sure you get the benefits you deserve from the Department of Veterans Affairs. To learn more or contact a veterans lawyer, visit http://www.legalhelpforveterans.com/ or call 800.693.4800

A new study has determined that vets with mental health conditions including post-traumatic stress disorder (PTSD) and depression typically must wait an average of two years after returning from deployment before their mental health issues are addressed by Veterans Affairs.

 ”When the vets do begin to receive mental health treatment, the study also found that care is often fragmented and not as effective as is needed,” commented veterans disability lawyer James Fausone.

The study, published in the journal Psychiatric Services in December 2012, looked at vets of the Iraq and Afghanistan wars between 2001and 2011 processed by Veterans Affairs (VA) medical centers.  These men and women typically were given with eight sessions of mental health treatment, a number considered far lower than that in the civilian population looking for PTSD or depression support, and widely considered “minimally adequate.” Seventy-five percent of vets who went to the VA for support did not even receive what researchers dubbed “minimally adequate care.”

Numerous issues may delay mental health care for veterans, including the social stigma that still may longer around mental health issues for some people, including concern that seeking care may jeopardize future job prospects. The overburdened VA system also means that many vets have long waits to get appointments for initial assessment; the average wait for a mental health evaluation at the VA was 50 days, according to a 2012 report from the VA’s inspector general.

The VA has announced that it is adding additional staff and partnering with community health centers to broaden support for veterans in their communities; 15 clinics in sevenU.S.states are now able to treat veterans with the VA’s approval.

But more is needed, say mental health advocates.  The VA inspector general’s report found that approximately 30 percent of high-risk (i.e., potential suicidal) vets were not receiving the mandated multiple follow-up mental health visits within 30 days after an emergency hospitalization. There was no documented contact by the VA of even reaching out to those vets to remind them of follow-up appointments.

http://www.foxnews.com/health/2013/05/31/for-veterans-mental-health-care-often-fragmented/

Legal Help for Veterans, PLLC fights for veterans rights. We fight to make sure you get the benefits you deserve from the Department of Veterans Affairs. To learn more or contact a veterans lawyer, visit http://www.legalhelpforveterans.com/ or call 800.693.4800

Legal Help for Veterans, PLLC fights for veterans rights. We fight to make sure you get the benefits you deserve from the Department of Veterans Affairs. To learn more or contact a veterans lawyer, visit http://www.legalhelpforveterans.com/ or call 800.693.4800

Now Congress is pushing for President Obama to “take direct action” to end the backlog. A bipartisan letter helmed by Reps. Patrick Murphy, D-Fla. and Mike Coffman, R-Colo. and cosigned by 164 House Republicans and Democrats, is urging the white House to run interference in order to help the more than 600,000 vets currently waiting for their overdue disability claims. The average time they wait to have a first-time filing processed is between 317 and 327 days, the letter states. Many vets are waiting as long as two years for their claim to be processed, and there are vets who waited as many as 1,000 days.

This letter is not the first of its kind – a similar one was sent a month ago by 67 senators which also requested that President Obama take action by becoming involved in solving the disability claims backlog at the Department of Veterans Affairs. Some cities are running a lag time longer than others; the average wait for a disabled vet inNew Yorkis 642 days, while the average wait for a vet inPhiladelphiais 510 days. While Congress has approved more funding and more employees for the Department of Veteran Affairs, the backlog situation has not improved. A spokesperson for Veterans Affairs has stated that the agency has processed more than 4 million claims in the past four years – a record number – while admitting that more needs to be done.

The VA’s goal is to process the backlog of claims by the end of 2015 as the system completes a switch from paper-based processing to a new electronic system. A backlogged claim is any claim 125 days or older. The electronic system has been rolled out in 20 offices throughout theUnited   States, and should be in all of the 56 offices by the end of 2013.

In response, White House press secretary Jay Carney said that the President is “deadly serious” about clearing the extensive backlog by 2015. But while the backlog issue predates Obama’s administration, advocates are pushing for him to become more hands-on in order to get the system resolved. According to Iraq and Afghanistan Veterans of America (IAVA), more than 575,000 vets have been waiting for their claim to be processed for more than 125 days.

Source

http://www.foxnews.com/politics/2013/06/01/democrats-and-republican-in-both-chamber-press-obama-to-end-backlog-veterans/

The largest group of veterans with claims pending are from the Vietnam era. It has been 40 years since the war ended and the tale of that war, which shows in disability claims, is still lengthening.  We can expect that the Iraq/Afghanistan tale to also be 40 years in the making with claims increasing until 2054.

VA officials recently blogged:

“In fact, about 60% of the 845,000 pending disability claims are from Veterans for whom VA has already completed at least one claim. About 78% of those Veterans are already receiving monetary compensation at some level—and about half of those are rated with at least a 50% disability, receiving $1000 or more monthly. The other 40% of the total inventory are from Veterans filing for the first time. This 60/40 percent split is roughly the same proportion for claims that have been pending more than 125 days—i.e. the backlog. Also, many people—including reporters covering the story—attribute the growing number of claims to the wind-down of current conflicts.

In reality, only one in five claims in the inventory come from Iraq and Afghanistan Veterans. The largest portion is actually from Vietnam-era Veterans. “

So veteran advocates, like the VA, have no shortage of work.

http://www.blogs.va.gov/VAntage/9378/separate-system-ensures-wounded-troops-receive-disability-benefits-quickly/

Legal Help for Veterans, PLLC fights for veterans rights. We fight to make sure you get the benefits you deserve from the Department of Veterans Affairs. To learn more or contact a veterans lawyer, visit http://www.legalhelpforveterans.com/ or call 800.693.4800

The University of Utah National Center for Veterans’ Studies undertook the research because few others had investigated the link between traumatic brain injury and suicide, traumatic brain injury is one of the most common injuries sustained in Iraq and Afghanistan, and “[s]uicide is currently the second leading cause of death among military members,” the magazine reported.

In fact, 303 active-duty soldiers killed themselves in 2011 and another 349 killed themselves in 2012. This prompted 53 Congress members to pen a March 4, 2013, letter to the Secretary of Defense and the Secretary of Veterans Affairs, stating, in part, that the number of suicides has reached “unacceptably high levels.”

Though everyone has his or her own reason for contemplating suicide, as Frontline stated, and the study’s lead author, Craig J. Bryan, cautioned that his narrow research can’t prove that someone who suffers a concussion will contemplate suicide, a person who suffers repeated concussions does become “more sensitized,” and “it becomes easier for that individual to experience depression and suicidal (thoughts) as a result.”

Still, the assistant professor of psychology’s study revealed:

• 18 participants had never been diagnosed with a concussion, and none of those participants reported contemplating suicide;
• 58 participants had been diagnosed with one concussion, and seven percent of those participants reported contemplating suicide;
• 85 participants had been diagnosed with several concussions, and 22 percent of those participants reported contemplating suicide.

Further, “[s]ome service members sustained as many as 15 traumatic brain injuries while deployed,” and “[a]n estimated 20 percent of service members sustained concussions during basic training,” per Frontline. Others suffered head injuries playing sports before enlisting.

Interestingly, “mild head injuries tend to be more likely to lead to suicidal thoughts than more severe ones,” Bryan said. “Resiliency is the rule. I want those who have experienced traumatic brain injuries, no matter how many, to realize that things are going to be OK, and that there’s hope, and there’s services available, and that the treatment works.”

Below, Cleveland, Ohio, medical malpractice attorney Christopher Mellino discusses common causes of brain injuries and how the severity of a brain injury is measured.

Common causes of brain injury:

Can the severity of a brain injury be measured?

• Veterans of Iraq and Afghanistan have a 75 percent higher rate of fatal motor vehicle accidents than do civilians (with a large portion of these being from motorcycle wrecks).
• Veterans are much more likely to be in a wreck in the six months after deployment than the six months before deployment.
• The more combat tours the veterans had completed the higher risk that they become involved in an accident.

These numbers are startling, but there are some explanations.

Some theorize that troops come back with driving habits that help them while deployed (rushing through intersections, etc.) that help survive overseas but contribute to higher wrecks back at home.

Others theorize that post traumatic stress disorder, which is becoming all too common in returning troops, causes aggressive driving.

Personally, I wonder if there’s another explanation. Suicide amongst veterans is the leading cause of non-battle deaths. Social scientists have long understood that suicides dramatically increase after a highly publicized suicide. This is known as the Werther effect. However, not only do obvious suicides increase, but fatal car accidents and even plane accidents increase significantly after a publicized suicide. The theory is that for many people, they do not want to have appeared to have killed themselves. Instead, they may purposefully cause a wreck or accident so it seems that they died accidentally.

Regardless, these men and women have served us, and our military owes it to them to try and help protect them from these fatal accidents, whatever the cause.