Allegations of institutionalized racism at the VA

Remember we all played a part

In America to help that banner wave

-- "Black Man," by Stevie Wonder

Having read numerous books about institutionalized racism in the wake of the nationwide reckoning over racial injustice following the murder of George Floyd -- e.g., "Caste," by Isabel Wilkerson, "Toxic Communities," by Dorceta E. Taylor, and "The Color of Law," by Richard Rothstein -- I cannot say I was surprised when I read a complaint filed last July in Connecticut federal district court on behalf of Black veterans. The Black Veterans Project and the National Veterans Council for Legal Redress claim discrimination in treatment and benefits by the U.S. Department of Veterans Affairs. Black Veterans Project et al. v. U.S. Department of Veterans Affairs, 21-935 (D. Conn., filed July 8, 2021).

The veterans groups had requested records from the VA pursuant to the Freedom of Information Act. In their complaint, they allege the VA failed to conduct a reasonable search for records relating to racial disparities across the VA benefits system. They also allege that Black veterans continue to face disparities in health and disability claims, citing a 2003 study of over 3,300 veterans that found Black veterans were significantly less likely to be granted service connection for post-traumatic stress disorder as compared to non-Black veterans. ("Service connection" refers to a service-related condition that is covered by VA benefits.)

According to the complaint, medical studies have consistently demonstrated disparities in health care for Black Americans, such as undertreatment for pain. It states there is no reason to believe that the VA's health care system is immune from medical racism found in other areas of America's health care system. The complaint goes on to assert there are medical studies and other reasons to conclude that health care disparities persist between Black and white patients, even when controlling for factors like economic status and outside insurance coverage.

The complaint, its sources and exhibits paint a gloomy journey, indeed. It certainly appears institutionalized racism is alive and well at the VA.

"Forum of Hate" Emails

The complaint refers to seven years of email exchanges among a group of judges and lawyers who worked at the VA's Board of Veterans' Appeals. Using their official VA accounts, the participants referred to the emails as their "Forum of Hate."

The Court of Appeals of Maryland discusses those email exchanges in Attorney Grievance Commission v. Markey et al., 469 Md. 485 (Md. June 26, 2020). The case involved a former VA judge and a former VA lawyer who were in the email chain. Concerning a Black woman judge at the VA, one email stated that she was, "a despicable impersonation of a human woman, who ought to [have] her cervix yanked out of her by the Silence of the Lamb[s] guy, and forced[-]fed to her." About an email participant's son's little league team, one exchange bragged that all the kids were white, and not a "Charo, Adrian, or BD in the bunch." One of the writers suggested the team should be called "The Maryland White Sheets," because, "Gotta start them when they are young," and that they should have a "'Bon fire' after every victory." The hearing judge found that that the terms "white sheets" and "bon fire" were references to the Ku Klux Klan, the term "Charo" was code for someone of Spanish descent, the term "Adrian" was code for African-Americans and "BD" was code for Asian.

Black Employees at the VA

In a survey of VA employees by their workers union in July 2020, nearly 80% of respondents said endemic racism within the VA is a "moderate or serious problem." Half reported having witnessed discrimination against the veterans they serve. The Washington Post, reporting on the survey, found government data that showed 12.3% of white workers held senior leadership roles within the VA, as compared to 3.8% of Black workers.

The complaint against the VA cites a news article about protesters gathered outside the Kansas City VA Medical Center calling out what they say is racial discrimination in the building. Members of the NAACP, Concerned Clergy Coalition and the Real Justice Center organized the protest to speak out against racial discrimination against Black veterans and Black staff members at the hospital. They were calling for an outside investigation into discrimination complaints, including non-Black staff members making lynching jokes, an emergency room nurse who used a racial slur, disproportionate hiring and terminations, and illegal personnel practices against Black staff.

Sen. Jerry Moran (R-Kan.), chair of the Senate committee on Veterans Affairs, sent a letter to the VA secretary demanding that the VA provide documentation regarding all discrimination complaints over the last 10 years, as well as a description of how the VA responded to the complaints.

The GI Bill and Black Veterans

Since the GI Bill was enacted in 1944, it has been widely celebrated as a benchmark of opportunity for those who have served in the armed forces. An article in the Journal of Blacks in Higher Education by Hilary Herbold, cited in the complaint against the VA, notes that military personnel who used their benefits to complete a college degree or vocational training program earned an average of $10,000 to $15,000 more annually than those who had not, and those increased earnings generated tax revenues eight to 10 times greater than the cost of the program. Many analysts call it the best investment the U.S. government has ever made. Altogether, 7.8 million servicemen and servicewomen were educated under the GI Bill after World War II.

But according to Herbold, for a number of reasons, Black veterans were at a distinct disadvantage when it came to benefiting from the GI Bill.

Congressman John Rankin, best known for establishing the House Committee on Un-American Activities, was an outspoken segregationist. He was also the main sponsor of the GI Bill. A Democrat from Mississippi, Rankin was notorious for his pro-segregationist and racist position on all issues relevant to Black Americans.

According the Herbold, the bill was passed with the certainty that Black people would encounter racial restrictions in moving to claim their benefits. He cites to a 1947 article that stated of the 1,700 employees at one VA facility in the South, only seven were Black, despite the fact that one-third of the South's veterans were Black. Meanwhile, VA hospitals operated racially segregated wards and directed Black veterans to vocational schools rather than the more prestigious colleges and universities that became available for veterans after World War II.

White veterans had the advantage of empowerment through veterans' organizations such as the American Legion, but the VA would not grant accreditation to the newly formed United Negro and Allied Veterans of America in 1946. At the same time, the American Legion granted only five of its state offices permission to charter posts for African- American servicemen, but only if they were segregated posts.

That Black people encountered racial restrictions when they tried to take advantage of the GI Bill is demonstrated by a 1947 study that showed that banks and mortgage agencies refused loans to Black veterans, colleges and universities refused to admit Black veterans, the VA relegated Black veterans to vocational courses, and restrictive covenants in deeds rendered trying to buy a nice house fruitless.

Simply put, the GI Bill was largely ineffective for Black veterans.

Racial disparities in PTSD disability ratings

The complaint also cites a 2003 medical study published in the Medical Care journal. Authors of this study set about to determine whether there are racial discrepancies in the granting of service connection for PTSD by the VA. The level of service connection reflects the degree of disability veterans are determined to be suffering as a result of PTSD and governs the amount of monetary compensation they receive, often providing much-needed economic support.

PTSD is the most common psychiatric condition for which veterans seek service connection. It is a chronic, disabling condition caused by involvement in horrifying and traumatic events. Afterward, victims suffer from recurrent, intrusive and distressing recollections of their trauma. Typically, they experience increased arousal characterized by irritability, hypervigilance, poor concentration or insomnia. The authors state that approximately 7% to 12% of American adults suffer from PTSD, compared with approximately 30% of Vietnam-era combat veterans, and 50% of former prisoners of war. Since 1980, more than 200,000 veterans have applied for service connection disability on the basis of PTSD. In either general or veteran populations, the prevalence of PTSD does not vary significantly by race.

The study concluded that the VA gave Black veterans rates of service connection for PTSD substantially lower than other veterans, even after adjusting for differences in PTSD severity and functional status. The study's conclusion is not surprising as other VA studies show that even in a supposedly equal access system, Black veterans are less likely than white veterans to be referred for cardiac procedures and other diagnostic studies.

Conclusion

When claims about racism within the VA mounted, the Government Accountability Office, the investigative arm of Congress, recommended in 2019 that the VA conduct an assessment to determine how to address weaknesses identified with the completeness and accuracy of race and ethnicity data in the electronic health record, and to implement corrective actions as necessary. Apparently the accusations of racial discrimination continued because in 2020, at the request of Sens. Elizabeth Warren (D-Mass.) and Brian Schatz (D-Hawaii), the GAO announced it would investigate claims of systemic racism within the VA.

The plaintiffs in this action are working with a group of law students at Yale Law School. These students work tirelessly in support of veterans. The instant complaint is simply requesting documents that would shed light on whether or not, and to what extent, Black veterans have been discriminated against at the VA. In its answer to the complaint, the VA alleges plaintiffs are not entitled to anything they requested.

This is Black History Month. We will all be watching as these law students press forward with their requests for information that should demonstrate how Black veterans are now receiving and have historically received benefits and treatment at the VA.