Thousands of veterans with less-than-honorable “bad paper” discharges have been unlawfully turned away when they attempted to seek health care at the Department of Veterans Affairs (VA), according to a report published by the Veterans Legal Clinic at the Legal Services Center of Harvard Law School on behalf of OUTVETS, a national LGBT veterans community organization.

The report, Turned Away: How VA Unlawfully Denies Health Care to Veterans with Bad Paper, found that inadequate and flawed training, guidance, and oversight of VA front-line staff puts more than 400,000 veterans at risk of being turned away for health care or has dissuaded them from even trying to apply.

For years, the Veterans Legal Clinic has been hearing from its veteran clients who have bad paper that when they try to apply for health care at VA, they are turned away and denied the opportunity to apply, simply on the basis of the less-than-honorable discharge status listed on their DD 214 discharge papers.

In response to hearing the same story from veterans again and again, Veterans Legal Clinic staff and students launched an investigation, which included interviewing additional veterans, reaching out to veterans advocates nationwide, and pursuing public records requests at VA and the Department of Defense. In its investigation, the Clinic partnered with Veterans Legal Services, a Boston-based civil legal aid office that serves veterans and their families, and pro bono attorneys at WilmerHale.

The report includes new data from the Department of Defense about the significant number of veterans who have received so-called “bad paper” discharges, as well as internal documents from VA health facilities that provide incorrect information to staff about health care eligibility for veterans with bad paper. The report shares the stories of individual veterans, many of whom were deployed to combat or who served multiple enlistments, who were unlawfully turned away by VA when they returned home. In many cases, veterans received “bad paper” discharges because they were gay or lesbian, or because they have Post-Traumatic Stress Disorder or another mental health condition caused by their military service that led to actions resulting in their separation from the military.

“By law, every person—regardless of military discharge status—has the right to apply for VA health care, to have VA consider that application on the merits, and to receive a written decision,” said Dana Montalto, Clinical Instructor at the Veterans Legal Clinic at the Legal Services Center of Harvard Law School, who co-authored the report. “However, we heard from veterans and veterans advocates from across the country that instead, when a veteran with bad paper attempts to apply for health care, the front-desk staffer denies the veteran on the spot, without due process, merely by looking at the veteran’s DD 214 discharge papers.”

Key Findings

  • For decades, and in cities across the country, VA has been turning away veterans with bad paper discharges when they seek treatment or attempt to enroll in health care. More than 400,000 veterans are at risk of being turned away if they were to try to apply for health care today.
  • VA enrollment manuals, handbooks, and trainings often provided incorrect information about VA’s eligibility rules for veterans with bad paper. Internal documents frequently stated or suggested that veterans with bad paper discharges are categorically ineligible for VA health care, which is incorrect.
  • Certain groups of veterans—including those with service-related mental health conditions—are more likely to be turned away by VA. Veterans who served in the Navy or Marine Corps, who were enlisted, who served in the Post-9/11 Era, or who have a mental health condition such as Post-Traumatic Stress Disorder (PTSD) are more likely to be discharged with bad paper, and are therefore more likely to be turned away by VA.

“VA has a duty to care for our returning service members.” said OUTVETS National Commander Bryan Bishop, an Air Force veteran. “Whether a veteran got bad paper when they were kicked out for being gay or lesbian, or based on conduct caused by an undiagnosed mental health condition like Post-Traumatic Stress Disorder or Traumatic Brain Injury, or some other reason, VA is supposed to help that person and try to get them whatever support they are entitled to.”

Veterans with bad paper are some of the most at-risk veterans in need of supportive services, with higher rates of mental health conditions and homelessness. Studies show that veterans with bad paper are at three times the risk of suicide, but that veterans with bad paper who have recently accessed mental health care at VA are at no greater risk of suicide than other veterans. “Access to VA health care is life-saving for veterans with bad paper,” said Anna Richardson, Co-Founder and Chief Counsel at Veterans Legal Services, who co-authored the report. “VA must adopt a no-wrong-door approach to ensure that every veteran gets the opportunity to apply for and to receive the support that they need and deserve.”

The Veterans Legal Clinic is using this report to call on VA to take immediate steps to ensure that no veteran is unlawfully turned away from applying for health care, including by improving its internal training and guidance, and by conducting outreach to find veterans unlawfully turned away.

Read The Washington Post’s coverage of the report, VA unlawfully turned away vulnerable veterans for decades, study says, with 400,000 more at risk.