Nearly half of eligible ex-service members who served in Iraq or Afghanistan are snubbing free, federal health care they earned in uniform because many harbor “huge mistrust” of the U.S. Department of Veterans Affairs, contends a leading veterans advocacy group.

About 1.5 million men and women who served in those wars have since separated from the U.S. military. Among those eligible to access VA medical help, only 55 percent of veterans have done so through the third quarter of 2012, VA figures show.

“It’s because the VA has a branding problem, an image problem,” said Tom Tarantino, chief policy officer for Iraq and Afghanistan Veterans of American (IAVA), which has more than 200,000 members.

For many younger veterans, Tarantino said, the issue that has most sullied the VA’s reputation is the average time it takes to complete the disability-compensation claims submitted by wounded veterans. The average wait for that money has grown to 272.3 days, or about nine months, a 10-day increase from early December, according a federal website.

VA Secretary Eric Shinseki last year vowed to shrink the so-called “VA backlog” to 125 days by 2015 as the agency finishes transitioning to a digital processing system.

“Any time we ever hear about the VA, what do we hear? That the backlog is astronomically high. Or, that the VA is late in providing GI Bill (tuition) checks. It’s not an antagonistic relationship. It’s: ‘Oh, there goes the VA again; they still don’t have it together.’ Meanwhile, the VA is pathologically incapable of telling its own story,” said Tarantino, who uses a VA medical center. The former Army captain spent time in Iraq, earning the Bronze Star. “The problem is there is a huge mistrust of the VA.

“And what’s unsettling is the VA is an outstanding health care system. But they have not done a good job to explain to the American people what it is they do or offer,” Tarantino added. “This is business 101. You can have the greatest product in the world but if people don’t know about or trust your product, you have a bad product.”

Katie Hanson is a military spouse; her husband, Lt. Cmdr. Marc Hanson, is on active duty in the Navy.

He has Florida as his home of record, even though he is based at Naval Air Station North Island, Coronado, in California. The Hansons never lived in Florida as a married couple. She now lives and works in California, and they own a home in South Carolina that they rent.

So where do they pay taxes?

She has to file a California return and they both have to file in South Carolina. If Florida had a state income tax, he'd have to file there. That's on top of their federal return.

For military personnel, "it's not unusual to have to file taxes in multiple states," said Katie Hanson, project manager for TurboTax's military edition.

That's just one of several tax complexities that military families must deal with when figuring out their taxes.

"Quite often the service members are aware of the benefits but their families are less aware," said Mark Luscombe, principal analyst at CCH, a tax preparation service. "Sometimes problems come up when a service member dies." He said survivors don't always understand the military tax issues.

First off is the question of where the home of record is.

Home of record is where you enter the military, Hanson said. Or it can be the place where you live while in the service that you consider your home. It's where the military will move you back to when you leave the service. Your home of record will determine where you file state income taxes.

There's also the question of what income is taxable.

"The basic pay in the military is taxable but a lot of the secondary stuff is excludable," Luscombe said.

Pay while serving in an officially declared combat zone, for example, is not taxable as income.

"When I was in the Navy in Vietnam, the rule then and still is that you have to have been in the combat zone for at least one day a month to get the exclusion for that month," Luscombe said.

Today, combat zones include Afghanistan, the Persian Gulf region, including Iraq, and the Balkans.

"Service in a combat zone includes any periods you are absent from duty because of sickness, wounds or leaves," says the Internal Revenue Service.

Those who were injured or exposed to diseases in combat zones can, for tax purposes, exclude from income their pay during the time they were hospitalized, even if the hospitalization occurs outside the combat zone. Usual tests pertaining to time and distance for moves do not apply for members of the military.

Service members deployed to combat zones can get an automatic extension for filing their federal tax returns, to 180 days after they return to the United States.

Members of the military also may request to defer payment of income taxes due during their time of service for up to 180 days after that service ends.

Before Army Spc. Andrew Velez left Texas for the final time, he asked his fragile sister to write him a promise – a vow he could carry with him to Afghanistan.
Monica Velez knew she owed him that much. In the horrid weeks after each had lost their beloved brother, Freddy Velez, to enemy fire in Iraq, Monica tried to end her life with pills and alcohol. Now, she put pen to paper: “I will not hurt myself. I will not do anything crazy. I know that Andrew loves me. I know that Freddy loved me.” Andrew folded her note and slipped it into his pocket.

“Don’t break your word to me,” he told her before heading back to war.

Seven months later, Andrew, 22, sat alone in an Army office at a base in Afghanistan. He put a gun to his head and committed suicide. Back in Texas, word reached Monica Velez who, once again, found herself in a dangerous place. Only now, she was alone. Days of alcohol and anti-depressants. Nights of dark thoughts: “It would just be better if I was gone.”

As the U.S. military suicide rate soared to record heights during 2012, the families of service members say they, too, are witnessing a silent wave of self-harm occurring within their civilian ranks: spouses, children, parents and siblings.
Some suicides and suicide attempts — like those that ravaged the Velez family — are spurred by combat losses.

Others may be triggered by exhaustion and despair: As some veterans return debilitated by anxiety, many spouses realize it's now up to them — and will be for decades — to hold the family together.
Specific figures are lacking as no agency tracks civilian suicides within military families.

However, Kristina Kaufmann, a long-time Army wife, knows of three other Army wives, all friends, who took their lives in recent years.

"When you know that you are the anchor — and if you go down, the family's going down — the problem is that you can only do that for so long," said Kristina Kaufmann.

One was Faye Vick, described by Kaufmann as “the perfect picture of an Army wife — pretty, nice, always with a smile.” Vick and her family lived around the corner from Kaufmann and near Fort Bragg, N.C. In 2006, when Kaufmann’s husband was in Afghanistan and Vick’s husband was deployed overseas, the 39-year-old mother placed herself, her infant and her 2-year-old son in a car inside a closed garage and started the engine, asphyxiating all three with carbon monoxide, according to Kaufmann and to local news reports at the time.

“And I know of too many others through the grapevine,” said Kaufmann, executive director of Code of Support, an Alexandria, Va.-based nonprofit that seeks to bridge the gap between civilians and military America.

“When you know that you are the anchor — and if you go down, the family’s going down — the problem is that you can only do that for so long,” said Kaufmann. “That population (of spouses) is at the most risk. Because the storm is going to happen when everybody comes home. That’s where we are, unfortunately, going to see an uptick in lots of negative outcomes, including suicide, including suicide among the spouses.”