understanding PTSD and TDIU for Veterans

Post-Traumatic Stress Disorder (PTSD)

If you are here because you have been denied veterans’ benefits for PTSD, you are not alone. In 2012, the VA claimed its own claims error rate was 14%. However, the VA’s own inspector general found a claims error rate of 38%.That means by even the VA’s own estimates they make mistakes in almost 4 out of 10 benefits claims cases! Additionally, appeals represent a third of the VA’s pending disability claims which means 1 in 3 cases the VA is processing are veterans appealing a denial.

A TDIU Vocational Evaluation can assist you greatly in gaining Objective Evidence of your Psychiatric Limitations/Mental Health Issues, to get an Objective Diagnosis, severity of issues and how they affect your employability and in Vocational Terms

How Do I Get Veterans’ Benefits for PTSD?

To get veterans’ benefits for PTSD, you need to establish a service connection between your PTSD disability and your time in service. PTSD is unique among veteran disability types because of the importance placed on stressors in diagnosing PTSD. So, in order to get VA disability benefits for PTSD you will need to get a service connection by establishing a stressor or stressors that qualify you for a diagnosis of PTSD.

There are essentially 3 different approaches to proving stressors.

The first type of stressor involves a situation where a combat veteran describes a stressor that is consistent with his or her combat exposure.
The second type of stressor involves a situation where the veteran describes a stressor that is not associated with his verified combat exposure.
The third type off stressor involves cases where the veteran’s PTSD stressor is related to fear of hostile military or terrorist activity while stationed in a combat theater of operations.

Credible supporting evidence is important in getting approved for PTSD VA benefits. But in practice, the “credible supporting evidence” requirement has been a major impediment to many Veterans receiving compensation for their PTSD diagnosis. Frankly, many things that happen in the service are never properly documented or recorded. As a result, it can be very difficult to prove that the stressor took place. Fortunately, in July 2010 the VA issued a new rule making it somewhat easier to prove that a stressor event happened during service. Under the new regulation, if a Veteran’s claimed stressors are related to the Veteran’s fear of hostile or military or terrorist activity then he could qualify for PTSD based on this as a stressor.

Additionally, in order to get VA benefits for PTSD, you might also need to get a private VOCATIONAL EXPERT OPININON to establish a connection between your service and your diagnosis and Vocational Limitations.

What Are PTSD Veterans Benefits?

Veterans benefits for PTSD are granted based on graduated disability ratings of 0%, 10%, 30%, 50%, 70% or 100%. Veterans who receive a disability rating of 0% do not receive disability benefits because there is little or no impairment. Disability benefit payments begin at 10% and increase at each rating level.

Veterans have a wide range of benefits available to them. They range from VA pension benefits (non-service connected) and VA compensation benefits – to vocational rehabilitation and grants for adapted vehicles, housing and equipment.

Why Did the VA Deny My Veteran’s Benefit Claim for PTSD that a Vocational Expert and Help with?

The most common reasons why the VA denies benefits for PTSD are:

The VA also likes to deny PTSD claims on the grounds that you don’t have a diagnosis of PTSD. In many cases, however, if you are not diagnosed with PTSD you may be diagnosed with depression or generalized anxiety. You would benefit from a TDIU Vocational Evaluation that tests for psychiatric/Mental Health issues and lists their severity and relationship to vocational limitations.
Another reason why the VA denies PTSD benefits claims is because many veterans make the mistake of re-filing PTSD benefits claims without any new evidence or they submit evidence that is not really material to their PTSD, South East VE can provide you with New Objective Evidence.

In order to ensure the greatest degree of success in re-opened disability claims, we recommend that you look very carefully at the reason why the VA denied your claim the last time. For instance, if the reason they denied you before was because there was no evidence of a present disability, then submitting a new medical record showing a diagnosed condition could potentially aid in getting your claim reopened. The new evidence you submit should address one of the reasons why VA denied your benefits before.

SouthEast Vocational Experts can provide Objective Evidence of your PTSD and level of severity through our objective Testing.

Quick FACTS – Military Sexual Trauma – MST – PTSD

MILITARY SEXUAL TRAUMA
Disabilities determined by VA to be related to your military service can lead to monthly non-taxable compensation, enrollment in the
VA health care system, a 10-point hiring preference for federal employment and other important benefits. Ask your VA
representative or Veterans Service Organization representative about Disability Compensation, Pension, Health Care, Caregiver
Program, Career Services, Educational Assistance, Home Loan Guaranty, Insurance and/or Dependents and Survivors’ Benefits.
DISABILITY COMPENSATION FOR CONDITIONS RELATED TO
MILITARY SEXUAL TRAUMA (MST)
Disabilities determined by VA to be related to your military service can lead to monthly non-taxable compensation, enrollment in the VA health care system, a 10-point hiring preference for federal employment, and other important benefits. Ask your VA representative or Veterans Service
Organization representative about Disability Compensation, Pension, Health Care, Caregiver Program, Career Services, Educational Assistance, Home Loan Guaranty, Insurance and/or Dependents and Survivors Benefits. Some Veterans may have experienced sexual trauma while serving in the military. These kinds of experiences can affect Veterans’ mental and physical health, even many years later. Veterans can
apply for disability compensation for any current difficulties that are related to their service, including difficulties related to MST.

HOW DOES VA DEFINE MST?
MST is defined by Title 38 U.S. Code 1720D as “psychological trauma resulting from a physical assault of a sexual nature, battery of a sexual nature, or sexual harassment which occurred while the Veteran was serving on active duty, active duty for training, or inactive duty training.” Sexual harassment is defined as “repeated, unsolicited verbal or physical contact of a sexual nature which is threatening in character.”

ARE VETERANS GRANTED DISABILITY COMPENSATION FOR MST?
Veterans are not granted compensation for the traumatic event itself, but can be granted disability compensation for conditions that result from MST. Compensation – April 2015
CAN YOU DEVELOP POSTTRAUMATIC STRESS DIS ORDER (PTSD) OR OTHE R MENTAL HEALTH DISORDERS AS A RESULT OF MST?
Yes. Exposure to any trauma can potentially result in PTSD or another mental health disorder. PTSD is the most common mental health diagnosis related to experiencing MST.
WHAT EVIDENCE CAN SU PPORT A DISABILITY C LAIM FOR PTSD AS A R ESULT OF MST?
Department of Defense forms used in reporting incidents of sexual assault or harassment, as well as investigative reports during military service are direct evidence to support these claims. However, VA knows that events involving sexual trauma are not always officially reported. Therefore, for PTSD claims related to MST VA has relaxed the evidentiary requirements and looks for “markers” (i.e., signs, events, or circumstances) that provide some indication that the traumatic event happened.
These include, but are not limited to:  Records from law enforcement authorities, rape crisis centers, mental health counseling centers, hospitals, or physicians Pregnancy tests or tests for sexually transmitted diseases Statements from family members, roommates, fellow Servicemembers, clergy members, or counselors Requests for transfer to another military duty assignment. Deterioration in work performance Substance abuse. Episodes of depression, panic attacks, or anxiety without an identifiable cause. Unexplained economic or social behavioral changes Relationship issues, such as divorce Sexual dysfunction
VA RELAXED THE STAND ARDS OF EVIDENCE FOR COMBAT RELATED PTSD. ARE T HE STANDARDS OF EVIDENC E FOR MST – RELATED PTSD CLAIMS MORE STRINGENT THAN OTHER PTSD CLAIMS?
No. In fact, VA relaxed its evidentiary standard for disability claims related to MST in 2002 to ensure all available evidence supporting these claims is considered. Because military service records may lack corroborating evidence that a stressful event occurred, VA regulations make clear that evidence from non-military sources may be used to corroborate the Veteran’s account of the MST. Further, when direct evidence of an MST is not available, VA may request a medical opinion to consider a Veteran’s account and any “markers” to corroborate the occurrence of the MST event as related to current PTSD symptoms.

CAN PREVIOUSLY DENIE D MST RELATED P TSD DISABILITY CLAIM S BE RE – EVALUATED?
Yes. Increased awareness of MST issues resulted in special training beginning in December 2011 for all VA regional office personnel who process MST-related claims and the mental health clinicians conducting the examinations related to these claims. This ongoing training focuses on discovering “marker” evidence to support the claim. VA wants all Veterans who filed MST-related PTSD claims before December 2011 to receive the benefits of this nationwide training. If your claim was submitted before that date and denied, you can request a re-evaluation from your local VA regional office.
WHAT DO VETERANS NEE D TO DO TO GET A PRE VIOUSLY DENIED MST- RELATED PTSD DISABILITY CLAIM RE – EVALUATED?
Veterans who want VA to review their previously denied MST-related PTSD claim can start by contacting their regional office, calling 1-800-827-1000 or logging into their free eBenefits account at www.eBenefits.va.gov.
CAN VETERANS PROVIDE NEW INFORMATION FOR A RE-EVALUATION OF A PREVIOUSLY DENIED MSTRELATED PTSD DISABILITY CLAIM?
Yes. VBA will accept new evidence to be reviewed when a claim is re-evaluated. It’s best to send any new evidence at the same time as you request a re-evaluation. Veterans Service Organizations, as well as MST specialists and/or Women Veterans Coordinators available at every VA regional office, can help you determine what type of information is best to submit.
DO I NEED TO BE SERVICE CONNECTED FOR MY CONDITIONS RELATED TO MST TO GET TREATMENT?
No. VA provides free health care for physical and mental health conditions related to experiences of MST. No documentation of the MST experiences or disability compensation rating is required. Some Veterans may be able to receive this free MST-related health care even if they are not eligible for other VA care.
HOW CAN YOU APPLY FOR DISABILITY COMPENSATION?
You can apply for disability compensation by completing VA Form 21-526, Veteran’s Application for Compensation and/or Pension. You may also apply online at www.ebenefits.va.gov, or you can appoint an accredited Veterans Service Officer (VSO) to assist you. Male and female MST coordinators are available at every VA regional office to assist Veterans filing claims related to personal assault or MST. You can call 1-800-827-1000, and VA will put you in touch with an MST coordinator, or you can email the MST coordinator at your local regional office from the list of Compensation – April 2015 coordinators located at http://www.benefits.va.gov/benefits/mstcoordinators.asp . For informationabout MST-related treatment, visit ww.mentalhealth.va.gov/msthome.asp.

Overview

Female deep in thought.

Military sexual trauma (MST) is the term that the Department of Veterans Affairs uses to refer to sexual assault or repeated, threatening sexual harassment that occurred while the Veteran was in the military. It includes any sexual activity in which one is involved against one’s will – he or she may have been pressured into sexual activities (for example, with threats of negative consequences for refusing to be sexually cooperative or with implied faster promotions or better treatment in exchange for sex), may have been unable to consent to sexual activities (for example, when intoxicated), or may have been physically forced into sexual activities. Other experiences that fall into the category of MST include unwanted sexual touching or grabbing; threatening, offensive remarks about a person’s body or sexual activities; and/or threatening or unwelcome sexual advances.

Male deep in thought. Both women and men can experience MST during their service. All Veterans seen at Veterans Health Administration facilities are asked about experiences of sexual trauma because we know that any type of trauma can affect a person’s physical and mental health, even many years later. We also know that people can recover from trauma. VA has free services to help Veterans do this. You do not need to have a VA disability rating (i.e., “service connected”) to receive these services and may be able to receive services even if you are not eligible for other VA care. You do not need to have reported the incident(s) when they happened or have other documentation that they occurred.

This website has information about the health care services that VA has available for Veterans who experienced MST. For information about VA disability compensation for conditions related to MST, please view this fact sheet about Disability Compensation for Personal Assault or Military Sexual Trauma.

FACTS – Military Sexual Trauma – MST – PTSD

HOW DOES VA DEFINE MST?
MST is defined by Title 38 U.S. Code 1720D as “psychological trauma resulting from a physical assault of a sexual nature, battery of a sexual nature, or sexual harassment which occurred while the Veteran was serving on active duty, active duty for training, or inactive duty training.” Sexual harassment is defined as “repeated, unsolicited verbal or physical contact of a sexual nature which is threatening in character.”

Overview

Female deep in thought.

TDIU – DIAGNOSING PTSD

PTSD is a result of a person experiencing a traumatic event. Any number of situations can trigger PTSD for service members, as they are routinely exposed to stressful and traumatic occurrences.

Some of the Common Symptoms of PTSD may include:

Panic Attacks
Generalized Anxiety
Reliving the event, or flashbacks
Feelings of detachment, emotional numbness or depression
Avoiding situations that are reminiscent of the traumatic event
Not talking about the traumatic event
Living in a constant state of alertness or readiness for danger
Loss of interest in normal daily activities

Veterans experiencing these symptoms should contact a health care professional to determine whether they are suffering from PTSD.

There are many combat Veterans who have developed post-traumatic stress disorder (PTSD) as a result of military service are eligible to receive disability compensation for their condition. PTSD is a serious disorder that requires ongoing treatment which may not be possible if the veteran is not awarded an adequate amount from the VA.

The VA, Veterans Disability and what is needed to get a PTSD Disability Rating:

In the past, the VA has maintained strict requirements for claiming PTSD disability but in recent years these have become less stringent. Since 2010, veterans are no longer required to prove that the PTSD-triggering event actually occurred. This applies to combat veterans and any veteran who experienced fear of hostile terrorist activity.

The way to create A DIRECT SERVICE CONNECTION FOR PTSD, VETERANS MUST HAVE:

A current PTSD diagnosis
A statement about the event that caused their trauma
Consistency between the veteran’s statement and the conditions of their service
A medical opinion that the stressor had a sufficient enough impact on them to cause PTSD

Why Us for TDIU – Veterans Disability

When a Veterans Representatives & Attorneys need an objective Vocational Assessment of a claimant’s Past Relevant Work, & Current Vocational Capabilities, they turn to us for Answers.

We have been providing Forensic Vocational Expert Services and Occupational assessments for over 17 years. We have also served as an unbiased expert for the U.S. Federal Government in more than 500 cases. We have performed over 3,000 assessments and have a specializations in brain injury (TBI), and Mental Health issues.

We are one of the few Vocational Experts to have in-depth Vocational & Psychological testing experience as well as to have worked as a on contract for the Social Security Administration ODAR courts, as well as for claimants.

We choose our evaluation tests based on the individuals’ needs and do not use a cookie cutter approach. We use standardized diagnostic vocational interview, but can also test the claimant using the most modern techniques, including a computerized measurement of aptitudes and abilities. We are one of the few vocational rehabilitation companies experienced with testing the aptitudes and abilities of Spanish and non-English speaking persons.

The interview and test battery can be administered via the internet allowing claimant’s throughout the United States to obtain this valuable expert service.

We have sat in and provided Vocational Expert Witness Testimony in over 500 Social Security Disability hearings; we know what the Administrative law Judge needs to know to make a decision.

We can provide a Vocational Evaluation (Social & Industrial Surveys) in Veteran’s Disability cases to prove Total Disability Individual Un-employability in (TDIU) Cases.

Our Specialization is Forensic Vocational Evaluations & Vocational Analysis.

We have performed thousands of Vocational Transferable Skills Analysis through the VDARE process.
We also can provide Intense Brief Therapy.
Our mission is to provide reliable, valid, and effective vocational evaluation and expert witness services.
We have been providing Vocational Evaluations for over 17 years and worked with a variety of clients and disabilities.
We invite you to consult with us on any issue relating to employment, including earning capacity, employability, job search effectiveness, wrongful termination, discrimination, harassment, and retaliation.
Earning capacity consulting includes the analysis of complex earning situations including entrepreneurial income and multiple source income from part-time, project and full-time employment.
We also offer Vocational Rehabilitation plans, Educational Plans, &Job Placement Services.
A vocational expert is able to determine the individual´s skills and abilities to engage in work.

TDIU for PTSD

Post-Traumatic Stress Disorder (PTSD)

How Do I Get Veterans’ Benefits for PTSD?

There are essentially 3 different approaches to proving stressors.

The first type of stressor involves a situation where a combat veteran describes a stressor that is consistent with his or her combat exposure.
The second type of stressor involves a situation where the veteran describes a stressor that is not associated with his verified combat exposure.
The third type off stressor involves cases where the veteran’s PTSD stressor is related to fear of hostile military or terrorist activity while stationed in a combat theater of operations.

What Are PTSD Veterans Benefits?

Why Did the VA Deny My Veteran’s Benefit Claim for PTSD that a Vocational Expert and Help with?

The most common reasons why the VA denies benefits for PTSD are:

The VA also likes to deny PTSD claims on the grounds that you don’t have a diagnosis of PTSD. In many cases, however, if you are not diagnosed with PTSD you may be diagnosed with depression or generalized anxiety. You would benefit from a TDIU Vocational Evaluation that tests for psychiatric/Mental Health issues and lists their severity and relationship to vocational limitations.
Another reason why the VA denies PTSD benefits claims is because many veterans make the mistake of re-filing PTSD benefits claims without any new evidence or they submit evidence that is not really material to their PTSD, South East VE can provide you with New Objective Evidence.

SouthEast Vocational Experts can provide Objective Evidence of your PTSD and level of severity through our objective Testing.

GET TDIU for PTSD

The VA, Veterans Disability and what is needed to get a PTSD Disability Rating for VA Disability and TDIU:

The way to create A DIRECT SERVICE CONNECTION FOR PTSD, VETERANS MUST HAVE:

A current PTSD diagnosis
A statement about the event that caused their trauma
Consistency between the veteran’s statement and the conditions of their service
A medical opinion that the stressor had a sufficient enough impact on them to cause PTSD

We use Advance Forensic Mental Health Evaluations to give objective evidence of your PTSD and other Mental Health issues and are able to relate these issues and limitations in Vocational Terms. This is something other professionals can Doctors cannot do, and what the VA ALJ’s are trying to do in a vacuum unless you have a Vocational Expert outlining the issues in Vocational Terms.

you can also get PTSD from MST see: MILITARY SEXUAL TRAUMA (MST) AND PTSD

If you have a PTSD Rating and you are having problems Obtaining or Maintaining Employment due to your Service Connected Disabilities and the VA is not increasing your disability rating you should consider a TDIU Vocational Evaluation

See: TDIU Assessment Process

See: Why Us for PTSD TDIU Veterans Disability

We can provide PTSD evaluations, TDIU Evaluations, and Veteran Disability Evaluations nationally.

Social & Industrial Survey is one of the structured interview styles the VA wants to have done.

Veterans Disability – Service Connected Condition

The Veterans Administration (VA) provides disability compensation for deserving veterans who have disabilities related to their military service. These conditions include those that developed while serving in the military that were not caused by active duty, and conditions that were caused or exacerbated by military service.

The Veterans Administration recognizes the following list of conditions as having developed in veterans because of their active service in the military. If you have a service-connected condition and having problems Finding and Maintaining Employment you may be eligible for 100% Veterans Disability due to TDIU, and could benefit from an evaluation.

Post Traumatic Stress Disorder (PTSD)

Related to combat service or personal trauma

Traumatic Brain Injury (TBI)

Often diagnosed, but generally related to concussion resulting from explosion

Why us for Veteran Disability Evaluations

Chronic Diseases:

If diagnosed within one year of separation from service

Anemia, primary
Arteriosclerosis
Arthritis
Atrophy, Progressive Muscular
Brain Hemorrhage
Brain Thrombosis
Bronchiectasis
Calculi of the kidney, bladder, or gallbladder
Cardiovascular-renal disease, including hypertension
Cirrhosis of the liver
Coccidioidomycosis
Diabetes mellitus
Encephalitis lethargic residuals
Endocarditis (all forms of valvular heart disease)
Endocrinopathies
Epilepsies
Hansen’s disease
Hodgkin’s disease
Leukemia
Lupus erythematous, systemic
Myasthenia gravis
Myelitis
Myocarditis
Nephritis
Other organic diseases of the nervous system
Osteitis deformans (Paget‟s disease)
Osteomalacia
Palsy, bulbar
Paralysis agitans
Psychoses
Purpura idiopathic, hemorrhagic
Raynaud‟s disease
Sarcoidosis
Scleroderma
Sclerosis, amyotrophic lateral
Sclerosis, multiple
Syringomyelia
Thromboangiitis obliterans (Buerger‟s disease)
Tuberculosis, active
Tumors, malignant, or of the brain or spinal cord or peripheral nerves
Ulcers, peptic (gastric or duodenal)

Tropical Diseases

If diagnosed within incubation period of illness following service in a tropical region

Amebiasis
Blackwater fever
Cholera
Dracontiasis
Filariasis
Leishmaniasis, including kala-azar
Loiasis.
Malaria
Onchocerciasis
Oroya fever
Pinta
Plague
Schistosomiasis
Yaws
Yellow fever

Diseases Specific to Prisoners of War

If held captive more than 30 days and diagnosed at any time following separation from service

Psychosis
Any of the anxiety states
Dysthymic disorder (depressive neurosis)
Organic residuals of frostbite
Post-traumatic osteoarthristis
Atherosclerotic heart disease
- Hypertensive vascular disease
- Hypertensive heart disease
- Myocardial infarction
- Congestive heart failure
- Arrhythmia
Stroke
Osteoporosis
Avitaminosis
Beriberi (including beriberi heart disease)
Chronic dysentery
Helminthiasis
Malnutrition
Pellagra
Other nutritional deficiency
Irritable bowel syndrome
Peptic ulcer disease
Peripheral neuropathy (except if related to infectious causes)
Cirrhosis of the liver
Osteoporosis (on or after September 28, 2009)

MILITARY SEXUAL TRAUMA (MST) AND PTSD

PTSD may also result from an unwanted sexual event, which includes any form of forced sexual contact or contact that took place without the victim’s knowledge or consent. Military sexual trauma (MST) is not only a result of the event itself, but the fear of retaliation if the event is reported.

Statistics from the VA show that in 2012, 23.6% of female veterans seen for health care reported a history of MST. Men also report suffering sexual assault while in the military.

Disability compensation is available to both male and female veterans who have suffered MST or who developed PTSD as a result of MST. In these cases, the veteran must have some proof that the sexual event occurred to receive disability compensation for it. However, in recent years, the VA has created less strict evidentiary requirements and will now accept a variety of what they call “markers”, which can include various signals, occurrences, or circumstances that would indicate a traumatic event took place.

Vocational Expert in Veterans Disability & TDIU

Georgia Vocational Evaluation Disability Evaluation Vocational Expert

Divorce, Veteran, LTD, SSA/SSI –

SouthEast Vocational Experts: Leaders in Forensic Mental Health & Vocational Evaluations.

Disability Evaluation process and procedures differ depending on the Venue as well as the issued involved in the case.

this will cover the major aspects – each case is different and therefore will have different needs, we do not have a one size fits all assessment process.

Disability Evaluation – Forensic VOCATIONAL EVALUATION PROCESS

1) Document Review – General list:

Hospital, Physician, Psychiatrist, Psychologist, & Counselor records, Disability Forms.

2) We Use Both a Structured and Unstructured Diagnostic Vocational Interview

This will be a review of the Veteran’s history and will also outline the Veteran’s age, education, current work status, past work experience, skills, current medical & psychological impairment(s), treatments, and physical & psychological limitations.

(This can be in-person or through SKYPE)

3) Assessment of Current Information and determining if more documentation is needed.

– If needed we will create Medical and/or Psychological Source forms and/or Mental Residual Functional Capacity (MRFC), Physical Residual Functional Capacity (RFC). This will be the disabled individual or their Representative responsibility to get completed and returned to us.

4) Vocational & Forensic Mental Health Evaluation (Psychometric Assessments) (most cases will require one or more tests)

Based on the case we will determine what assessments need to be completed. We will assess not only aptitudes but also may measure Attention, Concentration (ADHD), Memory, Cognitive Abilities, IQ, Mental Health / Psychiatric Measures (Depression, Bi-Polar, Acute Anxiety, GAD, PTSD, Schizophrenia, etc.)

5) Perform a Vocational Diagnostic Assessment of Residual Employability.

this includes a Transferable Skills Analysis

6) Labor Market Research (if needed)

Private, local, state, and federal government labor market studies to determine if any significant number of jobs exist that the claimant can perform in the local and national labor market.

The results of the vocational evaluation enable the Vocational Expert to render an opinion as to the employability of the permanently injured veteran’s and their ability to perform substantial gainful work activity based on quantifiable, accurate, and current information using Veteran’s Disability standards.

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We serve individuals nationwide, including clients near all VA regional offices and their areas of jurisdiction: places such as Montgomery, Alabama; Houston, Texas; Dallas, Texas; Anchorage, Alaska; Phoenix, Arizona; Little Rock, Arkansas; South Carolina; North Carolina; San diego, California; San Fransisco, California; Los Angeles, California; Oakland, California; San Diego, California; Denver, Colorado; Hartford, Connecticut; Wilmington, Delaware, Washington, D.C.; St. Petersburg, Florida; Atlanta, Georgia; Honolulu, Hawaii; Boise, Idaho; Chicago, Illinois; Indianapolis, Indiana; Des Moines, Iowa; Wichita, Kansas; Louisville, Kentucky; New Orleans, Louisiana; Togus, Maine; Boston, Massachusetts; Detroit, Michigan; St. Paul, Minnesota; Jackson, Mississippi; St. Louis, Missouri; Ft. Harrison, Montana; Lincoln, Nebraska; Reno, Nevada; Manchester, New Hampshire; Newark, New Jersey; Albuquerque, New Mexico; New York City; Winston-Salem, North Carolina; Fargo, North Dakota; Cleveland, Ohio; Muskogee, Oklahoma; Portland, Oregon; Philadelphia, Pennsylvania; Pittsburgh, Pennsylvania; Providence, Rhode Island; Columbia, South Carolina; Sioux Falls, South Dakota; Tampa, Florida; Nashville, Tennessee; Houston and Waco, Texas; Salt Lake City, Utah; White River Junction, Vermont; Roanoke, Virginia; Seattle, Washington; Huntington, West Virginia; Milwaukee, Wisconsin; Atlanta, Georgia; Columbus, Georgia; Savannah, Georgia; Jacksonville, Florida; Pensacola, Florida; Mobile, Alabama; and Cheyenne, Wyoming.