Comment on AO51-Proposed Rule-Vines, Brannan P.

With the high incidence of PTSD (post traumatic stress disorder) and TBI (traumatic brain injury) among Veterans of recent combat service in Iraq and Afghanistan - as well Veterans who have served in earlier eras - this proposed rule is very much needed. Veterans with psychological or neurological injuries are more likely to miss appointments, either simply because the appointment is forgotten or because current psychological symptoms prevent the Veteran from leaving home / traveling / facing a crowded facility, etc. In order to continue building and maintaining the relationship needed between Veterans and the VA for effective care - not to mention the bonds needed with the Veteran's family support system or caregiver(s) - barriers to care such as the current penalty must be removed.