By
MARILYNN MARCHIONE |
Associated
Press
America's newest veterans are
filing for disability benefits at a historic rate, claiming to be the most
medically and mentally troubled generation of former troops the nation has ever
seen.
A staggering 45 percent of the 1.6 million
veterans from the wars in Iraq and Afghanistan are now seeking compensation
for injuries they say are service-related. That is more than double the estimate
of 21 percent who filed such claims after the Gulf War in the early 1990s, top
government
officials told The Associated Press.
What's more, these new veterans are
claiming eight to nine ailments on average, and the most recent ones over the
last year are claiming 11 to 14. By comparison, Vietnam veterans are currently receiving
compensation for fewer than four, on average, and those from World War II and
Korea, just two.
It's unclear how much worse off these new
veterans are than their predecessors. Many factors are driving the dramatic
increase in claims — the weak economy, more troops surviving wounds, and more
awareness of problems such as concussions and PTSD. Almost one-third have been
granted disability so far.
Government officials and some veterans'
advocates say that veterans who might have been able to work with certain
disabilities may be more inclined to seek benefits now because they lost jobs or
can't find any. Aggressive outreach and advocacy efforts also have brought more
veterans into the system, which must evaluate each claim to see if it is
war-related. Payments range from $127 a month for a 10 percent disability to
$2,769 for a full one.
As the nation commemorates the more than 6,400 troops who died in post-9/11
wars, the problems of those who survived also draw attention. These new veterans
are seeking a level of help the government did not anticipate, and for which
there is no special fund set aside to pay.
The Department of Veterans Affairs is mired
in backlogged claims, but "our mission is to take care of whatever the
population is," said Allison Hickey, the VA's undersecretary for benefits. "We want
them to have what their entitlement is."
The 21 percent who filed claims in previous wars is Hickey's estimate of an
average for Operation Desert Storm and Desert Shield. The VA has details only on
the current disability claims being paid to veterans of each war.
The AP spent three months reviewing records and talking with doctors,
government officials and former troops to take stock of the new veterans. They
are different in many ways from those who fought before them.
More are from the Reserves and National
Guard — 28 percent of those filing disability claims — rather than career
military. Reserves and National Guard made up a greater percentage of troops in
these wars than they did in previous ones. About 31 percent of Guard/Reserve new
veterans have filed claims compared to 56 percent of career military ones.
More of the new veterans are women, accounting for 12 percent of those who
have sought care through the VA. Women also served in greater numbers in these
wars than in the past. Some female veterans are claiming PTSD due to military
sexual trauma — a new challenge from a disability rating standpoint, Hickey
said.
The new veterans have different types of injuries than previous veterans did.
That's partly because improvised bombs have been the main weapon and because
body armor and improved battlefield care allowed many of them to survive wounds
that in past wars proved fatal.
"They're being kept alive at unprecedented rates," said Dr. David Cifu, the
VA's medical rehabilitation chief. More than 95 percent of troops wounded in
Iraq and Afghanistan have survived.
Larry Bailey II is an example. After tripping a rooftop bomb in Afghanistan
last June, the 26-year-old Marine remembers flying into the air, then fellow
troops attending to him.
"I pretty much knew that my legs were gone. My left hand, from what I
remember I still had three fingers on it," although they didn't seem right,
Bailey said. "I looked a few times but then they told me to stop looking."
Bailey, who is from Zion, Ill., north of Chicago, ended up a triple amputee and
expects to get a hand transplant this summer.
He is still transitioning from active duty and is not yet a veteran. Just
over half of Iraq and Afghanistan veterans eligible for VA care have used it so
far.
Of those who have sought VA care:
—More than 1,600 of them lost a limb; many others lost fingers or toes.
—At least 156 are blind, and thousands of others have impaired vision.
—More than 177,000 have hearing loss, and more than 350,000 report tinnitus —
noise or ringing in the ears.
—Thousands are disfigured, as many as 200 of them so badly that they may need
face transplants.
One-quarter of battlefield injuries requiring evacuation
included wounds to the face or jaw, one study found.
"The numbers are pretty staggering," said Dr. Bohdan Pomahac, a surgeon at
Brigham and Women's Hospital in Boston who has done four face transplants on
non-military patients and expects to start doing them soon on veterans.
Others have invisible wounds. More than 400,000 of these new veterans have
been treated by the VA for a mental health problem, most commonly, PTSD.
Tens of thousands of veterans suffered
traumatic brain injury, or TBI — mostly mild concussions from bomb blasts — and
doctors don't know what's in store for them long-term. Cifu, of the VA, said
that roughly 20 percent of active duty troops suffered concussions, but only
one-third of them have symptoms lasting beyond a few months.
That's still a big number, and "it's very rare that someone has just a single
concussion," said David Hovda, director of the UCLA Brain Injury Research
Center. Suffering multiple concussions, or one soon after another, raises the
risk of long-term problems. A brain injury also makes the brain more susceptible
to PTSD, he said.
On a more mundane level, many new veterans have back, shoulder and knee
problems, aggravated by carrying heavy packs and wearing the body armor that
helped keep them alive. One recent study found that 19 percent required
orthopedic surgery consultations and 4 percent needed surgery after returning
from combat.
All of this adds up to more disability claims,
which for years have been coming in faster than the government can handle them.
The average wait to get a new one processed grows longer each month and is now
about eight months — time that a frustrated, injured veteran might spend with no
income.
More than 560,000 veterans from all wars currently have claims that are
backlogged — older than 125 days.
The VA's benefits chief, Hickey, gave these reasons:
—Sheer volume. Disability claims from all
veterans soared from 888,000 in 2008 to 1.3 million in 2011. Last year's
included more than 230,000 new claims from Vietnam veterans and their survivors
because of a change in what conditions can be considered related to Agent Orange
exposure. Those complex, 50-year-old cases took more than a third of available
staff, she said.
—High number of ailments per claim. When a veteran claims 11 to 14 problems,
each one requires "due diligence" — a medical evaluation and proof that it is
service-related, Hickey said.
—A new mandate to handle the oldest cases
first. Because these tend to be the most complex, they have monopolized staff
and pushed up average processing time on new claims, she said.
—Outmoded systems. The VA is streamlining and
going to electronic records, but for now, "We have 4.4 million case files
sitting around 56 regional offices that we have to work with; that slows us down
significantly," Hickey said.
Barry Jesinoski, executive director of
Disabled American Veterans, called Hickey's efforts "commendable," but said:
"The VA has a long way to go" to meet veterans' needs. Even before the surge in
Agent Orange cases, VA officials "were already at a place that was unacceptable"
on backlogged claims, he said.
He and VA officials agree that the economy
is motivating some claims. His group helps veterans file them, and he said that
sometimes when veterans come in, "We'll say, 'Is your back worse?' and they'll
say, 'No, I just lost my job.'"
Jesinoski does believe these veterans have
more mental problems, especially from multiple deployments.
"You just can't keep sending people into war five, six or seven times and
expect that they're going to come home just fine," he said.
For taxpayers, the ordeal is just beginning. With any war, the cost of caring
for veterans rises for several decades and peaks 30 to 40 years later, when
diseases of aging are more common, said Harvard economist Linda Bilmes. She
estimates the health care and disability costs of the recent wars at $600
billion to $900 billion.
"This is a huge number and there's no money set aside," she said. "Unless we
take steps now into some kind of fund that will grow over time, it's very
plausible many people will feel we can't afford these benefits we
overpromised."
How would that play to these veterans, who all volunteered and now expect the
government to keep its end of the bargain?
"The deal was, if you get wounded, we're
going to supply this level of support," Bilmes said. Right now, "there's a lot
of sympathy and a lot of people want to help. But memories are short and times
change."
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