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New veterans set record for war-disability claims

Monday, May 28, 2012 | 6:00 a.m. CDT
Matthew Saldana attends a Hiring Our Heroes job fair March 28 in Chicago. Saldana, a veteran of Iraq and Afghanistan, has been struggling to find a good full-time job since leaving the Army several years ago. He is one of thousands of vets trying to make their way in the civilian workplace at a time when job prospects are limited and the nation is emerging from its worst financial crisis since the Great Depression.

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 21 percent who filed such claims after some other relatively recent wars, 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 during the last year are claiming 11 to 14. By comparison, Vietnam War veterans claimed less than four, and those from World War II and Korea, just two. Problems can be anything from a bad back to hearing loss to post-traumatic stress disorder, or PTSD.

It's unclear how much worse off these new veterans are than their predecessors. Government officials and some veterans' advocates believe the weak economy is prompting some claims. They say 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 work.

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 and rate it as a full or partial disability.

Yet 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 under secretary for benefits for the VA. "We want them to have what their entitlement is."

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 — 43 percent of those filing disability claims — rather than career military.

More of them are women, accounting for 12 percent of those who have sought care through the VA. And some are claiming PTSD due to military sexual trauma.

The new veterans have different types of injuries than previous veterans did. Improvised bombs have been a main weapon of opposition forces, however body armor and improved battlefield care have led to many of them surviving wounds that in past wars proved fatal.

"They're being kept alive at unprecedented rates," said 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 Waukegan, 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. More than 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 more 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 Bohdan Pomahac, a surgeon at Brigham and Women's Hospital in Boston who has performed four face transplants on non-military patients and expects to start performing 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 less severe 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 an injured veteran might spend with no income.

More than 560,000 claims 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 War veterans 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 transistioning 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 already getting benefits come in to file additional claims, "We'll say, 'Is your back worse?' and they'll say, 'No, I just lost my job.'"

Jesinoski said he 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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Comments

Corey Parks May 28, 2012 | 6:49 p.m.

Being a vet my self and going through the out processes when you get back from "war" I can tell you that most of these claims are the work of administrators and VA workers briefing and recruiting Soldiers to apply. Most of the "disabilities" are hard to prove and easy to claim. Soldiers are briefed to take what you can get and the workers know that the more they sign up the better job security they have and the more money they hospitals get to care for them. It really pisses a lot of Soldiers off because you have all these non or false claims taking away from the Soldiers that are truly disabled.

(Report Comment)
Danny Haszard June 4, 2012 | 7:03 a.m.

PTSD treatment for Veterans found ineffective.
There have been a hundred or more Vets who have DIED from these 'atypical' antipsychotics being prescribed 'off-label'.
Seroquel,Risperdal,Zyprexa can cause diabetes.
I took Zyprexa Olanzapine a powerful Lilly schizophrenic drug for 4 years it was prescribed to me off-label for post traumatic stress disorder was ineffective costly and gave me diabetes.
*FIVE at FIVE* was the Zyprexa sales rep slogan, meaning *5mg dispensed at 5pm would keep patients quiet*.
*Tell the truth don't be afraid*-- Daniel Haszard -
FMI http://www.zyprexa-victims.com

(Report Comment)
Mark Foecking June 4, 2012 | 7:31 a.m.

@Corey:

I was a VA employee (Research service) for 16 years, and worked with a lot of physicians involved in patient care, and you're right - there is a high level of attempted fraud among psychiatric patients especially. I've heard patients coach each other on what to say to get benefits. To the doctor's credit, most of them know when a patient is exaggerating or faking sympytoms, but it's like anything else - persistence pays off. Keep trying, and you'll find a doctor who will approve your claim.

Most VA patients are honest, and do not malinger or exaggerate. But there's enough that do that it messes things up for everyone.

DK

(Report Comment)

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