CHICAGO — In a sobering reminder of the long-term costs of war, a dramatic spike in disability claims during the last seven years has overwhelmed the U.S. Department of Veterans Affairs and nearly doubled the cost of compensating wounded veterans, according to an unprecedented Chicago Tribune analysis.
The bulk of the increases didn't come from veterans of the current wars in Iraq and Afghanistan but from those who served years or even decades before. Veterans from the Vietnam and Persian Gulf eras accounted for roughly 84 percent of the rise in spending, which hit $34.3 billion last year.
The surge from past eras comes even as more soldiers than expected are returning home from Iraq and Afghanistan in need of care. With hundreds of thousands of troops still deployed, the VA already provides disability payments to nearly 200,000 veterans from the current conflicts.
The unanticipated crush of claims is exacerbated by the VA's antiquated compensation system, which hasn't been overhauled since 1945. Cumbersome and heavily bureaucratic, the system requires a mountain of paperwork, is based on diagnoses that lag far behind medical advances and runs on a computer system that is so outdated it can't accurately verify whether veterans were deployed.
The problems have led to a backlog at of least 500,000 claims — some veterans groups say it's as high as 1 million — that threatens the well-being of veterans with ailments ranging from brain injuries and back problems to cancers and mental disorders.
The Tribune's analysis of 200,000 claims in the backlog shows that nearly half take longer than 120 days, with thousands of claims languishing for two years or more. The compensation process entails so much paper that many claims have been misplaced or even accidentally shredded by employees.
Among the findings from the Tribune's analysis of more than 3 million disability claims approved by the VA:
• By the end of 2009, more than 3 million veterans were receiving compensation, a 24 percent increase since 2003. The total costs, meanwhile, grew from $19.5 billion to more than $34 billion.
•The psychological toll of war now accounts for more than a third of the $24 billion spent last year compensating veterans from the Vietnam, Persian Gulf and "global war on terror" eras, more than any other category. Yet studies have shown that the current system is ill-equipped to handle claims related to post-traumatic stress disorder and other conditions, adding to delays and forcing veterans into the even lengthier appeals process.
• The unpredictability of war has led to devastating illnesses that cost U.S. taxpayers billions every year. By the end of last year, more than 300,000 Vietnam-era veterans were receiving nearly $2 billion in disability payments for illnesses associated with Agent Orange and other dioxin-laden herbicides. Those costs are expected to increase by billions of dollars as the VA expands the list of illnesses associated with the chemicals.
The result is that some who have "borne the battle" die before their claims are processed while others are shortchanged by a system that wasn't built to deal with wounds veterans face today.
"Are we appropriately compensating veterans? The answer to that is really no," said Lonnie Bristow, a former president of the American Medical Association. "It's not for a lack of good intent; it's because they are using a screwdriver and hammer to make a jet fighter."
But some of the issues facing the VA lie outside the agency's control, the Tribune found.
Disability payments for veterans of the Vietnam era, which ended 35 years ago, cost the VA $15 billion in 2009 alone. That price tag, which doesn't include the cost of providing health care, is expected to continue climbing during the next 15 years. Experts now say the cost of compensating Vietnam veterans eventually will surpass the cost of actually fighting the war.
Lawmakers rarely take such costs into consideration when determining war funding. Since 2001, Congress has approved $944 billion to fund the global war on terror, and less than 1 percent was set aside to care for veterans, according to the Congressional Research Service.
From the beginning of the current wars, the Bush administration woefully underestimated the number of veterans who would seek disability compensation.
When U.S. forces invaded Iraq in March 2003, officials estimated that about 50,000 soldiers fighting in Iraq and Afghanistan would eventually seek disability benefits from the VA. Seven years later, about 500,000 veterans from those wars have put in claims, and the VA already provides more than $1 billion in compensation benefits to 180,000.
Where broken bones and bullet wounds once dominated the VA's compensation system, veterans like Mario Cifuentes are fueling it today with invisible ailments that affect their ability to work, maintain relationships and adjust to civilian life.
Cifuentes, a machine-gunner with the Army's 2nd Infantry Division, returned from the Iraq war with hearing loss after spending 15 to 18 hours a day patrolling the streets of Baghdad and searching homes of suspected insurgents for weapons.
He began receiving disability benefits, but soon realized that hearing problems weren't his only problem. He started having horrific nightmares of being blown up or shot by a sniper.
Six months later, Cifuentes put in a claim for post-traumatic stress disorder, or PTSD. He spent about an hour with a VA therapist who told him he had mild anxiety disorder, he said. The VA upped his compensation as a result.
The volume and complexity of claims flowing into the VA's antiquated system has left thousands of veterans stranded and, in some cases, is driving away veterans who need help.
Cifuentes says he still suffers from PTSD symptoms but isn't planning to fight with the VA for help with that particular issue.
"They say I need more evidence," he said. "But it gets old. I don't like talking about it."