VA Memo Orders Top Priority Given to Terror-War Veterans

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Two-tiered system of healthcare puts veterans of the war on terror at the top and makes everyone else — from World War I to the first Gulf War — "second-class veterans"

Manar and Holmes said Afghanistan and Iraq veterans deserve the best care possible, but so do all other veterans.

"All veterans are important to us, and we strive to provide the best service we can for all," said Mike Walcoff, VA associate deputy undersecretary for field operations, in a telephone interview from Washington, D.C. "However, the OIF and OEF veterans returning from Iraq and Afghanistan are going through a very difficult transition."

In his 30 years at Veterans Affairs, Walcoff said, he has not seen the kind of hiring that is now under way. Last fiscal year, which just ended, the VA hired about 1,100 people and plans to hire about 2,000 more in the coming fiscal year, officials said.

Although Veterans Affairs has been hiring more people, Manar said, it will be at least a year before the numbers make up for the normal job turnover, much less meet the increase in claims. And the time it takes to train new workers also creates a short-term problem.

"It takes three to six years before they're able to rate cases with a reasonable accuracy and a reasonable amount of production," Manar said.

On average, the training takes from 18 months to two years, Walcoff said, and "we are looking for ways to enable us to be productive faster."

Combat not required

What concerns veterans advocates most is that the priority designation isn't reserved for seriously injured combat veterans.

"All OIF/OEF claims will be given priority by (Veterans Benefits Administration) employees," the memo states. "This will allow all the brave men and women returning from the OIF/OEF theaters who were not seriously injured in combat, but who nevertheless have a disability incurred or aggravated during their military service, to enter the VA system and begin receiving disability benefits as soon as possible after separation."

Enclosures attached to the memo specify strict deadlines for handling the cases, the need to appoint staff to follow the cases and advocate for the veterans, and oversight to make sure the deadlines are being met. It states as a goal that all new claims from war-on-terror veterans should be processed within 100 days.

Average processing time now is about 183 days, according to VA officials, and the goal is 145 days.

Earlier this year, Cooper told members of the Senate Committee on Veterans Affairs that the disability claims workload was growing and becoming increasingly complex.

He said the number of first-time disability claims has grown from 578,773 in fiscal year 2000 to 806,382 in fiscal 2006, a 38 percent increase. Already, he said, 685,000 of the more than 1.45 million troops who deployed for the Bush administration's global war on terror have been discharged.

"It is expected that this high level of claims activity will continue over the next five years," Cooper said.

In recent history, the VA has consistently struggled with a backlog of claims that never seems to dip below the hundreds of thousands.

Critics have complained about the way VA is funded. The department's budget starts at zero every year and usually doesn't provide enough money for the known client population, which means VA must receive billions of dollars in supplemental funding halfway through budget cycles.

But Walcoff said the recent trends are good for veterans, noting, "The administration and Con gress have been very good to us."

Nonetheless, the backlog has continued to grow.

As of Sept. 15, more than 639,000 cases are pending at regional offices, Manar said, quoting VA figures. That doesn't include about 162,000 appeal cases and an additional 74,000 education cases, he said.

VA officials acknowledge that the backlog is growing, but they say the numbers are misleading because fewer than 400,000 claims are ratings-related. Those are the most difficult because they require documentation and medical evaluations. And even if all claims were processed as quickly as possible, about 318,000 cases would be pending at any one time because of guidelines in law meant to protect veterans, they said.

Other challenges

As Vietnam veterans — part of the baby-boom bulge — retire, Veterans Affairs will face other challenges.

Psychological studies of Holocaust survivors show that many develop symptoms of post-traumatic stress disorder after they retire, when they have time to slow down and reflect on their lives, Manar said. The same appears to be happen to Vietnam veterans.

In the past 18 months, 148,000 Vietnam veterans have gone to VA centers reporting symptoms of PTSD "30 years after the war," said Brig. Gen. Michael S. Tucker, deputy commanding general of the North Atlantic Regional Medical Command and Walter Reed Army Medical Center. He recently visited El Paso.

Tucker said he believes the VA will make the adjustments needed to meet all veterans' mental-health needs, including hiring more mental-health workers.

But a study to determine whether VA compensation can replace lost earnings indicated that veterans in the psychological trauma category "were substantially under-compensated," Manar said.

Some of the older veterans say they don't mind a triage system that puts people with the greatest need — many of whom would be recent combat veterans — at the front of the line. But they fear that the current system, which already lags in providing care, will cast them aside.

Holmes, the El Paso veterans advocate, also says war-on-terror veterans filing follow-up claims still receive priority over older veterans' first-time claims.

"They still go to the front of the line for educational needs or to add a new dependent," Holmes said. "They're (VA) trying to take away our benefits at the same time they're adding on benefits for these new people."

Ultimately, as billions of dollars flow weekly into the war in Iraq, Manar said, some hard choices must be made.

"It's going to become a bigger and bigger issue," he said of the piecemeal way VA is funded. "Money is going to get tighter and tighter. … At some point they're either going to have to bite the bullet and raise taxes, or they're going to have to cut services."

The VA has programs to put the oldest veterans at the front of the line, and it consulted veterans service organizations, including the VFW, about the decision to prioritize war-on-terror veterans, Walcoff said, adding that he welcomes their scrutiny.

"The veterans service organizations are part of a network that helps us ensure no one falls through the cracks," he said.

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