Department of Veterans Affairs benefits officials in Waco have denied a whopping 92 percent of claims related to Gulf War illness, giving Central Texas veterans one of the highest denial rates in the nation, according to data in a recent U.S. Government Accountability Office report.
The report found serious and persistent problems with how the VA handles the complicated Gulf War benefits claims, ranging from poorly trained examiners to inconsistent methods of handling claims in different regions of the country. For example, in the continental United States denial rates ranged from 47 percent in Boston to 95 percent in Roanoke, Va., according to an analysis by the advocacy group Veterans for Common Sense.
The VA estimates that 44 percent of the 700,000 service members who served in the 1990-1991 Persian Gulf War have developed such symptoms as joint pain, chronic fatigue syndrome and neurological problems after returning home from war. The illnesses are believed to have been caused by exposure to toxic elements like smoke from burning oil wells, depleted uranium and chemical warfare agents such as mustard gas.
Nationally, the VA denied 87 percent of Gulf War illness related claims in 2015, the most recent year data was available, a denial rate that has increased over the past five years. For all other claims, the VA denied disability claims at a rate of 43 percent.
“(Gulf War illness) disability compensation claim laws and regulations need urgent overhaul,” said Paul Sullivan, director of veteran outreach for the Bergmann and Moore law firm and a Gulf War veteran whose own Gulf War claim remains in limbo after 25 years. “The issue of GWI claims is here to stay for several more decades. As Gulf War veterans age, we will file more claims … because our conditions continue manifesting and worsening, thus revealing the true long-term cost of war and toxic exposures on our health.”
Veterans and advocates fought for years to convince the VA to recognize Gulf War illness and compensate veterans suffering its effects. But while the VA has taken some steps to expand eligibility for compensation, experts say the department continues to make it unduly difficult to file and win a benefit claim.
Advocates concede that Gulf War illness claims are among the most difficult claims that VA examiners encounter. According to Michael Figlioli, deputy director of Veterans of Foreign Wars, Gulf War illness is “intrinsically difficult to diagnose and treat. … (There is) no one distinctive set of symptoms that allow for a single, unmistakable diagnosis.”
The clinical names for the two main categories of Gulf War illness reflect that uncertainty: Medically Unexplained Chronic Multisymptom Illness and Undiagnosed Illness.
Even so, government investigators found that the VA does a poor job educating medical examiners charged with identifying the illness.
GAO investigators found confusion among VA medical examiners and said that as of February, just 10 percent had taken an optional, 90-minute web-based training course. “At the same time, several VA staff noted the complexity of Gulf War illness claims and some medical examiners stated they would benefit from additional training on Gulf War illness and how to conduct these exams,” the GAO found.
In response to the report, the VA said it would make the web training mandatory and aim to get examiners trained by November.
A VA spokeswoman said all examiners in Waco are “anticipated” to complete the training by then.
Anthony Hardie, a Gulf War veteran and director of Veterans for Common Sense, said it was troubling that the six offices that handled the most Gulf War claims, including Waco, also are the least likely to approve claims. Hardie told a congressional committee last week that he believes the VA might be funneling cases from across the country to those offices.
“A cynical person might conclude this consolidation of (Gulf War illness) claims processing to high-denying offices was intentional,” he said.
But Jessica Jacobsen, a VA spokeswoman in Dallas, said that in 2015 the Waco office only handled local cases.
Lack of a definition
One roadblock to better claims processing, the VA and critics agree, is the lack of a clear definition.
In 2014, the VA spent $2 million to fund an effort by the Institute of Medicine, now known as National Academy of Medicine, to come up with a single case definition of Gulf War illness, but researchers were unable to do so, citing a lack of evidence in studies.
The VFW has pushed for examiners to stop concentrating on individual symptoms and instead focus on clusters of symptoms that, taken together, paint a picture of Gulf War illness.
Hardie said the way the VA now handles claims of post-traumatic stress disorder and traumatic brain injury, which are likewise made up of a constellation of symptoms that can be difficult to diagnose, could provide a model.
Responding to pressure from veterans groups and lawmakers, the VA has made it easier for Iraq and Afghanistan veterans to obtain benefits related to PTSD and TBI and last year took the extraordinary step of offering new TBI exams to 24,000 veterans who had been denied disability compensation between 2007 and 2015.
Hardie said the current TBI rating system, which uses “buckets” of symptom sets scored for varying degrees of severity, could be a road map for future Gulf War illness claims processing.
Lawmakers say they will continue to push the VA to correct issues with Gulf War illness claims.
During a hearing last week, U.S. Rep. Mike Bost, R-Ill., a member of the House Veterans subcommittee on Oversight and Investigations, noted the discrepancy in the number of Gulf War veterans with successful claims. While an estimated 44 percent of service members developed Gulf War illness symptoms, just 26 percent receive benefits.
“Something does not add up,” he said.
VA denial rates
Among the six VA benefits offices that handled at least 1,000 Gulf War-related claims in 2015, the Waco office had the fourth-highest denial rate. The national average was 87 percent.
• Roanoke, Va.: 95% (of 2,124 total claims)
• Muskogee, Okla.: 94% (2,431)
• Atlanta: 93% (1,339)
• Waco: 92% (1,088)
• Columbia, S.C.: 90% (1,130)
• Nashville, Tenn.: 83% (1,763)