The Downhill Spiral Continues

With the number of American soldiers killed in Iraq having topped 2,000, those fortunate enough to return face the task of putting the war behind them and resuming their lives. Some are getting reacquainted with wives and children they left behind a year or more ago. Many face the task of catching up on bills or fixing homes that have gone in need of repair. Some lost jobs or had their businesses falter while they were gone. More than a few have found they have returned home with their war anxieties.

"They are witnessing far more traumatic experiences than they did in the first Gulf war," said Terri Tanielian, a senior military health policy analyst for the Rand Corporation. Longer deployments, fiercer engagements, and more casualties have left Iraq war veterans more vulnerable to psychological trauma than Gulf War veterans, Tanielian said. She said many veterans may be shunning counseling services offered by the military out of a misplaced sense of honor. "Their training is to go on with the mission and put on the brave face," Tanielian said.

A recent article in USA Today noted that more than one in four American troops have come home from Iraq with health problems that require medical or mental health treatment. According to the Pentagon's first detailed screening of service members leaving the war zone, almost 1,700 returning this year said they harbored thoughts of hurting themselves or that they would be better off dead. More than 250 said they had such thoughts "a lot." Nearly 20,000 reported nightmares or unwanted war recollections; more than 3,700 said they had concerns that they might "hurt or lose control" with someone else.

The survey results, which have not been publicly released, were provided to USA Today by the Army Center for Health Promotion and Preventive Medicine. They offer a window on the war and how the ongoing insurgency has added to the strain on troops.

Overall, since the war began, some 28 percent of Iraq veterans-about 50,000 service members this year alone-returned with problems ranging from lingering battle wounds to toothaches, and from suicidal thoughts to strained marriages. The figure dwarfs the Pentagon's official Iraq casualty count: more than 2,000 U.S. troops dead and more than 15,220 wounded as of early November. A greater percentage of soldiers and Marines surveyed in 2004-05 said they felt in "great danger" of being killed than those surveyed in 2003 after a more conventional phase of fighting. Twice as many surveyed in 2004-05 had fired a weapon in combat.

At the same time, months after VA officials told Congress that they expected the processing time for veterans' disability claims to drop, agency internal reports indicate little or no progress. Records show that the department is struggling in its attempt to reduce veterans' waiting time, in part because the productivity of VA employees nationwide is only three-quarters of what it expected. In some regional offices, it is far lower. The delays mean tens of thousands of veterans who were injured serving the country are waiting far longer to have their cases decided than lawmakers-or the VA-would like.

In March, the department came under fire from lawmakers for poor service. VA Secretary James Nicholson told Congress he expected processing times to drop to 145 days for the fiscal year, a target that had been changed from prior goals that aimed to bring the average to 100 or fewer days. For the first 11 months of the 2005 fiscal year, which ended Sept. 30, the department's average time to process disability claims was 167 days, one day slower than last year, according to a VA report obtained by Knight-Ridder. The average for August claims was 169 days.

Michael Walcoff, a top official in the VA's benefits division, said that Nicholson fully expected the department to meet its goals but that staff productivity had suffered throughout the year. "The secretary had very high expectations for us," Walcoff said. "I am concerned about productivity. I believe we have the capacity to be more productive than we have been this year."

Many claims for disability compensation, which pays veterans for injuries sustained while serving in the military, take far longer than the average. The VA report said 4,300 cases from August had taken longer than a year to decide. And while some categories of claims have shown improvement in the last two years, others showed a "marked deterioration in performance," and on balance things have not improved at all, the report said. As a result, the backlog of pending claims is rising-just the opposite of what the department had anticipated. Only last year, VA officials said the backlog should drop to 250,000 claims nationwide. Instead, it is now greater than 350,000.

The downhill spiral continues.

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