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Thursday, June 5, 2014

VA's Unacceptable 80 Percent Denial Rate of Gulf War Illness Claims - What's behind the numbers

(91outcomes.com - June 5, 2014) - A Military Times article today cites VA data showing the U.S. Department of Veterans Affairs (VA) has denied nearly 80 percent, or four out of five Gulf War Illness disability claims denied. [1]


Today's breaking news article also shows more than half of veterans denied for Gulf War Illness claims have been approved by VA for other conditions, demonstrating a VA bias against approving Gulf War Illness claims long alleged by ill Gulf War veterans.  


A full 38 percent (38%) of veterans filing Gulf War Illness claims had their claims denied entirely, both for Gulf War Illness and other conditions.
The explosive new report comes on the heels of another Military Times article in April that revealed VA Undersecretary for Benefits Allison Hickey meddling in Gulf War Illness research -- far outside of her benefits lane -- by attempting to quash an Institute of Medicine recommendation to call the condition "Gulf War Illness".  
According to the leaked email revealed in the April Military Times article:
"Hickey 'was concerned that changing the name from CMI to GWI might imply a causal link between service in the Gulf and poor health which could necessitate legislation for disability compensation for veterans who served in the Gulf'." [2]
While the average combined disability rating among all newly approved VA disability claims is estimated to be between 30 and 40 percent, the average combine rating for the approved Gulf War Illness claims was 67 percent, suggesting a high level of overall disability among veterans claiming Gulf War Illness.   

Research reports from the Institute of Medicine (IOM) and the Research Advisory Committee on Gulf War Veterans' Illnesses (RAC) have reported on research studies that have consistently shown high rates of Gulf War Illness symptoms among veterans of the 1991 Gulf War.

Comparison to Other VA Claims Approval Rates

In comparison with VA's nearly eighty percent (80%) denial rate of Gulf War Illness claims, VA denies Global War on Terrorism (GWOT) veterans' claims at a rate of less than two percent (2%).  

According to VBA data obtained from Veterans for Common Sense through the Freedom of Information Act (FOIA), VA's approval rate of GWOT veterans' claims is 98.3% (842,939 approved out of 940,503 total GWOT claims decided).  Less than two percent (14,990, or 1.7%) were denied by VA.   [162,066 GWOT claims remained pending, many part of the VA claims backlog].  [3]

This less than two percent (2%) denial rate of Global War on Terrorism (GWOT) claims stands in sharp contract to VA’s nearly eighty percent (80%) denial rate of Gulf War Illness claims publicly reported today.


VA Hiding Gulf War Data that was Formerly Released Quarterly


Formerly, VA publicly released the data on Gulf War veterans' claims on a quarterly basis.  

The data cited in today's Military Times Article was obtained by the media from an unnamed Congressional office.  The GWOT data provided above was received from Veterans for Common Sense through a Freedom of Information Act request.   

For years, VA formerly published the "Gulf War Veterans Information Service" (GWVIS) reports quarterly.  

Inexplicably, VA replaced these effective reports with the "Pre-9/11" report. The VA Research Advisory Committee on Gulf War Veterans' Illnesses (RAC) authored comprehensive recommendations on the report. VA failed to respond, and then simply stopped making the reports public: http://www1.va.gov/RAC-GWVI/recs_for_GWpre911_report2.doc

Testimony before a House Veterans' Affairs Subcommittee hearing on Gulf War issues on March 13, 2013 revealed that VA had stopped releasing its Gulf War data reports entirely:

"Claims. After a complete overhaul, VA has now apparently ceased publishing its data report on Gulf War veterans. The report was formerly published quarterly; VA has failed to published any further reports since February 2011. These reports are important for identifying approval rates of VA claims, among other issues. 

It remains unclear if VA is still creating these reports for internal use, or has replaced them with something new.  


Next Steps

In order to restore transparency, and the public's faith in the agency, VA must return to regularly publishing clear and comprehensive data reports on all its operations. 



***


Key findings

  • Nearly 80% Gulf War Illness Claims Denial Rate.  Of 54,193 Gulf War-related Illness claims filed with VA, four out of five – nearly 80 percent (80%) – were denied.
  • 52% of the denied for something else.  A full 52 percent of the denied Gulf War Illness claims were approved by VA for something else, implying a VA bias against approving Gulf War Illness claims. 
  • 38% denied for everything.  A full 38 percent (38%) of veterans’ claims for Gulf War Illness were had their claims denied entirely, both for Gulf War Illness and other conditions, which stands in stark contrast to the 2% denial rate of GWOT veterans' claims.


By the Numbers:
  • 696,842 Gulf War Veterans:  The total number of veterans deployed to the Persian Gulf theatre of operations during the 1991 Gulf War.
  • 54,193 GWI Claims:  The number of Gulf War-related Illness (“Gulf War Illness”) claims veterans have filed with VA, to March 2014.  [VA notes this figure represents original claims for service-connection; it does not include reopened claims or claims for an increased disability rating.]
  • 11,216 Approved:  The number of Gulf War Illness claims that VA granted.  [VA notes that due to data limitations, this figure does not include some Veterans who have been granted service connection on a direct basis (meaning that the disability became manifest during active service) rather than under the provisions of 38 C.F.R. § 3.317.]
  • 42,977 Denied: The total number of Gulf War Illness claims VA has denied.
  • Just over 20% Approved:  The percentage of Gulf War Illness claims that VA granted (11,216 approved out of 54,193 filed = 20.7%). 
  • Nearly 80% Denied:  The percentage of Gulf War Illness claims VA has denied (42,977 denied out of 54,193 filed = 79.3% denial rate). 
  • 22,470 Approved for Something Else:  The number of veterans filing GWI claims whose GWI claims were denied but VA approved their claims for some other condition.
  • 42% Denied for GWI but Approved for Something Else: The percent of veterans filing GWI claims whose GWI claims were denied but VA approved their claims for some other condition (22,470 approved for something else out of 54,193 total GWI claims filed = 41.5%).
  • 52% of the Denied were Approved for Something Else:  The percent of denied GWI claims approved for some other condition.    (22,470 approved for something else out of 42,977 denied GWI claims = 52.3%)
  • 20,507 Denied for all Conditions.  The number of veterans filing GWI claims who were both denied for GWI and not receiving compensation for other conditions.  (54,193 GWI claims filed minus 22,470 claims approved for something else = 20,507)
  • 38% Denied for all conditions:  The percent of all GWI claims filed that were denied for GWI and also not receiving compensation for other conditions (20,507 denied out of 54,193 = 37.8%)
  • 67% Average Disability Rating:  The average disability rating granted by VA for Gulf War Illness claims filed.    



-Anthony Hardie, 91outcomes.com 

***
SOURCES:
[1] Kime, Patricia, VA denies 4 in 5 Gulf War illness claims, new data showMilitary Times, June 5, 2014:  http://www.militarytimes.com/apps/pbcs.dll/article?AID=2014306050064
[2] Kime, Patricia, Top VA official questions use of term 'Gulf War illness': Undersecretary for benefits said name change would be 'limiting', Military Times, April 22, 2014:   http://www.militarytimes.com/apps/pbcs.dll/article?AID=2014304220036
[3] U.S. Department of Veterans Affairs, Veterans Benefits Administration, VA BENEFITS ACTIVITY: VETERANS DEPLOYED TO THE GLOBAL WAR ON TERROR: VBA Data Through Dec 2013, DMDC Data Through Oct 2013, http://www.scribd.com/doc/228350749/GWOT-Report-Dec-2013-Final
***
Additional notes:
1) Conservative estimates by the Institute of Medicine, part of the National Academy of Sciences, are that more than 250,000 of the roughly 697,000 veterans of the 1991 Gulf War are suffering from chronic multi-symptom illness issues that we (and now the IOM) calls Gulf War Illness.  Countless reputable peer-reviewed medical studies have determined rates of Gulf War Illness in 1991 Gulf War veterans to be between 25-34% in excess.  Based on those facts alone, GWI claims should be far, far higher.

Of note for those who aren't as familiar and have mistaken beliefs about this very real medical condition that affects more than one in three veterans of the 1991 Gulf War according to the IOM and the federal government, Gulf War Illness has been fully recognized for years by science and government, as has multiple sclerosis (MS, once thought to be witchcraft or female mental weakness), ALS (once thought to be demonic possession), stomach ulcers caused by H. Pylori bacterial inception (once thought to be caused by "stress"), etc.  Again, claims approval rates should be far higher.

2)  The point of posting OIF/OEF claims approval rates is to demonstrate clear comparisons:  1) VA does not deny "most" veterans' claims at all.  2) VA denies Gulf War Illness claims at astronomical rates.  3)  Statistically speaking, any kind of issues that are across the board for all veterans and are not specific to any particular war, era, or cohort -- such as fraudulent claims, poorly developed claims, etc., should be at relatively similar rates across all veteran cohorts. In this case, there is such a radical difference in approval rates, which is why this is making national news.

3)  It is worth noting that VA refused to respond to this reporter's request for additional information.  Here's more from the House Veterans' Affairs Committee on VA's stonewalling of the media and the public:  http://veterans.house.gov/VAHonestyProject

4)  The claims rates in this article are not all claims filed by all 1991 Gulf War veterans – they are solely Gulf War Illness claims.  

5)  PTSD claims are not included in the statistics in this article.  For GWOT veterans, as of Dec. 2013 VBA data, 1 in 4 of the total number of awarded GWOT claims included granting a claim for PTSD  (212,485 PTSD granted out of 842,939 total granted). 

6)  The Military Times article doesn't include that the average approval rate for these Gulf War Illness claims is **67%**.  As the IOM and other federal and scientific research and reports have consistently shown for nearly two decades, Gulf War veterans with Gulf War Illness are pretty frequently very bad off.  This average is also far higher than the typical VA claim approval rate of between 30 and 40 percent. 

7)  It is troubling to note, as does the article, that 52% of those denied for Gulf War Illness were approved for other things.  From the original VA memo to the Congressman, from which this story was drawn, "Of the 42,977 Veterans denied service connection for GWI, 22,470 (52%) are receiving compensation for other service-connected conditions."


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