In this Nov. 8, 2007, photo, wounded soldiers involved in physical therapy wait for President Bush to visit a physical therapy lab for wounded soldiers at the Center For The Intrepid at the Brooke Army Medical Center in San Antonio. (Gerald Herbert / AP)
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What the nation owes each year to veterans who are disabled by war and service has more than doubled since 2000, rising from $14.8 billion to $39.4 billion in 2011, according to the Department of Veterans Affairs.
The toll of wars in Iraq and Afghanistan, where troops served repeatedly in combat zones, is a key contributor to escalating costs of individual disability payouts, said Alison Hickey, VA undersecretary for benefits.
"I would point first and foremost to multiple deployments," said Hickey, a retired Air Force brigadier general. "I would call it unprecedented demand."
The 3.4 million men and women disabled during their service, some of them having served in World War II, are about 15 percent of the nation's 22.2 million veterans.
The disabled veteran population has increased 45 percent since 2000 and may grow sharply with a new generation whose members seek compensation for more ailments and are savvier than their elders about their VA rights, said Hickey and veteran advocates.
"We get veterans coming in to us all the time, World War II guys or Korea (War) guys, that never filed a claim because they think they didn't deserve it," said Garry Augustine, national service director for Disabled Veterans of America.
Augustine, a Vietnam veteran, said his generation was provided little more than their separation papers when they left the service. For the past two decades, however, the VA has offered instruction about benefits to soon-to-be-separating service members. Legislative changes have made such sessions mandatory.
By November, nearly half of veterans who served during the Iraq and Afghanistan wars had filed claims seeking disability compensation, VA data show.
The average number of conditions compensated for each veteran has grown from 2.3 for the World War II generation to 3.5 for those from the Vietnam War to 6 for Iraq and Afghanistan veterans, the VA says.
About one in seven disabled veterans were rated more than 70 percent disabled in 2000; today, that ratio is more than one in four, data show. Average annual payouts per veteran have risen to $11,737 in 2011 an increase of nearly 40 percent after adjusting for inflation.
Among the most common ailments of the current generation are worn out joints, ligaments and discs in their backs and legs, much of that from carrying body armor, Hickey said. "When you're wearing it all day long, walking up and down the roads of Fallujah, Baghdad and now Kabul, that has a wear-and-tear effect."
The number and complexity of disability claims have added to a backlog of pending cases, where 70 percent have been waiting longer than four months for the VA, Hickey said.
Other reasons for rising costs:
Vietnam veterans exposed to Agent Orange or veterans diagnosed with Gulf War syndrome can be compensated for more ailments.
WWII veterans' service-related disabilities worsen with age, making them eligible for additional compensation.
A change in rules associated with post-traumatic stress disorder makes it easier for diagnosed patients to prove the need for compensation.