2011 Issues   /   Trauma

Troops Severely Injured Outside of War Zones Now Eligible for Payouts

USM By U.S. Medicine
October 6, 2011

WASHINGTON — Military veterans injured between 2001 and 2005 are now retroactively eligible for traumatic injury benefits, even if they never deployed overseas to battle zones in Iraq and Afghanistan.

The benefit also applies to National Guard and Reserve members who were injured during the retroactive period and suffered a qualifying loss, even if it was unrelated to military service and occurred, for example, in a civilian automobile accident or while working around their homes.

VA has been making efforts to undo past oversights, providing retroactive financial compensation for veterans for Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) veterans who suffered traumatic injuries outside the war zone, as well as those injured by Agent Orange while serving in Vietnam.

In October 2010, President Obama signed the Veterans Benefits Improvement Act, which contains a provision allowing injuries incurred during OEF/OIF but outside a combat zone to be eligible for retroactive benefits.

Effective this month, if servicemembers have a qualifying injury or loss directly caused by a traumatic event during their service, regardless of where it happened geographically, they are eligible for large payouts through the Servicemembers Group Life Insurance Traumatic Injury Protection benefit (TSGLI). In 2005, motivated by the number of troops returning with TBIs, Congress created the TSGLI to help ease the financial burdens of traumatically injured servicemembers.

Qualifying injuries include amputations; limb salvage; paralysis; burns; loss of sight, hearing or speech; facial reconstruction; 15-day continuous hospitalization; coma; and loss of daily living activities due to TBI or other traumatic injuries. If found eligible, the TSGLI will provide payments ranging from $25,000 to $100,000, regardless of whether veterans were enrolled in TSGLI at the time of the injury.

The bill was not the first time Congress attempted to extend retroactive benefits to this group of veterans. In 2008, legislation passed the Senate that included a provision to eliminate the restrictions on benefits. However, that provision was not included in the bill passed by the House of Representatives, and never made it into law.

In 2008, the Congressional Budget Office estimated that expanding retroactive criteria would make an estimated 700 servicemembers eligible for benefits totaling $47 million.

Expanding Agent Orange Presumptions

For another type of retroactive benefit, VA has received fewer applicants than expected. More than $2.2 billion in retroactive benefits have been paid to approximately 89,000 Vietnam veterans and their survivors who filed claims related to one of three new Agent Orange presumptive conditions in the last year. This is little more than half the number of potential veterans and survivors VA estimated were eligible to apply for such benefits when regulations were amended last year.

In August 2010, VA changed regulations to add ischemic heart disease, hairy cell leukemia and other chronic B-cell leukemias, and Parkinson’s disease to the list of diseases presumed to be related to exposure to Agent Orange. VA has estimated this could result in payouts of as much as $42 billion in the first decade.

The change in regulations came after years of lobbying by veterans service organizations (VSOs), who argued that the effects of Agent Orange were wider and more varied than previously assumed, and an Institute of Medicine (IoM) report indicating an association between certain herbicides and these three conditions.

For new claims, VA may authorize up to one year of retroactive benefits if a veteran can show that he or she has experienced one of those conditions since the date of the regulatory change. VA has also reviewed, and continues to review, thousands of previously filed claims that may qualify for retroactive benefits under a long-standing court order of the U.S. District Court for the Northern District of California in Nehmer vs. U.S. Veterans Administration. The judge in that case ruled that whenever VA issues new determinations designating particular diseases as service connected, it must readjudicate all claims of veterans whose related claims were denied or are still pending.

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