Already there are hundreds of thousands of men and women drawing well-deserved four-figure checks for back pain, month after month. A growing number of scholars believe that the bill for the wars in Afghanistan and Iraq will surge beyond the bill for Vietnam, despite that fact that the number of killed and wounded is much smaller.
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According to the VA's own numbers, 2.2 million men and women have served in Iraq and Afghanistan since September 11, 2001. Almost half that number — 942,000, to be exact — have done two or more tours. In McInroe's experience in Spokane, almost every veteran he spoke to who served more than one tour had back problems, just like Matthew Gonzales.
Daniel Kramer
Matthew Gonzales was once a hard-charging athlete. After two tours of duty in Iraq, he is not one anymore, and won't be again, barring medical treatment he can't afford.
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As of last year, 600,000 of those veterans had already signed up for disability payments, and according to the advocacy group Veterans for Common Sense, an average of 9,700 more were signing up every month at the end of 2011.
The complaint most commonly reported to the VA by those post-9/11 veterans is, simply put, pain. "You look at these numbers of claims, and you wonder what they all are," says Patrick Bellon, a 33-year-old Iraq veteran and the executive director of Veterans for Common Sense. "A majority of these are these sorts of back and lower-leg injuries, because it's a lot of weight and you are carrying it under very difficult conditions."
According to a report by Dr. Drew Helmer of the Michael E. DeBakey VA Medical Center in Houston, 55 percent of the patients diagnosed — 377,205 people according to this set of numbers — in VA hospitals between the first quarter of fiscal year 2002 and the second quarter of FY 2011 suffer from "diseases of musculoskeletal system/connective system."
And given the vagaries of aging, their number will continue to grow year after year, decade after decade. McInroe thinks it is a ticking money bomb.
Think about it. Veterans disability payments range in a complex matrix from $127 a month (for a 10 percent disabled vet with no dependents) up to $3,285 a month (100 percent disabled, with a family), all tax-free.
Let's just split the difference, pick a number right in the middle, say $1,500 monthly. To simplify an amazingly complicated math problem, but also to use what McInroe believes is a wildly understated number, let's round that 377,000 up to 400,000 back-injured veterans. Let's also say that they will be drawing $18,000 a year for the next 50 years. At $7.2 billion a year, that comes to $360 billion, just for the back injuries.
McInroe believes that estimate is extremely low. He believes that more and more veterans will continue to apply for and receive disability payments for back injuries, and that more and more often, those disabilities will max out at 100 percent, or $3,000 a month. In his nightmare scenario, a million men and women would be 100 percent disabled and drawing $36,000 yearly, and before the last check is set, the taxpayers will be out $36 billion a year for 50 years: $1.8 trillion.
"And that's just for compensation," McInroe adds. "That does not include medical care." Nor does it include the 45 percent of veterans disabled by other means, such as the 46,000 combat-wounded, or the 150-000-plus sufferers of PTSD.
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McInroe has been trying to publicize this issue for years, dating back to the earliest days of Operation Iraqi Freedom. Starting around 2006, he began telling his higher-ups about his findings at national conventions and such. "I was just screaming about back pain," he says. His counterparts were doing likewise. He says that word came back from Washington to shut up or get fired.
At one convention, McInroe recalls, he led a seminar at which he stressed to some trainees the severity of the back-pain epidemic. Later at the same convention, he ran into Jill Manske, then the head of the VA's social workers, informally.
"She pulls me aside in one of the hallways and says, 'Carroll, I didn't know you were gonna teach classes on back injuries!'"
McInroe reported that he believed he had no choice, as in his view it was the top problem his vets were afflicted with. "And she said, 'God, don't ever do that again. People in the central office in DC are being fired for even mentioning back injuries. The Bush White House does not even want back injuries mentioned.'"
Manske is now retired. Reached at her home in central Texas, she says she had no recollection of such a conversation ever taking place.
McInroe is undaunted by her denial. He believes that the Bush White House saw the back injuries as just one more enormous ladleful of bad news in a hellbroth that was then already boiling over. "Iraq was fallin' apart, the WMDs were never found, they hadn't caught Osama, there were all these IEDs," he says. "This was just one more thing."
Another possible reason the Bush White House might have wanted to conceal the extent of the back-injury epidemic is that it reflected an unforeseen consequence of Donald Rumsfeld's all-volunteer, lean-and-mean modern military.
In contrast with past wars, the shadow army of contractors handled the bulk of the jobs in the rear, whereas in prior wars, front-line units would occasionally rotate back for lighter duty. As one expert put it, today's soldier is "relentlessly in the field," laden the whole time with upwards of 90 pounds of gear. And as Bellon puts it, at least in Afghanistan and Iraq, the concept of a front-line/rear divide was nebulous. "When there is no rear, where are you gonna go to?" he asks.