Gulf War Vets See VA Hospitals as a Sore Point

Army reservist Dana E. Berrier was not exactly given a heroine’s welcome when she appeared at the local veterans hospital here four years ago complaining of skin scabs, stomach problems, memory loss and fever that she believed stemmed from her service in the 1991 Persian Gulf War.

After an initial exam, Berrier says, she was sent to a psychiatrist who told her she could not stay at the clinic unless she agreed to therapy. Her records were lost. And she had to wait 10 months on a claim for special medical benefits, which later were denied.

“Lots of doctors didn’t want to give me the time of day,” Berrier recalled. “Basically, their attitude was: ‘Yeah, you got this in Saudi Arabia--right!’ They said it was all psychological--probably just stress.”

Berrier’s experience may not be the norm for Persian Gulf veterans seeking help from the Department of Veterans Affairs. But those who have dealt with VA hospitals across the country say it is not that unusual either.

This has made the hospitals a point of friction in the debate over “Gulf War syndrome,” even as an array of official panels press toward addressing the veterans’ plight. Allaying the bedside conflicts may be necessary before many veterans see the government as an ally rather than an adversary in the high-profile effort.

In Washington, VA officials point to a long list of efforts to help veterans who say they are suffering from the ailment: from free physical exams and fast-track procedures for follow-up care to special centers for difficult cases.

But interviews with some Gulf War veterans show that many have had to put up with long delays for care, bureaucratic mix-ups, difficulty in obtaining follow-up treatment and rigid restrictions on qualifying for medical and disability benefits.

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“Every veteran I have spoken to who has gone to the VA has been dissatisfied,” said Scott Vanderheyden, a spokesman for Vietnam Veterans’ Agent Orange Victims, a group that has taken an interest in obtaining care for Gulf War veterans as well.

Dr. Katherine Murray Leisure, who heads the Lebanon VA hospital’s Gulf War clinic and has become a favorite of many veterans as a result of her work on their behalf, agrees that in too many cases the veterans have been treated shabbily.

“They get word from Washington telling them about all the programs for Persian Gulf veterans, but the reality is that . . . they have a hard time,” Leisure said. “The veterans come in very angry, and I can’t blame them.”

Part of the problem may be the VA bureaucracy, not known for its efficiency. Some stems from the difficulties of creating a good doctor-patient relationship around an ailment with no known cause or cure.

Despite massive clinical studies involving more than 80,000 veterans who served in the Gulf War, VA and Pentagon physicians still have no firm explanation for the ailments. Although many veterans suffer from the same basic symptoms--23 separate ailments ranging from memory loss to joint aches--physicians say each can be caused by a wide range of factors not necessarily related to service in the Persian Gulf.

Moreover, the federal studies suggest that while the symptoms are genuine, some may not be more prominent in Gulf War veterans than in the population as a whole.

But what galls veterans most is the suggestion, which they say is proffered by many VA physicians, that the symptoms most likely are stress-related or psychosomatic.

“This is very real--there’s nothing that’s in anybody’s head,” Berrier said. “When I hear that, it really makes me mad.”

Also infuriating is the idea that the military that pronounced them in tip-top shape before they deployed is so clearly skeptical about the source of their problems since they returned.

Arquelio Martinez, a former National Guard staff sergeant, says the VA refused to acknowledge that his ailments were “service connected”--a key in qualifying for free medical care--despite assertions by a private physician that they stemmed from his time in the Persian Gulf.

But there also have been other difficulties for the Gulf War veterans to surmount.

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A recent inspection tour by members of the Presidential Advisory Committee on Gulf War Veterans’ Illnesses found that at many VA hospitals, the waiting times were long and the hospital staffs were often misinformed about policies affecting Gulf War veterans.

Chris Kornkven, a Watertown, Wis., veteran who served with the 304th Combat Support Company, says he had to wait more than five months to get an initial exam and several more months before he was able to obtain diagnostic tests.

While VA officials in Washington boasted about having designated special Gulf War clinics, Kornkven says he never did get to see a Persian Gulf specialist. The tests he was promised at a VA center in Houston were never performed. And there was little follow-up care.

Kornkven also tells of months-long snafus over billing procedures, in which VA officials battled with his private insurance company, leaving him in the middle. “It’s real hard to describe what happens day-to-day when you go to a VA hospital,” he said.

Not everyone qualifies for free medical care from the VA. To do so, veterans either must prove that their ailments are service-connected or that they are too poor to pay for the treatment. Most veterans have to pay cash or use their private health insurance.

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Congress recently eased some restrictions to make it easier for Gulf War veterans to qualify if they reported their symptoms before March 1993, two years after the war ended. But many still miss out because their ailments did not show up until later.

Veterans also complain that it is difficult to win VA approval of applications for free care or disability payments. They say even when an ailment would seem by its nature to be clearly linked to Gulf War service, the VA is reluctant to declare a connection--a prerequisite for such awards.

Veterans and their advocates say only 5% of the Gulf War veterans who apply are approved for disability compensation--and only after a complex “adjudication” process that often takes up to a year.

VA officials say the 5% figure applies only to a group of about 10,000 veterans whose illnesses VA physicians have been unable to diagnose. When the total includes Gulf War veterans whose symptoms have been diagnosed, the approval rate for disability payments is 30%.

Finally, veterans complain that the VA has not been very receptive to the dozen or so private physicians--and a handful inside the VA--who have criticized the VA’s studies or have put forward unconventional theories about what may be causing Gulf War ailments.

Leisure, for example, contends that the symptoms most likely were caused by infectious microorganisms present in the sand. Military investigators are probing possible exposure to chemical warfare agents.

Although the VA has conducted seminars for its physicians, Leisure and a few other VA doctors say higher-ups have been unreceptive to any input from outside Washington. “The [Veterans] Administration doesn’t want to recognize this,” she said of her work.

But not all Gulf War veterans are down on the VA’s actions.

Barry S. Kapplan, an ex-Army helicopter pilot from Connecticut who has been critical of the Pentagon’s handling of the Gulf War issue, says VA facilities he has dealt with have done all they could for him.

“Some things they are not going to be able to fix,” Kapplan said. “But they are doing the best they can.”

VA officials concede that there have been problems with ill-informed bureaucrats and insensitive physicians, but they add that the situation is improving.

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The recent Pentagon acknowledgment that some troops may have been exposed to chemical nerve agents while blowing up Iraqi ammunition bunkers at Khamisiyah in March 1991 appears to have had an effect on the VA’s perception of the overall problem.

Dr. Fran Murphy, one of the top VA officials involved in the Gulf War veterans’ program, says that some veterans are frustrated because doctors seem to be knocking down their individual ideas on what may have made them sick--such as inhaling fumes from a burning oil well--while offering none of their own.

“I think we need to spend a little bit more time, be more patient to try to explain this issue to veterans,” she conceded.

Officials say the VA is preparing to take a second look at the cases of some veterans who believe that their applications for medical benefits or disability compensation have been unjustly rebuffed.

“I would encourage any veteran who has had a bad experience early on to come back and try again,” Murphy said, adding that “we are much better informed” now than several years ago.

Meanwhile, Gulf War veterans groups plan to press Congress to do the same thing for them that it did for Vietnam War veterans who contend they were harmed by the Agent Orange defoliant used by the military--to liberalize standards so that virtually any reasonable claim is paid.

Berrier, whose ailments forced her to go on leave without pay from her civilian job, and other Gulf War veterans who believe that their ailments stem from their experiences in the Saudi and Iraqi deserts, say that cannot come too soon.