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Recent veterans face more health problems

America's newest veterans are filing for disability benefits at a historic rate, claiming to be the most medically and mentally troubled generation of former troops the nation has ever seen.

A staggering 45 percent of the 1.6 million veterans from the wars in Iraq and Afghanistan are now seeking compensation for injuries they say are service-related. That is more than double the estimate of 21 percent who filed such claims after the Gulf War in the early 1990s, top government officials told the Associated Press.

What's more, these veterans are claiming eight to nine ailments on average, and the most recent ones over the last year are claiming 11 to 14. By comparison, Vietnam veterans are receiving compensation for fewer than four, on average, and those from World War II and Korea, just two.

It's unclear how much worse off these veterans are than their predecessors. Many factors are driving the dramatic increase in claims -- the weak economy, more troops surviving wounds and more awareness of problems such as concussions and post-traumatic stress disorder. Almost one-third have been granted disability so far.

Government officials and some veterans' advocates say veterans who might have been able to work with certain disabilities may be more inclined to seek benefits now because they lost jobs or can't find any. Aggressive outreach and advocacy efforts also have brought more veterans into the system, which must evaluate each claim to see if it is war-related. Payments range from $127 a month for a 10 percent disability to $2,769 for a full one.

The AP spent three months reviewing records and talking with doctors, government officials and former troops to take stock of the most recent veterans. They are different in many ways from those who fought before them.

More are from the Reserves and National Guard -- 28 percent of those filing disability claims -- rather than career military. Reserves and National Guard made up a greater percentage of troops in these wars than they did in previous ones. About 31 percent of recent veterans from the Guard/Reserve have filed claims, compared to 56 percent of career military ones.

More of the veterans are women, accounting for 12 percent of those who have sought care through the VA. Women also served in greater numbers in these wars than in the past. Some female veterans are claiming PTSD due to military sexual trauma -- a new challenge from a disability rating standpoint, said Allison Hickey, the VA's undersecretary for benefits.

The veterans have different types of injuries than previous veterans did. That's partly because improvised bombs have been the main weapon and because body armor and improved battlefield care allowed many of them to survive wounds that in past wars proved fatal.

"They're being kept alive at unprecedented rates," said Dr. David Cifu, the VA's medical rehabilitation chief. More than 95 percent of the troops wounded in Iraq and Afghanistan have survived.

Of those who have sought VA care:

* More than 1,600 lost a limb; many others lost fingers or toes.

* At least 156 are blind, and thousands of others have impaired vision.

* More than 177,000 have hearing loss, and more than 350,000 report tinnitus -- noise or ringing in the ears.

Thousands are disfigured, as many as 200 of them so badly that they may need face transplants. One-quarter of battlefield injuries requiring evacuation included wounds to the face or jaw, one study found.

Others have invisible wounds. More than 400,000 of these veterans have been treated by the VA for a mental health problem -- most commonly, PTSD.

Tens of thousands of veterans suffered traumatic brain injury, or TBI -- mostly mild concussions from bomb blasts -- and doctors don't know what's in store for them long term. Cifu said roughly 20 percent of active-duty troops suffered concussions.

That's still a big number, and "it's very rare that someone has just a single concussion," said David Hovda, director of the UCLA Brain Injury Research Center. Suffering multiple concussions, or one soon after another, raises the risk of long-term problems.

On a more mundane level, many veterans have back, shoulder and knee problems, aggravated by carrying heavy packs and wearing the body armor that helped keep them alive. One recent study found that 19 percent required orthopedic surgery consultations and 4 percent needed surgery after returning from combat.