Afghan returnees find Veterans Affairs a formidable foe

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Jayson Nickol had his femur shattered two years ago by an insurgent’s AK-47 bullet in Afghanistan.

OTTAWA -- Jayson Nickol hasn't yet seen his 30th birthday but thanks to a five-month tour in Afghanistan he is already suffering from arthritis and chronic pain.

The 26-year-old Glenlawn Collegiate grad was shot by an insurgent wielding an AK-47 in June 2008. The bullet shattered his right femur.

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Nickol works on his claim with no help from Veterans Affairs. (PHIL HOSSACK / WINNIPEG FREE PRESS)

More than two years later, the injury has not fully healed and his doctors say it's unlikely he will improve much more.

For Nickol, the physical recovery is not the only struggle in his post-Afghanistan life.

The fight with Veterans Affairs Canada for disability pay related to his injury is as big a battle and far more frustrating.

"I'm more stressed about that than I was about getting shot," Nickol said. "The military has been pretty good about everything. Veterans Affairs Canada is a different story."

Nickol's injury resulted in three bone grafts, two surgeries to implant and then replace a rod in his leg, months of physical therapy, weeks in the hospital, and an end to the lifelong military career he once envisioned. He has developed arthritis in his hip and knee as his body compensates for the injured thigh bone.

"I come home at night and hobble around my house, pop a Tylenol 3 and go to bed," he said.

Nickol is one of more than 2,700 Afghanistan veterans receiving disability for injuries or illnesses associated with service in the war on terror.

That war -- triggered by the attacks on the United States nine years ago today -- has seen Canada deploy over 35,000 soldiers to Afghanistan for at least one tour each. Many have been multiple times.

It is a population of people nearly the size of the city of Brandon, mainly 20- and 30-somethings who will face health issues at rates far higher than the national average.

Veterans ombudsman Pat Stogran, a former commander from Afghanistan, said this country is not prepared to deal with their problems.

"We have this fixation on World War II and Korean War vets," said Stogran. "They have not taken into account the coming tsunami of stress injuries, traumatic brain injuries, amputations and so on that are associated with modern combat."

Stogran said if Canada doesn't step up its efforts to determine the needs of the modern-day veterans and implement the programs to help them, it could be catastrophic.

"It's a recipe for disaster much the way the Americans treated their Vietnam vets," said Stogran.

The Canadian military will only release the figures for soldiers wounded in Afghanistan at the end of each calendar year, fearing reporting injuries as they happen will give the enemy powerful information. As of Dec. 31, 2009, 1,442 Canadians were injured in Afghanistan and 138 had been killed. It's now 151. Of the injured, 913 injuries were sustained in non-battle incidents such as traffic accidents, accidental weapon discharges and illness. There were 529 soldiers wounded in battle.

Veterans Affairs Canada reports 2,726 soldiers from Afghanistan have been approved to receive a disability pension or award for an injury or illness suffered while or as a result of serving in Afghanistan. As more claims arise for longer-term problems -- including mental health disorders -- that number will grow significantly, said Stogran.

Veterans Affairs Minister Jean-Pierre Blackburn acknowledges the Afghanistan veterans pose a unique challenge for his department, which has until Afghanistan focused mainly on veterans who served decades ago in the Second World War and Korea.

"Modern veterans, their needs are different from veterans of the world wars or the Korean War," said Blackburn.

He noted while the majority of VAC clients are seniors, Afghanistan's veterans are younger and they have their entire lives ahead of them.

"They aren't sitting at home waiting for the end of their life," he said. "They want to be active in the world."

He said the department is in the midst of finalizing a report on how to update its technology to better handle the needs of modern veterans. He also said the new Veterans Charter was implemented with the modern-day soldier in mind.

The charter took effect April 1, 2006. Blackburn says it sees financial aid for veterans as a means to getting them as active as possible in society. Training them for the workforce, helping them find jobs, rehabilitating them so they can return to active civilian life.

But Stogran said the charter is about the bottom line, cutting long-term funding for disabled veterans to help balance the books.

Before April 1, 2006, veterans on disability received a monthly pension based on the extent of their disability. At 2010 rates, that monthly pension for Nickol -- who is married and whose injury is currently assessed at a 10 per cent disability -- would have been $299.73 a month. Not indexing for inflation, paid monthly until he turns 65, his payments from VAC would have exceeded $140,000. If he and his wife have children, his monthly pension would go up slightly each month for each child, amounting to several thousand dollars more over his lifetime.

But Nickol's injury occurred after April 1, 2006, meaning he qualified under the charter not for a monthly pension but for a lump-sum, tax-free, disability award of about $27,000.

Even taking into account the taxes he would pay on the monthly pension, the monthly long-term pension would far exceed the tax-free lump-sum payment he was given.

According to the VAC, 1,718 clients are receiving the earning loss benefit with an average annual payout of $16,500. Uptake on the other programs is small.

Stogran is also incensed that the government has done no research to determine the mental health needs of returning soldiers, or the impacts of traumatic brain injuries. Nor has there been anything done to consider that modern medicine allows more soldiers to survive injuries than in previous wars, meaning the percentage of Afghanistan veterans who will need support is much higher than it would have been for veterans of previous conflicts.

"For every person killed by an (improvised explosive device) there are probably eight to 10 others who were in the vicinity," said Stogran. "The magnitude of the problem is going to be much bigger than the department (of Veterans Affairs) is prepared to admit."

Veterans Affairs lists post-traumatic stress disorder (PTSD) as the fourth-highest reason for a disability claim since 2006. Anxiety disorders are seventh on the list of the top 10 most common reasons for a disability claim.

In 2008, a U.S. study found one in five soldiers who had served in Afghanistan or Iraq had post-traumatic stress disorder. Other estimates suggest as many as seven per cent of soldiers who have been at war will develop PTSD, 4.5 per cent will develop anxiety disorders and 13 per cent will experience depression.

If those estimates are correct, one in every four of the soldiers who have been in Afghanistan will have a mental health issue that could affect his or her ability to work and live a normal life post-war.

The Departments of National Defence and the VAC don't cross-check their lists for injured soldiers and soldiers receiving a disability payment. But if 1,442 Canadians were physically injured in Afghanistan but 2,726 are receiving disability benefits, it's not a stretch to believe more than 1,200 soldiers may have made claims for mental health issues.

Blackburn acknowledges the mental disorders are an issue his department must address better and pointed to an expansion of operational stress injury clinics and a new in-patient clinic at Ste. Anne's Hospital outside Montreal.

"This is a new reality for our soldiers," said Blackburn. "We need to deliver more support for those people."

Stogran, however, calls that clinic borderline useless because the criteria for admission is so steep most of its 10 beds are often empty. Since February 2010, 21 soldiers have been admitted, according to the VAC.

mia.rabson@freepress.mb.ca

Republished from the Winnipeg Free Press print edition September 11, 2010 A6