From the U.S. Government Accountability Office, www.gao.gov Transcript for: VA Processing of Gulf War Illness Claims Description: VA estimates that 44 percent of veterans who served in the Persian Gulf War in 1990-91 have Gulf War Illness--and soldiers that have since been deployed to Southwest Asia may suffer from similar medical issues. So, how is the VA dealing with vets who submit claims for Gulf War Illness? Related GAO Work: GAO-17-511: Gulf War Illness: Improvements Needed for VA to Better Understand, Process, and Communicate Decisions on Claims Released: July 2017 [ Background Music ] [ Melissa Emrey-Arras: ] There really weren't good records for what people were exposed to when they were deployed. [ Sarah Kaczmarek: ] Welcome to GAO's Watchdog Report, your source for news and information from the U.S. Government Accountability Office. I'm Sarah Kaczmarek. The Department of Veterans Affairs estimates that 44 percent of veterans who served in the Persian Gulf War between 1990 and 1991 have what's known as Gulf War illness. And service members who have been deployed to Southwest Asia since then may also suffer from similar medical issues. Melissa Emrey-Arras, a director on our Education Workforce and Income Security team recently took a look at how the VA is dealing with veterans' claims of Gulf War illness. So, first I asked Melissa, what exactly is Gulf War illness? [ Melissa Emrey-Arras: ] That's a great question, Sarah. Gulf War illness is really sort of an umbrella term that covers a very wide range of symptoms and illnesses. And those symptoms can range from fatigue or headaches to skin rashes and sleep problems. So there's a wide range of physical symptoms that are being called Gulf War illness. And these are symptoms that people experienced after serving in the Gulf War. So if you think back to the Gulf War in 1990, we had people coming back after their service who were experiencing these types of symptoms, and doctors began calling this Gulf War illness. [ Sarah Kaczmarek: ] What makes Gulf War illness claims different than other kinds of claims? [ Melissa Emrey-Arras: ] I think one of the main challenges with many of the symptoms related to Gulf War illness is that people just don't really know what the cause of those symptoms or illnesses is. I think part of that is because many of the people who served were exposed to things like pesticides, smoke from oil well fires, and even depleted uranium. So there's this whole range of exposures that they experienced. And it's really unclear sort of what is exactly causing their particular illnesses. And one of the challenges with this is that there really weren't good records for what people were exposed to when they were deployed. So I think it's a little bit different than other types of ailments where you clearly know, you know, this is the cause and this is the effect, and it's a particular known disease. [ Sarah Kaczmarek: ] And what do recent trends look like in the number of Gulf War illness disability claims? [ Melissa Emrey-Arras: ] In terms of the numbers of people that have been experiencing this and putting in claims for this, we know that for the time period that we looked at in our GAO study, which was fiscal year 2010 to fiscal year 2015, the VA processed 42,000 of these claims. [ Sarah Kaczmarek: ] And is the VA doing a good job communicating its decisions about these claims to veterans? [ Melissa Emrey-Arras: ] No, quite frankly. I think, we looked at the letters that veterans receive, and often times it's very confusing in terms of how they're written, especially for claims that are denied. If you look at the language that VA has in many of these letters, it's not clearly stated the specific reason for the denial. And that can lead to confusion on the part of the veterans, and it could potentially even lead to them appealing claims unnecessarily. [ Background Music ] [ Sarah Kaczmarek: ] Given these problems, I wondered how veterans can get the care they need for medical issues related to Gulf War illness. So, I asked Melissa to walk me through the recommendations in her report. [ Melissa Emrey-Arras: ] Well one of our recommendations is to VA to make sure that their medical examiners have the training on Gulf War illness issues before they do the medical exams. Currently, only 10 percent of medical examiners are taking the elective training on Gulf War illnesses, which means that 90 percent of the medical examiners have not taken the training and yet are performing these critical medical exams. The training itself is only 90 minutes, and it's online. And we think it would be very helpful for medical examiners. Another recommendation we have is to make sure that the letters that go to veterans explain to them whether their claim was approved or denied is clear, especially for individuals who are denied benefits; it's helpful for them to understand why their claim was denied. The third recommendation is really focused on helping VA move towards having a single definition of Gulf War illness and having a plan in place in terms of this research to get to that position. And having a single definition of Gulf War illness could really help in terms of the treatment of the disease and the identification of it. [ Sarah Kaczmarek: ] And finally, what do you see as the bottom line of this report? [ Melissa Emrey-Arras: ] I think the bottom line is that we know a little bit more now about Gulf War illness issues than we did before, but there's still much more that needs to be done. We need to make sure that our medical examiners at the VA are well-trained in these issues to help with the claims. We need to make sure that VA is doing the research to come up with a single definition. And we need to make sure that veterans are aware of their claims decisions and can understand their benefit and denial letters in clear English. [ Background Music ] [ Sarah Kaczmarek: ] Thanks for listening to the Watchdog Report. To hear more podcasts, subscribe to us on iTunes. For more from the Congressional Watchdog, the U.S. Government Accountability Office, visit us at gao.gov.