The Department of Veterans Affairs was on track to clear a longstanding backlog of veterans’ disability claims, its secretary said, but the addition of newly eligible Vietnam-era veterans may overwhelm the system.

“We are about to add tens of thousands of new beneficiaries to the claims system,” VA Secretary Robert Wilkie said during a stop Thursday at the Salem VA Medical Center. “I’ve seen estimates that go anywhere from 70,000 to 400,000.”

A federal appeals court in January ruled that Vietnam veterans who served on ships off the shores of Vietnam were exposed to Agent Orange. With that ruling comes the presumption that the chemical defoliant caused any of an array of diseases. Affected servicemen, called Blue Water Navy veterans, are entitled to medical care and disability payments.

Wilkie said the VA is working with the Department of Defense to figure out how many veterans are eligible.

“The original metric was to use the Vietnam service ribbon, but the way the Navy worked during those days is if you were attached to the ship’s company and the ship traversed the waters, you got a ribbon. But there may be a third of the crew back in Bremerton, Washington, that didn’t deploy for whatever reason and they got a ribbon as well,” he said. “So we have to do a lot of detective work along with the Navy, and it’s going to take us some time.”

Estimates of the potential costs of disability benefits for the Blue Water Navy veterans range between $1.1 billion and $5.5 billion over 10 years. The range depends on the number of veterans and whether their children and estates will be eligible to file claims.

Congress two years ago passed legislation to modernize the disability system, which by then had left a half-million veterans waiting years to resolve their claims. The backlog has been reduced to 108,000 claims.

Wilkie credits the creation of computer programs to process claims and a move away from paper shuffling, when it would sometimes take more than a year for claims to be handed off from one person to the next.

He said he doesn’t know why the VA took so long to computerize records.

“I can’t give you the historical reasons. But I can tell you the federal government as a whole, because of what I call industrial-age processes, has done a very poor job,” he said. “I would like for the federal government to be dragged into the 20th century, then worry about the 21st century later.”

Wilkie stopped in Salem to meet with leadership at the medical center after attending ceremonies in Bedford to mark the 75th anniversary of D-Day.

Thursday also coincided with the start of expanded access to community health services for veterans, including about 38,000 veterans who receive care in Salem.

Veterans who drive more than 30 minutes for primary and mental health care at a VA center can opt to see eligible doctors closer to home. The program was developed through legislation last year referred to as the MISSION Act.

It also opens up options for urgent care and allows for telehealth that crosses state and jurisdictional lines.

Wilkie said it will increase access to care for veterans in rural areas.

“It’s not a libertarian choice. It is not giving somebody a card and saying go out into the community and prosper. It does say, if we don’t have it, we will help you find it,” he said.

The program has led to criticism that it is opening the door to privatization.

“I just presented a $220 billion budget to Congress, the largest budget in the history of this department,” he said. “The other thing is the budget calls for a workforce of 390,000. So my response to privatization arguments is, if we are privatizing, we are going about it in a very strange way.”

Wilkie said the percentage of veterans who want care outside of the VA has been trending downward because the quality of care is as good as or better than in the community, and veterans want to go where providers understand the culture and speak their language.

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Luanne Rife writes about the businesses, policies, discoveries and inventions that affect the health of people living in southwestern Virginia.

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