Veterans for Common Sense et al v. Nicholson et al

Filing 48

Attachment 1
Declaration of Paul Sullivan in Support of 46 Memorandum in Opposition to Defendants' Motion for Protective Order to Stay Discovery filed byVeterans United for Truth, Inc, Veterans for Common Sense. (Attachments: # 1 Exhibit A# 2 Exhibit B# 3 Exhibit C)(Related document(s) 46 ) (Sprenkel, Stacey) (Filed on 11/27/2007)

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Veterans for Common Sense et al v. Nicholson et al Doc. 48 Att. 1 Department of Veterans Affairs Gulf War Veterans Information System February 2006 Release Date: March 31, 2006 Dockets.Justia.com Gulf War Veterans Information System February 2006 February 2006 GWVIS Report Table of Contents Section One Description GWVIS Report Introduction Overview History and Partnership Preparation Categories Data Sources Limitations Page 1 1 1 1 2 3 3 Two February 2006 GWVIS Reports Service Member Statistics Compensation and Pension (C&P) Statistics Undiagnosed (UDX) C&P Statistics Al Jubayl and Khamisiyah C&P Statistics Al Jubayl and Khamisiyah UDX C&P Statistics Inpatient and Outpatient Health Care Use Readjustment Counseling Service - Vet Center Benefit Utilization Healthcare Enrollment by Priority Group Mortality Data 5 6 7 8 9 10 11 12 13 14 Three Glossary of Terms, Definitions, and Limitations Terms, Definitions, and Limitations 15 15 Gulf War Veterans Information System February 2006 Section One GWVIS Report Introduction Overview The Gulf War Veterans Information System (GWVIS) provides the best available current data identifying the 6.4 million Gulf War service member population. The GWVIS reports monitor, in part, the service members' use of Department of Veterans Affairs (VA) healthcare and disability benefits. GWVIS reports are distributed each quarter during the fo llowing months: March, June, September, and December. History and Partnership In 1997, VA's Office of Policy, Planning, and Preparedness, working with the Veterans Benefits Administration (VBA), the Veterans Health Administration (VHA), and other VA organizational elements, created the GWVIS reports to identify Gulf War service members and monitor, in part, their VBA compensation and pension benefit use. VBA works to enhance GWVIS reports with several governmental partners, including: DoD's Defense Manpower Data Center (DMDC) and Deployment Health Support Directorate (DHSD), VHA, VA's Office of Policy, Planning and Preparedness, VA's Office of the General Counsel, VA's Readjustment Counseling Service (RCS), and VBA's Compensation and Pension Service (C&P Service). GWVIS reports are consistent with the "Veterans Health Care Act of 1992" (Public Law 102-585) in identifying Gulf War service members and reporting on various aspects of their VA healthcare and benefit activity. Preparation VBA uses four steps to prepare the quarterly GWVIS reports: 1. Every three months, the Department of Defense (DoD) sends VBA an updated list identifying all current and prior military service members since the start of the Gulf War on August 2, 1990. 2. VBA compares DoD's updated list of service members with VBA information systems. 3. VBA uses the results from the comparison to prepare reports about Gulf War veterans and their compensation and pension benefit use sorted by specific cohorts based on Gulf War deployment status. 1 Gulf War Veterans Information System February 2006 4. VBA provides VHA a copy of the DoD data. VHA then prepares the "Gulf War Readjustment Counseling Service ­ Vet Center Utilization," the Gulf War Service Member VHA Healthcare Enrollment by Priority Group," the "Gulf War Mortality Data," and the "Gulf War Inpatient and Outpatient Health Care Utilization" information to VBA used in the GWVIS report. Categories GWVIS reports are prepared for all categories shown below. The following chart describes how some categories are combined to create other categories: The Count for this category ... Total Deployed Conflict Combining GWVIS Categories ... Is the sum of these categories Era and Deployed Conflict and Theater Al Jubayl, Khamisiyah, and Other Conflict The following graph illustrates how GWVIS categories are combined in this report: TOTAL All Service Members 8/2/90 - Present ERA Non- Deployed Service Members 8/2/90 - Present DEPLOYED Active Duty and Activated Reserve Forces Only 8/2/90 - Present CONFLICT Desert Shield / Desert Storm 1 st Year Only 8/2/90 ­ 7/31/91 THEATER Other Deployments Starting 2n d Year 8/1/91 - Present AL JUBAYL 01/19/91 KHAMISIYAH 03/04/91 ­ 03/10/91 OTHER CONFLICT Excludes Al Jubayl And Khamisiyah 08/02/90 ­ 0 7 / 3 1 / 9 1 2 Gulf War Veterans Information System February 2006 Data Sources VBA uses data from the Department of Defense (DoD) and Veterans Affairs (VA) to prepare GWVIS reports. The list below identifies the DoD and VA organizational source, scheduled cycle dates and specific file names. DoD: Defense Manpower Data Center (DMDC) extract dated January 9, 2006: · Active Duty Master File · Active Duty Loss File · Reserve Components Common Personnel Data System · Operation Desert Shield/Storm Files · Operation Mission/Contingency Files Deployment Health Support Directorate (DHSD) extract dated August 2005: · Khamisiyah Master File · Al Jubayl Master File VA: Veterans Benefits Administration (VBA): · Beneficiary Identification and Records Locator Subsystem (BIRLS) dated December 30, 2005 · Compensation and Pension Master Record (CPMR) dated December 21, 2005 · Pending Issue File (PIF) dated January 7, 2006 Veterans Health Administration (VHA): · VHA Gulf War Veteran Mortality Study, one time study prepared in 2001 · VHA Patient Treatment Files and Outpatient Care Files, dated August 2004 · VHA Healthcare Enrollment Files, dated October 2005 · Readjustment Counseling Service - Vet Center (RCSVC) Utilization File, data up until February 09, 2006 Limitations There are twelve limitations to the GWVIS report. 1. GWVIS reports do not contain information about individual veterans. 2. GWVIS reports do not provide information on how claims are adjudicated. Questions raised on this matter should be referred to VBA's Compensation and Pension Service (C&P Service). 3. GWVIS reports do not cite statutes or regulations for terms and definitions. Questions about compensation and pension terms and definitions should be referred to C&P Service. Questions 3 Gulf War Veterans Information System February 2006 about any healthcare terms and definitions should be referred to VHA. The terms and definitions used in this document are intended for this report only, and they should not be relied upon for any other purpose, such as the presentation of claims for VA benefits. 4. Unless otherwise noted, this report provides current counts from the data sources listed. This report does not contain cumulative counts of C&P benefit use. 5. GWVIS reports do not distinguish between a veteran and a "civilian veteran." Some veterans counted in the GWVIS report may currently be on active duty due to re-enlistment to active duty or due to activation from the Reserve Forces to active duty. In contrast, "civilian veterans," as defined by the Census Bureau and in VA's official counts, are those no longer on active duty. 6. The GWVIS report differs from existing VBA Reports Control Symbol (RCS) and Computer Output Identification Number (COIN) reports. The GWVIS report identifies all veterans with military service on or after August 2, 1990. In contrast, the COIN and RCS reports sort veterans into only one period of military service, such as Vietnam Era, Peacetime, or Gulf War. COIN and RCS reports contain lower counts of Gulf War veterans because some veterans of the Gulf War period who served prior to August 1990 have multiple periods of military service. These veterans may be counted in the COIN and RCS reports under another period of military service. 7. VA works closely with DoD to identify service members recently deployed to Southwest Asia as part of Operation Iraqi Freedom (OIF) and/or Operation Enduring Freedom (OEF). Data about these service members provided by DoD to VBA remains incomplete, and the data may be delayed while DoD updates their computer system. VA will release the data as soon as it becomes available. 8. This report contains "Gulf War Mortality Data." Please contact VHA's Office of Public Health and Environmental Hazards for more information regarding Gulf War mortality data. The GWVIS statistical reports, containing death counts, do not constitute a Gulf War veteran mortality study. 9. Some of the veterans identified in this report had prior active military service. Therefore, not all of the claims counted in this report were incurred during the Gulf War period or deployment to Southwest Asia. VBA's computer systems do not attribute each of a veteran's disabilities to a specific period of service or deployment. 10. The report, "Gulf War Readjustment Counseling Service - Vet Center Utilization," contains counts of unique veterans who sought or are using RCSVC services. The counts do not constitute a VA study of war zone veterans. 11. The report, "Gulf War Service Member VHA Healthcare Enrollment by Priority Group," is limited to counts of Gulf War service members' VHA healthcare enrollment by priority group. VA services and treatment available to enrolled veterans generally are not based on priority groups. 12. This report gathered information only from the Benefits Delivery Network (BDN). Therefore, a small number (less than 8,000) of new veteran records processed in the VBA corporate environment are excluded from this report. Only VBA-related tables are effected by the data exclusion. 4 Gulf War Veterans Information System February 2006 Section Two February 2006 Reports Report Name Service Member Statistics Compensation and Pension (C&P) Statistics Undiagnosed (UDX) C&P Statistics Al Jubayl and Khamisiyah C&P Statistics Al Jubayl and Khamisiyah UDX C&P Statistics Inpatient and Outpatient Health Care Use Gulf War Readjustment Counseling Service - Vet Center Utilization (RCSVC) Gulf War Service Member VHA Healthcare Enrollment by Priority Group Mortality Data Page 6 7 8 9 10 11 12 13 14 5 Gulf War Veterans Information System February 2006 Service Member Statistics February 2006 Category Service Members Service Member Separations Active Duty Separations Activated Reserve Forces Separations Non-Activated Reserve Forces Separations Non-Activated Reserve Forces, Service- Connected Veteran Deaths 2 1 Conflict 696,841 621,108 505,772 115,336 0 0 11,910 609,198 Theater 432,498 333,761 327,222 6,539 0 0 3,742 330,019 Deployed 1,129,339 954,869 832,994 121,875 0 0 15,652 939,217 Era 5,336,917 4,599,616 2,902,074 309,527 1,388,015 116,900 47,733 3,280,768 Total 6,466,256 5,554,485 3,735,068 431,402 1,388,015 116,900 63,385 4,219,985 Estimated Living Veterans Interpreting GWVIS Categories The Count for this category: ... Is the sum of: Total Deployed Deployed Conflict 1 And: Era Theater 1. VBA identified 116,900 Non-Activated Reservists who are service-connected or pensioners as "veterans." VBA identified 7,554 reported deaths (effective end of month December 2005,) among the 116,900. The 7,554 deaths are included in the count for Deaths found under "Era." The 109,346 remaining living veterans are included in the count of "Estimated Living Veterans" reported under "Era." 2 These counts reflect raw data that has not been subjected to any statistical analysis nor has it been adjusted in any way to make it a mortality study. There has been no adjustment to account for age, gender, race, and other items required for a valid mortality study. In addition, the data will not reflect deaths that occurred after December 2005. The use of these data to draw conclusions regarding mortality rates will result in inaccurate conclusions. For analysis of Gulf War veteran mortality, see "Mortality among US Veterans of the Persian Gulf War: 7-Year Follow-up, "Han K. Kang and Tim A. Bullman, American Journal of Epidemiology, 2001,154(5): 399-405. 6 Gulf War Veterans Information System February 2006 Compensation and Pension Statistics February 2006 Category Service Members Estimated Living Veterans Claims Filed Claims Processed C&P Benefit Granted Claims Granted Service Connection Claims Denied Service Connection Claims Pending Service-Connected Ten Percent (10%) or Greater, Receiving Compensation or Pension. Service-Connected Zero Percent (0%), Receiving Compensation or Pension Service-Connected Ten Percent (10%) or Greater, No Compensation or Pension Service-Connected Zero Percent (0%), No Compensation or Pension Non-Service Connected, Receiving Pension Non-Service Connected, No Pension Conflict 696,841 609,198 260,209 228,513 200,107 198,951 29,562 31,696 149,149 3,343 5,879 40,580 1,156 28,406 Theater 432,498 330,019 114,928 100,999 93,014 92,789 8,210 13,929 72,387 1,624 1,846 16,932 225 7,985 Deployed 1,129,339 939,217 375,137 329,512 293,121 291,740 37,772 45,625 221,536 4,967 7,725 57,512 1,381 36,391 Era 5,336,917 3,280,768 1,078,492 938,714 825,263 821,837 116,877 139,778 612,291 13,088 28,191 168,267 3,426 113,451 Total 6,466,256 4,219,985 1,453,629 1,268,226 1,118,384 1,113,577 154,649 185,403 833,827 18,055 35,916 225,779 4,807 149,842 The Count for this category: Total Deployed Interpreting GWVIS Categories ... Is the sum of: Deployed Conflict And: Era Theater 7 Gulf War Veterans Information System February 2006 Undiagnosed Illness (UDX) Compensation and Pension Statistics February 2006 Category Service Members Estimated Living Veterans Undiagnosed Illness (UDX), Claims Processed UDX, Claims Granted Service Connection UDX, Claims Denied Service Connection UDX, Service-Connected Ten Percent (10%) or Greater, Receiving Compensation or Pension UDX, Service-Connected Zero Percent (0%), Receiving Compensation or Pension UDX, Service-Connected Ten Percent (10%) or Greater, No Compensation or Pension UDX, Service-Connected Zero Percent (0%), No Compensation or Pension UDX, Nonservice-Connected, Receiving Compensation or Pension UDX, Nonservice-Connected, No Pension Conflict 696,841 609,198 12,868 3,317 9,551 2,818 213 131 155 3,809 5,742 Theater 432,498 330,019 1,506 281 1,225 238 25 7 11 551 674 Deployed Era Total 6,466,256 4,219,985 14,374 3,598 10,776 3,056 238 138 166 4,360 6,416 1,129,339 5,336,917 939,217 3,280,768 14,374 3,598 10,776 3,056 238 138 166 4,360 6,416 Not Applicable Not Applicable Not Applicable Not Applicable Not Applicable Not Applicable Not Applicable Not Applicable Not Applicable Interpreting GWVIS Categories The Count for this category: ... Is the sum of: Total Deployed Deployed Conflict And: Era Theater 8 Gulf War Veterans Information System February 2006 Al Jubayl and Khamisiyah Compensation and Pension Statistics February 2006 Category Service Members Estimated Living Veterans Veteran Deaths Claims Filed Claims Processed C&P Benefit Granted Claims Granted Service Connection Claims Denied Service Connection Claims Pending Service-Connected Ten Percent (10%) or Greater, Receiving Compensation or Pension. Service-Connected Zero Percent (0%), Receiving Compensation or Pension Service-Connected Ten Percent (10%) or Greater, No Compensation or Pension Service-Connected Zero Percent (0%), No Compensation or Pension Non-Service Connected, Receiving Pension Non-Service Connected, No Pension Al Jubayl 1,334 1,193 36 459 413 337 336 77 46 247 6 12 71 1 76 Khamisiyah 1 Other Conflict 550,056 479,495 9,085 195,224 171,789 151,198 150,330 21,459 23,435 113,052 2,638 4,237 30,403 868 20,591 Conflict 696,841 609,198 11,910 260,209 228,513 200,107 198,951 29,562 31,696 149,149 3,343 5,879 40,580 1,156 28,406 145,451 128,510 2,789 64,526 56,311 48,572 48,285 8,026 8,215 35,850 699 1,630 10,106 287 7,739 1 The total number of service members ever identified with possible low-level chemical warfare agent exposure or serving at or near Khamisiyah, Iraq, at the time of the demolition of chemical warfare munitions is 145,470 as of September 28, 2005. This is an increase of 3 service members' records based on new data from DoD as of August 2005. In this report, VBA displayed compensation and pension statistics on 145,451 service memb ers. VA and DoD have completed their review of service member records. However, there is a possibility of future changes, if needed, based on further review by DoD. 9 Gulf War Veterans Information System February 2006 Al Jubayl and Khamisiyah Undiagnosed Illness (UDX) Compensation and Pension Statistics February 2006 Category Service Members Estimated Living Veterans Veteran Deaths Undiagnosed Illness (UDX), Claims Processed UDX, Claims Granted Service Connection UDX, Claims Denied Service Connection UDX, Service-Connected Ten Percent (10%) or Greater, Receiving Compensation or Pension UDX, Service-Connected Zero Percent (0%), Receiving Compensation or Pension UDX, Service-Connected Ten Percent (10%) or Greater, No Compensation or Pension UDX, Service-Connected Zero Percent (0%), No Compensation or Pension UDX, Nonservice-Connected, Receiving Compensation or Pension UDX, Nonservice-Connected, No Pension Al Jubayl 1,334 1,193 36 65 20 45 19 0 1 0 8 37 Khamisiyah 1 Other Conflict 550,056 479,495 9,085 8,448 2,140 6,308 1,808 148 80 104 2,534 3,774 Conflict 696,841 609,198 11,910 12,868 3,317 9,551 2,818 213 131 155 3,809 5,742 145,451 128,510 2,789 4,355 1,157 3,198 991 65 50 51 1,267 1,931 1 The total number of service members ever identified with possible low-level chemical wa rfare agent exposure or serving at or near Khamisiyah, Iraq, at the time of the demolition of chemical warfare munitions is 145,470 as of September 28, 2005. This is an increase of 3 service members' records based on new data from DoD as of August 2005. In this report, VBA displayed compensation and pension statistics on 145,451 service members. VA and DoD have completed their review of service member records. However, there is a possibility of future changes, if needed, based on further review by DoD. 10 Gulf War Veterans Information System February 2006 Gulf War Inpatient and Outpatient Healthcare Utilization October 1990 through October 2004 The tables below provide cumulative numbers for inpatient and outpatient care for deployed Gulf War veterans from October 1990 through October 2004. Gulf War Veteran Inpatient Stays Inpatient Category Service Members Estimated Living Veterans Unique Gulf War Veteran Inpatients Total Gulf War Veteran Inpatient Stays Conflict 696,841 609,198 38,433 95,580 Theater 432,498 330,019 8,539 17,482 Deployed 1,129,339 939,217 46,972 113,062 Era 5,336,917 3,280,768 128,109 328,422 Total 6,466,256 4,219,985 175,081 441,484 Gulf War Veteran Outpatient Visits Outpatient Category Service Members Estimated Living Veterans Unique Gulf War Veteran Outpatients Total Gulf War Veteran Outpatient Visits Conflict 696,841 609,198 297,125 6,589,285 Theater 432,498 330,019 108,281 1,388,381 Deployed 1,129,339 939,217 405,406 7,977,666 Era 5,336,917 3,280,768 1,058,138 20,947,923 Total 6,466,256 4,219, 985 1,463,544 28,925,589 Interpreting GWVIS Categories The Count for this category: ... Is the sum of: Total Deployed Deployed Conflict And: Era Theater 11 Gulf War Veterans Information System February 2006 Gulf War Readjustment Counseling Service ­ Vet Center Benefit Utilization3 The tables below provide counts of unique Gulf War veterans using Readjustment Counseling Service ­ Vet Center (RCSVC) as of October 2005 4 . Category Service Members Estimated Living Veterans Count of Unique Veterans Using Vet Centers 5 Conflict 696,841 609,198 72,840 Theater 432,498 330,019 27,391 Deployed 1,129,339 939,217 97,410 Era 5,336,917 3,280,768 227,663 Total 6,466,256 4,219,985 327,894 Category Service Members Estimated Living Veterans Count of Unique Veterans Using Vet Centers Al Jubayl 1,334 1,193 137 Khamisiyah 145,451 128,510 16,714 Other Conflict 550,056 479,495 55,989 Conflict 696,841 609,198 72,840 The Count for this category: Total Deployed 3 Interpreting GWVIS Categories ... Is the sum of: Deployed Conflict And: Era Theater The report, "Gulf War Readjustment Counseling Service ­ Vet Center Benefit Utilization" contains counts of unique veterans who sought or are using RCSVC services. The counts do not constitute a VA study of war zone veterans. For further information about RCSVC, please go to: http://www.va.gov/rcs/ 4 The Readjustment Counseling Service, effective with the August 2005 report, used a new data matching methodology, which ensured a more reliable result. 5 The Readjustment Counseling Service Vet Centers were created through legislation passed by Congress. Vet Centers provide a continuum of care during the post-war adjustment from military to civilian life for veterans (and family members) in or near their local communities. Key access links to community agencies, VA, and professional readjustment counseling, community education, and outreach to special veteran populations are made available to war zone veterans through the Vet Centers. 12 Gulf War Veterans Information System February 2006 Gulf War Service Member VHA Healthcare Enrollment by Priority Group6 The tables below show counts of Gulf War service members' VHA healthcare enrollment by priority group, as of October 2005. Category Gulf War Service Members Estimated Living Veterans Enrollment Priority Group 1 Enrollment Priority Group 2 Enrollment Priority Group 3 Enrollment Priority Group 4 Enrollment Priority Group 5 Enrollment Priority Group 6 Enrollment Priority Group 7 Enrollment Priority Group 8 Total Enrollment Conflict 696,841 609,198 37,936 33,317 54,093 1,762 46,623 22,482 2,661 44,456 243,330 Theater 432,498 330,019 14,553 16,438 25,579 424 24,287 2,577 1,349 17,672 102,879 Deployed 1,129,339 939,217 52,489 49,755 79,672 2,186 70,910 25,059 4,010 62,128 346,209 Era 5,336,917 3,280,768 132,563 132,459 234,012 6,415 260,863 40,491 14,457 182,626 1,003,886 Total 6,466,256 4,219,985 185,052 182,214 313,684 8,601 331,773 65,550 18,467 244,754 1,350,095 The Count for this category: Total Deployed Interpreting GWVIS Categories ... Is the sum of: Deployed Conflict And: Era Theater 6 For definitions of VA's eight enrollment priority groups, please see the Glossary of Terms, Definitions, and Limitations. 13 Gulf War Veterans Information System February 2006 Gulf War Mortality Data 1990 - 1997 This report, supplied by VHA, shows death rates from 1990 to 1997 of US Gulf War veterans deployed to the Gulf War region before March 1, 1991 compared to non-Gulf War veterans over the same period.1 Gulf War Mortality Data Non-Gulf War Gulf War Veterans Ratio of Veterans Death Veteran Number Death Number Death Rates3 2 2 Gender of Deaths Rate of Deaths Rate Male Female 4,312 194 11.1 6.6 5,542 376 12.9 5.7 0.95 1.16 Significance of the ratio of death rates4, 5, 6 Not significant Not significant 1 This study compared the mortality among the 621,902 Gulf War veterans who served at least one day during Operations Desert Shield and Desert Storm (those arriving in the Southwest Asia theater of operations after August 2, 1990, but before March 1, 1991) to the mortality among 746,248 non-Gulf War veterans who served during this conflict but were not deployed to this area, and includes Active Duty, and activated Reserve Forces. The Southwest Asia theater of operations is as defined by DoD's Defense Manpower Data Center. Non-Gulf War veterans used for comparison in this study were service members who served during this period but did not deploy to the Southwest Asia theater of operations, and includes Active Duty, and activated Reserve Forces (from "Mortality among US Veterans of the Persian Gulf War: 7-Year Follow-up," Kang, Han K., and Tim A. Bullman, American Journal of Epidemiology, 2001, 154(5): 399-405). This study by the Department of Veterans Affairs is still ongoing. 2 3 Crude death rate for all causes of death, per 10,000 person years. Death rate ratio comparing death rate of Gulf War veterans to the death rate of Non-Gulf War veterans, controlling for, race, branch of service, unit component and marital status. A ratio of 1 indicates that the death rates are the same for the two groups. Determination if the death rate ratio was statistically significantly different from 1. Differences are considered significant when there is 95% confidence that the difference did not occur by chance. Although this study found no real difference between death rates among Gulf War and Non-Gulf War veterans, it found that death rates for both groups were less than half of that found in their civilian counterparts. An increased death rate among Gulf War veterans from motor vehicle accidents found in an earlier VA study has disappeared in this seven year follow up study. 4 5 6 14 Gulf War Veterans Information System February 2006 Section Three Glossary of Terms, Definitions, and Limitations This section provides the terms, definitions, and limitations used in the GWVIS report. Questions about terms and definitions should be referred to C&P Service or VHA, as appropriate. The terms and definitions in this document are intended for this report only, and they should not be relied upon for any other purpose, such as the presentation of claims for VA benefits. Activated Reserve Forces Separations Activated Reserve Forces Separations is a subset of Service Member Separations. Activated Reserve Forces Separations identifies only current and former activated Reserve Forces personnel with a discharge who were called to active duty on or after August 2, 1990, by the Federal Government. All Activated Reserve Forces are counted, regardless of: · · · · Length of enlistment Re-enlistment Character of service Death Limitations: In some cases, DMDC cannot determine if a service member enlisted directly into active duty or if a service member was activated from the Reserve Forces. In those cases, the service members are counted under Active Duty Separations. Active Duty Separations Active Duty Separations is a subset of Service Member Separations. Active Duty Separations identifies current and former active duty personnel with a discharge and with service on or after August 2, 1990. All Active Duty Separations are counted, regardless of: · · · · Length of enlistment Re-enlistment Character of service Death Limitations: In some cases, DMDC cannot determine if a service member enlisted directly into active duty or if a service member was activated from the Reserve Forces. In those cases, the service members are counted under Active Duty Separations. 15 Gulf War Veterans Information System Al Jubayl February 2006 Al Jubayl is a subset of the Conflict category. On or about January 19, 1991, service members serving in and around Al Jubayl, Saudi Arabia reported an incident involving a "loud noise," "bright flash," and possible "Iraqi chemical warfare agent attack." There are 1,334 service members identified by the DoD as having served in and around the port city of Al Jubayl on January 19, 1991. DoD concludes that the chemical attack was "unlikely." Additional information regarding events at or near Al Jubayl can be viewed at DoD's web site: http://www.deploymentlink.osd.mil Claims Denied Service Connection A veteran's claim is denied when VA determines none of the veteran's conditions meet eligibility requirements for service connection under VA statutes and regulations. This denial is called "Nonservice-Connected," or "NSC." Claims Denied Service Connection is the sum of NonserviceConnected - No Pension and Nonservice-Connected - Receiving Pension. Limitation: Claims Denied Service Connection includes claims where all the veteran's conditions were determined to be Nonservice-Connected even if the veteran was granted pension. The total number of Claims Denied Service Connection may decrease as appealed or reopened claims are granted. This is not a cumulative count. Claims Filed Claims Filed equals the total of Claims Granted Service Connection, Claims Denied Service Connection, and Claims Pending. This is not a cumulative count. Limitations: Some duplicate counting may exist in the category Claims Filed if a veteran who was previously granted or denied disability benefits subsequently reopens his/her claim. Pending claims may increase or decrease each quarter based on the number of veterans who open new claims or re-open prior claims. This is not a cumulative count. Claims Granted Service Connection A veteran's claim is granted when VA determines at least one of the veteran's conditions meets eligibility requirements for service connection under VA statutes and regulations. This grant is called "service-connected," or "SC." Veterans frequently file a claim for more than one condition. For veterans who filed a claim for more than one condition, this category contains veterans with a full grant of all conditions as well as veterans with a combination of grants and denials. Disabilities are evaluated according to VA regulations, and the extent of the disability is expressed as a percentage from zero percent to 100 percent, in increments of 10 percent. Claims Granted Service Connection includes all service-connected disabilities, from zero percent to 100 percent, regardless of whether the veteran receives monetary compensation. 16 Gulf War Veterans Information System February 2006 Limitations: Claims Granted Service Connection excludes claims where all the veteran's conditions were determined to be Nonservice-Connected even if the veteran was granted pension. The number of Claims Granted Service Connection includes veterans who have subsequently died. The total number of claims granted remains constant or increases each quarter. However, subcategories of Claims Granted Service Connection may increase or decrease. An increase or decrease may occur when a veteran with a granted claim re-enlists on active duty or is ordered to active duty from the Reserve Forces. Veterans who return to active duty are not permitted to receive both active duty pay and VA payments. This is not a cumulative count. Claims Pending Claims Pending identifies where VA is reviewing a veteran's claim for compensation or pension benefits. This includes appealed and reopened claims, diary issues, issues pending authorization, and issues pending acceptance. Limitations: The count of Claims Filed is the sum of Claims Pending and Claims Processed. Therefore, duplicate counting may exist in the category Claims Filed if a veteran who was previously granted or denied disability benefits subsequently reopens their claim. Pending claims may increase or decrease each quarter based on the number of veterans who open new claims or re-open prior claims. This is not a cumulative count. Claims Processed Claims Processed equals the total of Claims Granted Service Connection and Claims Denied Service Connection. Claims Processed does not include pending claims. This is not a cumulative count. Conflict Conflict is a subset of Deployed. Conflict identifies active duty service members deployed to Southwest Asia during the Gulf War, from August 2, 1990, through July 31, 1991. This includes Active Duty as well as Activated Reserve Forces. Limitations: The initial Gulf War air campaign began on January 17, 1991, and it lasted through February 28, 1991. The Gulf War ground invasion into Iraq and Kuwait began February 24, 1991, and it stopped on February 28, 1991. VA defines the Southwest Asia theater as Iraq, Kuwait, Saudi Arabia, the neutral zone between Iraq and Saudi Arabia, Bahrain, Qatar, the United Arab Emirates, Oman, the Gulf of Aden, the Gulf of Oman, the Persian Gulf, the Arabian Sea, the Red Sea, and the airspace above these locations. 17 Gulf War Veterans Information System C&P Benefit Granted February 2006 C&P Benefit Granted is a sum of "Claims Granted Service Connection" and "Non-Service connected, Receiving Pension." This is not a cumulative count. Deployed Deployed identifies active duty service members who served at least one day in the Southwest Asia theater of operations from August 2, 1990, through the present. VA uses the period from August 2, 1990, to the present to identify service members deployed to the Southwest Asia theater of operations who are potentially eligible for additional VA benefits (such as undiagnosed illness compensation). Deployed includes Activated Reserve Forces. Deployed equals the sum of the Conflict and Theater categories. Limitations: VA defines the Southwest Asia theater as Iraq, Kuwait, Saudi Arabia, the neutral zone between Iraq and Saudi Arabia, Bahrain, Qatar, the United Arab Emirates, Oman, the Gulf of Aden, the Gulf of Oman, the Persian Gulf, the Arabian Sea, the Red Sea, and the airspace above these locations. Era Era identifies service members who did not deploy to the Gulf War. This includes Active Duty, Activated Reserve Forces, and Non-Activated Reserve Forces. Estimated Living Veterans Estimated Living Veterans is a subset of the Service Member population. It identifies individuals with active duty service and a discharge on or after August 2, 1990. Estimated Living Veterans includes service members called to active duty from the Reserve Forces. Subtractions are made for deaths. Limitations: Estimated Living Veterans includes living Non-Activated Reserve Forces with a VA service-connected condition or who are in receipt of pension. Subtractions are made for deaths from among those Non-Activated Reserve Forces who had a VA service-connected condition or who were in receipt of pension. This report does not distinguish between a veteran and a "civilian veteran." Some veterans counted in this report may currently be on active duty due to re-enlistment to active duty or due to activation from the Reserve Forces to active duty. In contrast, "civilian veterans" (as defined by the Census Bureau and in VA's official counts) are those no longer on active duty. VBA continues to work with VA's Office of Policy, Planning and Preparedness to resolve differences in the number of estimated living Gulf War veterans counted in GWVIS and those determined to be Gulf War veterans in VetPop2004, v1.0, which is 4,449,000 as of January 2006. VetPop2004 estimates the number of civilian veterans (veterans not on active duty), while the VBA counts unique social security numbers, and includes both civilian veterans and veterans who are on active duty. Moreover, VetPop2004 includes a combination of reported separations up through September 2003 and projected 18 Gulf War Veterans Information System February 2006 separations after 2003 whereas VBA includes reported separations up through December 2005. The number of estimated living Gulf War veterans has increased as the number of service members discharged from active duty exceeded the number of Gulf War veterans who died. Healthcare Enrollment Priority Group The table below describes VA Healthcare Priority Groups 1 through 8. Healthcare Enrollment Priority Group Priority Group Priority 1 Description of Priority Group Veterans with service-connected disabilities rated 50% or more disabling, or Veterans determined by VA to be unemployable due to service-connected conditions Veterans with service-connected disabilities rated 30% or 40% disabling · Veterans with service-connected disabilities rated 10% or 20% disabling · Veterans who are former POWs · Veterans awarded the Purple Heart · Veterans whose discharge was for a disability that began in the line of duty · Veterans who are disabled because of VA treatment or participation in VA vocational rehabilitation program · Veterans whose receipt of disability compensation is suspended because of the receipt of military retired pay · Veterans receiving compensation at the 10 percent rating level based on multiple non-compensable service-connected disabilities that clearly interfere with normal employability · Veterans who are receiving aid and attendance or housebound benefits (on pension) from VA · Veterans who have been determined by VA to be catastrophically disabled · Veterans receiving VA pension benefits · Veterans who are eligible for Medicaid programs · Veterans with income and assets below VA Means Test Thresholds · Veterans with 0% service-connected conditions, but receiving VA compensation · Veterans seeking care only for disorders relating to Ionizing Radiation and Project 112/SHAD · Veterans seeking care for Agent Orange Exposure during service in Vietnam · Veterans seeking care for Gulf War Illness or for conditions related to exposure to Environmental Contaminants during service in the Persian Gulf · Veterans of World War I or the Mexican Border War · Veterans who served in combat in a war after the Gulf War or during a period of hostility after November 11, 1998, for 2 years following discharge or release from the military · · Priority 2 Priority 3 Priority 4 Priority 5 Priority 6 19 Gulf War Veterans Information System February 2006 Priority Group Priority 7 Description of Priority Group Veterans who agree to pay specified copayments with income and/or net worth above VA Means Test threshold and income below the Geographic Means Test Threshold · Subpriority a: Noncompensable 0% service-connected veterans who were enrolled in VA Health Care System on a specified date and who have remained enrolled since that date · Subpriority c: Nonservice-connected veterans who were enrolled in the VA Health Care System on a specified date and who have remained enrolled since that date · Subpriority e: Noncompensable 0% service-connected veterans not included in Subpriority a above. VA is not currently using Subpriority e · Subpriority g: Nonservice-connected veterans not included in Subpriority c above. VA is not currently using Subpriority g Veterans who agree to pay specified copayments with income and/or net worth above VA Means Test Threshold and the Geographic Means Test Threshold · Subpriority a: Noncompensable 0% service-connected veterans enrolled as of January 16, 2003 and who have remained enrolled since that date · Subpriority c: Nonservice-connected veterans enrolled as of January 16, 2003 and who have remained enrolled since that date · Subpriority e: Noncompensable 0% service-connected veterans applying for enrollment after January 16, 2003 · Subpriority g: Nonservice-connected veterans applying for enrollment after January 16, 2003 Priority 8 Khamisiyah Khamisiyah is a subset of the Conflict category. The DoD identified 145,470 service members as having served in and around the Khamisiyah Ammunition Supply Point in Iraq at the time of the demolition of chemical warfare munitions. On March 4, 1991, and on March 10, 1991, the U.S. military destroyed Iraqi "chemical warfare agent rockets," possibly exposing U.S. service members to low levels of chemical warfare agents. Based on the most recent analysis of Khamisiyah, the military believes 101,766 service members were possibly exposed to low- level chemical warfare agents. Additional information about the current Khamisiyah analysis can be viewed at DoD's web site: http://www.gulflink.osd.mil/khamisiyah_iii/ Limitations: On September 28, 2005 VA received an updated list of 145,470 service members from DoD who were possibly in the hazard areas according to at least one of DoD's modeling efforts or DoD's 50-kilometer radius analysis. This is an increase of 3 service members' records as of August 2005 based on new data from DoD. In this GWVIS report, VBA displayed compensation and pension statistics on 145,451 service members. VA and DoD have completed their review of service member records. However, there is a possibility of future changes, if needed, based on review by DoD. 20 Gulf War Veterans Information System Non-Activated Reserve Forces Separations February 2006 Non-Activated Reserve Forces Separations is a subset of Service Member Separations. Non-Activated Reserve Forces Separations identifies individuals with current and former Reserve Forces service and a discharge from Reserve Forces on or after August 2, 1990. Non-Activated Reserve Forces Separations are counted under Estimated Living Veterans only when the individual becomes either serviceconnected or a pensioner. All Non-Activated Reserve Forces Separations are counted, regardless of: · · · · Length of enlistment Re-enlistment Character of service Death Limitations: Non-Activated Reserve Forces Separations may include service members who are veterans due to active duty service prior to the start of the Gulf War on August 2, 1990. Due to system limitations, VA cannot determine the status of these service members' active duty service, if any. Non-Activated Reserve Forces, Service-Connected This category identifies a subset of Non-Activated Reserve Forces Separations who are serviceconnected or who are pensioners. This category is included in the count of veterans because they are receiving service-connected or war-time related benefits. Limitations: Non-Activated Reserve Forces Separations may include service members who are veterans due to active duty service prior to the start of the Gulf War on August 2, 1990. Due to system limitations, VA cannot determine the status of these service members' active duty service, if any. Nonservice-Connected, No Pension This category identifies the number of veterans who do not qualify for VA compensation or pension. VA determined the veteran did not qualify for compensation because none of the veterans' conditions are related to military service. In addition, VA determined the veteran did not qualify for a pension based on VA's disability and income requirements. This denial is called "nonservice-connected," or "NSC." This is not a cumulative count. Nonservice-Connected, Receiving Pension This category identifies the number of veterans where VA determined the veteran's condition(s) were not related to military service. This denial is called "nonservice-connected," or "NSC." However, the veteran qualifies for a pension due to a nonservice-connected disability and income qualifications. This is not a cumulative count. 21 Gulf War Veterans Information System Other Conflict February 2006 Other Conflict is a subset of Conflict. Other Conflict identifies active duty service members deployed to Southwest Asia during the Gulf War, from August 2, 1990, through July 31, 1991, not already identified in the categories Al Jubayl and Khamisiyah. This includes Active Duty as well as Activated Reserve Forces. Reserve Forces This category inc ludes military service members from the following seven Reserve Forces components: Air National Guard, Marine Corps Reserve, Navy Reserve, Air Force Reserve, Army National Guard, Army Reserve, and Coast Guard Reserve. Service-Connected Ten Percent (10%) or Greater, No Compensation or Pension This category identifies the number of veterans where VA rated at least one service-connected condition at ten percent (10%) or higher. However, the veteran is not in receipt of compensation or pension payments. For example, this category includes service-connected military retiree veterans who are entitled to VA compensation but who elected not to receive it. It also includes veterans with disability severance pay who are on the Temporary Disability Retirement List (TDRL) and the Permanent Disability Retirement List (PDRL). This is not a cumulative count. Service-Connected Ten Percent (10%) or Greater, Receiving Compensation or Pension This category identifies the number of veterans where VA rated at least one service-connected condition at ten percent (10%) or higher, and the veteran receives compensation or pension payments. This is not a cumulative count. Service-Connected Zero (0%) Percent, Receiving Compensation or Pension This category identifies the number of veterans where VA rated at least one service-connected condition at zero percent (0%). The veteran qualifies for pension payments based on nonservice-connected disability and income, or the veteran qualifies for compensation based on VA regulations for multiple zero percent service-connected conditions. This is not a cumulative count. Service-Connected Zero (0%) Percent, No Compensation or Pension This category identifies the number of veterans where VA rated at least one service-connected condition at zero percent (0%). However, the veteran does not qualify for compensation or pension payments. This is not a cumulative count. 22 Gulf War Veterans Information System Service Members February 2006 Service Members identifies individuals with any military service on or after August 2, 1990, the start of the Gulf War. VA identifies Service Members because they may be eligible for VA benefits (education, life insurance, home loan guaranty, and compensation and pension) under certain conditions. This includes: · · Active Duty Services: Army, Navy, Air Force, Marine Corps, and Coast Guard Reserve Components: Air National Guard, Marine Corps Reserve, Navy Reserve, Air Force Reserve, Army National Guard, Army Reserve, and Coast Guard Reserve All Service Members are counted, regardless of: · · · · · · Length of enlistment Re-enlistment Character of service Death Activated Reserve Forces Non-Activated Reserve Forces Limitations: Individuals in the Public Health Service (PHS) or in the National Oceanic and Atmospheric Administration (NOAA) are not identified or counted as Service Members. Details about the benefit use of individuals in PHS and NOAA are not provided in this report. Service Member Separations Service Member Separations is a subset of Service Members. Service Member Separations identifies individuals with a discharge from military service on or after August 2, 1990. Service Member Separations equals the sum of three categories: · · · Active Duty Separations Activated Reserve Forces Separations Non-Activated Reserve Forces Separations All Service Members Separations are counted, regardless of: · · · · · · Length of enlistment Re-enlistment Character of service Death Activated Reserve Forces Non-Activated Reserve Forces 23 Gulf War Veterans Information System Theater February 2006 Theater is a subset of Deployed. Theater identifies active duty service members who deployed to Southwest Asia during the Gulf War from August 1, 1991, until the present. This includes Active Duty as well as Activated Reserve Forces. Service members who served in both the Conflict and the Theater time periods are reported only under Conflict. Limitations: VA defines the Southwest Asia theater as Iraq, Kuwait, Saudi Arabia, the neutral zone between Iraq and Saudi Arabia, Bahrain, Qatar, the United Arab Emirates, Oman, the Gulf of Aden, the Gulf of Oman, the Persian Gulf, the Arabian Sea, the Red Sea, and the airspace above these locations. Total Total equals the sum of the categories Deployed and Era. Undiagnosed Illness (UDX), Claims Denied Service Connection An undiagnosed illness (UDX) claim is denied when VA determines none of the veteran's UDX conditions met eligibility requirements under VA regulations. This denial is called "nonserviceconnected," or "NSC." Limitations: There may be overlap between the categories Undiagnosed Claims Denied Service Connection and Claims Granted Service Connection. This happens when a veteran had all UDX conditions denied and a veteran has at least one diagnosed condition granted. The Theater category contains counts of veterans granted and denied UDX claims even though DMDC reports some of the veterans as Era (non deployed). VA is reviewing these veterans' records with DoD to determine the veterans' correct deployment status. This is not a cumulative count. Undiagnosed Illness (UDX), Claims Granted Service Connection A veteran's undiagnosed illness (UDX) claim is granted when VA determines at least one of the veteran's UDX conditions meets eligibility requirements under VA regulations for service connection. This grant is called "service-connected," or "SC." This category is a subset of Claims Granted Service Connection because the veteran has at least one granted condition. For veterans who filed a claim for more than one UDX condition, this category contains veterans with a full grant of all UDX conditions as well as veterans with a combination of grants and denials for UDX conditions. Disabilities are evaluated according to VA regulations, and the extent of the disability is expressed as a percentage from zero percent to 100 percent, in increments of 10 percent. Undiagnosed (UDX) Claims Granted Service Connection includes all service-connected UDX disabilities, from zero percent to 100 percent, regardless if the veteran receives compensation. Limitations: The Theater category contains counts of veterans granted and denied UDX claims even though DMDC reports some of the veterans as Era (non deployed). VA is reviewing these veterans' 24 Gulf War Veterans Information System February 2006 records with DoD to determine the veterans' correct deployment status. This report provides the current count of veterans granted service connection for a UDX condition. This is not a cumulative count. Therefore, the count may increase, decrease, or remain the same. The count may decrease if a serviceconnected veteran's UDX condition was subsequently diagnosed or resolved. Undiagnosed Illness (UDX), Claims Processed Undiagnosed Illness (UDX) Claims Processed equals the total of Undiagnosed Illness (UDX) Claims Granted Service Connection and Undiagnosed Illness (UDX) Claims Denied Service Connection. Undiagnosed Illness (UDX) Claims Processed does not include pending claims. This is not a cumulative count. Undiagnosed Illness (UDX), Nonservice-Connected, No Pension This category identifies the number of veterans who do not qualify for VA compensation or pension. VA determined the veteran did not qualify for compensation because none of the veterans' Undiagnosed Illness (UDX) conditions are related to military service. In addition, VA determined the veteran did not qualify for a pension based on VA's disability and income requirements. This denial is called "nonservice-connected," or "NSC." This is not a cumulative count. Undiagnosed Illness (UDX), Nonservice-Connected, Receiving Compensation or Pension This category identifies the number of veterans where VA determined the veteran's undiagnosed UDX condition(s) did not meet VA regulations for service connection. This denial is called "nonserviceconnected," or "NSC." However, the veteran qualified for a pension due to disability and low income, or the veteran was granted service connection for a diagnosed condition. Limitations: There may be overlap between the category Undiagnosed (UDX) Nonservice-connected Receiving Compensation or Pension and the category Claims Granted Service Connection. This happens when a veteran had all UDX conditions denied and has at least one diagnosed condition granted. This is not a cumulative count. Undiagnosed Illness (UDX), Service-Connected Ten Percent (10%) or Greater, No Compensation or Pension This category identifies the number of veterans where VA rated at least one service-connected Undiagnosed Illness condition at ten percent (10%) or higher. However, the veteran is not in receipt of compensation or pension payments. For example, this category includes service-connected military retiree veterans who are entitled to VA compensation but who elected not to receive it. It also includes veterans with disability severance pay who are on the Temporary Disability Retirement List (TDRL) and the Permanent Disability Retirement List (PDRL). This is not a cumulative count. 25 Gulf War Veterans Information System February 2006 Undiagnosed Illness (UDX), Service-Connected Ten Percent (10%) or Greater, Receiving Compensation or Pension This category identifies the number of veterans where VA rated at least one service-connected Undiagnosed Illness (UDX) condition at ten percent (10%) or higher, and the veteran receives compensation or pension payments. This is not a cumulative count. Undiagnosed Illness (UDX), Service-Connected Zero (0%) Percent, No Compensation or Pension This category identifies the number of veterans where VA rated at least one service-connected Undiagnosed Illness (UDX) condition at zero percent (0%). However, the veteran does not qualify for compensation or pension payments. This is not a cumulative count. Undiagnosed Illness (UDX), Service-Connected Zero Percent (0%), Receiving Compensation or Pension This category identifies the number of veterans where VA rated at least one service-connected condition at zero percent (0%). The veteran qualifies for pension payme nts based on nonservice-connected disability and income, or the veteran qualifies for compensation based on VA regulations for multiple zero percent service-connected conditions. This is not a cumulative count. Unique Count of Veterans Using Vet Centers This category counts the number of unique veterans where the Readjustment Counseling Service Vet Center (RCSVC) computer system indicates the veteran sought or is using RCSVC services. Veteran Deaths Identifies deceased veterans reported only in VBA's Compensation and Pension Master Record (CPMR) and the Beneficiary Identification and Records Locator Subsystem (BIRLS). Limitations: These counts reflect raw data that have not been subjected to any statistical analysis nor adjusted in any way to make it a mortality study. There has been no adjustment to account for age, gender, race, and other items required for a valid mortality study. In addition, the data will not reflect deaths reported after December 2005. The use of these data to draw conclusions regarding mortality rates will result in inaccurate conclusions. For analysis of Gulf War veteran mortality, see "Mortality among US Veterans of the Persian Gulf War: 7-Year Follow-up," Han K. Kang and Tim A. Bullman, American Journal of Epidemiology, 2001, 154(5): 399-405. 26

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