V. MEDICAL FOLLOW-UP OF THE 325th MAINTENANCE COMPANY
Following their service in the Gulf War, the 325th Maintenance Company returned to Florida. As previously discussed, a number of soldiers from the unit had experienced health problems while in Saudi Arabia. In many cases, these health problems persisted or even intensified after their return home. As a result of the large number of health problems within the 325th, health testing was conducted while the unit was at an annual training tour of duty at Ft. Stewart in 1992. An Army occupational medicine physician from Florida examined members of the 325th. He reported skin rashes in 10 to 15 soldiers, as well as a number of cases of non-specific symptoms, such as headaches, fatigue, and sleep difficulty. The physician was also able to perform pulmonary function tests on 20 to 30 soldiers from the unit. He recalls asthma-like symptoms in a number of these soldiers, many of whom complained of recurring breathing difficulties. He also noted that he saw symptoms consistent with possible chemical sensitization from CARC exposure in some of the soldiers. Due to the numerous health complaints within the unit, all Gulf War veterans still in the unit were given several other tests including blood tests while at Ft. Stewart.
Some soldiers from the 325th Maintenance Company communicated their CARC painting experiences to their US representative, Charles Canady of Floridas 12th District. A series of correspondence between the congressman and DoD officials discussed the issues of CARC exposures and medical care for Operation Desert Storm National Guard members.[160,161] The matter was referred to the National Guard Bureau for investigation. The National Guard Bureau inspector general issued an assessment addressing health care issues for veterans of Operations Desert Shield and Desert Storm in June 1994.
The House of Representatives Committee on Veterans Affairs held a hearing regarding Gulf War veterans issues on June 9, 1993. Major General Robert Ensslin, Jr., adjutant general for the state of Florida responsible for the mobilization, deployment, and demobilization of the 325th, delivered a statement regarding the 325th Maintenance Company. In his statement MG Ensslin noted that over 200 Army National Guard members were released from active duty who had not completed medical treatment for duty related injuries or illnesses. Although this action to expedite the return of soldiers to their home station was well intended, many National Guardmembers had difficulty in receiving treatment once discharged.
On October 9, 1996, the issue of the 325th Maintenance Companys exposure to CARC was discussed at a Presidential Advisory Committee on Gulf War Veterans Illnesses (PAC) hearing. The PAC was established in May 1995 to ensure independent, open, and comprehensive examination of health concerns related to Gulf War service. At the hearing, a representative from the Florida Department of Veterans Affairs and a member of the 325th Maintenance Company provided statements. Both speakers explained that a number of veterans from the 325th had become ill due to their work with CARC. They also described some of the difficulties that veterans faced in obtaining treatment and compensation for their illnesses.
As with members of active Army units, National Guardmembers in units like the 325th can pursue health care through the DoD's Comprehensive Clinical Evaluation Program (CCEP). However, unlike Army servicemembers, National Guardmembers are not paid when they miss duty unless a doctor states that they are incapacitated and unable to perform their duty. For a Gulf War veteran to receive disability and medical treatment through the Comprehensive Clinical Evaluation Program, participation in Phase I of the program is required. This involves undergoing a free medical evaluation. A physician's diagnosis of a health problem determined at this evaluation can then be sent for a determination of whether the illness is connected to a soldier's Gulf War service, called "line of duty." Though Guardmembers are reimbursed for their travel expenses to go to a clinic to receive their Phase I medical evaluation (i.e., mileage, lodging, food), time taken off from civilian work to have the evaluation performed is not reimbursed. Additionally, establishing the line of duty status for an illness does not guarantee compensation. Veterans only receive compensation if they are unable to perform their assigned duty or their military occupational specialty. Conversations with a specialist working with the CCEP revealed that Guardmembers often do not avail themselves of the CCEP evaluation process because of the monetary cost of taking the time off from their civilian jobs, as well as their belief that they will be unable to receive line of duty compensation.
A number of Guardsmen who served with the 325th Maintenance Company during Operation Desert Shield/Storm left the National Guard at some point following the war. Unlike those who remained in the unit, these Guardsmen are not eligible for the DoD's CCEP program. Instead, they can enroll in the Department of Veteran's Affairs (VA) Persian Gulf Registry to receive medical evaluation. Due to the large number of soldiers in the 325th who were experiencing health problems, Veterans Affairs staff made a number of visits to the unit's headquarters in Lake Wales, Florida, between 1992 and 1993. The VA representatives were also on hand at the unit's annual training at Ft. Stewart shortly after their return from Saudi Arabia. Over 100 claims from the 325th have been processed. Through this program, several members of the 325th were discharged and given compensation for disabilities that were associated with their service in the war.
As of October 1999, 66 members of the 325th Maintenance Company had received CCEP medical evaluations, and 97 members had received VA Persian Gulf Registry evaluations. Since there were about 200 members of the 325th who performed painting operations, a high proportion have enrolled in the two registries. At the start of the Gulf War in 1990, these 163 soldiers ranged in age from 19 to 58 years.
Seventy of the 163 soldiers had a diagnosis or symptoms of a respiratory disease, including 10 diagnosed with asthma. Asthma is the most specific type of chronic effect that would be expected after long-term exposure to isocyanates. Generally, in other populations, this disease has developed in workers who have been exposed for at least 12 months to several years.
Several members of the 325th have been awarded compensation for disability due to a variety of service-connected diseases. Because the complete medical and compensation records could not be reviewed due to privacy act considerations, the particular disabling conditions for which these veterans were compensated are unknown. The CCEP and VA Persian Gulf Registry databases do not provide information about changes in diagnoses over time, ongoing treatment, or disability determinations within the DoD or VA health care and benefit systems.
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