In Part 1 (read it here!) I focused on the evolution of visible and invisible injuries throughout the history of America’s military engagements. For Part 2, I’m focusing on the compensation for wounded veterans and the expectations for their lives after their injuries…

Pensions & Compensation: What Do We Owe the Wounded Veteran?

Wounded and disabled veterans are a visible reminder of the consequences of war—one that lasts far beyond the conflict itself. They are the living, breathing symbol of what happens in war. Since the Revolutionary war, our nation has taken care of its wounded veterans but our relationship to the wounded and our expectations of them and their lives have changed and evolved throughout time. The wounded veteran represents a juncture of many complicated social institutions, statuses, and relationships: from the military institution, to the U.S. government, our national sentiments towards that particular war, and the way disability is generally constructed in society. Throughout history, our treatment of the wounded veteran reflects these changes in the meaning of war, service, and sacrifice.

From its earliest beginnings, the government has provided for American soldiers who were wounded in combat. One of the first legislative acts in the American colonies was to establish pensions for veterans who were wounded and disabled in combat (McVeigh and Cooper 2013; VA History; Van Ells 2001). The U.S. government’s support and resources for the disabled combat veteran has been consistent, however the approach and expected outcomes for the post-war lives of these veterans has evolved over time. What started with pensions for disabled veterans in the Revolutionary War has expanded to today’s integrative and individualized rehabilitation programs.

America’s Early Wars

Soldiers wounded in America’s first wars, the Revolutionary War and the War of 1812, were given pensions to compensate for their loss and inability to labor. Soldiers with limb loss and other serious disabilities were provided up to half-pay for the rest of their lives. Some veterans were given land grants, which could be sold for cash if one so desired, as compensation for their injuries and wounds. Besides these financial benefits, veterans received little else which forced them to rely on family and friends as the primary sources of care and support (McVeigh and Cooper 2013; VA History; Van Ells 2001).

The Civil War in the United States was the deadliest war in American history; new estimates claim the potential loss of life around 750,000 Americans (Hacker 2011). Nearly 75 percent of all surgeries performed on the Civil War battlefields were amputations resulting from bullet wounds and other battle injuries. Many soldiers who survived their amputations did not survive postsurgical infections, which was a common occurrence during this time period (Pasquina and Cooper 2009). Disabled men who served in the war were able to receive a pension, based on their rank and degree of disability (Logue and Blanck 2010; McVeigh and Cooper 2013; Van Ells 2001). Beyond pensions, there were some additional resources provided to help disabled and injured veterans. Amputees were given free prosthetic limbs, and there were national homes for disabled veterans that provided room and board and some medical care for those in need (Pasquina and Cooper 2009; VA History; Van Ells 2001).

World War I: Pivoting to Rehabilitation

At the time of World War I, the US had spent over 5 billion dollars on Civil War pensions and there was a growing dissatisfaction with pension system. In the Civil War, wounded veterans were held with high regard in society—their wounds were wounds of valor. After World War I, wounded veterans were looked down upon—their wounds were stigmatized, negatively separating them from ‘normal’ society. With the eugenics movement and the focus on physical normality, the abnormal and dysfunctional body of a wounded veteran was unsightly and something that needed to be hidden (Linker 2011). This social climate led to the idea that our nation should get rid of the pension system, focusing instead on the rehabilitation of wounded veterans to make them productive citizens (i.e. laborers) again. This was the start of comprehensive rehabilitation programs for wounded veterans. The motivational posters in military hospitals during this time highlight the shift in focus to rehabilitation, suggesting “usefulness” and “getting back to work” for permanently wounded soldiers through crafts and other activities. The goal was to ensure that a soldier’s disability was a not handicap, smoothing over the unsightly visible image of the human cost of war (Linker 2011; Pasquina and Cooper 2009).

In addition to pensions (for veterans injured in combat), disabled veterans had access to life insurance and occupational training (VA History). This new rehabilitation effort was not yet streamlined, with three different agencies provided support for the wounded, leaving veterans navigating a patchwork of institutions (Linker 2011; VA History; Van Ells 2001). The need for a consolidated government organization for veterans services led to the establishment of the U.S. Department of Veterans Affairs in 1930, which is now the second largest department in the U.S. government behind the U.S. Department of Defense (VA History).

World War I Veterans in Red Cross Library at Walter Reed Military Hospital

World War II: Expansion of All Veteran Benefits

The end of World War II ushered in widespread prosperity in America, and it also brought a new wave of veteran benefits accessible by all veterans, not just the wounded. The 1944 Servicemen’s Readjustment Act provided funds for higher education (GI Bill), home loans with no down payment (VA Home Loan), and unemployment compensation for all veterans. This gave millions of Americans who had served in the war a short-cut access to the American Dream (VA History; Van Ells 2001). For veterans with disabilities, financial compensation through the pension system as well as medical and rehabilitation care continued. The heroic return of World War II veterans into a flourishing home economy paired with access to the most comprehensive package of benefits for veterans in US history created a generation of veterans that remained ahead of their civilian peers for most of their lives (Smith et al. 2012). Van Ells (2001) describes the impact this may have had on next generation of war veterans in the Korean and Vietnam conflicts, “…the process of veteran readjustment went so smoothly that many Americans came to believe that a non-traumatic postwar period was normal” (247).

Korean War & Vietnam War

The benefits and compensation established for World War II veterans continued for Korean and Vietnam War veterans, but many programs (such as the GI Bill) saw reduced financial support and increased restrictions (VA History). Veterans of the Korean War era call their war, the forgotten war, feeling as though Americans forgot about their wartime service and sacrifices. Medical attention to wounded and disabled veterans continued toward establishing greater rehabilitative care during this era. The higher proportion of amputees from the Vietnam War prompted the creation of a therapeutic adaptive skiing clinic, and several specialty spinal cord treatment centers (largely for paraplegia), which have continued to today (Pasquina and Cooper 2009). Disability pensions after the Vietnam War were further refined, with differences in compensation based the degree to which one’s injuries prevented full employment (Boyle 2009).

Mental health issues with returning combat veterans came to the forefront, with many Vietnam veterans being described as having “post-Vietnam syndrome” (Finley 2011: 95). The VA established special Vet Centers in 1979 that provided rehabilitation counseling because they realized that many veterans were still experiencing problems in civilian life. Post-traumatic stress disorder was not recognized as a disability by the Department of Veterans until after its inclusion in the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1980. In addition, cancers and other illnesses associated with Agent Orange, an herbicide used during the Vietnam War, were not recognized as a combat disability for compensation until several years later (Finley 2011; Scott 1992).

Gulf War to Now: Continued Expansion of Benefits

Veterans of the most recent conflicts, the Gulf War and the Iraq and Afghanistan wars, continue to receive the benefits that were established in the generations that came before them. Standard benefits for all veterans include: the GI Bill (which has since been reshaped to the Post-9/11 GI Bill), VA home loans, and a hiring preference in the federal government (VA History). Over the last two decades, benefits for disabled veterans have expanded, including a greater recognition and compensation for PTSD and traumatic brain injury (TBI).

In addition to disability pensions and vocational rehabilitation programs, disabled veterans can apply for housing and automobile grants to purchase or modify their home or car to accommodate their disability (VA 2012). There are new VA integrated care centers that provide focused and intensive rehabilitation care for the most severely wounded in Washington DC, Texas and California. Specialty care centers have also been established around the nation for the “invisible” wounds of war, treatment programs that are specifically designed for PTSD and TBI (VA Polytrauma 2012). The VA recently created a program that provides financial support and resources to designated family caregivers of wounded veterans (VA 2012). Iraq and Afghanistan veterans are filing for disability benefits at an unprecedented rate, almost half of the veterans from these wars have filed a claim and many have filed for multiple health issues (Marchione 2012).

VA Polytrauma Center in San Antonio, Texas

Conclusion: Where do we stand today?

While disabled veterans have always received enough medical care to recover from their wounds (such as adaptive equipment like prosthetic limbs), the recovery process has evolved over time to include more support for total and complete rehabilitation and reintegration. World War I represents a turning point in this evolution, where injured veterans were actively encouraged to continue leading productive lives (Linker 2011). For Iraq and Afghanistan wounded veterans, this has manifested into comprehensive medical care, programs, and resources from both public and private organizations that encourage an active and involved lifestyle.

In War’s Waste, Linker argues that there is an “ethic of rehabilitation” for disabled and wounded veterans, one that began in World War I when veterans were encouraged to be productive in hopes of eliminating the need for a pension system (2011: 1). She describes how this focus on complete rehabilitation has flowered into greater expectations for disabled veterans, “war wounds in themselves are not enough to earn respect. The maimed veteran who earns accolades is the one who makes good, applying his (and now her) military skills to fight for a full recovery” (Linker 2011: 1). This requirement that veterans continue to ‘fight’ and be ‘warriors’ now extends into perpetuity. For today’s generation, we call wounded veterans “wounded warriors”—a literal and symbolic reference to the unprecedented standards we hold our post-9/11 wounded veterans to.

Interested in learning more? Here’s some resources I recommend:

Linker, Beth. 2011. War’s Waste: Rehabilitation in World War I America. Chicago, IL: University of Chicago Press.

McVeigh, Stephen and Nicola Cooper, eds. 2013. Men After War. New York, NY: Routledge.

Scott, Wilbur J. 1992. “PTSD and Agent Orange: Implications for a Sociology of Veterans’ Issues.” Armed Forces & Society 18(4): 592-612.

VA History in Brief. U.S. Department of Veterans Affairs. http://www.va.gov/opa/publications/archives/docs/history_in_brief.pdf

Van Ells, Mark D. 2001. To Hear Only Thunder Again: America’s World War II Veterans Come Home. Lanham, MD: Lexington Books.

Other Sources Cited:

Boyle, Brenda M. 2009. Masculinity in Vietnam War Narratives: A Critical Study of Fiction, Films, and Nonfiction Writings. Jefferson, NC: McFarland & Company, Inc.

Department of Veterans Affairs (VA). 2012. “Returning Service Members (OEF/OIF/OND).”U.S. Department of Veterans Affairs. http://www.oefoif.va.gov

—–. 2013. “Federal Benefits for Veterans, Dependents and Survivors.” U.S. Department of Veterans Affairs, 2013 Edition. ISBN: 978-0-16-090303-8.

—–. 2012. “VA Polytrauma System of Care.” U.S. Department of Veterans Affairs.  http://www.polytrauma.va.gov/system-of-care/care-facilities/

Finley, Erin P. 2011. Fields of Combat: Understanding PTSD among Veterans of Iraq and Afghanistan. Ithaca, NY: ILR Press.

Hacker, J. David. 2011. “A Census-Based Count of the Civil War Dead.” Civil War History 57(4) December 2011: 307-348.

Logue, Larry M., and Peter Blanck. 2010. Race, Ethnicity, and Disability: Veterans and Benefits in Post-Civil War America. Cambridge: Cambridge University Press.

Marchione, Marilynn. 2012. “U.S. Vets’ Disability Filings Reach Historic Rate” USA Today, May 28. http://usatoday30.usatoday.com/news/health/story/2012-05-28/veteran-disability/55250092/1

Pasquina, Paul F. and Rory A Cooper, eds. 2009. Care of the Combat Amputee. Textbooks of   Military Medicine. Washington, DC: Office of Surgeon General at TMM Publications.

Smith, Irving III, Kris Marsh, and David Segal. 2012. “The World War II Veteran Advantage? A Lifetime Cross-Sectional Study of Social Status Attainment.” Armed Forces & Society 38(1): 5-26.