Vietnam veterans are falling ill, but why now?

In the past few years, Dr. Michael Koopmeiners has seen a surge in the number of veterans seeking help for war-related disabilities at the Minneapolis VA Medical Center.

At Koopmeiners' clinic, which evaluates new disability claims, business has more than doubled since 2004 -- from 6,800 to nearly 15,000 patients a year.

But only a fraction of the cases have anything to do with Iraq or Afghanistan.

Instead, most are Vietnam veterans who have waited until now, more than three decades after their war ended, to come forward and seek help. Vietnam veterans, he says, outnumber those of every other conflict combined.

Nationally, too, Vietnam veterans are coming forward by the tens of thousands with a vast array of medical problems, from hearing loss to cancer, that they believe are connected to their military service. In 2007 alone, a quarter of a million veterans were added to the VA disability rolls -- more than a third of them Vietnam veterans, according to a VA spokeswoman.

The question is why now?

To some extent, the recession is fueling the surge, say experts and veterans groups. Anyone with a military disability may qualify for free care and monthly payments from the Department of Veterans Affairs.

"Most folks walked off the battlefield in one piece and felt 'OK, I made it,' " Rowan said. "What they didn't know was there was a whole lot of stuff that would come up and bite them in the butt 40 years later."

Links to Agent Orange

In particular, many are developing illnesses that have been linked statistically to the notorious herbicide Agent Orange, which was widely used in Vietnam. Even though some conditions are quite common -- such as diabetes and prostate cancer -- the VA views them as service-related disabilities.

So veterans such as Jim Fiebke, who never thought they would be asking the government for anything, are finally doing just that.

Fiebke, a retired sales executive from Rochester, spent a year as an Army clerk in Vietnam from 1969 to 1970.

He had no reason to doubt it for 30 years, until he was 52 and developed multiple myeloma, an insidious form of cancer of the blood cells and bone marrow. At first, Fiebke figured it was just bad luck. But in 2003, a chance encounter in a parking lot left him wondering if his illness could be an aftershock of Vietnam.

"This lady walks up and says, is that your car?" he recalled. She had noticed his Vietnam veteran license plate, as well as the telltale signs that he was fighting cancer ("I didn't have hair and looked a little sick"). The woman told him that she had lost her husband, a Vietnam veteran, to cancer, and that there was a connection to Agent Orange. "You should get in and check on that," he remembers her saying.

"I did. And I was just shocked."

20 million gallons of herbicide

Fiebke learned that his cancer was one of the diseases that the VA calls "presumptive conditions" -- presumed, that is, to be caused by Agent Orange.

Fiebke assumes he was exposed to Agent Orange; the area around his base camp "was just sprayed down to nothing." But all he needed to show was that he served even one day on Vietnamese soil to qualify.

"When I applied [for disability], I went down thinking I don't know what's going to happen," he said. He was approved almost immediately and rated 100 percent disabled because of the severity of his illness. That entitled him to "top priority" care at the VA and $3,000 monthly disability payments. The money allowed him to retire at age 57 and concentrate on his health, he said.

Fiebke admits that he was stunned by the outcome.

"There are people that would say these people are getting money and medical care and they don't even know for sure if Agent Orange did it," he said. "And that's true."

But Rowan, of Vietnam Veterans of America, says there's no reason to feel guilty.

"Even though [these illnesses are] in the general population, we seem to get it worse; we seem to get it at a higher rate," he said.

As of last fall, 12 percent of Vietnam-era veterans were receiving disability payments averaging $11,670 a year, according to VA statistics, and the total number of veterans receiving disability benefits had climbed to nearly 3 million. Meanwhile, the requests have hit record levels.

Getting benefits, finally

Richard Bergling, of Anoka, waited until 2006 to apply for disability benefits, after developing Type II diabetes. "My wife said you could have applied for PTSD 20 years ago, and why didn't you," said Bergling, who battled post-traumatic stress for years after serving on a Navy riverboat in Vietnam from 1967-1969. "I felt that there were guys out there that were worse off than me and if I took funds away from them, then they're the ones who would be shortchanged."

At 62, his attitude has changed. "To me, that's not an entitlement," he said of his $940 monthly disability payment. "To me, it's more holding up their end of the bargain."

For a long time, he said, he was like many Vietnam veterans, embittered about the military and the hostility they faced coming home from an unpopular war.

A change of perspective

"I think we're coming out of the closet now," said Cook, 61, who has a nerve condition linked to Agent Orange. "Do we want to take more money from the government? I think the Vietnam veterans have been slighted for a long time. If there are things that guys are suffering for serving their country ... they're entitled. I guess I've never felt that way before."

For some veterans, it's also an economic decision. "When the economy is bad, people obviously will apply for benefits," said Milton Schoen, Hennepin County's veteran service officer. But most of the claims are legitimate, and some long overdue, he said. "I have not seen people coming in and gaming the system."

Still, it can be tricky to tell if some conditions are service-connected three or four decades after the fact, says Koopmeiners, who runs the clinic that assesses those claims. For something like hearing loss or knee problems, he said, the VA still has to ask: Is it old age or an old injury?

If the medical evidence is unclear, he adds, "the tie goes to the veteran."

Maura Lerner • 612-673-7384