Another Reason Chiropractors Should Be at Every VA Facility

Musculoskeletal Injuries #1 Complaint Among Veterans of Iraq, Afghanistan

By Peter W. Crownfield, Executive Editor

A recent report from the Veterans Health Administration (VHA) Office of Public Health and Occupational Hazards cites musculoskeletal injuries as the number-one complaint among U.S.

veterans of Iraq and Afghanistan. According to the report, titled "Analysis of VA Health Care Utilization Among U.S. Southwest Asian War Veterans," 41.7 percent of veterans who sought VA health care after returning from duty in the Middle East or Southwest Asia were diagnosed with a musculoskeletal condition.

In September 2003, the U.S. Department of Defense (DoD), Defense Manpower Data Center, developed an initial roster of deployed Operation Iraqi Freedom and Operation Enduring Freedom troops. The roster, which includes veterans who have left active duty after serving in one or both of the above operations, is updated periodically, with the latest update on May 31, 2006. A total of 588,923 such veterans have become eligible for VA health care since Fiscal Year 2002.

The VA report analyzed electronic inpatient and outpatient health records to determine which veterans of Operation Iraqi Freedom and Operation Enduring Freedom had accessed VA health care as of June 30, 2006, and to determine the nature of such care. Of the nearly 600,000 eligible veterans, 184,524 sought VA health care from FY 2002 to the third quarter of 2006.

According to the report, "The three most common possible health problems of war veterans were musculoskeletal complaints (principally joint and back disorders), mental disorders, and 'Symptoms, Signs and Ill-Defined Conditions.'" Overall, 76, 986 veterans who sought VA health care received an ICD-9 diagnosis of "Diseases of Musculoskeletal System/Connective System" (710-739), making it the most common diagnosis among the subject population.

According to the American Chiropractic Association (ACA), the report emphasizes the need to accelerate and expand the integration of chiropractic care into the VA health care system:

"Service members serving in combat areas typically haul more than 80 pounds of equipment daily," said ACA President Richard Brassard, DC. "It's easy to understand why an astounding number of men and women returning from overseas tours are seeking health care for symptoms associated with musculoskeletal injuries, primarily back and joint disorders."

As reported in DC earlier this year, legislation to expand the chiropractic benefit to all veterans is moving through Congress. House Resolution 5202, introduced on April 26, 2006, by Jeb Bradley (R-N.H.) and Bob Filner (D-Calif.), amends the Health Care Programs Enhancement Act of 2001 by requiring the provision of chiropractic care "at not fewer than 75 medical centers by not later than December 31, 2008, and at all medical centers by not later than December 31, 2010."Currently, less than 30 percent of the nation's VA medical centers have a chiropractor on staff. As of press time, H.R.5202 has been referred to the House Subcommittee on Health.

"We must fully support our men and women in uniform by providing them with the health care benefits they need following their military service," said Dr. Brassard. "By working in concert with medical doctors and other health care providers at VA facilities, chiropractors can definitely make an impact on the upsurge of back pain among our nation's veterans."

Recall that H.R.5202 is not the only piece of legislation designed to expand the chiropractic presence within the military health care system. On Sept. 30, 2006, the U.S. Senate passed H.R.5122, the National Defense Authorization Act for FY 2007, following passage by the House. Section 712 calls for the Secretary of Defense to evaluate the cost and feasibility of making chiropractic services available to all active-duty military personnel, reservists, retirees and eligible dependents; and to submit a report to the House and Senate Armed Services Committee by March 31, 2008. President George W. Bush signed H.R.5122 into law on Oct. 17, 2006.

Resources

1. "Analysis of VA Health Care Utilization Among U.S. Southwest Asian War Veterans. Operation Iraqi Freedom, Operation Enduring Freedom." VHA Office of Public Health and Environmental Hazards.
2. "Veterans Health Care Facilities Must Place Increased Focus on Musculoskeletal Injuries." American Chiropractic Association press release, Oct. 23, 2006.
3. "H.R.5202 Mandates Chiropractic at Every VA Medical Center by 2010." Dynamic Chiropractic, June 20, 2006. www.chiroweb.com/archives/24/13/05.html.
4. THOMAS (Library of Congress) summary of H.R.5202 and current bill status; accessed Nov. 9, 2006.
5. "Congress Paves Way for All Military Personnel to Receive Chiropractic." Dynamic Chiropractic, Nov. 8, 2006. www.chiroweb.com/archives/24/23/05.html.