WASHINGTON -- Zach McIlwain has low testosterone levels, post-traumatic stress disorder, limited mobility in his left hand and debilitating migraines that sometimes last for days. The 27-year-old received his injuries during two combat tours in Iraq, and he applied for disability benefits while still overseas.
That was in 2009. It took almost three years for the Department of Veterans Affairs to approve his benefits.
The VA "continued to lose paperwork, and somehow I was at fault for it," McIlwain said. The VA had more than 770,000 disability compensation claims pending as of June 1, and the department has been in the spotlight for weeks amid its promises to expedite its sluggish decision-making process.
The department said that by 2015, all claims should be decided in 125 days or fewer with an error rate of 2 percent, goals it's far from realizing.
And if it's going to reach those goals, there's a pressing problem to overcome: a tendency to lose or otherwise mishandle veterans' records. Over the years, poor record-keeping at both the VA and the Department of Defense has resulted in losses of paperwork and denials to veterans, lengthening the claim response time.
The Government Accountability Office, Congress' investigative arm, found in a report last year that the record-gathering process for veterans who go to the VA to seek evidence for claims could take months.
Kerry Baker, a VA appellate practitioner at Chisholm, Chisholm and Kirkpatrick in Providence, R.I., is a Marine veteran who's worked at the VA. He said veterans could derive evidence from three types of logs: personnel records, service medical records that follow a veteran throughout his or her time in service, and unit or ship records. McIlwain went through hundreds of pages of his records to document his dates of treatments and injuries. In 2010, private practitioners he consulted determined that his hand injury was service-connected.
"I tried to make sure I reached the threshold," McIlwain said. "I don't know what more I could have done."
Millions of files like McIlwain's fill warehouses and computer servers. Some claim that individual folders of evidence may be 4 or 5 feet tall, the VA said. McIlwain said it was probably easier for the VA to lose his paperwork than to process it.
Staff mistakes as simple as placing mail in the wrong folder can delay claim processing, the GAO said. It also said an inefficient IT system required that several claims folders be logged in multiple databases. The VA's Office of Inspector General reported in May 2011 that the staffs at 10 out of 16 VA regional offices had "improperly managed" mail, meaning they may not have applied all the evidence necessary for prompt disability ratings.
The VA said it has started initiatives to speed up the process, including new organizational models and electronic processing.
"The Department of Veterans Affairs wants to ensure that all veterans are getting their benefits in a timely manner," VA spokesman Steve Westerfeld said. "Certainly, any veteran that has not been able to get that because of anything the VA has done -- that is unacceptable."
Baker said levels of documentation varied in Vietnam, and that some still did now.
The National Guard and Reserve, because of members' multiple, nonconsecutive deployments, faces particular difficulties when obtaining scattered records, the GAO said.
Specific records are necessary in the case of "blue water" Navy veterans, said Ian de Planque, the deputy legislative director at the American Legion. Those who at some time set foot on land were eligible for Agent Orange benefits; sailors who served off the coast were not. A matter of a few feet -- if documented -- could make all the difference.
"It's certainly not the only thing causing the backlog, but it certainly contributes to it," de Planque said.
John Rossie, the executive director of the Blue Water Navy Vietnam Veterans Association, has been working to get veterans their benefits since around 1990. Of the couple of hundred claims he's worked on, he said 25 percent of the veterans hadn't had proper documentation of evidence, and most of those claims were denied.
Other reasons for delays include the mandated "duty to assist," which requires VA assistance in retrieving veterans' records. Rossie said the VA didn't have the time to search for records if they weren't in obvious places, so it would deny the claims when records couldn't be found.
As much as poor records can hurt veterans, complete ones can salvage claims.
After leaving the Navy, Josh Stone made sure he had all his medical records -- about 50 to 75 pages. Doing so, he found out, was vital.
Stone, 34, of Stuart, served in Afghanistan as a combat medic. He's had trouble with the VA backlog: He's waiting for results from a hearing he had in 2011 for a higher award percentage. But without his records, he said, he wouldn't have received the benefits for tinnitus and an ankle injury that he did.
He's now an accredited veterans' disability representative at Gordon & Doner in Palm Beach Gardens, a law firm that works to get veterans their benefits.
While working in the battlefield, Stone said, taking copious notes about wounded soldiers can be difficult. He said he and his colleagues did their best to document medical records after the fact, but sometimes it simply didn't work out.
"Records in the field are lacking," he said.
Many enlisted clerks -- some just 19 or 20 years old -- are tasked with documenting administrative and medical records, Stone said. If available, he said, military records tend to thoroughly detail station locations and sick hall visits. "When they're right and accurate, they're extremely detailed," he said.
Service members don't automatically receive their records from the VA on leaving the military, and must ask for them in order to prevent denials in future claims processes. Some records are kept at the National Archives in College Park, Md., but many aren't. Archivist Eric Van Slander said space limitations prevented the archives from keeping every piece of information. Records for an individual veteran wouldn't be very detailed unless the service member performed above and beyond -- or performed horribly.
"Your average GI Joe-type of guy is not going to be mentioned," Van Slander said.
John Wells, who owns a military law firm in Slidell, La., said he accounted for the loss of records when he helped his clients with claims.
"What I tell people to do is to get three copies of their medical records," Wells said. "One to put in a safe place -- a safety deposit box -- one just to send in to the VA and a third to send in to the VA when they lose the first one."