As Malvin Espinosa prepared to retire from the Army in 2011, a Veterans Affairs counselor urged him to apply for disability pay.
List all your medical problems, the counselor said.
Espinosa, a mechanic at Ft. Lee in Virginia, had never considered himself disabled. But he did have ringing in his ears, sleep problems and aching joints. He also had bad memories of unloading a dead soldier from a helicopter in Afghanistan.
"Put it all down," he recalled the counselor saying.
Espinosa did, and as a result, he is getting a monthly disability check of $1,792, tax free, most likely for the rest of his life. The VA deems him 80% disabled due to sleep apnea, mild post-traumatic stress disorder, tinnitus and migraines.
The 41-year-old father of three collects a military pension along with disability pay — and as a civilian has returned to the base, working full-time training mechanics. His total income of slightly more than $70,000 a year is about 20% higher than his active-duty pay.
Similar stories are playing out across the VA.
With the government encouraging veterans to apply, enrollment in the system climbed from 2.3 million to 3.7 million over the last 12 years.
The growth comes even as the deaths of older former service members have sharply reduced the veteran population. Annual disability payments have more than doubled to $49 billion — nearly as much as the VA spends on medical care.
More than 875,000 Afghanistan and Iraq war veterans have joined the disability rolls so far. That's 43% of those who served — a far higher percentage than for any previous U.S. conflict, including World War II and Vietnam, which had significantly higher rates of combat wounds.
Disabled veterans of the recent wars have an average of 6.3 medical conditions each, also higher than other conflicts.
Incentives to seek disability ratings have increased due to changes in VA policy, including expanded eligibility for post-traumatic stress disorder and a number of afflictions that affect tens of millions of civilians.
Nearly any ailment that originated during service or was aggravated by it — from sports injuries to shrapnel wounds — is covered under the rationale that the military is a 24/7 job.
The disability system was unprepared for the massive influx of claims, leading to backlogs of veterans waiting months or longer to start receiving their checks.
But once the payments begin, many veterans say, they are a life-saver.
Ray Lopez struggled to keep a steady job after leaving the Marines in 2001. Stints as a TSA screener, insurance agent and soft drink salesman ended badly.
At 35, Lopez is rated 70% disabled for back, shoulder and knee pain, as well as post-traumatic stress disorder from having witnessed a deadly helicopter crash off the coast of San Diego.
He couldn't support his wife and two children, he said, without the monthly $1,800 disability check. "If it wasn't for that, I'd be on the streets," he said.
Lopez trains boxers three days a week and is pursuing a community college degree.