A recent legal settlement has brought fresh attention to two of the biggest health problems veterans face.
The settlement concerned protective military earplugs that allegedly were defective. The Pentagon settled with the earplugs' maker 3M Company.
And the two problems? Retired Army Brig. Gen. William Gothard of Fayetteville, N.C. has both of them. He said his 36 years of service have left him with hearing loss and a maddening condition called tinnitus.
"It sounds like a chorus of cicadas sitting on your shoulders constantly, and the less ambient noise around, the worse that tinnitus is," he said.
Medical experts say this constant distraction can be so bad that it undermines relationships and job performance by making it hard to concentrate on tasks or conversations.
Gothard said that there's a good chance the earplugs he was issued by the military are at least partly to blame for his hearing problems.
Troops were issued those rubber earplugs from 2003 until 2015, a span that includes the peak years of the wars in Afghanistan and in Iraq, where Gothard served in 2006. He still has the set he was issued and said he used them a lot while he was in the Army.
"Anytime we were on a (shooting) range, anytime, you know, flying in a helicopter, riding in a Humvee," he said. "We used them every day when I was in Iraq, whenever we went out on a patrol or went anywhere, just simply because the vehicle noise is loud as well."
The earplugs were originally made by a company that 3M bought. The government alleged both companies knew the plugs had a design flaw even and didn't disclose it.
3M paid $9.1 million to the government and a whistleblower to settle the claim, but in the settlement did not admit liability or guilt.
None of the settlement money went to the former service members who wore the earplugs.
A 3M spokeswoman declined to comment but emailed a written statement.
"3M has great respect for the brave men and women who protect us around the world," the statement read. "We have a long history of serving the U.S. military, and we continue to sell products, including safety products, to help our troops and support their missions. We are not commenting on specific litigation matters at this time."
And there is litigation. Attorneys across the country are signing up veterans who used the earplugs and in some cases have already filed suit.
"In North Carolina, we are getting calls daily from folks that are affected," said Raleigh attorney Ben Whitley, who is talking with Gothard and other vets. "We're representing over a couple hundred folks as it stands right now, and I suspect there will be hundreds more."
Hearing loss is often seen as something that comes with age. But Whitley said that's not what he's seeing among the veterans who served during the years the earplugs were sold.
"I'm talking to 26-year-olds that have dual-ear hearing aids and other younger folks that have experience during that period of time," he said.
It's not clear how much of that hearing damage might be related to the earplugs. Hearing problems have long been one of the most common consequences of military service. The VA said about a million veterans get disability payments for service-related hearing loss, and nearly 1.8 million get disability for tinnitus.
Many likely causes seem obvious: gunfire, explosions and artillery, and military jets and helicopters, which don't have the sound-deadening of commercial jets.
It's unlikely the military will be able to protect all troops from every noise. But it's trying to get a better sense of which protection devices are best for different jobs.
Col. LaKeisha Henry leads the Pentagon's Hearing Center of Excellence in Texas. Among other things, it has been developing a list of proper devices and guidance for using them.
"This will allow for the right hearing protective device for the environment and the task for the service member or Department of Defense civilian," Henry said.
The Pentagon has taken a host of other steps in recent years, too, such as improving programs to train troops about hearing protection and increasing research into service-related hearing issues.
A 2011 Government Accountability Office report found many service members were issued hearing protection devices but didn't always use them because of concerns about comfort and communication, especially in combat situations.
Some veterans even told the GAO that they thought of hearing damage as part of the cost of serving.
"If you believe that your hearing protection is going to compromise your ability to perform your job, or to hear your team members, or to hear the enemy …. you may choose not to wear your hearing protection," Henry said.
