What’s more, these new veterans are claiming eight to nine ailments on average, and the most recent ones over the last year are claiming 11 to 14. By comparison, Vietnam veterans are currently receiving compensation for fewer than four, on average, and those from World War II and Korea, just two.

It’s unclear how much worse off these new veterans are than their predecessors. Many factors are driving the dramatic increase in claims — the weak economy, more troops surviving wounds, and more awareness of problems such as concussions and PTSD. Almost one-third have been granted disability so far.

Government officials and some veterans’ advocates say that veterans who might have been able to work with certain disabilities may be more inclined to seek benefits now because they lost jobs or can’t find any. Aggressive outreach and advocacy efforts also have brought more veterans into the system, which must evaluate each claim to see if it is war-related. Payments range from $127 a month for a 10 percent disability to $2,769 for a full one.

As the nation commemorates the more than 6,400 troops who died in post-9/11 wars, the problems of those who survived also draw attention. These new veterans are seeking a level of help the government did not anticipate, and for which there is no special fund set aside to pay.

The Department of Veterans Affairs is mired in backlogged claims, but “our mission is to take care of whatever the population is,” said Allison Hickey, the VA’s undersecretary for benefits. “We want them to have what their entitlement is.”

The 21 percent who filed claims in previous wars is Hickey’s estimate of an average for Operation Desert Storm and Desert Shield. The VA has details only on the current disability claims being paid to veterans of each war.

The AP spent three months reviewing records and talking with doctors, government officials and former troops to take stock of the new veterans. They are different in many ways from those who fought before them.

More are from the Reserves and National Guard — 28 percent of those filing disability claims — rather than career military. Reserves and National Guard made up a greater percentage of troops in these wars than they did in previous ones. About 31 percent of Guard/Reserve new veterans have filed claims compared to 56 percent of career military ones.

More of the new veterans are women, accounting for 12 percent of those who have sought care through the VA. Women also served in greater numbers in these wars than in the past. Some female veterans are claiming PTSD due to military sexual trauma — a new challenge from a disability rating standpoint, Hickey said.

The new veterans have different types of injuries than previous veterans did. That’s partly because improvised bombs have been the main weapon and because body armor and improved battlefield care allowed many of them to survive wounds that in past wars proved fatal.

“They’re being kept alive at unprecedented rates,” said Dr. David Cifu, the VA’s medical rehabilitation chief. More than 95 percent of troops wounded in Iraq and Afghanistan have survived.

Larry Bailey II is an example. After tripping a rooftop bomb in Afghanistan last June, the 26-year-old Marine remembers flying into the air, then fellow troops attending to him.

“I pretty much knew that my legs were gone. My left hand, from what I remember I still had three fingers on it,” although they didn’t seem right, Bailey said. “I looked a few times but then they told me to stop looking.” Bailey, who is from Zion, Ill., north of Chicago, ended up a triple amputee and expects to get a hand transplant this summer.

He is still transitioning from active duty and is not yet a veteran. Just over half of Iraq and Afghanistan veterans eligible for VA care have used it so far.

Of those who have sought VA care:

—More than 1,600 of them lost a limb; many others lost fingers or toes.

—At least 156 are blind, and thousands of others have impaired vision.

—More than 177,000 have hearing loss, and more than 350,000 report tinnitus — noise or ringing in the ears.

—Thousands are disfigured, as many as 200 of them so badly that they may need face transplants. One-quarter of battlefield injuries requiring evacuation included wounds to the face or jaw, one study found.

“The numbers are pretty staggering,” said Dr. Bohdan Pomahac, a surgeon at Brigham and Women’s Hospital in Boston who has done four face transplants on non-military patients and expects to start doing them soon on veterans.

Others have invisible wounds. More than 400,000 of these new veterans have been treated by the VA for a mental health problem, most commonly, PTSD.

Tens of thousands of veterans suffered traumatic brain injury, or TBI — mostly mild concussions from bomb blasts — and doctors don’t know what’s in store for them long-term. Cifu, of the VA, said that roughly 20 percent of active duty troops suffered concussions, but only one-third of them have symptoms lasting beyond a few months.

That’s still a big number, and “it’s very rare that someone has just a single concussion,” said David Hovda, director of the UCLA Brain Injury Research Center. Suffering multiple concussions, or one soon after another, raises the risk of long-term problems. A brain injury also makes the brain more susceptible to PTSD, he said.

On a more mundane level, many new veterans have back, shoulder and knee problems, aggravated by carrying heavy packs and wearing the body armor that helped keep them alive. One recent study found that 19 percent required orthopedic surgery consultations and 4 percent needed surgery after returning from combat.

All of this adds up to more disability claims, which for years have been coming in faster than the government can handle them. The average wait to get a new one processed grows longer each month and is now about eight months — time that a frustrated, injured veteran might spend with no income.

More than 560,000 veterans from all wars currently have claims that are backlogged — older than 125 days.

The VA’s benefits chief, Hickey, gave these reasons:

—Sheer volume. Disability claims from all veterans soared from 888,000 in 2008 to 1.3 million in 2011. Last year’s included more than 230,000 new claims from Vietnam veterans and their survivors because of a change in what conditions can be considered related to Agent Orange exposure. Those complex, 50-year-old cases took more than a third of available staff, she said.

—High number of ailments per claim. When a veteran claims 11 to 14 problems, each one requires “due diligence” — a medical evaluation and proof that it is service-related, Hickey said.

—A new mandate to handle the oldest cases first. Because these tend to be the most complex, they have monopolized staff and pushed up average processing time on new claims, she said.

—Outmoded systems. The VA is streamlining and going to electronic records, but for now, “We have 4.4 million case files sitting around 56 regional offices that we have to work with; that slows us down significantly,” Hickey said.

Barry Jesinoski, executive director of Disabled American Veterans, called Hickey’s efforts “commendable,” but said: “The VA has a long way to go” to meet veterans’ needs. Even before the surge in Agent Orange cases, VA officials “were already at a place that was unacceptable” on backlogged claims, he said.

He and VA officials agree that the economy is motivating some claims. His group helps veterans file them, and he said that sometimes when veterans come in, “We’ll say, ‘Is your back worse?’ and they’ll say, ‘No, I just lost my job.’”

Jesinoski does believe these veterans have more mental problems, especially from multiple deployments.

“You just can’t keep sending people into war five, six or seven times and expect that they’re going to come home just fine,” he said.

For taxpayers, the ordeal is just beginning. With any war, the cost of caring for veterans rises for several decades and peaks 30 to 40 years later, when diseases of aging are more common, said Harvard economist Linda Bilmes. She estimates the health care and disability costs of the recent wars at $600 billion to $900 billion.

“This is a huge number and there’s no money set aside,” she said. “Unless we take steps now into some kind of fund that will grow over time, it’s very plausible many people will feel we can’t afford these benefits we overpromised.”

How would that play to these veterans, who all volunteered and now expect the government to keep its end of the bargain?

“The deal was, if you get wounded, we’re going to supply this level of support,” Bilmes said. Right now, “there’s a lot of sympathy and a lot of people want to help. But memories are short and times change.”

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Online:

VA’s Home Page http://www.va.gov/

VA budget, performance: http://www.va.gov/budget/report/

IOM Coming Home report: http://books.nap.edu/openbook.php?record_id=12812

Costs of war: http://bit.ly/y5cLsH

Veterans quick facts: http://www.va.gov/vetdata/Quick_Facts.asp

War casualty reports: http://www.defense.gov/news/casualty.pdf

Brain Injury Center: http://www.dvbic.org/

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Follow Marilynn Marchione’s coverage on Twitter at http://twitter.com/MMarchioneAP

“Our study suggests that’s really not the case,” said lead researcher Neal Freedman of the National Cancer Institute. “There may actually be a modest benefit of coffee drinking.”

No one knows why. Coffee contains a thousand things that can affect health, from helpful antioxidants to tiny amounts of substances linked to cancer. The most widely studied ingredient — caffeine — didn’t play a role in the new study’s results.

It’s not that earlier studies were wrong. There is evidence that coffee can raise LDL, or bad cholesterol, and blood pressure at least short-term, and those in turn can raise the risk of heart disease.

Even in the new study, it first seemed that coffee drinkers were more likely to die at any given time. But they also tended to smoke, drink more alcohol, eat more red meat and exercise less than non-coffee-drinkers. Once researchers took those things into account, a clear pattern emerged: Each cup of coffee per day nudged up the chances of living longer.

The study was done by the National Institutes of Health and AARP. The results are published in Thursday’s New England Journal of Medicine.

Careful, though — this doesn’t prove that coffee makes people live longer, only that the two seem related. Like most studies on diet and health, this one was based strictly on observing people’s habits and resulting health. So it can’t prove cause and effect.

But with so many people, more than a decade of follow-up and enough deaths to compare, “this is probably the best evidence we have” and are likely to get, said Dr. Frank Hu of the Harvard School of Public Health. He had no role in this study but helped lead a previous one that also found coffee beneficial.

The new one began in 1995 and involved AARP members ages 50 to 71 in California, Florida, Louisiana, New Jersey, North Carolina, Pennsylvania and Atlanta and Detroit. People who already had heart disease, a stroke or cancer weren’t included. Neither were folks at diet extremes — too many or too few calories per day.

The rest gave information on coffee drinking once, at the start of the study. “People are fairly consistent in their coffee drinking over their lifetime,” so the single measure shouldn’t be a big limitation, Freedman said.

Of the 402,260 participants, about 42,000 drank no coffee. About 15,000 drank six cups or more a day. Most people had two or three.

By 2008, about 52,000 of them had died. Compared to those who drank no coffee, men who had two or three cups a day were 10 percent less likely to die at any age. For women, it was 13 percent.

Even a single cup a day seemed to lower risk a little: 6 percent in men and 5 percent in women. The strongest effect was in women who had four or five cups a day — a 16 percent lower risk of death.

None of these are big numbers, though, and Freedman can’t say how much extra life coffee might buy.

“I really can’t calculate that,” especially because smoking is a key factor that affects longevity at every age, he said.

Coffee drinkers were less likely to die from heart or respiratory disease, stroke, diabetes, injuries, accidents or infections. No effect was seen on cancer death risk, though.

Other research ties coffee drinking to lower levels of markers for inflammation and insulin resistance. Researchers also considered that people in poor health might refrain from drinking coffee and whether their abstention could bias the results. But the study excluded people with cancer and heart disease — the most common health problems — to minimize this chance. Also, the strongest benefits of coffee drinking were seen in people who were healthiest when the study began.

About two-thirds of study participants drank regular coffee, and the rest, decaf. The type of coffee made no difference in the results.

Hu had this advice for coffee lovers:

— Watch the sugar and cream. Extra calories and fat could negate any benefits from coffee.

— Drink filtered coffee rather than boiled — filtering removes compounds that raise LDL, the bad cholesterol.

Researchers did not look at tea, soda or other beverages but plan to in future analyses.

Lou and Mariann Maris have already compared them. Sipping a local brew at a lakefront coffee shop, the suburban Milwaukee couple told of how they missed coffee after briefly giving it up in the 1970s as part of a health kick that included transcendental meditation and eating vegetarian.

Mariann Maris switched to tea after being treated for breast cancer in 2008, but again missed the taste of coffee. It’s one of life’s great pleasures, especially because her husband makes it, she said.

“Nothing is as satisfying to me as a cup of coffee in the morning,” she said.

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Online:

New England Journal: http://www.nejm.org

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Follow Marilynn Marchione’s coverage on Twitter http://twitter.com/MMarchioneAP

But few studies have looked at coffee and the risk of dying of any cause, let alone specific diseases. Some of those that have involved too few deaths to make firm comparisons.

CAN WE TRUST THIS ONE?

No study is perfect, and like most diet studies, this one is just based on observing people’s habits and resulting health. So it can’t prove coffee lengthens lives. But experts say it’s the best look yet at this issue.

It involved more than 400,000 people and was done by the National Institutes of Health and AARP.

Researchers also took into account smoking, drinking alcohol, exercise and other things that can skew results.

HOW MUCH DIFFERENCE DID COFFEE MAKE?

Very little, especially in relation to bigger factors such as smoking.

Compared with those who drank no coffee, men who had two or three cups a day were 10 percent less likely to die at any age. For women, it was 13 percent.

A single cup a day lowered risk a tiny bit: 6 percent in men and 5 percent in women. The strongest effect was in women who had four or five cups a day — they had a 16 percent lower risk of death.

SO IT’S OK TO DRINK ALL I WANT?

Watch the sugar and cream. Extra calories and fat could negate any good from drinking coffee.

Doctors also suggest drinking filtered coffee — that removes the compounds that raise LDL or bad cholesterol.

It could be that the extra jostling of egg and sperm does damage. Or that other problems lurk in the genes of sperm so defective they must be forced to fertilize an egg.

“I don’t want to scare people,” because the vast majority of babies are born healthy, said the study’s leader, Michael Davies of the University of Adelaide in Australia.

Couples could use simple IVF without sperm injection, freeze the embryos and implant only one or two at a time, he said. All of those can cut the chance of a birth defect.

The study was published online Saturday by the New England Journal of Medicine and presented at a fertility conference in Barcelona, Spain. Health agencies in Australia paid for the research.

More than 3.7 million babies are born each year through assisted reproduction. Methods include everything from drugs to coax the ovaries to make eggs to artificial insemination and IVF. Fertility treatments account for about 4 percent of births in Australia and as many as 8 percent of them in Denmark, where costs are widely covered, Davies said.

In the United States, more than 60,000 babies were born in 2009 from 146,000 IVF attempts. About three-quarters of them used ICSI, or intracytoplasmic sperm injection.

ICSI was developed because of male infertility. But half the time, it was not done for that reason but to improve the odds that at least some embryos will be created from an IVF attempt. Many clinics do it in all cases.

IVF costs around $10,000 to $12,000 per attempt and another $2,000 for sperm injection.

The study used records on nearly 303,000 babies conceived naturally and 6,163 conceived with help in Australia from 1986 through 2002, plus records on birth defects detected by age 5. Researchers counted heart, spinal or urinary tract defects, limb abnormalities and problems such as cleft palate or lip, but not minor defects unless they needed treatment or were disfiguring.

They looked at birth defect rates according to type of fertility treatment. They also had three comparison groups of women who conceived naturally, including some with some history of infertility or who previously needed help to get pregnant.

Among fertility treatments, only ICSI, the sperm injection, resulted in higher rates of birth defects once other factors that affect these odds were taken into account.

“They take a sperm that is probably not normal and force it to conceive,” said Dr. Darine El-Chaar, an OB-GYN at Canada’s University of Ottawa. She led a smaller previous study of this and called the new work impressive and “the study that needed to be done” to sort out the source of these risks.

In the study, frozen embryos were less likely to result in birth defects than fresh ones used soon after they were created. Defective ones may be less likely to survive freezing and thawing, so the fittest embryos result in pregnancies, Davies said.

Babies born to women with a history of infertility who ended up conceiving on their own, or who had natural pregnancies after assisted ones, also had higher rates of birth defects. That suggests that infertility itself is playing a role.

Dr. Glenn Schattman, president of the Society for Assisted Reproductive Technologies and a Cornell University fertility specialist, said it was reassuring that ordinary IVF is safe. If ICSI is chosen because male infertility is involved, “parents have to be aware that by having a child with their own genetic material, they might be increasing their risk” of a birth defect, he said.

Dr. Joe Leigh Simpson, a geneticist and research chief at the March of Dimes, said doctors should take this work seriously and discuss it with patients. He said techniques have improved over the last decade and ICSI may be safer now than when this study began.

Even with genetic testing for various diseases, “we always tell our patients that this doesn’t guarantee a perfect baby,” he said.

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Online:

New England Journal: http://www.nejm.org

Infertility information: http://www.sart.org and http://www.asrm.org

Sperm injection explanation: http://bit.ly/Inb688

CDC on fertility treatments: http://www.cdc.gov/art/ARTReports.htm

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Follow Marilynn Marchione at http://twitter.com/MMarchioneAP