As a peer mentor for Wounded Warrior Project, Josh Renschler regularly helps severely injured veterans navigate the Veterans Affairs Department health care system.
So he's no longer surprised by stories about delays and headaches in accessing medical care.
"We just keep seeing the same problems over and over again," Renschler said. "It's always a battle to get seen."
Even for veterans being helped by third-party advocates like WWP, getting timely appointments and reliable care remains a struggle, group officials said.
Nearly 40 percent of WWP members reported difficulty in getting physical care from VA doctors and 35 percent could not access mental health services in the last year, according to the group's annual membership survey, released Wednesday.
For many, that led to dissatisfaction and hopelessness with the system.
While the survey results aren't reflective of the veterans' population as a whole, it is a snapshot of the lives of 21,120 respondents — all post-9/11 veterans who were injured or have become ill since serving in the military.
The survey results show that even among the most vulnerable returning warfighters, VA services remain a frustrating resource.
Nearly 80 percent have three or more service-related conditions, facing both physical and mental challenges.
And their difficulties accessing care echo recent VA scandals that have affected veterans of all ages nationwide. Among the most common reasons they walk away from seeking VA care are long wait times, lapses in regular appointments, and frustration that the difficulties in getting medical care aren't worth the returns.
Renschler — a retired Army sergeant who was wounded in 2004 in a mortar blast — said the survey responses show an inclination to avoid VA services for many members despite evidence that such care can help recovery and despite assistance from WWP officials.
"The journey it takes to get many of these vets to go to a hospital to get help in the first place is incredible," he said. "These are guys who are naturally inclined to suck it up and drive on. So when you throw up obstacles to getting them care, it can scare them away for good."
VA Secretary Bob McDonald, who took over the department last month, promised to revamp every department clinic to make it more centered on veterans' needs and schedules.
Renschler said he and group leaders have seen improvements in VA procedures in recent months, but emphasized more changes must be put in place to solve the problem.
Other survey results showed lingering health and emotional problems for returning injured veterans, similar to results of past surveys.
More than half of survey respondents reported having problems with their appetite related to their injuries. About 40 percent reported sleep problems, and nearly 20 percent reported abusing alcohol.
Almost half those surveyed also said they had trouble concentrating and nearly half said they no longer take pleasure or have little interest in activities.
For the first time since WWP began taking its survey four years ago, though, respondents cited VA as the primary place where they receive mental health services.
Previously, the majority cited peer support or speaking with another Iraq or Afghanistan veteran as their therapeutic outlets.
"This was a little surprising, given the challenges we've seen VA have over the past several months," said Jeremy Chwat, chief program officer at Wounded Warrior Project.
Despite the severity of their health problems, 28 percent of WWP members surveyed said they worried about the stigma of seeking mental health care to help address those issues.
"Nearly 75 percent of our warriors are still struggling with memories related to combat. This is probably not surprising but it's significant. Overall, the population is struggling to reintegrate," Chwat said.
Complete results of the latest WWP survey, as well as part surveys back to 2010, are available on the WWP website.