Pensions for service in excess of 25 years are, but medical pensions are different.
Not too many years ago, if you had a permanent medical condition that could be confirmed to be the result of military service, they assessed your degree of disability and based a medical pension based on that assessment.
For example, a friend of mine got too close to an IED and his legs are pretty messed up. Pins, muscle loss, bone damage, etc. He did not lose his legs, but cannot stand for long stretches, run, and has difficulty walking. He was granted a pension.
If that same incident happens today, The individual receives a one time payment. The max settlement is $250,000, but you have to be pretty messed up to get that amount.
The trouble with one time payouts is that, as we age, the damage caused usually gets worse. Medical expenses can increase. You cannot go back and claim anything because you signed a waiver as part of the settlement.