VA Should Institute Better Claims Process For PTSD, Study Finds

Main Category: Veterans / Ex-Servicemen
Also Included In: Psychology / Psychiatry;  Anxiety / Stress
Article Date: 11 May 2007 - 22:00 PDT

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A combined panel from the Institute of Medicine and the National Research Council released a report on Tuesday stating that the Department of Veterans Affairs needs to revise its standards for evaluating post-traumatic stress disorder, the San Diego Union-Tribune reports (Rogers, San Diego Union-Tribune, 5/9). The report found that the VA uses insufficient criteria for rating disabilities due to mental illness and is not consistent in applying standards for relapsing conditions.

PTSD claims increased from 120,265 in 1999 to 215,871 in 2004, and payments increased from $1.72 billion to $4.28 billion during the same period. The panel suggested that VA develop new standards for evaluating PTSD based on those set by the American Psychiatric Association. The panel also recommended that VA establish certification programs for workers who handle PTSD claims. In addition, the panel said VA should base PTSD awards on how greatly the disorder affects all aspects of a veteran's life, not just his or her ability to gain employment (Schmid, AP/Dayton Daily News, 5/8). The panel also noted that female veterans are less likely to receive compensation for PTSD, in part because of the difficulty in some cases of proving that the sexual assault and harassment that caused the condition took place during military service (Adams, McClatchy/Philadelphia Inquirer, 5/9).

Nancy Andreasen, chair of the committee that released the report and head of the psychiatry department at University of Iowa's Carver College of Medicine, said, "As the increasing number of claims to the VA shows, PTSD has become a very significant public health problem. Comprehensive revision is needed" (San Diego Union-Tribune, 5/9). VA press secretary Matt Burns said, "VA is studying the findings, conclusions and recommendations of the report to determine actions that can be taken to further enhance the services we provide." He added, "VA is a recognized leader in the diagnosis and treatment of PTSD, and we will continue to take steps to ensure veterans have timely and seamless access to compensation for which they are eligible" (AP/Dayton Daily News, 5/8). Dave Gorman, executive director for Disabled American Veterans, said, "It's a step forward. It insists on training and accountability and more thorough examinations -- a lot of the things we've been seeking for a long time" (San Diego Union-Tribune, 5/9).

A summary of the report is available online.

Military Health Records System
Pentagon and VA officials in testimony before the House Veterans Affairs Subcommittee on Oversight and Investigations on Tuesday said that implementing a shared electronic health records system between the agencies might take years, the Arizona Daily Star reports. Stephen Jones, assistant defense secretary for health affairs, and Gerald Cross, the VA's acting principal deputy undersecretary for health, testified before the committee that the two agencies had just begun to take action on recommendations made by a presidential task force led by VA Secretary Jim Nicholson last month.

Jones and Cross said that an EHR system within the Pentagon might not be complete until 2012. In addition, they declined to say whether a joint fully operating EHR system could be in place within five years (Arizona Daily Star, 5/9).

Additional VA Action
Nicholson during a tour of a VA hospital in Missouri on Tuesday announced the formation of a national advisory commission designed to boost care for younger veterans, the St. Louis Post-Dispatch reports. The 17-member advisory commission will be composed of veterans from the first Gulf War and veterans from the wars in Iraq and Afghanistan, in addition to members of their families (O'Neil, St. Louis Post-Dispatch, 5/9).

Congressional Action
The House Armed Services Readiness Subcommittee by voice vote on Tuesday authorized a funding increase for military readiness and training, including improvements to Walter Reed under its portion of the 2008 defense authorization bill (HR 1585), CQ Today reports. The subcommittee authorized an unspecified amount of funding for modernization and revitalization of Walter Reed. The panel said the full committee first must decide whether to prohibit closure of the facility, which was ordered in 2005.

A ban on closing the facility was included in the fiscal year 2007 Iraq war supplemental bill (HR 1591) that Bush recently vetoed, along with funding to renovate the facility. It is "not clear whether the prohibition will be part of a revised war funding bill that appropriators are in the process of hammering out," CQ Today reports. The legislation is scheduled for markup on Wednesday by the full Armed Services Committee (CQ Today, 5/8).

Further Action
Rep. Henry Waxman (D-Calif.) on Tuesday introduced legislation that would prohibit the sale or commercial development of any part of the West Los Angeles Veterans Affairs campus, the nation's largest VA medical center, the Los Angeles Times reports. Under the legislation, a 1988 ban on private development of 109 acres of the campus' property would be expanded to cover the site's entire 388-acre campus. Waxman previously had expressed concern that VA had leased portions of the campus to commercial vendors. The measure also would require VA to complete a 1998 congressional mandate that required that the agency create a master plan for the property in order to ensure veterans' future needs were met. The California Department of Veterans Affairs estimates that more than one million veterans live within 50 miles of the center, more than 42 other states combined.

Broadcast Coverage
C-SPAN's "Washington Journal" on Tuesday included a discussion with Thomas Insel, director of the National Institute of Mental Health, about PTSD ("Washington Journal," C-SPAN, 5/8). Video of the segment is available online.

In addition, NPR's "Talk of the Nation" on Tuesday in the first hour of the program included a discussion about traumatic brain injuries with Bob Woodruff, author and former co-anchor of ABC's "World News"; Rear Adm. Adam Robinson, commander of the National Naval Medical Center and chief of the Navy Medical Corps; Cmdr. Jim Dunne, commander of the trauma unit at the medical center; and Maria Mouratidis, head of the Traumatic Stress and Brain Injury Program at the medical center (Conan [1], "Talk of the Nation," NPR, 5/8). Audio of the segment is available online.

"Talk of the Nation" in the second hour of Tuesday's program included a discussion about advances in battlefield medicine with a military medic, surgeon, psychologist and nurse who served in Iraq (Conan [2], "Talk of the Nation," NPR, 5/8). Audio of the segment is available online.

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