US Vets With PTSD Not Getting Equal And Fair Compensation From VA, Says New Report

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Main Category: Psychology / Psychiatry
Also Included In: Anxiety / Stress;  Bio-terrorism / Terrorism;  Depression
Article Date: 11 May 2007 - 10:00 PDT

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The current method for making sure former US military personnel with service-connected post-traumatic stress disorder (PTSD) get fair and equal disability compensation from the US Department of Veterans Affairs (VA) is not working and should be revised according to a new report from the Institute of Medicine and National Research Council.

The study was commissioned by the VA in the wake of a significant increase in the number of PTSD disability claims that has thrown up inconsistencies in awards to veterans from different parts of the country.

The report questions the effectiveness of the VA's current method for assessing PTSD disability, suggesting this leads to disparities in the payments awarded to claimants, with some receiving too little compensation, others receiving too much and in some cases payments being awarded to claimants who should not get any at all.

Nancy Andreasen, Andrew H Woods Chair of Psychiatry and director, Psychiatric Neuroimaging Research Center, Carver College of Medicine, University of Iowa, Iowa City, chaired the committee that drafted the report and said that as the increasing number of claims to the VA shows, veterans with service-related PTSD are a significant public health problem.

"Our review of the current methods for evaluating PTSD disability claims and determining compensation indicates that a comprehensive revision is needed," she explained.

Claims for PTSD have spiked in recent years, and the disability payments for the condition have risen significantly.

Between 1999 and 2004 the number of PTSD cases rose by 80 per cent from 120,265 to 215,871. Compensation payments went up almost 150 per cent in the same period, from a total of 1.72 to 4.28 billion US dollars.

Most of the current compensation claims for PTSD are from veterans of the Vietnam War, who form the majority of living veterans. However, claims are also being made by former servicemen and women from earlier conflicts, plus those who served in the first Gulf War and also from those returning from the current conflicts in Iraq and Afghanistan, from whom many future claims are expected to be made.

The report criticised a number of current methods, including:

• The duration and quality of PTSD evaluation and the level of detail on which raters determine compensation levels varies widely.
• A large number of veterans initially denied compensation eventually receive it after applying (and sometimes re-applying several times) for re-evaluation.
• The rating system is based only on an individual's ability to work and not on their overall capacity to function.
• This occupational focus penalizes veterans who can and do work, despite their symptoms, which serves as a disincentive.
• The lack of a proper clinical assessment makes it possible for fraudulent claims to be made, sometimes long after military service has ceased.

Among the recommendations for improvement, the report mentions:

• The VA should develop a new evaluation system based on criteria that are specific to PTSD to replace the current method which is described as crude and overly general.
• The compensation awarded should reflect the extent to which the PTSD affects all aspects of the claimant's life, and not just their ability/inability to work.
• All claimants should undergo a thorough clinical assessment by a trained PTSD professional. These exams should give a detailed analysis of each claimant's condition so that the non-clinical disability raters are able to make consistent and fair judgements about how much compensation to award.
• Clinical assessments will also make it easier to weed out fraudulent claims.
• Ensuring thorough assessments by trained clinicians will help genuine PTSD claimants, particularly those whose condition has been triggered long after military service has ceased, for example because of renewed trauma, family tragedy, or other factors.

The report also mentions another area of contention in assessment of PTSD claims, and that is where the PTSD is triggered not by combat exposure but by sexual assault while in service.

According to the report, the available information suggests that female veterans are less likely to get PTSD compensation and this could be partly due to the difficulties of proving non-combat related PTSD, for instance from sexual assault or harassment while in service.

The report recommends that the VA increase its efforts to assess, record and manage PTSD claims related to sexual assault in service, for instance by ensuring disability raters get quality reference materials and criteria-based assessment data on which to judge claims appropriately and fairly.

Click here for US Department of Veteran Affairs.

Click here for a private site about PTSD and Combat PTSD support (run by a US Vietnam Vet).

Written by: Catharine Paddock
Writer: Medical News Today
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

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