On PTSD Anti-Benefit Forces Still at Work Against Pro-Veteran Advocates

Editor’s Note: No use running the thoughts of Sally Satel from the American Enterprise Institute. She advocates energetically for less benefits.

From the NYT:

The Department of Veterans Affairs is preparing to issue new rules to make it easier for veterans who have been diagnosed with post-traumatic stress disorder to receive disability benefits. The new regulations, which apply to veterans of all wars and will cost as much as $5 billion over several years, essentially eliminate a requirement that veterans document specific events that might have caused their P.T.S.D. and simply require those with the illness to show that they served in a war zone.

Given the research that exists about P.T.S.D., is this a step forward?

By Charles Figley, mental health and trauma specialist

Unconscionable Red Tape
– The very system that is supposed to help veterans with P.T.S.D. often makes their depression worse. –

Charles Figley holds an endowed professorship in disaster mental health and trauma at Tulane University. He is co-editor of “Combat Stress Injury: Theory, Research, and Management.”

I have watched with frustration over the years as those who are injured in battle attempt to get help when claims are denied. These changes will correct many of the problems combat veterans with P.T.S.D. and traumatic brain injuries experience in getting the help they need as soon as possible. Benefits delayed are benefits denied.

While the new rules will require additional expense, we owe our veterans financial and medical support while they struggle to recover. These rule changes are needed because research shows that P.T.S.D. can be caused by any number of stressers that are difficult to determine. Also, the extent of the trauma may go unnoticed for weeks or months before the effects become apparent.

For too long war veterans seeking medical benefits have been met with the antiquated V.A. medical claims system. They are put through unconscionable red tape. The consequences of the V.A.’s failure to provide prompt treatment for P.T.S.D. and traumatic brain injury and benefits are sobering. The bureaucratic delays can often worsen depression, which in turns makes it more difficult for the veteran to connect with family members, find employment, regain economic viability and avoid further crises like substance abuse.

The tragedy is veterans suffering from P.T.S.D. are especially ill equipped to deal with the V.A.’s inordinate delays in determining an initial request for disability benefits, let alone the delays in resolving appeals of incorrect decisions, which are even longer. In other words, the very system that is supposed to help veterans often makes matters worse.

A study cited in my book, “Combat Stress Injuries,” found that combat veterans with P.T.S.D. were far more likely to die significantly earlier, suffer from cardiovascular disease and cancer, as well as physical injuries caused by military service. Despair and depression leading to suicide is all too often the result in this downward spiral.

Approximately 18 veterans a day take their own lives. There are compelling studies demonstrating that the suicide rate among the young veterans returning from Iraq and Afghanistan is at least double that of the general population. Proper care and benefits for these veterans have to be a national commitment.

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The Added Stress for Female Vets
– Military sexual trauma, claims of which are consistently denied, is the primary causal factor of P.T.S.D. for women.-

Anuradha K. Bhagwati, a former captain in the Marine Corps, is the executive director of the Service Women’s Action Network, a nonprofit advocacy organization that advances the rights of military women.

The new federal regulations making it easier for combat veterans with post-traumatic stress disorder to receive compensation is great news for the more than 250,000 women who have served and sacrificed in Iraq or Afghanistan. Adding to the challenges of readjusting to society after combat, many of these women face additional trauma, by having to prove their combat status to V.A. medical staff and claims officers who don’t know or believe that women are being exposed to the same horrors of war as their male counterparts.

Part of this ignorance results from male bias, but the rest is due to the Combat Exclusion Rule that precludes women from direct ground combat — even though commanders are knowingly violating this policy overseas. It’s a policy that needs to be revised immediately, in part because it’s too easy for a claims officer from Veterans Affairs to assume a woman is presenting a fraudulent claim for a combat-related wound or injury.

Unfortunately, despite the improvements, the new regulations fail to address the majority of P.T.S.D. claims filed by women veterans: military sexual trauma (including sexual harassment and sexual assault).

Military sexual trauma is the primary causal factor of P.T.S.D. for women. Before we mistake the epidemic as a woman’s issue, it is useful to know that last year, 40 percent of the patients seeking treatment for military sexual trauma at V.A. hospitals were men. These claims are consistently denied for the same reason that combat-related P.T.S.D. claims have been denied: the failure to prove an “initial stressor” — in this case, an initial incident of sexual harassment, assault or rape, despite a diagnosis of P.T.S.D. from the V.A.’s own psychiatrists, psychologists and counselors.

The V.A.’s double standard when it comes to survivors of sexual trauma is shameful. We’ve got nothing to celebrate until all sources of P.T.S.D. are considered equal.