PTSD: 25 Years and Still Under Fire
Over 25 years ago, I first became aware of posttraumatic stress disorder and the affect it had upon many I knew. At the time, I was a VFW post service officer taking the job very serious. I was representing a former POW Ray Allen, in his quest to obtain VA dental benefits. In many interviews with Ray I found that he and a few other former POW's had common problems as nightmares, flashbacks and a quick temper.
PTSD issues have been a target of the naysayer, since I filed my first case of PTSD for a veteran in February 1983. I was employed by the Veterans Service Office in Columbus, Ohio. The director was a gentleman, who believed, PTSD was non existent excuse for Vietnam veterans to act different. He was followed by a compassionate man who knew and understood the condition. We had in the early days of PTSD claims, both those who believed and those who did not believe. My first director tried to stop me from filing PTSD claims; the second director in 1985 encouraged me to do so.
Currently there are those in the media trying to stop veterans from receiving benefits for PTSD because they do not believe the issues in DSM-IV are as stated. When I checked their biographies, I saw no mention of prior military service. I only wish those all knowing, possibly non-veteran writers would spend a day in my office. They would change their minds I am sure.
The first of two recent examples are Knight-Ridder's investigation dated May 19, 2005 which stated in part "The report's findings mirror the results of a March (2005) Knight Ridder series on the VA's disability compensation program, which found payments for mental ailments are subject to wide swings and veterans in certain states are far more likely to get high post-traumatic stress disorder payments than those in other states. The exclusive Knight Ridder analysis was based on a review of 2.5 million veteran claims records, released only after Knight Ridder sued the VA in federal court last November." Is the purpose of Knight-Ridder to help those who shed not only blood, but their ability to function in society; or to make it even more difficult for those who defend this nations policy to obtain their benefits? This question bothers me considerably.
In another article entitled "VA Lays Blame in Disability Disparities" by the Associated Press dated May 20, 2005 it states in part Staffing shortages and an outdated system for assessing claims are among the reasons for wide differences in disability payments for veterans, the government said Thursday." It further stated "Claims examiners use 60-year-old guidelines to assess ailments; the guidelines don't include nonphysical conditions such as post-traumatic stress disorder that are now recognized, according to a report from the Veterans Affairs Department."
The article quickly goes into the financial aspects of claims processing such as the budget and dollars available. It continues by stating "More than one-third of the variance in disability compensation results from different rates of acceptance for certain ailments, such as post-traumatic stress disorder, according to an investigation by the department's inspector general."
The report also indicated investigators found that 25 percent of the VA approved cases of post-traumatic stress disorder they reviewed lacked the proof they expected of the required event or series of events that led to the ailment. Which led the budget oriented Veterans Affairs Secretary James Nicholson to say this report had turned up "some information that demands the attention of this agency." The Associated Press reported Nicholson further saying "The amount of dollars involved is huge and the lives involved are important," Our number one goal is to take care of those veterans who are deserving." It somewhat leaves me wondering which has priority, the veteran or the budget.
There is now a major push, to review Post Traumatic Stress Disorder claims. This is to determine if the accepted stressors meet the Commissions opinion of a suitable stressor; which will over rule the American Psychiatric Association's research work for the past 28 years. Is the new commission to review this particular condition? Is their knowledge going to override decades of American Psychiatric Association research? Perish the thought.
A. The person has been exposed to a traumatic event in which both of the following were present:
1. the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others
2. The person's response involved intense fear, helplessness, or horror."
These PTSD claims do take a very long time. One issue that bears mention is the VA only does as current regulation requires. The changes in PTSD criteria were not and are not set by the VA. It is established by congressional mandate through the Federal Register by direction or request of the Secretary of the VA. This normally is a result of the American Psychiatric Association and the Diagnostic Statistical Manual of Mental Disorders (DSM). We are now working with the DSM-IV which had been in print over two years, before the VA got on the same page. It was an additional year, in some cases that all rating specialists rated according to DSM-IV.
If the opinion of the review will save the taxpayer money, the veteran had better watch out.