The government is preparing to issue new rules that will make it substantially easier for veterans who have been found to have post-traumatic stress disorder to receive disability benefits, a change that could affect hundreds of thousands of veterans from the wars in Iraq, Afghanistan and Vietnam.
The regulations from the Department of Veterans Affairs, which will take effect as early as Monday and cost as much as $5 billion over several years according to Congressional analysts, will essentially eliminate a requirement that veterans document specific events like bomb blasts, firefights or mortar attacks that might have caused P.T.S.D., an illness characterized by emotional numbness, irritability and flashbacks.
For decades, veterans have complained that finding such records was extremely time consuming and sometimes impossible. And in the wars in Afghanistan and Iraq, veterans groups assert that the current rules discriminate against tens of thousands of service members — many of them women — who did not serve in combat roles but nevertheless suffered traumatic experiences.
Under the new rule, which applies to veterans of all wars, the department will grant compensation to those with P.T.S.D. if they can simply show that they served in a war zone and in a job consistent with the events that they say caused their conditions. They would not have to prove, for instance, that they came under fire, served in a front-line unit or saw a friend killed.
The new rule would also allow compensation for service members who had good reason to fear traumatic events, known as stressors, even if they did not actually experience them.
There are concerns that the change will open the door to a flood of fraudulent claims. But supporters of the rule say the veterans department will still review all claims and thus be able to weed out the baseless ones.
“This nation has a solemn obligation to the men and women who have honorably served this country and suffer from the emotional and often devastating hidden wounds of war,” the secretary of veterans affairs, Eric K. Shinseki, said in a statement to The New York Times. “This final regulation goes a long way to ensure that veterans receive the benefits and services they need.”
Though widely applauded by veterans’ groups, the new rule is generating criticism from some quarters because of its cost. Some mental health experts also believe it will lead to economic dependency among younger veterans whose conditions might be treatable.
Disability benefits include free physical and mental health care and monthly checks ranging from a few hundred dollars to more than $2,000, depending on the severity of the condition.
“I can’t imagine anyone more worthy of public largess than a veteran,” said Dr. Sally Satel, a psychiatrist and fellow at the American Enterprise Institute, a conservative policy group, who has written on P.T.S.D. “But as a clinician, it is destructive to give someone total and permanent disability when they are in fact capable of working, even if it is not at full capacity. A job is the most therapeutic thing there is.”
But Rick Weidman, executive director for policy and government affairs atVietnam Veterans of America, said most veterans applied for disability not for the monthly checks but because they wanted access to free health care.
“I know guys who are rated 100 percent disabled who keep coming back for treatment not because they are worried about losing their compensation, but because they want their life back,” Mr. Weidman said.
Mr. Weidman and other veterans’ advocates said they were disappointed by one provision of the new rule: It will require a final determination on a veteran’s case to be made by a psychiatrist or psychologist who works for the veterans department.
The advocates assert that the rule will allow the department to sharply limit approvals. They argue that private physicians should be allowed to make those determinations as well.
But Tom Pamperin, associate deputy under secretary for policy and programs at the veterans department, said the agency wanted to ensure that standards were consistent for the assessments.
“V.A. and V.A.-contract clinicians go through a certification process,” Mr. Pamperin said. “They are well familiar with military life and can make an assessment of whether the stressor is consistent with the veterans’ duties and place of service.”
The new rule comes at a time when members of Congress and the veterans department itself are moving to expand health benefits and disability compensation for a variety of disorders linked to deployment. The projected costs of those actions are generating some opposition, though probably not enough to block any of the proposals.
The largest proposal would make it easier for Vietnam veterans with title="In-depth reference and news articles about Ischemic cardiomyopathy." ischemic heart disease, title="In-depth reference and news articles about Parkinson's Disease."
Parkinson’s disease and hairy-cell leukemia to receive benefits.
The rule, proposed last fall by the veterans department, would presume those diseases were caused by exposure to Agent Orange, the chemical defoliant, if a veteran could simply demonstrate that he had set foot in Vietnam during the war.
The rule, still under review, is projected to cost more than $42 billion over a decade.
Senator Jim Web, Democrat of Virginia and a Vietnam veteran, has asked that Congress review the proposal before it takes effect. “I take a back seat to no one in my concern for our veterans,” Mr. Webb said in a floor statement in May. “But I do think we need to have practical, proper procedures.”
More than two million service members have deployed to Iraq or Afghanistan since 2001, and by some estimates 20 percent or more of them will develop P.T.S.D.
More than 150,000 cases of P.T.S.D. have been diagnosed by the veterans health system among veterans of the two wars, while thousands more have received diagnoses from private doctors, said Paul Sullivan, executive director of
Veterans for Common Sense, an advocacy group.
But Mr. Sullivan said records showed that the veterans department had approved P.T.S.D. disability claims for only 78,000 veterans. That suggests, he said, that many veterans with the disorder are having their compensation claims rejected by claims processors. “Those statistics show a very serious problem in how V.A. handles P.T.S.D. claims,” Mr. Sullivan said.
Representative John Hall, Democrat of New York and sponsor of legislation similar to the new rule, said his office had handled dozens of cases involving veterans who had trouble receiving disability compensation for P.T.S.D., including a Navy veteran from World War II who twice served on ships that sank in the Pacific.
VA to Accept Military's PTSD Diagnosis
February 25, 2008
Veterans who are diagnosed with post-traumatic stress disorder (PTSD) while on active duty will now be recognized as having PTSD for VA purposes. This decision will end VA's requirement that veterans diagnosed with PTSD while on active duty provide additional evidence of exposure to specific stressors during their service in order to establish their diagnosis of PTSD. Responding to an inquiry from U.S. Senator Daniel K. Akaka (D-HI), Chairman of the Veterans' Affairs Committee, VA Secretary Peake directed the VA regional offices to no longer require such evidence but instead to immediately schedule examinations for such veterans in order to determine the severity of their PTSD for VA compensation purposes
Posttraumatic Stress Disorder Overview Posttraumatic Stress Disorder can occur following a life-threatening
event like military combat, natural disasters, terroristincidents,serious accidents, or violent personal assaults like rape. Most
survivors of trauma return to normal given a little time.
Compassion and love heal.
Together, we can end the war at home.
This is very special to me. This is my story since Viet Nam. This is something that the Worrier's who have been in the killing fields, need to hear as part on their debriefing. Not to EVER lose the last line, "and, I would need cleansing in all these things". Their feelings need to be validated by the old worrier's, and to know that help is in the worriers tent with the medicine man, the chief, and GOD. There can be much cleansing done!
A warrior gave this to me in a PTSD group therapy session. Author is unknown, you can use it.
Nez Perce Warrior's Reflection:
They said I would be changed in my body.
I would move through the physical world in a different manner.
I would hold myself in a different posture.
I would have pain where there was no blood.
I would react to sights, sounds, movement and touch in a crazy way, as though I were back in war.
They said I would be wounded in my thoughts.
I would forger how to trust, and I would think that others were trying to hurt me. I would see dangers in the kindness and concern of my relatives and others.
Most of all, I would not be able to think in a reasonable manner, and it would seem that everyone else was crazy.
They told me that it would appear to me that I was alone even in the midst of the people, and that there was no one else like me.
They warned me that it would be as though my emotions were locked up, and I would be cold in my heart and not remember the ways of caring for others.
While I might give meat and blankets to the elders, or food to the children, I would not be able to feel the goodness of these actions. That I would do these things out of habit and not from caring. They predicted that I might do harm to others without plan or intention.
They knew that my spirit would be wounded.
They said I would be lonely and that I would find no comfort in family, friends, elders or spirits. I would be cut off from both beauty and pain. My dreams would be dark and frightening. My days would be filled with searching and not finding. I would not be able to find connections between myself and the rest of creation. I would look forward to an early death.
And, I would need cleansing in all these things.
A Guide to Post Traumatic Stress Disorder