- The Washington Times - Tuesday, May 8, 2007


The surge in the number of veterans suffering post-traumatic stress disorder requires development of better tests to evaluate affected personnel and determine how best to compensate them, a panel of medical professionals said yesterday.

“As the increasing number of claims to [the Department of Veterans Affairs] shows, PTSD has become a very significant public health problem,” said Dr. Nancy Andreasen, chairwoman of the committee that prepared the report.

“Our review of the current methods for evaluating PTSD disability claims and determining compensation indicates that a comprehensive revision is needed,” said Dr. Andreasen, head of the psychiatry department at the University of Iowa’s Carver College of Medicine.

Claims increased from 120,265 in 1999 to 215,871 in 2004 and payments jumped from $1.72 billion to $4.28 billion in the same period, a combined committee from the Institute of Medicine and the National Research Council 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,” agency spokesman Matt Burns said.

“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,” he added.

Although the largest share of claims is still coming from Vietnam War veterans, many more claims are expected in the future from personnel who served in the 1991 Gulf War and in the current conflicts in Iraq and Afghanistan, the panel said.

The VA uses only crude criteria for rating disabilities related to mental illness and is not consistent for relapsing conditions, according to the report, which the VA requested.

The panel urged the VA to develop new criteria based on the diagnostic standards of the American Psychiatric Association and to establish certification programs for workers who deal with PTSD claims.

The panel said the VA should base compensation decisions on how greatly PTSD affects all aspects of a veteran’s daily life, not just his or her ability to be gainfully employed.

Dr. Andreasen noted that in the case of a paraplegic, compensation is based on both ability to work and quality of life, while in the case of mental illness, the ratings are tightly linked to the ability to be employed.

The report also noted that PTSD can be triggered by trauma other than combat, such as sexual assault. Female veterans are less likely to receive compensation for PTSD, which may be partly because they have difficulty substantiating exposure to traumatic events unrelated to combat, including sexual harassment or assaults that occurred during service, the report said.

It urged the VA to gather data and provide reference materials to help disability raters better address the management of PTSD claims related to sexual assault during military service.

Dr. Robert J. Ursano, chairman of the department of psychiatry at the Uniformed Services University of the Health Sciences in Bethesda, Md., a member of the committee, said the recommendations are complex and the VA will have to study how to implement them over time.

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