April 20, 2014

New PTSD Regulations Expedite Benefits to More Veterans

In July, the Department of Veterans Affairs (VA) released new regulations on Post Traumatic Stress Disorder (PTSD) claims.

The changes arose, at least in part, due to the often seemingly-endless appeals processes for PTSD claims, which average 4.4 years according to Veteran Journal. The VA is also the subject of a class action lawsuit, which asserts that the extensive time to process claims, upwards of fifteen years in some cases, violates Veterans’ constitutional rights. With evidence that “nearly 3,000 soldiers die a year while waiting for their appeals to the VA for mental health benefits,” and with over 85,000 Veterans on a waiting list to claim mental health benefits (2009), it is unsurprising that President Obama hailed the new regulations:

I don’t think our troops on the battlefield should have to keep notes just in case they need to apply for a claim. And I’ve met enough veterans to know that you don’t have to engage in a firefight to endure the trauma of war. So, we’re changing the way things are done.

The new rule applies to Veterans of any era and to all new claims and appeals received on or after July 13, 2010, as well as all pending yet undecided claims and appeals filed before July 13, 2010.

The fundamental change in the rule, implemented to expedite decisions, is to allow for a Veteran to “establish the occurrence of an in-service stressor though his or her own testimony;” prior to the rule change, the VA was required to verify the stressor accounts through extensive record analysis, a “very involved an protracted process.”

The Veteran’s stressor testimony must be in conjunction with several other elements: 1) the Veteran must be diagnosed with PTSD, 2) a VA psychiatrist must confirm that the claimed stressor is adequate to support the diagnosis, 3) the Veteran’s symptoms are related to the claimed stressor, and 4) the claimed stressor is consistent with the “places types, and circumstances of the Veteran’s service and the record provides no clear and convincing evidence to the contrary.”

The new regulations also allow for PTSD claims to be processed where the Veteran’s stated stressor is not directly related to combat or POW service. The stressor need only be related to a “fear of hostile military or terrorist activity . . . consistent with the places, types, and circumstances of the Veteran’s service.” VA adjudicators determine whether or not the claimed stressor is consistent with the Veteran’s service.

The rule change will be especially beneficial to those Veterans “whose military records have been damaged or destroyed,” providing no definitive evidence of combat action that could result in PTSD, despite reasonable Veteran testimony to the contrary. Additionally, women Veterans, whose roles in the military “placed them at risk of hostile military or terrorist activity,” will see a great benefit from the rule change.

While the changes seemingly make it easier for claims to be processed, and therefore increase the risk of fraud, James Dwyer, chief of PTSD services for the VA of Greater Los Angeles, believes that gains to the system outweigh any such risk. Dwyer states that “every large system has to deal with” such concerns and “anyone who puts on the uniform, signs the papers, goes over, serves, should have the benefit of the doubt.” Additionally, as Veteran Journal contends, fraudulent claims are unlikely “due to the fact that a veteran must first be diagnosed with PTSD and if that veteran shows improvements their benefits can be cut back over time to reduce costs.”

Image Source: Wikimedia Commons

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