July 7, 2010
V.A. Is Easing
Rules to Cover Stress Disorder
By
JAMES DAO
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 at
Vietnam 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
ischemic heart 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 Webb, 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.
“It
doesn’t matter whether you are an infantryman or
a cook or a truck driver,” Mr. Hall said.
“Anyone is potentially at risk for
post-traumatic
stress.”
Compassion and
love heal.
Together, we can end the war at
home.
Utilizing data gathered from the large-scale VA Matsunaga study,
describes the effects of trauma on Native Hawaiian and Japanese-American
veterans.
Brief information about the Department of Veterans Affair’s network
of more than 100 specialized programs for veterans with PTSD, including
the Vet Centers operated by VA's Readjustment Counseling Service
