Thursday, November 05, 2009

PTSD Diagnoses to be Based on Veterans’ Own Testimonies

VA hopes to implement a new rule by early 2010 that would make it easier for vets with PTSD to collect disability compensation. VFW says the ruling will help its service officers, too.


VFW November/December Magazine Issue by Tim Dyhouse


Veterans diagnosed with post-traumatic stress disorder (PTSD) will find it easier to file VA disability claims. They will no longer be required to provide evidence—other than their own testimony—of an event that caused their PTSD.


VA published a proposal in the Aug. 24, 2009, Federal Register noting that it would no longer require "corroboration of a stressor" (the event or experience that caused the PTSD) if a VA psychiatrist or psychologist confirms that a veteran's stressful experience "adequately supports" a PTSD diagnosis and the vet's symptoms are related to the stressor.


VFW favors the proposal because it "eases the evidentiary burden" on vets suffering from PTSD and the VFW service officers who help them.


"The change also will make VA's job a little easier because it won't have to do as much development to obtain evidence necessary to establish a service-related stressor," said Gerald T. Manar, deputy director for VFW's National Veterans Service. "Our service officers won't have to help VA and the vet find records that prove a stressor. Service officers only need to be sure that VA properly understands the work and experiences vets had while serving."


But Manar doesn't necessarily agree with a VA representative's assessment that the new ruling would "allow us to pay benefits much faster" when VA's backlog of claims and appeals stands at some 1 million.


"By policy, VA works on its oldest cases first," said Manar, who worked at VA for 30 years. "As a consequence, anyone seeking service connection of PTSD under these proposed changes will still have to wait until 150,000 cases that have been pending for more than six months are settled. What it may do is allow VA to move those six-month-and-older cases where stressor verification is an issue more quickly."


Doctors Must Provide Testimony

Before this new ruling, VA claims adjudicators were required to corroborate that non-combat veterans actually experienced a stressor related to hostile military activity. Now, combat support personnel in the Iraq and Afghanistan wars—as well as those of previous wars—who experience combat should find it easier to garner service-connected disability compensation.


"Supply convoys in Vietnam were frequently ambushed," Manar said. "But because those troops weren't classified as 'infantry' they weren't eligible for the Combat Infantryman Badge, and it was extremely difficult to prove they were in combat."


He says VA only recently began accepting unit records showing Vietnam War ambushes or records proving an individual was assigned to a unit that was ambushed. Manar advises vets who were denied a service-connected PTSD claim for lack of evidence to reapply.


"The proposed change eases the evidence burden, but it does not create any kind of presumption," he said. "If a Vietnam-era veteran claims, for instance, that his stressor was received in combat in Vietnam and military records show he never went to Vietnam, then VA is free to deny the claim in spite of this change in regulations."


Manar points out that even vets who have received a medal for combat or valor, or were prisoners of war, must still obtain a doctor's supporting testimony.


"Simply being in combat or imprisonment is not sufficient to ease the evidence burden on a veteran," he said. "A physician must testify that the stressor which caused the PTSD is the stressor which occurred while in combat or as a POW."


Though the burden of proof on the veteran has eased, Manar doesn't believe the new ruling will open the door to "significant" numbers of fraudulent claims.


"Does that mean that some veterans will try to game the system?" he says. "Sure. But they will have to fool a doctor twice into believing that they have PTSD and that it is related to a stressor in service. Can that be done? Yes, but probably fewer times than you would think."


According to Manar, the main result of the new ruling will be that the collecting of evidence to prove a stressor "largely goes by the boards with this change." VFW doesn't believe, he says, that the change will open the floodgates of new or reopened claims for PTSD service connection. Rather, it could allow VA to operate more efficiently.


"The river of claims will grow deeper and flow quicker," he said. "VA will have to paddle more quickly to move against the current, but, since their boat is lighter thanks to this regulation change, they should be able to make progress upstream."