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Tuesday, May 08, 2007

Institute of Medicine: 'Comprehensive Revision Needed' of Gov't PTSD-Compensation System

From McClatchy News:

The Department of Veterans Affairs must change the way it evaluates former soldiers for post-traumatic stress disorder if it hopes to eliminate the wide disparities across the country in how much it compensates those who have the disability, a new report has concluded. Released Tuesday by the highly regarded Institute of Medicine, the report says that the recent surge in cases of PTSD, coupled with ineffective VA rules, suggests that veterans could be getting disability payments that are too high or too low.

Saying that PTSD has become a "very significant public-health problem," one of the report's authors, Nancy Andreasen of the University of Iowa, concluded that a "comprehensive revision is needed" of the government's PTSD-compensation system. Among other things, the report calls for new testing procedures and new training regimens to ensure that government "raters," who decide on veterans' cases, do a better - and more uniform - job.

Knight Ridder, which McClatchy Newspapers bought last summer, reported in 2005 on the VA's unequal levels of disability compensation, particularly among more subjective conditions such as PTSD. The investigative report found that the size of the benefit varied widely by geography and mental problems had larger variations than physical ailments.

Click on 'Article Link' below tags for more...

The report was commissioned by the Veterans Administration.


The VA has come under fire in recent years for the way it handles disability compensation cases, including its inability to bring down a huge backlog of cases and reduce its high number of errors. Wide variations among the 57 regional offices that handle cases compound the delays and mistakes.

Among the more vexing problems are the wide swings in the amount of disability payments depending on a veteran's regional office. Veterans in some states get more money per month than those in other states. Currently, a veteran who's considered 100 percent disabled is eligible for a monthly payment of $2,471.

In its 2005 investigation, McClatchy found that the more subjective ailments had the largest disparities. For example, veterans with PTSD who were assigned to the Wilmington, Del., office were more likely to have the highest disability rating than their counterparts in Lincoln, Neb. In Delaware, 34 percent of those with PTSD had the highest rating; in Lincoln it was 10 percent, the investigation showed. The report was based on 2004 data.

Description of the Institute of Medicine report:

In recent years, the number of veterans seeking disability compensation for post-traumatic stress disorder (PTSD) has spiked by almost 80 percent and the U.S. Department of Veterans Affairs (VA) is currently providing more than $4 billion in compensation for the condition. The surge in claims by Vietnam War veterans and other former military personnel has revealed inconsistencies in how veterans are rated for PTSD disability and in compensation levels.

Against this backdrop, VA’s Veterans Benefits Administration (VBA) asked the Institute of Medicine and National Research Council to convene a committee of experts to address several issues surrounding its administration of veterans’ compensation for PTSD. The resulting report, PTSD Compensation and Military Service, recommends ways to fix shortcomings in VA's program for evaluating and compensating veterans for service-connected PTSD and to restore confidence that the agency is compensating all veterans fairly. The report also addresses questions about how long after a traumatic event PTSD can arise and how to better manage PTSD claims related to sexual harassment or assault during military service.

Report summary.

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