AP: Raising Traumatic Stress Malingering, VA Disability Claim Fraud Fears

Here we go again. Fears of PTSD malingering and VA claim fraud bobbed to the surface this weekend in a piece by Allen G. Breed, AP:

Moved by a huge tide of troops returning from Iraq and Afghanistan with post-traumatic stress, Congress has pressured the Department of Veterans Affairs to settle their disability claims — quickly, humanely, and mostly in the vets' favor.

The problem: The system is dysfunctional, an open invitation to fraud. And the VA has proposed changes that could make deception even easier.

PTSD's real but invisible scars can mark clerks and cooks just as easily as they can infantrymen fighting a faceless enemy in these wars without front lines. The VA is seeking to ease the burden of proof to ensure that their claims are processed swiftly.

But at the same time, some undeserving vets have learned how to game the system, profitably working the levers of sympathy for the wounded and obligation to the troops, and exploiting the sheer difficulty of nailing a surefire diagnosis of a condition that is notoriously hard to define.

"The threshold has been lowered. The question is how many people will take advantage of that," said Dr. Dan G. Blazer, a Duke University psychiatrist who has worked with the military on PTSD issues. PTSD, he adds, is "among the easiest (psychiatric) conditions to feign."

Mark Rogers, a longtime claims specialist with the Veterans Benefits Administration, agrees. "I could get 100 percent disability compensation for PTSD for any (honorably discharged) veteran who's willing to lie," said Rogers, a Vietnam-era vet who is now retired. "I just tell him what to say and where to go."

The only problem with this, of course, are the reams of past years' studies showing quite the opposite. Two that come immediately to mind:

• In 2007, Navy Times reported: "In 2001, 10 percent of soldiers going through the medical retirement process received permanent disability benefits. In 2005, with two wars raging, that percentage dropped to 3 percent, according to the Government Accountability Office. Reservists dropped from 16 percent to 5 percent."
  
  
• Also in 2007, US News & World Report found the military to be downgrading disability ratings, reporting: "Since 2000, 92.7 percent of the disability ratings handed out by PEBs have been 20 percent or lower... Moreover, fewer veterans have received ratings of 30 percent or more since America went to war in Afghanistan and Iraq... As of 2006, for example, 87,000 disabled retirees were on the list of those exceeding the 30 percent threshold; in 2000, there were 102,000 recipients."

Then again, maybe PTSD diagnoses shouldn't be taken seriously.

Breed, in a companion AP piece getting a bit less buzz but championing the same cause, reports "the fact that, as a constellation of self-reported symptoms, PTSD is very subjective."

Apparently, biological changes in the brain aren't objective, either.

Everyone agrees that each case of malingering or fraud should be penalized and stopped, no matter if that claim is being filed with the VA or a civilian's private insurance company. Unfortunately, this AP piece appears to do more to spread distrust and blame the veteran than anything else. Not surprisingly, the push-back has begun.

Found Links: Traumatic Stress, Brain Injury Research, Related Military News

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• Blood protein triggers scars in the brain after injury | EurekaAlert release -- Clip: "A protein called fibrinogen that is known to help form blood clots also triggers scar formation in the brain and spinal cord, according to new research in the April 28 issue of the Journal of Neuroscience. Researchers found that fibrinogen carries a dormant factor that activates when it enters the brain after an injury, prompting brain cells to form a scar. Scars in the brain or spinal cord can block connections between nerve cells and often keep injury patients from reaching full recovery."
  
  
• It pays to remember what made you sad | New Scientist
  
  
• Pentagon: Boost Training With Computer-Troop Mind Meld | Wired -- Clip: "The Pentagon is looking to better train its troops — by scanning their minds as they play video games. Adaptive, mind-reading computer systems have been a work-in-progress among military agencies for at least a decade. In 2000, far-out research agency Darpa launched “Augmented Cognition,” a program that sought to develop computers that used EEG scans to adjust how they displayed information — visually, orally, or otherwise — to avoid overtaxing one realm of a troop’s cognition."
  
  
• A brain-recording device that melts into place | PhysOrg.com -- Clip: "...the ultrathin flexible implants, made partly from silk, can record brain activity more faithfully than thicker implants embedded with similar electronics. ...In people with epilepsy, the arrays could be used to detect when seizures first begin, and deliver pulses to shut the seizures down. In people with spinal cord injuries, the technology has promise for reading complex signals in the brain that direct movement, and routing those signals to healthy muscles or prosthetic devices."
  
  
• Placebo effect beats God, Prozac | SF Chronicle -- An intense opinion piece with lots of interesting data and ideas to consider.
  
  
• Aging: The Secret Life of the Middle-Aged Brain | Huffington Post -- A few tips and clearing up of myths.
  
  
• The Conversation: Brain research brings wonders and worries | Sacramento Bee -- Important read. Intro clip: "What ethical concerns will arise from new technology and medicine that can reveal our thoughts and enhance our brains?"

The Singular Trails and Trials of Female Combat Veterans

Sharing a handful of recent news reports focusing on the unique military service and civilian reintegration experiences of our women veterans. A good intro for our purposes from Jayme Fraser, Montana Kaimin:

Military policies banning women from the frontline are disappearing as the number of female veterans in the United States nears 1.9 million.

“I think we’re growing up,” Army National Guard Capt. Dawn Gray said. “If you look at other countries, especially Israel, women are not excluded from any combat role if they can physically handle it.”

The role of women in war has expanded significantly since World War II, when women moved into the workplace void left by men going off to war.

“There are only a few places that women aren’t actively assigned and I expect that will change, too,” Gray said.

Female pilots fly combat missions for the Air Force and Navy. Though Army policy prohibits women from the frontline, temporary assignments and test programs, as well as changing dynamics of urban warfare in Iraq, have put more female soldiers into combat.

Combat Clips: A Selection of OEF/OIF Veteran Statistics, April 2010

Quick looks at the latest news containing statistics of interest to returning veterans, military families and their caregivers.

First up, Kristin M. Hall for AP:

Brig. Gen. Stephen Townsend addressed the 101st Airborne Division with military brusqueness: Suicides at the post had spiked after soldiers started returning home from war, and this was unacceptable.

"It's bad for soldiers, it's bad for families, bad for your units, bad for this division and our Army and our country and it's got to stop now," he insisted. "Suicides on Fort Campbell have to stop now."

It sounded like a typical, military response to a complicated and tragic situation. Authorities believe that 21 soldiers from Fort Campbell killed themselves in 2009, the same year that the Army reported 160 potential suicides, the most since 1980, when it started recording those deaths.

But Townsend's martial response is not the only one. Behind the scenes, there has been a concerted effort at Fort Campbell over the past year to change the hard-charging military mindset to show no weakness, complete the mission.