Rules eased for filing PTSD claims

By Ed O'Keefe
Friday, July 9, 2010; A02

Veterans organizations are eagerly anticipating changes in government policy designed to ease the burden of proof for receiving disability benefits for post-traumatic stress disorder, saying new rules should help veterans receive fair compensation for the mental scars of war.

The Department of Veterans Affairs is to announce Monday that veterans will no longer need to provide detailed documentation proving they experienced a traumatic event during combat in order to file PTSD disability claims, congressional aides and veterans advocates said.

Eligible veterans instead will be screened by VA medical staff to confirm that claims are consistent with the location and circumstances of military service and PTSD symptoms, which often include nightmares, flashbacks, irritability and deep depression.

The changes follow more than a year of work by Obama administration officials, lawmakers and veterans advocates. VA officials declined to comment ahead of Monday's anticipated announcement.

The changes could make life easier for Robert Kingsley, 27, an Air Force veteran waiting for full disability benefits though VA considers him unemployable.

Others might also avoid the experience of Navy reservist Richard Sanchez, 43, whose PTSD claims were approved in May after he filed more than five years of paperwork.

And female veterans should have an easier time earning benefits, because Pentagon rules prohibiting front-line action make it difficult to prove stressful combat events, advocates said.

Women often face more skepticism about PTSD claims during visits to male-dominated VA medical centers, said retired Army Sgt. Carolyn Schapper.

"If you happen to go once and the first person you speak to questions the authenticity of your story, you're less likely to go back," she said. "That's true for men and women, but women are more likely to be questioned than men."

She had an easier time filing disability claims because of her rank, she said.

But "if you think you have PTSD because a mortar was hitting your forward operating base, you more than likely don't have paperwork," Schapper added.

That lack of proof prolonged Sanchez's efforts. A veteran of the wars in Afghanistan and Iraq, Sanchez injured his back and right ankle in 2006 while serving in Kuwait as a truck driver. In 2008 he was admitted into a VA treatment program for PTSD symptoms, but the department denied his disability claims soon after, he said.

"I was very confused," Sanchez said. "Do I have it or don't I have it? If so, what am I supposed to do? I just wanted some help."

He locked himself in his house for six months, skipped appointments and lost touch with his children, he said.

Sanchez said the department finally sent him a letter in March noting an improper denial of claims. The money started arriving in May.

"They acknowledged they made a mistake and they're working on correcting it," he said Thursday. "I haven't given up faith in the system."

But Kingsley is growing anxious. VA says he suffers from traumatic brain injury and tinnitus, but it won't confirm his PTSD claims until military records arrive to prove his case from a 2005 tour of duty in Iraq.

"It puts all the stress on my parents, since I can't get a job," Kingsley said.

Some observers have said they fear that the more relaxed policies could lead to fraud.

Sanchez said he worries that some veterans will try to game the system for financial gain. "There are some vets that really don't need it," he said. "I've met them, and they've admitted that they're doing it just for the money, which makes it harder for us who really need it."

Although veterans groups generally support the changes, they don't like VA's apparent decision to prohibit private medical professionals from screening veterans for PTSD symptoms.

"This requirement seems to be a step backward in an otherwise commendable move by the VA," said Barry Searle of the American Legion.

"You've got a fixed number of VA physicians, as opposed to all the others out in the private sector that could handle the cases faster and move them into the adjudication process," Searle said.

Carl Blake of the Paralyzed Veterans of America said VA should establish a training program for private doctors.

"Just because you're a psychiatrist or a psychologist doesn't necessarily make you qualified in general to make a determination of PTSD without training or understanding of the unique experiences that veterans share," he said.

Congressional aides estimate the policy change will cost at least $5.2 billion in benefits payments over 10 years, about the cost of a half-month's worth of military operations in Iraq, said Rep. John Hall (D-N.Y.), who pushed for the changes.

"We need to consider this part of the cost of waging war," Hall said. "You can't just say, 'Well, we're going to pay for the guns and the ammunition and the machines,' and then look the other way with the medical costs."

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