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New federal rules issued last week will make it much easier for veterans to claim treatment for post-traumatic stress disorder – and officials are still trying to evaluate the likely impact. On the one hand, the relaxed rules might have helped save some Wisconsin National Guard members who died earlier this year in a series of preventable accidents that may have been related to the disorder. But some officials believe the new rules will also lead to fraudulent – and potentially expensive – claims of PTSD by some veterans.

While veterans can receive medical treatment from a VA (U.S. Department of Veterans Affairs) hospital such as Milwaukee’s Zablocki VA Medical Center by simply proving their veteran status, if the veterans want disability benefits for PTSD, they need approval from another section of the vast VA system – the Veterans Benefits Administration. Until last week, that meant what amounted to an investigation, by VA officials, into the veteran’s claim that he or she suffered a traumatic “stressor” during military service.

(photo courtesy of U.S. Army)

Robert Granstrom, director of the Wisconsin VA Regional Office, says the search for documentation that a veteran was actually present during a traumatic firefight, explosion or other event could add three to six months to the time it took to process a claim for benefits. Since last week, when the new rules took effect, the VA has to prove a lot less. “It expedites benefits,” he says. “This is a great thing for veterans.”

The state Department of Veterans Affairs explains the new standard: “If the veteran can show that (he or she) served in a war and performed a job during which events could have caused the disorder,” the veteran is eligible for PTSD benefits, pending a diagnosis by a VA doctor. Under the old system, the investigations sometimes extended back to the Vietnam or Korean wars, or even World War II, and relied on written records or even witnesses. “What I’m hearing from veteran’s groups is that (process) ranged from difficult to impossible in some cases,” says Sara Stinski, DVA spokeswoman.

Nationally, she says, the relaxed rules are expected to add $5 billion in federally-funded benefit payments over 10 years. Some VA officials worry fraudulent claims for PTSD benefits will also rise. “That is a concern,” Stinski says. Granstrom, however, says he doesn’t think fraud under the new system is very likely. He says claims are still reviewed even though the process has been shortened dramatically. “If we thought some of them were fraudulent, we would report it,” he says, to the office of the VA’s inspector general.

Several high profile cases reported in the national media have cast doubt on PTSD benefits, even under the old rules. One Oregon veteran told the VA he was traumatized when his friend was killed at his side during the Gulf War, splattering him with gore. He benefits were later revoked when VA officials discovered the friend was still alive. And a Navy veteran from Virginia had his benefits revoked when officials discovered he had forged documents to get them.

In 2005, concerns of fraud in PTSD benefits prompted a VA review of 2,100 randomly selected cases. It found some of them were incomplete but concluded, as stated in a news release, “The problems with these files appear to be administrative in nature, such as missing documents, and not fraud.” A broader review of 72,000 cases was called off when several U.S. senators, including Barack Obama, objected. Now president, his administration is expanding PTSD benefits, a decided change from the policy under the administration of George W. Bush.

Sufferers come forward

About 54,000 veterans receive disability benefits in Wisconsin. Granstrom says a PTSD disability can range from 10 to 100 percent disabled. Nationally, PTSD is the fourth highest cause of military disabilities. The number of Wisconsin veterans receiving PTSD benefits wasn’t available from the Wisconsin Regional Office on Wednesday.

Dr. Karen Berte, manager for trauma and post-deployment recovery services at the VA Zablocki Medical Center, says the Iraq and Afghanistan wars are causing an influx of veteran seeking treatment for PTSD , but also of older veterans because news accounts of present-day conflicts can awaken decades-old traumas in veterans. Some of these veterans claiming PTSD have served in past wars such as Vietnam, Korea or World War II.

“It’s in our national conscience. It’s in the news, and it’s in conversation,” Berte says. The declining stigma associated with PTSD may also be prompting some older veterans to seek treatment and benefits, she says.

Berte says that PTSD, or simply the process of re-adjusting to civilian life after a tour of duty, can lead to risk taking by veterans. “These can be people who experience depression, and they may engage in risky behavior, maybe not with a conscious thought of, ‘I want to hurt myself,’ but more with a thought of, ‘I don’t care what happens to me.’”

Symptoms of PTSD, according to the National Institutes of Health, include emotional numbness or also strong guilt, depression or anxiety. Sufferers may lose interest in activities they once enjoyed. “Sometimes civilian life has that bland or numbed-out feeling,” Berte says, and risky behavior becomes a way for veterans to “feel alive again,” as she puts it.

A total of 10 service men from the Wisconsin National Guard have died in war zones since the U.S. invaded Afghanistan in 2001, but since the beginning of the year, seven have died in Wisconsin in car accidents, shootings and a boat accident. Most of the cases involved guardsmen taking risks.

Three of the men were killed in car accidents while not wearing seat belts. One ran a red light in Fitchburg in February and crashed; the second wrecked in Bloomington on April 1 while speeding; and the third crossed a center line and struck a truck near Cuba City on April 3. A fourth guardsman was killed in March in a motorcycle accident. He wasn’t wearing a helmet. Then, on April 15, a guardsman fell off a boat into a Wisconsin lake without a life jacket and drowned.

In Chicago, one guardsman, a Chicago police officer, was shot during a robbery. Another was shot in Chippewa County, Wis., investigators believe, by his girlfriend’s estranged husband. A rash of deaths across the country due to high-risk behaviors by National Guard members prompted special training sessions, including some in Wisconsin in June on preventing more such accidents.

“You’re not invincible just because you survived a combat zone,” says Jacqueline Guthrie, spokeswoman for the state National Guard.

What is post-traumatic stress disorder?

“PTSD is an anxiety disorder that some people get after seeing or living through a dangerous event. When in danger, it’s natural to feel afraid. This “fight-or-flight” response is a healthy reaction meant to protect a person from harm. But in PTSD, this reaction is changed or damaged. People who have PTSD may feel stressed or frightened even when they’re no longer in danger.”

Symptoms include flashbacks of the traumatic event, bad dreams, feeling emotionally numb, depressed, guilty or anxious, difficulty sleeping, outburst of anger or being easily startled.

(source: National Institutes of Health)

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