The Institute of Medicine and the National Research Council released an anticipated report entitled PTSD Compensation and Military Service on May 8.

The report came as criticism has mounted over Veteran Administration (VA) Sec. Jim Nicholson’s tenure at the VA that saw budget shortfalls, a backlog of 600,000 disability cases, staffing shortages at Vet Centers, security breaches, alleged neglect of Post Traumatic Stress Disorder (PTSD) cases, and even the criminalization of the VA benefit process.

After a storm of veterans’ and Democrats’ denunciations, on Nov. 10, 2005, the (VA) announced that there would “no across-the-board review of (PTSD) cases,” reversing its controversial plan to review 72,000 PTSD cases.

“The process of gathering evidence to prove PTSD disability is extremely time-consuming. It requires the compilation of medical records, military service records, and testimonies from other veterans who can attest to a person’s combat exposure. I cannot fathom why the VA would require veterans to go through this emotionally painful process a second time,” said Sen. Barrack Obama (D-IL) on August 10, 2005.

Days later, Cheryl Reed of the Chicago Sun Times, broke a story detailing how the VA planned to implement a PTSD restructuring anyway, announced in a low-profile press release through Sen. Larry Craig (R-ID), then Chairman of the Senate Committee on Veterans’ Affairs, a move that drew condemnation for the low-profile manner in which the plan was announced.

Craig's press release announced that the VA would contract with the (non-profit) Institute of Medicine (IOM) on a two-pronged approach to the examination of PTSD.

The current IOM report cites a 2005 VA Office of Inspector General report stating that from 1999 to 2004 the number of beneficiaries receiving PTSD benefits grew 148 percent, representing benefit payments of some $4.3 billion; a figure equal to what the U.S. spends in Iraq in approximately 16 days, according to the National Priorities Project.

Vietnam Vets

The IOM website notes that, “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.”

This claim is echoed in the Army Times (May 8, 2007) “While the largest share of claims is still coming from Vietnam War veterans, there are expected to be many more claims in (the) future from personnel who served in the first Gulf War and in the current conflicts in Iraq and Afghanistan, the panel said.”

While some critics fear the report will be used by the VA to restrict PTSD benefits for veterans, the Vietnam Veterans of Americans (VVA) lauded parts of the IOM report.

"This report reiterates the need for much better training and standardized certification of adjudicators at VA, better training for VA's examining clinicians, and adequate time and resources for examining clinicians to do their job properly at VA. Further, it notes that the onset of legitimate PTSD or a major relapse can occur at any time, sometimes decades after the experience, sparked by a variety of causes," said VVA National President. John Rowan.

The IOM report also notes that PTSD can be triggered by trauma other than combat, such as sexual assault, a crime increasingly experienced by female solders.

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