UI's Andreasen Leads Report On VA Post-Traumatic Stress Cases

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The U.S. Department of Veterans Affairs should revise how it evaluates and compensates former military personnel for service-related post-traumatic stress disorder.

The report, issued by Institute of Medicine and National Research Council, committee was chaired by University of Iowa psychiatry professor Nancy Andreasen.

PTSD cases within the VA system jumped almost 80 percent between fiscal years 1999 and 2004, increasing from 120,265 cases to 215,871. PTSD payments increased almost 150 percent over the same period, rising from $1.72 billion to $4.28 billion.

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The large increase in PTSD disability claims revealed inconsistencies in compensation awarded nationwide, raising questions about the VA's current ways of assessing and rating PTSD and reimbursing veterans for treatment, the report stated.

"As the increasing number of claims to the VA shows, PTSD has become a very significant public health problem, particularly for veterans of current and past conflicts," said Andreasen, M.D., Ph.D., the Andrew H. Woods Chair of Psychiatry and director of the Psychiatric Neuroimaging Research Center at the UI Roy J. and Lucille A. Carver College of Medicine. "Our review of the current methods for evaluating PTSD disability claims and determining compensation indicates that a comprehensive revision is needed."

The committee recommended that the VA ensure that all veterans applying for PTSD compensation receive a thorough, initial evaluation by an experienced clinical professional. Currently, the time devoted to evaluations varies widely as does the amount of detail examiners provide the raters who determine the appropriate level of compensation. The report could help the VA devise new ratings criteria for PTSD.

The committee also found that PTSD can develop any time after exposure to trauma, manifest as a relapsing condition or flare up after being suppressed and undiagnosed. Combat exposure and sexual assault are potential triggers for PTSD among service members.

Most PTSD compensation claims come from Vietnam War veterans, who comprise the majority of living veterans, but claims also are made by former and current military service personnel. The report estimates many more claims will be made in the future by personnel now on active duty.

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