Better stress tests are urged for vets

The increase in the number of veterans with post-traumatic stress disorder requires better tests to evaluate personnel and determine how best to compensate them, a panel of medical experts said Tuesday.

“As the increasing number of claims to the [Department of Veterans Affairs] shows,” post-traumatic stress “has become a very significant public health problem,” said Nancy Andreasen, chairwoman of the committee that prepared the report.

“Our review of the current methods for evaluating PTSD disability claims and determining compensation indicates that a comprehensive revision is needed,” said Andreasen, head of the psychiatry department at the University of Iowa’s Carver College of Medicine.

Claims increased to 215,871 in 2004 from 120,265 in 1999 and payments jumped to $4.28 billion from $1.72 billion in the same period, said a combined committee from the Institute of Medicine and National Research Council.

“VA is studying the findings, conclusions and recommendations of the report to determine actions that can be taken to further enhance the services we provide,” VA press secretary Matt Burns said.

“VA is a recognized leader in the diagnosis and treatment of PTSD, and we will continue to take steps to ensure veterans have timely and seamless access to compensation for which they are eligible,” he said.

Although the largest share of claims still comes from Vietnam War veterans, many more claims are expected from personnel who served in the 1991 Persian Gulf War and in the current conflicts in Iraq and Afghanistan, the panel said.

But the VA uses only crude criteria for rating disabilities due to mental illness and is not consistent about relapsing conditions, according to the report, which had been requested by the VA.

The panel urged the VA to develop new criteria based on the diagnostic standards of the American Psychiatric Assn. and to establish certification programs for workers who deal with post-traumatic stress claims.

The panel said the VA should base compensation decisions on how greatly the disorder affects all aspects of a veteran’s daily life, not only his or her ability to be gainfully employed.

Andreasen said that in the case of a paraplegic, compensation is based on ability to work and quality of life, while in the case of mental illness, the ratings are tightly linked to the ability to be employed.

The report also said PTSD can be triggered by non-combat trauma, such as sexual assault.