PTSD Ruling Eases Burden On Sufferer

It has gone by many names. Shell shock. Battle fatigue. The thousand-yard stare.

Today, we define the struggle as post-traumatic stress disorder, a largely invisible wound of wartime service. As long as men and women have taken up arms and placed themselves in harm's way, the mental and emotional aftershocks have haunted those for whom we owe our freedom and defense. For much of our nation's history, the condition has been swept to the side, ignored and stigmatized. Those who suffer are torn between seeking the help they need and revealing the fact that they have it.

VA recently took a great step forward in closing the gap between suffering and assistance for veterans diagnosed with PTSD. A new rule clarification relaxes the burden of additional evidence for veterans diagnosed with PTSD and seeking VA benefits. Essentially, a VA diagnosis of PTSD sustained in the service is now proof enough, without additional investigation and documentation, to move the claims process along. All too often in the past, veterans who were brave enough to step forward and seek treatment and obtain a diagnosis only had their claims for benefits questioned, doubted and denied. Even in situations where VA doctors acknowledged PTSD, the veteran in question would have to produce additional documentation recording the event that caused the stress, Page 5 John Ivens Post 42 Newsletter August 2010 often impossible to find. Denied and feeling betrayed, many turned away from the VA health-care system. Those who persisted were put through grueling interrogations, asked to describe over and over, in detail, the events they so desperately hoped to escape.

Military historians will be familiar with Carl von Clausewitz's famous phrase "the fog of war." The ability to know and recount with any certainty every detail of a military operation long ago is frankly impractical and unrealistic. How do you document a Vietnamese civilian detonating a bomb outside a bar in Saigon? How do you document witnessing scores of amputee children in rural Afghanistan, scarred for life by leftover mines they tripped while playing in a field? How do you document the terror of riding out with supply convoys through IED-laden Iraq?

The new regulation puts it this way: "If a stressor claimed by a veteran is related to the veteran's fear of hostile military or terrorist activity and a VA psychiatrist or psychologist or contract equivalent confirms that the claimed stressor is adequate to support a diagnosis of PTSD, and that the veteran's symptoms are related to the claimed stressor, in the absence of clear and convincing evidence to the contrary, and provided the claimed stressor is consistent with the places, types, and circumstances of the veteran's service, the veteran's lay testimony alone may establish the occurrence of the claimed in-service stressor..." What that means is a monumental step forward. In addition to reduced burden of documentation, the clarification erases such lines as war era or combat theater. The rule reaches out to all veterans who struggle with PTSD. Female veterans who routinely have been told they couldn't have seen combat because it was not in their MOS no longer have to defend the location of their stressing incident or the duty they were performing. The PTSD suffered by maintenance mechanics who had to clean the blood from vehicles damaged by IEDs can now be acknowledged.

Challenges yet remain. VA and military doctors do not always agree on the symptoms or diagnoses of PTSD. Veterans who suffer need more than compensation based on their service-connected disability; they need treatment, counseling and camaraderie from their fellow veterans. The American Legion, as it has been throughout the battle to lift the burden of additional documentation, is there for them, to show the American people that veterans who suffer from PTSD deserve our compassion as much as those wounded in other ways. These veterans need to know they can step forward without fear and not only gain acceptance but also gratitude of their nation and reasonable access to the benefits they are due.