The Department of Veterans Affairs disability examination program for PTSD: Critical analysis and strategies for remediation.

Abstract

The Department of Veterans Affairs disability program for posttraumatic stress disorder provides benefits to more than 1 million military veterans. Over time there has been a significant increase in the number and size of these awards. The program has, for decades, received criticism on several grounds, including granting of unjustified or inflated awards and providing a system that serves as a disincentive to recovery. Change-resistant political and cultural factors have been considered the driving forces behind these problems, while scant empirical attention has been paid to policies and procedures that might be more amenable to remediation. The present article describes a descending chain of factors responsible for the increase in PTSD claims within the VA, including claims-specific policies, claims lacking in foundation, lack of standardization in examination procedures and VA decision making, the role of examiner training and bias, problems in VA’s contract examiner program, and flaws in the form required for use by examiners to report examination results. Specific and actionable suggestions for remediation derived from this analysis, most of which involve direction and supervision from forensic mental health experts, are proposed.

Military sexual trauma-related posttraumatic stress disorder service-connection: Characteristics of claimants and award denial across gender, race, and compared to combat trauma

“…Our study was focused on describing military and demographic characteristics of veterans filing PTSD claims for MST and combat exposure and predictors of PTSD and MST service-connection award denial, and thus excluded other potentially important covariates of PTSD service-connection awarding including PTSD symptom severity, comorbid mental and physical health issues and/or diagnoses (e.g., depression, substance use disorders), and locations that might impact claims decisions (i.e., VBA regional office where claim was filed, VHA setting where veteran completed their C&P exam, VHA where veteran sought care if applicable) [ 26 , 27 ]. Furthermore, military and demographic variables were limited to administrative data routinely collected and reported by VBA and VHA.…”