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New soldiers entering the war are at risk of being exposed to trauma, which increases the chance of being diagnosed with PTSD. Other target groups at heightened risk for PTSD are those required to serve multiple deployments and female service members. According to the NADCP (2007) 1 in 5 veterans report symptoms of a mental disorder. These figures can be utilized to predict and implement future treatment needs and funding requirements. Streamlining the application process, by allowing timely access to benefits, can result in reduced benefit necessities.
A policy which improves access to benefits for veterans is supported by veteran’s organizations everywhere. A recent change in the policy removes the requirement for veterans to submit written documentation of a stressful event during military service. The most critical support for this change is that of U.S. politicians who make policy decisions. President Obama, in his speech on July 10, 2011, expressed his support for veterans, specifically those suffering with PTSD. He understands the plight of soldiers of war, whether in combat or non-combat, being affected by the war’s trauma. President Obama understood the necessity for new policy as the old policy prevented many of those with PTSD from receiving the care they needed. As stated by the President “I don’t think our troops on the battlefield should have to take notes to keep for claims applications” (The White House, 2010). The Texas Veteran Commission, realizing the growing number of veterans with PTSD, is optimistic in its view that the new policies will allow this vulnerable group easier access to benefits (Cervantes, 2010).
B. Christopher Frueh, a professor of psychology and director of the Division of Social Sciences at the University of Hawaii, is not a supporter of the rule change.
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Sally Satel, psychiatrist, and scholar concurs with Professor Frueh in that compensation without treatment risk veterans being dependent upon benefits. She states that there are two overwhelming concerns with the system, the lack of a universal assessment tool and the unintentional side effects of receiving disability benefits prior to treatment. A premature conclusion that one’s injuries render them disabled could prove detrimental to the recovery process (Satel, 2011).
One could construe pre-amended policy restrictions, such as deadlines for appeals and mandatory documented proof of traumatic exposure, to be associated with a hidden agenda limiting the number of soldiers who receive disability benefits for PTSD. However, some believe that exaggerated symptoms and loose regulations make benefits vulnerable to possible fraudulent claims, economic dependency, and an increased cost to society (Dao, 2010).
The number of veterans returning from combat is increasing at a rapid rate making it imperative that benefits be rendered expeditiously. The VA statistics indicate that PTSD is the fourth most common service related disability. The VA treated 593,634 patients, of which 171, 423 were diagnosed with PTSD as reported by the VA in June 2010 (Vietnam Veterans of America & Veterans of Modern Warfare, n.d.).
The ability of the government to meet the financial obligation to veteran’s suffering with PTSD is crucial. The Secretary of the VA sought additional funding to adequately supply more mental health programs for the treatment of PTSD. A recent survey conducted by the VA of its mental health service providers shows that required appointments are not being scheduled within the specified two week time frame. The reasons cited were inadequate staff or space, hours of operation, limited time given for patient care, and requirements to complete compensation and pension examinations (U.S. Medicine, 2011).
It has been estimated that the cost of providing medical care and disability for returning veterans would be between $589 billion and $984 billion, previously estimated at $400 billion to $700 billion. The 2011 VA disability rates for a veteran alone range from $123 to $2,673 per month. The range in compensation is based upon PTSD ratings governed by 38 CFR § 4.130, DC9411. It establishes graduated ratings of 0% (symptoms not severe enough either to interfere occupational and social functioning) to 100% (total occupational and social impairment). Compensation differs for veterans with a spouse, children or parents which will increases the amount of monthly payment. There is no pay differential for veterans alone or with dependents for 10% and 20% impaired functioning. The US government is not ready financially for the cost of disability benefits for veterans professed Committee Chair Rep Bob Filner, D-CA. While VA disability benefits are appropriated as mandatory funding, being calculated and set yearly, the VHA’s budget is at the discretion of Congress. Congress providing more funding to the VHA’s budget lessens funding for other areas (U.S. Medicine, 2010).
Other social and medical issues can become prevalent when treating PTSD necessitating the need for more resources. Veterans with PTSD have a higher rate of divorce, suicide, drug and alcohol abuse, and violence. Linda Bilmes reports that “…recent studies show that PTSD sufferers are at a higher risk for heart disease, rheumatoid arthritis, bronchitis, asthma, liver, and peripheral arterial disease. It can be noted that some of the medical conditions are systemic of other underlying issues. They are 200% more likely to be diagnosed with a disease within five years from returning from deployment” (U.S. Medicine, 2010). According to Bilmes, veterans with PTSD utilize non-mental health services 71% to 170% more than those without PTSD (U.S. Medicine, 2010).
Although there are concerns raised by the policy, its primary focus is on the well timed receipt of benefits for each veteran. However, funding for the implementation of the policy poses a great challenge. The amount of benefit applicants and applicant accessibility place a financial strain on an exhausted economy. In addition to the accessibility of benefit compensation, the policy should emphasize the importance of the diagnosis and treatment of veterans. Untreated symptoms of veterans diagnosed with PTSD exacerbate preexisting social problems such as domestic violence, drug and alcohol addiction and public endangerment.
The current policy does not provide adequate incentive for veterans with PTSD to seek diagnosis and treatment. Mental health treatment and bi-annual psychiatric re-evaluation should be mandatory for receiving financial disability compensation. This policy amendment to Title 38 would improve the act by mandating that all returning servicemen receive screenings and treatment, if necessary, following their active service. Many returning members of the service do not exhibit symptoms immediately upon their return, as evidenced throughout history. This amendment will help to prevent cases of PTSD from going undetected which will allow these members of the military to return to productive, full lives. This would legitimize the current PTSD mental health crisis and decrease the overwhelming societal costs of untreated PTSD.