VA expects no claims spike under new PTSD rules - Navy News | News from Afghanistan & Iraq - Navy Times

VA expects no claims spike under new PTSD rules

Veterans Affairs Department officials who are lowering the bar for veterans to receive benefits related to post-traumatic stress disorder say they don’t expect more people to try to jump over it.

But VA may be underestimating a potential flood of claims that could result from an Obama administration decision to make it far easier for veterans who served in noncombat jobs to prove their mental health issues are service-connected.

Final rules are expected to be published in Tuesday’s Federal Register, and will apply to any PTSD-related claim filed beginning Tuesday or that is pending before VA, including those under appeal at any step in the process. As a result, retroactive benefits claims are possible for some veterans, because the effective date for benefits is the date a claim is filed.

Veterans whose PTSD claims were denied will have to reapply, with their benefits effective from the day of the claim.

Dr. Robert Petzel, VA undersecretary for health, described the new policy as “historic,” especially beneficial to women veterans and those who had been assigned to support and administrative units. Those veterans, unlike troops from combat units, had to prove they experienced something in their service that caused their PTSD. And the records of people in supporting units often don’t contain information about sniper fire, explosions, mortar attacks and other incidents that could be the cause of fear, helplessness and horror — the root causes of post-traumatic stress, Petzel said.

Expecting help for more veterans

It was Rep. John Hall, D-N.Y., who used “lowering the bar” as a description of the new PTSD rules. Hall, chairman of the House Veterans’ Affairs Committee’s disability assistance panel, said previous PTSD rules were an additional “psychological blow” to veterans whose benefits claims were being challenged by a policy that made them prove they participated in a traumatic event.

“The least we can do is assume a veteran is telling the truth,” Hall.

The head of the nation’s largest group of combat veterans, Veterans of Foreign Wars, said he expects the policy “will enable more veterans to seek the care they deserve and have earned” — indicating that VFW national commander Thomas Tradewell thinks more people will get benefits.

Even President Obama, in an address to the nation on Saturday, indicated this was a major policy change. Obama said the old rules “kept the vast majority of those with PTSD who served in noncombat roles, but who still waged war, from getting the care that they need.”

VA adding no claims processors

While Obama, Petzel, Hall and most veterans’ service organizations described this as a historic change, the VA’s top benefits official repeatedly said Monday that he did not expect more veterans to receive benefits.

Instead, Michael Walcoff, acting undersecretary for benefits, said the chief advantage of the new rule would be to speed up the claims process by eliminating the need to do a review of a veteran’s records for evidence of a traumatic event.

VA does not plan to add any claims processors, nor does it believe it will need more mental health officials to diagnosis PTSD in veterans, which is part of the benefits approval process, Walcoff and Petzel said.

Walcoff said more than 400,000 veterans receive disability benefits based on a diagnosis of PTSD. VA records show about 80,000 are Iraq and Afghanistan veterans, although a VA fact sheet on PTSD says that 129,654 Iraq and Afghanistan veterans have received a provisional diagnosis of PTSD from VA since the fall of 2001.

The policy allows a veteran diagnosed with PTSD by VA to qualify for disability benefits — up to about $2,700 — if they can point to a “stressor” that occurred in the military as a result of hostile activities that was likely to cause the PTSD. The event must appear consistent with their military service in terms of where they were assigned and their specific duties.

A key to getting a claim approved is that a veteran must have experienced, witnessed or been confronted with an event — either actual or threatened — that resulted in a psychological response of fear.

VA officials will be reviewing pending claims, Walcoff, said, looking for a statement of “fear” as response to a traumatic event. If that isn’t included in a veteran’s pending claim, the VA will ask for additional information, he said.

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