VA should revise its methods for evaluating and rating PTSD in veterans

WASHINGTON -- To ensure more consistent and appropriate disability compensation for veterans, the U.S. Department of Veterans Affairs (VA) needs to revise how it evaluates former military personnel for service-connected post-traumatic stress disorder (PTSD) and determines the payment amounts they merit, says a new report from the Institute of Medicine and National Research Council. A surge in the number of disability claims for PTSD has revealed inconsistencies in compensation levels awarded across the country, raising questions about the effectiveness of the VA's current ways of assessing and rating this condition, and whether some veterans are getting payments that are too low, too high, or unmerited.

The agency should develop new evaluation methods and rating criteria specific to PTSD to replace current standards that yield a crude and overly general assessment of PTSD disability, said the committee that wrote the report. It urged the VA to base compensation decisions on how greatly PTSD affects all aspects of a veteran's daily life, not just his or her ability to be gainfully employed.

The agency also should ensure that all veterans applying for PTSD compensation receive a thorough, initial evaluation by an experienced clinical professional. These exams should be of sufficient duration to provide a detailed picture of each veteran's condition so that disability raters -- non-clinical personnel who determine whether a disability is connected to military service and the level of impairment it entails -- can make more consistent and better informed decisions about the level of compensation each veteran merits. More thorough evaluations also would enhance VA's ability to detect inappropriate claims, though the committee confirmed that PTSD symptoms can manifest many years after a traumatic event or may interfere with a veteran's ability to function only later in life.

"As the increasing number of claims to the VA shows, PTSD

Contact: Christine Stencel
The National Academies

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