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

ting point to help VA devise new ratings criteria specific to PTSD. The committee emphasized the need to rate PTSD disability based on a fuller range of an individual's capacity to function, not just on his or her ability to work. The focus on occupational impairment in the current rating scheme penalizes veterans who can and do work despite their symptoms, and may serve as a disincentive to work, the report says.

Many disability claims are being submitted by veterans who have been out of military service for several years, which has prompted questions about how long after a traumatic event PTSD can manifest and whether standardized tests could detect dissembling if someone tried to make a fraudulent claim. The committee found abundant evidence that PTSD can develop at any time after exposure to trauma. It also can manifest as a relapsing condition or flare up after being suppressed and undiagnosed. Aging, loss of mental acuity, the death of friends or spouses, and other factors can trigger or exacerbate symptoms as well. Standardized tests can be a useful part of an assessment, but they are no substitute for a thorough clinical assessment by a trained professional, the committee concluded.

Combat exposure is not the only potential trigger for PTSD among service members; sexual assault is another form of trauma. The available information suggests that female veterans are less likely to receive compensation for PTSD, which may in part be due to the difficulty of substantiating exposure to traumatic events unrelated to combat, including sexual harassment or assaults that occurred during service. VA should make a concerted effort to gather data and provide reference materials to help disability raters better address the management of PTSD claims related to sexual assault during military service, the report says.


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Contact: Christine Stencel
news@nas.edu
202-334-2138
The National Academies
8-May-2007


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