In Print: Volume 88: Number 4
Sweet Dreams Aren’t Made of These: How the VA’s Disability Compensation Program Leaves Veterans Alone in the Nightmare of Posttraumatic Stress Disorder
By Alexandra S. Haar
88 Wash. U. L. Rev. 969 (2011)
Posttraumatic stress disorder (PTSD) already afflicts a large number of veterans, and these numbers are only rising with the wars in Iraq and Afghanistan. The daunting psychological effects of war have been acknowledged since the World War II era, albeit under the names of shell shock, traumatic war neurosis, and combat exhaustion. With the Global War on Terror, servicemen and servicewomen have deployed and redeployed to remote areas, and officials in the Department of Veterans Affairs (VA) and the Department of Defense (DOD) are struggling to meet the psychological needs of present and future veterans who suffer from PTSD. From 1999 to 2006, PTSD diagnoses in veterans increased by 126%, while diagnoses of other anxiety disorders decreased by 34%. Even more troubling, these numbers may underrepresent the actual impact of PTSD on the Armed Forces, as soldiers fear the stigma of weakness associated with having a psychological disorder, and VA clinicians can easily confuse PTSD with other disorders such as depression or brain injury.9 In light of all these difficulties, it is important to focus specifically on compensation rules regarding PTSD.
Over the past few years, the media has begun to bring the veteran‘s story to the public. In 2007, reporters exposed the deplorable conditions at the Walter Reed Army Medical Center and other VA facilities. Included on the list of deteriorating facilities were many psychiatric wards, where veterans were forced to tolerate not only “mouse droppings, belly-up cockroaches, stained carpets, [and] cheap mattresses” but also PTSD and other disorders. Then, in 2009, the shootings at Fort Hood shocked the nation, and regardless of the shooter‘s actual reasons, the tragedy forced the public to look at the immense stress experienced by mental health professionals at VA facilities. With PTSD at the forefront of many Americans‘ minds, the time is ripe for us to explore what is being done to treat veterans with this disorder.
After providing a basic overview of the VA‘s disability compensation program, this Note will examine the ways in which the regulations would and do apply to veterans who seek treatment for PTSD. Specifically, this Note explores the scientific underpinnings—or lack thereof—of the medical aspects of the regulations. This Note will also look at the particular training deficiencies that affect a clinician‘s ability to accurately diagnose a veteran with PTSD, as well as the unique effects of VA procedures on veterans. In concluding that the current system is grossly insufficient, this Note will provide several specific suggestions as to how the compensation program can be revised to better treat veterans who suffer from PTSD.