More vets may get treat­ment for PTSD

Women in par­tic­u­lar could ben­e­fit from change to rules

Austin American-Statesman - - FRONT PAGE - By Jeremy Schwartz

Like tens of thou­sands of her fel­low sol­diers, Ser­ena Hay­den, 28, filed a claim for ser­vice-re­lated post-trau­matic stress dis­or­der when she left the Army in 2008 and moved to Pflugerville. As a mil­i­tary pub­lic af­fairs of­fi­cer in Iraq, she trav­eled in con­voys sus­cep­ti­ble to road­side bombs and viewed the war’s horror in hos­pi­tals and mor­tu­ar­ies. In one of the attacks that marked her de­ploy­ment dur­ing the bloody 2007 surge, a mor­tar fell about 30 feet from the trailer she called home.

Dur­ing her 14-month de­ploy­ment, she ar­ranged for a pub­lic af­fairs sol­dier to ride in a con­voy. The sol­dier was killed when the con­voy was at­tacked.

“I sat curled up next to his body bag, cry­ing and cry­ing be­cause of the guilt I felt,” she said. “I still to this day feel re­spon­si­ble. I don’t know when it’s ever go­ing to end or get bet­ter.”

Be­cause she didn’t serve in a di­rect com­bat role, Hay­den had to prove to Depart­ment of Vet­er­ans Af­fairs of­fi­cials that her PTSD stemmed from in­ci­dents dur­ing her de­ploy­ment. A VA of­fi­cial re­jected her PTSD claim.

But Hay­den and thou­sands of ser­vice mem­bers might find some re­lief with a reg­u­la­tion that went into ef­fect Tues­day that changes how

the VA treats claims for PTSD. The new reg­u­la­tion, hailed as a sea change by some vet­er­ans or­ga­ni­za­tions, will make it eas­ier for the more than 2 mil­lion ser­vice mem­bers who have served in Iraq and Afghanistan to get ben­e­fits for PTSD, which af­fects an es­ti­mated 20 to 30 per­cent of re­turn­ing troops.

Un­til Tues­day, ser­vice mem­bers had to prove that their PTSD was con­nected to a ser­vice-re­lated “stres­sor” to re­ceive dis­abil­ity pay­ments for PTSD. For com­bat troops, the step was largely a for­mal­ity; but for the thou­sands of troops who did not serve in di­rect com­bat roles — truck driv­ers, me­chan­ics, pub­lic af­fairs of­fi­cers and oth­ers in sup­port roles — the re­quire­ment meant track­ing down in­ci­dent re­ports, hard-to-find doc­u­ments and state­ments from wit­nesses.

The old rules were par­ticu- larly trou­ble­some for the more than 250,000 women who have served in Iraq and Afghanistan and who are barred from serv­ing in com­bat roles.

Women’s vet­er­ans groups com­plained that VA claims of­fi­cials, un­aware of the na­ture of com­bat in the cur­rent con­flicts, un­fairly de­nied women’s PTSD claims be­cause of their gen­der.

Though the VA would not re­lease statis­tics show­ing how many fe­male vet­er­ans have had PTSD claims de­nied, a 2003 study of more than 3,300 vet­er­ans pub­lished in the jour­nal Med­i­cal Care showed that women were de­nied at a higher rate than men: 52 per­cent of women had their PTSD deemed to be ser­vice-con­nected, com­pared with 71 per­cent of male vet­er­ans.

Paul Sul­li­van, head of the Austin-based Vet­er­ans for Com­mon Sense, which pe­ti­tioned for the rule change nearly two years ago, said the change will help the thou­sands of troops who didn’t serve in tra­di­tional com­bat roles even as it frees up heav­ily taxed VA staffers who could con­cen­trate on pro­cess­ing claims rather than chas­ing down ser­vice records.

He said that the change will al­low more vet­er­ans to get treat­ment for PTSD more quickly, cut­ting down on costs from PTSD-re­lated prob­lems, such as sub­stance abuse, home­less­ness and un­em­ploy­ment.

“Over the long term, there will be a net sav­ings to Amer­ica,” he said. “There will be fewer long-term so­cial prob­lems. This is a sub­stan­tial vic­tory.”

Hay­den said the change in the rules is over­due. In Iraq, she said, “you’re vul­ner­a­ble no mat­ter whether you’re on the base or not. There’s no safe place what­so­ever … Just be­cause we’re not al­lowed in com­bat roles doesn’t mean that over there we’re not.”

Jen­nifer Sch­in­gle, an as­so­ci­ate coun­sel with the VA Board of Ap­peals, said too many fe­male vet­er­ans have been caught in bureau­cratic rab­bit holes as they try to prove a ser­vice-re­lated stres­sor.

“In a road­side ex­plo­sion, whether or not they were hold­ing a gun ready to fight or pass­ing by, they will still be af­fected, and they are en­ti­tled to the same ben­e­fits,” she said. “Our fe­male vet­er­ans and troops are serv­ing in a unique way, and the law should re­spect them.”

The new reg­u­la­tions will ap­ply to vet­er­ans who have yet to ap­ply for ben­e­fits, cur­rently have a claim or are in the ap­peals process, an of­fi­cial with the VA said. Vet­er­ans of pre­vi­ous con­flicts who have been de­nied a PTSD claim can re-file un­der the new rules, but they would not get ben­e­fits retroac­tive to their orig­i­nal fil­ing date if they are ap­proved.

Women’s vet­er­ans or­ga­ni­za­tions gen­er­ally ap­plauded Tues­day’s rule change, which the VA had been fi­nal­iz­ing for about a year, but said it didn’t ad­dress what they say is an even stronger pre­dic­tor of PTSD among fe­male troops: sex­ual trauma.

Rachel Na­tel­son, le­gal ad­viser for the Ser­vice Women’s Ac­tion Net­work, said the new reg­u­la­tion will still re­quire vet­er­ans who have suf­fered sex­ual as­sault out­side the war zone to prove that their as­sault hap­pened — and she said it is not clear whether the reg­u­la­tion will help ser­vice mem­bers who suf­fer sex­ual as­sault in the war zone.

Sex­ual as­sault “vic­tims in par­tic­u­lar wouldn’t be in a po­si­tion to ben­e­fit from the new” reg­u­la­tion, Na­tel­son said. Mil­i­tary sex­ual trauma “claimants re­ally are not be­ing given the ben­e­fit of the doubt.”

Some crit­ics have sug­gested that loos­en­ing the rules on PTSD ben­e­fits will re­sult in in­creased fraud by vet­er­ans seek­ing to get money for phony claims.

But Sul­li­van said it’s highly un­likely that vet­er­ans would abuse the re­laxed rules, which still re­quire vet­er­ans to be di­ag­nosed with PTSD and to have served in a war zone.

Un­til Tues­day, vet­er­ans such as Hay­den faced years of frus­trat­ing de­nials and ap­peals.

Kris­tine Tur­ley found her­self in a five-year fight for her PTSD ben­e­fits when she re­turned from a 2004 Iraq tour. Tur­ley, serv­ing with the Washington Na­tional Guard, faced daily mor­tar attacks and dan­ger­ous con­voy mis­sions. She tore lig­a­ments in her leg while run­ning dur­ing a mor­tar at­tack on her base.

“When I came back and sub­mit­ted my claim, it was like, ‘Why do you think you have PTSD?’” Tur­ley said. “I’m like, ‘I am not mak­ing this thing up.’ If the whole coun­try is con­sid­ered a war zone, why isn’t that sig­nif­i­cant enough? There is no safe zone in Iraq.”

Soon af­ter, her claim was de­nied. “I felt like no­body had my back,” Tur­ley said. “I’m deal­ing with all this stuff and do­ing ev­ery­thing right, but what is it they want? What do I have to do to prove to them?”

Tur­ley went di­rectly to the of­fice of Sen. Patty Mur­ray, D-Wash., who sup­ported over­haul­ing the VA’s rules on PTSD. With help from the sen­a­tor’s of­fice, Tur­ley’s PTSD claim was ap­proved in 2009.

Hay­den said she has been ap­proved for dis­abil­ity com­pen­sa­tion for de­pres­sion and anx­i­ety, but, “I know I have symp­toms out­side de­pres­sion and anx­i­ety — anger be­ing a huge one,” she said. “I have yelled at peo­ple, and it’s just not me, not who I was.”

Hay­den said she also suf­fers from sur­vivor’s guilt, which can be a symp­tom of PTSD. Hay­den, now a project man­ager with an Austin con­struc­tion com­pany and the com­mu­ni­ca­tions of­fi­cer for the Austin-based fe­male vet­er­ans group Grace Af­ter Fire, is wait­ing to hear about her request for an ap­peals hear­ing with the VA.

“I don’t want ex­tra money. I just want (the VA) to rec­og­nize it,” Hay­den said.

Ri­cardo B. Brazz­iell Amer­i­cAn-StAteS­mAn

Ser­ena Hay­den, who served in Iraq and saw some of the war’s hor­rors first­hand, was de­nied ben­e­fits for post-trau­matic stress dis­or­der be­cause she didn’t serve in di­rect com­bat.

Cour­tesy of ser­ena Hay­den

New rules will make it eas­ier for vet­er­ans such as Ser­ena Hay­den, who served in Iraq, to get treat­ment for PTSD. ‘I don’t want ex­tra money. I just want (the VA) to rec­og­nize it,’ she said.

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