A US Marine takes a rest during a patrol outside Musa Qala District Center base in Afghanistan. (Dmitry Kostyukov, AFP / Getty Images)

COMING HOME

Nearly 30% of Vets Treated by V.A. Have PTSD

A new study by the Veterans Administration reveals nearly 30% of its patients who served in Iraq and Afghanistan have PTSD. Jamie Reno reports.

The Department of Veterans Affairs has quietly released a new report on post-traumatic stress disorder, showing that since 9/11, nearly 30 percent of the 834,463 Iraq and Afghanistan War veterans treated at V.A. hospitals and clinics have been diagnosed with PTSD.

Veterans advocates say the new V.A. report is the most damning evidence yet of the profound impact multiple deployments have had on American service men and women since 9/11. Troops who’ve been deployed multiple times to Iraq and Afghanistan are more than three times as likely as soldiers with no previous deployments to screen positive for PTSD and major depression, according to a 2010 study published by the American Journal for Public Health.

The report, which revealed that 247,243 veterans from the Iraq and Afghanistan Wars have been diagnosed with PTSD, was buried on the V.A.’s website without fanfare. “As far as we can tell, V.A. didn’t tell anyone these numbers were made public," says veterans advocate Paul Sullivan at Bergmann & Moore, a law firm that focuses entirely on veteran disability issues. “No press release. Nothing. I actually found the report while searching for new data. I simply changed the V.A.’s web address from second quarter to third quarter by altering one digit, and the new numbers appeared. Magic, eh?”

Why was there evidently no effort to publicize these new PTSD numbers? Josh Taylor, a spokesman for the V.A., would not directly answer that question, but told The Daily Beast that the agency still estimates that the overall PTSD rate is 20 percent across the entire population of Iraq and Afghanistan veterans, not just those who have come to a V.A. facility and are reflected in the report that shows the rate at 30 percent.

Taylor says the 20 percent estimate comes from reviews of “current literature” regarding Iraq and Afghanistan veterans. But the most “current” piece of literature Taylor cites is a 2008 RAND Corp. study. titled Invisible Wounds of War: Psychological and Cognitive Injuries, Their Consequences, and Services to Assist Recovery. The report was a collection of existing data on PTSD that was collected from April 2007 to January 2008 that also included a population-based survey of service members and veterans who served in Afghanistan or Iraq to assess health status and symptoms.    

"V.A. has been underestimating the number of PTSD sufferers since the war started and this latest issue is a glaring example," says Sullivan, former executive director of Veterans for Common Sense, who used to work at the V.A. and created the disability claim report the agency now uses. He was one of the advocates who blew the whistle on poor conditions at Walter Reed Army Medical Center.

“We believe they are downplaying the problem,” a veterans advocate says of the V.A. “Their PR office is a few years behind the science.”

A similar discrepancy showed up in 2009, when the V.A. estimated the prevalence of PTSD at 12 percent and 18 percent for Afghanistan and Iraq veterans, respectively. This was based on a 2004 study. But the VA's own healthcare report that same year said the number of PTSD sufferers who'd actually been seen by doctors was 23 percent.

One veterans advocate and Gulf War vet, who asked not to be named because he still maintains close relationships with V.A. leaders, suggests that, “In an apparent effort to make the PTSD problem look less serious, V.A. is just making numbers up. Their math doesn’t add up.”

“We believe they are downplaying the problem,” Sullivan says. “Their PR office is a few years behind the science.”

He adds that the underlying issue is "do they have enough doctors and claims processors to handle this? If V.A. believes the number is smaller than it actually is, then V.A. leaders will be unprepared. V.A.'s patient count reflects this. The V.A. numbers of actual patients is more accurate than their estimates because the troops who've been on multiple deployments are now discharging form the military and seeking V.A. health care in record numbers.

The new PTSD report of nearly 30 percent actually is closer to the predictions from a 2009 study by Michael Atkinson of the Naval Postgraduate School, Adam Guetz of Stanford University, and Lawrence Wein of the Stanford Graduate School of Business, which is not cited by the V.A. The study concluded that PTSD among Iraq veterans will be as high as 35 percent.

Most advocates interviewed for this story agree that the V.A. has made demonstrable improvements in its overall care of veterans in the last four years. But they also said there are major hurdles for the V.A. to clear, especially with regard to PTSD diagnosis and treatment and the department’s ever-growing albatross: the enormous backlog of disability claims.

The invisible but signature wound from the long Iraq and Afghanistan wars, PTSD is a mental health condition triggered by a terrifying and/or tragic event. Symptoms include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event, according to the Mayo Clinic.

Because of the nature of the conflicts in Iraq and Afghanistan, the V.A.’s Taylor says, “VA revised its regulatory criteria for PTSD determinations in 2010, a critical step forward to simplify the process for veterans seeking health care and disability compensation.”  

Taylor adds, “As a result of the President’s leadership, V.A. investments in mental health programs increased by more than one-third in the past three years. With that support, V.A. has hired more than 4,000 mental health professionals. In April of this year, Secretary Shinseki announced that the department would add another 1,600 professionals, bringing the total mental health clinical staff up to almost 22,000.”

But the dramatic increase in demand as more troops leave active duty and enter the V.A. system appears to be outrunning the evidently sincere efforts by the current administration to make things better for veterans.

Approximately 10,000 more Iraq and Afghanistan veterans pour into V.A. medical facilities each month, according to a Bergmann & Moore analysis of V.A. numbers.

When asked specifically how many post-9/11 veterans diagnosed with PTSD by V.A. doctors have actually been approved for disability benefits, the V.A. provided The Daily Beast with a copy of a document titled “VA BENEFITS ACTIVITY: VETERANS DEPLOYED TO THE GLOBAL WAR ON TERROR,” which is data through May 2012.

The document, which veterans groups have unsuccessfully filed Freedom of Information Act (FOIA) requests to obtain, shows that there are now a total of 1,634,569 veterans from post-9/11 wars, and that 745,481 of these veterans have filed disability claims, which is an astonishing 46 percent.

The document also shows that while the number of veterans who have been diagnosed by V.A. doctors with PTSD is 247,243, the number of them who are actually getting disability benefits is 137,911.  In other words, 44 percent of post-9/11 veterans diagnosed with PTSD are still not getting their benefits.

When asked to comment on this document, Sullivan said, “It shows that President Obama’s sincere effort two years ago to implement regulations streamlining PTSD disability compensation appears to have had only a minimal impact. Before these regulations, V.A. was approving about half of the disability claims. So there has only been minimal change.”

He adds: “The magnitude of the impact these wars have had on veterans and their families is severe and escalating.”

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