Changes urged in US veteran combat stress policies

WASHINGTON, May 9 (Reuters) With more and more veterans developing post-traumatic stress disorder, the US government must overhaul its flawed system to identify who is afflicted and who deserves disability payments, a panel of experts said.

The Department of Veterans Affairs is seeing big gains in veterans saying they have post-traumatic stress disorder, or PTSD.

The numbers are expected to grow as more troops who have fought in Iraq and Afghanistan leave active military duty.

A 12-member Institute of Medicine panel criticised procedures used by the VA, which requested the report and said yesterday that it welcomed the findings. The institute provides advice on health issues to US policymakers.

The VA said the number of veterans getting compensation for PTSD rose from 122,034 in September 1999 to 267,047 in August 2006. The report said as of 2004, veterans were receiving 4.28 billion dollars in benefits for PTSD, up 150 percent from 1999.

''As the increasing number of claims to the VA shows, PTSD has become a very significant public health problem for the veterans of current conflicts and past conflicts,'' Dr Nancy Andreasen of the University of Iowa's Carver College of Medicine, who headed the panel, told reporters.

''Our review of the VA's current methods for evaluating PTSD disability claims and determining compensation finds shortcomings, and indicates that a comprehensive revision of the disability determination criteria is needed,'' she added.

Some veterans groups have said the VA is doing a poor job of evaluating whether veterans have PTSD, rejecting too many meritorious cases. The report did not examine how the Pentagon evaluates and treats active-duty troops for PTSD, but it has also come under criticism.

THOROUGH EVALUATIONS NEEDED The VA must ensure every veteran submitting a PTSD compensation claim receives a more thorough clinical evaluation conducted by a trained professional, the panel said.

Andreasen said some VA evaluations of these veterans last just 20 minutes while others take three to four hours.

The VA needs to update ''problematic'' criteria it uses to determine a veteran's level of disability, and should make sure those carrying out evaluations are specifically trained to understand PTSD cases, the panel added.

Some troops developed PTSD after experiencing wartime trauma like suffering wounds or witnessing others being hurt.

Experts say PTSD symptoms include irritability or outbursts of anger, sleep difficulties, trouble concentrating, extreme vigilance and an exaggerated startle response. A person may initially respond to the trauma with horror or helplessness, then may persistently relive the event.

VA spokesman Matt Burns said in a statement the department is studying the panel's conclusions and recommendations.

''VA is a recognized leader in the diagnosis and treatment of PTSD, and we will continue to take steps to ensure veterans have timely and seamless access to compensation for which they are eligible,'' Burns said.

The panel cited inconsistencies in compensation levels awarded by the VA, raising doubts about the effectiveness of its methods for assessing the condition and providing the payments veterans deserve.

Current methods are too crude and overly general, the panel found.

The panel recommended the VA base compensation decisions on how much PTSD affects all aspects of a veteran's life, not just the ability to work.

Focusing on one's ability to work penalizes veterans who do hold down a job despite PTSD symptoms, and may discourage them from remaining employed, the report said.

Reuters SZ RS1004