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PTSD ruling benefits ‘fobbits’

Not everyone is happy with the change in making claims easier to acquire

On or off the FOB, military can claim PTSD - but not all vets agree they should. /U.S. Army photo

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The Greek historian Herodotus described an Athenian warrior who had been struck blind "without blow of sword or dart" when a soldier standing next to him was killed.

Psychiatry calls the invisible wound Herodotus described as post-traumatic stress disorder, or PTSD.  This diagnosis - which became widely known after the Vietnam War - has created an awareness of the causes and consequences of being afflicted with it.

Veterans with PTSD can receive disability benefits from the Department of Veterans Affairs - with a fair amount of difficulty.

The mental injuries of war "can be as debilitating as any physical battlefield trauma," said retired Army Gen. Eric Shinseki, secretary of Veterans Affairs.

The process of receiving PTSD benefits has been made easier.

Shinseki's remarks came as a new VA regulation allows veterans to receive disability benefits for PTSD if, as non-combatants, they had good reason to fear hostile activity, such as firefights or explosions.

No longer will mentally traumatized veterans have to document the event of circumstance - "the stressor" - that caused their condition by searching unit records or gathering witness statements. Under the new regulation, if mental health specialists within the VA health care system have diagnosed veterans with PTSD, they will have to show that they served in a war zone or some other area where they were exposed to the threat of death or serious injury.

"I think this is nonsense," said Charles Westcott, a veteran who served with Joint Base Lewis-McChord's 3rd Brigade, 2nd Infantry Division in Iraq and has been diagnosed by the VA as suffering from PTSD. "The fobbits get to claim they suffer from PTSD?  I think they need to prove they have PTSD."

"Fobbits" is a term used by soldiers to describe those who while deployed served only on a forward operating base, or FOB, and did not go out on combat patrols.

In other words, veterans can now file a claim for benefits for being traumatized by events they did not actually experience.

The idea that a veteran can sustain an enduring mental disorder based on the anticipation of a traumatic event that did not happen is a marked departure from the clinical - and common sense - approach that disabling stress disorders are caused by traumatic events that actually happen to veterans.

The symptoms of PTSD fall into three categories: re-experiencing (e.g., nightmares, flashbacks); hyper-arousal (e.g., anxiety, sleeplessness); and phobias (e.g., fear of doing something).  Symptoms must last at least one month and impair normal functioning to some degree.

Overwhelming calamity such as a natural disaster, rape, accidents, and assault also can result in PTSD.

A 2010 article in the Journal of Traumatic Stress summarized over two dozen studies and found that of the service members previously deployed to Iraq and Afghanistan between 5 and 20 percent have been diagnosed with PTSD.

Under the new regulations, which went into effect on July 13, veterans applying for PTSD-related benefits no longer need to produce official documentation and eyewitness reports corroborating their claims of traumatic stress injury, nor do they need to have suffered the traumatic stress in a direct combat situation. The cost estimates for the program run as high as $5 billion.

"We're now moving to treat all veterans equally," said Shinseki.  "Today, VA begins simplifying the process by which veterans with PTSD are able to access health care and receive benefits."

The ruling is retroactive to all veterans.

The new mandate is designed to prevent what happened to Navy veteran Richard Sanchez. After serving tours in Afghanistan and Iraq, he was diagnosed with PTSD.  But when he went to file his claim with the VA, he was denied because he did not have the right documentation. After fighting both the VA and his disorder, Sanchez finally received his benefits.

Tom Taratino, of the Iraq and Afghanistan Veterans of America and a veteran of the war in Iraq, called the decision absolutely monumental.

"You have a lot of people - you have truck drivers who drive the streets of Baghdad, and they get hit with IEDs," wrote Taratino. "You have women who, you know, there's still the myth that women don't serve in combat.  Well, if I'm a female soldier and I went on a hundred combat patrols as a medic or as an intelligence analyst, I shouldn't have to prove I was in combat," he added.

The new ruling will have immediate application for the 12,000 soldiers from three Stryker brigades returning to JBLM after deployments to Iraq and Afghanistan.

Of the roughly 1.6 million troops who have served in Afghanistan and Iraq, more than 134,000 have been seen at VA health care facilities for potential PTSD, according to one government report.

Although officials at Madigan Army Medical Center would not directly comment on the ruling, the medical staff will pay special attention to the 5th Brigade, 2nd Infantry Division, which lost 36 soldiers.

But challenges remain.

While the VA is lowering the threshold in order to address the issue of PTSD, others fear the door to fraud has been opened.

"The question now is how many people will take advantage of that," said Dr. Dan Blazer, a psychiatrist who has worked with the military on PTSD issues.  "PTSD is among the easiest (psychiatric conditions) to feign."

Like Herodotus' Athenian warrior, one veteran claimed he was spattered with blood and chunks of head when his best friend was shot in the face in Iraq. Only after the VA rated the veteran 100 percent disabled did someone check the veteran's story, only to learn that the "dead" soldier was alive and well.

"The VA should not be an ATM machine," pointed out Gary Resnick, another JBLM veteran who served with 3rd Brigade, 2nd Infantry Division in Iraq.

Another JBLM soldier who served in Afghanistan and Iraq said he thought the new regulation was a waste of man power and money.

"It's too easy to claim PTSD," said the veteran, who asked not to be identified. "It's also an excuse for some soldiers to get out of the Army."

When queried about the potential for fraud, Shinseki skirted the question and said that more research into PTSD and traumatic brain injury, or TBI, was needed.

"I know if we take your temperature and you're registering at 102 degrees you've got a fever, and there are ways to cope with that," said Shinseki in a recent Associated Press story. "PTSD and TBI are in need of the same kind of metrics."

The Wall Street Journal, Milford Daily News, Associated Press, and Kitsap Sun contributed to this article.

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