Tuesday, August 12, 2014

Post-traumatic Fraud

Alan Zarembo at the LATimes has done some good reporting on Post-Traumatic Stress (disorder), you can get a sample here, but I would like to focus on a much needed discussion area related to it - the inevitable fakers.

It is not a slight topic, as each person who fakes it, takes away time and money from those who actually have it an need help. Often times, the fakers over-due their drama as well - and as a byproduct injure the image of everyone who served. 

They are enabled by a cabal of compassion addicts whose whole lives are spent getting attention for themselves by demonstrating to others how much they "care," a medical industry that gets bonuses by the number of people they see and not the actual help they provide, and lastly the worst - those who promote it for political reasons in order to diminish and smear military service in general, and to marginalize veterans specifically.

We all know fakers are there ... they always have been (topic discussed in Stolen Valor) - but the question is - who is or is not?
The 49-year-old veteran explained that he suffered from paranoia in crowds, nightmares and unrelenting flashbacks from the Iraq war. He said he needed his handgun to feel secure and worried that he would shoot somebody.

The symptoms were textbook post-traumatic stress disorder.

But Robert Moering, the psychologist conducting the disability examination at a Veterans Affairs hospital in Tampa, Fla., suspected the veteran was exaggerating. Hardly anybody had so many symptoms of PTSD so much of the time.

As disability awards for PTSD have grown nearly fivefold over the last 13 years, so have concerns that many veterans might be exaggerating or lying to win benefits. Moering, a former Marine, estimates that roughly half of the veterans he evaluates for the disorder exaggerate or fabricate symptoms.

Depending on severity, veterans with PTSD can receive up to $3,000 a month tax-free, making the disorder the biggest contributor to the growth of a disability system in which payments have more than doubled to $49 billion since 2002.
For those of us who have experience with the VA, it quickly becomes clear that much of the disability ratings are off balance. It really is a case of overdoing the original concept ... and it encourages bad behavior.
To get paid for PTSD, veterans must link their symptoms to trauma that occurred during their service. In 2010, the VA expanded what situations could qualify. Credible fear of being attacked — without actually suffering or witnessing violence — became sufficient.


The VA also dropped its requirement to support each case of war-related PTSD with records of the underlying trauma. Those veterans are now taken at their word.

After the changes, the number of new PTSD claims rose 60% to more than 150,000 a year, and approval rates jumped from 55% to 74%.
Again ... here is the problem. For every dollar the government takes from taxpayers or borrows from their grandchildren to give benefits to people who shouldn't be receiving it, that is a dollar that is not going to someone who truly needs it.
Of the 572,612 veterans on the disability rolls for PTSD at the end of 2012, 1,868 — a third of 1% — saw a reduction in their ratings the next year, according to statistics provided by the VA.

Even some veterans whose diagnosis falls under deep suspicion have managed to keep their disability ratings.


In one case that Moering reviewed in 2009, he searched military records and concluded that a Navy veteran on the disability rolls for PTSD had lied to VA clinicians about having served in the elite SEALs and concocted his combat history.

The VA responded by reducing his PTSD rating from 50% to 30%, records show.
...
Marines whose symptoms were fading expressed concern that medical records documenting their progress would be used against them in disability exams. One with mild PTSD was contemplating putting off college because he worried attending would make him appear too healthy.

Wilschke worried that some patients weren't being honest with her.

Several VA mental health providers said the incentives of the disability system have undermined their relationship with patients and inhibited them from fully engaging in treatment.

In 2005, the VA office of the inspector general looked at 92 cases of PTSD and found that while most veterans received treatment when their disability ratings had room to rise, visits dropped off after their ratings topped out at 100% disabled.
...
Of the 572,612 veterans on the disability rolls for PTSD at the end of 2012, 1,868 — a third of 1% — saw a reduction in their ratings the next year, according to statistics provided by the VA.

Even some veterans whose diagnosis falls under deep suspicion have managed to keep their disability ratings.


In one case that Moering reviewed in 2009, he searched military records and concluded that a Navy veteran on the disability rolls for PTSD had lied to VA clinicians about having served in the elite SEALs and concocted his combat history.

The VA responded by reducing his PTSD rating from 50% to 30%, records show.
This too is a VA scandal. I wish more people than just Zarembo would cover it.

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