The United States provides benefits to veterans with post-traumatic stress disorder (PTSD), which occurs in, or is aggravated by, their military service. The United States Department of Veterans Affairs (VA) will benefit veterans determined by VA suffering from PTSD, which develops during, or as a result of, their military service. These benefits include not only tax-free cash payments but may also include free and low cost mental health care and other health care; vocational rehabilitation services; employment assistance; support for independent living; and much more.
VA's disability allowance for PTSD has evolved over time, in response to legislation, scientific progress, political pressure, revision of diagnostic classification schemes, regulatory changes, case law, and administrative decisions. Veterans advocacy organizations, researchers, doctors, politicians, administrators, and citizens will undoubtedly continue to influence how the United States evaluates, prosecutes, and manages the program. For example, current change or reform efforts include urging the VA to put more emphasis on vocational rehabilitation and treatment versus cash payments; revise the General Rating Formula for Mental Disorders to better reflect the problems experienced by veterans with PTSD; and consider the quality of life of veterans as a factor in determining disability ratings.
Video Veterans benefits for post-traumatic stress disorder in the United States
AS. veteran benefits
History
Since the founding of the country, the United States has sought to compensate men and women who have served in their armed forces. In 1917, the US Congress passed a law emphasizing a compensation model for veterans' disability benefits. Congress seeks to clarify and better define the provisions of the law in 1919 amendments to the original bill. Since that year, compensation has been given to veterans who suffer from physical or mental disabilities occurring during, or compounded by, military service, and which have adversely affected the ability of veterans to work. The amount of compensation provided - both cash payments and services sponsored by the VA - is based on the average average veteran decrease in income capacity. Since OIF/OEF, PTSD has grown into the third most compensated defect in the VA after hearing loss and tinnitus. Effectiveness
Whether adequate disability benefits of veteran compensation with PTSD for losses in average earning capacity has been debated. Older veterans aged 65 years and scored 50% handicapped or higher for PTSD, including individual IU allowances, received more as compensation (plus earned income and pension benefits such as Social Security or pensions) than veterans who inexperienced may work in the world of work and/or receive Social Security and other pension benefits. However, younger veterans (aged 55 and under) generally receive less in compensation allowances (plus income earned) than their non-disabled counterparts get through the job. For example, the parity ratio for a 25 year old veteran rated 100% disabled by PTSD is 0.75, and for a 35 year veteran rated 100% disabled by PTSD, the value is 0.69. The parity ratio for 75 year old veterans who receive IU benefits is 6.81.
Research shows that veterans who receive disability benefits for PTSD experience a decrease in the severity of PTSD symptoms, and have lower rates of poverty and homelessness.
In addition to the lost revenue, the commission mandated by Congress, argues that VA's disability benefit program should compensate veterans for non-economic losses, particularly with regard to the quality of life of a veteran. The US Government Accountability Office analyzed this recommendation and suggested that it be considered one of three major changes to modernize the VA disability benefit program.
Some experts argue that the VA disability benefit program is "countertherapeutic" because it does not provide incentives to overcome the symptoms and problems caused by the disorder, and, in fact, veteran awards to remain ill, while other researchers take issue with this statement. In a similar vein, a military scholar, who lost both legs during combat operations in Iraq, pointed out that the current VA disability benefit policy instills in veterans a lack of self-efficacy and fosters dependence.
Maps Veterans benefits for post-traumatic stress disorder in the United States
VA disability claim process
To begin the disability claims process, veterans file claims to the Veterans Return Administration (VBA), an organizational element of the VA. In order for a veteran to receive a disability benefit for PTSD, VBA, based on their review of medical and psychological evidence, should conclude that the veteran does suffer from PTSD-related services. Achieving such a determination usually requires a veteran to receive a Compensation and Retirement exam (C & amp; P exam), which is a mental health evaluation of a forensic conducted by a psychologist or psychiatrist at a local VA medical facility or by a psychologist or psychiatrist in an independent practice who conducts an evaluation for private vendors contracted by VA.
Benefits claim procedure
VA provides a detailed description of the benefit claim process on its website. Briefly, a VSR (Veterans Service Representative), an employee of the Veterans Return Administration (VBA), reviews the information submitted by a veteran to determine whether VBA requires additional evidence (for example, medical records) to prosecute the claim.
VA has a legal obligation to help veterans obtain evidence that will support their claims. For example, the VSR may request records of veteran military personnel, disability records of Social Security, or personal medical records. VSR almost always asks for a Compensation and Retirement check (C & amp; P exam), also referred to as the VA vest test. .
After VBA gets all the relevant documentation (evidence), RVSR (Veteran Service Ratings Representative) makes a decision on veteran claims. RVSR refers in part to the General Rating Formula for Mental Disorders when making this determination.
Get help
Veterans may receive assistance by filing a VA disability compensation claim from Veterans Service Officers, also known as "VSO Representatives" or "Veterans Service Representatives". Veterans do not have to pay Veteran Service Officers for their services. VA recommends consultation with Veterans Service Officer:
VA encourages individuals who apply for disability compensation to work with accredited representatives... to assist them... Being accredited means organizations and individuals must have VA permission to represent Veterans before the Department in their claim for VA benefits. The purpose of this requirement is to ensure that Veterans have qualified and competent representatives. These people receive special training in VA law and procedure allowances.
There are two types of Veterans Service Officers:
1) District Veterans' Officials - Most states have established veteran agencies to assist veterans, with offices in every county in the state run by Veterans County Service Officers.
2) VSO Representative is a volunteer or employee of the Nonprofit Veterans Service Organization (VSO). To represent a veteran before VA, the Veterans Service Organization must have been hired by the US Congress or has received official approval from the US Department of Veterans Affairs to represent veterans in the defect compensation claim process. From the perspective of the federal government, state veterans' agencies are "veteran service organizations" because they also have to accept approval to represent veterans.
Some veteran advocates recommend that veterans learn how to file their own claims so that they remain in control of the process.
Post-adjudication representation
Veterans may appeal VBA's decision on their compensation claim, and they may request to be represented by an accredited Veterans Service Officer, attorney, or claim agent in the appeal process. Note that VA does require a veteran to be represented in appeal.
VA prohibits lawyers or claims agents from levying veteran fees for professional services prior to veteran claim adjudication.
Unless they agree to work on the basis of pro bono, lawyers and claims agents representing veterans before the Veterans Return Administration, the Veterans Council Appeal, and the Court of Appeal for Veteran Claims require payment for their services. At the federal court level, most lawyers work for the cost of Equal Access to Justice Act. This is the cost of a lawyer ordered by the court to be paid by the federal government when the government's position in litigation is not "justified substantially."
Disabled Ratings
The common ranking formula for mental disorders
If VBA determines that a veteran suffers from PTSD-related services, then they assign a disability rating, expressed as a percentage. This rating of disability determines the amount of compensation and other disability benefits that VA provides to veterans. Disability ratings indicate the extent to which PTSD has removed veterans from their average earning capacity them. A 0% rating indicates that a veteran has PTSD but the disorder does not affect his ability to work, whereas a 100% theoretical assessment means that the veteran is unable to work at all due to PTSD.
VA rated a defect for PTSD in accordance with the General Level Formula for Mental Disorders (38 CFR Ã,§ 4.130), which set criteria for the defect rating of 0%, 10%, 30%, 50%, 70 %, or 100%.
Some argue that by relying on the current Formula Rating , "VA uses the old rules developed for mental disorders that do not resemble PTSD," and, consequently, "[i] the relevant criteria... may exceed.. More relevant factors lead VA to veteran compensation with valid PTSD diagnoses. "Similarly, veteran service organizations argue, for example, that"... veteran service is connected to schizophrenia and other veteran services connected to other psychiatric disorders should not be evaluated using the same general formula "and have supported the effort to revise the Rating Formula .
Concern has been expressed by some RSVR (VBA appraisers who are prosecuting claims) that automated software does not advocate the use of their independent appraisals to evaluate claims altogether, allegations rejected by senior VA officials.
Since 2001, the VA has revised its disability ratings schedule to include medical advances that have occurred since the last review, updated medical terminology, added medical conditions that are not currently in the Ranking Schedule, and filters out criteria for further clarity, consistency and appraisal of the app.
Request for increased disability
A veteran currently receiving compensation for service-connected PTSD may file a claim for increased disability rating (VA also refers to this as an increase in defects evaluation ,), or for Individual helplessness: If a veteran believes that PTSD, either alone or in combination with disabilities related to other services (eg, diabetes, back injuries, chronic pain, etc.), makes him unable to pursue and retain employment, and they meet the eligibility requirements, then they can claim compensation based on helplessness.
PTSD C & amp; P exam
As mentioned above, VBA almost always requires a compensation and retirement check (C & amp; P exam), also known as the VA vest claims, for veterans claiming PTSD related services. There are two types of PTSD C & amp; P: Home and Reviews . Initial Examination for Pascatrauma Stress Disorders should be performed by a VA psychologist or psychiatrist certified by the Office of Disabled Persons and VHA Medical Assessment (DMA) to evaluate veterans for this purpose. The definition of "VA psychologist or psychiatrist" includes psychologists and psychiatrists in the private sector who perform C & amp; P for the Medical Disability Evaluation (MDE) company under contract with Veterans Benefits Administration (VBA) to provide C & amp; P VA name. Although the litigation occurred after the initial $ 6.8 billion MDE contract award in 2016, pending further appeals, the company with the current VBA contract is Logistics Health, Inc. (LHI); Veterans Evaluation Services (VES); QTC (QTC in turn contracted with Magellan Health to manage their provider network); Los Angeles Medical Support, A Medical Corporation (MSLA); and VetFed.
The Review Evaluation for Pascatrauma Stress Disorders can be solved by VA or non-VA psychologists and psychiatrists. Clinical psychology or counseling personnel, psychiatric residents, licensed clinical social workers, nursing practitioners, physician assistants, and clinical nurse specialists may also conduct PTSD examinations, even if they are "closely watched" by a psychologist or psychiatrist.
Concerns about the reliability and validity of the PTSD exam C & amp; P
Researchers, current and former VA psychologists, investigative journalists, and individual veterans have expressed concerns about inter-rater reliability and validity of C & amp; P for PTSD because:
- Some VA medical centers do not allocate enough time to C & amp; P and psychiatrists to conduct a thorough evidence-based assessment, with less time might reduce the validity of results.
- The time allocated for the exam varies from one to four hours, which in itself indicates a lack of consistency and the likelihood of a lower inter-rater reliability ratio.
- Research has demonstrated clear regional variance with respect to the proportion of veteran prosecutors receiving VA defect compensation for PTSD.
- One psychological survey of C & amp; P revealed that only 15% follow the VA guidelines themselves on best practices for PTSD compensation and retirement exams. For example, one of the best practice recommendations is to assess veterans for PTSD using the Doctor-Managed PTSD Scale (CAPS), especially given empirical evidence that using CAPS improves the reliability and validity of the PTSD C & amp; P, but mostly C & amp; Ps psychologists do not use this validated instrument in accordance with the survey.
- An empirical study published in 2017 shows that the examiner bias of C & amp; P may have led to an increase in the number of false negative inferences (related to PTSD diagnosis and service connections) to black veterans, and to high rates. false positive conclusion for white veterans. This finding is consistent with previous research and legal scholarship discussing the potential of implicit racial bias on the part of general mental health physicians, and C & P and psychiatrist in particular.
- Some VA facilities prohibit examiners using symptom validity tests to filter or assess counterfeiting and other forms of simulation.
- Some researchers have published empirical studies in peer-reviewed scientific journals that point to significant levels of both the PTSD C & amp; P are false and false positives.
- Social scientists conduct independent PTSD assessments of veterans who have filed disability benefits claims for PTSD, some of which have been awarded PTSD-related service compensation and others have not. This study found a significant level of false positive and false positive VBA adjective decisions. Although the VBA adjudicator relies on other sources of evidence, in addition to C & amp; P, VBA almost always ask for C & amp; P for PTSD claims, and C & amp test results P significantly affects VBA determination.
- Reports of investigative journalists, newspaper editorials and private war veterans, suggest that a substantial percentage of veterans who filed a PTSD defect claim exaggerate or play with PTSD symptoms.
Disability Benefits Questionnaire (DBQ)
Mental health professionals document the PTSD C & amps Review and Review results Initial and Review P on a Disability Benefit Questionnaire (DBQ). VA develops Disability Benefit Questionnaires (DBQs) to streamline the VBA assessment process and thereby complete the claim process more quickly. In addition, veterans may ask their treating physician to complete DBQ and may pass the need for a C & amp; P. However, it is important to note that the VA does not advise their mental healthcare physicians to complete DBQs for their patients, and similar recommendations have been offered to private psychologists and psychiatrists whose patients ask them to complete the DBQ, as it potentially creates conflict of interests due to multiple role relationships (serving simultaneously as treating physicians and forensic evaluators).
C & amp; P Psychologists have expressed concern that the DBQ "Symptom List" (Part II, Number 5 on Initial PTSD DBQ ; Part VII on the PTSD DBQ Review ; and Part III on Mental Disorders DBQ ) contains a series of signs, symptoms, and functional disorder description without a guide about when this item should be supported. C & amps Tester P is of the opinion that the guide is important because if not the C & amp; P will (of course) use their own idiosyncratic judgment as to when to authorize each item in the "Symptom List". Additionally, disability ratings may be based largely on the "List of Symptoms" of supported items, as these items are captured word for word
Important definition
Disposal status
To be eligible for a VA allowance, a veteran should be dismissed under aside from an unreserved condition . Stated differently, if a veteran receives a release of Bad Behavior or dismissal they are, in many situations, ineligible for VA benefits.
On duty and exceptions
There are exceptions to the general rule that injuries or illnesses are occurring in, or aggravated by, military service eligible for VA defect compensation benefits. For example, such injuries or diseases must meet the criteria of the task . " In the task force means an injury or illness arising or aggravated during an active military, naval or air service period unless the injury or illness is the result of a deliberate fault of the veteran himself or... is the result of abuse of alcohol or drugs. "
Traumatic trigger
Matthew J. Friedman of the National Center for PTSD notes that:
PTSD is unique among psychiatric diagnoses because it is so important to be placed in etiologic agents, traumatic stressors . In fact, a person can not make a diagnosis of PTSD unless the patient has actually met the "stressor criteria," meaning that he has been exposed to a traumatic historical event.
A traumatic stressor is an event that meets Criteria A of the Mental Disorders Diagnostic and Statistical Manual, the fifth edition of the diagnostic criteria for PTSD. The definition of PTSD Criteria A in DSM-5 is:
The person is exposed: death, death threatened, actual or threatened serious injury, or actual or threatened sexual violence, as follows: (one is required)
1. Direct view.
2. Watching, directly.
3. Indirectly, knowing that close relatives or close friends are affected by trauma. If the event involves actual or threatened death, it must be violent or unintentional. 4. Repeated or extreme indirect exposure to the details of the hostilities of events (s), usually in the course of professional duties (for example, first respondent, collecting body parts, professionals repeatedly exposed to details of child abuse). This does not include indirect non-professional exposure through electronic media, television, movies, or images.
Relevant rules, updated on August 4, 2014 to reflect the publication of DSM-5. So, on August 4, 2014, C & amp; P began using DSM-5 when diagnosing veteran mental disorders.
Connection-services
The term, service-connected , means that a veteran has a disease or injury that is "connected" to his military service, that is, illness or injury that occurred in, or exacerbated by, his or his military service.
The official definition in the Code of Federal Regulation begins:
Service connections connote many factors but basically it means that the facts, indicated by the evidence, specify that certain injuries or diseases that result in defects occur to coincide with service in the Armed Forces, or if there is already such a service, is exacerbated therein.
The relationship between service connections and access to VA health care is emphasized in this definition:
'Service-connected' veterans are documented, compensated conditions or compounded by military service, and they receive priority for enrollment into the Veterans Affairs (VA) health care system.
Type of military service
The regulation describes three categories of military service, active duty , active duty for training , and inactive job training . Eligibility for VA defect compensation requires that veterans services occur during any of these three categories. The definitions of active duty military service include "anytime service as a cadet at the Army, Air Force, or Coast Guard Academy, or as a cadet at the US Naval Academy."
Note
References
External links
AS. Veterans Affairs Department useful information
- Federal benefits for Veterans, Dependents, & amp; Survivors
- Apply for Online Benefits
- VA Short Benefit
- Compensation and Pension Services
- VA Health Care Summary
- Veteran Health Benefits Guide
- VA Online Health Assessment
Other veterans have benefited resources
- The American Veterans and Member Services Survival Guide
- Overview of the Benefits Claim Processing Clause
- National Resource Directory - Veterans Service Organization List
- The Safe Harbor Navy Foundation - The Navy Safe Harbor Foundation
US. government resources for military and veteran personnel
- MakeTheConnection.net
- Create a Search Engine Connection Resources
- National Resources Directory
PTSD care resources for veterans
- Information & amp; Resources About PTSD
- Where to get help for PTSD
- Understanding PTSD
- PTSD Treatment Program at US Department of Veterans Affairs
- My Health e Veterinarians: Gates to Veterans Health and Fitness
- Operation Warrior Wellness: Overcoming PTSD
- Military Sexual Trauma Resources Provided by VA
- Military Sexual Trauma Resources for Women Provided by State Law
Source of the article : Wikipedia
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