Panel: Better tests needed for veterans

The surge in the number of veterans suffering post-traumatic stress disorder requires development of better tests to evaluate affected personnel and determine how best to compensate them, a panel of medical experts said Tuesday.

“As the increasing number of claims to the VA shows, PTSD has become a very significant public health problem,” said Nancy Andreasen, chair of the committee that prepared the report.

“Our review of the current methods for evaluating PTSD disability claims and determining compensation indicates that a comprehensive revision is needed,” said Andreasen, head of the psychiatry department at Carver College of Medicine, University of Iowa.

Claims increased from 120,265 in 1999 to 215,871 in 2004 and payments jumped from $1.72 billion to $4.28 billion in the same period, a combined committee from the Institute of Medicine and National Research Council said.

“VA is studying the findings, conclusions and recommendations of the report to determine actions that can be taken to further enhance the services we provide,” Department of Veteran Affairs press secretary Matt Burns said.

“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,” he added.

The inch-thick report recommended that the VA abandon its “crude and overly general” assessment techniques for compensating PTSD, a psychiatric disorder with such symptoms as emotionally painful flashbacks, nightmares and sleep problems.

The report describes the VA’s process for evaluating PTSD disability claims as “complex, legalistic, and protracted (and) particularly difficult for veterans with PTSD to manage because of the stresses and uncertainties involved.”

Sean Zielinski, a licensed clinical psychologist who handles PTSD cases for the VA Southern Nevada Health Care System, said he agrees with the report’s basic finding that veterans who suffer from PTSD are inaccurately evaluated and inconsistently compensated under the rating system.

Zielinski said the VA relies too much on drugs for PTSD treatment and not enough emphasis is placed on counseling and talking through the problems.

“Basically the VA sold out to pharmaceutical companies years ago,” he said in a telephone interview Tuesday.

The VA, he said, is more like a corporation. “The guys at the top get bonuses to do what they are doing,” he said.

Zielinski said veterans with PTSD have psychological scars for life that must be tackled with more than drugs. “The place is run like a business. I’m the last of the therapists so to speak. I talk to people.”

In his experience from working in Southern Nevada under the VA’s Reno regional office since 1980 Zielinski said he’s seen his caseload increase.

When he first started with the VA in 1971 in New York, about 25 percent of his cases were related to PTSD. Now it’s about 90 percent. “That’s also because we’ve gotten a lot better about identifying PTSD,” he noted.

Zielinski said about 40 percent of his patients are Vietnam War veterans and 20 percent are from the wars in Iraq and Afghanistan or the Gulf War. The rest are from World War II and the Korean War.

He said he has sessions with seven individuals a day, or one every 45 minutes, and holds a group session in which 10 out of 15 have PTSD.

“I take home work every night,” he said. “It’s insane because there’s no way to keep up with any of this.”

He said he writes letters to help veterans get their proper disability rating, but too often the claims are dropped because their experiences that caused PTSD can’t be verified.

The Associated Press contributed to this report.