Study Describes Factors Associated with Veterans Seeking PTSD Service Connection
PTSD is the most prevalent compensable mental health disorder within VA's disability system, and the number of Veterans with PTSD service-connected disability is increasing rapidly. Between 1999 and 2010, the number of Veterans who were service-connected for PTSD increased from 120,265 to 437,310, and in 2010 more than 37,000 Veterans became service-connected for PTSD. Although policymakers are concerned about this increase, there has been little research concerning the reasons for it. This exploratory, qualitative study sought to describe the reasons Veterans seek PTSD disability benefits and examined differences between those who served in different military service eras. Investigators conducted in-depth interviews with 44 Veterans who had submitted VA disability claims on the basis of military-related PTSD. Interviews were conducted over 18 months (11/05 to 6/07), and questions focused on reasons for seeking PTSD disability benefits. Participants included male and female Vietnam and OEF/OIF Veterans, both in mental health treatment for PTSD (n=21) and not in treatment (n=23).
Findings show five inter-related categories of reasons for seeking PTSD service connection: 1) tangible need (e.g., financial, healthcare), 2) need for problem identification or clarification (getting a thorough, official PTSD evaluation), 3) justification/legitimization of disability status (e.g., recognition of military trauma), 4) encouragement from trusted others (e.g., clinician, commanding officer, family), and 5) professional assistance (e.g., Veterans advocate). These major categories did not vary by military service era; however, certain themes took somewhat different forms in OEF/OIF Veterans compared with Vietnam Veterans. For example, for Vietnam Veterans, reasons for applying for PTSD service-connection were affected by changes associated with aging, as well as decades of difficulty understanding and coping with post-deployment difficulties. In comparison, OEF/OIF Veterans wanted to avoid the problems Vietnam Veterans had in obtaining needed services and benefits by being more proactive.
The authors note that research is underway to determine how best to standardize VA's disability evaluation process for PTSD service connection. They also note that the recent increase in the rate of service connection may reflect the success of VSO (Veteran Service Officers) advocacy efforts - and/or the increased support for and appreciation of Veterans in the larger society since the Vietnam conflict.
Sayer N, Spoont M, Murdoch M, et al. A qualitative study of U.S. Veterans’ reasons for seeking disability benefits on the basis of post-traumatic stress disorder. Journal of Traumatic Stress November 22, 2011;e-pub ahead of print.
This study was funded by HSR&D (DHI 05-111). Drs. Sayer, Spoont, and Murdoch are part of HSR&D's Center for Chronic Disease Outcomes Research, Minneapolis, MN.