Post-traumatic stress disorder (PTSD) has been a controversial diagnosis since its inception. Originally called by many names (“compensation neurosis”), it was not officially given the name PTSD until well after the end of the Vietnam War. By then, many veterans with PTSD also were bedeviled with substance abuse, joblessness, and homelessness.
PTSD and TBI (traumatic brain injury) are now called the invisible wounds of war. That is fair, and I do believe that we need to take excellent care of our Soldiers with PTSD and TBI. What I question is the way the disability system provides incentives for Soldiers to stay sick.
Currently, if a Soldier has PTSD, he receives a 50% rating on his or her medical retirement rating from the Army. (This is a separate process from the VA disability rating.) Many Soldiers thus are upset if their diagnosis is depression, another anxiety disorder, or a mental health rating that does not warrant 50%.
There is a view among some advocacy groups that the DoD and the VA want to minimize PTSD, in order to avoid paying out on disability ratings. The advocacy groups say the doctors want to avoid spending government money. But factually, doctors just want their patients to get better.
The doctors and others do worry about the negative disincentive of the disability system. If someone is going to get disability payments for having a disorder, then why should they get better? There must be a better way to promote healing.
It may be through employment. Most Soldiers leaving the military and veterans I know say, “I just want a job”. If a veteran is guaranteed a job, then there is both economic security and an incentive to get out of the house each day to go to it.
With the technology available today for people with disabilities, and with supportive employment programs, there are very few ex-Soldiers who could not work.
The diagnosis of PTSD has always been mired in politics. Perhaps we can use the political process to advocate for a healthier health and employment system to ensure that all who have answered the call to service can get a decent job.
