Here’s a VA OIG investigation into problematic PTSD claims. There investigation focused on the claims that could have saved the VA money if done correctly by ratings claim personnel. Unfortunately, they did not focus on legitimate PTSD claims that should have been awarded to veterans.
From the VA Office of Inspector General:
Systemic Issues Reported During Inspections at
VA Regional Offices
http://www.va.gov/oig/52/reports/2011/VAOIG-11-00510-167.pdf
Of the 16 VAROs inspected, 8 (50 percent) did not follow VBA policy when processing PTSD claims. Service connection for PTSD requires credible evidence that a claimed in-service stressful event occurred, medical evidence diagnosing the condition, and a nexus (established by medical evidence)
linking current symptoms and the in-service stressful event.
We projected VARO staff did not correctly process about 1,350 (8 percent) of approximately 16,000 PTSD claims completed from April 2009 through July 2010. This generally occurred because VARO staff lacked sufficient experience and training to process these claims accurately. Additionally,
some VAROs were not conducting monthly quality assurance reviews. For these reasons, veterans did not always receive accurate benefits. The figure below provides projected error rates by the types of PTSD errors identified.
For example, we projected that of the PTSD claims incorrectly processed, about 38 percent involved improper verification of a related in-service stressful event. Stressor verification errors occurred when staff did not
obtain sufficient evidence that the alleged stressful events actually occurred. Further, inaccuracies related to incorrect effective dates occurred because RVSRs used the wrong dates to establish benefits, often resulting in inaccurate payments to veterans.
Following are descriptions of the remaining three types of PTSD errors.
Incorrect evaluations: Assigning incorrect evaluations for veterans’ mental status inconsistent with evidence in medical examination reports.
Lack of nexus: Improperly granting service connection for PTSD without a medical opinion linking a current diagnosis of PTSD to a claimed, in-service stressful event.
Additional benefits not considered: Not considering entitlements, such as Dependents’ Educational Assistance.
Effective July 13, 2010, VA amended its rule for processing PTSD disability compensation claims. The new rule allows VARO staff to rely on a veteran’s lay testimony alone to establish a stressor related to fear of hostile military or terrorist activity, provided the claimed stressor is consistent with the circumstances of service. Prior to the rule change, we identified a 13 percent error rate associated with PTSD claims processing. From the date
of the rule change until September 2010, however, we identified a 5 percent error rate. Because of this noticeable improvement in PTSD claims processing, we made no recommendations for corrective actions in this area.
We may modify our review of PTSD claims in future inspections until VAROs have sufficient time to implement fully the amended rule.
BTW - my son in law, to his credit, has fought to NOT be diagnosed with PTSD, and he saw far worse than most who did time in Iraq or Afghanistan.