U.S. Senator Charles E. Schumer, standing with local veterans, affected family members, and members of the mental healthcare community today announced that he is introducing legislation that will lower the burdensome threshold that Syracuse area veterans of the Iraq and Afghanistan wars have to meet to receive treatment for Post Traumatic Stress Disorder (PTSD). Current regulations set by the Department of Veterans Affairs (VA) require that veterans pinpoint the stressor that triggered their PTSD, even if they have already been diagnosed. Stringent policies require that veterans track down incident reports, buddy statements, present medals, and overcome other hurdles to meet the threshold that VA mandates in order to receive desperately needed treatment and support. Schumer's legislation will help simplify the process for the hundreds of thousands of veterans needing treatment. The legislation will apply to veterans of all previous United States Conflicts.
"We need to remove the barriers that prevent our soldiers and veterans from receiving care," said Schumer. "In an era where mental injuries are stigmatized and in a war where danger can strike in any place, it is clear that the current VA regulations are in need of change. This legislation will help our brave men and women access the treatment and support they need."
"Senator Schumer's bill that would establish service in combat as the presumptive stressor for the incurrence of PTSD is entirely consistent with the scientific literature and will lead to greater respect for our women and men in uniform, decreased psychiatric stigma and improved mental health treatment services for thousands of veterans," said Mantosh Dewan, M.D., professor and chair of the Department of Psychiatry and Behavioral Sciences. "This is clearly a big step forward and greatly appreciated by all of us in the mental health community."
Currently, a veteran diagnosed with PTSD must prove that the stressor triggering the PTSD occurred during "combat with the enemy". This means that the service member must prove that the trigger for PTSD occurred during personal participation in a fight with a military adversary or hostile unit force in order to receive care from the Veteran's Health Administration. If the veteran cannot meet this burden of proof, or suffers from PTSD triggered by service in a combat zone but not in direct combat with the enemy, they must pay for their own care outofpocket or through private insurance. This stringent requirement prevents many service members from receiving care because their injuries were sustained during service in a combat zone but not during direct engagement with the enemy. This is especially true for women, who are prohibited from serving in combat roles and therefore have a difficult time meeting the burden of proof.
The stringent regulations and burdenofproof requirements present a significant barrier to treatment for service members suffering from mental health disorders that already carry a great stigma. Since October 2001, about 66,000 service members from Upstate New York and 5,500 from Central New York have deployed to the wars in Iraq and Afghanistan, with many exposed to prolonged periods of combatrelated stress or traumatic events. According to the Syracuse VA Medical Center, from October 2008 to March 2009, 476 Iraq and Afghanistan veterans across 13 counties in the Central New York area were diagnosed with PTSD. Early evidence suggests that the psychological toll of the deployments may be disproportionately high compared with physical injuries. According to a study from the RAND corporation, the nation's largest independent health policy research program, nearly 20 percent of military service members who have returned from Iraq and Afghanistan report symptoms of post traumatic
stress disorder (PTSD)or major depression, and only half of those afflicted have sought treatment. Among those who do seek help for PTSD or major depression, only about half receive treatment because of the many barriers preventing them from getting the treatment and support they need.
Because of these stringent regulations, the disability claims backlog at the VA tops 800,000, a great majority of which are Vietnam Veterans seeking compensation for PTSD. These facts are a clear indication that current regulations at the VA are too strict for veterans, past and present, who are seeking disability benefits. In an effort to ensure that veterans suffering from PTSD have greater access to the critical care they need, Senator Schumer today introduced legislation that lowers the burdensome threshold that veterans have to meet to receive compensation.
The Compensation Owed for Mental Health Based on Activities in Theater Act, or the COMBAT PTSD Act, would expand the definition of 'combat with the enemy" in Title 38, USC to include active service in a theater of combat. This would essentially establish service in combat as the presumptive stressor for the incurrence of PTSD. The veteran would still need to be clinically diagnosed with PTSD, but, he or she would no longer need to "prove" that a specific event caused this diagnosis or that the specific trigger was an event during direct combat with the enemy.
According to the Rand study, unless treated, PTSD, depression, and TBI can have farreaching and damaging consequences. Individuals afflicted with these conditions face higher risks for other psychological problems and for attempting suicide. They have higher rates of unhealthy behaviors - such as smoking, overeating, and unsafe sex - and higher rates of physical health problems and mortality. Individuals with these conditions also tend to miss more work or report being less productive. These conditions can impair relationships, disrupt marriages, aggravate the difficulties of parenting, and cause problems in children that may extend the consequences of combat trauma across generations. There is also a possible link between these conditions and homelessness. The damaging consequences from lack of treatment or undertreatment suggest that those afflicted, as well as society at large, stand to gain substantially if more have access to effective care.
The COMBAT PTSD Act would ensure that more service members afflicted with PTSD would be able to receive treatment. This is especially relevant in New York. In total, New York has the fourth largest veteran population in the country and has sent over 70,000 troops to Iraq and Afghanistan. There are almost 12,000 New York service members currently deployed in Iraq and Afghanistan theatres of combat. In the Syracuse area, there are over 31,000 veterans and there are 360 service members currently deployed in Iraq and Afghanistan.
Here is how the numbers break down across the rest of Central New York:
In There are
7,000 veterans living in Cayuga County, approximately
490 of which served in Iraq or Afghanistan.
3,600 veterans living in Cortland County, approximately
250 of which served in Iraq or Afghanistan.
5,600 veterans living in Madison County, approximately
390 of which served in Iraq or Afghanistan.
20,500 veterans living in Oneida County, approximately
1,400 of which served in Iraq or Afghanistan.
10,800 veterans living in Oswego, approximately
750 of which served in Iraq or Afghanistan.
In addition to the obvious obligations we have to our veterans, this legislation makes fiscal sense. According to the study, if 50 percent of those needing care for PTSD and depression received treatment and all care was evidencebased, this larger investment in treatment would result in cost savings overall. If 100 percent of those needing care for PTSD and depression received treatment and all care was evidencebased, there would be even larger cost savings. The cost of depression, PTSD, or comorbid PTSD and depression could be reduced by as much as $1.7 billion, or $1,063 per returning veteran. These savings come from increases in productivity, as well as from reductions in the expected number of suicides.
Given these estimates, evidencebased treatment for PTSD and major depression would pay for itself within two years. No reliable data are available on the costs related to substance abuse, homelessness, family strain, and other indirect consequences of mental health conditions. If these costs were included, savings resulting from effective treatment would be higher, according to the study.
Senator Schumer introduced the COMBAT PTSD Act in the Senate today. The legislation has been introduced in the House of Representatives by Congressman John Hall. The legislation has been endorsed by the Iraq and Afghanistan Veterans of America (IAVA), Veterans of Foreign Wars (VFW), The American Legion, Veterans for Common Sense (VCS), National Guard Association of the US (NGAUS), National Legal Veterans Services Program (NVLSP), Ex Prisoners of War, and Disabled American Veterans (DAV).