PTSD in Returning Wounded Warriors: Ensuring Medically Appropriate Evaluation and Legal Representation Through Legislative Reform

45 Pages Posted: 1 Oct 2010

See all articles by Bryan A. Liang

Bryan A. Liang

University of California San Diego School of Medicine

Mark S. Boyd

Independent

Date Written: October 1, 2010

Abstract

Recent military engagements including Operation Enduring Freedom and Operation Iraqi Freedom have created a tremendously large cohort of wounded warriors returning with Post Traumatic Stress Disorder (PTSD). Indeed, PTSD is deemed a “signature” wound of these conflicts. Yet PTSD is as ancient as war itself, and has been recognized in the US as early as the Civil War. But getting assistance requires navigating a highly complex disability claims process while these veterans are disabled. Further, the process has is flawed on clinical and legal bases. The disability system for wounded warriors prohibits attorney assistance at the outset, or even any charges beyond $10 for assistance - the level set during the Civil War. Further, the determination of disability is not premised upon clinically recognized standards and characteristics such as the Diagnostic Statistical Manual (DSM) for mental health disorders. This system results in a legal, medical, and ethical failure to adhere to the social contract for these military personnel. In response, we propose reform addressing these system weaknesses. Through federal statute, we first address medical evaluation standards. Wounded warrior disability determinations would be required to exclusively employ clinical definitions based on the DSM. These evaluations could be performed by both VA physicians as well as those outside the VA. Such a system will maximize the number of wounded warriors recognized for potential PTSD and available for assistance. We then address the legal concerns. Taking the successful Social Security Administration system that as a model, we propose a similar system for wounded warriors to allow lawyer assistance to navigate the complex VA disability system. Reasonable caps on fees would be put into place. Through this reformed system, wounded warriors returning from recent and future conflicts can be assured that when they return home, their injuries will be addressed using a medically sound standards, they will be able to access needed legal assistance, and the social contract between them and their country is fulfilled.

Keywords: Veterans, PTSD, Disability, Inequity, Legal Representation, Medical Evaluation

JEL Classification: H11, H40, H51, I31, I12, K23, K40

Suggested Citation

Liang, Bryan A. and Boyd, Mark S., PTSD in Returning Wounded Warriors: Ensuring Medically Appropriate Evaluation and Legal Representation Through Legislative Reform (October 1, 2010). Stanford Law & Policy Review, Forthcoming, Available at SSRN: https://ssrn.com/abstract=1685868

Bryan A. Liang (Contact Author)

University of California San Diego School of Medicine ( email )

San Diego Center for Patient Safety
350 Cedar Street
San Diego, CA 92101
United States
619-515-1568 (Phone)
619-515-1599 (Fax)

Mark S. Boyd

Independent

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