Doctors say VA's streamlined claims process facilitating fraudulent PTSD claims

Photo: Sinclair Broadcast Group)

Thousands of U.S. soldiers are suffering the effects of traumatic incidents long after they return home from war zones.

The results is often a serious and mentally debilitating condition known as post traumatic stress disorder.

Six years after the Department of Veterans Affairs made changes to simplify the disability claim process, some VA doctors say the system is ripe for fraud.

Vets making false PTSD claims, doctors being pressured to diagnose and a system that incentivizes life long health problems are a few of the concerns among former and current doctors interviewed by News 4.

At the root of their concern is neglect for the veterans who desperately need the help.

In 2008, 23,801 veterans applied for and were granted service-connected disability for PTSD.

That number continues to rise and in 2015 there were 63,049 for that year alone, bringing the total number to 751,499 veterans.

In 2010 the VA fast-tracked the claims process.

Some might say the numbers are undoubtedly a success story, a result of the complaint riddled VA system making a much needed change.

"The VA has a long history of, at times providing spotty medical care or of being identified as being behind on claims," said Menninger Clinic Director of Research, Dr. Chris Frueh who is also a former VA Psychologist.

In response, the VA expedited their application process, but Frueh said they have also revised standards, essentially lowering the threshold for documenting traumatic stressors.

"I think since they did that they've had a dramatic rise in the number of applications for disability for post traumatic stress disorder," Frueh said.

There is not an objective test for PTSD, but there are ways to determine whether a patient is malingering, or faking symptoms.

Frueh said many VA doctors don't do this type of forensic testing and in some cases they are skipping another important step, checking military personnel records.

During his time at the VA and since then, Frueh has done studies, looking at the validity of PTSD diagnoses.

"We drew the personnel files of a hundred consecutive veterans who reported having seen combat in Vietnam and many of them have never apparently served in Vietnam according to the military records," Frueh said.

7 percent of the veterans in his study had no documentation of time served.

Frueh also referenced a 2016 study done by the National Centers for PTSD; researchers did diagnostic interviews with a large sample of veterans already receiving disability benefits for PTSD and found 30 percent did not meet the criteria for the disorder

"There's a VA backlog that everyone talks about that's created in large part by everyone rushing to the VA and clogging the system because they know how easy it is to get money," said veteran Chris Hernandez.

Hernandez, who is retired from the Army National Guard, served 6 years in the Marines and was deployed to Iraq in 2005.

"You're going outside the wire on missions with people who are so dedicated they would literally rather die than let each other down and you come back and you miss it," Hernandez said. "You plummet to a certain degree."

Despite the high stress environment overseas, Hernandez said he did not suffer from PTSD at any time when he returned, although he did experience situational depression.

He is now speaking out on behalf of the veterans who do suffer from PTSD.

"Early in the war, there were veterans who truly suffered horrible trauma, had serious problems, deserved help and they didn't get it," Hernandez said.

He thinks medical benefits should be made available to all veterans who may need it, but thinks the VA should be more discerning about who is awarded disability payments.

All the doctors News 4 interviewed agree, the pendulum has swung the other way, some say, too far.

Frueh said there is enormous pressure on VA doctors to diagnose.

A current VA psychologist who we are identifying only as Dr. Smith, estimates about half of the veterans he sees are feigning or exaggerating symptoms of PTSD, and he adds, questioning the validity of the disorder is discouraged by the VA.

"People show up and the symptoms are just not there and there is clearly pressure to find PTSD," Smith said.

Psychiatrist, Dr. Harry Croft has been screening vets for PTSD for more than 20 years.

Currently he handles evaluations for a business that contracts with the VA.

Even with is extensive experience, he finds diagnosing PTSD is not always black and white, and determing if it is service-connected can also be challenging.

"We don't yet have a test to make certain that people are giving us the full truth," Croft said.

He disagrees with the large number of veterans said to be faking PTSD, although he admits his data may be skewed as many of the veterans he sees have already been pre-screened for the disorder.

"I'd like to think that most of our veterans are not doing that, could I be wrong, maybe," Croft said.

Either way, he sees the VA as having a, "let's err on the side of caution" approach and said it mirrors his own.

He thinks the cost of getting it wrong is too high, having seen the lives of many veterans who have PTSD destroyed.

"They're marriages fail, they can't socialize like they used to, they can go back to school but they can't concentrate so they can't get a degree, they get angry at work and they get fired," Croft said.

Frueh doesn't blame the veterans or the doctors for fraudulent PTSD claims, he blames the VA.

While he thinks it is a well intentioned program, he believes the current disability system is failing our country.

"My biggest concern is that we are consigning a generation of young men and women who have served our country honorably to a life of psychiatric invalidism," Frueh said.

All the doctors interviewed by News 4 agreed that PTSD in most cases is treatable and that the current system does not incentivize veterans to recover.

"There is a chance they could engage in therapy and get better, but just be afraid to say they're better," Smith said.

"Veterans will get better, they'll tell you they're getting better, but they don't want it written in their medical records because they fear they'll lose their disability," Frueh said.

There is also concern veterans who actually have PTSD will have to wait in line behind those who don't.

"I am trying to open the doors and clear out all the obstacles for those veterans to go and get the help that they need and deserve," Hernandez said.

News 4 reached out to the VA multiple times and they have yet to agree to an interview or respond to questions regarding these claims.

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