"The first benefit is health care. PTSD is by far the easiest mental health diagnosis to have declared “service-connected,” a designation that often means the difference between little or no care and broad, lasting health coverage. Service connection also makes a vet eligible for monthly disability payments of up to $3,000. That link may explain why most veterans getting PTSD treatment from the VA report worsening symptoms until they are designated 100 percent disabled—at which point their use of VA mental health services drops by 82 percent. It may also help explain why, although the risk of PTSD from a traumatic event drops as time passes, the number of Vietnam veterans applying for PTSD disability almost doubled between 1999 and 2004, driving total PTSD disability payments to more than $4 billion annually.
Perhaps most disastrously, these payments continue only if you are sick. For unlike a vet who has lost a leg, a vet with PTSD loses disabil- ity benefits as soon as he recovers or starts work- ing. The entire system seems designed to encour- age chronic disability. “In the several years I spent in VA PTSD clinics,” Frueh says, “I can’t think of a single PTSD patient who left treatment because he got better. But the problem is not the veterans. The problem is that the VA’s disability system, which is 60 years old now, ig- nores all the intervening research we have on re- silience, on the power of expectancy, and on the effects of incentives and disincentives. Som times I think they should just blow it up and start over.” But with what?"
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