TwinCities.com

December 19, 2007

Vet mental disability pay uneven

By Chris Adams, McClatchy Newspapers

PTSD awards vary widely from state to state

WASHINGTON - Veterans coming home from the wars in Iraq and Afghanistan with debilitating mental ailments are discovering that their disability payments from the government vary widely depending on where they live, a McClatchy Newspapers analysis has found.

As a result, many of those veterans who receive monthly payments for post-traumatic stress disorder from the Veterans Affairs Department could lose tens or even hundreds of thousands of dollars in benefits over their lifetimes.

The Bush administration has sought to reassure soldiers they'll be treated fairly, but veterans in some areas of the country are far more likely to be well compensated, according to the analysis, which is based on 3 million disability claims obtained under the Freedom of Information Act and other VA documents. The analysis is the first to examine state-to-state variations for those who have left the military since the war in Afghanistan began in 2001.

For veterans, their families and their advocates, the issue of disability compensation is hugely important. Disability checks are now worth up to $2,527 a month for a single veteran with no children. Because they last a lifetime, low payments set now - when veterans are young - have a dramatic impact.

So far, more than 43,000 recent veterans are on the disability compensation rolls for a range of mental conditions from post-traumatic stress disorder to depression and anxiety. Of those, more than 31,000 have PTSD, which has emerged as a signature injury from the war on terrorism. Given the number of troops who have served in Iraq and Afghanistan, that's a fraction of what the total will be.

Assessments of those injuries, however, are all over the map.

Of the recent veterans processed by the VA office in Albuquerque, N.M., 56 percent have high ratings for PTSD. Of those handled by the office in Fort Harrison, Mont., only 18 percent do, the McClatchy analysis found.

"There's no reason in the world a veteran from Ohio should be shortchanged on benefits simply because he is from Ohio," said U.S. Rep. Zack Space, a Democrat from Ohio, where veterans have among the lowest compensation rates in the nation. "And there's no reason a veteran from New Mexico should be getting more benefits simply because he lives in New Mexico."

A VA benefits official, Michael Walcoff, said the VA was working to minimize unwarranted variations across the country. Judging a condition such as PTSD, however, can be difficult.

"This has been an issue we have been concerned about," he said. "We are trying to learn what we can do to minimize the variances."

So far, 1.5 million Americans have served in the global war on terrorism, and half of them have left active service and transitioned to veteran status, VA documents show.

Those discharged veterans already have produced more than 180,000 disability cases, in which veterans are found to have mental or physical ailments linked to their military service. Most already are receiving monthly compensation checks.

Among all the ailments that Iraq and Afghanistan veterans now have, PTSD ranks fourth, behind ringing in the ear, back strain and hearing loss. But because it tends to be far more debilitating than those other conditions - and generates far higher payments - PTSD is the most important disability to emerge from the recent wars.

The McClatchy analysis found that a recent veteran with PTSD on the rolls in Albuquerque is likely to have a higher payment than a new veteran with PTSD on the rolls in the Montana office.

The VA workers who decide PTSD cases determine whether a veteran's ability to function at work is limited a little, a lot or somewhere in between. They examine the frequency of panic attacks and the level of memory loss. The process is subjective, and veterans are placed on a scale that gives them scores - or "ratings" - of zero, 10, 30, 50, 70 or 100.

McClatchy's analysis found that some regional offices are far more likely to give veterans scores of 50 or 70 while others are far more likely to stick with scores of 10 or 30.

Consider the New Mexico and Montana offices, where there are big differences up and down the scale.

In Montana, more than three-quarters of veterans have ratings of zero, 10 or 30. In New Mexico, a majority of the veterans have ratings of 50 or 70.

On top of that, 6 percent of New Mexico veterans had the highest rating possible - 100, worth $2,527 a month - compared with just 1 percent of Montana veterans.

Because payments are loaded toward the highest end of the scale - the difference between the highest rating and the next highest rating is more than $1,000 a month - the huge gap in ratings has a significant impact on how much the VA is paying, on average, to veterans in different states.

PAYMENTS FOR VETS

Factoring in all mental and physical disabilities, the average payment for recent veterans ranges from a high of $734 a month in the Little Rock, Ark., office to a low of $435 a month in Honolulu.

This list contains these elements in this order: regional office, percent of cases with high rating (50 or above) for PTSD, average payment for all disabilities for recent veterans.*

Top 10

Albuquerque, N.M., 56%, $669
Phoenix, 51%, $597
Little Rock, Ark., 48%, $734
St. Paul, Minn., 46%, $557
Providence, R.I., 45%, $579
Denver, 45%, $567
Boston, 44%, $519
Louisville, Ky., 44%, $580
Salt Lake City, 43%, $489
Oakland, Calif., 42%, $559

Bottom 10

Cleveland, 26%, $488
Manchester, N.H., 26%, $525
Wilmington, Del., 24%, $462
Des Moines, Iowa, 23%, $530
St. Louis, 22%, $502
Cheyenne, Wyo., 21%, $441
Pittsburgh, 21%, $443
Boise, Idaho, 20%, $502
Jackson, Miss., 20%, $469
Fort Harrison, Mont., 18%, $500

Totals, 35%, $528