October 6, 2010: PTSD (post-traumatic stress disorder) is becoming a problem in ways no one expected. For example, there is now more fraud (false claims for disability pay because of PTSD) and use of PTSD to excuse anti-social activity. For example, in the six years after September 11, 2001, 26,000 military personnel were discharged for psychological and discipline problems. This is normal. Only 11 percent of those discharged had served in a combat zone, and most of them were not in combat. Some of these men are now claiming that their anti-social behavior was all because of PTSD.

While PTSD is a common side-effect of combat, and non-military stress situations in general, the huge medical advances in the last two decades has made it easier to detect exactly who has it. This has created a larger number of PTSD casualties, because it's now more likely that those with PTSD will be correctly diagnosed. This includes many people who would have otherwise never known they had it, or those who, as is often the case, only exhibited symptoms when they got much older.

The U.S. Veterans Administration is spending several hundred million dollars a year (out of nearly $100 billion spent on veterans) on PTSD related issues. This has resulted in lawyers soliciting troops coming back from duty overseas, and urging them to claim they have Combat fatigue (or PTSD) and apply for disability benefits. This was recently big news in Australia, where there was a similar problem, but the involvement of crooked lawyers in disability scams has been big business in the United States for decades. It's estimated that about three percent of the 24 million American veterans suffer from PTSD. About ten percent of all veterans were in combat. Currently, only about half the veterans getting treatment for PTSD, are receiving disability payments (which largely go to those who have physical loss). But better detection tools are revealing that PTSD is more widespread than previously thought. Perhaps 4-5 percent of vets may have it.

Despite the careful psychological screening of recruits, there are also many (about two percent of all recruits) discharged for psychological reasons that are not related to military service. About fifteen percent of those discharges were for troops who had spent time in a combat zone. A new policy mandates more careful scrutiny of these discharges, because of non-service related psychological problems, means the subject is not eligible for disability payments.

PTSD (also known as shell shock or combat fatigue) usually first manifests itself while troops are still in the combat zone, if not in combat itself. This has meant stationing lots of mental health personnel as close to the fighting as possible. Getting troops to acknowledge that PTSD is just another combat injury has proved difficult. There is progress, albeit slow, in getting the troops to report problems they are having. But the crooked lawyers will coach troops to exhibit the right symptoms, and then guide them through the application process, in return for a portion of the disability payments received. This messes up the work doctors are doing to get an accurate view of the PTSD problem.

PTSD was first noted after the American Civil War. That war was one of the first to expose large numbers of troops to extended periods of combat stress. The symptoms, as reported in the press a century and a half ago, were not much different from what you hear today. At the time, affected veterans were diagnosed as suffering from "Irritable Heart" or "Nostalgia." Symptoms noted included fatigue, shortness of breath, palpitations, headache, excessive sweating, dizziness, disturbed sleep, fainting and flashbacks to traumatic combat situations. Many of these symptoms were noted while troops were still in uniform. During the late 20th century, the condition came to be known as PTSD.

The problem with the lawyers assisting troops in scamming the government for benefits payments is nothing new. It has been going on for years in the civilian disability insurance and social security disability systems. Lawyers involved in class action suits, for large numbers of victims have been caught doing coaching, and records falsification, on a large scale.

Veterans groups are trying to stem this sort of fraud, as it diverts money needed by veterans with real injuries, into the pockets of scammers. With the growing number of combat veterans coming home, the demand for resources will be higher than it has been for decades.