December 6, 2005: The U.S. Veterans Administration is faced with a flood of disability claims from troops who are claiming injury because of PTSD (Post-Traumatic Stress Disorder). Because PTSD is a mental condition, and difficult to diagnose with certainty (unlike, say, a missing limb or eye), such claims are subject to abuse. Approving every one of them would mean troops with more visible injuries would have fewer resources. Something has to be done.
Formerly called Combat Fatigue, the condition was first widely noted in the late 19th century, after the American Civil War. That war, one of the first to expose large numbers of troops to extended periods of combat stress, had the stress angle brought to the attention of the general public because of the appearance of newly invented mass media (cheap newspapers made possible by highly efficient steam powered presses). The PTSD symptoms, as reported in the press over 150 years ago, have not changed. At the time, affected veterans were diagnosed as suffering from "Irritable Heart." Symptoms noted included fatigue, shortness of palpitations, headache, excessive sweating, dizziness, disturbed sleep, fainting and flashbacks to traumatic combat situations. In World War I, the condition was called Shell Shock, and the symptoms were the same, although there was more attention paid to vets who jumped and got very nervous when they heard loud noises. During World War II and Korea, the condition was called Combat Stress Reaction. Same symptoms. During Vietnam, the term Post-Traumatic Stress Syndrome became popular, until it evolved into what we currently regard as PTSD.
Actually, if you comb through military writings for the last few thousand years, you will note that PTSD has always existed. Too much combat "leaves a mark on a man" as the ancients were wont to note. But, the condition could always be faked or, as many veterans preferred, hidden. Whatever the case, PTSD is real. The only problem is making sure that the real victims get available treatment, and that resources are not drained away by people who are faking it, for financial gain.
Medical research is getting close to being able to diagnose PTSD with a great deal of certainty, whether the victim wants to admit to admit having it or not. For example, it's now possible, via a blood test, to determine who is most vulnerable to the psychological aftereffects of combat. This makes it possible to keep people out of combat units, who are likely to be most vulnerable to PTSD. This kind of screening, using cruder tools, has been done for a long time. You don't want people with you in combat, who are more prone to get quickly traumatized by it. Again, the old saying, "he doesn't have the nerves for it." In combat, someone having a mental breakdown can be dangerous for those around him.
Unfortunately, the tools for quickly and accurately diagnosing PTSD are not yet here, but they are getting close. Meanwhile, the massive publicity PTSD has received, and societies greater willingness to accept it as just another medical condition, has brought a big increase in the number of veterans claiming disability (and a medical pension) because of it. So far, over 25,000 veterans of Iraq and Afghanistan have put in claims. That's more than the number killed, or wounded in more visible ways. If it appears that anyone can claim (with a minimal amount of fakery) PTSD, you could see a flood of applications, many from people possessed of more greed than injury. This is what happened, under similar circumstances, with the workers disability compensation programs in some states. How well the Veterans Administration handles this will also be a major political issue, as the proper care of war veterans is a hot button item.
