New Regulations on PTSD Claims

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On Tuesday, July 13, 2010, the Department of Veterans Affairs (VA) is scheduled to publish a final regulation that will make access to care and the claims process easier for Veterans seeking compensation for Post-Traumatic Stress Disorder (PTSD).  The rule reduces the evidence needed if the PTSD stressor claimed by a Veteran is related to fear of hostile military or terrorist activity and is consistent with the places, types, and circumstances of the Veteran’s service.

PTSD is a recognized anxiety disorder that can develop from seeing or experiencing an event that involves actual or threatened death or serious injury to which a person responds with intense fear, helplessness or horror, and is not uncommon among war Veterans.

Under the new rule, VA will not require corroboration of a PTSD stressor related to fear of hostile military or terrorist activity if a VA psychiatrist or psychologist confirms that the stressful experience recalled by a Veteran adequately supports a diagnosis of PTSD and the Veteran's symptoms are related to the claimed stressor.

Previously, VA required non-combat Veterans to corroborate the fact that they experienced a PTSD stressor related to hostile military activity.

This final rule simplifies the development that is required for these cases.

VA expects this rulemaking to decrease the time it takes VA to decide disability claims and access to health care, falling under the revised criteria and for Veterans to access health care.  More than 400,000 Veterans currently receiving compensation benefits are service connected for PTSD.  If service connection for PTSD is established under the new rule, a Veteran disabled by PTSD will be entitled to disability compensation, which is a tax-free benefit paid to a Veteran for disabilities that are a result of -- or made worse by -- injuries or diseases associated with active service.

Below is the Rating Tool used by the VA Rating Board to determine your rating percentage.  Check it carefully to make sure you are not being cheated.

Note:  Rating tool used for psychological & emotional disabilities.


EVALUATION:  100%    Total

?      Gross impairment in thought or communication

?      Persistent delusions or hallucinations

?      Grossly inappropriate behavior

?      Persistent danger or hurting self or others

?      Intermittent inability to perform ADL

?      Disorientation to time or place

?     Memory loss for relative names, own occupation, own name


?      Suicidal Ideation

?      Obsession rituals which interfere with routine activities

?      Speech intermittently illogical, obscure, or irrelevant

?      Near continuous panic or depression affecting ability to function independently,

appropriately, and effectively

?      Impaired impulse control

?      Spatial disorientation

?      Neglect of personal appearance and hygiene

?      Difficulty adapting to stressful circumstances

?      Inability to establish and maintain effective relationships


?      Flattened effect

?      Circumstantial, circumlocutory, or stereotyped speech

?      Panic attacks more than once per week

?      Difficulty in understanding complex commands

?      Impairment of short and long term memory (forgetting to complete tasks)

?      Impaired judgment

?      Impaired abstract thinking

?      Disturbances of motivation and mood

?      Difficulty establishing and maintaining effective work and social relationships


?     Depressed mood                                            ?     Panic attacks weekly or less often

?     Chronic sleep impairment                               ?     Anxiety

?     Mild memory loss for forgetting names, directions, recent events

?     Suspiciousness


?      Inability to perform occupational tasks only during periods of significant stress

?      Continuous medication


•    Continuous medication not required

Please familiarize yourself with the GAF table.  It will help you understand how you should be rated for the best possible outcome.  Below is the GAF table used by mental health professionals

Note:  The lower your GAF score the higher your disability rating.


91—100         Superior functioning in a wide range of activities, life’s problems never seem to get out of hand, is sought out by others because of his or her many positive qualities.  No symptoms.

81—90          Absent or minimal symptoms (e.g., mild anxiety before an exam), good functioning in all areas, interested and involved in a wide range of activities, socially effective, generally satisfied with life, no more than everyday problems or concerns (e.g., an occasional argument with family members).

71—80         If symptoms are present, they are transient and expectable reactions to psychosocial stressors (e.g., difficulty concentrating after family argument).  No more than slight impairment in social, occupational, or school functioning (e.g., temporarily falling behind in school).


61—70        Some mild symptoms (e.g., depressed mood and mild insomnia) OR some difficulty in social, occupational, or school functioning (e.g., occasional truancy, or theft within the household), but generally functioning pretty well, has some meaning interpersonal relationships.


51—60       Moderate symptoms (e.g., flat affect and circumstantial speech, occasional panic attacks) OR moderate difficulty in social, occupational, or school functioning (e.g., few friends, conflicts with peers or co-workers).


41—50       Serious symptoms (e.g., suicidal ideation, severe obsessional rituals, frequent shoplifting) OR any serious impairment in social, occupational, or school functioning (e.g., no friends, unable to keep a job).

31—40       Some impairment in reality testing or communication (e.g., speech is at time illogical, obscure, or irrelevant) OR major impairment in several areas, such as work or school, family relations, judgment, thinking, or mood (e.g., depressed man avoids friends, neglects family, and is unable to work; child frequently beats up younger children, is defiant at home, and is failing in school).


21—30     Behavior is considerably influenced by delusions or hallucinations OR serious impairment in communication or judgment (e.g., sometime incoherent, acts grossly inappropriately, suicidal preoccupation) OR inability to function in almost all areas (e.g., stays in bed all day:  no job, home or friends).

11—20     Some danger of hurting self or others (e.g., suicide attempts without clear expectation of death; frequently violent; manic excitement) OR occasionally fails to maintain minimal personal hygiene (e.g., smears feces) OR gross impairment in communication (e.g., largely incoherent or mute).

1—10      Persistent danger of severely hurting self or others (e.g., recurrent violence) OR persistent inability to maintain minimal personal hygiene OR serious suicidal act with clear expectation of death.

0             Inadequate information.

It is important that you find out from your mental health professional what GAF score you were given.  Those with psychological disabilities typically never score higher than 50.  Make sure your score is 50 or below.  Your GAF score carries a lot of weight with the rating board.


Rating of 0% - 20%

•    Certification of Eligibility for home loan guaranty.

•    Home loan guaranty fee exemption.

•    VA Priority medical treatment card.

•    Vocational Rehabilitation and Counseling under Title 38 USC Chapter 31 (must be at least 10%).

•    Service Disabled Veterans Insurance (Maximum of $10,000 coverage) must file within 2 years from the date of new service connection.

•    10-point Civil Service preference (10 points added to Civil Service test score).

•    Clothing allowance for veterans who use or wear a prosthetic or orthopedic appliance (artificial limb, braces, wheelchair) or use prescribed medications for skin condition, which tend to wear, tear or soil clothing.

•    Temporary total evaluation (100%) based on hospitalization for a service connected disability in excess of 21 days; or surgical treatment for a service connected disability necessitating at least 1 month of convalescence or immobilization by cast, without surgery of more major joints.

Rating of 30%

•    Additional allowance for dependent (spouse, child(ren), step child(ren), helpless child(ren), full-time students between the ages of 18 and 23 and parent(s).

•    Additional allowances for a spouse who is a patient in a nursing home or helpless or blind or so nearly helpless or blind as to require the regular aid and attendance of another person.

Rating of 40%

•    Automobile grant and/or special adaptive equipment for an automobile provided there is loss or permanent loss of use of one or both feet, loss or permanent loss of one or both hands or permanent impaired vision in both eyes with central visual acuity of 20/200 or less in better eye.

•    Special adaptive equipment may also be applied for if there is ankylosis of one or both knees or one or both hips.

Rating of 50%

•    VA Medical outpatient treatment for any condition except dental.

•    Preventative health care services.

•    Hospital care and medical services in non-VA facilities under an authorized fee basis agreement.

Rating of 60%

•    Increased compensation (100%) based on Individual Unemployability (IU) (applies to veterans who are unable to obtain or maintain substantially gainful employment due to service connected disability).

Rating of 100%

•    Dental treatment.

•    Department of Defense Commissary privileges.

•    Veteran’s employment preference for spouse.

•    Waiver of National Service Life Insurance premiums.

•    National Service Life Insurance total disability income provisions.

•    Specially adapted housing for veterans who have loss or permanent loss of use of both lower extremities or the loss of blindness in both eyes having light perception only plus loss of use of one lower extremity or the loss or permanent loss of use of one lower extremity with loss or permanent loss of use of one upper extremity or the loss or permanent loss of use of one extremity together with an organic disease which affects the functions of balance and propulsion as to preclude locomotion without the aid of braces, crutches, canes or wheelchair.

•    Special home adaptation grant (for veterans who don’t qualify for Specially Adapted Housing) may be applied for if the veteran is permanently and totally disabled due to blindness in both eyes with visual acuity of 5/200 or less or loss or permanent loss of use of both hands.

Rating of 100% (Permanent and Total) In Addition to the Above

•    Civilian Health and Medical Program for Dependents and Survivors (CHAMPVA).

•    Survivors and dependents education assistance under Title 38 USC Chapter 35.

VA Care ~ Sleep Apnea:

The number of veterans receiving disability benefits for a sleeping disorder has increased 61% in the past two years and now costs taxpayers more than $500 million per year, according to Veterans Affairs data released to USA TODAY. More than 63,000 veterans receive benefits for sleep apnea, a disorder that causes a sleeping person to gasp for breath and awaken frequently. It is linked to problems ranging from daytime drowsiness to heart disease. The top risk factor for contracting the disorder appears to be obesity, though a sleep expert at the VA and a veteran's advocacy organization cite troops' exposure to dust and smoke in places such as Afghanistan and Iraq as contributing factors. More claims are likely to be made in the future as BabyBoomers age and get heavier, says Max Hirshkowitz, director of the Sleep Disorder Center at the Houston Veterans Affairs Medical Center. Veterans are four times more likely than other Americans to suffer from sleep apnea, Hirshkowitz said. About 5% of Americans have the disorder, he said, compared with 20% of veterans. Veterans with a disability rating of 50% require breathing assistance with the airway pressure device, the VA said. The breathing machines work well, Hirshkowitz said, and can prevent veterans from developing more serious heart and lung problems.

Veterans benefits for sleep apnea are more generous than those for workers in the private sector, records show. Elaine Fischer, a spokeswoman for the Washington State Department of Labor and Industries, which handles workers' compensation in that state, said the department is not aware of any occupational exposure that would cause sleep apnea. "We're unaware of it being directly caused by something work related," she said. In 2007, Congress asked the Department of Veterans Affairs to pay closer attention to sleep apnea among veterans. Greater awareness of the disorder has prompted more veterans to seek treatment, Hirshkowitz said. The result has been a sharp increase in claims and disability payments to veterans: According to data provided to USA TODAY by Veterans Affairs:

•    The number of veterans claiming sleep apnea as a disability has jumped to 63,118 in 2010 from 39,145 in 2008, a 61% increase.

•    Payments to apnea patients with a disability rating of 50 — by far the largest group receiving benefits — rose to a minimum of $534 million in 2010 from $306 million in 2008. The minimum payment for a disability with a rating of 50 is $9,240 a year but increases if a veteran is married and has children.

The Social Security Administration recognizes sleep apnea as a disability. It pays benefits to those who can't work because of a disability that is likely to last at least one year or will kill them. The VA says veterans, however, can receive benefits and hold jobs. Hirshkowitz said, "Some veterans may be predisposed to sleep apnea because many are built like football players. They're big men, and as they age, many become sedentary and gain an enormous amount of weight. When you get to middle age or late middle age your level of exercise does not maintain particularly when you have knee problems and hip problems." Daniel Chapman, a psychiatric epidemiologist at the Centers for Disease Control and Prevention, agreed: "I really can't think of a reason other than what's happening in the general population, which is that we're growing increasingly obese." Chapman and Hirshkowitz said some sleep apnea cases may be caused by exposure to toxins from smoke or fires. Along with increased screening, the rise in sleep apnea cases may also be due to exposure to dust, sand and grit in Iraq and Afghanistan, said Thom Wilborn, a spokesman for the Disabled American Veterans organization. "Give a guy a rifle and put him in a desert, and he's going to suffer some respiratory issues," Wilborn said. Losing weight can help some people with sleep apnea, Hirshkowitz said. Though he notes that some thin men and some women also have the disorder. [Source: USA Today Tom Vanden Brook article 7 Jun 2010 ++]

Tricare Breast Cancer MRI's Update 01:

Tricare covers mammograms every year beginning at age 40. However, if you and your doctor determine you fall into a higher risk category, Tricare will cover mammograms beginning at age 35. Mammograms are part of Tricare's clinical preventive services, so Tricare beneficiaries can receive them at no cost and without prior authorization. To find a mammography facility near you: Go to • ; Click on "Search by Facility"; Enter your ZIP code and a search radius; Select "Radiology Centers" from the "Facility Type" menu ; and Click the "Search Facilities" button. For more information about breast cancer prevention and other important health issues, visit the "Healthy Living" portal at .

Your risk for breast cancer increases if you have a close relative with the disease, but 70 to 80% of women who develop breast cancer have no family history of it, according to the American Cancer Society. It is important that you get regular screenings and mammograms based on your age and risk factors. Know Your Risks

The best way to determine when to begin regular mammograms is by discussing your risk factors with your doctor. Some possible risk factors include:

•    Gender: Breast cancer is 100 times more common in women than men, but men can get it too.

•    Age: Breast cancer risk increases as you age. Two of three invasive breast cancers develop in women 55 and older.

•    Genetics: Between 5 and 10% of breast cancer cases could be due to heredity.

•    Family history: If you have a close blood relative with breast cancer, your risk doubles.

•    Dense breast tissue: Women with denser breast tissue have a greater risk of developing breast cancer than those with more fatty tissue.

•    Not having children or having them later in life: Women who never had children, or had them after 30, have a slightly higher risk.

•    Recent birth control use: Women who use oral contraceptives are at a slightly greater risk for developing breast cancer. However, once oral contraceptive use stops, the risk may decline back to normal over time.

•    Obesity: Especially after menopause, obesity can be a continual risk factor for breast cancer.

•    Lack of exercise: Evidence suggests that lack of exercise increases a woman‘s risk for breast cancer. However, more studies are needed to determine how much exercise will decrease the risk.

For more information on the risk factors for breast cancer, visit the American Cancer Society‘s Web site at

[Source: Tricare Health Matters Dr. Jack Smith article Issue 5 2010 ++]

Flag Presentation Update 05:

The United States Flag Code establishes advisory rules for display and care of the flag of the United States. It is Section 1 of Title 4 of the United States Code (4 U.S.C. § 1 et seq). The following guidelines for displaying the flag indoors and should be followed:

Indoor Display

•    The union is always in the upper left corner. When on display, the flag is accorded the place of honor, always positioned to its own right. Place it to the right of the speaker or staging area or sanctuary. Other flags should be to the left.

•    The flag of the United States of America should be at the center and at the highest point of the group when a number of flags of states, localities, or societies are grouped for display.

•    When one flag is used with the flag of the United States of America and the staffs are crossed, the flag of the United States is placed on its own right with its staff in front of the other flag.

•    When displaying the flag against a wall, vertically or horizontally, the flag's union (stars) should be at the top, to the flag's own right, and to the observer's left.

Outdoor Display

•    When the flag is displayed from a staff projecting from a window, balcony, or a building, the union should be at the peak of the staff unless the flag is at half-staff. When it is displayed from the same flagpole with another flag, the flag of the United States must always be at the top except that the church pennant may be flown above the flag during church services for Navy personnel when conducted by a Naval chaplain on a ship at sea.

•    When the flag is displayed over a street, it should be hung vertically, with the union to the north or east. If the street runs north-south, the stars should face east. For streets running east-west, the stars should face north. If the flag is suspended over a sidewalk, the flag's union should be farthest from the building and the stars facing away from it.

•    When flown with flags of states, communities or societies on separate flag poles which are of the same height and in a straight line, the flag of the United States is always placed in the position of honor—to its own right. The other flags may be the same size but none may be larger.

•    No other flag should be placed above it. The flag of the United States is always the first flag raised and the last to be lowered.

•    When flown with the national banner of other countries, each flag must be displayed from a separate pole of the same height. Each flag should be the same size. They should be raised and lowered simultaneously. The flag of one nation may not be displayed above that of another nation in time of peace.[8]

•    The flag should be raised briskly and lowered slowly and ceremoniously.

•    Ordinarily it should be displayed only between sunrise and sunset, although the Flag Code permits night time display "when a patriotic effect is desired." Similarly, the flag should be displayed only when the weather is fair, except when an all weather flag is displayed. (By presidential proclamation and law, the flag is displayed continuously at certain honored locations like the United States Marine Corps Memorial in Arlington and Lexington Green.)

•    It should be illuminated if displayed at night.

•    The flag of the United States of America is saluted as it is hoisted and lowered. The salute is held until the flag is unsnapped from the halyard or through the last note of music, whichever is the longest.

[Source: Jul 2010 ++]

Agent Orange & Graves Disease:

Medical researchers have long realized that severe long-term health effects were caused by the U.S. military's use of Agent Orange chemical defoliant during the Vietnam War, both within the Vietnamese civilian population as well as among American veterans. However, research announced in 2010 added one more item to the list: exposure to Agent Orange in Vietnam also seems to have increased veterans' (and presumably civilians') risk of contracting a thyroid condition called Graves' disease. A State University of New York at Buffalo study found in 2010 that Agent Orange was linked to an increased risk of Graves' disease. The research indicates that one of the chemicals found in the Agent Orange defoliant binds with cells in the body's immune system and may cause abnormal growth there. Overall, American veterans of the Vietnam War who were exposed to Agent Orange were three times more likely to develop Graves' disease than the general population.

Graves' disease is an autoimmune condition caused by overproduction of hormones in the thyroid. Normally it is an inherited condition, and is several times more likely among women than men. Untreated, it leads to a wide range of serious complications in the body, including weakened bones, heart damage, eye problems, and thyroid storms (a rare condition in which the thyroid becomes so overactive that the effects become life-threatening and require urgent treatment). Neurological symptoms are also common, including serious mood swings. Proper therapy can reduce the symptoms, depending upon how far the disease has progressed, but the most effective option available to today's medicine may be surgery to remove part of the thyroid gland (a thyroidectomy). [Source: Helium health & fitness D. Vogt article Aug 2010 ++]

National Guard (In Federal Status) and Reserve Activated as of August 31, 2010

This week the Army, Marine Corps, and Coast Guard announced a decrease in activated reservists, while the Air Force and Navy announced an increase. The net collective result is 215 fewer reservists activated than last week.

At any given time, services may activate some units and individuals while deactivating others, making it possible for these figures to either increase or decrease.  The total number currently on active duty from the Army National Guard and Army Reserve is 75,360; Navy Reserve, 7,008; Air National Guard and Air Force Reserve, 15,280; Marine Corps Reserve, 4,364; and the Coast Guard Reserve, 781.  This brings the total National Guard and Reserve personnel who have been activated to 102,793, including both units and individual augmentees.

U.S. Soldier MIA from Korean War Identified

The Department of Defense POW/Missing Personnel Office announced today that the remains of a U.S. serviceman, missing in action from the Korean War, have been identified and returned to his family for burial with full military honors.

United States Army Sgt. Charles P. Whitler will be buried Sept. 2 in his hometown of Cloverport, Ky.

In early November 1950, Whitler was assigned to 3rd Battalion, 8th Cavalry Regiment, occupying a defensive position near the town of Unsan by the Kuryong River known as the "Camel's Head."  Two enemy elements attacked the U.S. forces, collapsing their perimeter and forcing a withdrawal.  Whitler's unit was involved in fighting which devolved into hand-to-hand combat around the 3rd Battalion's command post.  Almost 400 men were reported missing or killed in action following the battle.

In late November 1950, a U.S. soldier captured during the battle of Unsan reported during his debriefing that he and nine American soldiers were moved to a house near the battlefield.  The POWs were taken to an adjacent field and shot. Three of the 10 Americans survived, though one later died.  The surviving solider provided detailed information on the incident location.

Analysts from DPMO developed case leads with information spanning more than 58 years.  Through interviews with eyewitnesses, experts evaluated circumstances surrounding Whitler's captivity and death and researched wartime documentation of his loss.

In May 2004, a joint U.S.-North Korean team, led by the Joint POW/MIA Accounting Command, excavated a mass grave near the "Camel's Head."  An elderly North Korean man reported he had witnessed the death of seven or eight U.S. soldiers near that location and provided the team with a general description of the burial site.

The excavation team recovered human remains and other personal artifacts, ultimately leading to the identification of seven soldiers from that site, one of whom was Whitler.

Among other forensic identification tools and circumstantial evidence, scientists from JPAC and Armed Forces DNA Identification Laboratory also used dental comparisons and mitochondrial DNA - which matched that of Whitler's sister and niece - in the identification.

More than 2,000 servicemen died as prisoners of war during the Korean War.  With this accounting, 8,022 service members still remain missing from the conflict.

For additional information on the Defense Department's mission to account for missing Americans, visit the DPMO Web site at or call 703-699-1420.

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