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Are some veterans exaggerating or lying about their PTSD?

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Are some veterans exaggerating or lying about their post-traumatic stress disorder, in a bid to secure benefits from the Veterans Administration?

Reporter Alan Zarembo poses that question in an investigation in the Los Angeles Times. He notes that over the last 13 years, the number of veterans on disability for PTSD has increased from 133,745 to more than 656,000. Depending on the severity of their condition, he writes, veterans can receive up to $3,000 a month, tax free, for PTSD-related disability.

According to Zarembo, a VA psychologist from Florida estimated that about half the veterans he evaluates for PTSD are exaggerating or lying about their symptoms. He quotes Christopher Frueh, a University of Hawaii psychologist with 15 years of experience treating PTSD in the VA system:

"It's an open secret that a large chunk of patients are flat-out malingering," Frueh said.

Zarembo writes that various studies have reached conflicting conclusions on the malingering question.

He notes that PTSD is difficult to define and diagnose. Citing former and current VA mental health clinicians, Zarembo says assessing the condition is even more difficult because the VA system "gives veterans a financial incentive to appear as sick as possible."

As an example, he refers to a 2005 analysis by the VA office of the inspector general that looked at 92 cases of PTSD. It found that, "while most veterans received treatment when their disability ratings had room to rise, visits dropped off after their ratings topped out at 100% disabled," Zarembo writes.

Zarembo cites Frueh and others who argue that the VA's disability system incentivizes veterans to report less improvement than other patients in treatment.

The VA sent Zarembo a statement pointing to "several studies" that cast doubt on that conclusion, adding:

"It is counterproductive to disparage VA disability policies and treatment efforts without clear supporting evidence."

The VA cited one study in which nearly half of the veterans given a treatment known as prolonged exposure therapy went on to fall below the threshold for PTSD, Zarembo writes.

The article also quotes Gail Poyner, an Oklahoma City psychiatrist who says she was fired from a company the VA hired to conduct disability tests "because she insisted on giving veterans tests to determine whether they were exaggerating.

"It's political," Poyner said. "It's not prudent to suggest that people who have served our country are not being honest."

The VA told Zarembo that it encourages its examiners "'to conduct comprehensive, accurate and thorough evaluations' and to use their clinical judgment in deciding whether to test for malingering."

If you're a veteran, or you work within the VA system, we want to hear from you: Do you know of instances in which vets have exaggerated or lied about their PTSD? Do you think this is a serious problem? Do you think it's a problem at all? Tell us about it in the comments section below, or e-mail us at Impatient@scpr.org. Your experience could inform our reporting.

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