VA Responds to Concerns Raised by Chairman Murray and Senator Tester for Improved Military Sexual Trauma Claims Process

(Washington, D.C.) – Today, Senate Veterans’ Affairs Committee Chairman Patty Murray and Committee Member Jon Tester announced the Department of Veterans Affairs (VA) will be working to improve the accuracy and consistency of their disability claims process related to Military Sexual Trauma (MST). This announcement comes after Chairman Murray and Senator Tester sent a letter to Under Secretary for Benefits Allison Hickey in October about the critical need to take further action to ensure that veterans who suffer disabilities related to MST will have their claims properly decided.

The letter was sent as a response to a December 2010 VA Office of Inspector General Report, Review of Combat Stress in Women Veterans Receiving VA Health Care and Disability Benefits, which found VBA had not fully assessed available MST-related claims data, which led to no clear understanding of how consistently these claims are being adjudicated.

“With an unacceptable number of our troops returning home with the damaging effects of MST, something had to be done,” Chairman Murray said. “The actions recently taken by the VA to address this issue are a significant step in the right direction. I am thankful they heard our concerns and moved quickly to tackle them. As Chairman, I will continue to monitor the progress of these improvements.”

“VA standards need to be fair and accountable for all victims of service-related trauma,” Senator Tester said. “It’s also critical that the VA is responsive to the evolving needs of America’s veterans and I’m pleased that the agency will be taking a close look at how it handles Military Sexual Trauma. I appreciate the VA’s quick response to our letter and will keep a close eye on their progress.”

Chairman Murray and Senator Tester’s letter requested that the Veterans Benefits Administration (VBA) take action to address concerns about the ability to correctly identify and adjudicate claims for disabilities based on MST. Last week, VBA took action on the concerns raised by Chairman Murray and Senator Tester and issued a training letter, “Adjudicating Posttraumatic Stress Disorder (PTSD) Claims Based on Military Sexual Trauma (MST).”  Compliance with this training letter and a new on-line training program for decision makers will help them correctly decide a claim related to MST.  

Finally, Chairman Murray and Senator Tester’s letter expressed concern with the current evidentiary standard for adjudicating PTSD claims based on in-service personal assault, such as MST. The issued training letter clarifies the types of evidence, and provides specific examples to aid decision makers in applying a liberal interpretation of the requirements, consistent with medical and lay evidence, which may be used to support a claim based upon MST. 

The full text of the Senators’ letter is below.

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The Honorable Allison A. Hickey
Under Secretary for Benefits
Department of Veterans Affairs
810 Vermont Avenue, NW
Washington, DC 20420

Dear Under Secretary Hickey: 

We are writing to commend your recent efforts to improve the recognition of disabilities related to Military Sexual Trauma (MST). These efforts are long overdue and more work remains to be done. Far too many servicemembers, both men and women, are returning home from service carrying the devastating wounds that result from MST. After sacrificing so much to serve their country, they often face tremendous challenges in obtaining the services and benefits they desperately need. That is why we urge you to take further action to ensure that veterans who suffer disabilities related to MST will have their claims properly decided.      

A December 2010 VA Office of Inspector General Report, Review of Combat Stress in Women Veterans Receiving VA Health Care and Disability Benefits, found that VBA had not fully assessed available MST-related claims data. As a result, there is no clear understanding of how consistently these claims are being adjudicated. We understand that you recently directed a review of MST-related claims and request that you provide us with the results of this review and the actions taken in response to the review findings. There are also additional steps you can take to ensure that veterans who suffer disabilities related to MST will have their claims properly decided. These actions include ensuring that regulations and policies concerning MST are based upon sound medical research and are providing VBA decision makers with the training and supervision needed to correctly adjudicate these claims.

In 2002, VA implemented universal MST screening after research found that medical and mental health conditions associated with MST were unreported and thus untreated. VA’s own research, The Veterans Health Administration and Military Sexual Trauma, (December 2007), found that 22 percent of screened female veterans and one percent of screened male veterans reported MST. This research found that the likelihood of a mental health diagnosis, including but not limited to PTSD, more than doubled for veterans exposed to MST. This underscores the need for VBA to properly recognize mental and physical health conditions associated with MST.

Additionally, we have concerns regarding the evidentiary standard for adjudicating PTSD claims based on in-service personal assault such as MST. Under the current standard, evidence such as records from law enforcement authorities or rape crisis centers may be used to corroborate the veteran’s account of the stressor incident. However, research shows that MST is severely underreported in both military and civilian settings. As a result, the evidence described in the regulation may not exist. 

Although the current regulation allows medical or mental health professionals to consider evidence, such as behavioral changes, and to provide an opinion as to whether the evidence indicates that a personal assault occurred, claims processors may not correctly interpret evidence used by a medical professional in the context of a particular case. A clinician skilled in diagnosing and treating disabilities associated with MST should make determinations as to whether the post-MST behavior change is consistent with the reported MST experience. We request that you consider our concerns as you explore potential regulatory changes that may be necessary to resolve the issues surrounding the reported improper adjudication of PTSD claims based on MST.              

We are also aware of the steps you have taken to require training concerning MST, and are pleased that you are focused on improving VBA’s ability to correctly identify and adjudicate claims for disabilities based on MST. While much attention has been given to PTSD claims, we urge you to provide training on other mental health and medical conditions that may result from MST. 

Thank you for your attention to this request. We look forward to continuing to work with you on behalf of our nation’s veterans. 

Sincerely,

Patty Murray                                                                                                    
Chairman

Jon Tester
U.S. Senator

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