On July 18, the House Veterans’ Affairs Subcommittee on Disability Assistance and Memorial Affairs held a hearing,“Invisible Wounds: Examining the Disability Compensation Benefits Process for Victims of Military Sexual Trauma.”
“[The Veterans Benefits Administration] VBA has placed a primary emphasis on informing VA [Department of Veterans Affairs] regional office personnel of the issues related to MST [military sexual trauma] and providing training in proper claims development and adjudication,” said Thomas Murphy, director of the Compensation and Pension Service at the Department of Veterans Affairs. He continued, “During August 2011, VBA reviewed a statistically valid sample of approximately 400 MST-related PTSD [posttraumatic stress disorder] claims. The goal was to assess current processing procedures and formulate methods for improvement. This led to development of an enhanced training curriculum with emphasis on standardizing evidentiary development practices. The VBA ‘Challenge Training Program,’ which all newly hired claims processors are required to attend, now includes a module on MST within the course on PTSD claims processing. MST topics are also included in the standard ‘PTSD and Other Psychological Conditions’ training course that all claims adjudicators are required to complete. Additionally, the VA electronic Learning Management System includes learning topics on MST.” Mr. Thomas added, “To further reinforce the importance of proper MST claims processing, VBA developed and issued Training Letter 11-05, Adjudicating Posttraumatic Stress Disorder Claims Based on Military Sexual Trauma, in December 2011. This was followed by a nationwide Microsoft Live Meeting broadcast on MST claims adjudication. The broadcast focused on describing the range of potential markers that could indicate occurrence of an MST stressor and the importance of a thorough and open-minded approach to seeking such markers in the evidentiary record.”
Col. Alan Metzler, deputy director of the Sexual Assault Prevention and Response Office (SAPRO) at the Department of Defense (DoD), testified regarding a number of improvements DoD has made to address sexual assault in the military. Col. Metzler said, “In recent months we have expanded or implemented several new initiatives that will further support our victims and encourage prevention.” He continued by describing the improvements to several programs, including the DoD Safe Helpline: “The Department is also reaching out to victims with a new initiative that was launched last year. In April 2011, the department launched the DoD Safe Helpline as a crisis support service for adult servicemembers of the DoD community who are victims of sexual assault. Available 24/7 worldwide, users can ‘click, call, or text’ for anonymous and confidential support. The Safe Helpline is owned by the department and operated by the nonprofit Rape, Abuse, and Incest National Network (RAINN), the nation’s largest anti-sexual violence organization, through a contractual agreement with DoD SAPRO. Safe Helpline has a robust database with a wide range of military and civilian services available for referral. The database also contains SARC [Sexual Assault Resource Center] contact information for each military service, the National Guard, and the Coast Guard, as well as referral information for legal resources, chaplain support, health care services, the Departments of Labor and VA, including VA’s Veterans Crisis Line, Military OneSource, and 1,100 civilian rape crisis affiliates. In its first year of operation, from April 2011 to April 2012, the Safe Helpline had more than 36,000 unique visitors to its website. Additionally, the DoD Safe Helpline assisted more than 2,700 individuals through its online and telephone hotline sessions and texting referral services. Please note that website visitors and the people helped are not filing reports of sexual assault. Rather, they are confidentially accessing information and finding out about services available to them.”
Margaret Middleton, executive director of the Connecticut Veterans Legal Center, discussed the legal issues her clients have faced when filing disability claims for MST. Ms. Middleton said, “As written, 38 CFR 3.304(f) requires that a veteran seeking disability compensation for PTSD caused by MST must provide VA with ‘credible supporting evidence that the claimed in-service stressor occurred.’ Part Five of this section includes a long list of potential evidence, including police records and medical reports, which could be used to corroborate the personal assault. On paper, this requirement seems reasonable…Working with victims of MST taught me how misinformed that view is. What I have learned from these men and women is that the response to assault in the military is very particular to the military culture and military justice system and should not be thought of as analogous to sexual assault in civilian society.” Ms. Middleton detailed an incident involving a young servicemember who had been raped and added, “Section 3.304 places a heavy burden on a traumatized veteran like this client. The culture and atmosphere of the military discouraged her from reporting this rape, but winning a PTSD claim like hers requires the kind of documentation that can only come from speaking about the event. As time passes producing this type of documentation becomes increasingly difficult. For veterans like our client, whose rape occurred in the 1970s, this is a monumental obstacle to overcome. As her advocates, assisting this veteran was incredibly involved. Her parents had died, her marriage failed, there were no surviving letters of hers from that time, and no journals or court records. She had lost contact with anyone she had served with thirty years earlier. She had been too ashamed and afraid to seek medical help. Mental health treatment was even less common and more stigmatized then than it is now. She didn’t seek a transfer and she wasn’t demoted – she just did her job and suffered silently. What documentary evidence is she supposed to provide to corroborate her experience? In a civil case, a judge or jury would be able to weigh the credibility of her testimony and the testimony of a doctor treating her; why does the VA demand more?”
Joy Ilem, deputy national legislative director of Disabled American Veterans, echoed Ms. Middleton’s concerns: “To DAV, the question at hand for this subcommittee is whether VBA adjudicators and rating specialists who are responsible for developing and rating MST claims are using all the amended provisions in M21-1 [VA’s guide on adjudication procedures for compensation and pensions] and following those prescribed VBA-wide guidelines in the Code of Federal Regulations to assist veterans in uncovering potential evidence that may be available to support their claims, even if unreported. In cases where veterans indicated that no official report of assaults were filed, VA adjudicators should be asking veterans detailed questions or considering stressor statements provided by veterans to determine if other reports could have documented these events (such as calls or visits to rape crisis centers or mental health counseling centers; requests for pregnancy tests or tests for sexually transmitted diseases; statements in personal diaries or letters to clergy or family members immediately following personal assaults). In our view, if a veteran indicates an assault took place on a specific date(s), he or she should be asked about subsequent treatment for any health or mental health problems following the sexual assault, i.e., complaints of stomach pain; nausea; vomiting; headaches; anxiety; panic attacks; depression; or suicidal ideation, etc. Rating specialists should be examining military personnel records for requests for transfer filed by individuals following assault to another duty assignment; a deterioration in work performance noted; or documentation of a sudden onset of substance abuse or other unexplained social or behavioral changes. The M21-1 guidance lists additional options to assist VBA claims developers but it unclear whether these efforts are consistently and exhaustively being made. DAV asks this subcommittee to require VBA to examine compliance with this guidance system-wide and submit a report of its findings to aid the subcommittee in its oversight role.”
Anu Bhagwati, executive director of the Service Women’s Action Network; Lori Perkio, assistant director of Veterans Affairs and Rehabilitation of The American Legion; Dr. Barbara Van Dahlen, executive director of Give an Hour; and Ruth Moore, an MST survivor, also testified.
