Over the past several decades, the combat role of women has expanded exponentially, especially in places like Afghanistan. Some researchers are concerned that the incidents of female Post Traumatic Stress Disorder have increased even more quickly.
A group of doctors looked at female Air Force veterans. Not surprisingly, PTSD incidents increased as the women had more combat experiences. Unit cohesiveness decreased the effects somewhat, but there was no significant correlation.
“This important study advances understanding of the impact of risk and protective factors on the development of PTSD symptoms among female military service members,” stated Dr. Susan G. Kornstein, who edits the Journal of Womens’ Health, where the study appeared.
Sporadic PTSD diagnoses first appeared during the American Civil War. Back then, doctors usually labeled the condition as “nostalgia.” Tragically, the prescribed treatment usually involved a vigorous offensive campaign, which was what probably caused the condition in the first place.
In World War I, which began in 1914, PTSD (“shell shock”) became very widespread. Not coincidentally, the armies of the world replaced picric acid with TNT shortly before the conflict began. Picric acid is an explosive substance that is basically the same ingredient in fireworks. So, if a shell exploded in the Crimean War of the 1850s or the Franco-Prussian War of the 1890s, it usually caused little injury unless the soldier was directly under the blast.
But TNT is much more powerful. The shock wave violently knocks soldiers down if they are anywhere close to the blast. Furthermore, scientists have identified an additional shock wave that is something like an Electromagnetic Pulse. This EMP somehow disrupts brain functions, although doctors are still not exactly sure how.
Recently uncovered footage from a British army hospital sheds additional light on these cases. This before-and-after video is a good example. It is quite clear that the victim’s symptoms are not just psychological, like heightened awareness and flashbacks. There is a physical component to PTSD as well. In the “after” portion, the victim has made a remarkable recovery. But there are some lingering physical symptoms that may disrupt daily activities. The victim cannot control his fingers. So, walking down the sidewalk is not a big deal, but almost anything else could be problematic.
Is PTSD a “Disorder” or an “Injury”?
Labels like “post traumatic stress disorder” imply that the injury is a processing disorder that randomly affects people. Some individuals suffer from severe PTSD, some suffer no symptoms whatsoever, and others are in between. As a result, many doctors and patients are fatalistic about the condition. They figure that the injury has no discernable cause and therefore no discernable treatment.
Fortunately, the reality is quite different. It all goes back to the relationship between the amygdala and the cerebral cortex. The amygdala controls emotional responses; the cerebral cortex controls logical responses. There is a delicate balance between the two because people need both to function properly.
Combat stress erodes the cerebral cortex. Doctors are not sure if one very traumatic event or the cumulative effect of several lesser events causes that erosion. In either case, the amygdala becomes too powerful. That explains overly-emotional reactions to certain events. These symptoms include:
- Heightened awareness, and
- Inappropriate emotional outbursts.
The cerebral cortex erosion also explains the physical symptoms of PTSD. Certain brain cells control certain physical functions. After extensive treatment, other brain cells often assume some of the lost functions. But the injury itself is permanent and this process never entirely reverses the symptoms.
In the early 2000s, the Canadian Armed Forces did away with the “PTSD” designation and replaced it with OSI, or Operational Stress Injury. OSI victims are eligible for the Sacrifice Medal, which is the equivalent of a Purple Heart.
How to Obtain Compensation
The injury/disorder distinction is especially important for returning contractors with this diagnosis. The Defense Base Act only covers physical injuries. The most recent medical evidence has answered this question for good.
There are some other qualifications, as well. The injury must occur in a combat zone. A “combat zone” is any country that has at least one U.S. military establishment. It does not matter how big or small the presence is. Furthermore, there must be a nexus between the injury and the service. The relationship need not be direct, but there needs to be something there. Finally, the victim must usually work for an arm of the U.S. government. In some cases, contractors who work for sympathetic foreign governments may also be eligible for compensation.
The process begins when victims file injury claims. These claims must be in writing and must contain some details about the incident.
Strict time deadlines apply in filing cases. If the victim sustained a trauma injury, the deadline is usually not a problem. But if the victim contracts an occupational disease, like hearing loss, the timing may be an issue. An attorney can almost always sort out this issue.
Next, there is a settlement conference between the victim and the insurance company. A DBA Claims Administrator usually presides over this conference; this person usually reviews medical records to prepare for this meeting. Some conferences succeed but most fail. So, many of these cases proceed to the next level.
That next level is a trial-like hearing before an Administrative Law Judge. The ALJ is not a real “judge” and there is no jury. But many of the same rules of evidence and procedure apply. Attorneys may present evidence, challenge the other side’s evidence, and make legal arguments.
Many other cases settle after a simple mutual agreement. These out-of-court settlements could occur at any time.
Contact Barnett, Lerner, Karsen & Frankel, P.A. for more information about available DBA benefits.