Time, Gender, and Regional Trends in the Application for Service-Related Post-Traumatic Stress Disorder Disability Benefits, 1980–1998

Abstract

The aim of this study was to describe time trends in the application and approval rates for Veterans Affairs post-traumatic stress disorder (PTSD) disability benefits and identify gender or regional differences in such rates after controlling for other available predictors. This was an administrative, historical cohort study of all 180,039 veterans who filed PTSD disability claims between 1980 and 1998. Applications for PTSD disability benefits increased geometrically between 1985 and 1998. Observed claim approval rates for PTSD disability benefits were twice as high for combat-injured men and women than for uninjured men and women. Among uninjured veterans, women serving after the Vietnam conflict had higher estimated claim approval rates than did comparable men, and estimated claim approval rates varied twofold across regions. Instead of a gender bias in claim approval rates for PTSD disability benefits, there may be a "combat injury bias" that disproportionately affects women. Research is needed to understand why claim approval rates vary by region.