Navy veteran and rape victim Ruth Moore struggled for more than two decades to resolve her disability compensation claim with the government.
Sheer persistence and help from Vermont Sen. Bernie Sanders finally paid off in 2009, when the Veterans Affairs Department granted Moore a permanent disability rating of 70 percent and stated she was unable to work. Moore, who lent her name to legislation the House passed in June aimed at improving the benefits claims process for victims of military sexual trauma, is talking more like an advocate than a victim these days.
“I have to do this, not for me, but for all my brothers and sisters who have endured,” Moore says. “I still try to shy away from the camera, but whenever I speak to people, it’s not just my story. My story is so similar to every other MST survivor in this country.”
It’s a tragic tale. In fiscal 2012, according to VA statistics, 52,823 women and 32,651 men received outpatient treatment for physical or mental health conditions related to military sexual trauma.
The 2012 documentary The Invisible War and a spate of alleged assaults this year have jump-started the conversation once again in Washington around what to do about the military’s sexual assault and harassment epidemic. So far, the high-profile debate has focused on sex assault investigations and prosecutions in the Defense Department and the chain of command, more so than disability compensation for victims. But the notion of reforming the MST claims process is gaining momentum, both in Congress and at VA.
The Senate version of the 2013 Ruth Moore Act, sponsored by Sen. Jon Tester, D-Mont., and still circulating in the upper chamber, has more teeth than the House-approved measure. Both bills would require VA to provide extensive reporting to lawmakers and veterans on the MST claims process from soup to nuts, as well as information on employee training.
Tester’s legislation would make it easier for vets seeking disability benefits through MST claims by requiring VA to relax evidentiary standards. The bill would allow a vet’s own testimony in addition to documentation from a mental health professional to serve as sufficient proof that a service-related sexual trauma occurred and caused physical or mental conditions.
The original House bill, sponsored by Rep. Chellie Pingree, D-Maine, contained that requirement as well, but it was stripped out to secure passage. The House legislation does include nonbinding language urging VA to ease the burden of proof for post-traumatic stress disorder claims related to military sexual trauma. “What they took out can be put back in,” Moore says. “It can be amended.”
PTSD claims stemming from sexual assault face a higher burden of proof than combat-related claims. The government in 2010 relaxed documentation standards for combat-related PTSD claims because too many vets were unable to provide all the necessary evidence that their diagnosis was related to a specific event. A claim that is consistent with the circumstances of the vet’s service experience and supported by a mental health professional is now sufficient evidence to link PTSD with military service.
“A lot of military sexual trauma groups were upset that it didn’t extend to them,” says Brett Buchanan, an Army veteran and VA-accredited claims agent with disability representation company Allsup.
Tester’s bill would do just that. Since many sexual assault victims don’t report incidents right away, the lack of official records increases the burden on claimants to submit corroborating documents of an assault or harassment and subsequent suffering. According to Moore, VA repeatedly denied her PTSD claim based on a series of misdiagnoses and insufficient medical records relevant to the assault—despite testimony from her former husband corroborating the rape and her treatment for a sexually transmitted disease resulting from it.
As with other PTSD cases, VA initially reviews a claimant’s service record for an account of the incident. Many sexual assaults, however, go unreported. In light of that, the department has developed procedures to help victims provide the proper documentation, according to Curtis Coy, deputy undersecretary for economic opportunity at the Veterans Benefits Administration. He told a congressional panel in June the department accepts evidence from other sources, including statements from family members and other service members, proof of mental health counseling and requests for transfer to another military duty assignment.
“If I had been treated promptly and received benefits in a timely manner, back at the time of my discharge, my life would have been much different,” Moore told a congressional panel in 2012, detailing the homelessness, sexually transmitted disease, multiple miscarriages and severe depression she has suffered as a result of being raped during her military service.
VA provides free treatment to vets suffering from mental and physical conditions related to military sexual trauma, even those without a disability rating or documentation. The department also has tried since 2011 to improve the claims process for PTSD-MST and to enhance training for claims examiners. Through the leadership of Allison Hickey, undersecretary for benefits and an Air Force vet, VA increased the number of MST claims granted to 53 percent in February 2013, comparable to the 59 percent approval rating for all PTSD claims. The approval rate for MST claims was about 34 percent in June 2011, when VA first started tracking disability claims related to military sexual trauma. As part of the initiative, the department has pledged to review previously denied PTSD claims based on MST.
VA did not initially support the Pingree-Tester bills, but has relented. Coy told lawmakers that the department supports the legislation’s reporting requirements, but he did not directly endorse the easing of documentation standards. “As VA has continued its close review of this legislation as part of an administration-wide focus on the critical issue of MST, we would like to further consider whether statutory changes could also be useful, while continuing to carry forward the training, regulatory and case review efforts described above,” he said, referring to Tester’s bill and the department’s own reform effort. “VA would like to follow up with the committee on the results of this review, and, of course, are glad to meet with you or your staff on this critical issue.”
Moore, a Maine resident, believes the legislation that bears her name will help others avoid the trauma she suffered because of a dysfunctional system. “I can tell you, we will be whooping it up here on the farm” if the bill becomes law, she says.
This article appeared in the August issue of Government Executive magazine as Burden of Proof.