QUESTIONS AND ANSWERS ON IOM PTSD STUDY


Question:
Why does VA need this study?

Answer:
The study will provide VA with the best information available on the diagnosis, 
treatment, and compensation for PTSD.  This information will provide VA with the 
best foundation for the formulation of policy as it relates to PTSD.

Question:
Why is this study being conducted now?

Answer:
Over the next two years, the Secretary and the Veterans Disability Benefits 
Commission is closely examining compensation for all health conditions, 
including PTSD.

Question:
Does the decision to study PTSD now have anything to do with the 
Secretary’s recent decision to audit certain PTSD compensation claims?

Answer:
The decision to contract with IOM to study PTSD is independent of the VA’s 
decision to audit certain PTSD compensation claims.  VA’s audit is directly 
related to recent results of an audit performed by the Office of the Inspector 
General.

Question:
How will IOM conduct the study?

Answer:  
One committee will review the current scientific and medical literature related to 
the assessment of PTSD and the validity of screening instruments used to 
diagnosis PTSD (Task 1).  A second committee will provide technical assistance 
on issues related to treatment, prognosis, and compensation of PTSD (Task 2).  
Where relevant, recommendations will be made that provide the scientific basis 
for future policy decisions.

Question:  
Will IOM undertake this using a Committee process?

Answer:
Yes.  IOM will use two Committees to complete the tasks.  IOM will use the 
existing committee on Gulf War and Health: Physiologic, Psychologic, and 
Psychosocial Effects of Deployment Related Stress to complete the first task 
related to diagnosis and validity of diagnostic instruments.  This Committee 
should complete its task within 6 months.

A second IOM committee of approximately 12 experts will meet four times during 
a 12 month period to complete the 2nd task related to the treatment and 
compensation for PTSD.  

Question:
Is there opportunity for public input?

Answer:
Yes.  The first meeting of the 2nd Committee will be open to the public, the 
sponsor will review the study tasks for the committee and allow discussion to 
clarify aspects of the implied tasks not explicitly stated in the written study tasks, 
Veteran Service Organizations will also be invited to attend this open meeting. 
During subsequent open meetings, the committee will hear from experts both in 
the Veterans Health Administration (VHA) and the Veterans Benefit 
Administration (VBA) about how PTSD cases are adjudicated and learn about VA 
compensation policies and practices. The committee will hold at least one 
meeting where veterans and veteran service organizations/associations can 
make presentations about how their PTSD has been managed by the VA. 
Emphasis here will be on understanding attitudes about care and compensation.

In order to afford the public greater knowledge of Academy activities and an 
opportunity to provide comments on those activities, the Academy will post on its 
website (http://www.national-academies.org) the following information as 
appropriate under its procedures: (1) notices of meetings open to the public; (2) 
brief descriptions of projects; (3) committee appointments (including biographies 
of committee members); (4) report information; and (5) any other pertinent 
information.

Question:
What will IOM look at in terms of PTSD diagnosis?

Answer:
Specifically related to the assessment and diagnosis of PTSD, the first committee 
will review and comment on the objective measures used in the diagnosis of 
PTSD and known risk factors for the development of PTSD.  The committee will 
review the utility and objectiveness of the criteria in the Diagnostic and Statistical 
Manual of Mental Disorders (DSM-IV), and will comment on the validity of current 
screening instruments and their predictive capacity for accurate diagnoses.  Task 
1 is expected to be completed within six months.



Question:
What will IOM look at in terms of the treatment and compensation for 
PTSD?

Answer:
A second committee will review the literature on various treatment modalities 
(including pharmacotherapy and psychotherapy) and treatment goals for 
individuals with PTSD. Specifically, the committee will review the literature on 
best treatment practices, types and timing of specific interventions, and comment 
on the prognosis of individuals diagnosed with PTSD (and existing 
comorbidities).  The committee will review the literature on compensation 
practices for PTSD including examining the criteria for establishing severity of 
PTSD as published in the VA Schedule for Rating Disabilities (VASRD); 
evaluating the basis for assigning a specific level of compensation to specific 
severity levels and how changes in the frequency and intensity of symptoms 
affect compensation practices for PTSD; assessing how compensation practices 
and reevaluation requirements for PTSD compare with other chronic conditions 
which have periods of remission and return of symptoms; and reviewing 
strategies used to support recovery and return to function in patients with PTSD.  
The IOM expects that the second committee will complete its task in 12 months

Question:
Will reports be published?

Answer:
A final written report and oral presentation will be provided to VA at the end of the 
study period for each of the two tasks.  Reports will be prepared in sufficient 
quantity to ensure their distribution to the sponsor and other relevant parties in 
accordance with Academy policy.  The reports and report summaries will be 
made available to the public without restriction.  The final report will also be 
available in Open Book format on the web without restriction. 

Question:
How much will the study cost?

Answer:
The study will cost $1,386,411 

Question:
Why can’t VA do the study if VHA’s clinicians are expert in PTSD?

Answer:
The IOM provides a vital service by working outside the framework of 
government to ensure scientifically informed analysis and independent guidance. 
The IOM's mission is to serve as adviser to the nation to improve health. The 
Institute provides unbiased, evidence-based, and authoritative information and 
advice concerning health and science policy to policy-makers, professionals, 
leaders in every sector of society, and the public at large