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PubMed2006

Annual prevalence of diagnosed schizophrenia in the USA: a claims data analysis approach.

BACKGROUND: Schizophrenia is a debilitating chronic mental illness. However, the annual prevalence of schizophrenia is not well understood because of under-representation of schizophrenia patients in epidemiological surveys. This study used multiple administrative claims databases to estimate the annual prevalence of diagnosed schizophrenia in the USA. METHOD: The annual prevalence of diagnosed schizophrenia in the USA was estimated for different health insurance coverage groups. The prevalence for privately insured individuals was calculated from an administrative claims database of approximately 3 million privately insured beneficiaries covering the period 1999-2003. The prevalence for Medicaid enrollees was calculated from California Medicaid claims covering the period 2000-2002. The prevalence for Medicare and Medicaid/Medicare dual eligibles was estimated using a combination of both databases. Published statistics were used to estimate the prevalence of schizophrenia in the uninsured and veteran populations and to weight the prevalence rates obtained to the population of the USA. RESULTS: The 12-month prevalence of diagnosed schizophrenia in the USA in 2002 was estimated at 5.1 per 1000 lives. The Medicaid population was identified with the highest prevalence rate among the populations studied. Sensitivity analyses taking into consideration the Veterans Affairs population only changed the estimate slightly to 5.3 per 1000 lives. CONCLUSION: Analyses of administrative claims data contribute to the understanding of the prevalence of diagnosed schizophrenia.

Adolescent↗
PubMed1979

Symptoms in veterans considering compensation claims.

The symptomatology of 56 male veterans considering compensation claims was compared to the symptomatology seen in 163 veterans not considering such claims. Antisocial behaviors, somatic/neurotic complaints, and persecutory ideas were all positively correlated with consideration of a claim. Although the symptom profile is consistent with diagnosis of antisocial personality, a correlation with this diagnosis was not established. Nonetheless, the clinical profile does suggest a link between noncompensable disorders and consideration of a claim. The implications of this finding for military and Veterans Administration psychiatry are discussed.

Adult↗
PubMed1985

Do Vietnam veterans suffer from toxic neurasthenia?

This paper evaluates the claim that Vietnam veterans with psychiatric disorders are suffering from toxic neurasthenia--a neurasthenic syndrome caused by exposure to pesticides while serving in Vietnam.

2,4,5-Trichlorophenoxyacetic Acid↗
PubMed2003

Time, gender, and regional trends in the application for service-related post-traumatic stress disorder disability benefits, 1980-1998.

OBJECTIVES: 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. METHODS: This was an administrative, historical cohort study of all 180,039 veterans who filed PTSD disability claims between 1980 and 1998. RESULTS: 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. CONCLUSIONS: 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.

Adult↗
PubMed1983

Psychodynamic and social development of neurotic patients applying for disability compensation: a catamnestic study.

Neurotic illnesses in which the desire for compensation or pensioning complicates the picture must not always take an unfavorable course. Prognostic criteria allowing definitive projections for individual cases are not available. The award or denial of compensation--in a group comparison--has no influence on the neurotic symptomatology. There are no differences in the psychodynamic and social histories of those subjects who apply for a pension because of the inability to work and those who claim compensation following an external trauma. In one-fourth of the subjects who were examined in connection with accidental or war injury, conspicuous personality characteristics could be demonstrated for the time preceding the incident. Satisfactory therapeutic possibilities for the group of neurotic applicants for disability compensation or pensions are not yet available.

Disability Evaluation↗
PubMed2004

Survey of methods for the rating of psychiatric impairment in Australia.

One of the enduring clinical issues in the assessment of plaintiffs in personal injury and workers' compensation claims, as well as applicants for social security and disablement benefits, is that of the evaluation of impairment and work incapacity. Many writers on this topic confuse the concepts of impairment and disability, and similar confusion is reflected in a number of the rating methods that purport to evaluate impairment but in reality assess disability. In Australia there are 20 distinct statutory schemes for workers' compensation, motor accident compensation, and social security and other benefits, which utilise a variety of methods for the rating of psychiatric impairment. Recent legislative changes designed to restrict access to personal injury compensation at common law, which in two Australian State jurisdictions require the use of impairment rating scales, also specify the rating methods to be used in the assessment of psychiatric impairment. This article discusses the concepts of impairment and disability as defined by the World Health Organisation, and reviews the various methods for the rating of psychiatric impairment that are specified by statute in the federal and State jurisdictions in Australia.

Australia↗
PubMed1980

Optimum radiographic examination for consideration of compensation awards: II. Cervical and lumbar spines.

In a large Veterans Administration (VA) hospital, a prospective study was undertaken to determine the optimum number of radiographic projections needed to assess applicants for VA compensation for cervical and lumbar spine disease or injury claimed to be service-related. Results show that the final radiographic assessment could be made in 100% (245) of cervical spine examinations using two views (anteroposterior and lateral) and in 99.3% (699/704) of lumbar spine examinations using two views (anteroposterior and a single well centered lateral). Extrapolating these results to data on compensation examinations performed in the entire VA system (fiscal year 1978), it was concluded that limiting the radiographic examinations of the cervical and lumbar spines to these views would eliminate 193,000 radiographs in the evaluation of 100,000 applicants and yield an annual savings of about $1,000,000.

Accidents, Occupational↗
PubMedDate not supplied

[A few remarks on the so-called war pension].

The legislator has provided for a possibility of granting war disability pensions to some persons listed in appropriate legal acts. In the area of psychiatry, the most frequently indicated disorder is PTSD (post-traumatic stress disorder--formerly KZ-syndrome) manifesting in the form of neurasthenic-depressive-anxiety disturbances. The latest literature on the subject mentions the problem of simulation and meta-simulation of PTSD symptoms and claims that "... recognition of PTSD as the basis for indemnity ends can take place no sooner that PTSD symptoms have become stable and no sooner than after one year of treatment--with adequate psychological and pharmacological therapy". Expert practice, however, reveals that applications for war disability pensions with a diagnosis of PTSD mentioned in the application form--are filed by persons who have never been subject to psychiatric treatment before. It often happens that an expert draws up a disability pension form based on one psychiatric consultation. It seems fully justified to state that after half a century, which has passed since the end of the war and occupation, it is impossible to verify the causal nexus between the disorders suffered by the living combatants and the psycho-physiological injuries inflicted upon them many decades ago. Another thesis, suggesting that it would be justified to grant war disability pensions in all such cases, seems to be of discrete character and therefore appears incompatible with the nature of opinioning.

Aged↗
PubMed1980

Optimum radiographic examination for consideration of compensation awards: III. Knee, hand and foot.

In a large Veterans Administration (VA) hospital, a prospective study was undertaken to determine the optimum number of radiographic projections needed to assess applicants for VA compensation for knee, hand, and foot diseases or injury claimed to be service-related. Results show that the final radiographic assessment could be made in all 535 (100%) of the knee examinations using two views (anteroposterior and lateral), all 181 (100%) of the hand examinations using one view (anteroposterior), and all 223 (100%) of the foot examinations using two views (anteroposterior and lateral). Extrapolating these results to data on compensation examinations performed in the entire VA system (fiscal year 1978), it was concluded that limiting the radiographic examinations of the knee, hand, and foot to these views would eliminate 91,000 radiographs in the evaluation of 119,000 applicants and yield an annual savings of about $500,000.

Accidents, Occupational↗
PubMed1980

Optimum radiographic examination for consideration of compensation awards: I. General methodology and application to chest examination.

A major goal of the radiologist is to devise methods to decrease health care costs and radiation exposure without sacrificing diagnostic accuracy. In a large Veterans Administration (VA) hospital, a prospective study was undertaken to determine the optimum number of radiographic projections needed to assess applicants for VA compensation for chest disease or injury claimed to be service-related. Three separate readings of every chest radiographic assessment could have been made from a single posteroanterior view. In eight cases, granulomas or mild hyperexpansion of the lungs were only appreciated using the lateral projection, but these findings were not clinically significant and did not affect decisions as to whether compensation sould be awarded. The only potentially serious lesion missed (a possible pulmonary nodule) using the posteroanterior view alone was also missed using the lateral and only suggested by the oblique views. Extrapolating these results to data on compensation examinations performed in the entire VA system (fiscal year 1978), it was concluded that limiting the radiographic examination of the chest to a single posteroanterior view would eliminate 150,000 radiographs in the evaluation of 190,000 applicants and yield an annual savings of almost $900,000.

Accidents, Occupational↗
PubMed1996

Compensation seeking status and psychometric assessment of combat veterans seeking treatment for PTSD.

Examined differences between compensation seeking (CS) veterans and noncompensation seeking (NCS) veterans on the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and other psychological measures in 142 combat veterans evaluated for posttraumatic stress disorder (PTSD) at an outpatient Veterans Affairs (VA) hospital PTSD clinic. Patients were grouped on the basis of their compensation seeking status, with 69% classified as CS for PTSD. The CS veterans achieved significantly more pathological scores across a wide range of psychological inventories and MMPI-2 validity indices, although they did not differ in frequency of PTSD diagnoses from NCS veterans. Implications of these findings are discussed, and clinicians are advised to be aware of the compensation seeking status of combat-veterans being evaluated for PTSD.

Adult↗
PubMed1975

[About insurance medical evaluation of psychoreactive disturbances (author's transl)].

Results arising from injuries within the valid field of the statutory Accident Insurance and of the Federal Law Governing Pensions and Grants can only be recognized as such and give rise to financial compensations if bodily or psychic damages within the legally protected Risk Area are made "probable", and if a connexion between these injuries and the unbiased finding of the actual health disorders prove to be "substantial". The assessment of the damage must bear in mind the individual conditions of the victims. Symptomatology, differential diagnosis and medical insurance estimation of the "neurosis in the true sense", of the personality alteration brought about by selfexperienced hardships (concentration camp neurosis) and the psychogenic breeding of symptoms with a final view to having an ailment recognized, are discussed with a special bearing on the phenomenons which cause the will to express itself.

Concentration Camps↗
PubMed2007

Factors associated with receipt of pension and compensation benefits for homeless veterans in the VBA/VHA Homeless Outreach Initiative.

Public support payments may facilitate exit from homelessness for persons with mental illness. We examined data from 10,641 homeless veterans contacted from October 1, 1995 to September 30, 2002 in a collaborative outreach program designed to facilitate access to Department of Veterans Affairs (VA) disability benefits. Those who were awarded benefits (22% of contacted veterans) were more likely to report disability, poor to fair self-rated health, and were more likely to have used VA services in the past. Thus, this program achieved only modest success and was most successful with veterans who were already receiving VA services and who might have received benefits even without the outreach effort.

Adult↗
PubMed1983

The effects of compensation on psychiatric disability.

Psychiatrically impaired veterans who were receiving 100%, partial or no compensation for their psychiatric disabilities were compared on type and level of psychopathology, self-esteem, locus of control and treatment utilization. All groups were highly elevated on measures on measures of psychopathology. There were no differences between groups on psychopathology measures, except that the 100% group scored significantly higher than the uncompensated group on hostility. Differences in locus of control were not found. On 3 of 10 subscales, partially compensated patients reported higher levels of self-esteem than patients in one or both of the other groups. Uncompensated patients required the most hospitalization. Those who were receiving 100% disability compensation required less hospitalization and the number of days they spent in the hospital was significantly reduced following attainment of full compensation.

Adult↗