‘Wounding Warriors’ Review: Ready But Not Able A robust disability program, though well-intentioned, creates disincentives to work and harms the veterans it is meant to help. Sally Satel
Consider a tale of two Army veterans. Jeff served two terms as an infantry soldier in Afghanistan, moved home to the Midwest, graduated from college and landed a secure job in a utilities firm. Matt fought alongside Jeff, left the Army at the same time and headed home to North Carolina. By the time he was in his 30s, though, Matt was unemployed and dependent on government checks.
Why did Jeff thrive while Matt lost his civilian footing? The answer, according to Daniel M. Gade, a retired Army lieutenant colonel, and Daniel Huang, a former Wall Street Journal reporter, is the Department of Veterans Affairs—in particular, its robust disability system. “Economists have known for decades that disability insurance benefits create a disincentive to work,” they write in “Wounding Warriors.” “Rather than foster resilience, the VA is responsible for breeding passivity.”
In their compelling exposé, the authors show in detail how a well-intended system can inadvertently lure fragile veterans, step by step, away from the worlds of work and community. The trajectory typically starts just before separation from the service. Soldiers meet with VA representatives who emphasize opportunities to collect disability compensation. Jeff, for one, wanted to “get out and get on” with his life, while Matt took the VA agent’s advice “and filed for every condition he could think of.”
Matt’s career plan had been to secure a coveted job in law enforcement, but the field was highly competitive in his hometown. So he took a job with his dad’s construction company. But the physical toll of the job was too much for the former paratrooper’s knees and back. Deeply depressed, now out of work and living in his parents’ home, Matt tried college but felt overwhelmed. Meanwhile, anxious about his future, he kept applying for, and being granted, higher disability ratings—receiving, eventually, a monthly tax-free check exceeding $3,000. One of his disabilities was listed as posttraumatic stress disorder.
For many partially or fully disabled veterans, PTSD is their primary diagnosis. The condition, marked by extreme hypervigilance, intrusive memories of traumatic events and phobias reminiscent of terrifying war experiences, can be debilitating. But it is also treatable. A psychologist who conducts “compensation and pension” exams for the VA told the authors that, when it comes to PTSD, the agency “has been doing a disservice to millions of veterans by telling them that they’re disabled.”
In Matt’s case, remarkably, even after the VA determined him to be “housebound,” it didn’t mandate treatment. “The natural athlete who had conquered his fear of heights to excel as an airborne soldier,” the authors write, “had become a disabled man one year later.” The VA’s record on treatment in general looks poor: More veterans today, relative to their overall numbers, are compensated for disabilities than ever before in the VA’s history. Under 0.1% of the veterans who receive disability benefits for mental disorders have their benefits reduced over time because their condition has improved.
Of course, some minority of former soldiers are so badly wounded that productive work is impossible. But more often than not, Messrs. Gade and Huang contend, the problem is the VA’s habit of “orienting them away from their capabilities, emphasizing instead their impairments.”
Yes, there are success stories. Molly, for example, a member of the Georgia National Guard, was deployed to Iraq and worked as a combat medic. When she returned to civilian life, she began to suffer crippling anxiety but was able to use VA disability support as a safety net: It caught her when she fell and gave her time to restore her well-being.
But many others are caught in a disability trap. Adding to the problem is the fact that benefits can have a symbolic meaning. According to the psychologist who conducts exams for the VA, many veterans see disability payments as a “formal, belated recognition by the United States government of the individual’s sacrifices.”
Is there a healthier way for veterans to feel their nation’s gratitude and re-experience the purpose and belonging that defined their time in the military? According to Lt. Col. Gade, who doesn’t appear in the first person until his powerfully written epilogue, there is. It would begin, he says, by targeting the precarious transition phase, a time when a vulnerable veteran’s life path is often forged. During that period, the VA should view most mental conditions as temporary, if not normal, “symptoms” of re-entry into civilian life. “Our system must reject the idea that any veteran is unemployable or permanently and ‘totally’ disabled.” he says. And we need to adjust the way benefits are gauged. As things now stand, veterans have an incentive to avoid reporting any improvement in their condition, lest they lose their benefits. Relatedly, treatment for an illness should be linked with the compensation associated with it. “If you don’t get treatment for your PTSD,” Lt. Col. Gade writes. “certainly you have no right to expect the taxpayer to fund its effects.”
As worthy as such reforms may be, they probably won’t be adopted any time soon. Why is change so hard? Resistance comes—as it has for decades—from formidable veterans’ lobbies, bureaucratic inertia and timid politicians. Today the need for change has a special urgency, yet a government program meant to help them is, in fact, making many veterans worse.
Messrs. Gade and Huang state that their goal in writing “Wounding Warriors” was “not to destroy current systems but to shine a light on their inner workings in hopes of finding solutions that are effective and moral for the taxpayer, the citizen, and the veteran.” Mission accomplished.
Dr. Satel is a senior fellow at the American Enterprise Institute and a visiting professor at the Vagelos College of Physicians and Surgeons at Columbia University.
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