TOPEKA — For Dan Bartlett, some weeks are better than others. Last week wasn’t good.

“We lost one,” he said, referring to the death of a middle-age military veteran. “We’d worked with him and his family a lot. We did everything we could. But things just got to the point where he couldn’t take it anymore.”

Bartlett, 60, is the American Legion’s service representative at the U.S. Department of Veteran Affairs hospital in Topeka. For the past 18 years, he’s helped veterans and their dependents apply for benefits.

“It’s a very, very complicated process,” he said.

Bartlett and his assistant, Tanya Hayes, are experts at helping veterans and their families navigate the bureaucracy when they seek help dealing with Post-Traumatic Stress Disorder or PTSD.

“We (the public)hear a lot about the veterans. We don’t hear so much about their families,” Bartlett said. “But I have to tell you, the phone calls that get to me the most are when mamas call here and say, ‘Can you save my son?’”

New rules

The VA last week adopted a new rule that Bartlett and others said should make it easier for veterans to receive benefits and medical care for PTSD.

The new rule will require less evidence from a non-combat veteran that the trauma they experienced was related to hostile military activity. The claim can now be accepted based on fear of military or terrorist activity, if the veteran was deployed in a war zone.

VA officials said they expect the new rule will reduce the time it takes for the agency to decide claims, which will expedite access to medical care and other benefits.

“This is something we’ve fought for for years,” Bartlett said.

PTSD is a medically recognized anxiety disorder that can develop from seeing or experiencing an event that involves actual or threatened death or serious injury to which a person responds with intense fear, helplessness or horror. It is not uncommon among those who have experienced war or other similarly terrifying circumstances.

In recent years, Bartlett said, it’s not been unusual for military support personnel – truck drivers, for example – to be denied PTSD benefits because they weren’t considered to have seen combat even though they were in comparable danger.

“If you’re an equipment operator and you’re driving up and down the road every day (in Iraq) you may be in fear for your life, wondering if you’re going to be the next one killed, if you’re ever going to get back home again, if you’ll ever see your family again. This goes on day in, day out. We call it the white- knuckle syndrome,” he said.

Opening some doors

Bartlett said he expected the new rules will prompt more veterans to apply or re-apply for benefits.

“It’s going to open some doors,” he said. “I think we’re going to have a lot more individuals come in.”

The benefits – monthly checks and access to health care, primarily – are key factors in helping veterans put their lives back together.

“But you’re still going to have to prove the circumstances that caused the PTSD,” Bartlett said, noting that his office helps veterans assemble the necessary paperwork.

Other groups including Disabled American Veterans and Veterans of Foreign Wars offer similar services.

Intrusive thoughts

Shawn Martin, team leader at The Vet Center in Manhattan, welcomed news of the regulatory change.

“This is very good for veterans,” he said. “It really simplifies the process for PTSD. Before, the process tended to minimize being in a combat zone, but, really, if you’re in a convoy and your truck gets hit by an IED (improvised explosive device), you’re going to be affected. But that wasn’t considered combat because nobody was shooting at you and you weren’t shooting at anybody.”

There’s little doubt, Martin said, that being in a combat zone – rather than actual combat – can result in stress disorders.

“We have several people who come here on a daily basis for PTSD counseling,” he said. “I’d say about half of them were in combat, half of them were in a combat zone.”

Most have what are called intrusive thoughts.

“That’s when you don’t want to think about something, but you can’t get it out of your mind. It keeps coming back. It’s distressful,” Martin said. “Usually, it’s because you’ve seen someone lose their life.”

Other symptoms, he said, include irritability, hyper vigilance, emotional numbness, loss of interest in family, friends and activities once enjoyed, trouble falling or staying asleep, and an inability to concentrate.

“PTSD puts a lot of chaos in a person’s life,” said Dr. John Pope, associate chief of staff for behavioral health at the Robert J. Dole VA Medical Center in Wichita. “I’ve had PTSD patients who’ve had five or six marriages. It’s very difficult for them to deal with anyone in a close interpersonal manner and I believe that arises from having lost close friends (in war) and they don’t want to get back into a close relationship because it’s so difficult to lose. It’s like they put up an emotional shield.”

Common diagnosis

Pope said PTSD patients account for two-thirds of his caseload.

“It’s the most common diagnosis we see in the VA’s mental health clinics,” he said.

Pope said he expected the policy change to help veterans who’ve in the past not been able to meet the criteria for help.

“It’s going to make it easier for the veteran whose field commanders did not keep good records,” he said. “I’ve been with the VA for 20 years. I’ve looked at a lot of records and it’s clear to me there’s been some poor documentation, especially during Vietnam.”

But Pope said he wasn’t sure the change in regulations would cause a spike in benefit applications or in the hospitals’ PTSD caseloads.

“The thing you have to remember is the change applies to the benefit side of things. It’s not going to change things on the medical side,” he said. “We see a lot of veterans for PTSD now who never apply for benefits.

“Most military people don’t want to be seen as disabled in any way,” he said. “Now, if they lose their job or their insurance or there’s some kind of financial cataclysm, they may have to (apply for benefits), but as a whole, veterans tend to be very independent.”