The contribution of social disability to the evaluation of mental disability among PTSD veterans

Background: Israeli veterans who claim for recognition of their mental disability and compensation undergo multi-professional assessments including a detailed psychosocial evaluation. Objectives: To conduct a systematic evaluation of the social disabilities of veterans with PTSD; to examine the relationships between the various aspects of their social disability and their PTSD symptom severity, on the one hand, and the ratings they receive from psychiatrists determining their overall disability, on the other hand. Method: The study was conducted on 120 veterans with PTSD, all filing for compensation. Data was collected by means of semi-structured interviews that were carried out by social workers in a joint meeting with the veterans and their spouses and that covered marital, parental and social functioning; from the self-report PTSD questionnaire that the veterans filled out; and from the final disability ratings in the veterans' files. Results: Findings showed a disturbing picture of impaired marital, parental and social functioning of veterans with PTSD. In addition, they indicate that both PTSD severity and the psychiatrists' disability ratings were correlated with only a quarter or so of the veterans' specific social disabilities in the areas studied. Discussion: Several explanations for the pattern of correlations between these two assessments are offered. In addition, we highlight the importance of a sensitive and detailed evaluation of social disability as well as recommending the development of practical guidelines for the determination of disability.