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During the troop surge in Iraq, I learned to constantly look for threats, how to distinguish the sharp crack of a shot aimed at me from one headed for an enemy, and the myriad ways explosives can be hidden on the side of the road. I’ve learned that hypervigilance can be the difference between life and death. What I didn’t learn was how to stop it.
Now, I take three psychiatric medications every day and go to therapy every week. It took a lot of work over 15 years, but I’m mostly functional now. I raise my children, go to work and be part of my community. And I am among the nearly 5 million U.S. veterans receiving service-connected disability compensation, of which approximately a quarter have a mental health condition, such as post-traumatic stress disorder, as their primary disability. That compensation is not charity, but compensation for injury suffered in the line of duty, and an acknowledgment that the government has a duty when the service it requires destroys corpses. and lie.
But now, under a new interim rule issued by the US Department of Veterans Affairs, the fact that medication is helping me can also be used to reduce my disability compensation. The rule directs the VA to rate disabilities based on how well veterans function with medication and treatment, rather than the underlying severity of their conditions. Basically, if the pills work, good job staying alive; now proceed without compensation for the inherent handicap.
This problem has, in fact, been attacked very recently. Last year, the Court of Appeals for Veterans Claims ruled Ingram v. Collinscase that reaffirmed a rule first articulated in Jones vs. Shinseki. The court was clear: When the VA’s criteria for treatment do not explicitly mention drug-based improvements as a reason to discontinue disability benefits, the VA must ignore the effects of the drugs and assess the disability as it would exist without treatment. This was not a radical interpretation, but a simple application of the law. Treatment can mask the symptoms, but it doesn’t erase the harm. In response, the new VA rule advocates a blanket policy of only considering the condition as it presents itself under treatment, effectively penalizing veterans like me for doing the work of staying alive.
The consequences of this change are not abstract. Peer-reviewed research and VA data show that disability compensation is directly related to real-life stability for veterans with mental health conditions. A long-term study following veterans who applied for PTSD disability benefits found that those who received benefits experienced significant reductions in PTSD symptoms over a decade compared to veterans who were denied. Those who received compensation were much less likely to experience poverty, with rates of about 15 percent compared to 45 percent among those denied benefits, and their risk of homelessness was nearly half that of denied veterans. Even years later, these differences in socioeconomic stability persisted despite continued deterioration. Compensation doesn’t erase the injury, but it gives veterans the resources to manage and live with it.
I know the stakes personally. The medicine I’m taking doesn’t erase the hurt. When I stopped my medication, the symptoms returned. I found myself back in the dark place where I think I would have been better off if the IED with my name on it that I was always scanning for had gone off and killed me. I’ve buried too many friends whose treatment worked until it didn’t. Their medications stabilized them and therapy helped, but the underlying injury remained. Now they are dead by suicide.
That is why Ingram counted. It recognized that improvement through treatment should not negate evidence of harm. Symptoms managed by medication are still symptoms, and the underlying disability remains. VA’s interim rule rejects this principle, allowing improvement in function to justify denial of disability status.
The moral and legal logic of compensation is clear: it’s not just about a veteran being able to work. It is about recognizing the permanent loss of quality of life that has come as a result of their injuries. For example, in the civil context, when construction workers fall off scaffolding and are unable to walk until they receive surgery and physical therapy, their employers must provide them with workers’ compensation. It doesn’t matter if treatment can bring them back to full function and they can eventually go back to work. The injuries occurred at work and the company must provide compensation. “You break it, you buy it.” But for the Trump administration, despite its spending spree on billionaire tax breaks, military contracts, and increased Immigration and Customs Enforcement that is tearing the country apart, adequately compensating veterans for sacrificing their well-being under government rule is a waste of money we don’t deserve.
The Trump administration’s interim rule fundamentally misunderstands both the law and the human cost of fighting. Improvement does not equal cure, and functioning does not erase evil. VA disability compensation is not a salary. It’s a recognition of veterans’ lives that will never be the same and a resource to help them pick up the pieces. The fact that the symptoms can be controlled with daily maintenance medication is proof that the injury is permanent and serious, not that the medication can just make it go away. The law once recognized this distinction, and basic decency should still be.