Review of Combat Stress in Women Veterans Receiving VA Health Care and Disability Benefits

As directed by the Conference Report to Accompany the Consolidated Appropriations Act of 2010 (Public Law 111-117), we conducted a review to assess the Department of Veterans Affairs’ (VA) capacity to address combat stress in women veterans. We assessed women veterans use of VA health care for traumatic brain injury (TBI), post­ traumatic stress disorder (PTSD), and other mental health conditions, and whether the Veterans Benefits Administration (VBA) properly adjudicated women veterans’ disability claims for these conditions. We also assessed whether VBA developed and disseminated military sexual trauma (MST) training and reference materials and policies to claims processors and the feasibility of requiring MST training and testing as part of VBA’s claims processor certification. 
To conduct this review, we analyzed integrated data from VA and the Department of Defense (DoD) for almost 500,000 male and female veterans who separated from the military from July 1, 2005, to September 30, 2006 for their experience transitioning to  VA and using VA healthcare and compensation benefits through March 31, 2010. Nearly half of these veterans served in Operation Enduring Freedom (OEF) or Operation Iraqi Freedom (OIF) before their separation. Using integrated data from VA and DoD, we described veterans’ experience transitioning to VA and using VA health care and their compensation benefits through March 31, 2010. 
We interviewed VA officials and reviewed relevant policies and procedures. We interviewed experts in VA, DoD, and academia who conduct research on combat injuries and spoke with representatives from veterans service organizations and women veterans’ groups. We reviewed a random statistical sample of about 750 veterans’ claims files—to examine VBA’s disability award and denial decisions—and conducted site visits at 4 VBA regional offices. We also conducted a national survey of VBA’s local Women Veterans Coordinators.