8 ms·

Not unlikely. My alternate hypothesis is disability compensation inflation. There is a LOT of this in the military. 100% VA disability is ~$4,000/mo (increas

Not unlikely. My alternate hypothesis is disability compensation inflation. There is a LOT of this in the military. 100% VA disability is ~$4,000/mo (increasing every year) for the rest of your life. That is more than a typical enlisted retirement pension. And there are a handful of unfalsifiable conditions that will take you straight to 100% - PTSD (for any reason, not just combat), MST ('military sexual trauma'), and a variety of "oh my back or knees hurt, but there's nothing amiss on the MRI" type claims. There are a lot of perfectly healthy people out there receiving 100% VA disability because they just had the inclination to play the system.

rowanG077 4y ago
I don't really know how it works in the US but I would assume some medical professional will have to give you a diagnosis.
- Eleison23 4y ago
  Haha, are you familiar with the way diagnosis is obtained for "mental disorders", such as bipolar disorder, ADHD, PTSD? There are no clinical scans, blood tests, there is no way to rule out these conditions. They are not illnesses but they are clusters of symptoms that have been labeled so as to medicate or "treat" them without promising cures or healing. Therefore all you need to do is convince a few psychiatric clinicians that your mental processes and behaviors are sufficiently non-standard and boom, you've got a mental illness that will never be cured, never be healed, and makes you a highly-valuable repeat customer up to and beyond the hour of your death. And that's how you get 100% VA disability. Congratulations!
  - spamuel 4y ago
    lol, someone gets it.
  - rowanG077 4y ago
    I really doubt it's that easy. These are professionals who have studied for thousands of hours. I don't doubt there are cases were someone who isn't actually ill slips through but I doubt it would be more then a few percent.
    - Calavar 4y ago
      You're right, it's not that easy. I worked in the VA system for three years during residency, and it was relatively rare to see a veteran who was considered 100% service connected. I had a patient who was exposed to Agent Orange and later developed Hodgkin lymphoma, and while the cancer was treated successfully, the surgery and radiation left him with permanent disabilities that impaired his day to day life. Even he was not determined to be 100% service connected. (He came close - something like 80% if I remember correctly - but not 100%.) I personally never saw someone who was determined to be 100% service connected purely for PTSD, but I am also not a psychiatrist so it's possible that there is a selection bias there.
    - ZeroGravitas 4y ago
      And even if they did slip through at a higher rate. The answer wouldn't be to make it abitrarily harder to claim, because real people with real issues would inevitably be hurt. If the system had 0% fraud rates, then it kind of implies that many real people have been denied because they failed to jump through the hoops.
    - PicassoCTs 4y ago
      These professionals are trained in the halls that brought us the biggest replication crisis ever. And we have collected data on humanity for 20 years in Google and FB. If science goes were the data is, the true neuro-science/psychology today is proprietary and sold in chunks as a service to governments. Might aswell ask Palantir directly about what humanity is really like without the grand illusions of a surplus of resources spend on postponing the eternal crisis that is our home. No need to take Freuds last standing followers serious, just because they perpetuate a "Can-do-fix-all-things" illusion, we cling to while drowning in the things we can't fix.
  - jprd 4y ago
    I'm sure "Mental Disorders" was probably not meant to denigrate the giant chunk of humanity that does suffer from such disorders, especially not those in the military that are probably most at risk? Particularly because the US military is volunteer based and mostly recruits from disadvantaged citizens? Also, if this is a legit shadow practice in the US military, the issue isn't people claiming disability, but our collective lack for caring for them.
    - pessimizer 4y ago
      > I'm sure "Mental Disorders" was probably not meant to denigrate the giant chunk of humanity that does suffer from such disorders The suffering that they have is real, whether or not we debate the appropriateness or usefulness of the labels that have been placed on that suffering. Attempting to shame people for discussing those labels (even extremely negatively) as if the discussion itself damages the sufferers is darkly ironic, because the suppression of the discussion of that distress will result in a failure to improve the treatment of that distress. ----- edit: I do understand the sentiment, but it's one that has long been cultivated through patients' groups that are founded and funded by pharmaceutical and other medical companies, and push the treatments that their funders push. Their funders are generally deeply invested in the status quo and cast objections to current received wisdom as attacks on the sick, unless they're trying to push a new drug, which is when they push change. A patients' group can atrophy into an organization with no members, a single funding source, and a lawyer who spends an hour writing a press release every few months, and hires someone to update the website once a year.
  - rightbyte 4y ago
    I worked as a substitute teacher for a Asberger and Autism class. Half of them seemed to be there because they played Magic the Gathering. And the other half had obvious clinical difficulties with interactions. I was quite perplexed by the width of severity of who was eligible for the class. There was certainly a overprescription of needing to go in that class -- or maybe the diagnosis itself.
- sigmoid10 4y ago
  These doctors will have a really hard time proving that someone doesn't have PTSD or something similar. It's already hard enough to diagnose all the legit cases.
- CSMastermind 4y ago
  Yes, but again there are some conditions that are unverifiable or for which they don't verify. For instance, if you have erectile dysfunction then it's a 10% disability claim. They take you at your word, no "proof" needed. Same with 10% for tinnitus (ringing of the ears). For PTSD there is a screening process but if you were verifiably in combat, something that less than 5% of the military ever experienced even when the wars were actively going on, then the screening consists of a single session talking to a psychiatrist. It's known in the community what you need to say and do during that interview to get 100% rated. Similar with you're a woman who claims you were sexually assaulted during your service. Basically, the only hurdle is you being willing to lie. For chronic pain claims the process is more drawn out but essentially if you're willing to persistently lie then you can get a 100% rating. It will take a year or two of going to doctors' appointments and insisting that you're in pain regardless of what tests they run who but eventually you'll get a diagnosis of some unknown condition with a 100% rating. I've never done this, but I know a few people who have to varying degrees of legitimacy. For what it's worth the 100% claims I've seen are far closer to exaggeration than outright fabrication. Someone who probably actually should be 60% rated or whatever working the system to get up to 100%. You hear stories out people completely faking it but I don't know them personally. That could just be my cohort though, I was in the Marine Corps Infantry on combat deployments during my time do pretty much everyone I know has something legit wrong with them. And I will say the VA is an absolute nightmare. I feel some incredibly blessed to have a software career where I don't need to rely on the VA. I've never seen a better argument against socialized medicine in the US than just experiencing the VA firsthand.
  - wpietri 4y ago
    If they start verifying these claims, I think we'd have a strong candidate for worst job in the world: > if you have erectile dysfunction then it's a 10% disability claim. They take you at your word, no "proof" needed.
    - dendrite9 4y ago
      There was an ig nobel prize awarded for using stamps as an overnight test for erectile dysfunction. A stamp technique was developed to detect complete nocturnal erections for the evaluation of impotence. The test correctly detected complete nocturnal erections in 22 potent men and absence of complete nocturnal erections in 11 impotent men (P value under 0.001). This is a simple, useful screening test for organic impotence. https://www.goldjournal.net/article/0090-4295(80)90414-8/ https://www.goldjournal.net/article/0090-4295(80)90414-8/
- pessimizer 4y ago
  I bet it's pretty easy to get a diagnosis for a made-up syndrome caused by secret superspies using alien weapons, one that has no particular symptoms other than a general distress, and no particular physical indications of suffering. edit: and getting a diagnosis for something real is probably a lot harder.
daniel-cussen 4y ago
Haha, you know I know a lawyer tell me the monthly payments to victims of torture was 10x what another human rights lawyer said, $2000 / mo vs $200 / mo. Yeah play the system. You know who else plays the system? Bosses insisting above 7 objections and ways out to perform repetitive strain injury with my back in order for me to have an injury that can't or won't ever be corroborated "by a medical professional". And get me to spend the rest of my life with backpain over $3 of labor, begging dogshit after dogshit to please believe me and diagnose my injury. That's playing the system.
azinman2 4y ago
This unbelievably cynical. I don’t buy it.
- jjeaff 4y ago
  Same. Are they faking the abnormally high rates of suicide too?
- origin_path 4y ago
  Why not? Disability benefits always have this problem. The UK did a massive effort some years ago where everyone claiming disability was re-reviewed, because there had been a constant run of stories in the press and complaints to MPs about people claiming it fraudulently. There were people who were claiming they couldn't leave the house who were caught going on foreign vacations, people who were acting like they couldn't walk who were caught on CCTV outside the assessment center walking perfectly healthily and so on. Where there's free money, there will be people who find ways to get it. Was ever thus.
  - azinman2 4y ago
    What you’re describing is just generic fraud, and is expected to be uniformly distributed. Thus you’d expect to see it across the CIA at random and not in a big non-uniform lump with people spending time in Cuba all reporting similar conditions. Then you also have the fact that damage to their vestibular system can be seen.
    - origin_path 4y ago
      Yes, agreed, in this particular case it sounds a bit odd to be fraud. I'm just pointing out that the belief in disability benefits fraud in general isn't unbelievably cynical, it's pretty rational. In this case maybe it's offset by specific details of the cases.
  - _HMCB_ 4y ago
    “Why not?” (!)
  - 4y ago
neilv 4y ago
What if you're mistaken with these 2 theories? Someone (a doctor, so an especially credible reporter) is claiming a miserable, debilitating medical condition. For the sake of the scenario, let's assume the doctor is correct. With that assumption, if they're being told that they're probably either imagining it or lying, isn't that adding insult to injury? And maybe slowing down whatever help they could get with the condition?
- fhsm 4y ago
  That seems like an overly pessimistic valance to bring to the hypothetical conversation about the factual possibilities which obviously include fictitious disorder, somatization, or, yes perhaps but not necessarily, malingering.
2-718-281-828 4y ago
Same for Long Covid - both regarding mass psychosis as well as an easy way out into disability compensation.
citizenpaul 4y ago
Reminds me about Japan and their supposed superior aging. Though the general population believes Japaneses people live longer, turns out its probably not true. In the early 2010s there was some effort to find out why Japanese people live to 100+ more often. When researchers went to find these centurions...whoops most of them don't exist anymore and died 20+ years ago. Turns out that Japan is very lax in checking its social security payouts. They were finding a huge numbers of these people were simply never reported dead and the families kept on cashing the checks that came every month.
MarkMarine 4y ago
That is a remarkable take on disabled vets, when you see 15 year long fights to get covered for brain damage received in combat due to IEDs, but there are no visible wounds. Cancers and breathing problems from burn pits. Untreated mental illness leading to a much higher rate of suicide and alcoholism than the rest of the population. But I guess we should go after those disability queens right? Screw the warfighters who signed up to take incoming rounds for the promise of a dodge charger and a communications degree. I love that you scoff at PTSD being a mention it and get 100% condition. You must be smoking the good stuff.
- spamuel 4y ago
  I'm explicitly talking about the people getting VA disability for things they're making up or exaggerating. I think I was very clear about that. I am a combat veteran, and I think it's ridiculous that the guy who was such a behavior issue that we wouldn't let him off the FOB now pulls in $4k/mo for his "PTSD" from making sure the MREs were accounted for.
- neilv 4y ago
  (I agree with your points, and gentle reminder on HN's conventions of discourse: https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html ) IMHO, many disabled veterans not getting all the help they need, which the US could muster, seems to be a real and unconscionable problem. As well as there being tragedies of veterans who the US can't help enough. (Recently including a friend of a friend, who died young, believed due to burn pits.) This context is another reason we should be careful about vocal speculation of benefits/aid fraud. Dismissive-sounding talk risks making a terrible situation even worse, for many genuinely injured people.
  - MarkMarine 4y ago
    I am not sure which HN discourse bullet you were referring me to, but if it’s not being snarky… fair. I’m only snarky about this to avoid just losing my cool, to hear someone talk about disabled vets like some kind of freeloading liars, just sucking off the system drives me up the wall. I can’t imagine a more evil and cynical way to talk about people who were willing to lay down their lives so people on here can live a cushy existence, in the peak of empire, wrapped in the warm blanket of safety and security that our overwhelming military force provides these “titans of industry.” This statement I responded to casts doubt on every PTSD or sexual assault claim made, ignoring the difficulty in making these, glossing over the idea that going to a foreign country and killing people, watching your friends die and be dismembered, or being assaulted by people that you were supposed to trust with your life, has on someone’s mental health. I find it maximally disgusting, and I stand by what I said.

rowanG077 4y ago

I don't really know how it works in the US but I would assume some medical professional will have to give you a diagnosis.

Eleison23 4y ago
Haha, are you familiar with the way diagnosis is obtained for "mental disorders", such as bipolar disorder, ADHD, PTSD? There are no clinical scans, blood tests, there is no way to rule out these conditions. They are not illnesses but they are clusters of symptoms that have been labeled so as to medicate or "treat" them without promising cures or healing. Therefore all you need to do is convince a few psychiatric clinicians that your mental processes and behaviors are sufficiently non-standard and boom, you've got a mental illness that will never be cured, never be healed, and makes you a highly-valuable repeat customer up to and beyond the hour of your death. And that's how you get 100% VA disability. Congratulations!
- spamuel 4y ago
  lol, someone gets it.
- rowanG077 4y ago
  I really doubt it's that easy. These are professionals who have studied for thousands of hours. I don't doubt there are cases were someone who isn't actually ill slips through but I doubt it would be more then a few percent.
  - Calavar 4y ago
    You're right, it's not that easy. I worked in the VA system for three years during residency, and it was relatively rare to see a veteran who was considered 100% service connected. I had a patient who was exposed to Agent Orange and later developed Hodgkin lymphoma, and while the cancer was treated successfully, the surgery and radiation left him with permanent disabilities that impaired his day to day life. Even he was not determined to be 100% service connected. (He came close - something like 80% if I remember correctly - but not 100%.) I personally never saw someone who was determined to be 100% service connected purely for PTSD, but I am also not a psychiatrist so it's possible that there is a selection bias there.
  - ZeroGravitas 4y ago
    And even if they did slip through at a higher rate. The answer wouldn't be to make it abitrarily harder to claim, because real people with real issues would inevitably be hurt. If the system had 0% fraud rates, then it kind of implies that many real people have been denied because they failed to jump through the hoops.
  - PicassoCTs 4y ago
    These professionals are trained in the halls that brought us the biggest replication crisis ever. And we have collected data on humanity for 20 years in Google and FB. If science goes were the data is, the true neuro-science/psychology today is proprietary and sold in chunks as a service to governments. Might aswell ask Palantir directly about what humanity is really like without the grand illusions of a surplus of resources spend on postponing the eternal crisis that is our home. No need to take Freuds last standing followers serious, just because they perpetuate a "Can-do-fix-all-things" illusion, we cling to while drowning in the things we can't fix.
- jprd 4y ago
  I'm sure "Mental Disorders" was probably not meant to denigrate the giant chunk of humanity that does suffer from such disorders, especially not those in the military that are probably most at risk? Particularly because the US military is volunteer based and mostly recruits from disadvantaged citizens? Also, if this is a legit shadow practice in the US military, the issue isn't people claiming disability, but our collective lack for caring for them.
  - pessimizer 4y ago
    > I'm sure "Mental Disorders" was probably not meant to denigrate the giant chunk of humanity that does suffer from such disorders The suffering that they have is real, whether or not we debate the appropriateness or usefulness of the labels that have been placed on that suffering. Attempting to shame people for discussing those labels (even extremely negatively) as if the discussion itself damages the sufferers is darkly ironic, because the suppression of the discussion of that distress will result in a failure to improve the treatment of that distress. ----- edit: I do understand the sentiment, but it's one that has long been cultivated through patients' groups that are founded and funded by pharmaceutical and other medical companies, and push the treatments that their funders push. Their funders are generally deeply invested in the status quo and cast objections to current received wisdom as attacks on the sick, unless they're trying to push a new drug, which is when they push change. A patients' group can atrophy into an organization with no members, a single funding source, and a lawyer who spends an hour writing a press release every few months, and hires someone to update the website once a year.
- rightbyte 4y ago
  I worked as a substitute teacher for a Asberger and Autism class. Half of them seemed to be there because they played Magic the Gathering. And the other half had obvious clinical difficulties with interactions. I was quite perplexed by the width of severity of who was eligible for the class. There was certainly a overprescription of needing to go in that class -- or maybe the diagnosis itself.
sigmoid10 4y ago
These doctors will have a really hard time proving that someone doesn't have PTSD or something similar. It's already hard enough to diagnose all the legit cases.
CSMastermind 4y ago
Yes, but again there are some conditions that are unverifiable or for which they don't verify. For instance, if you have erectile dysfunction then it's a 10% disability claim. They take you at your word, no "proof" needed. Same with 10% for tinnitus (ringing of the ears). For PTSD there is a screening process but if you were verifiably in combat, something that less than 5% of the military ever experienced even when the wars were actively going on, then the screening consists of a single session talking to a psychiatrist. It's known in the community what you need to say and do during that interview to get 100% rated. Similar with you're a woman who claims you were sexually assaulted during your service. Basically, the only hurdle is you being willing to lie. For chronic pain claims the process is more drawn out but essentially if you're willing to persistently lie then you can get a 100% rating. It will take a year or two of going to doctors' appointments and insisting that you're in pain regardless of what tests they run who but eventually you'll get a diagnosis of some unknown condition with a 100% rating. I've never done this, but I know a few people who have to varying degrees of legitimacy. For what it's worth the 100% claims I've seen are far closer to exaggeration than outright fabrication. Someone who probably actually should be 60% rated or whatever working the system to get up to 100%. You hear stories out people completely faking it but I don't know them personally. That could just be my cohort though, I was in the Marine Corps Infantry on combat deployments during my time do pretty much everyone I know has something legit wrong with them. And I will say the VA is an absolute nightmare. I feel some incredibly blessed to have a software career where I don't need to rely on the VA. I've never seen a better argument against socialized medicine in the US than just experiencing the VA firsthand.
- wpietri 4y ago
  If they start verifying these claims, I think we'd have a strong candidate for worst job in the world: > if you have erectile dysfunction then it's a 10% disability claim. They take you at your word, no "proof" needed.
  - dendrite9 4y ago
    There was an ig nobel prize awarded for using stamps as an overnight test for erectile dysfunction. A stamp technique was developed to detect complete nocturnal erections for the evaluation of impotence. The test correctly detected complete nocturnal erections in 22 potent men and absence of complete nocturnal erections in 11 impotent men (P value under 0.001). This is a simple, useful screening test for organic impotence. https://www.goldjournal.net/article/0090-4295(80)90414-8/ https://www.goldjournal.net/article/0090-4295(80)90414-8/
pessimizer 4y ago
I bet it's pretty easy to get a diagnosis for a made-up syndrome caused by secret superspies using alien weapons, one that has no particular symptoms other than a general distress, and no particular physical indications of suffering. edit: and getting a diagnosis for something real is probably a lot harder.

daniel-cussen 4y ago

Haha, you know I know a lawyer tell me the monthly payments to victims of torture was 10x what another human rights lawyer said, $2000 / mo vs $200 / mo. Yeah play the system. You know who else plays the system? Bosses insisting above 7 objections and ways out to perform repetitive strain injury with my back in order for me to have an injury that can't or won't ever be corroborated "by a medical professional". And get me to spend the rest of my life with backpain over $3 of labor, begging dogshit after dogshit to please believe me and diagnose my injury. That's playing the system.

azinman2 4y ago

This unbelievably cynical. I don’t buy it.

jjeaff 4y ago
Same. Are they faking the abnormally high rates of suicide too?
origin_path 4y ago
Why not? Disability benefits always have this problem. The UK did a massive effort some years ago where everyone claiming disability was re-reviewed, because there had been a constant run of stories in the press and complaints to MPs about people claiming it fraudulently. There were people who were claiming they couldn't leave the house who were caught going on foreign vacations, people who were acting like they couldn't walk who were caught on CCTV outside the assessment center walking perfectly healthily and so on. Where there's free money, there will be people who find ways to get it. Was ever thus.
- azinman2 4y ago
  What you’re describing is just generic fraud, and is expected to be uniformly distributed. Thus you’d expect to see it across the CIA at random and not in a big non-uniform lump with people spending time in Cuba all reporting similar conditions. Then you also have the fact that damage to their vestibular system can be seen.
  - origin_path 4y ago
    Yes, agreed, in this particular case it sounds a bit odd to be fraud. I'm just pointing out that the belief in disability benefits fraud in general isn't unbelievably cynical, it's pretty rational. In this case maybe it's offset by specific details of the cases.
- _HMCB_ 4y ago
  “Why not?” (!)
- 4y ago

neilv 4y ago

What if you're mistaken with these 2 theories? Someone (a doctor, so an especially credible reporter) is claiming a miserable, debilitating medical condition. For the sake of the scenario, let's assume the doctor is correct. With that assumption, if they're being told that they're probably either imagining it or lying, isn't that adding insult to injury? And maybe slowing down whatever help they could get with the condition?

fhsm 4y ago
That seems like an overly pessimistic valance to bring to the hypothetical conversation about the factual possibilities which obviously include fictitious disorder, somatization, or, yes perhaps but not necessarily, malingering.

2-718-281-828 4y ago

Same for Long Covid - both regarding mass psychosis as well as an easy way out into disability compensation.

citizenpaul 4y ago

Reminds me about Japan and their supposed superior aging. Though the general population believes Japaneses people live longer, turns out its probably not true. In the early 2010s there was some effort to find out why Japanese people live to 100+ more often. When researchers went to find these centurions...whoops most of them don't exist anymore and died 20+ years ago. Turns out that Japan is very lax in checking its social security payouts. They were finding a huge numbers of these people were simply never reported dead and the families kept on cashing the checks that came every month.

MarkMarine 4y ago

That is a remarkable take on disabled vets, when you see 15 year long fights to get covered for brain damage received in combat due to IEDs, but there are no visible wounds. Cancers and breathing problems from burn pits. Untreated mental illness leading to a much higher rate of suicide and alcoholism than the rest of the population. But I guess we should go after those disability queens right? Screw the warfighters who signed up to take incoming rounds for the promise of a dodge charger and a communications degree. I love that you scoff at PTSD being a mention it and get 100% condition. You must be smoking the good stuff.

spamuel 4y ago
I'm explicitly talking about the people getting VA disability for things they're making up or exaggerating. I think I was very clear about that. I am a combat veteran, and I think it's ridiculous that the guy who was such a behavior issue that we wouldn't let him off the FOB now pulls in $4k/mo for his "PTSD" from making sure the MREs were accounted for.
neilv 4y ago
(I agree with your points, and gentle reminder on HN's conventions of discourse: https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html ) IMHO, many disabled veterans not getting all the help they need, which the US could muster, seems to be a real and unconscionable problem. As well as there being tragedies of veterans who the US can't help enough. (Recently including a friend of a friend, who died young, believed due to burn pits.) This context is another reason we should be careful about vocal speculation of benefits/aid fraud. Dismissive-sounding talk risks making a terrible situation even worse, for many genuinely injured people.
- MarkMarine 4y ago
  I am not sure which HN discourse bullet you were referring me to, but if it’s not being snarky… fair. I’m only snarky about this to avoid just losing my cool, to hear someone talk about disabled vets like some kind of freeloading liars, just sucking off the system drives me up the wall. I can’t imagine a more evil and cynical way to talk about people who were willing to lay down their lives so people on here can live a cushy existence, in the peak of empire, wrapped in the warm blanket of safety and security that our overwhelming military force provides these “titans of industry.” This statement I responded to casts doubt on every PTSD or sexual assault claim made, ignoring the difficulty in making these, glossing over the idea that going to a foreign country and killing people, watching your friends die and be dismembered, or being assaulted by people that you were supposed to trust with your life, has on someone’s mental health. I find it maximally disgusting, and I stand by what I said.