Afghanistan War veteran Jason Kander was once a rising star in the Democrat party. Today, he is trying to control his debilitating Post Traumatic Stress Disorder.
Kander said he had not had a full night’s sleep in about a dozen years. Instead, his heightened awareness woke him up at night and he silently patrolled his house, convinced that someone was about to break in. Kander remarked that he was “exhausted all the time from just constantly being on edge.” The issue was not just an internal one. The former Afghanistan intelligence officer also looked down on other people who, according to him, did not “understand how dangerous the world is.” Extensive physical therapy has helped immensely. Kander’s improvements include sitting with his back to the door for almost a half-hour and getting a full night’s sleep. “I think I’m more fun to live with, that’s for sure,” he concluded.
After being elected to the Missouri House of Representatives, the people made Kander Secretary of State in 2012. Four years later, his strong showing against Republican incumbent Senator Roy Blount had many people talking about a 2020 Presidential run.
Despite its long history, Post Traumatic Stress Disorder is one of the most misunderstood combat injuries. During the American Civil War, doctors often diagnosed PTSD victims with nostalgia, or an extreme form of homesickness. According to physicians, if nostalgia patients saw more active combat, symptoms like depression and sleeplessness would disappear. Unbeknownst to these professionals, extreme combat operations probably caused these symptoms in the first place.
In World War I and World War II, doctors often took the opposite approach with regard to shell shock (WWI) and battle fatigue (WWII) PTSD victims. In the early 20th century, most doctors believed that a brief respite from the front, preferably at the victim’s home, would cure the problem.
Today, doctors understand that PTSD is not a processing disorder which randomly affects certain people. Instead, PTSD is much like any other combat-related brain injury. The physical nature of PTSD is important because the Defense Base Act only provides compensation for physical injuries.
Post-explosion shock waves cause many combat-related Traumatic Brain Injuries. The sudden loud noise creates a biological electromagnetic pulse which disrupts brain functions. So, even if a victim is a block away from an IED or other explosion, a brain injury is likely.
Post Traumatic Stress Disorder is a narrower injury. Exposure to combat stress shrinks the cerebral cortex. This part of the brain controls logical thoughts and responses. When the cerebral cortex shrinks, the amygdala becomes too large. This part of the brain controls emotional responses. This imbalance explains PTSD symptoms like:
- Heightened awareness,
- Sleeplessness, and
- Random outrage.
Many practitioners use the horse-and-rider analogy. The amygdala is the horse, and the cerebral cortex is the rider. As long as the rider remains in control of the horse, everything is fine, but if the rider’s grip on the reins slackens even a little, the horse may run wild.
Dealing with PTSD
Like other types of brain injuries, PTSD is permanent. Once brain cells die in the cerebral cortex or anywhere else, they never regenerate. So, brain injury victims never get “better” from a strictly medical standpoint.
Extensive physical therapy can ease the aforementioned symptoms. Afterward, though PTSD victims will never be cured, they can lead somewhat normal lives.
Brain injury physical therapy is nothing like other kinds of physical therapy. When people break their bones, physical therapists mist simply strengthen the surrounding muscles. Most people make fairly steady progress in terms of things like range of motion and lifting ability.
However, a brain injury physical therapist must teach uninjured parts of the brain to assume lost function. Nothing can duplicate the cerebral cortex, but there are other areas of the brain that can control the amygdala.
Breakthroughs are common in this area. For example, a Minnesota company just developed a way to help ease PTSD nightmares. A SmartWatch app monitors brain activity, and when it spikes, the app sends a digital signal to the brain which ends the nightmare but does not wake the person.
So, progress sometimes comes in fits and starts. After several weeks of little or no improvement, many patients and therapists get frustrated and many insurance companies try to cut off physical therapy funding.
A DBA attorney is critical in these situations. The Defense Base Act lets victims choose their own doctors and therapists. Sometimes, a new therapist-patient combination is all it takes. Additionally, Defense Base Act lawyers fight to keep the money flowing. According to research, the longer people stay in PTSD physical therapy, the better the results. It is not a matter of milestones.
Injury Compensation Available
To receive money for both medical bills and lost wages, injured overseas contractors must file claims under the Defense Base Act. These claims can settle out of court at any time, and in many cases, that is what happens. Nevertheless, they all follow the same basic procedure.
Step one is reporting your injury to a supervisor. That is not always easy to do in PTSD situations. Most contractors do not run to the doctor after their first nightmare or bout with depression. In fact, most former contractors have a very high tolerance for these things, so they often do not seek help straight-away.
The discovery rule usually applies in these situations. Victims need not report their injuries until they know, or should know, what the problem is and they connect that problem to a service-related incident.
A short time thereafter, there may be an oddly-named thing called a “settlement conference.” At this meeting, a DBA overseer tries to facilitate a settlement between the victim and insurance company. At this early phase, this conference often does not produce results. But there are exceptions, and since an early settlement is usually in everyone’s best interests, your DBA attorney always negotiates in good faith at these settlement conferences.
Next, a DBA lawyer can present your claim for damages to an administrative law judge. At this trial-like hearing, lawyers can introduce evidence, challenge the other side’s evidence, and make legal arguments. Therefore, there is a very good chance that the ALJ will resolve your claim on favorable terms.
For more information about Defense Base Act eligibility, contact Barnett, Lerner, Karsen, Frankel & Castro, P.A.