ABSTRACT
The chapter looks at PTSD in relation to compensable complaints, an issue that enters into the economic currency of this diagnosis. A striking feature of American discourse on veterans’ benefits is in the special status the armed services member acquires as one who can reasonably make claims on the state. Since it was introduced into the DSM in 1980, the diagnosis of PTSD is increasingly cited in civil and criminal courts, employment cases, and veterans’ compensation and benefits hearings. The chapter shows how this expansion in the use of the diagnosis broadened psychiatry’s role in civil courts as well in veterans’ claims. Looking back on psychiatric expertise in 19th-century cases of railway spine, a forensic forerunner of PTSD, provides historical context for contemporary dilemmas around the role of experts in adjudicating cases and separating the truly ill from “fakers and malingerers.” The cases draw out pressures on evaluators and show how PTSD serves as an institutional defense—one that silences veterans in the course of approving disability claims, narrowing as well public discussion over social welfare and social distribution of responsibility for warfare, rape, and other forms of societally produced harms. The chapter also takes up the gender dynamics of disability claims based on military sexual trauma (MST) and some of the unintended consequences of new laws that rely heavily on clinical testimony.
