Support the Ruth Moore Act Senate Version

I had not previously supported the Ruth Moore Act, for reasons I explained in a prior blog post – A Problem with the Ruth Moore Act on Military Sexual Trauma. But a new Senate version (Ruth Moore Act of 2015 – S.865) of the bill improves the legislation. 

Ruth-Moore

Ruth Moore as a young U.S. Navy recruit

I now support the Ruth Moore Act of 2015 (Senate version), although the Senate can improve the legislation significantly with two additions. The House of Representatives passed their version of the Ruth Moore Act of 2015 (H.R.1607) by voice vote on 27 July 2015. The Senate received the legislation the following day and referred it to the Committee on Veterans’ Affairs where it awaits action. The Senate version is a superior bill two major ways:

  1. S.865 amends a statute (38 U.S.C. 1154), whereas H.R.1607 merely offers a Sense of Congress encouraging the Department of Veterans Affairs (VA) to change their regulations governing adjudication of military sexual assault claims. Under the House bill, the VA would retain discretion regarding the adjudicative process, i.e., they could choose to not change the current regulation (38 C.F.R. § 3.304). On the other hand, a federal agency cannot write regulations inconsistent with laws (statutes) passed by Congress and signed by the President. Thus, the Senate version of the Ruth Moore Act would compel the VA to update its regulations to conform to the statute.
  2. The Senate version strikes an appropriate balance between requiring an evidentiary threshold (standard of proof) for veterans’ disability claims, while at the same time recognizing that contemporaneous reports of sexual assaults, e.g., reports to a commanding officer or to law enforcement, often do not exist for a variety of reasons. The evidentiary threshold to which I refer consists of:
    • Diagnosis of a mental disorder by a mental health professional who opines that the sexual trauma caused the mental disorder;
      • “if consistent with the circumstances, conditions, or hardships of such service;”
      • “together with satisfactory lay or other evidence of such trauma;” and
      • “service-connection of such covered mental health condition may be rebutted by clear and convincing evidence to the contrary.”
        • See the Senate bill (S.865) for the exact language of the proposed addition (subsection c) to Section 1154 of title 38, United States Code.

Both the House and Senate bills improve current regulations by recognizing that sexual trauma can cause other mental disorders, in addition to posttraumatic stress disorder (PTSD).  Each bill contains this provision:

The term `covered mental health condition’ means post-traumatic stress disorder, anxiety, depression, or other mental health diagnosis described in the current version of the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association that the Secretary determines to be related to military sexual trauma.

The Senate, and Congress as a whole, can improve this legislation by:

    1. Requiring that the Secretary establish a rigorous Quality Assurance (QA) program, consisting of peer reviews, e.g., reviews of compensation and pension examinations (C&P exams) conducted by psychologists and psychiatrists experienced in conducting such disability evaluations. The QA program should apply to all mental health professionals who conduct MST C&P exams in military sexual trauma (MST) cases, i.e., VA employees, fee-for-service examiners, and contract examiners who perform evaluations under contract to a third-party IME company, which in turn contracts with the Department of Veterans Affairs.
    2. Provide examiners with the resources necessary to conduct thorough, evidence-based disability evaluations that conform with established standards such as the AAPL Practice Guideline for the Forensic Evaluation of Psychiatric Disability.1  Such resources would include:
      1. Sufficient time to conduct the examination (for VA employees).
      2. Ongoing training, education, supervision, and consultation.
      3. Psychological evaluation instruments (standardized psychometric tests).

  Footnote 1. American Academy of Psychiatry and the Law (2008). AAPL practice guideline for the forensic evaluation of psychiatric disability. Journal of the American Academy of Psychiatry and the Law, 36(4), S3–S50. | http://bit.ly/AAPL-Disability