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Gender Differences in service connection for PTSD.

Maureen Murdoch¹, James Hodges, Carolyn Hunt

¹Center for Chronic Disease Outcomes Research and Section of General Internal Medicine, Minneapolis VA Medical Center, and Department of Internal Medicine, University of Minnesota School of Medicine, Minneapolis Minnesota 55417, USA. murdo002@tc.umn.edu

|July 30, 2003

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Gender and Race Differences in Rates of PTSD Service Connection: Results From a Nationally Representative Panel of OEF/OIF/OND Veterans.

Military medicine·2025

Men veterans receive higher rates of service connection for posttraumatic stress disorder (PTSD) than women veterans. This difference is linked to combat exposure, not symptom severity, suggesting a combat advantage favoring men.

Area of Science:

Military medicine
Psychiatry
Health services research

Background:

Female veterans access VA healthcare at lower rates than male veterans.
This disparity may stem from lower rates of service connection for psychiatric conditions among women.
"Service connected" status is crucial for VA healthcare enrollment priority.

Purpose of the Study:

Investigate gender disparities in service connection rates for posttraumatic stress disorder (PTSD).
Determine if observed discrepancies are attributable to factors like symptom severity or functional impairment.

Main Methods:

Utilized a mailed survey linked to administrative data for 3337 veterans.
Conducted claims audits on 11% of the sample.
Oversampled women veterans to achieve a 1:1 gender ratio.

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Main Results:

Unadjusted service connection rates for PTSD were 71% for men and 52% for women (P < 0.0001).
Adjusting for PTSD symptom severity or functional impairment did not explain the gender gap.
Adjusting for combat exposure revealed estimated rates of 53% for men and 56% for women, indicating a combat advantage for men.

Conclusions:

The study found no evidence of gender bias in PTSD service connection awards.
A significant combat advantage disproportionately favoring men was identified.
The appropriateness of this combat advantage warrants further investigation.