"I Had to Relive All of That Again": Retraumatization, Invalidation, and Institutional Betrayal Among Veterans Filing...

Thousands of Veterans file military sexual trauma (MST)-related PTSD disability claims annually through Department of Veterans Affairs (VA) for broadly covered healthcare benefits and monthly compensation. Although MST-related claims have been subject to much governmental reporting and oversight, no study has examined the perspectives or experiences of Veterans filing MST-related disability claims, including potential associations with institutional betrayal (i.e. wrongdoings perpetrated by an institution upon individuals dependent on that institution). Between March-October 2024, we interviewed 15 Veterans who recently filed MST claims. Data were analyzed inductively through thematic analysis. Most participants described MST-related claims process components that were retraumatizing, such as having to "relive" their MST experience through repeated telling of their MST across multiple individuals (e.g. therapists, disability evaluators, via the claim form). These experiences were retraumatizing even for individuals with a positive perception of those involved in evaluating their claims. Participants described feelings of invalidation through perceptions of needing to be a "perfect victim" and that their claim was impacted by aspects of their identity (e.g. race) or pre-military trauma. For some, being awarded MST-related disability was seen as validating. For others, retraumatization and invalidation contributed to perceptions of VA-enacted institutional betrayal, which impacted their trust in and likelihood of using VA healthcare. Veteran participants' experiences with the MST claims process extend prior work on institutional betrayal among MST survivors. These findings underscore the need for additional support during the MST claims process, such as increased information and expectation-setting ahead of claim filing and disability evaluations.