Clinical Topics   /   Trauma

Howls of Protest Over No Assistance Dogs for PTSD Subhead: VA Refuses Funding

USM By U.S. Medicine
December 13, 2012

By Stephen Spotswood

WASHINGTON – The use of trained dogs has been accepted therapy since the 1960s for persons with visual, hearing and mobility impairments. Only recently, however, have service dogs been trained to assist men and women suffering from mental health issues, such as post-traumatic stress disorder (PTSD).

Jim Stanek of Paws and Stripes with his assistance dog, Sarge.

Despite only limited scientific research in the area, many Iraq and Afghanistan veterans have reported that being paired with one of these specially trained animals has substantially improved their quality of life. The dogs not only act as companions to veterans dealing with traumatic events, they also are trained to identify symptoms and react when their owners are exhibiting signs of stress.

That’s why VA’s decision to limit benefits to animals assisting with visual, hearing, and mobility impairments, excluding those trained to assist solely with mental health problems, created such an outcry. The new rule went into effect this fall.

“This restriction is based on a lack of evidence to support a finding of mental health service dog efficacy,” explained a VA statement published in the Federal Register this fall. “Although we do not disagree with some commenters’ subjective accounts that mental health service dogs have improved the quality of their lives, VA has not yet been able to determine that these dogs provide a medical benefit to veterans with mental illness.”

The American Humane Association called on the VA to reverse the policy ending assistance dog reimbursement for veterans suffering from PTSD.

“American Humane Association’s focus on animal-assisted therapy dates back to 1945 when we promoted therapy dogs as a means to help World War II veterans recover from the effects of war,” said American Humane Association President and CEO Robin Ganzert. “We know from years of experience that the human-animal bond is a source of powerful healing, whether they are children suffering from cancer or military men and women who have suffered the stress of battle. Service dogs, in particular, are an amazing, positive resource for assisting our nation’s best and bravest though their physical pain and mental anguish.”

Despite those objections, the VA’s statement noted that it was possible to provide benefits covering service dogs trained to assist with visual, hearing and mobility impairments because of the department’s national experience directly observing positive clinical outcomes. Those observations were bolstered by the existence of nationally established training protocols for the dogs.

“We are unaware of similarly vetted and accepted training protocols for mental health service dogs or how assistance from such dogs could be consistently helpful for veterans to mitigate mental health impairments,” VA stated.

When the new rule was proposed, opponents argued that VA’s exclusion of mental health service dogs contradicts the definition established by the Americans With Disabilities Act (ADA) to include animals trained to help people with psychiatric, intellectual or other mental disabilities. VA noted that the ADA was not applicable in this case.

The new rule was even controversial for disabled veterans eligible for the assistance animal benefit, because the VA said it will provide coverage only in the future if the service dog and veteran have successfully completed a training program accredited by Assistance Dogs International or the International Guide Dog Federation.

In written comments about the proposed rule, John Ensminger, a New York attorney and author of Service and Therapy Dogs in America, expressed his concern for the accreditation requirement and for whether there were enough ADI and IGDF accredited training programs to meet the growing demand for service dogs in the military.

“The ADI approach is destined to produce a very small number of dogs,” Ensminger said.

The benefits would cover travel expenses associated with obtaining the dog and the cost of an insurance policy for medically necessary treatment and prescription medications. The policy cannot exclude service dogs with pre-existing conditions. Expenses not covered include license tags, nonprescription food, grooming, insurance for personal injury, nonsedated dental cleanings, nail- trimming, boarding, pet-sitting or dog-walking services and over-the-counter medications.

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