Ronald Nesler of Las Cruces, N.M., a Vietnam veteran rated 100 percent disabled by post-traumatic stress disorder, learned this month that his case, as decided in 1997 by the Department of Veterans Affairs, lacked documents to support the finding of service-connected PTSD.

The VA regional office in Albuquerque advised Nesler in an Aug. 11 letter that he has 60 days to provide evidence he was exposed to the stressful wartime incidents described in his claim papers years ago, or there could be "a change in your disability claims compensation."

Nelser's award of about $2,500 a month is at risk because of a VA inspector general review of 2,100 randomly selected PTSD cases with 100 percent disability awards. The inspector general found that 25 percent, or 527 of them, lacked documents to verify veteran-reported evidence.

The review of PTSD cases was released in May, as part of a 200-page report on variances in VA disability compensation across the nation. The VA has announced that starting in January it will review documents of 72,000 PTSD cases, those awarded 100 percent disability ratings from Oct. 1, 1999, through Sept. 30, 2004.

"Everybody talks about how PTSD is a very subjective diagnosis. This is not about diagnosis," said VA spokesman Scott Hogenson. "This is about collecting the empirical paperwork that says, 'Yes, this individual was in this set of circumstances during this time in which these things happened, which may have led to post-traumatic stress.' "

From 1999 to 2004, the inspector general said, the number of veterans awarded compensation for PTSD jumped by 80 percent, from 120,000 cases in fiscal 1999 to 216,000. PTSD payments jumped by 149 percent, from a $1.7 billion total a year to $4.3 billion.

Nesler reached Vietnam in 1970 and served for 13 of his 14 months as a meteorological observer for Battery B, 6th Battalion, 32nd Artillery, part of the 1st Field Forces Vietnam.

The whole war experience was stressful, Nesler said. His most disturbing memories, he said, are of atrocities committed by soldiers. Nesler said he saw an American soldier detonate a directional mine toward a small bus, filled with Vietnamese women and children, near the town of Ninh Hua.

The incident, he said, was covered up, but the screams and faces haunt him still. Nesler said he also feels guilt for not filing an official report.

Nesler, a staff sergeant, was discharged in 1975 after eight years. As the years passed, he grew more anxious and had nightmares, insomnia and difficulty concentrating, all of which the VA later would tie to the war. In 1997, before VA approved his PTSD claim, Nesler gave to VA the names of a senior officer, two warrant officers and several senior enlisted soldiers who likely could verify the bus incident.

"I thought that was my proof," he said. A VA official told him only recently that the people were never contacted. Still, the VA ruled in 1997, based on "unrefuted evidence," that Nesler had served in a combat zone, had witnessed "a bus being bombed" and had a well-founded diagnosis of PTSD. It found "total occupational and social impairment" from a variety of symptoms.

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MILITARY UPDATE

By Tom Philpott