WASHINGTON - The Department of Veterans Affairs must change the way it evaluates former troops for post-traumatic stress disorder if it hopes to eliminate the wide disparities across the country in how much it compensates those who have the disability, a new report has concluded.

Released yesterday by the highly regarded Institute of Medicine, the report says that the recent surge in cases of stress disorder, coupled with ineffective VA rules, suggests that veterans could be getting disability payments that are too high or too low.

Saying that stress disorder has become a "very significant public-health problem," one of the report's authors, Nancy Andreasen of the University of Iowa, concluded that a "comprehensive revision is needed" of the government's PTSD-compensation system.

The current system raises basic fairness questions, giving varying amounts to veterans in different areas, the report concluded. Female veterans also are less likely to get compensation for stress disorder, in part because of the difficulty in proving sexual assaults and harassment, which experts have found are widespread in the military.

The report calls for new testing procedures and training regimens to ensure that government "raters," who decide on veterans' cases, do a better - and more uniform - job.

Knight Ridder, the newspaper company that McClatchy Newspapers bought last summer, reported in 2005 on the VA's unequal levels of disability compensation, particularly among more subjective conditions such as stress disorder. The report found the size of the benefit varied widely by geography and that mental problems had more variation than physical ailments.

The VA, which requested and paid for the Institute of Medicine study, said in a statement that the report was welcome and that it would study the findings and recommendations. The institute is part of the National Academies, an independent research group that advises the government on scientific issues.

Post-traumatic stress disorder is one of the most prevalent conditions - mental or physical - to emerge from the wars in Afghanistan and Iraq.

Often tied to intense warfare, the mental condition can manifest itself in hair-trigger nerves, flashbacks and nightmares, which often lead to intense feelings of fear, helplessness and horror. Some former troops isolate themselves or try to numb their memories with drugs or alcohol. Some, unable to cope, have killed themselves.

See more on the report via http://go.philly.com/vetstressEndText