Recently I have had the pleasure of going through the disability claims process. I am not here to denigrate the VA employees, as overall my experience has been alright. However, I do want to address the documentation and proof of injury and ongoing treatment requirements as part of the disability claims process. More specifically, I would like to make an argument that the burden of proof should be placed on the servicemember's original branch of service, not on the service member.
I make this argument based on several observations. Firstly, the military has developed a well-tested and effective psychological conditioning system that encourages service members to disregard their own personal health for the sake of the mission. This is why we have expressions such as "soldier on", and "putting the mission first", and "no pain, no gain." Service members are taught that pain is good, and that it is admirable to continue on with an injury is a better solution than seeking treatment. This alone has severe consequences for veterans who lack the experience that would enable them to fully comprehend the damage that injuries can do over time. This means that any soldier who leaves the military at a young age has a good chance of having an undocumented injury, simply because they have been mentally conditioned to ignore pain, coupled with the fact that their younger body is more tolerant of pain. However, as they get older, they will realize that those injuries are much worse than they thought. Unfortunately, they will be left without recourse because they were too inexperienced to realize the problems that they faced.
I also want to point out that the reward structure within the military is such that it encourages supervisors to delay or prevent soldiers from seeking treatment. If we assume that the average time that a soldier spends under the supervision of one squad leader is 6-18 mos, many soldiers will have multiple squad leaders. Every day, squad leaders are tasked with ensuring that they have the as many soldiers present for duty as possible. We all know that squad leaders face enormous pressure to ensure that all their soldiers are there, working. This alone creates an incentive for squad leaders to encourage soldiers to ignore or work through injuries. Couple this culture with the fact that, if an injury is severe, there is a good chance that, by the time the injury evolves into something more troublesome, the squad leader will most likely be no longer responsible for the welfare of the soldier. Therefore, economic incentives to manage the long-term welfare are absent, while economic incentives to ignore the short-term welfare are strong. This sets the stage for soldiers (and other service members) to not seek treatment for injuries.
What the VA needs to do is conduct more thorough research on the psychological, cultural, and economic factors that influence treatment seeking behaviors of soldiers and veterans. In particular, emphasis needs to be placed on identifying which factors help mitigate the psychological conditioning that encourages veterans to ignore injuries until they develop into long standing injuries. The VA should also investigate the size of this effect. My suspicion is that many veterans ignored their injuries for many years, only to find out that their failure to seek treatment has hurt them severely.