Today’s wounded veterans look over their shoulders. They also look ahead, seeing shadows and pitfalls and are always ready for the other boot to drop. They’re not the first generation to grasp how the federal bureaucracy has become a battlefield of booby traps and heartbreaks, with a growing trail of flimsy excuses and obfuscations, that even after the lessons of Vietnam and the Persian Gulf War, the system still appears stacked against them, overwhelming and cold.

Nowhere, it seems, does another constituency currently exist – save for Native Americans – that is more justified in being just a little paranoid when it comes to its relationship to the federal government. Just a month ago, a RAND study found that more than 300,000 vets – 20 percent of returning service members — may have Post Traumatic Stress Disorder, but most of them aren’t getting the help they need.

Then, a story like this emerges:

A psychologist who helps lead the post-traumatic stress disorder program at a medical facility for veterans in Texas told staff members to refrain from diagnosing PTSD because so many veterans were seeking government disability payments for the condition.

“Given that we are having more and more compensation seeking veterans, I’d like to suggest that you refrain from giving a diagnosis of PTSD straight out,” Norma Perez wrote in a March 20 e-mail to mental-health specialists and social workers at the Department of Veterans Affairs’ Olin E. Teague Veterans’ Center in Temple, Tex. Instead, she recommended that they “consider a diagnosis of Adjustment Disorder.”

VA staff members “really don’t . . . have time to do the extensive testing that should be done to determine PTSD,” Perez wrote.

The email can be found here.

Over 1.7 million servicemen and women having been deployed to Iraq or Afghanistan since 2002, and over 300,000 of have them have since left the service. Of those, more than 53,000 (July 2007 figures) have been treated by the VA for PTSD. So there is genuine concern among health care providers that mental disorders are not only recognized and addressed, but are diagnosed properly in the first place. But this email suggests an “out” was given to providers to diagnose veterans for a “readjustment disorder” rather than PTSD and that can mean the difference of more than $2,000 a month in disability benefits or no cash assistance at all. In light of other schemes to lowball veterans in their time of ultimate need, this doesn’t look too good.

Last year, attorneys from the biggest firms in Washington got together to provide pro bono services to soldiers and veterans struggling through the briar patch of the disability/compensation system. Turns out that severely wounded soldiers were being denied lifetime healthcare for themselves and their families even if their injuries rendered them largely incapable of being breadwinners ever again. Of the more than 50,000 injured soldiers at the time of the report deemed “unfit for duty” and headed for medical boards out of the service, more than a quarter were given zero to 30 percent disability ratings, meaning they got nothing more than a one-time cash payment and a hearty handshake from Uncle Sam.

In April, the congressionally-mandated Veterans Disability Benefits Commission provided Congress with preliminary findings from its investigation into whether the military has been lowballing disability ratings, a charge denied by the Pentagon. Its analysis is based on thousands of disability records since the War on Terror began.

It found that 81 percent of all disabilities between 2000 and 2006 were rated 0 to 20 percent by the military. Out of 50,676 Army soldiers deemed unfit for duty, 27 percent received 0 percent ratings.

Advocates like to point out that soldiers who do not qualify for military health care and the pension, often go to the Veterans Administration to apply for benefits and health care. In 59 percent of those cases, according to the commission’s early findings, the VA has given a 30 to 100 percent disability rating to the same soldier who earned a zero to 30 percent rating from the military.

Commission chairman, retired Army Lt. Gen. James Terry Scott, said that while a few technical reasons can explain the disparities, the most telling is that the military rates only one injury while the VA provides a combined rating for all a veteran’s injuries. Scott testified to Congress in April the reason for the difference could be a simple explanation — the military has an incentive to offload the cost to the VA.

“It is … apparent that (the Defense Department) has strong incentive to assign less than 30 percent so that only separation pay is required and continuing family health care is not provided,” Scott said during the April 12 hearing.

On top of that, Smith said, if a soldier receives a disability rating from the military above 30 percent, he or she gets a pension based on annual salary at the time of discharge. Despite rank, a 100 percent disability at the VA will get the veteran no more than $28,000 a year in compensation, and no family health care coverage.

About the same time last year, members of congress began investigating an unusual number of dishonorable discharges due to “personality disorders” in the Army. Despite complaints that many of these soldiers were suffering from PTSD and even traumatic brain injury, advocates began reading the numbers as another way the military was getting out of footing the bill.

Donald Louis Schmidt of Chillicothe, Ill., was being treated for posttraumatic stress disorder after his second combat tour in Iraq. His commanders at Fort Carson later decided he was no longer mentally fit and discharged him with personality disorder.

“They just slapped me with that label to get me out quicker,” Schmidt said. He said superiors told him “‘Everything will be great. Peachy keen.’ Well, it’s not.”The discharge left Schmidt ineligible for disability pay and benefits.

He was also required to return more than $10,000 of his $15,000 reenlistment bonus, but he said no one explained that to him until it was too late.”If I didn’t have family, I’d be living on the sidewalk,” Schmidt said.

“It’s not right that they would do this to him after him going to war for us,” Schmidt’s mother, Patrice Semtner-Myers, said. “They threw him away. They’re done with him.”

Soldiers who do not get military healthcare and seek the VA for assistance when they get out encounter a backlog of at least 300,000 initial disability claims , and appeals can take years. In a class action lawsuit launched by veterans advocates and playing out in a federal court in California today, the plaintiffs argue that the VA is systematically denying vets treatment through a lack of sound policy and resources. “Well, if you’re suicidal you can’t wait a month. You can’t wait three months. People placed on waiting lists have killed themselves. It’s a documented fact,” said Gordan Erspamer, an attorney with the law firm Morrison and Forrester who is handling the case pro bono.

Less than a week later after the April RAND study was released, CBS published internal emails by Dr. Ira Katz, head of VA mental health care, in which he seemed to be hiding information from reporters about the suicide risk among veterans. He had told CBS at one point there were 790 suicides in 2007. But in an email in which he clearly states the contents should not be shared with reporters, he says the number of suicide attempts in VA medical centers topped 1,000 a month, that’s 12,000 a year, putting quite a different hue on the situation.

Despite this and other clues that the federal system is not an entirely honest broker, men and women still turn the VA by the millions each year for medical care and assistance. By all accounts, the care itself is superior — when the veteran can get access. The doctors and medical personnel – all those who work tirelessly in VA facilities to shuttle vets through – can’t be blamed.

But we’re talking about the same Washington establishment – the VA, DoD, and Congress, too – that forced Vietnam veterans suffering from Agent Orange exposure to walk bloody miles (for almost 20 years) to get their due. The same system that hid the fact that 100,000 Persian Gulf War I soldiers might have been exposed to deadly nerve gas, sarin, mustard and cyclosarin on the battlefield and even worse,their protective gear might have been faulty, but denied the vets’ full access to treatment and benefits for what we still loosely consider “Gulf War Illness” until 2001.

The sad thing is, the folks at the VA and DoD will probably figure out how to handle their internal emails – didn’t they get lessons from the White House? – before they figure out how to get it right with their latest constituents. Let’s hope not, and hope that someday, veterans will be able to stop looking over the shoulders.