The Department of Veterans Affairs decided to undertake the review after the department's inspector general issued a report last May, showing the agency had been inconsistent in granting a 100 percent PTSD rating to veterans. It found that the likelihood of a veteran's getting the maximum payment varied widely in regions across the country, calling into question the evaluation procedures. For example, in 2004, V.A. statistics show that an average of 8.9 percent of veterans in New Mexico, Maine, Arkansas, West Virginia, Oklahoma and Oregon received a 100 percent PTSD rating. On the other hand, an average of 2.8 percent of vets received the maximum payment in Indiana, Michigan, Connecticut, Ohio, New Jersey and Illinois.

Once a soldier is out of the military, he can make a claim at the V.A. to receive compensation for wounds, illnesses or mental trauma from service. Doctors perform examinations and make recommendations to adjudicators, who use a ratings system to decide how much money, if any, a veteran will receive. To grant payments to a veteran for PTSD, the agency documents "stressors," the traumatic events that occurred. It examines military records, reviews combat awards like Purple Hearts, and in some cases interviews veterans' war buddies. The V.A. report found that in one out of four cases, agency staff may have failed to fully document the events that triggered trauma from veterans who later got full payments for PTSD.

The report expresses concern that the number of veterans receiving payments for PTSD is growing rapidly, from approximately 120,000 cases in 1999 to 216,000 in 2004. PTSD benefit payments, it notes, have soared from $1.7 billion in 1999 to $4.3 billion in 2004.

It also raises the specter that some veterans might be engaging in fraud, stating that 2.5 percent of cases where veterans were getting some money for PTSD were "potentially fraudulent." "We noted an abundance of Web sites providing advice to veterans filing PTSD claims or offering ways to compile less than truthful evidence to obtain approval," the report reads. It notes that one Web site sells a fake Purple Heart for $19.95.

Veterans groups, already enraged that the department might go back and take money from vets, have assailed the accusations of fraud. "It is like accusing somebody of sexual battery or a sexual offense," says Steve Smithson, deputy director for claims services at the American Legion. "Even if that person is later proven innocent, there is still going to be that shadow around him. They are trying to give people the impression that people are gaming the system."

Rick Weidman, director of government relations at Vietnam Veterans of America, says when the department briefed him on the inspector general report, agency officials used the word "fraud" seven times. "They used that as a pretext to find that the whole system was fraudulent and there was insufficient documentation of stressors," Weidman says. "It is outrageous. Say it is 2 percent? I'm willing to guess that the rate of fraud in travel and expenses among high-level V.A. officials is 2 percent. Let's investigate every one of them."

Veterans advocate Robinson, a retired Army Airborne Ranger, who served in the Gulf War, says that in all compensation systems there will always be some individuals who try to pull a fast one on the system. But in this case, he adds, the number of people unfairly being denied compensation "far outweighs" any losses from veterans involved in fraud.

PTSD is a particularly acute problem in Iraq because combat is marked by constant threats that can come from any direction at any time, and the line between civilians and insurgent enemies is blurry at best. A study by the Department of Psychiatric and Behavioral Sciences at Walter Reed Hospital, published in the New England Journal of Medicine in July 2004, showed 17 percent of troops returning from duty in Iraq met the strict screening criteria for mental problems such as PTSD. Nearly 25,000 veterans from Iraq and Afghanistan have been diagnosed with mental-health disorders from war, including PTSD, the V.A. told Congress last month.

By comparison, studies show that up to 30 percent of Vietnam vets, given they were often engaged in guerrilla warfare in jungles, have experienced PTSD. A 1950 study of WWII showed that 10 percent of vets suffered from "traumatic war neurosis," the term that predated PTSD. In any event, the price tag for PTSD from Iraq is going to be steep and will continue to be for decades as veterans collect checks, in some cases for the rest of their lives.

Veterans Affairs says it wants to make sure that vets getting payments for mental wounds deserve the money. "We have a responsibility to preserve the integrity of the rating system and to ensure that hard-earned taxpayer dollars are going to those who deserve and have earned them," Daniel L. Cooper, the V.A.'s undersecretary for benefits, tells Salon in a written statement. He says the V.A. will look into 72,000 cases, dating from 1999 to 2004, where veterans received the maximum payment for mental trauma from war.

Cooper says the department will work hard to make sure that "the veteran is treated consistently and fairly" during the process. "There is no focus on fraud," Cooper writes. "The focus is on proper justification and consistency in all cases." But, he adds, "if there is fraud found, that case will be immediately referred to the [inspector general] for resolution." During the review, Cooper says the department will go through each case to make sure that stressors from war have been "properly validated" and proved.

What that boils down to, says Robinson, is that veterans caught in the V.A. review are going to have to prove they were hurt all over again. "If you had a claim granted during this time period, you better get out your [military records] and start calling your buddies for evidence of your combat exposure," he says.

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