The Food and Drug Administration recently approved extended clinical trials for 3,4-Methylenedioxymethamphetamine (MDMA) Post Traumatic Stress Disorder treatments. MDMA, which is also known as Molly or Ecstasy, is a common party drug. Could this treatment, if successful, be available for contractors who were injured in Afghanistan?
MDMA is still not legal for medicinal purposes, but the Multidisciplinary Association for Psychedelic Studies (MAPS) wants to change that. “We’re looking at possible FDA approval for treatment at the end of 2021, and the accessibility of treatment in clinics by 2022,” said MAPS spokesperson Brad Burge. The studies began in the 1990s. In a 2018 trial, two-thirds of veterans and first responders with PTSD symptoms improved when taking MDMA.
PTSD Symptoms: A Closer Look
Most doctors once believed that Post Traumatic Stress Disorder was a processing disorder. Some people could take intense combat, and some people could not. Today, doctors understand that a chemical imbalance in the brain, which is caused by combat stress, causes PTSD symptoms.
The significance for injured contractors is huge. Defense Base Act benefits are usually only available for private military contractors with physical injuries. In 1941, contractors suffering from battle fatigue (one of the World War II labels for PTSD) were probably ineligible for DBA benefits. That is usually no longer the case.
Let’s take a closer look at the aforementioned chemical imbalance. Exposure to combat stress erodes the cerebral cortex. This part of the brain controls logical responses to stressful situations. When the cerebral cortex shrinks, the amygdala enlarges. This part of the brain controls emotional responses to stressful situations.
As long as these two parts of the brain balance, everything is okay. Assume I go to the pastry table at a morning meeting. That is not what most people would consider a stressful situation, but I do have a decision to make. My cerebral cortex tells me not to take a doughnut because they are unhealthy. My amygdala tells me to eat lots of doughnuts because they taste good. So, I compromise and take one. Or maybe two.
If my amygdala and cerebral cortex are out of balance, that just means I eat too many doughnuts. But for returning military contractors, infinitely more is at stake. Their chemical imbalance explains symptoms like depression, heightened awareness, flashbacks, and mood swings. Any one of these symptoms could make it difficult or impossible to function at work, home, or anywhere else.
During World War II, treatment for battle fatigue almost always consisted of sedatives and sleep. After a brief rest period, soldiers were sent back to the line, where they once again showed battle fatigue symptoms and went to field hospitals. So, it’s not surprising that, according to some estimates, as many as a quarter of WW2 battlefield hospital patients were battle fatigue casualties.
In other words, PTSD treatment techniques had not advanced much since the American Civil War, which was some 80 years earlier. Way back in the day, doctors labeled PTSD patients with nostalgia, which they believed was an extreme form of homesickness. The best treatment, according to Army doctors, was a vigorous offensive campaign. They did not know that such action caused the brain injury in the first place.
Today, PTSD treatment is usually a carefully-controlled combination of drugs and physical therapy. Drugs take the edge off the symptoms, so patients can make it through the day, at least for the most part. Physical therapists train uninjured areas of the brain to assume lost functions. So, patients do not just feel better. They improve physically.
A quick note here. There is no “cure” for PTSD or any other brain injury. Once brain cells die, they do not regenerate. Stem cell treatments may one day cure brain injuries, but that day is not very close.
Therefore, improvement is the best outcome. When therapists rehab a broken bone or other such injury, progress is usually steady and measurable. But with brain injuries, progress takes place in fits and starts. Many patients see no progress for weeks and then suddenly experience a breakthrough. For this reason, most doctors recommend lengthy physical therapy in PTSD cases.
Unfortunately, insurance company lawyers often use lack of progress as an excuse to end funding. They pressure therapists to state that the victim has reached MMI (maximum medical improvement). If that happens, the money stops. So, a DBA attorney must advocate for victims in these situations. Courtroom advocacy alone is not enough.
Injury Compensation Available
The extended physical therapy usually means an extended period of lost wages. Sessions are so frequent and intense that it is usually impossible to work. At least it is impossible to work at the previous level. Improvement comes, but it does not come quickly.
In the meantime, the Defense Base Act usually pays two-thirds of the victim’s average weekly wage. If the victim must accept light duty, the DBA usually pays two-thirds of the difference between the old and new salaries.
The AWW is not always easy to calculate. In addition to regular cash compensation, the AWW typically includes:
- Non-cash compensation, like housing allowance or tuition reimbursement,
- Overtime, and
- Regular performance bonuses.
Additionally, the victim’s current pay might be misleading. If a contractor comes to Iraq and is injured on his first day, it is inappropriate to use his last job to determine his current AWW. There is a big difference between a security officer in Bel Air and a security guard in Baghdad.
Count on Barnett, Lerner, Karsen, Frankel & Castro, P.A. to obtain maximum compensation.