N. Assess Duty/Work Responsibilities And Patient’s Fitness (In Relation To Military Operation)
BACKGROUND
Ideally, service members who become ineffective as a result of PTSD will be returned to duty at the earliest possible time. For most military specialties the time to enlist and train the soldier to minimal operational readiness often exceeds a year. Consequently, service members who become ineffective due to stress related conditions constitute a significant source of trained personnel who potentially have much to offer despite their disability. Assessment of fitness to duty may also have implications for medical boards & vocational rehabilitation.
RECOMMENDATION
- The determination of when to return a service member to duty should take into consideration the individual’s service member’s role, the complexity and importance of his job, and the service member’s functional capabilities.
- The continuing presence of symptoms of PTSD should not be considered as the sole basis for preventing a return to duty.
DISCUSSION
Practitioners who are managing patients suffering from stress reactions or PTSD should consider a variety of factors when deciding when the individual is ready to return to work or military duty.
First, what is the patient’s job and level of responsibility? Patients in lower skill jobs (e.g., truck drivers, food service personnel, and basic supply functions) can be expected to function effectively despite continuing anxiety. In addition, the cost of functional failure of individuals in these roles is likely limited. In contrast, patients in higher skill jobs or those that involve more potent risks (e.g., artillery forward observers, combat controllers, physicians, and pilots) should not be returned to duty unless there appears to be a high probability that they have resumed effective functioning. Individuals in leadership positions should be required to demonstrate a higher level of reconstitution as errors on the part of these individuals can potentially lead to much greater consequences.