The Department of Veterans Affairs funding of mental-health treatment has been marked, in recent years, by penny-pinching and layoffs.

But disability payments are on the rise to veterans who contracted post-traumatic stress disorder during their military service.

That money compensates those whose lives have been impaired by PTSD.

In 2004, $4.3 billion in PTSD disability payments were paid to 215,871 vets, according to an agency audit published in May. That far outstrips the VA's $2.4 billion annual budget for treating seriously mentally ill veterans.

In 1999, by comparison, the VA paid $1.7 billion in PTSD disability checks to 120,265 vets.

The PTSD disability payments average more than $19,000 per veteran annually. They are part of the nondiscretionary spending that is automatically approved by Congress each year.

But the rapid rise in these payments is triggering new scrutiny.

Veterans who receive the disability payments go through a claims-review process that is independent of hospital or clinical treatment. The process involves medical examinations, reviews of their military records and other efforts to rate the level of disability. There has been a big push in recent years to reduce the backlog of pending cases.

There is no requirement that the veterans who receive these benefits undergo treatment.

Agency auditors, in a study of 2,100 cases, concluded that 2.5 percent appeared to be potentially fraudulent. They note that some Internet sites now provide advice on how to embellish or fabricate claims.

Auditors also found that veterans with PTSD did not often appear to improve. Instead, their conditions typically worsened until they gained a 100 percent disability rating.

The audit is part of a broader effort to revamp the claims process, which some say should offer more incentives to get treatment and become healthy enough to work.

Despite the surge in disability payments, many veterans who struggled with PTSD never sought compensation.

Some 479,000 Vietnam veterans have likely suffered from PTSD, according to the VA's most extensive survey of the illness back in 1987.

Hal Bernton