BRUNSWICK, Maine — The morning after Scott Couture’s Veterans Administration psychiatrist told the Maine Marine Patrol that Couture has post-traumatic stress disorder brought on by combat experiences in Iraq, Couture’s boss knocked on his front door.

“He said, ‘I want your weapon and your truck and your badge,’” said Couture, who as a military policeman in Iraq not only saw the horror of war firsthand, but says he perpetrated it.

“I’d always thought to myself, ‘If they find out I have PTSD or a PTSD rating, that’s the last day I’ll be working.’”

He knew it was time for his career to end. By the time he was fired in 2015, Couture had been away from the job for months. He exhausted his sick and vacation time, two years worth of Family Medical Leave Act time and weeks of sick time donated by other state employees. Finally, in hopes of qualifying for retirement due to his disability, he asked the Veterans Administration to reveal his PTSD diagnosis to his superiors and inform them that it had rendered him unable to work.

Couture’s firing triggered a scramble for a financial future for himself and his family. The scramble became a stressful, protracted slog that has only worsened the anxiety, depression, nightmares and angry outbursts that define life with PTSD.

“You start to wonder. You start to see patterns in yourself,” he said. “I know people who didn’t come home. I knew people who were wounded severely. I wasn’t going to be the guy to come forward and say, ‘By the way, I get a little upset sometimes.’”

As a state employee, Couture was a member of the Maine Public Employees Retirement System, which means he was not paying into Social Security and does not qualify for Social Security disability benefits. Though he receives income from the Veterans Administration, which has deemed Couture 80 percent disabled — 70 percent for PTSD and 10 percent for an ankle injury — it doesn’t cover the bills for a family of four.

Couture, who like thousands of PTSD sufferers lives under the constant threat of his own emotional outbursts, applied for a disability retirement through the state system in September 2014. So far, he has been stymied because he has so far been unable to prove that his disability is permanent and makes him unable to work.

“We thought certainly if the state retirement system’s reason for turning him down was ‘we’re not convinced you’re disabled enough yet we have this letter from the state of Maine saying you can’t do your job because of your PTSD,’ it seemed like what else would we need?” said Darcie Couture, Scott’s wife.

The Maine Public Employees Retirement System’s primary function is administering retirement benefits to more than 40,000 retired state, local and educational employees. The system also has a disability retirement program, which as of the end of 2015 provided benefits to about 1,350 former public employees with permanent disabilities.

Though the system, known as MePERS, could not pinpoint a number in response to questions from the Bangor Daily News, some people are receiving disability retirement benefits because of PTSD — including five individuals who were awarded benefits on that basis in 2015.

Sandy Matheson, executive director of the system, said there’s a high bar for qualifying for disability retirement benefits because unlike plans offered by some employers or the Social Security administration, MePERS does not have a long-term disability program.

That means essentially that it’s all or nothing: Unless public employees can prove that their disability makes it impossible for them to ever work again, they are not eligible for the program.

“We feel terrible about it,” said Matheson, “but we do our assessments based on definitions that are in law. … There is nobody healthy walking up to our door [and applying for disability retirement].”

Last year, Matheson hired a consultant to conduct an audit into why there was a sudden increase in the number of disability retirement claims and, by extension, denials. In 2015, only 38 percent of disability applicants were awarded benefits on their first application. An additional 35 percent of those who completed the appeals process were awarded benefits.

The audit was inconclusive about the reasons for the high application and denial rates, but a 2015 task force found some underlying factors. Chief among them was confusion about what MePERS offers and that long-term disability insurance is not an option.

“Members often apply to or are referred by their employers to MePERS at a point in their disability progression when they find it too difficult to work, but before their condition becomes a permanent disability,” reads the task force report.

Matheson said there is a wide gulf between a typical long-term disability insurance program and what MePERS offers, namely that the former would involve resources for injured employees to help them in ways that could avoid or delay permanent disability. Those resources could include advocacy services, transition support, counseling and training to explore new career paths.

Another result of the task force was an attempt to fix the problem by exploring the implementation of a long-term disability program within MePERS. To that end, the system proposed legislation, LD 1463, which is under consideration in the Legislature.

Sponsored by Rep. Robert Foley, R-Wells, it sought to allow the system to offer long-term disability plans — likely funded by either employees or employers and not the state’s general fund. Allowing the system to offer the plans was amended by the Appropriations Committee earlier this month. It now calls only for a study into the issue.

Foley said most people can’t afford to purchase disability insurance on the private market, but group plans make it more affordable.

“Since I got involved in this I’ve heard from probably 30 teachers and state employees who have gone through the system, been denied and their lives are devastated,” said Foley, who also has concerns that the MePERS system is “a closed paper loop” when it comes to applications and appeals.

“I don’t know how you can judge a person’s disability if you’ve never interviewed them or their doctor,” said Foley. “I’m hoping we can open up that process.”

Couture’s initial denial in December 2014 led to a months-long application and appeal process that cost well into five figures for their attorney alone. In December 2015, Couture participated in an hours-long hearing where he was asked to recount his combat experience. Couture said it was one of the most emotionally difficult experiences of his life since returning from war.

“You can say this is a last-ditch effort for me with PERS because I’m psychologically done,” he said. “I can’t do that again.”

Bruce Merrill, Couture’s attorney, said the tough questions were necessary from a legal perspective.

“I know it was difficult for Scott to sit through,” said Merrill. “It was also very difficult to hear his wife say in essence that she married somebody and he was a great husband and a great father, but when he went to war and came back he wasn’t the person she had married. The war had that much of an impact on him.”

The Veterans Administration doesn’t let its doctors testify on behalf of patients, forcing the Coutures to hire a psychologist to see Scott for months and, eventually, reaffirm the VA’s findings: Scott is sick and the chances of him keeping a regular job again are slim.

James Doherty, a spokesman for the Togus VA Medical Center, said VA doctors can’t testify for patients because it would divert them from their core mission. There are nearly 53,000 Maine veterans in the VA Healthcare System, including 5,760 with PTSD, according to data from the end of 2015.

“We’re here for treatment,” said Doherty. “Veterans can always access their entire medical records to obtain all applicable progress notes, treatment records and consults.”

Rep. Jared Golden, D-Lewiston, is a Marine Corps combat veteran who serves on the Legislature’s Veterans and Legal Affairs Committee. Among other efforts on behalf of veterans, Golden sponsored legislation last year that led to a special legislative commission that essentially audited the Maine Bureau of Veterans Services.

The resulting report found that the bureau has not been expanded in years and is reaching only a percentage of Maine’s 140,000 veterans — partially because many veterans are unaware the bureau exists. The Maine bureau has about one outreach worker for every 20,600 veterans. That compares poorly with nearby states like Massachusetts, which has one worker for every 12,000 veterans.

Golden said he understands Couture’s struggle and that bureaucratic roadblocks often push veterans away when they need help the most.

“It can literally be that one moment in the bureaucratic process where someone helps a veteran overcome that red tape, or not,” said Golden. “Then they lose faith in the system. They lose faith that the government and the nation means it when they say they want to fulfill their obligation to care for those troops and take care of our veterans.”

Golden said properly taking care of veterans’ needs is “an all-hands-on-deck enterprise.”

“I envision a Bureau of Veterans’ Services that is so well-known that an individual like Scott Couture would go to the bureau and say, ‘I need your help to resolve this,’” said Golden. “That’s the role of the state that I’m trying to advocate for.”

Rough estimates are that building a system like that could cost up to an additional $5 million a year.

For Scott Couture, hope is fading. He’s still awaiting a final decision on his appeal for disability retirement. Though he is doing occasional tree work as a day laborer, prolonged interactions with others remain a struggle.

“I don’t think I’m special. I don’t think I’m out of the ordinary,” he said. “I just know that there are some problems that I have had a really hard time coping with, but it’s hard. You just don’t want to see how broken you are. Do you?”

Any veteran in Maine who needs help or advice about services offered by the Veterans Administration should call 207-623-8411, ext. 5515.

Christopher Cousins

Christopher Cousins has worked as a journalist in Maine for more than 15 years and covered state government for numerous media organizations before joining the Bangor Daily News in 2009.