Journal of Traumatic Stress June 2012, 25, 1–4 COMMENT The Reality of Malingered PTSD Among Veterans: Reply to McNally and Frueh (2012) Brian P. Marx, 1,2 James C. Jackson, 3,4 Paula P. Schnurr, 5,6 Maureen Murdoch, 7,8 Nina A. Sayer, 7,8 Terence M. Keane, 1,2 Matthew J. Friedman, 5,6,9 Robert A. Greevy, 10 Richard R. Owen, 11,12 Patricia L. Sinnott, 13,14 and Theodore Speroff 3,10,15 1 VA National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA 2 Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA 3 Center for Health Services Research, Geriatric Research Education and Clinical Center (GRECC), VA Tennessee Valley Healthcare System, Nashville, Tennessee, USA 4 Division of Allergy/Pulmonary/Critical Care Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA 5 VA National Center for PTSD, White River Junction VA Medical Center, White River Junction, Vermont, USA 6 Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA 7 Center for Chronic Disease Outcomes Research and Section of General Internal Medicine, Minneapolis VA Medical Center, Minneapolis, Minnesota, USA 8 Departments of Medicine and Psychiatry, University of Minnesota, Minneapolis, Minnesota, USA 9 Department of Pharmacology & Toxicology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA 10 Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, Tennessee, USA 11 VA Mental Health Quality Enhancement Research Initiative (MH QUERI), Central Arkansas VA Healthcare System, North Little Rock, Arkansas, USA 12 Division of Health Services Research, Department of Psychiatry, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA 13 Health Economics Resource Center, VA Palo Alto Health Care System, Palo Alto, California, USA 14 Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, California, USA 15 Division of General Internal Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA In this reply to McNally and Frueh (2012), we offer some additional insight into the studies they use to support their argument that we should be worried about malingering among veterans. We also describe other research on the disability system of the Department of Veterans Affairs and compensation-seeking behavior that challenges their conclusions. Concerns about the validity of disability claims are in- herent to any disability system—not just the Department of Veterans Affairs’ (VA’s) Compensation and Pension program and not just for the diagnosis of posttraumatic stress disor- der (PTSD). The commentary by McNally and Frueh (2012) This research was supported by grant number SDP 06-331 from the U. S. Department of Veterans Affairs Quality Enhancement Research Initiative. Correspondence concerning this article should be addressed to Brian P. Marx, 150 South Huntington Avenue, 116B-4, Boston, MA 02130. E-mail: brian.marx@va.gov Copyright C  2012 International Society for Traumatic Stress Studies. View this article online at wileyonlinelibrary.com DOI: 10.1002/jts.21714 expresses particular concern, however, regarding the legiti- macy of PTSD claims by veterans in recent years. At is- sue is the interpretation of a documented increase in PTSD claims and the explanation for this increase. McNally and Frueh dismiss clinical need as a possible explanation and instead argue that the increase is better explained by malin- gering for financial gain. Although we agree that some veter- ans may malinger to receive compensation, to become eligi- ble for healthcare, or for other reasons, we contend that the evidence regarding the prevalence of this problem is insuffi- cient to support McNally and Frueh’s conclusions. In fact, no prevalence estimate for malingered PTSD among veterans cur- rently exists. Further, a careful examination of their evidence, along with relevant studies that they omitted, suggests that 1