I wouldn't say incompetence, but there is certainly a lack of education and experience, given that this is a relatively new subject. It is not an easy subject, particularly when we're talking about post-traumatic stress. It calls for relatively specific experience.
While I won't say incompetence, I think there is certainly work to be done. The people who decide whether to accept or reject applications need to be prepared, so they are able to understand the circumstances in that kind of case.