A three-judge panel of the same court ordered the V.A. in 2011 to ensure that suicidal veterans are seen immediately, among other changes. It found the department's "unchecked incompetence" in handling the flood of post-traumatic stress disorder and other mental health claims was unconstitutional. The new decision said courts are powerless to carry out the fixes sought by two veterans groups that sued the department in 2007, saying that hundreds of thousands of veterans had to wait an average of four years to fully receive the mental health benefits owed them.