Saving Money By Cheating Vets

by hilzoy

From the Washington Post:

"The physician in charge of the post-traumatic stress disorder program at a medical facility for veterans in Texas told staff members to refrain from diagnosing PTSD because so many veterans were seeking government disability payments for the condition.

"Given that we are having more and more compensation seeking veterans, I'd like to suggest that you refrain from giving a diagnosis of PTSD straight out," Norma Perez wrote in a March 20 e-mail to mental-health specialists and social workers at the Department of Veterans Affairs' Olin E. Teague Veterans' Center in Temple, Tex. Instead, she recommended that they "consider a diagnosis of Adjustment Disorder."

VA staff members "really don't . . . have time to do the extensive testing that should be done to determine PTSD," Perez wrote.

Adjustment disorder is a less severe reaction to stress than PTSD and has a shorter duration, usually no longer than six months, said Anthony T. Ng, a psychiatrist and member of Mental Health America, a nonprofit professional association.

Veterans diagnosed with PTSD can be eligible for disability compensation of up to $2,527 a month, depending on the severity of the condition, said Alison Aikele, a VA spokeswoman. Those found to have adjustment disorder generally are not offered such payments, though veterans can receive medical treatment for either condition. (...)

"Many veterans believe that the government just doesn't want to pay out the disability that comes along with a PTSD diagnosis, and this revelation will not allay their concerns," John Soltz, chairman of VoteVets.org and an Iraq war veteran, said in a statement.

Melanie Sloan, executive director of CREW, said in a statement: "It is outrageous that the VA is calling on its employees to deliberately misdiagnose returning veterans in an effort to cut costs. Those who have risked their lives serving our country deserve far better.""

Yes. They do.

You can see the email here (pdf); the press release from VoteVets and CREW is here; more from VetVoice here.

The idea that any vet returning with PTSD is getting inadequate treatment, and is being deprived of benefits to which s/he is entitled, for budgetary reasons is completely disgraceful. The right response to not having enough money to meet those needs is to ask for more, not to renege on our obligations.

I hate this sort of thing. I hate that these stories come out so often: Fort Bragg a few weeks ago, this today: one story after another about our shortchanging soldiers. Iraq and Afghanistan are no fun at all. The least we can do when people come home is not to make their lives harder for no good reason, especially not when they have been wounded, physically or psychologically. It's just so wrong.

Comments

[John Thullen]

I often fake shrapnel wounds, making like I got wammoed by a roadside IUD or was it IED or was it COD, I don't know, all I know is I'm looking to be catherterd, triached, and purplehearted, all in the name of universal commie health care.

Glenn Reynolds and Moe Lane and Larry Kudlow have never encountered this punishment, never having taken a hard shard of metal to the windpipe, on account of talking too much and being worried that maybe taxes would cut into their golf time, not to mention their pontificating speaking engagements.

They could use a little mental adjustment at taxpayer expense, but they figure they can tough it out, being well-endowed, and long-winded, and brave.

Well, longwinded.

[LT Nixon]

Thank you for raising awareness for this story! A FOIA request is in the works.

[Redhand]

I've always viewed the VA as a final institutional betrayal of the traumatized, disabled veteran and his/her family. This stuff so reminds me of the VA's positions on Agent Orange after Vietnam and Gulf War (I) Syndrome. The Agency seems to measure performance by bugetary considerations in all cases.

Here the situation is arguably worse. They know there is a medical causal connection between PTSD and combat exposure, and are intentionally trying to cover up the link to save money.

[aimai]

This never would have happened if the doctors were at all involved in the monetary issues--diagnosis should have been protected from the money side. Instead of making the correct diagnosis, which would at least have laid a paper trail and enabled the accurate collection of statistics on the problem, the VA asked its medical staff to betray their patients and misdiagnose them. This was done not only to save money but to protect Bush and Cheney and the Army top brass from another consequence and cost of the war. Frankly, I will be very surprised if we don't see a memo, some day, ordering that wounded soldiers be lost in transit until they die of their wounds. The knock on costs of the wounded and their rehab is going to be staggeringly much higher than the government is willing to pay.

aimai

[OCSteve]

Thanks for highlighting this hilzoy.

[rob!]

when the hell will the Republicans once and for all lose their image of being pro-military?

they couldn't give a rat's ass about our men and women in uniform, unless its to go overseas somewhere and fight a war. other than that, they just don't care what happens to them.

how many stories like this have to surface?

[Hartmut]

Wennn wir den Abschied kriegen
Wo wenden wir uns hin?
Die Gesundheit ist verloren
Die Kräfte sind dahin
Und schließlich wird es heißen:
"Ein Vogel und kein Nest.
He, Alter, nimm den Bettelstab/sack!
Bist auch Soldat gewest.

(When we get our discharge
Whereto do we turn?
Health is lost, strength is gone
In the end they will say:
"A bird but not a nest
Hey, wrinkly, take the beggar's stick/bag
For you have been a soldier too.)

Prussian Soldier song (author unknown)
It's just a return to old traditions [/retch]

[Porcupine_Pal]

Veterans consistently form a large segment of homeless shelter populations, and prisons.

Service in the armed forces, for many is an opportunity to learn a useful trade of occupation....unless you are unfortunate enough to be an infantryman or in armor. They learn how to kill people, a skill that is not readily transferrable to the private economy.

Veterans who actually serve in combat roles suffer the worst of all possible outcomes. They experience the physical and psychic injuries that inevitably accompany the experience.

And they are left at the end of it, without a productive, useful substitute.

[Warren Terra]

Terrible as this story is, it's not even close to as bad as the story of how the mlitary routinely faked pre-existing conditions to deny essentially all benefits to incapacitated veterans, a story the Nation covered extensively last year (this is just one of the pieces), and for which they won some national magazine award. There were eventually hearings in Congress, but I can't remember much action in the Blogosphere or much of any response from the New York Times, the Washington Post, et al.

[john miller]

A couple notes.

First of all, the VA itself is pretty well noted as having one of the finest medical systems in the country when it comes to providing care, particularly long term care for chronic conditions. Which of course highlights the irony in what is being reported on.

The problem is in getting into the system to begin with, past the screening and into actual treatment. Part of this is financial. Many veterans who seek care in the system do have some private insurance and the VA could be reimbursed, provided that the care is improved. However, insurance companies tend to have no difficuklty denying coverage as unnecessary when it comes to the VA because they know the treatment will be given anyway. This is particularly true with mental health and substance abuse issues.

It is almost as if the VA is performing a triage system due to the fact tha they just don't have the resources they need to handle the influx, so they try to get away with underdiagnosing which reduces perceived care needs as well as disability issues.

I think it was OCSteve who on a thread in the past talekd about this being something that has gone on for decades, including the aftermath of WWI. It is just that the public is much more aware of what is happening now. The question will be where the money comes from.

[Bruce Baugh]

It would be nice to see soldiers and veterans questioning the patriotism and decency of the officials responsible for this sort of travesty as loudly, often, and quickly as they do the patriotism and decency of people on the left who express any skepticism about military practice or culture or whatever. Nell and I wouldn't vote to cast injured men and women out into the street and sue them for the privilege of ever having gotten any help; these guys would, and they seem to get a lot of a pass for it.

[Hartmut]

Unfortunately any soldier that dares to criticize or doubt the divine wisdom of G#d's anointed and his prophets (i.e. Bush N'Pundits) cease at that moment to be a part of the troops to be supported and transmorph instantly into DFH* and America haters**.

*unwashed longhairs having intercourse
**and want the terrorists to win