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Downgrading PTSD to save money?

Posted By Uncle Jimbo • [February 14, 2012]

Budget cuts for the military are a fact of life. We can argue all we want about the relative benefits of building more ships, or planes or the number of troops we need. But the one thing there should be no argument about is taking care of those who have been wounded, this includes both invisible and visible injuries, by their time at war. Taking care of an injured troop means immediate care and continued care when they leave the military.  There seems to be plenty of focus on the visible injuries and it is easy to understand that you replace a missing leg with a prosthetic and add copious doses of physical therapy to teach the troop how to walk on it. Injuries like PTSD are tougher to deal with because invisible wounds are just that, invisible.  Those suffering from this type of trauma may look just fine, but all to often they are far from it.

Some of our community have publicly discussed their own battles with this debilitating injury including CJ Grisham and Jeremiah Workman. It has been a major challenge to get combat vets to overcome the stigma attached to admitting they have PTSD. Now we find out that the concerns over the cost of treating these wounded troops may have been used to deny them care.  One of CJ's co-writers discusses this:

This article seems to say they are passing out PTSD diagnosis to anyone who walks by and sneezes. It is not easy to get a PTSD diagnosis, that is the truth. When this same issue was brought up in the Veterans Administration, the government investigation showed that there was less then 1% actual fraud on PTSD diagnosis and service-connection compensation. When we do get that term put on our records as a service-connection, it is not a favor done for us. It means that we owe these men and women who have been destroyed in mind, body and spirit by the incredible sacrifices the average person would not think possible.

Here is the scary part

In a lecture to colleagues, a Madigan Army Medical Center psychiatrist said a soldier who retires with a post-traumatic-stress-disorder diagnosis could eventually receive $1.5 million in government payments, according to a memo by a Western Regional Medical Command ombudsman who attended the September presentation

The psychiatrist went on to claim the rate of such diagnoses eventually could cause the Army and Department of Veterans Affairs to go broke (By Hal Bernton, Seattle Times staff reporter).

This psychiatrist went beyond just noting the cost of treating those who were hurt and rightly had a knot jerked in his tail.

A Madigan Army Medical Center psychiatrist who screens soldiers for PTSD has been removed from clinical duties while investigators look into controversial remarks he made about patients and the financial costs of disability benefits, according to U.S. Sen. Patty Murray.

Keppler allegedly made inappropriate comments about the forensic team's role as financial gatekeeper in the Army retirement process during a September presentation, according to Murray.

In a meeting last fall attended by an Army ombudsman, Keppler and other team members reportedly made disrespectful comments about patients whose files were under review.

More than a dozen soldiers who believed their PTSD diagnoses were wrongly dropped by the Madigan team gained new reviews this year at Walter Reed Army Medical Center in an unusual intervention arranged by Army Surgeon General Lt. Gen. Patricia Horoho.

That is a good first step, but does anyone really think this was an isolated incident? I know it wasn't.  The same problem exists right back here in the Army's flagship PTSD program at Walter Reed. I know of multiple instances where diagnoses of PTSD have been downgraded or determined to be not "Line of Duty". One method of limiting the number of diagnoses is to find that the condition "Existed Prior to Service". For some patients this means taking isolated incidents that occurred long before joining the military and naming them as the proximate cause, even if the service member never had any symptoms or received any treament for them. This is analogous to telling an amputee his injury existed prior to service because the now-missing ankle was sprained on a Boy Scout hike when he was a kid.

 We let our Vietnam vets languish with no help as they dealt with these same problems. Thankfully we understand this damage better now and can offer help. But we cannot allow the bean counters to deny care. The cost of treating our combat wounded is a price we must pay. We owe it to them.

If you are aware of any cases where this has happened please let me know. I will be taking this information as high up the flag pole as needed to make sure ALL wounded warriors get the respect and care they deserve.


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