More on diagnostic abuse of veterans: The coverup and the why
April 10th, 2009
Mark Benjamin and Michael de Yoanna at Salon complete their story on the army’s misdiagnosis of PTSD as other conditions, such as anxiety disorders. [See my earlier take on this story.] Yesterday they described the farce of an Army “Internal Investigation,” a.k.a. coverup of these diagnostic abuse, conducted by officers previously accused of involvement in such abuse!
What also escaped the black pen was the name of the man who presided over the review: Brig. Gen. James Gilman, who commands Great Plains Regional Medical Command, which oversees several Army hospitals, including the one under scrutiny at Fort Carson. Gilman assigned Col. Bruce Crow, the clinical psychology consultant to the Army surgeon general, to supervise the actual investigation….
Crow, meanwhile, was also implicated in the “personality disorder” scandal. As Knorr was writing up his review back in 2007, the Army dispatched Crow to Congress to “set the record straight,” as he told the House Committee on Veterans’ Affairs on July 25, 2007. Crow said the Army would study soldiers dismissed with personality disorders but suggested the Army was doing nothing wrong. He said soldiers with a diagnosis of personality disorder only “feel” they have been wrongly separated from the Army. “I want to assure the Congress that the Army Medical Department’s highest priority is caring for our warriors and their families,” he told the panel.
The investigators did not even talk to the officer accused of applying pressure to misdiagnose:
It appears, however, that investigators did not question the Army officer who Douglas McNinch said had pressured him not to diagnose PTSD. In an interview with Salon, McNinch said the pressure to misdiagnose soldiers came from the psychiatrist who used to head the Department of Behavioral Health at Fort Carson. “His name was Steve Knorr,” McNinch said.
Another officer involved in the investigation was junior to this same Knorr:
Salon has learned that one of the officers conducting the investigation of the tape is a junior officer to Knorr at their shared Army post. Lt. Col. Kris Peterson, chief psychiatrist at Madigan Army Medical Center at Fort Lewis, Wash., assisted Col. Bruce Crow in the investigation of the tape. Knorr is now a health consultant at Madigan.
In typical military behavior, a general announced what the investigation would conclude before it was even conducted.
Cody told Stichman and his associates that an internal investigation of the tape would be conducted. To Stichman’s surprise, Cody then suggested what the not-yet-completed investigation would reveal.
Cody denied that the Army was pressuring doctors not to diagnose PTSD in soldiers. “There is no one in leadership telling doctors to do this,” stated Cody. “This is not Army policy.” Cody called the evidence on the tape “anecdotal.”
In today’s concluding installment, Benjamin explains what is at stake for the military in this alleged behavior, money, a lot of it:
[I]f soldiers are identified as suffering from PTSD and thus disabled, the Army may have to separate those soldiers from the military and pay benefits — benefits that are extensive and can last a lifetime. The direct costs to the Army for treating soldiers with PTSD are potentially astronomical.
If you are a soldier who is officially disabled, you are entitled to collect a percentage of your base pay each month. The percentage depends upon your level of disability. Though this doesn’t happen in every case, the proper disability rating for PTSD is 50 percent, according to an Army memo that is now part of a class-action lawsuit by the National Veterans Legal Services Program. So let’s say, for example, that a 25-year-old private first class was discharged from the Army because of combat-induced PTSD and lived to be 75 years old while collecting benefits at the proper rate of 50 percent. The PFC would receive $784 a month, or half of $1,568 base pay (based on 2009 pay levels) for 50 years. That’s $470,400.
Now take that half-million dollar figure and multiply it by the number of returned troops who may be suffering from PTSD. Almost 2 million men and women from all service branches have served in Iraq and Afghanistan. The academic studies of PTSD cited in the Rand report include estimates of the true incidence of PTSD among Iraq veterans that range up toward 20 percent. A 2004 study in the New England Journal of Medicine said that 19.9 percent of Marines deployed to Iraq and 18 percent of Army troops deployed to Iraq may suffer from “broad definition” PTSD.
When a soldier with PTSD is diagnosed with a less serious illness, his benefits may very well be reduced dramatically. PTSD is often the result of witnessing bloodshed or nearly dying and is often linked to combat. But if a soldier’s injury is more vague, like anxiety disorder — the condition the Fort Carson psychologist on Sgt. X’s tape said he was being pressured to diagnose in soldiers instead of PTSD — a soldier may struggle to prove that an injury occurred as a result of the war and lose out on tens of thousands of dollars in benefits. A soldier suffering from anxiety disorder may receive some disability benefits, but almost certainly will not receive benefits that total 50 percent of base pay.
Thus, the amounts at stake could be over $100 Billion, depending on what level of benefits are avoided.
Also involved is the insatiable need for manpower to fight this country’s never-ending wars:
A recent Rand Corp. study estimates that nearly 20 percent of those Army troops who have served in Iraq and Afghanistan might suffer from PTSD or major depression. If they were all barred from the battlefield, the Army could lose as many as one out of every five combat troops while trying to fight two wars.
Given what is at stake, it will take tremendous effort to change the system apparently producing these abuses.
Entry Filed under: Healthcare,Mental Health,Psychiatry,Psychology,Veterans