Fraud puzzle concept

Just in. An Army PTSD policy memo buried deep in the nether regions of the internet highlighted supremely low levels of fraudulent disability claims made by veterans with PTSD.

I personally searched for this report for the past two years until today. Many advocates cited the report’s statistics without knowing where to find the research that confirmed what we all know – VETERANS DO NOT LIE – at least not 99.4% of us.

The document is called, Policy Guidance on the Assessment and Treatment of Post-Traumatic Stress Disorder, and it went into effect 10 April 2012 and expired two weeks ago, so it is a pretty fresh find, at least for us out here. The tall and short of it is that the report – from the Army no less – cites evidence that suggests disabled veterans just do not make fraudulent disability claims.

As a quick aside, this document was not searchable when I found it, which is a typical trick of DoD and VA to keep many Google sleuths from finding the data. This means that no matter how hard a person looks, they could only find it by dumb luck. And, I was dumb lucky today. So I found the document and did OCR it for all veterans to hopefully find when looking for insight.

According to research cited in the Army memo, out of 2,100 veterans’ claims, only 13 veterans made potentially fraudulent disability claims. This means VA was willing to spend millions upon millions to detect a tiny splinter of potential fraud and in so doing gum up the entire disability compensation system. In 2011, this fact was cited as the reason for relaxing the PTSD criteria a few years ago despite the cries of others in VA who are still Veteran Haters.

The Haters are those DoD and VA employees convinced veterans lie because of the financial incentive; ferreting out supposed liars is worth the multi-million dollar industry for the Insurance Industry and VA. The industry created malingering detectors like the fabled MMPI-2 and similar to bust people making fraudulent disability claims.

The memo stated the chance of fraud was so low the Army directive to commanders and MEDCOM regional commanders implied for the leaders to not bother with heavily testing for malingering. This makes sense since so few veterans actually made up their conditions.

Here is a little quick history on why this issue matters. Until around 2005, VA believed veterans would lie a lot because of the incentive to do so when seeking disability compensation money. However, when it came time to evaluate this assertion, Veteran Haters struggled to find any direct evidence to support their assertion. Instead, VA OIG and numerous VA researchers, who believe veterans are more honest than common criminals, found the opposite was true.

This leads to the conclusion that veterans are more honest than VA thought. Yet, there are clearly many Veteran Haters in the system harming veterans.

This issue of malingering matters because it means many VA claims were probably denied until recently merely based on the bias of the VA evaluator who assumed you lied. Evaluators would look for any basis to deny based on the false assumption that many veterans lie when it comes to disability compensation and PTSD. If true, this would mean many veterans were falsely denied compensation and in turn denied proper health care treatment that would have relied on the compensation determination.

Fear no more. That is right my friends. Veterans, by and large, are usually just as honest today as the day they swore to protect the country from all enemies, foreign and domestic. While every group has some rotten apples no doubt, the Army has apparently pulled back its previously suspicious position of screwing its troops (pre-2012). What I have a hard time believing is the fact that Army seemed to embrace this reality.

Here is part of what the Army policy memo says:

Although there has been debate on the role of symptom exaggeration or malingering for secondary gain in DoD and VA PTSD Disability Evaluation System (DES} processes, there is considerable evidence that this is rare and unlikely to be a major factor in the vast majority of disability determinations.  Strong evidence comes from an internal 2005 study by the VA Office of the Inspector General showing that of 2,100 VA disability cases rated at 50% or higher, only 13 (0.6%} had evidence that they were potentially fraudulent (Marx, 2011}.  These findings were later corroborated in a study by Dohwenrend, who found virtually no evidence of attempts by veterans to inflate disability claims (Marx, 2011).  Several other studies have shown that compensation seeking and disability benefits are associated with improved treatment outcomes (Marx, 2011). As a result of these and other studies, the VA recently relaxed policies that required veterans to provide proof of specific combat-related traumatic stressors, essentially accepting that deployment to a war-zone is sufficient to meet the A 1 criterion. This is consistent with evidence from peer-reviewed studies showing that the perception of threat (distinct from the level of actual threat) is an independent predictor of PTSD symptoms, and is also consistent with the DSM-V committee’s current recommended definition change. (Page 5)

I am sure some of you more inquisitive types are wondering, “who the heck is this Marx guy and why doesn’t he work at VA?” Well, you are in luck. Dr. Brian Marx does work at the Boston VA and is a rather outspoken researcher on the subject of veterans not being liars.

What Dr. Marx did

Back in 2008, Dr. Marx called out some of his colleagues who supported claims that veterans malinger a lot. He highlighted how the naysayers used unreliable studies to really disparage veterans in support of creating more studies and spending more tax dollars:

Selective coverage also is reflected in the Frueh et al. presentation of issues concerning malingering. Although they cite extensively from the 2005 report by the VA inspector general, they fail to acknowledge that the same report found that only 13 of 2100 (0.6%) service-connected PTSD cases subjected to detailed review were deemed to be potentially fraudulent. The highly influential study by Dohrenwend et al. cited by Frueh et al. also presented minimal evidence of attempts to inflate disability claims.7

Furthermore, their suggestion that 53% of treatment-seeking (especially compensation-seeking) veterans exaggerate symptoms or malinger on psychological tests is based on a small sample drawn from a clinical setting.8 The evidence is further limited by reliance on a measure of malingering that has not been validated in relation to assessment of PTSD outside a forensic setting. In addition, interpretation is tempered by previous research suggesting that, among veterans with PTSD, putative symptom exaggeration may be as much a sign of severe distress and psychiatric comorbidity as malingering.9 Even if the limitations of the study are ignored, the finding that service connection for PTSD was equally common for veterans who showed purported signs of symptom exaggeration and those who did not is inconsistent with the hypothesized negative impact of VA psychiatric disability policies.

How Army defines “malingering” and how to evaluate it:

Malingering: Although the influence of secondary gain is an important clinical consideration in the differential diagnosis, the diagnosis of malingering should not be made unless there is substantial and definitive evidence from collateral or objective sources that there are false or grossly exaggerated symptoms that are consciously produced for external incentives. Poor effort testing on psychological/ neuropsychological tests does not equate to malingering, which requires proof of intent, per OTSG/MEDCOM Policy 11-076. In addition, this diagnosis requires the signatures of two credentialed care providers, including a supervisor, Department Chief, or Deputy Commander for Clinical Services {OTSG/MEDCOM Policy 11-076). (Page 7)

The Army policy memo also defines Adjustment Disorder and Personality Disorder. These are two big whammies Army was using from 2001 to 2010 to screw troops out of proper benefits. The Army trick was to re-categorize the person’s conditions to avoid paying out medical retirement and related VA disability. Be sure to check that out if you are interested.

Keep in mind, this policy just expired two weeks ago, so it is no longer binding. However, it should give any reader a good idea of what Army had changed its position from when it treats Post Traumatic Stress Disorder and other conditions.

Read More: Army Policy

OTSG/MEDCOM Policy Memo 12-035

 

Read More: Dr. Brian Marx

Military-Related PTSD, Current Disability Policies, and Malingering

 

8 COMMENTS

  1. I HAVE BEEN IN THE SYSTEM SINCE 1979 AND NOW I ACTUALLY KNOW WHY. THANK YOU BROTHER BENJAMIN. ALTHOUGH THIS DOES NOT “CURE” MYMALADIES, IT DOES “LIGHTEN” THE LOAD.

  2. I have been through living mental and emotional Hell with PTSD since serving 15 months in a combat unit in the Vietnam war. Every VA clinician or administrator and ALL politicians and Congressional staffers I have dealt with in the past 40 years have automatically assumed I was lying about my condition to scam the system. That has been at least as traumatic for me as the stress in the war that created my PTSD. Thank you for publishing this article. Screw the VA bonus parasites and screw the corrupt Congress.

  3. What all this proves to me, Ben, is that a culture of self-deception and practiced deceit runs all through the VA system, especially at VA Central Office (VACO), and has for a very, very long time. The proof supporting your remarks in this article is the April 16, 2007 cover story for US News & World Report entitled, “CHEATING OUR VETS: HOW THE PENTAGON (& VA) IS SHORTCHANGING WOUNDED SOLDIERS.” This explosive story told in shocking detail how the DoD and VA were engaged in a clear anti-veteran campaign to screw veterans, even those who had TBI and losses of limbs, and more.
    My own experience with the VA have shown me that dishonesty and falsified medical and other records are a common occurrence and not at all something rare.

  4. I think that now that the Phoenix VAMC has been proven to have engaged in hostile actions to veterans in dire need of medical care by keeping them off the books, the next big step for Congress is to grant whistleblower protection to any VA employee who presents reasonably credible information of wrongdoing and corruption by other VA employees and management officials. As Dr. Sam Foote stated as the story unfolded, many VA employees would prefer to speak out, but fear of retaliation by way of their employment termination from VA. The only way to counter this evil practice by VA is to give full protection of federal law to any VA employee who blows the whistle.

  5. Like most of us know this from experience but to see it documented and researched is something else. At the minimal VETERANS are traumatized everyday just in training accidents, let alone overseas duty in nations that hate us and the little skirmishes that happen all the time. And then there are the war trauma! It blows my mind how there can be any doubt about a VETERANS claim at all. Nice find Benjamin! TY

  6. Thank You Benjamin. It is time to weed out the people at the VA,who are so Biased against us Veterans.Good to find a report backing what millions of Veterans know to be true. Thank You Again. God Bless

  7. Jul 5, 2014,
    I to just discovered this same article and a couple of others that preceded it. I am working with a family that the the son has PTSD and I doubt that his command is working with him through this

  8. Hello, I was shot in the head in 1972 in germany, by a german citizen point blank and survived. When I was discharged in 1973, I went to a v.a. hospital who would not give me treatment for p.t.s.d. stating you must have a service connected disability to seek care. I told them I was shot in the face. They told me to file for disability and when I did, I was told the v.a. has not record of me being shot and denighed my claim, stating they needed more information or evidence. The army did not give me any paperwork showing that I had been shot. I could not remember who was with me at the time of the shooting, so I could not contact them to verify my story. So I had no idea how to get the information, I told the v.a. to go check the cq records or the captains records or the c.i.d. and I applied again and again with the same response, we need more information evidence and told me my records had been burnt up in a fire. I finely obtained a lawyer out of kansas, who was able to get my disability for p.t.s.d. and got me back pay from the date I hired him, not back to my discharge date or when I first filed or any other date I requested disability. Back pay was 2001 not 1973. I was not told why the v.a. changed their minds to give me my disability and was never given the reason, I was just happy that someone was able to mget the v.a. to listen. I called the v.a. and asked why I was not given back pay from 1973, they stated you let your claim lapse. I told them how was I going to keep fighting and they keep turning me down, stating they needed more evidence. Just to find out by obtainging my medical records and happened just 2 months ago that I found out that during a rating by the v.a. that infact the v.a. had records all along showing that I had been shot in the face at point blank range and that I had powder burns, laceration, contunsions about my face and that I was taken to a german hospital and then to an american hospital. I do not remember this, why ?, I guess because I was shot in the head. I had to suffer for 40 years with p.t.s.d. and to find out that I also had a traumatic brain injury. The v.a. sent me to a private hospital for treatment of my p.t.s.d. and while in the hospital I was speaking with another patient and told him that I was there for help with my p.t.s.d., and was given a rating of 30% and that I felt it should be at a higher rating and told him, You know I wish the rater would have been shot in the head like I was so maybe they could know what I had to go through The statement was like telling someone the old saying if you could have walked a mile in my shoes, you may think differant. Someone from the staff heard part of the conversation and reported to the v.a. that I wanted to shoot the rater and then it changed from me wanting to shoot the rater, to I wanted to shoot people at the denver v.a. and then changed again to I wanted to shoot people at my local v.a. clinic and the v.a. proceeded to punish me through the disruptive committee and my local clinic jumped on the band wagon and told higher management that on many ocassions I had come into the clinic at least twice a month and would become disruptive. I told the committee to provide me with any and all evidence showing that I had ever been disruptive at any v.a. at any time. I was told there is no evidence anywhere showing that I had ever been disruptive, BUT it had been colorabated. By whom, they would not respond to my inquiry. They never offered me any recourse to fight back or to clear my good name. I advised the v.a. that the person whom told them that I had been disruptive, was a employee who was retalating against me, for something I said about her when we were both employeed by the v.a. and now that person is the lead administrator of my local v.a. clinic. I asked for an investigation and my civil and constitutional rights be aheared to. The director told the senators office they never heard of the this person, whom I claimed was retalating against me, where the records show that the person I was talking about was actually a member of the disruptive committee and she was able to lie to the committee and allowed only hearsay to punish me and placed into my medical records that I had threatened to shoot staff at my local clinic with no evidence and proceeded to contact the f.b.i., I.G office and my local police dept in a rural area. Any inguiry by the d.a.v. or senators office to the director was responded to telling the d.a.v. or senators office if you have any futher inquires about this matter please contact the lead administrator of my local clinic, the lead administrator is the one that is retalating against me, so of course she is going to lie about me. So the v.a. let her police herself and answer those inquires. She also stated to those inquires, that I would not be able to seek care at my local clinic because I would not admit, that I had been disruptive. Why would anyone in their right mind admit to something they never did in the 1st place. They made me go to a different clinic 60 miles away, I was told to go there for to years and that will prove that you are not disruptive. I did as I was told, the v.a. red flagged my records for every v.a. employee to see and shune me. They would ask why are your records flagged, I told them I guess because I am a former v.a. employee ?. The director tell’s the senators office that my records were never Red Flagged, nor was my medical records coded for disriptive behavior and their was never any investigation to verify the allagations. My record show over and over disruptive behavior coding and orders to Red Flag my records and placed into my records that if the v.a. ever hears that I am ever reported again that I have been disruptive or do not do what ever my treatment provider says, You will be arrested, banished from care at any v.a. facility by federal authorities. and the kicker they state this is open ended and will never end. So they have given the employee who started these charges the ability at any time of her choosing to say that I have been disruptive again with out any evidence to have me arrested and banished from care. Also stating that they never heard of the employee I am speaking about. When it in the records she was on the disruptive committee when they took action against me. I have written to the o.i.g. and other agencies. no response or acknowledge that they received my complaint. I had my records sent to me and also found out that the regional office did infact have all the needed evidence that I in fact was shot in the head and have a traumatic brain injury, where I should of had a disability from the very begaining when I first applied. The very sad part is that in my heart I know that I did nothing wrong and that if they are doing this to me, the v.a. has to be doing this to many other veterans and are getting away with it. Active duty members will be on the chopping block next, you father, your mother, your brother, sister ect. Will there ever be justice and those hurting veterans and their families pay for their misdeads. I have be in a mental prison for the last 10 years wondering everyday is this the day, I am going to be arrested by the v.a. for something I never did. Told oh the v.a. can’t do that with out evidence, well they did and I am locked in my home, afraid to go out in public and have the cops arrest me in front of strangers, my family members, just because someone at the v.a. does not like me for saying I did not thing they were doing their job as required. Retalation pure and simple. I want to be a free man, without worry of having my good name slugged through the mud and lableing me as a possible murder. I hand my head in shame not for me, but for the way the v.a. is huting me and my fellow veterans. God bless all of you. If you call the I.g. phone number you can not speak with a person. Why are they in the shadows.

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