Is Army PTSD Misdiagnosis Scandal Also Fraud?

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Recent comments uncovered by Army investigation reveal possible high-level medical fraud being committed against active duty military personnel. To prevent fair disability ratings for servicemembers with PTSD, Army psychologists have been “cooking the books.” During a PTSD conference at Madigan, an unnamed psychiatrist warned participants the Medical Review Board must be on the lookout for taxpayers when diagnosing PTSD.  He expressed concern that military members suffering from PTSD and receiving disability would bankrupt the Army and the Department of Veterans Affairs. For that reason, the psychiatrist said he would not follow standard operating procedure, which he equated to “rubber stamping,” in assigning PTSD ratings. Dr. William Keppler and another Army doctor have been suspended from clinical duties while the Army investigation unfolds. Madigan falls under the Western Regional Medical Commend (WRMC). The WRMC issued the following statement regarding its investigation into the matter:

The U.S. Army Medical Command and the Western Regional Medical Command are taking this issue very seriously, and have initiated investigations to look into the concerns outlined in the Memorandum For Record. We are very sensitive to the issues that have been raised and are working hard to address them. Soldiers expect and deserve the best possible care with compassion, and our priority is to make sure that all Soldiers are getting a fair clinical assessment and diagnosis in the Disability Evaluation System (DES) process. However, while the investigation is being conducted, it would be inappropriate for us to comment further on the details of any inquiry until it is completed.

When taken at face value, the psychiatrist’s statements mean many veterans who were diagnosed at Madigan were likely not awarded their diagnosis properly. This misdiagnosis is the result of a failure for the medical professional to follow the law and their ethics codes. This failure is the result of the professional believing they had a duty to the taxpayer rather than a duty to their patient. Any civilian medical professional guilty of misdiagnosing a client on purpose could be guilty of medical malpractice. Further, by submitting knowingly false statements to the government in the form of a disability compensation evaluation is fraud. Here is the minimal requirement for fraud:

Black’s law dictionary defines constructive fraud as “all acts, omissions, and concealments involving breach of equitable or legal duty, trust or confidence, and resulting in damage to another, 38 Cal Rptr. 148, 157; i.e. no scienter (knowledge) is required. Thus the party who makes the misrepresentation need not know that it is false.’ (USLegal.com).

Here, we know within a reasonable amount of inference that at least the doctors in question knew they were misdiagnosing servicemembers. The veterans who were misdiagnosed have damaged in the form of lower disability ratings and the doctors in question must be prosecuted. The Army has a duty to notify all former and current servicemembers possibly affected that their exams were possibly tainted. My question is, where did this idea come from, that a psychiatrist has a higher duty to whoever pays the bill rather than the patient. I doubt highly that it came from the American Medical Association or the American Psychological Association. Sounds to me like it came from someone within the DOD or the executive. At this point, the Army is tight lipped on the matter. However, Senator Patty Murry, Chair of the Senate Committee on Veterans Affairs, is closely following the matter. We will report back as the investigation unfolds. Update: According to the Seattle Times, “the Army Medical Command has a hotline available for soldiers and veterans who have been screened by forensic psychiatric teams since 2007 as part of the evaluation process for medical retirement. Soldiers and veterans with concerns about their diagnosis may call 800-984-8523.”

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Eddie Young
Eddie Young

Execute a half dozen of these shitbags and I believe that other medical “professionals” at the VA will get the hint. It’s bad enough that the bottom 1% of US medical college graduates and 99% of foreign medical college graduates staff the VA anyway.

I’d like to see Sen. Murray show her stones and transfer all of the MDs that treat congresspersons to the VA and transfer the bottom VA MDs to treat them.

Bob
Bob

Funny that nobody considered the burden of the taxpayers when sending us going nen go war.

Robert Bauman
Robert Bauman

As a Navy Seabee serving in Vietnam 1967 – 1968 I dealt with constant sniper fire along the roads while driving Heavy Equipment to construction sites and running convoys.

The PTSD I suffered from cost me 2 marriages and 30 some jobs in 40 years. I submitted a claim in March 2003 and was told by the VA, “Seabees are noncombat, support troops for the Marines and could not possibly have seen combat.” In 2005 I suffered a breakdown from stress and anxiety, and the many fears that haunted me since 1968.

The VA insisted my PTSD was NonService Connected and refused to help me. My VSO suggested a Private Psychological Group. I paid $500 for a 5 hour intense interview, and was proven to suffer from PTSD due to combat situation in Vietnam.

In September 2007, 39 years after the fact, the VA grudgingly approved my claim and awarded me 70% Service Connected PTSD.

corriell brotherwood
corriell brotherwood

When I was active duty I was given the test for PTSD 3 times. Each time the test results said I had PTSD but I was told that I did not have PTSD and sent to anger manegment classes. Finaly it got so bad that one moring I just froze in bed and my wife could not get me to responed. I was taken to a hospital off base and dignosed with GAD. I froze up a month later and when my NCO picked me up from the VA hospital he told me I wa being discharged in three days for hardship. I have not been able to hold a fulltime job since and was fired from my last job for my inability to handle conflict

Sue Frasier
Sue Frasier

This is a clear rush to judgement and it can only happen if you are not keeping up with the REST of military veterans news. The Army just recently halted the use of an anti-malaria vaccine it had used on deployed troops for entire DECADES specifically because it was giving out false readings and exact symptoms of PTSD. They really couldn’t tell one from the other. The news of “changed diagnosis” cases may very well be a result of the Halt Order on the anti-malaria vaccine. We should be giving the practitioners the benefit of the doubt until a complete internal investigation is done to explore their motives. This is classic of how PTSD-Whiners all rush to judgement in a situation when they themselves don’t even keep up with the news. — Sue Frasier, Army 1970, national veterans activist.

Eric Witten
Eric Witten

Any person that has been through a Medical Evaluation Board and/or a Physical Evaluation Board has most likely been subjected to something that is at least similar to this situation. While most of the physicians I had interactions with did not overtly display this attitude, but, there were a couple that were extremely concerned about the financial effects of their opinions. I know that not everyone has the same experiences with the same doctors at the same facilities but, I have encountered veterans at many different locales that have expressed concerns about their experience. I think you really highlighted the most significant issue here, which is the patient and doctor relationship. We (veterans of military service) are all led to believe that we can trust the doctors that are treating us and the bureaucrats will make financial decisions. This trust is violated simply by the design of the military healthcare system. The military services hold their physicians accountable for financial issues that aren’t related to their practice. The physician’s should only be held accountable for the quality and timeliness of care provided to their patients. Now, we have veterans who aren’t receiving the appropriate level of care and we have physician’s who don’t want to stay in military service because of this. All the while, it was never the intent of our elected officials or the public in general to create this environment. I can’t think of anyone who would try to skimp on caring for veterans because of money except some manager or officer trying to improve their own position. It is very sad but, interestingly enough, veterans are their own worst enemy. There is a small portion of our population that is so concerned that someone else is going to get something that they can’t have, that they will go to amazing lengths to prevent it from happening. Congress has expressed at every opportunity that their intent is to take excellent care of veterans now and in the future. However, there are those that oppose this, and they are among us.

les
les

And I would bet that every one of the doctors are republican?

Jason
Jason

Last time a law suit came out about PTSD being misdiagnosed it didnt apply to those that were not discharged with PTSD as their chief complaint. Does anyone know if the decissions made by this inquiry will effect those that have PTSD as a secondary complaint?

Michael Parker
Michael Parker

A changed diagnosis from PTSD (or other menetal conditon) to personality disorder or adjustment disorder does not lower the DoD disability rating, it eliminates it.

Enclosure 5 of DoDI 1332.38 states personality disorder and adjustment disorder are non compensable conditions. With such a diagnosis the individual doesn’t even get a MEB and a PEB, rather they get a nonmedical administrative discharge. Such a discharge can affect other benefits such as GI Bill eligibility.

This is the root of the evil. The reason they are calling them personality disorders and adjustment disorders is because DoD made up a rule that these conditons would not be compensated.

If these same DoD/DA civilian doctors were themselves found to be unfit for continued service due to personality disorder or adjustment disorder, they would receive a full disability retirement under the Federal Employees Retirement System. It is only the military members with such diagnoses that are thrown overboard like yesterday’s garbage.

To fix the problem, you got to fix DoDI 1332.38.

Albatross9668
Albatross9668

I had heard that there is a big difference between the “medical” side of the VA and the “comp & pen” side, with most of this type of thing being allowed to go on over on the “comp & pen” side where the rating decisions are made. This is scary that these things are happening on the “medical” side too… I am going through that right now… I just filed a NOD for notes that my rating exam doctor made about the condition of both of my knees that was “left out, omitted” on my rating decision explanation. I was rated 10% for each knee, but if this information had been included, according to the CFR and the VA’s own policies on rating knees, I would have gotten the higher rating… This isn’t where our government should be trying to “save taxpayer money”, by committing fraud against veterans… Unbelievable!

Donald Marshall
Donald Marshall

I am not surprised at all. I had a then unknown multiple (six types of germ cell cancers) forms of cancer. The medical review board found that I had no disability. I have struggled with nerve damage, and two heart attacks from the massive amounts of chemo that they gave me at Walter Reed. I have had two heart attacks (one at 39 and the other at 44) all linked to the chemo. The bottom line is they can do anything they want and there is not a dam thing we can do about it. We are the disposable portion of society. It is amazing a congressman can serve less than one term and still get full pay with increases for the rest of their lives. A soldier can give 20 plus years and get half of their pay for retirement, and give parts of their body and mind and the government will look for any stick it to them.

Nancy Zapata
Nancy Zapata

Each time a veteran is treated by a VA psychiatrist at a VA Hospital or VA Community Clinic to keep their prescribed medications current, the doctor must write up the patient visit in the VA system, but before posting the visist notes to the patient’s database, the doctor has to separately determine and enter a GAF score figure into a “Confidential GAF Summary” database on the patient. This is the key indicator from the VA doctor that (unknown to the disabled veteran, or even his attorney), tells VBA disability compensation claim adjusters how to rate the claim. When it comes to PTSD disability claims, the VBA will screw with veterans for years until they receive several VA C&P exams from psychologists detailing the veteran’s inability to work or function socially due to combat PTSD, PLUS a trend of low GAF scores of “49” and less from the vet’s treating psychiatrist on his/her “confidential GAF summary” report. A rolling five years of GAF scores are secretively held in this database, and, unless you ask specifically for this report, medical history clerks at VA hospitals will not provide it to you or your attorney or service rep. Sometimes you have educate the VA personnel of the report’s existance. If you are in a PTSD Disability Claim and Appeal process, obtain all medical records from all doctors, and anyone else who provides medical patient notes. Knowing how your doctors have rated you on the CONFIDENTIAL GAF SUMMARY will give you direct knowledge of how and if, or when, the VBA may decide in your favor. Otherwise you’ll be flying blind for years or decades bouncing about in their secretive adjudication process. GOD BLESS AMERICAN VETERANS

Michael Parker
Michael Parker

In this case, it is not the VA. It is DoD. The VA is calling it PTSD but DoD is changing it to adjustment disorder or something else. Not that the VA didn’t try something similar in the past. Remember the Texas VA PTSD email that blew up a few years ago?

This is about ratings under the Defense Disability Evaluation System, not the VA.

Mike

David A Castaneda
David A Castaneda

I can guarantee that when doctors begin to look at the paychecks instead of the patients, a gross injustice is about to be made. Not only do they have no business misdiagnosing for monies sake but they do not have the right to do this! It is in fact, a direct violation of their Hippocratic oath! “Lest you do no harm!” Harm in the form of deliberately misdiagnosed patients is still harm and those who have done it are committing a federal fraud. They better damn well be held responsible for this too!

Dawn
Dawn

I see this disgrace continues. Was discharged in 1990 with Personality disorder/adj. disorder after notifying command of sexual assaults. Actually was suffering from PTSD but of course ignored to avoid paying retirement/benefits. Was diagnosed after only 2 -10 minute sessions with Dr. My service was excellent prior with high evals. Took 15 years of continuous appeals to get 50%. and was forced to get Attorney to grant me that. If I would have known the motives of Government then I would have raised hell before leaving. The money isn’t the issue but the negative mark that can never be erased from my record for simply coming forward. I have also been refused Federal employment because of this diagnosis and discharge characterization. Shame on the Government and Drs. that facilitate this fabricated discharge.

W.Kucera USARMY
W.Kucera USARMY

This month in March i am waiting over 2 years for my PTSD appeal. My first eval. was in July 2009 from my Psychologist which lasted 120min. All information was sent in to the VA.
The second eval was from the VA in Jan. 2010 and lasted about 10 min. I had better job interviews then this joke of a eval. I received a letter from the VA giving me a 10% rating. I appealed the rating and had another eval from my Psychologist Feb. 2010. Information again was sent to the VA.
Another letter was sent by the VA 09/13/2011, for another psych eval testing and psych gedo clinic at Viera clinic. However on 09/15/2011 another letter was sent to me stating to cancell both appointments and will not be rescheduled. As you can see i have no idea what the hell is going on or is this just a game that we all lose. The ebenifits on line does not help or the 800 number is a big wast. Turning 63 how much longer does the vietnam vets have left. I would like some answers.

Thanks Walt

Marc Conder
Marc Conder

A diagnosis is part objective fact and the rest? subjective opinion. Unlikefor example, Lukemia, PTSD has a strong behavioral component that most physicans can not understand, particularly since it is episodic, and most often occurs outside of the exam room.
Until there is a quatifiable test that can be administered by any health care professional, PTSD will remain an issue of questioning.
I have worked in the health care field for 30 plus years,and in my opinion what the VA needs is a peer review board, men, no more then 24 months off the battle field. These people would know instantly the signs of PTSD, unlike a physican in a quiet office in one of our MEDCENS.

Terry
Terry

Ahhh… The gratitude of a grateful nation.

I will admit that not every claimant is suffering from PTSD, but to purposely misdiagnose a combat veteran because someone is concerned about the monetary costs of that veteran’s benefits to the federal budget is beyond calling it a disgrace. Perhaps the policy makers and DOD personnel should have considered this BEFORE they repeatedly commit American forces to such hell holes. They call them heroes and defenders of our way of life in public but treat them like unclaimed step children to be put out with the garbage when they return as “damaged” goods.

And then they wonder why I have no trust or faith in bureaucrats.

Viet Nam Vet 70-72

laura ledbetter
laura ledbetter

I somewhat agree with the Docs that felt it their duty to save a few tax payer dollars. Reason being, there are deecent percentage of claims applicants whose symptoms and diagnosis are pretty dodgey at best. Now dont get me wrong there were probably some cases that needed a higher rating but did not get it because of these fakers.

Eric Witten
Eric Witten

Terry brought up an excellent point in his post. It is something that has infuriated me since I volunteered for service in the Army in 1993. Our government has found more ways to employ our military services in combat operations without calling it war than I could ever imagine. Military service in itself is a very unique occupation within our society. Merely having served a two or three year enlistment seems to institutionalize young people almost like a young person having spent time in prison. The average person doesn’t understand this. Unless you have “been there and done that,” a person cannot begin to comprehend. My best example is the common sense approach applied by civilian law enforcement. Most departments will immediately relieve an officer of his/her duties for an undetermined amount of time after having been involved in or witness to a catastrophic event. This will be followed by medical and emotional evaluations. The officer may be reassigned to administrative duties for some time or they may return the officer to normal duty if that is what he/she wants to do. In military service there is no timeout. There is no break. The service member may experience several catastrophic events in a twenty four hour period and they are expected to do it again on the next patrol. I definitely agree with Benjamin on his observations. I refuse to sit nice and quiet while I draw my benefits and allow my brethren to suffer. If a few people get a couple thousand dollars they did not deserve then shame on them. I believe in the honesty and integrity of those I served with. The VA simply states that they should err on the side of the veteran and they need to maintain that attitude in rating.

laura ledbetter
laura ledbetter

I apologize Benjamin and Eric if my post was misunderstood. I wrote that because of my frustration with my own dealings with the VA. There are vets I know nothing happen to and are getting paid benefits. I did not experience my trauma until after the war and because I dont have medical records from that time, my claim gets disapproved. Trust I am appealing this decision. It just frustrates me that the system is not working for me and working for those that I know are lying.

Michael Parker
Michael Parker

Well again, this issue has to do with Army doctors changing VA PTSD diagnoses to a non compensable mental condition (adjustment disorder/personality disorder). These are active duty troops, not post service veterans. So, those who are actually faking it can be dealt with under UCMJ but we can’t screw the masses to avoid a few cheaters.

Please understand that both the VA and DoD assess an individual who is undergoing disability evaluation under the Integrated Disability Evaluation System (IDES). The IDES was supposed to stop the variance between DoD and VA diagnoses and ratings. Unfortunately, no one is making DoD follow the rules.

This issue happens with non mental condition cases as well and across all the Services. The VA will service connect and rate a condition while DoD states it Existed Prior (EPTS) to Services (EPTS) and is not compensable. Both the DoD and the VA are required to back up EPTS determinations with clear and unmistakable evidence but again, no one is holding DoD feet to the fire on this requirement. Until somebody does, wounded warriors will get cheated out of DoD disability benefits.

Laura,

Have you tried getting statements from freinds/relatives who know about your trauma?

Mike

Liam Athias Babington
Liam Athias Babington

Considering the fact that I was misdiagnosed, well not even misdiagnosed, I was completly ignored. I ended up putting a gun up under my chin, the rond never went off !! even after 3 tries, even when I went to my vanuted medical hospital in the Air Force I did not recieve any help. I was given a different diagnosis. and still kept in, I was treated as if I had a cold or something. It was not until I went home that I got the propper help that I needed…from a private psychologist. I took my complaint all the way to a 3 Star General while I was still in the Air Force! I had better luck talking to a wall. The fraud is widespread folks, if you really think that whatr happened at Madigan is a fluke then you are fooling yourselves. it is an epidemic…..and it may get worse before it get’s better. And yes, for those whom question what I wrote here, I got the proof, An dI do not care who knows!!

brenda
brenda

it’s very sad when veterans that were injured while in the military are treated so bad, when the veterans that don’ have anything at all wrong with them, gets away with everything..i’m a disable vet, and i injured my right knee while i was in bootcamp during a drill ceremony back in the seventies; i didn’t know that i could have applied for help once i got out of the military because no one told me i could…but anyway once i got all the information that i needed, i applied for disable vet compensation…i got turned down twice, which i had a representative, but the third time i decided to appeal for myself…well to make a long story short, i have been receiving ten percent for several years, and now that the pain has gotten worrier across my hip to my left knee and leg….the doctor has given me a walking cane, two knee bracelets for both knees, pain pills that i have to constantly take for my pain, i had to quit my job of four years due to the eight hours of standing forty hours a week, and then to have them deny me of more percentage for my knee…plus my doctor stated that the pain has gone from one knee to the other knee…they are thinking about surgery, but the doctor stating that he don’t want to do it right now, so i have decided to go to another doctor to see just what is going on with both my knees….like i told my doctor, you are not in my body and you don’t know how painful my knees really get, sometimes it hurt just to walk from one room to the other…i have to drive because my husband is very ill and unable at times to drive by his self…so what do i do, continue suffering because i can’t get the help that i really do need…what type of government does we have?….oh! i forgot, some of us don’t have family members working in the government that can award us 50 to 100 percentage for our disability, and some of us don’t have doctors that can help the vets that really need to be help…keep praying vets, because “GOD” is going to open that door of blessing for us one day soon, so we can get the percentages that we really desire because of our injuries…don’t give up…”BE BLESS EVERYONE, BETTER DAYS AHEAD FOR ALL OF US VETERANS”

Bob Sanford
Bob Sanford

I drove 60 in a freezing rainstorm and was a total wreck. My psychiatric evaluation then took less than 15 minutes. The shrink said because i was not a filthy dirty homeless wreck that could actually count to ten forward and backward that I did not deserve a rating more than 30%. Wouldn’t my personal psychologist know more about me? He gave me a GAF score of 31 which from what I can determine would be rated much higher than 30%. I feel that some of the people making the ratings are there only because they can not get employment elsewhere.

Zerses
Zerses

How DARE the military STILL be cooking the books!

This isn’t NEW, this is a continuation of the garbage that has been going on EVER SINCE TRICARE WAS IMPLEMENTED MILITARY WIDE!!!

WAKE UP DOD! YOU are FULL of INFILTRATORS, you BLIND BOYS AND GIRLS.