RBANS Testing

VA Caught Using Inferior RBANS To Screw TBI Veterans

RBANS Testing


Benjamin KrauseVeterans are being denied compensation and health care benefits based on inferior traumatic brain injury testing like RBANS to erroneously justify denials.

NBC in Minneapolis uncovered a recent scandal based in Montana where one VA psychologist was caught using the inferior the Repeatable Battery for Neuropsychological Status (RBANS). RBANS is a screening tool originally designed to help diagnose dementia.

RBANS is only approved as a minimal screening tool and not appropriate for those with confirmed traumatic brain injury. VA often uses RBANS despite clear indications of brain injury without assessing the initial severity of TBI. Certain higher level of TBI cannot be addressed with RBANS whatsoever. But VA persists in using TBI without adequately assessing TBI severity.

RELATED: VA Caught Defrauding 300 Veterans With TBI

VA Benefits Administration used the inferior decision to justify reducing one combat veteran, Captain Charles Gatlin, from 70% to 10% for his traumatic brain injury (TBI) residuals.

It only took a four-year fight and tons of resources to get the decision reversed. The Gatlin family contacted the Montana Board of Psychologists to help get justice. Senior psychologists in the State of Montana dropped the hammer on VA and its psychologist, Robert Bateen. Batten was a trained psychologist but not necessarily trained to implement RBANS.

RELATED: NBC Reveals True Cost Of TBI Scandal

Despite protests from VA executives, Montana penalized Dr. Bateen for using an inferior system to diagnose residuals of TBI and for making clinical decisions that would knowingly harm the patient. VA claimed Gatlin was no patient at all that that Bateen owed him no duty. Basically, VA claimed Bateen was above the law because VA asked him to do it.

VA claims it can tell doctors and psychologists to deviate from accepted standards of care regardless of the impact on veterans. The State of Montana disagreed.

As a result, Bateen’s license to practice psychology in the state is conditioned on him no longer assessing the severity of brain injury residuals.

While VA continues to use exams questioned in the halls of psychology, Montana took steps necessary to protect its citizens.

Should other states join the cause in upholding a state’s right to protect its citizens? Why ask state governments evaded their responsibility to stand up against this kind of abuse?

@deptvetaffairs Stop Screwing TBI Veterans #VAisLying Click to Tweet

Source: https://www.kare11.com/story/news/investigations/2015/12/07/traumatic-brain-injury-flawed-test-veteran-association/76930080/

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  1. I always find it interesting doing a little search on the internet. Doing a search on “Dr. Robert Bateen shows Ben had a blog post about this in September 2014. Nice to see he continued to follow this. It also showed a blog post by Eric Newhouse where it discusses the VA trying to tell the state regulators in Montana to buzz off…that they didn’t have jurisdiction. In the same post at that blog, Bateen said he was following VA policy, which appears to be to screw veterans.
    Clearly, the state decided otherwise.
    The VA hacks telling the state to “buzz off” were, Dr. Thomas G. Lynch, assistant deputy under secretary for health for clinical operations; Lois Mittlestaedt, chief of staff to the under secretary for benefits; and Richard J. Hipolit, deputy general counsel.
    In a letter to the board, they said:

    “Based on Dr. Bateen’s education, training and professional experience, Dr. Bateen was practicing within American Psychological Association ethical guidelines and accepted standards of care,” said a letter to the board last September signed by Dr. Thomas G. Lynch, assistant deputy under secretary for health for clinical operations; Lois Mittlestaedt, chief of staff to the under secretary for benefits; and Richard J. Hipolit, deputy general counsel.
    “VA believes that Dr. Bateen did not conduct a neuropsychological evaluation, but rather conducted a cognitive screen,” they said, adding that the assessment screen, the Repeatable Battery for the Association of Neuropsychological Status (RBANS) was adequate.

    Adequate. If the test were “adequate”, the results from the Army exams would have been duplicated, not showing after 3 years to have improved enough for his percentage to be reduced to 10%.

    Who are those 3? Well, searches on Lynch finds the VA HQ staff directory, so he is still screwing veterans. Mittlestaedt results in a few articles, including a 2013 Nextgov dot com article discussing eliminating bonuses for benefits officials for 2012, and showing she received one of the highest VA bonuses in 2011 at the height of the claims backlog, of $23,091.00…along with Diana Rubens….and Chairman Miller lamenting that they had gotten bonuses during the backlog. And Hipolit? He’s been in the VA General Counsels office since 1982.

    According to the USA Today database on VA bonuses, Hipolit received $12,705.00 for a bonus in 2014.

    But veterans trying to get proper health care for TBI’s are the bad people.

    Miller needs to quit warming his seat.

      1. Heads up before this is removed!!! We are being censored. I left several replies, including one to you about my concern about Miller. My e-mails have disappeared!!!

      2. It’s not being sensored. I set up a sandbox test site and somehow one of the plugins is causing the comments to get posted over there instead of on the main site. No idea how this happened.

      3. Guess my other question is what is a “sandbox test site”?? We have not agreed to having our comments posted on some other site.

      4. Wade, it is not on another website in the way that you mean. A “sandbox” site is a copy of this site where I can test different plugins without worrying about crashing the actual website that is not live. When an error comes up, as it did here, I delete the copy and start over.

    1. Go to a civilian doctor to document the conditions, then present them to the VA and ask why they disagree with the civilian doctor.

      My septum was deviated badly when I got back from the Gulf. Over the next 6 years, I kept going to the VA for sinus infections so bad my nose would bleed. They just prescribed antibiotics and showed me the door.

      In 1997, I had moved to Wisconsin and had another sinus infection. I went to the VA Ear, Nose and Throat doc, and within 5 minutes he told me what the problem was and asked if I wanted him to do surgery on it. He said one side was almost completely closed off. Within a month I had the surgery, and I have not had a sinus infection since then. I even sleep better because I can breathe better. He was a young doc that actually wanted to help veterans.

      I wish I would have gone to a civilian doctor years prior.

  2. The psychologist in Montana VAHS would have used Rubber BANdS instead of RBANS if he had any available on his dirty desk. WTF’s the difference? Just wrap the rubber band around the patients head, stretch it out to the max, and let it snap back to the forehead. Occch! “That will snap you back to VA thinking, kid”. Yeah, next!?!?
    Montana, of course, is well known for their citizens falling off their bucking broncos on their head and takes seriously TBIs, since everyone is walking around with one.
    But to answer your question – yes the only way of effecting the VA is to sic State Boards of Psychology or National Brain Injury Association state departments on these bastards, because these Boards and the doctors who work on them take this stuff seriously. The problem is they have to be informed of this behavior taking place at the VA. If all the states had their Boards yelling at the VA,…that would be multilateral attacking the crumb-bag organization for conducting outmoded treatment for these evaluations. The whole word has to attack the monster ! By the way, what does the mysterious Dr. David Shulkin have to say about this? Or is he too busy being an entrepreneur wannabe like the Nazi doctor who got zillions for inventing hepatitis C treatment prescriptions on VA time and selling them for an inflamed price? Bet that made him jealous.

  3. What can we do to protect ourselves? As a patient of the VA medical system, report what you consider unacceptable practice to the state licensing board……………..If a state board receives multiple complaints about the same person logic would dictate that the persons actions would raise reasonable concern for the safety of patients……..If you feel that your safety has been violated you have every right to raise the question to your states licensing board………………We are our best advocates

    CFR › Title 38 › Chapter I › Part 47 › Section 47.2

    38 CFR 47.2 – Reporting to State Licensing Boards.

    Authorities (U.S. Code)

    prev | next
    § 47.2 Reporting to State Licensing Boards.
    It is the policy of VA to report to State Licensing Boards any currently employed licensed health care professional or separated licensed health care professional whose clinical practice during VA employment so significantly failed to meet generally accepted standards of clinical practice as to raise reasonable concern for the safety of patients. The following are examples of actions that meet the criteria for reporting:
    (a) Significant deficiencies in clinical practice such as lack of diagnostic or treatment capability; errors in transcribing, administering or documenting medication; inability to perform clinical procedures considered basic to the performance of one’s occupation; performing procedures not included in one’s clinical privileges in other than emergency situations;
    (b) Patient neglect or abandonment;
    (c) Mental health impairment sufficient to cause the individual to behave inappropriately in the patient care environment;
    (d) Physical health impairment sufficient to cause the individual to provide unsafe patient care;
    (e) Substance abuse when it affects the individual’s ability to perform appropriately as a health care provider or in the patient care environment;
    (f) Falsification of credentials;
    (g) Falsification of medical records or prescriptions;
    (h) Theft of drugs;
    (i) Inappropriate dispensing of drugs;
    (j) Unethical behavior or moral turpitude;
    (k) Mental, physical, sexual, or verbal abuse of a patient (examples of patient abuse include intentional omission of care, willful violation of a patient’s privacy, willful physical injury, intimidation, harassment, or ridicule); and
    (l) Violation of research ethics.
    (Authority: 38 U.S.C. 501; 7401-7405; Section 204(b) ofPub. L. 99-166, 99 Stat. 952-953; Pub. L. 99-660, 100 Stat. 3743)
    [63 FR 23665, Apr. 30, 1998]

    1. ^
      With that in-place, doesn’t it really make it even more surreal that the very VA OIG does not use this to put real teeth in accountability?

      I would make few friends if I were the VA Secretary. They would have to let loose thugs OUT of prison to make room for the flow of fresh federal meat being arrested and replace each and every one with a Veteran. The VA then could act as an extension to one’s military career service, no union, UCMJ ‘Lite’, a platform for Active Military transitioning to Civilian Life, something that would do good on so many levels.

      There lay the huge problem; no real accountability with teeth. The VA OIG may as well be the cast to The Nut Cracker…without the ‘nuts’, but truly mad as a hatter.

      1. @namnibor,
        Newt Gingrich was just on Fox 35 ( local) news in Orlando.
        He actually went against the government on a few issues. One being the governments’ (potus, Congress and Senate) inability to address the lack of accountability and transparency within ALL agencies!

        He was asked “Who would [he] support?”
        His answer was “Whoever is nominated by the RNC!” He didn’t hesitate to throw Hitlery under the bus.
        He also praised (in my opinion) Mr. Donald Trump. Newt commended Trump on his stance concerning not allowing more Muslims into the U.S. until the “vetting process is fixed!”
        There’s also reports coming out from overseas (Europe) where many Muslims are diagnosed with deadly deseases!

      2. Donald.is doing one thing for sure and that’s bringing things to the fore front on subjects that most Americans are thinking about and can’t do it themselves. He might not be right all the time.

        But at least he’s making people think about what’s really going on.

        Nothing at all by our elected officials.like I said before I watch cspan and everytime their are so many empty seats.it gives the impression they just don’t care.

        They can blame Obama all they want.but they have to do their jobs.no matter who holds the presidency.

        When the people voted in Obama.is because they were tired of the same old stuff and demanded change.but our elected officials just stopped doing everything for the people.

        I know not everyone could go to a rally in Washington.but if the word would get out of a veteran rally.

        I’m sure thousands upon thousands would show up to support those who can’t make it.

      3. A walking, breathing, petri dish of a mass of bio-terror…it’s definitely plausible, look at our own dirty laundry of history in our very early days in how we gave infected blankets as ‘gifts’ to Native Americans?

        Problem is, we have so-called leaders that have their collective heads where sun does not shine and have all but forgotten and traded what learned from past for the silver coins that greed grants those in such a ‘prostate position’.

        Yeah, I am in a mood.

        Good for Newt Gingrich to say that because I agree we need to press pause and close things up. We even sent all Iranian Students back during the Carter Admn….anyone else remember that? This POTUS and his Admn. are truly making me more than a little worried about our USA.

        Notice that NOW they (FBI/NSA) are saying they have “found out” that those two recent thugs responsible for California horror, we both radicalized LONG ago. WTF People?~!

        If I were a monkey near the POTUS I would throw something wet and brown at him. Monkeys roll that way!
        Yep, am in a mood. Need a reptile tranquilizer.

  4. CAN’T just blame Obama. Congress has done nothing for years to thwart the bringing in of folks from other countries all because of providing cheap labor & getting federal contracts for companies over seas to profit & avoid paying taxes. . Congress doesn’t even want to stop the influx of those who are the no fly zone with military assault type weapons or those who come here on all type of visa’s with no tracking mechanism. No accountability whatsoever.. Congress does it all and or nothing at all (depending on their needs) at the expense of Americans expense, then they use he taxpayers money for other side agendas. We too are already paying in more ways than one. Taxpayer money doesn’t belong for congress’s own use but it does as if we owe THEM. NO! Since everything is running amok & our country is in shreds, then it’s all Congress’s fault because they have the ultimate power with policies & the U.S.Treasury checkbook and Look over there while we screw everyone over here. It’s called diversionary tactics, in creating chaos for us, so no one has or can take the time to figure out why or what they really are doing with taxpayer money for how many decades now????? If we’re in many trillions of dollars debt among other money shenanigans, then IT’S CONGRESS SO VOTE THE BASTARDS OUT & put real states man or women in who actually care about us Americans, vets, civilians, all of us….It’s one of the reasons why we need public funding for candidate!

    1. Agree that Congress is crap and only interested in themselves and not Americans. But also think that Obama is very weak and too PC and has put the US in imminent danger.

  5. I sent you a long email on very similar state issues here in Colorado. Essentially the state says VA providers are exempt from having to follow state law, unless they also have an outside practice. So in reality, veterans are treated as second class citizens unworthy of protection under the law. A VA doctor can screw up at the VA one day, and not face consequences, but if they screw up exactly the same way a few days later in their outside practice, then the state will sanction them.

    What was uncovered in Montana is the same that can happen anywhere. VA doctors can be held accountable if there is a will to do so.

    Again, why even bother to have them licensed or have certain credentials if nobody cares to hold them accountable?

    As I found, many states require licensing and regulation of hair stylists, nail techinicians, etc., but don’t give a damn when it comes to veterans getting pathetic medical care.

  6. This man’s tactic of going to the state licensing boards works without question. I have used it in my own battles with VHA. Here is why that “new” information works: although the licensing sanction does not bind VA to do anything to a doc, it does indeed go onto the docs record and the have their own Disruptive Behavior Committees within the licensing boards for doctors. Those committees do not like getting the middle finger any more than we do.

    So when you file and get a sanction against one doc, the others that work with you are put on notice that the one thing they thought, (I am untouchable) simply isn’t true. Even the Social Workers have their own licensing boards, nurses too.

    By sending that notice of sanction, he put the VA doctors on notice that he wasn’t pulling any punches. They will back down if you use your rights, and the tools are there to use. He was the one that initiated the complaint against the doc and his board. That is the only way a complaint can get into that board, because of HIPPA, only the patient has enough relevant info to do this.

    Well done to that vet for blazing the trail once again for others to follow.

    Semper Fi

  7. “Above the law”? If that’s the case, what law is it that puts VA scum above it? It seems Vets are always gonna get skrewd if va is above the law. Until VA is bound by some law, just don’t see what can be done, anywhere, anytime. I wouldn’t be surprised to hear that Montana case overturned. If not, then that State has opened a door.

  8. This morning I had my civilian Psych Dr. and her Resident appointment and GUESS WHAT?!! The Attending Psych. Dr.’s last day was today and she told me she was going to work for….THE VA!!! I asked why there seems to be this exodus of employees going to the A Psych especially after what I had shared what mine and many other veteran’s experience has been to their detriment?

    Her answer?

    Banker’s hours and they do not have to see THAT MANY patients per day, every weekend off, and…wait for it…PERFORMANCE BONUSES!!!

    I kid you not!!

    She also speaks English as a third or so language and by her dressing attire, a Muslim. Now, when I mention “Muslim”, I know it does not mean they are terrorists or anything BUT..how freaking INSENSITIVE of the VA knowing that many veterans whom have PTSD or other ailments from the current wars over there, thinking the very therapist they are going to be assigned to without any choice MAY just TRIGGER such anxieties, et al?

    How about hiring American Grad Students? Simply amazing. She was under the impression that the VA “is getting MUCH better”….LOL! WTF?!!!

  9. What I’m seeing here looks to be like this administration is trying to fabricate a situation to declare martial law ,is pretty obvious to me what else would one think, that is what I’ve come up with by just doing the math and common sense.

    1. Ronald, unfortunately based on this POTUS’s (aka the trojan horse) behavior (too numerous and complex to mention in this reply box), you are absolutely right. Probably the most significant give away sign by this POTUS was when he proposed (during his first term) that a national police force be established operating independently from the military, federal and state agents as well as state and local law enforcement. The national police force would be controlled by the federal government with Obama acting as Commander-In-Chief. His proposition, unbeknown to the public, was in disguise martial law without declaring one. The next president if a republican or independent will have their hands full in bringing our country back to a republic and reestablishing international trust (even with the socialist countries) unless Hillary is elected and business as usual.

      Ronald, I am Vietnam vet who is honored to have a fellow American observe as to what is going on. It is people like you which restores my faith that our country will survive as long as our gutless representatives wake up. Ronald, stay low and down wind. Wishing you a Merry Christmas and a Healthy prosperous New Year.

  10. What can veterans do if a VA neurological doctor tells you have a traumatic brain injury and they put in for disability and they denigh the claim. Telling you why are you putting other claims.when your 100 percent disabled perment and total.

    I also when working for the VA.in the outpatient area.seen a patient going to the ground.like fainting and I put my arms around his waist to help him and then he just dropped and hurt my back.

    I’m really having problems.I was seen by the employee doctor and had physical therapy.it’s all documented.

    Never was on workmans comp.wondering if I qualifie for disability for my back.does anyone know.

  11. Y’all gotta Google and read this;
    “The Muslim Brotherhood Has Taken Over the White House”
    Dec. 7, 2015
    by Dave Hodges
    of “The Common Sense Show”
    It should make y’all mad as hell what Obamy has done!

  12. @all,
    My opinion,
    How much, (healthcare & benefits), damage will VA (VHA & VBA) do to veterans, past, present and future, until someone is elected and/or appointed into positions of authority which actually cares about veterans?
    It seems no one is stopping these “entities” from screwing us! State Healthcare Board’s should be part of any evaluations of all VHA’s nationwide. They might find other egregious acts committed by unqualified physicians, physicians assistants, nurses and other healthcare professionals. Thereby censoring them from making bad decisions!

    With everything going wrong in today’s society. And, With VA claiming it’s so shorthanded, It would seem VA would welcome other outside healthcare professionals to lend a hand!

  13. This just shows that the VA is reckless and is hell-bent to do as the VA pleases, even when that means ignoring real world modern medicine practices…and will even try to say they are *exempt* from any State or otherwise agency just because they are “Federal”.
    Too bad we do not have a VA Sec. or a President of USA that are advocates for Veterans. Instead, we have just talking heads that have no problem paying outrageous relocation scams of their employees and granting bonuses to VA Employees, even employees performing badly or caught breaking the law. It’s ALL about VA Employees….not the very Veterans that they are supposedly there to serve.

    The VA has all but conveniently forgotten their original Mission Statement.

    I am hoping that this Veteran in this article, after those 4 years of fighting, not only got his 70% reinstated BUT ALSO back pay for those erroneous 4+ years of reduction to 10% brought back to 70%.
    The fact that JUST THIS VA DR. has performed some 9000+ such erroneous TBI Exams should be multiplied by all 50 States to get a good base number of their FUBAR.
    Lastly, WHY THE HELL did the VA decide to IGNORE the comprehensive testing the Military performed?
    I experienced some of this when I used the VA where the VA wanted to refuse to even look at my civilian Dr.’s comprehensive testing as well as medications tried/failed…matter-in-fact, the VA Psychiatrist tried to toss all the civilian Psych. Dr.’s notes and logs of meds tried/failed, into her round file, the trash can beside her desk.

    The VA Infectious Disease Dept. did a similar thing, trying to ignore very expensive genotype and phenotype lab tests my civilian insurance paid for to determine what Resistance I had and it happened to be so that there’s was and still is only but ONE three drug cocktail for my particular strain…the VA wanted to place me on old school meds from early 1990’s instead and had I stayed at the VA, I definitely would have died years ago…fact.
    The VA is very dangerous and reckless. I will stick with Medicare and civilian Dr.’s rest of my life as am already damaged from whatever experimenting the USAF Medical did on me.
    My brother is now using his private insurance from his job instead of the VA because it was jus found by his civilian Dr. that a good part of his problems were from shitty medication choices (old school/FDA warnings) and meds that were clashing, causing incredible dangerous heart issues. F The VA.

  14. You rock ben we’ve got to stay on top of this administration but nothing’s been done we need to take the fight to them you’re the only one that can do this you have a lot of supporters you’ve lived up to your word leave no one behind an i salute you for that.

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