By Craig Cole & Lynn Salsi

In a May 2008 “Washington Post” article, “Official Urged Fewer Diagnoses of PTSD,” staff writer, Christopher Lee reports on the Veteran’s Administrations attempts to give less Post Traumatic Stress Disorder diagnoses to veterans in order to save money. (C. Lee, Washington Post)

Post Traumatic Stress Disorder, PTSD, is is an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Traumatic events that may trigger PTSD include violent personal assaults, natural or human-caused disasters, accidents, or military combat. (Keith Armstrong, Courage After Fire)

“Given that we are having more and more compensation seeking veterans, I’d like to suggest that you refrain from giving a diagnosis of PTSD straight out,” said Norma Perez, a Veteran’s Administration psychologist, in an email to other V.A. mental health staff. Ms. Perez recommended that staff consider diagnoses of Adjustment disorder instead. “Additionally,” states Ms Perez, “We really don’t or have time to do the extensive testing that should be done to determine PTSD.” (C. Lee, Washington Post)

Veterans are eligible for disability payments if diagnosed with PTSD. With a diagnosis of Adjustment Disorder, veterans are not eligible for payments, but both can receive medical treatment. (C. Lee, Washington Post)

According to Anthony T. Ng, a psychiatrist and member of Mental Health America, Adjustment Disorder is a less severe reaction to stress than PTSD, and usually lasts no longer than 6 months. Ng also states that diagnosing a patient with PTSD can take weeks or months because a diagnosis of PTSD implies long term effects. (C. Lee, “Washington Post”)

“Most people exposed to trauma, in general, can get better,” said Ng. “You don’t want to over-diagnose people with PTSD.” While over-diagnosing PTSD could be harmful, many believe that veterans are not given the care they deserve so the VA can cut costs. (C. Lee, “Washington Post”)

“It is outrageous that the VA is calling on its employees to deliberately misdiagnose returning veterans in an effort to cut costs,” said Melanie Sloan, executive director of citizens for responsibility and ethics in Washington (CREW). “Those who have risked their lives serving our country deserve better,” (M. Sloan, Letter to Inspector General of VA)

John Soltz, an Iraq War Veteran and chairman of www.votevets.org, said, “Many veterans believe that the government doesn’t want to pay out the disability that comes with a diagnosis of PTSD.” (C. Lee, “Washington Post”)

Veterans Administration Secretary James Peake says that the VA’s policies do not reflect Ms. Perez’ email, but many current as well as former VA employees are coming forward with information contradicting Secretary Peake’s statement. (C. Lee, “Washington Post”)

Under condition of anonymity, the employees say that these practices are common place. According to these employees, they were often “bullied” into changing diagnoses on compensation exams. A VA employee from Pennsylvania thinks that the Eastern Pennsylvania behavioral health system should be investigated. (M. Sloan, Letter to Inspector General of VA)

A former VA employee that processed benefit claims for seven years said that these practices were only a small part of what is happening within the VA. (M. Sloan, Letter to Inspector General of VA)

The employee states, “The problem began when the VA implemented an Incentive Award Program.” The Incentive Award Program offers bonuses to the employees and hospitals that process the most claims, and award lower levels of disability compensation to veterans. (M. Sloan, Letter to Inspector General of VA)

Veterans for Common sense have brought at least one lawsuit against the VA based on these claims. Veterans for Common Sense v. Peake, Civil No. 07-3758 (N.D Ca.) alleges that the VA is not only intentionally misdiagnosing veterans who suffer from PTSD, they are also charged with trying to coerce service members who have PTSD, to accept a personality disorder discharge. When given a PD discharge, veterans are denied benefits and medical treatment by the VA due to pre-existing conditions. (C. Lee, “Washington Post”)

A veteran who went to a VA medical center in Albuquerque, New Mexico, said when he was admitted to the hospital for depression, he was informed if he accepted a diagnosis of Adjustment Disorder in place of PTSD, it would “preserve his military career and not be seen as a black mark.” (2008 Rand Corp. study: “Invisible Wounds of War”)

A Vietnam veteran, who worked at the VA, reported that employees are trained to suspect that the veterans are lying about their symptoms. Some veterans turn to suicide because they are not able to handle the effects of PTSD. The veteran suicide rate is at an all-time high, and is believed to be in part because of improper treatment from the VA. (2008 Rand Corp. study: “Invisible Wounds of War”)

Because of multiple deployments, a study completed by Rand Corp reported, a one-in-five Iraq and Afghanistan war veteran suffers from PTSD or depression. Researchers estimated the number of veterans suffering from PTSD to be around 300,000 from the current wars. This is highly disproportionate to the number of physical injuries. The economic cost to the US, including medical care, lack of productivity, and lives lost to suicide is estimated to reach four to six billion over two years. (C. Lee, “Washington Post”)