PTSD UPDATE 21:
A Veterans Affairs Department psychologist denies that
>> she was trying to save money when she suggested that counselors make
>> fewer
>> diagnoses of post-traumatic stress disorder in injured soldiers. Norma
>> Perez, who helps coordinate a post-traumatic stress disorder clinical
>> team
>> in central Texas, indicated she might have been out of line to cite
>> growing disability claims in her 20 MAR e-mail titled
"Suggestion." She
>> said her intent was simply to remind staffers that stress symptoms
could
>> also be adjustment disorder. The less severe diagnosis could save VA
>> millions of dollars in disability payouts. "In retrospect, I
realize I
>> did
>> not adequately convey my message appropriately, but my intent was
>> unequivocally to improve the quality of care our veterans
received,"
>> Perez
>> said in testimony prepared for delivery4 JUN before a Senate panel. The
>> Senate Veterans' Affairs Committee and the VA inspector general are
>> investigating whether there were broader VA policy motives behind the
>> e-mail, which was obtained and disclosed last month by two watchdog
>> groups. VA has strenuously denied that cost-cutting is a factor in its
>> treatment decisions. "One question that was raised repeatedly
about this
>> latest e-mail was, 'Why would a clinician be so concerned about the
>> compensation rolls?"' said Sen. Daniel Akaka (D0HI) who chairs the
Senate
>> panel. "As an oversight body, we must know whether the actions of
these
>> VA
>> employees point to a systemic indifference to invisible wounds."
>>
>> VA Secretary James Peake has called Perez's
e-mail suggestion
>> "inappropriate." VA officials this week said her e-mail was
taken out of
>> context. "The e-mail, as characterized by others, does not reflect
the
>> policies or conduct of our health care system," said Michael
Kussman,
>> VA's
>> undersecretary for health, in testimony prepared for the Senate
hearing.
>> "We certainly agree that it could have been more artfully
drafted." In
>> her
>> e-mail to staffers at the VA medical center in Temple, Texas, Perez
>> wrote,
>> "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. ... We really don't or have time to do the extensive testing that
>> should be done to determine PTSD." Many veterans and injured
troops have
>> long charged that the government might seek to reduce disability costs
by
>> assigning a lower benefits rating. Last year, retired Lt. Gen. James
>> Terry
>> Scott, chairman of the Veterans' Disability Benefits Commission, said
he
>> believed the Army might at least subconsciously consider cost. A
lawsuit
>> filed in San Francisco accuses VA of misclassifying PTSD claims.
>>
>> In her testimony, Perez said symptoms for PTSD
and adjustment
>> disorder
>> are often similar, as are the treatments for them. She said by making
an
>> initial diagnosis of a lesser disorder, VA staff can begin treatment
>> right
>> away without going through the arduous process of diagnosing PTSD.
Perez
>> also noted that awarding disability benefits is not part of her staff's
>> work, but she did not say why she chose to cite that as a factor in
>> urging
>> fewer PTSD diagnoses. Veterans diagnosed with PTSD are eligible to
>> receive
>> up to $2,527 a month in government benefits. A recent Rand Corp. study
>> found about 300,000 U.S. military personnel who served in Iraq or
>> Afghanistan are suffering from PTSD or major depression, potentially
>> saving the government millions of dollars if lesser diagnoses are used
in
>> disability benefits decisions. "Although our clinic is a treatment
>> clinic,
>> we all fully support the compensation process and the department's
policy
>> of erring in the best interest of the veteran whenever there is any
>> doubt," Perez wrote. Perez's testimony comes after Peake was
called to
>> Capitol Hill last month to answer questions about internal e-mails
>> suggesting that VA officials were hiding the number of veterans trying
to
>> kill themselves. One of the e-mails, disclosed during a San Francisco
>> trial, started with "Shh!" Some lawmakers have said the VA's
top mental
>> health official who wrote it, Dr. Ira Katz, should be fired, but Peake
>> has
>> said he has no plans to do so. [Source: Air Force Times AP article
Posted
>> 4 Jun 4 08 ++]