Sunday, January 1, 2012

Money Saved at Misdiagnosed Vets' Expense

OFF THE WIRE
By CHRIS COUGHLIN 
NEW HAVEN (CN) - The Vietnam Veterans of America says the Pentagon has "systematically and wrongfully discharged" more than 22,000 veterans since 2001 "on the basis of so-called 'personality disorder'" - rather than post-traumatic stress disorder - to deny them medical care and save the Pentagon $12.5 billion in medical and disability payments.
     "The military classifies PD [personality disorder] as a condition pre-existing military service," the four plaintiff chapters of the Vietnam Veterans of America say in their federal complaint against the Department of Defense and the Department of Homeland Security.
     "Veterans discharged from the military on the basis of a PD diagnosis are not entitled to receive service-connected disability benefits or VA health care.
     "By its own admission, DoD dismissed 22,656 service members on the basis of PD between fiscal years 2001 and 2007; 3,372 of these discharged service members had served in combat or imminent danger zones in support of OCO [overseas contingency operation - Pentagonspeak for the wars in Iraq and Afghanistan]. Approximately 2,800 of the service members whom DoD had dismissed on the basis of PD had deployed in support of Operation Iraqi Freedom or Operation Enduring Freedom.
     "By discharging over 22,000 service members on the basis of PD, DoD saved the military approximately $4.5 billion in medical care and $8 billion in disability compensation that these service members would have received had they been discharged on the basis of Post-traumatic Stress Disorder ('PTSD') or another service-connected disability."
     The veterans say the Pentagon and Homeland Security have blown off their requests for "records relating to the use by branches of the United States armed forces and the National Guard of PD discharges and adjustment disorder or readjustment disorder discharges to discharge service members since October 1, 2001."
     And: "Because DoD refuses to admit that it incorrectly discharged many service members on the basis of PD, an unknown number of veterans who served with integrity and valor in the armed forces continue to be denied service-connected disability benefits and VA health care."
     Personality disorder is a wide-ranging term used to cover symptoms right to the verge of schizophrenia. Post-traumatic stress syndrome however is linked to a trauma that may be severe and short-lived, such as combat, or prolonged, such as childhood abuse. PTSD may be so severe as to be indistinguishable from personality disorder.
     "Personality disorder ('PD') is a pervasive and inflexible pattern of inner experience and behavior that deviates markedly from the expectations of an individual's culture and leads to distress or impairment. Symptoms begin during adolescence or early adulthood," the complaint states.
     For the Pentagon, and the veterans, the distinction is that treatment for PTSD is covered by Pentagon policy; treatment for personality disorder is not.
     "From October 2001 through September 2010, the Department of Defense and its component and subcomponent services systematically and wrongfully discharged approximately 28,800 service members who have service-connected disabilities on the basis of so-called personality disorder," according to the complaint. "Veterans who responded courageously to the government's call to action after September 11, 2001 by serving in the Armed Forces have returned home only to find that DoD's personality disorder designation prevents them from accessing service-connected disability benefits and veterans health care. By carelessly disregarding the personality disorder regulations which were promulgated for the benefit of service members, DoD has broken the United States' longstanding promise to provide for its veterans."
     The complaint adds: "Prior to 2008, DoD regulations on PD discharges required that service members get formal counseling regarding the reason for their impending discharge and receive a PD diagnosis from a psychiatrist or psychologist stating that the PD interfered with their ability to function in the military.
     "DoD's compliance with the counseling requirement was as low as 40% between 2001 and 2007, as was compliance with the diagnoses requirement. In 2008, the Government Accountability Office ('GAO') found that 'DoD does not have reasonable assurance that its key personality disorder separation requirements have been followed' after reviewing PD discharges occurring between 2001 and 2007."
     The veterans say: "DoD has admitted that its doctors failed to interview anyone but the service members before making most of the over 22,000 PD diagnoses that led to discharge. ...
     "DoD's mistreatment of service members prompted Congress to hold a hearing investigating PD discharges in July 2007.
     "DoD's exploitation of service members caused Congress to pass and President Bush to sign a January 2008 bill requiring that DoD submit a report on PD discharges. The bill did not require DoD to submit records verifying the claims made in the report.
     "In June 2008, DoD released an eleven-page report in which it admitted that DoD leadership 'shares Congress' concern regarding the use of PD as the basis for administratively separating Service members who deployed in support of GWOT [the Global War on Terror] and who may have been more appropriately processed for disability.' However, DoD did not release records verifying or expanding on the claims made in the report."
     The veterans call this "the PD discharge scandal of 2007-08."
     The Pentagon said it changed its process to more vigorously screen for trauma-related injury, but "in September 2010, GAO determined that 'the military services have not demonstrated full compliance with DoD's PD separation requirements,'" according to the complaint.
     The complaint states: "After the PD discharge scandal of 2007-08, DoD discharged significantly fewer service members on the basis of PD.
     "After the PD discharge scandal of 2007-08, DoD discharged significantly more service members on the basis of PTSD.
     "After the PD discharge scandal of 2007-08, DoD also discharged significantly more service members on the basis of 'other designated physical or mental conditions not amounting to disability.' Adjustment disorder and readjustment disorder discharges fall into this category.
     "VVA has argued that DoD is discharging more service members on the basis of adjustment or readjustment disorder so as to cut the costs that increased when DoD was forced to discharge fewer service members on the basis of PD.
     "Even in light of these statistics, DoD and its components continue to deny that any veteran was misdiagnosed with PD before 2008. In August 2010, the Army told the Associated Press that they had 'reviewed the paperwork of all deployed soldiers dismissed with a personality disorder between 2001 and 2006' and '"did not find evidence that soldiers with PTSD had been inappropriately discharged with personality disorder."'"
     The Vietnam Veterans submitted FOIA requests to the Pentagon, the Army, Navy, Air Force, Marines, the National Guard, and Air National Guard.
     But "To date, plaintiffs have received no correspondence from the Navy, Air Force, Marines, National Guard Bureau, Army National Guard, and Air National Guard regarding this FOIA request."
     The veterans want to see the record.
     The lead plaintiff, the Vietnam Veterans of America Connecticut Greater Hartford Chapter 120, says: "Veterans' advocates such as Vietnam Veterans of America, a nonprofit organization whose founding principle is 'Never again will one generation of veterans abandon another,' pushed Congress to investigate DoD's mistreatment of service members in 2007. Although DoD discharged significantly fewer service members on the basis of personality disorder after this Congressional investigation, DoD refuses to admit that it mistreated veterans or to repair the harm that its punitive practice has caused to those it discharged on this basis from 2001 to 2007. As a result, thousands of veterans who served their country and whom DoD discharged on the basis of personality disorder are now unable to access the service-connected disability compensation and medical care they are due."
     They are represented by Michael Wishnie with Jerome N. Frank Legal Services Organization of New Haven.