Misdiagnosed soldiers don’t qualify for benefits

? At the height of the Iraq war, the Army routinely dismissed hundreds of soldiers for having a personality disorder when they were more likely suffering from the traumatic stresses of war, discharge data suggests.

Under pressure from Congress and the public, the Army later acknowledged the problem and drastically cut the number of soldiers given the designation. But advocates for veterans say an unknown number of troops still unfairly bear the stigma of a personality disorder, making them ineligible for military health care and other benefits.

“We really have an obligation to go back and make sure troops weren’t misdiagnosed,” said Dr. Barbara Van Dahlen, a clinical psychologist whose nonprofit “Give an Hour” connects troops with volunteer mental health professionals.

The Army denies that any soldier was misdiagnosed before 2008, when it drastically cut the number of discharges due to personality disorders and diagnoses of post-traumatic stress disorders skyrocketed.

Unlike PTSD, which the Army regards as a treatable mental disability caused by the acute stresses of war, the military designation of a personality disorder can have devastating consequences for soldiers.

Defined as a “deeply ingrained maladaptive pattern of behavior,” a personality disorder is considered a “pre-existing condition” that relieves the military of its duty to pay for the person’s health care or combat-related disability pay.

According to figures provided by the Army, the service discharged about a 1,000 soldiers a year between 2005 and 2007 for having a personality disorder.

But after an article in The Nation magazine exposed the practice, the Defense Department changed its policy and began requiring a top-level review of each case to ensure post-traumatic stress or a brain injury wasn’t the underlying cause.

After that, the annual number of personality disorder cases dropped by 75 percent. Only 260 soldiers were discharged on those grounds in 2009.

At the same time, the number of post-traumatic stress disorder cases has soared. By 2008, more than 14,000 soldiers had been diagnosed with PTSD — twice as many as two years before.

The Army attributes the sudden and sharp reduction in personality disorders to its policy change. Yet Army officials deny that soldiers were discharged unfairly, saying they reviewed the paperwork of all deployed soldiers dismissed with a personality disorder between 2001 and 2006.

“We did not find evidence that soldiers with PTSD had been inappropriately discharged with personality disorder,” wrote Maria Tolleson, a spokeswoman at the U.S. Army Medical Command, which oversees the health care of soldiers, in an e-mail.

Command officials declined to be interviewed.

Advocates for veterans are skeptical of the Army’s claim that it didn’t make any mistakes. They say symptoms of PTSD — anger, irritability, anxiety and depression — can easily be confused for the Army’s description of a personality disorder.

They also point out that during its review of past cases, the Army never interviewed soldiers or their families, who can often provide evidence of a shift in behavior that occurred after someone was sent into a war zone.

“There’s no reason to believe personality discharges would go down so quickly” unless the Army had misdiagnosed hundreds of soldiers each year in the first place, said Bart Stichman, co-director of the National Veterans Legal Services Program.

Stichman’s organization is working through a backlog of 130 individual cases of wounded service members who feel they were wrongly denied benefits.