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Archive for Monday, August 16, 2010

Misdiagnosed soldiers don’t qualify for benefits

August 16, 2010

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— 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.

Comments

Paula Kissinger 4 years, 5 months ago

Not politics, Hydra...fact. In the early 90's, while in the Army on active duty, my husband sustained a broken ankle that was diagnosed as a sprain. Later it was correctly diagnosed but, by then, of course, too late to do "the right thing". Arthroscopy was then performed by a "military doctor" and botched. He was eventually discharged for medical reasons...his ankle was trashed.

My son was born in a military hospital overseas and delivered by a "military "doctor". What should have been a C Section resulted in a horrendous labor and forceps delivery that was, again, botched. 18 months later I had to have a complete hysterectomy. My son has some sort of mental illness that closely resembles an autism disorder but his other characteristics do not fully support it.

My husband, son and I are walking proof that the military medical corps is totally incompetent. Did you know that you, as a dependent or service member, cannot sue the military for these acts of negligence/ignorance ?

At the time these events took place, Bill Clinton was President but he had nothing to do with these events personally. I by no means am an Obama supporter but what happens within the military today will not be his fault 5 years from now. He acts on advisors' recommendations. The fault lies in the non-supervision of the doctors, their ignorance and incompetence. No politics involved at all.

Word to the wise : always ask your potential new doctor if they served in the military. If they say yes, run, do not walk, out of the office !

jaywalker 4 years, 5 months ago

"Just yet another example of the bushco legacy."

Early leader for Dumbest Line of the Day.

The Army needs to fix this immediately. Period.

yankeevet 4 years, 5 months ago

An Air Force buddy was around airplanes; loud noises for over 20yrs; he retired with a military pension; then complained too the VA of hearing loss.........they said they would give him 100 dollars for hearing loss...........but since he got a military pension; they would deduct the money from his pension...........WTF???? and give it back too him.........

jafs 4 years, 5 months ago

The obvious insanity here is that the Army routinely tests applicants psychologically before allowing them in.

Then they turn around after soldiers come back from war and claim they had a "pre-existing" psychological condition.

Either they missed the condition on their tests, which means they're incompetent at testing.

Or they're simply wrong.

Either way, it's not the soldier's fault.

notajayhawk 4 years, 5 months ago

Okay, folks, before everyone jumps in with this being an Army problem, let alone a Republican or a Bush problem, take a minute to find out what we're talking about.

Diagnosing mental disorders is not like diagnosing physical disorders. It's not something you can take an x-ray or CT scan of and 'see' what's wrong. You can't do blood tests. A lot of it is derived from observable behaviors, but for the most part the diagnosis is based on what the patient tells you is wrong, complicated by the fact that they quite often don't know themselves.

There is a lot of symptom overlap between, say, PTSD, major depression, bipolar disorder, and the axis II (personality) disorders. Every single day I see people who have been diagnosed with these various disorders almost interchangeably over the years, all by qualified professionals, all backed up by the available evidence. And it's not just the Army that has this problem - do you have any idea how many people may have a disabling illness that Social Security turns down, calling it a personality disorder? (The real sad part is that the same symptom set may be present and it may be just as debilitating; it's not that personality disorders are any less devastating that leads to denial of benefits, it's just that they generally can't be 'cured'.)

Unfortunately the mental health profession is not at a place where we can discriminate between such illnesses with the definitive assuredness of the medical profession (and even they misdiagnose things). And I doubt we ever will be.

pace 4 years, 5 months ago

The Army denies that any soldier was misdiagnosed before 2008

what a tragic statement. Support our troops doesn't mean purchase an unrelated yellow sticker and put it on your suv. It means make your senate and congress do something for them.

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