Walter Reed Overturns PTSD Diagnoses From Madigan Army Medical Center

First we need a little background on the issue. From Uncle Jimbo at Blackfive.

In a lecture to colleagues, a Madigan Army Medical Center psychiatrist said a soldier who retires with a post-traumatic-stress-disorder diagnosis could eventually receive $1.5 million in government payments, according to a memo by a Western Regional Medical Command ombudsman who attended the September presentation

The psychiatrist went on to claim the rate of such diagnoses eventually could cause the Army and Department of Veterans Affairs to go broke (By Hal Bernton, Seattle Times staff reporter).

This psychiatrist went beyond just noting the cost of treating those who were hurt and rightly had a knot jerked in his tail.

A Madigan Army Medical Center psychiatrist who screens soldiers for PTSD has been removed from clinical duties while investigators look into controversial remarks he made about patients and the financial costs of disability benefits, according to U.S. Sen. Patty Murray.

Keppler allegedly made inappropriate comments about the forensic team’s role as financial gatekeeper in the Army retirement process during a September presentation, according to Murray.

In a meeting last fall attended by an Army ombudsman, Keppler and other team members reportedly made disrespectful comments about patients whose files were under review.

More than a dozen soldiers who believed their PTSD diagnoses were wrongly dropped by the Madigan team gained new reviews this year at Walter Reed Army Medical Center in an unusual intervention arranged by Army Surgeon General Lt. Gen. Patricia Horoho.

That is a good first step, but does anyone really think this was an isolated incident? I know it wasn’t.  The same problem exists right back here in the Army’s flagship PTSD program at Walter Reed. I know of multiple instances where diagnoses of PTSD have been downgraded or determined to be not “Line of Duty”. One method of limiting the number of diagnoses is to find that the condition “Existed Prior to Service”. For some patients this means taking isolated incidents that occurred long before joining the military and naming them as the proximate cause, even if the service member never had any symptoms or received any treament for them. This is analogous to telling an amputee his injury existed prior to service because the now-missing ankle was sprained on a Boy Scout hike when he was a kid.

So basically, this quack was going to save the government money by downgrading PTSD of returning Soldiers.  Walter Reed has since overturned six of the misdiagnosed cases.  From the Seattle Times.

When an Army forensic psychiatric team at Madigan Army Medical Center examined Sgt. 1st Class Stephen Davis, it concluded the soldier who served in Iraq and Afghanistan had exaggerated his symptoms of post-traumatic stress disorder (PTSD) and had wrongly been diagnosed with the condition.

But a psychiatric team at Walter Reed National Military Medical Center recently reversed the Madigan diagnosis. It concluded the 45-year-old Davis had PTSD, which is expected to make him eligible for a retirement pension and health insurance for his wife and dependents.

“This isn’t just about money and benefits to myself and my wife,” Davis said Wednesday in a meeting with reporters at Sen. Patty Murray’s office in Seattle. “It’s doing what’s right. Taking care of soldiers that are coming home.”

Davis is one of 14 soldiers whose Madigan diagnoses were reviewed at Walter Reed as part of a wider investigation into the PTSD screening and treatment at the Western Washington medical center.

The Army Medical Command said Wednesday that six of those soldiers had PTSD diagnoses reinstated. The remaining eight soldiers, according to Walter Reed doctors, had behavioral-health conditions other than PTSD, including two who were never initially diagnosed with the condition.

The article describes in great detail how some Soldiers who obviously had PTSD were misdiagnosed  by Dr. Gatekeeper and his team in order to save Uncle Sam a buck.

The Seattle Times looked at the medical records of a mix of six soldiers and veterans who were screened for possible medical retirements at Madigan. (Only one of those cases was reviewed by Walter Reed doctors.)

They all had been deployed to combat zones, some repeatedly. All were initially diagnosed with PTSD by Army or VA medical providers and often underwent extensive treatment, only to have the Madigan team overturn their diagnoses. After interviews and administering tests, the Madigan team concluded five of them were exaggerating their symptoms and some had other conditions such as personality disorders.

“What they are saying is that I’m a liar, and that really angers me,” said Tony Stephens, a Washington National Guard veteran from Poulsbo who had initially been diagnosed by the VA with PTSD after returning from Iraq. “They have stripped my honor from me.” At this point, his case is not under review.

The five other soldiers who offered their medical records to The Seattle Times requested anonymity. Those include a soldier who, on his third tour of duty to a war zone, was evacuated because of a suicide attempt. After his return home, he said he slept so fitfully that he once attacked a beloved service dog that had awakened him from a nightmare.

“My (Madigan) report clearly states that I have a personality disorder. I’m a malinger and I overexaggerated my symptoms,” the soldier said. “I find myself thinking I would rather be in a combat zone than dealing with all this.”

Another soldier who had his diagnosis reversed was a combat medic who served in Afghanistan. Shortly after his arrival there, he responded to a suicide bomber who struck a bazaar, injuring 13 U.S. soldiers and more than 20 civilians. The following months were punctuated by other bloody bomb attacks.

He was evacuated before the end of his tour because of his nightmares, jumpiness and other symptoms of acute stress, including voicing thoughts of homicide, according to medical records.

The Madigan team found this soldier had an adjustment disorder but still met “psychiatric standards for retention” in the Army.

I do not think simply firing a couple doctors at Madigan is justice.  What they tried to do cuts much deeper than that.  Our nation’s Veterans deserve better than this.



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