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VIP Member
VA Doctor In Hot Water Over Stance on Stress Disorder
............ • Level of Care for Vets Investigated
By JENNIFER A. DLOUHY, P-I WA Bureau
Thursday, June 5, 2008
WASHINGTON -- A Department of Veterans Affairs psychologist told senators Wednesday that cost cutting was not the reason she urged fellow clinicians at the Temple, Texas, Veterans Affairs hospital to "refrain from" diagnosing veterans with post-traumatic stress disorder.
The doctor, Norma Perez, said her e-mail March 20 was only intended to remind colleagues that they had the option of initially diagnosing patients with a less severe condition known as "adjustment disorder."
Perez said she was concerned that veterans would get "conflicting messages" and varying diagnoses from the VA. Veterans who were told they have PTSD at one appointment -- but then later told they don't meet the clinical guidelines for that diagnosis when VA officials reviewed their eligibility for compensation -- have been "frustrated" and confused by the discrepancy, Perez said.
"In retrospect, I realize I did not adequately convey my message appropriately," Perez told skeptical senators at a Senate Veterans Affairs Committee hearing, but "my only intent was to improve the quality of care our veterans receive."
The panel is investigating whether her e-mail indicated a cutback in VA treatment of PTSD.
An inspector general at the VA is conducting an independent investigation of the e-mail and the adequacy of care for veterans with post-traumatic stress disorder.
Although a veteran diagnosed with PTSD could be eligible for disability payments of up to about $2,500 monthly, veterans with the less severe condition of adjustment disorder generally are not entitled to disability compensation.
Sen. Patty Murray, D-Wash., said Perez's message seemed to indicate that strained resources at the VA are blocking veterans from getting "both the proper diagnosis and the care they need."
"This latest episode ... furthers the perception that the VA is shortchanging our veterans," Murray said.
The e-mail, with the subject line "Suggestion," was widely distributed by watchdog groups in May. In it, Perez said: "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."
Perez continued: "Additionally, we really don't ... have time to do the extensive testing that should be done to determine PTSD."
In testimony Wednesday, Perez said that comment was meant to refer to the initial medical appointments done at the Temple walk-in center.
VA Secretary James Peake has repudiated the e-mail.
Sen. Daniel Akaka, D-Hawaii, chairman of the Veterans Affairs Committee, said the e-mail "appears to have linked the increase in veterans seeking compensation for PTSD with a desire to assign a lesser diagnosis of adjustment disorder."
"Why would a clinician be so concerned about the compensation rolls?" Akaka asked.
Perez said her VA hospital is not connected to compensation in any way.
Michael Kussman, the VA's undersecretary for health, said there was "no systemic effort to deny a diagnosis" to veterans.
He noted that the VA expects to spend $3.5 billion on mental health care in fiscal 2008 and conducts PTSD screening for all VA applicants, regardless of their stated medical complaints.
Kussman added that the VA is calling roughly 500,000 veterans who have never received health care from the department to remind them of available services.
By last month, nearly 329,000 veterans were receiving disability compensation for PTSD connected with their military service, according to the VA. Although the vast majority -- 222,191 -- are veterans who served during the Vietnam era, 37,460 served recently in Iraq or Afghanistan.
People who suffer from the disorder may suffer from flashbacks, have trouble sleeping, and avoid talking about the violent experience that triggered their anxiety.
Source: Seattle Post-Intelligence, Seattle WA
............ • Level of Care for Vets Investigated
By JENNIFER A. DLOUHY, P-I WA Bureau
Thursday, June 5, 2008
WASHINGTON -- A Department of Veterans Affairs psychologist told senators Wednesday that cost cutting was not the reason she urged fellow clinicians at the Temple, Texas, Veterans Affairs hospital to "refrain from" diagnosing veterans with post-traumatic stress disorder.
The doctor, Norma Perez, said her e-mail March 20 was only intended to remind colleagues that they had the option of initially diagnosing patients with a less severe condition known as "adjustment disorder."
Perez said she was concerned that veterans would get "conflicting messages" and varying diagnoses from the VA. Veterans who were told they have PTSD at one appointment -- but then later told they don't meet the clinical guidelines for that diagnosis when VA officials reviewed their eligibility for compensation -- have been "frustrated" and confused by the discrepancy, Perez said.
"In retrospect, I realize I did not adequately convey my message appropriately," Perez told skeptical senators at a Senate Veterans Affairs Committee hearing, but "my only intent was to improve the quality of care our veterans receive."
The panel is investigating whether her e-mail indicated a cutback in VA treatment of PTSD.
An inspector general at the VA is conducting an independent investigation of the e-mail and the adequacy of care for veterans with post-traumatic stress disorder.
Although a veteran diagnosed with PTSD could be eligible for disability payments of up to about $2,500 monthly, veterans with the less severe condition of adjustment disorder generally are not entitled to disability compensation.
Sen. Patty Murray, D-Wash., said Perez's message seemed to indicate that strained resources at the VA are blocking veterans from getting "both the proper diagnosis and the care they need."
"This latest episode ... furthers the perception that the VA is shortchanging our veterans," Murray said.
The e-mail, with the subject line "Suggestion," was widely distributed by watchdog groups in May. In it, Perez said: "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."
Perez continued: "Additionally, we really don't ... have time to do the extensive testing that should be done to determine PTSD."
In testimony Wednesday, Perez said that comment was meant to refer to the initial medical appointments done at the Temple walk-in center.
VA Secretary James Peake has repudiated the e-mail.
Sen. Daniel Akaka, D-Hawaii, chairman of the Veterans Affairs Committee, said the e-mail "appears to have linked the increase in veterans seeking compensation for PTSD with a desire to assign a lesser diagnosis of adjustment disorder."
"Why would a clinician be so concerned about the compensation rolls?" Akaka asked.
Perez said her VA hospital is not connected to compensation in any way.
Michael Kussman, the VA's undersecretary for health, said there was "no systemic effort to deny a diagnosis" to veterans.
He noted that the VA expects to spend $3.5 billion on mental health care in fiscal 2008 and conducts PTSD screening for all VA applicants, regardless of their stated medical complaints.
Kussman added that the VA is calling roughly 500,000 veterans who have never received health care from the department to remind them of available services.
By last month, nearly 329,000 veterans were receiving disability compensation for PTSD connected with their military service, according to the VA. Although the vast majority -- 222,191 -- are veterans who served during the Vietnam era, 37,460 served recently in Iraq or Afghanistan.
People who suffer from the disorder may suffer from flashbacks, have trouble sleeping, and avoid talking about the violent experience that triggered their anxiety.
Source: Seattle Post-Intelligence, Seattle WA
