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Army probing PTSD diagnoses

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The Army launched a review Wednesday of its handling of post-traumatic stress disorder and other behavioral health evaluations at all of its medical facilities since 2001, in response to fears that some soldiers had their diagnoses reversed because of the costs of caring for them.

The review, ordered by Secretary of the Army John M. McHugh and Chief of Staff Gen. Ray Odierno, follows disclosures that some soldiers found to be suffering from post-traumatic stress disorder had that diagnosis rejected during subsequent evaluations at Joint Base Lewis-McChord in Washington state.

In reviewing those evaluations this year, Army investigators have found cases in which “the original PTSD diagnoses were more accurate,” according to an Army statement.

The Army will review diagnoses and evaluations made at all of its medical facilities.

Army leaders also have ordered an independent review by the service’s inspector general into whether the disability evaluation system affects the behavioral health diagnoses given to soldiers and whether the command climate or other non-medical factors affect the diagnoses, according to information given Wednesday to members of Congress.

The diagnoses are the first step in evaluating the amount of disability benefits a soldier receives.

In addition, the Army auditor general has been ordered to audit the Army Medical Command Ombudsman Program, which was set up to mediate for soldiers and family members in the wake of the scandal over conditions at the former Walter Reed Army Medical Center.

“The Army clearly realizes they have a nationwide, systematic problem on their hands,” said Sen. Patty Murray (D-Wash.), chairman of the Senate Veterans’ Affairs Committee, who requested the review at Lewis-McChord. “I credit them with taking action, but it will be essential that this vast and truly historic review is done the right way.”

The Army’s review of 400 cases at Lewis-McChord has led to more than 100 service members having their PTSD diagnoses restored.

The controversy stems from the work of a special forensic psychiatric team that in 2007 began evaluating mental health diagnoses of service members preparing to leave the military.

The screening team reversed at least 290 PTSD diagnoses made by the military or the Department of Veterans Affairs.

Service members with such diagnoses are entitled to a 50 percent disability rating, a level at which the military is responsible for considerable medical benefits after retirement.

The Army is investigating whether the Lewis-McChord team used the cost of a PTSD diagnosis as a consideration in their evaluations, according to Murray’s office. Three officers have been placed on leave while the investigation continues, including Col. Dallas Homas, the hospital commander, and William Keppler, the head of the psychiatry team.

A PowerPoint presentation that Keppler gave to staff members emphasized that every diagnosis of PTSD costs the military $1.5 million in health benefits and pension payments.

Juliana Ellis-Billingsley, a member of the screening team, resigned in February. “I find that I can no longer work in a system that requires me to sacrifice my professional and moral principles to political expediency,” Ellis-Billingsley wrote in her resignation letter.

Army leaders had told Murray that the problem was isolated, but the decision to order a nationwide review indicates otherwise, the senator said.

“Reviewing our processes and policies will ensure that we apply an appropriate standard at every installation — one that is influenced only by the opinion and expertise of our medical professionals,” McHugh and Odierno said in a joint statement.

Lewis-McChord, one of the largest military installations in the nation, has attracted attention in recent months because of several high-profile incidents. It is the home base for Staff Sgt. Robert Bales, accused in the massacre of 17 Afghan villagers in March, as well as four soldiers found guilty of charges in the killings of three unarmed Afghan civilians in 2010. (A fifth was found guilty on a related charge.)

The Army-wide review is to be led by Vice Chief of Staff Gen. Lloyd Austin and Undersecretary of the Army Joseph Westphal. The review is meant to identify and correct problems in the Army’s approach to behavioral health diagnoses and disability evaluations, according to the statement released by the service.

“We owe it to every soldier to ensure that he or she receives the care they need and deserve,” McHugh said.

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