VA Staffer Discourages PTSD Diagnoses

The Department Of Veterans Affairs Condemns "Inappropriate" E-mail

(CBS)  This story was written by CBS News investigative team producer Pia Malbran.

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A Department of Veterans Affairs team leader in Texas suggested mental health professionals should diagnose patients with “adjustment disorder” rather than post traumatic stress disorder in order to save time and money treating veterans, according to an internal VA e-mail.

VA Secretary James Peake immediately called the e-mail “inappropriate” and a violation of VA policy.

On March 20, Norma J. Perez, a PTSD program coordinator and psychologist at the Olin E. Teague Veterans’ Center in Temple, Texas sent an e-mail with the subject line “Suggestion” to several staffers including psychologists, social workers, and a psychiatrist.

In the e-mail, Perez wrote, “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.” She then went on to say, “consider a diagnosis of Adjustment Disorder…”

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Read the e-mail, obtained by Citizens for Responsibility and Ethics in Washington and VoteVets.org

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"This means the veterans will not get disability benefits and health care for PTSD,” Paul Sullivan, the executive director of the advocate group Veterans for Common Sense, told CBS News.

Andrew Pogany, an investigator with the National Veterans Legal Services Program, said he thinks “purposely misdiagnosing someone is a serious ethical issue that [could] fall under malpractice.”

"VA staff across the country are working their hearts out to get our veterans the care they need and deserve," said U.S. Senator Patty Murray (D-Wash), a key member of the Senate Veterans Affairs Committee. "But e-mails like these make their jobs far more difficult."

In her e-mail, Perez also told staffers, “we really don’t... have time to do the extensive testing that should be done to determine PTSD.”

Sullivan, whose group has a pending lawsuit against the VA to force the agency to improve the treatment of veterans, said this “shows our suit has merit and that the VA lacks the capacity to provide proper care.”

In a statement, however, Secretary Peake said, “a single staff member, out of VA's 230,000 employees, in a single medical facility sent a single e-mail with suggestions that are inappropriate and have been repudiated at the highest level of our health care organization.” He added, “the employee has been counseled and is extremely apologetic.”

Peake promised that the VA is “committed to absolute accuracy in a diagnosis and unwavering in providing any and all earned benefits. PTSD and the mental health arena is no exception.”

[sgtrds-e4]

Classic effing right wing run the war as a for profit business idea! To this criminally corrupt administration our troops are just an expense to be slashed or written off whenever possible.

[sgtrds-e4]

This "team leader" will probably be given an award by Herr Bush himself.

[randynason]

I do not believe this "single staff member" made the decision on their own to misdiagnose PTSD. It has all the earmarks of a decision from higher-up in the echelon. I heard about this practice a good year ago, and am surprised that it has taken this long to come out in the national news. Belive me, this is only the tip of the iceberg. There are far worse incidents that have been inflicted upon the vets than have not yet come to light.

[bobnjersey]

[In a statement, however, Secretary Peake said %u201Ca single staff member, out of VA%u2019s 230,000 employees, in a single medical facility sent a single e-mail with suggestions that are inappropriate and have been repudiated at the highest level of our health care organization.%u201D He added %u201Cthe employee has been counseled and is extremely apologetic.%u201D ]

so ... all the emails and all the communications for all the staff have been evaluated?

[gce65]

Heckuva job Norma Perez! Heckuva job!

[fthoodvet]

From a wife of a US Army Combat Veteran who IS suffering from PTSD, I can promise you that this staff member is not alone. They tried to diagnose my husband with a multitude of different "personality" disorders so that he would not be awarded compensation. We had to fight for almost a year to get the proper diagnosis and even then he has not been given the proper care. I can not speak for the level of treatment at Fort Hood now, but during that time, Fort Hood only had 3 psychiatrists for 47,000+ troops most of which had been to OIF once or more than once. This attempt for misdiagnosis is being done in the Army as well...not just the VA. After getting put on the Temporary Retirement List from the Army, my husband was supposed to see this Norma Perez before he was transferred down to the Austin VA for treatment. The treatment that our veterans receive is unacceptable and embarassing for all of the sacrificing that they have done for us.

[veteran72]

Just another case of the Republicans "Supporting" our Troops......they''re supporting them to death.....literally....

[veteran72]

From a wife of a US Army Combat Veteran who IS suffering from PTSD, I can promise you that this staff member is not alone. They tried to diagnose my husband with a multitude of different "personality" disorders so that he would not be awarded compensation. We had to fight for almost a year to get the proper diagnosis and even then he has not been given the proper care. I can not speak for the level of treatment at Fort Hood now, but during that time, Fort Hood only had 3 psychiatrists for 47,000+ troops most of which had been to OIF once or more than once. This attempt for misdiagnosis is being done in the Army as well...not just the VA. After getting put on the Temporary Retirement List from the Army, my husband was supposed to see this Norma Perez before he was transferred down to the Austin VA for treatment. The treatment that our veterans receive is unacceptable and embarassing for all of the sacrificing that they have done for us.


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Posted by fthoodvet at 11:55 PM : May 15, 2008
report abuse

Hang in there, help is on the way come November.

[veteran72]

In a statement, however, Secretary Peake said %u201Ca single staff member, out of VA%u2019s 230,000 employees, in a single medical facility sent a single e-mail with suggestions that are inappropriate and have been repudiated at the highest level of our health care organization.%u201D He added %u201Cthe employee has been counseled and is extremely apologetic.%u201D

"Now, you better never, ever, again, let anyone know this is our Institutional Policy for dealing with these "loafers", and next time just act like you really care, no matter how much you don''t".....
"Is that clear"???!!!


"Yes, Sir"......8sniff*....."I just hate spending money that could be funneled into our paychecks, perks, and secret slush-funds".....*sniff*....

"I know,.....I know.....It''ll be all right".....

[samrensho]

Mission Accomplished Georgie. Great support of the soldiers you send to die for your oil riches.

[hesingswfrog]

This is typical in Texas. They try to screw claimants of every kind at every possible junction. There''s something in the water down there ... cynicism, greed, and hate.

[sgtrds-e4]

Whenever Bush or Cheney need medical treatment they should have to go to the same VA hospitals as real vets do.

[soshljustic]

Not only is it PTSD but it is also adjustment disorder-it is difficult to turn off the hypervigilence needed for combat when its over-in essence with both diagnoses it would provide for additional benefits under the DSM. Instead of a one or the other diagnostic criteria, it should be both, which allows for additional therapies of coping mechanisms to learn to adjust to the hypervigilent state in order to reduce the PTSD!!!

[sedean1]

So, counseled and apologetic? When will she be fired? Wouldn''t that tell the public and more importantly the Vets that the VA is serious about their welfare and treatment? Fire her fanny!

[viperash50]

This is not about Bush or Cheney why does everyone try to make everything political ?...under the 8 years Bush has been President the VA has doubled it''s funding from what it was under Clinton wake the hell up and check your statements...throwing your hate at Bush does not correct the real problems

[cyberus-2009]

Funny how no matter how many times this comes out its always a "violation of policy" and/or an isolated incident.
Seems to me that since it keeps coming up its not an isolated incident, and it sure doesn''t seem to be violation of policy .. it seems to be the unwritten policy.

[dennisjr6]

@ SgtRDS-E4 at 12:47 AM : May 16, 2008

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I AGREED WITH WHAT YOU WROTE...

[specter878]

Counceled and is sorry. THAT IS NOT ENOUGH. Those of us who have been through the hell of combat and still carry it around through no fault of our own should demand this persons firing. We have enough BS to deal with through VA without this kind of nonsense.

[sgtrds-e4]

@ SgtRDS-E4 at 12:47 AM : May 16, 2008

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I AGREED WITH WHAT YOU WROTE...

Posted by dennisjr6 at 01:12 AM : May 16, 2008

Thank you. I think none of our government leaders should ever get any better or worse health care then the average American, but certainly no better then vets. They seem to have forgotten that THEY work for US, not the other way around.

[sgtrds-e4]

Funny how no matter how many times this comes out its always a "violation of policy" and/or an isolated incident.
Seems to me that since it keeps coming up its not an isolated incident, and it sure doesn''''t seem to be violation of policy .. it seems to be the unwritten policy.

Posted by cyberus at 01:08 AM : May 16, 2008

Couldn''t agree more. there is no way in hell that this is an isolated incident, but is rather an understood unwritten policy.

[fthoodvet]

I just looked on the VA''s website for the Central Texas Veteran''s Hospital in Temple. It used to include the email addresses and phone numbers for the PTSD Staff (including Ms. Perez)....ironically they are no longer there! I am going to see if I still have one of her cards so that I can post her email address up here (and send her a personal "Thank You" email from my husband (who is suffering from PTSD) and myself).

[pfd572]

%u201Cthe employee has been counseled and is extremely apologetic.%u201D

Apologetic? This person needs to be fired and her license to practice revoked. Anytime anyone suggests or condones the misdiagnosing a patient they should suffer greater consequences then ''counseling''. This just amazes me.

[pfd572]

viperash: Sorry, but this can be laid right at bush/cheney''s doorstep. In the last eight years they have doubled spending? How about in the last 5 years they have quadrupled the number of VA patients with their war. Of course this is their ultimate fault and responsibility. How can you suggest anything else? There isn''t enough money left to provide the required and morally responsible care our vets need, its being spent on making them patients in the first place. No excuses and no ''passing the buck'' on this one.

[usmcvn2]

I just looked on the VA''''''''s website for the Central Texas Veteran''''''''s Hospital in Temple. It used to include the email addresses and phone numbers for the PTSD Staff (including Ms. Perez)....ironically they are no longer there! I am going to see if I still have one of her cards so that I can post her email address up here (and send her a personal "Thank You" email from my husband (who is suffering from PTSD) and myself).


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Posted by fthoodvet at 01:48 AM : May 16, 2008


Try.
... [e-mail]

See if that works.

[haoli25]

Remember this when one of the "adjustment disorder" patients takes out a mall with an AK-47.

[nonayabiness]

If there is anyone out there who doubts PTSD can be real, I can say first-hand that many years ago I dated a Gulf War Vet, 82nd Airborne who was affected.

He was back from overseas about 2 months when I met him. Great, great guy. Got along well, no problems. About 6 months later, we went to 4th of July fireworks. They made him shudder and jump each time the sound went off. I offered to leave, since he was obviously uncomfortable. He resisted, wanting me to be there with the rest of my family carrying out our annual tradition.

The next day, he could not speak. We never spoke again.

[andrew_693]

why is everybody angry? the hospital was doing their patriotic duty and taking the benefits that belong to the vets away so that rehab money can be used for making more weapons so we can keep the oil men richer and keep the fun war going. I believe that the GI bill money should be used for building more mansions and giving new planes for people like Cheney, Rumsfeld and Condoleeza Rice who likes to spend thousands in new shoes while at Fifth Avenue in NYC. It''s all in the bible and you should not question anything. Let the government tell you what to think through their fox news.

[messiahx4eve]

Once again, veterans are expected to bend over and take a good scr3wing without a kiss or hint of astrolube, and beg for seconds. Being psychologist/sociologist myself, what Perez is suggesting is paramount ot a hipshot diagnosis based on saving the government from spending the money owed to our soldiers who served and those who got wounded.Those people making these decisions have NEVER seen combat nor experienced what its like out in the field of combat.....EVER.

[ramos937]

While this shows an incredible lack of good judgment (and she puts it in writing too), the glaring fact that the VA personnel have inadequate resources is quite clear.

[palmward]

Notice that Peake doesn''t discuss what the counseling of the one bad apple entails. I suspect that it might have had something to do with not publishing directives like this in emails to get found by the media, rather than to consider looking at her priorities.
Our system may have been bad before and getting worse, but under Reagan and the Bushes (AND Clinton, I might add), it''s been irreversibly broken. How in hell do we expect to get health care for the whole country if our heroes are treated like this?

[palmward]

Notice that Peake doesn''t discuss what the counseling of the one bad apple entails. I suspect that it might have had something to do with not publishing directives like this in emails to get found by the media, rather than to consider looking at her priorities.
Our system may have been bad before and getting worse, but under Reagan and the Bushes (AND Clinton, I might add), it''s been irreversibly broken. How in hell do we expect to get health care for the whole country if our heroes are treated like this?

[palmward]

Notice that Peake doesn''t discuss what the counseling of the Perez entails. I suspect that it might have had something to do with not publishing directives like this in emails to get found by the media, rather than to consider looking at her priorities.
Our system may have been bad before and getting worse, but under Reagan and the Bushes (AND Clinton, I might add), it''s been irreversibly broken. How in hell do we expect to get health care for the whole country if our heroes are treated like this?

[palmward]

Sorry about the triple post...:-

[sistatee-2009]

Ms. Perez obviously blew her way through college.

[bluestardad]

THE NAZIS ATTACK ON POLAND IN 1939 WAS PROMOTED IN THE SAME WAY AS THE BUSH ATTACK ON IRAQ IN 2003!

NAZIS FACED WAR CRIMES TRIALS!

BUSH AND HIS NEOCON BUDDIES WILL FACE WAR CRIMES TRIALS!

OTHER COUNTRIES ARE ALREADY FILING WAR CRIMES CHARGES!

Lawyers File War Crimes Charges Against Rumsfeld And Others
In German Court

By Michael Ratner

29 November, 2006
Revolution


On November 14, the Center for Constitutional Rights (CCR), the International Federation for Human Rights, Germany''s Republican Attorneys'' Association, and other groups and individuals filed a formal complaint with the German Federal Prosecutor to open an investigation and, ultimately, a criminal prosecution of former Defense Secretary Donald Rumsfeld and other major U.S. officials. The complaint argues that Rumsfeld and other high-ranking civilian and military officials named as defendants in the case have committed war crimes, and in particular torture, against prisoners in Iraq, Afghanistan, and Guantanamo Bay. Following is an interview Revolution did with Michael Ratner, president of the CCR, who was among those in Germany on November 14 to file the complaint.

AMERICA STAND UP OR SHUT UP!

[carlylaine]

Nancy_Naive

that was one of the funniest things you''ve written...usually, you just tick me off because I see things differently from you, but girl that was dang funnay!

Carly

[johngoodnews]

She''s just another unqualified flunky who''s where she is for plausible deniability. It''s a Federal agency trademark to put unqualified people in positions where the agency''s unpopular decisions can be publicly vetted and then, if unpopular, easily denied by the real decision makers as being the work of a staffer who misunderstood or was acting outside the scope of employment--or, and this is a possibility given the stupidity of the action, she had a manager who wanted to fire her but needed something really, really good to nail her on.

[tekgiz]

I love this country, but I am ashamed to say that we have a long history of short changing our casualties in war, and our veterans after.

I speak from personal experience. A Marine Corporal that I was friends with lost both legs and one hand in Viet Nam. He was suffering from PTSD, comlicated by survivor guilt, (Yeh, even someone that chewed up can feel that) but though civilian mental health facilities recognized the problem (it was called, variously, shell-shock, or combat fatigue, in those days) the Navy Hospital, and later the Veterans Hosp. denighed that he was suffering from anything but physical injuries.

It was well over a decade later that PTSD was recognized as a legitimate diagnosis by the services and the VA. (1984, I believe) By that time a lot of our people were beyond help, homeless, thrown away by society.

Thank the Lord for the Viet Nam Veterans of America. Doug and I were helped without judgement, without reproach and without charge.

[Renegade.Rivers]

I find this quite telling because that was the same thing they done to the Vietnam Vets. I was diagnosed by the VA with adjustment disorder on several occasions. Even though I had been diagnosed as having PTSD by a private psychiatrist. Although I did get 100% disability after a 16 year fight with the VA due to wounds I received in Vietnam, and an injury I received, they never acknowledged that I had PTSD.

[skyk-2009]

Ms. Perez obviously blew her way through college.


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Posted by SistaTee at 04:30 AM : May 16, 2008
+ report abuse

Ms. Perez is acting on behalf of and supporting a very corrupt administration. Pretending she acted alone is to ignore the REAL problem... the Bush Administration. They care little about veterans, especially those that they can no longer use.

[ptsdveteran]

How long has Ms. "PEREZ" been in the U.S.? They,the VA, tried to claim Vietnam veterans PTSD as drug and alcohol problems, or problems from childhood. The VA touts its care for veterans, but to 99% of its employees, its just a job and a paycheck. PEREZ, a real American name!!!!

[excoachken]

I would suggest that PTSD program coordivator Norma Perez "refrain from showing up for work" in the future. Isn''t there a well trained and "caring" veteran, that happens to be a psychologist, who would do a better job in her position???

[tekgiz]

===How long has Ms. "PEREZ" been in the U.S.? They,the VA, tried to claim Vietnam veterans PTSD as drug and alcohol problems, or problems from childhood. The VA touts its care for veterans, but to 99% of its employees, its just a job and a paycheck. PEREZ, a real American name!!!!

Posted by ptsdveteran at 07:06 AM : May 16, 2008

I know nothing of Ms Perez''s background, but I am surprised at you, brother (See Henry V, shkspr) Many people in Texas with Hispanic surnames have ancestors that lived there well before the Johnny come latelies from the East Coast moved in. And a lot of them served with honor during the war to free Texas on the side of the Texans.

[veteran72]

Whenever Bush or Cheney need medical treatment they should have to go to the same VA hospitals as real vets do.


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Posted by SgtRDS-E4 at 12:47 AM : May 16, 2008
+ report abuse

You can''t even get them to attend one of the Funerals for the thousands of Military members they''ve murdered for profit. The VA is just for the "Little People",....not for Royalty....

[willymack]

Hey all you Perez experts out there ! None of you ever even met the lady. Why don''t you read her e-mail again. Perhaps she was just appalled at the PTSD rubber stamp being applied to some guys that really do not have it but are glad to get the cash each month. Maybe she is aware that most employers shrink from a PTSD tag on your service record that makes you a potential psyco. Or maybe she is aware that too many parents are quick to give their kids Ryddellin in middle school instead of discipline. If we did not have so many phonies looking for the rubber stamp then more tax payer funds could could be spent on guys really suffering from PTSD ....... like McVet.

[chad55555]

I can believe this came from a VA doctor,they live in their own little rose colored world and Veterans are treated like dogs. This doctor should be fired and removed from any office that deals with veterans.THIS SHOULD MAKE PEOPLE TYHINK TWICE BEFORE FIGHTING FOR PEOPLE LIKE THIS IN THIS COUNTRY.SOUNDS LIKE INSIDE VA TALK THAT SHE WAS NOT TO REPEAT.GIVES VETERANS AN IDEA WHAT TO EXPECT FUTHER DOWN THE ROAD. SHE WAS ONLY REPEATING WHAT ONE OF HER MEETINGS WAS ABOUT.
AMERICA ,AMERICA WHERE HAVE YOU GONE WHEN YOU DO VETERANS,CHILDREN,HELPLESS,AND OLD PEOPLE WRONG.STANDING BY YOUR COUNTRY IS HARD TO DO WHEN THEY DON''T STAND BY YOU.

[Renegade.Rivers]

Hey all you Perez experts out there ! None of you ever even met the lady. Why don''''t you read her e-mail again. Perhaps she was just appalled at the PTSD rubber stamp being applied to some guys that really do not have it but are glad to get the cash each month. Maybe she is aware that most employers shrink from a PTSD tag on your service record that makes you a potential psyco. Or maybe she is aware that too many parents are quick to give their kids Ryddellin in middle school instead of discipline. If we did not have so many phonies looking for the rubber stamp then more tax payer funds could could be spent on guys really suffering from PTSD ....... like McVet.

Posted by willymack4
----------------------------------------------------
Your a frickin'' jerk, and no doubt a neo-con boot lickin'' Bushie Nazi. Many of these soldiers need help, not your Bushit.

[bjrober]

My husband died nine years ago, and he was a Vietnam vet. He never applied for PTSD but I know he had it, he would wake up screaming and it was absolutely horrible, drinking excessively, etc. We don''t know why some of these troops get PTSD and others don''t, but I think we should treat them and not let them fall throught the cracks.

[bjrober]

FTHOODVET

So sorry that you are being treated this way, but things have got to change. When mine was in Nam and came back messed up, there was no help for the families and so many divorced their spouses. I knew mine was not the same man I sent to Nam and we stood by him, it was not easy, but thank God we made it, he died of cancer after we were married 36 years.

[missingamerica]

%u201Cpurposely misdiagnosing someone is a serious ethical issue that [could] fall under malpractice.%u201D

Could? COULD?