TEMPLE, Texas, May 15, 2008

VA Staffer Discourages PTSD Diagnoses

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

  • The Olin E. Teague Veterans' Center in Temple, Texas is a full-service teaching hospital and the headquarters of the Central Texas Veterans Health Care System.

    The Olin E. Teague Veterans' Center in Temple, Texas is a full-service teaching hospital and the headquarters of the Central Texas Veterans Health Care System.  (U.S. Department of Veterans Affairs)

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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…”

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

Quote

VA staff across the country are working their hearts out to get our veterans the care they need and deserve. But e-mails like these make their jobs far more difficult.

Sen. Patty Murray (D-Wash)
"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.”

© MMVIII, CBS Interactive Inc. All Rights Reserved.
Add a Comment See all 122 Comments
by darnedsocks May 19, 2008 12:42 PM EDT
WHAT A CREEP! THIS GUY OUGHT TO BE FIRED! THE VETERANS NEED TO BE CARED FOR! HOW WOULD HE LIKE IT IF IT WERE HIM?! DUH! EVER HEARD OF THE "GOLDEN RULE"?
Reply to this comment
by kansas1946 May 19, 2008 1:09 AM EDT
Just typical of the enviornment created by the Bush administration for veterans. The only time Republicans love veterans are when they are getting shot at. After that, forget em'', especially if it costs any money.
Reply to this comment
by symc655 May 19, 2008 12:59 AM EDT
Wake up people, do you think this is the only VA that mistreats people and try to save dollars by denying benefits....Well I work at one and it happens every day its just not recorded in email. What about denying a bill if they go to the nearest hospital when they are having chest pain because they did not go to a VA 100miles away!!!
Reply to this comment
by Markus May 17, 2008 10:27 PM EDT
Hey Begonia5 ........You called this one right on the money!!!!!Thanks for the contact info...CALLS WILL BE MADE IN SHORT ORDER......WELL DONE!
.............COUNSELED?????? MY A** !
SINCERELY,
MIKETNT303
Reply to this comment
by Markus May 17, 2008 10:25 PM EDT
Hey Begonia5 ........You called this one right on the money!!!!!Thanks for the contact info...CALLS WILL BE MADE IN SHORT ORDER......WELL DONE!
..........................COUNSELED?????? MY A** !
SINCERELY,
MIKETNT303
Reply to this comment
by begonia5 May 17, 2008 3:48 PM EDT
Citizens can complain to Norma Perez "boss" Olin E. Teague Veterans Medical Center and ask the V.A. Hospital Director, Mr. Bruce Gordon, why Norma Perez, hasn''t been fired yet. He can be reached at 254-778-4811, extension 42306.

She''s shocked and awed the Vets with a paltry apology and "oops" ONLY after her email has been revealed.

For some odd reason the families dealing with the damaged goods manufactured by the GOP''s profit margin wars and vets who committed suicide thanks to her policies.... didn''t FEEL for her sad words of apology.

One can call Norma Perez at 254-778-4811, extension 42867 and tell her what your think of her lies, maltreatment of veterans, and her deliberate orders to re-name symptoms of PTSD to avoid care and expense of damaged goods manufactured for the GOP

An alternative number is 800-423-2111, extension 42306 for Mr. Gordon, Hospital Director and extension 42867 for Norma Perez.

This typical compassionate Christian Nation should be woman hauled before a Congressional Joint Armed Services Committee hearing and questioned about her lack of medical ethics and her failure to "support our troops" dying for our OIL CEO profit margins and election era desperation.
Reply to this comment
by begonia5 May 17, 2008 3:45 PM EDT
Citizens can complain to Norma Perez "boss" Olin E. Teague Veterans Medical Center and ask the V.A. Hospital Director, Mr. Bruce Gordon, why Norma Perez, hasn''t been fired yet. He can be reached at 254-778-4811, extension 42306.

She''s shocked and awed the Vets with a paltry apology and "oops" ONLY after her email has been revealed.

For some odd reason the families dealing with the damaged goods manufactured by the GOP''s profit margin wars and vets who committed suicide thanks to her policies.... didn''t FEEL for her sad words of apology.

One can call Norma Perez at 254-778-4811, extension 42867 and tell her what your think of her lies, maltreatment of veterans, and her deliberate orders to re-name symptoms of PTSD to avoid care and expense of damaged goods manufactured for the GOP

An alternative number is 800-423-2111, extension 42306 for Mr. Gordon, Hospital Director and extension 42867 for Norma Perez.

This typical compassionate Christian Nation should be woman hauled before a Congressional Joint Armed Services Committee hearing and questioned about her lack of medical ethics and her failure to "support our troops" dying for our OIL CEO profit margins and election era desperation.
Reply to this comment
by begonia5 May 17, 2008 3:44 PM EDT
Citizens can complain to Norma Perez "boss" Olin E. Teague Veterans Medical Center and ask the V.A. Hospital Director, Mr. Bruce Gordon, why Norma Perez, hasn''t been fired yet. He can be reached at 254-778-4811, extension 42306.

She''s shocked and awed the Vets with a paltry apology and "oops" ONLY after her email has been revealed.

For some odd reason the families dealing with the damaged goods manufactured by the GOP''s profit margin wars and vets who committed suicide thanks to her policies.... didn''t FEEL for her sad words of apology.

One can call Norma Perez at 254-778-4811, extension 42867 and tell her what your think of her lies, maltreatment of veterans, and her deliberate orders to re-name symptoms of PTSD to avoid care and expense of damaged goods manufactured for the GOP

An alternative number is 800-423-2111, extension 42306 for Mr. Gordon, Hospital Director and extension 42867 for Norma Perez.

This typical compassionate Christian Nation should be woman hauled before a Congressional Joint Armed Services Committee hearing and questioned about her lack of medical ethics and her failure to "support our troops" dying for our OIL CEO profit margins and election era desperation.
Reply to this comment
by deathsong May 17, 2008 2:43 AM EDT
I will try this one more time. Employees at the lower level react to what those at the top level promote. The Fargo VA serves food in there cafeteria on paper plates and this shows a lack of respect from the top. It then trickles on down to the lowest levels. I had a cysto and urology dilation at that hospital and I was the first in line. I sat in an exam room for four hours, becoming the last to be seen. The nurse was upset as she came and went not understanding why I was being left for the last. I will never go to urology again. So will be saving taxpayers a lot of money. The longer you wait the more paranoia sets in and you wonder what they are up to. If they were trying to get rid of me, It worked.
Reply to this comment
by deathsong May 17, 2008 2:42 AM EDT
I will try this one more time. Employees at the lower level react to what those at the top level promote. The Fargo VA serves food in there cafeteria on paper plates and this shows a lack of respect from the top. It then trickles on down to the lowest levels. I had a cysto and urology dilation at that hospital and I was the first in line. I sat in an exam room for four hours, becoming the last to be seen. The nurse was upset as she came and went not understanding why I was being left for the last. I will never go to urology again. So will be saving taxpayers a lot of money. The longer you wait the more paranoia sets in and you wonder what they are up to. If they were trying to get rid of me, It worked.
Reply to this comment
by deathsong May 17, 2008 2:09 AM EDT
What we see at the lower level, reflects what the impression of those higher up. For example the Fargo VA serves food in the calf on paper plates, to save money. Now things like this coming from the top, leaves the other employees thinking the Vet''s are not worth much and slowly the respect for our Veterans is gone. Although I saw an effort from that hospital to improve the respect level, it is not coming from the top. I went for a cysto and urethra dilation and was the first in line and put my gown on and sat in an exam room for four hours with a nurse stopping from time to time to say your next. She even apologized and said she didn''t know why they left me for the last. I won''t go back to Urology. So they have one left to treat.
Reply to this comment
by deathsong May 17, 2008 2:07 AM EDT
What we see at the lower level, reflects what the impression of those higher up. For example the Fargo VA serves food in the calf on paper plates, to save money. Now things like this coming from the top, leaves the other employees thinking the Vet''s are not worth much and slowly the respect for our Veterans is gone. Although I saw an effort from that hospital to improve the respect level, it is not coming from the top. I went for a cysto and urethra dilation and was the first in line and put my gown on and sat in an exam room for four hours with a nurse stopping from time to time to say your next. She even apologized and said she didn''t know why they left me for the last. I won''t go back to Urology. So they have one left to treat.
Reply to this comment
by deathsong May 17, 2008 2:06 AM EDT
What we see at the lower level, reflects what the impression of those higher up. For example the Fargo VA serves food in the calf on paper plates, to save money. Now things like this coming from the top, leaves the other employees thinking the Vet''s are not worth much and slowly the respect for our Veterans is gone. Although I saw an effort from that hospital to improve the respect level, it is not coming from the top. I went for a cysto and urethra dilation and was the first in line and put my gown on and sat in an exam room for four hours with a nurse stopping from time to time to say your next. She even apologized and said she didn''t know why they left me for the last. I won''t go back to Urology. So they have one left to treat.
Reply to this comment
by va555 May 16, 2008 11:16 PM EDT
As a VA employee I am outraged. This is unethical on so many levels. Not only does the veteran lose his or her claim, but does not get the appropriate treatment as the treatment follows the diagnosis.Such a practice could also affect funding for programs for vets with PTSD. As a psychologist, she must have a license. In NYS we have a code of ethics to follow. She should be reported to her state''s professional licensing board at the state ed. dept. As much as I love my job working with vets, I am beginning to think all of us ''civilians'' should be let go and only vets allowed to work for the VA. Maybe then things would change. No vet would ever do that to another vet.
Reply to this comment
by grunt1984-2009 May 16, 2008 9:53 PM EDT
Norma Perez is the writer of the email, call her boss, call her!
Submitted by Anonymous on 16 May 2008 - 5:25am.
Please call the Olin E. Teague Veterans Medical Center and ask the V.A. Hospital Director, Mr. Bruce Gordon, why Norma Perez, hasn''t been fired yet. He can be reached at 254-778-4811, extension 42306.

Then call Norma Perez at 254-778-4811, extension 42867 and tell her what your think of her lies, maltreatment of veterans, and her advocacy of misdiagnosis and malpractice regarding Iraq and Afghanistan veterans with PTSD. Urge her to resign immediately.

An alternative number is 800-423-2111, extension 42306 for Mr. Gordon, Hospital Director and extension 42867 for Norma Perez.

Shouldn''t this woman be hauled before a Congressional Joint Armed Services Committee hearing and questioned about her lack of medical ethics and her failure to "support our troops"?

Every psych case this woman has handled will have to be reevaluated because of her fraud and abuse. In a dimwitted attempt to save money, she ended up costing the V.A. more money and creating even more of a backlog in mental health services at the V.A.

I cannot believe this *** still has a job!

Submitted by Anonymous on 16 May 2008 - 5:25am.
Reply to this comment
by pragmaticus May 16, 2008 9:00 PM EDT
The article and blogs demonstrate the danger of mixing psychiatry and politics. Read Goodwin and Guze''s seminal book "Psychiatric Diagnosis" to understand the early problems of such mixtures, including the sadly humorous political path of the PMS diagnosis.

Also described in this book is a "heretical view" endorsed by those who laid the foundation for American descriptive psychiatry:

"In our view there are only about a dozen diagnostic entities in adult psychiatry that have been sufficiently studied to be useful."

As of the printing of DSM-IV, PTSD was not one of those diagnoses.

Further, American psychiatry struggles presently with a pseudo-plague of overdiagnosed bipolar disorder, with powerful, published research emerging to this effect. Why?

The psychiatric profession and money make for a messy mix.
*** In most settings, reimbursement REQUIRES diagnosis, thus everyone who sees a psychiatrist gets one.
*** Patients won''t return unless a medication is prescribed.
*** Psychiatrists are paid much more per minute for short visits than for long visits, thus they now tend to see 20-25 patients per day. Careful diagnosis cannot occur with such a schedule.

Bankrupting the American taxpayer for politically motivated diagnoses is reprehensible and disrespectful to those who actually need disability benefits. Flagellating a president with fallible psychiatric diagnostic processes is useless.
Reply to this comment
by usmcvn2 May 16, 2008 7:22 PM EDT
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Reply to this comment
by pfd572 May 16, 2008 7:15 PM EDT
riptide: I liked it very much, well done.
Reply to this comment
by riptide213 May 16, 2008 6:54 PM EDT
As citizens, voters, political candidates or incumbents we must rally and stand together to support our troops and wounded warriors when an unmistakable injustice is clearly identified.

Intended or not it%u2019s a corrupted betrayal of public office trust made even worst since it directly related to peoples health and treatment status.

Nation needs more V for Veteran than A for Administration emphasis.

We the people regret to inform all involved with insulting and impairing actions or omissions that are detrimental to the respect, entitlement, health or welfare of our uniformed services and veterans are no longer employable by the US government.

All those involved, please do one honorable thing in the wake of this treachery as a sign of respect to our troops and volunteer to leave government quietly out the backdoor of shame.

When will the military scandals end?

Water Reed penthouse vs. pauper treatment.

Ft. Bragg barracks sewage slum.

Stop Loss and In Lieu of Tasking Backdoor Draft.

VA dodging diagnosis.

Leadership must bear responsibility for failing to lead or poorly leading organizations entrusted to support and serve those who support and serve their nation.



Army. A body of men assembled to rectify the mistakes of the diplomats.
Josephus Daniels



Reply to this comment
by pfd572 May 16, 2008 6:52 PM EDT
My family has a strong and proud military service record. My grandfather, father, aunts, uncles and many of their children all served. The ''Greatest Generation'' members all saw action during WWII and Korea, the younger generation were in Nam and other recent engagements. My grandfather, father and uncles, plus come of the kids, were career military, all serving 25 plus years. I lost an uncle to complications from his action during the Battle of the Bulge and lost 3 cousins in Nam. My point is I am not just an armchair political philosophiser, I know what I am talking about. This administration and its minions have committed high crimes against the people and especially against their ''employees''.
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