VA Says E-mail Was “Poorly Worded”

Veterans Affairs Psychologist Claims E-mail Appearing to Encourage VA Staff To Misdiagnose PTSD Was Out Of Context

(CBS)  This story was written by CBS News producer Pia Malbran for cbsnews.com.

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A Veterans Affairs psychologist claims an e-mail, in which she appears to encourage VA staff to misdiagnose post traumatic stress disorder, has been taken out-of-context.

“I sent an e-mail to my staff on March 20 to stress the importance of an accurate diagnosis,” Norma J. Perez told the Senate Committee on Veterans’ Affairs Wednesday during a hearing in Washington, DC.

Perez’s internal e-mail was leaked to the media last month by two veteran watchdog groups. As the coordinator of the PTSD clinic at a VA hospital in Texas, Perez sent a message titled “Suggestion” to her mental health staff. She wrote: “given that we are having more and more compensation seeking veterans, I'd like to suggest you refrain from giving a diagnosis of PTSD straight out. Consider a diagnosis of Adjustment Disorder…”

Lawmakers are concerned that Perez appeared to be more interested in the cost of treatment rather than the appropriate diagnosis. A veteran diagnosed with adjustment disorder will not receive as much compensation as one diagnosed with PTSD.

“Any suggestion that we would not diagnose a condition, any condition is unacceptable,” said Dr. Michael Kussman, the VA's Under Secretary for Health, who testified alongside Perez.

Perez told the Committee that there is “no relationship whatsoever” between the VA’s disability process and the treatment clinics. As to why she mentioned “compensation” in her e-mail, Perez said she just wanted to emphasize consistent diagnoses.

During the hearing, Sen. Patty Murray, a Democrat from Washington State, pointed out that treatment guidelines say “adjustment disorder” must be determined within six month of a traumatic event. Sen. Murray questioned whether adjustment disorder is an appropriate diagnosis for VA staffers to consider since many veterans often go to the VA more than six month after leaving combat.

In response, Perez said “that is why it’s just a suggestion.” She also pointed out that at the Texas clinic where she worked many new veterans would show up.

The VA’s head of mental health, Dr. Ira Katz, who was also present at the hearing, told the Committee he disagreed with Perez. He said he has concerns about diagnosing a veteran with adjustment disorder past the six month period.

The VA’s inspector general is now conducting an investigation. Lawmakers and veterans advocates are hoping the inspector general will determine whether or not Perez's suggestion is part of a bigger trend within the VA system.