Army checking whether cost concerns affected PTSD diagnoses at Madigan

In a lecture to colleagues, a Madigan Army Medical Center psychiatrist said a soldier who retires with a post-traumatic-stress-disorder diagnosis could eventually receive $1.5 million in government payments, according to a memo by a Western Regional Medical Command ombudsman who attended the September presentation.

The psychiatrist went on to say that the rate of such diagnoses eventually could cause the Army and Department of Veterans Affairs to go broke.

“He (the psychiatrist) stated that we have to be good stewards of the taxpayers’ dollars, and we have to ensure that we are just not ‘rubber stamping’ a soldier with the diagnoses of PTSD,” stated the ombudsman’s memo.

That memo has helped spark what the Army Medical Com­mand calls a “top-to-bottom” review of a forensic psychiatric team at the Army hospital. The team screens soldiers under consideration for medical retirement.

In a statement Monday, officials of the Western Regional Medical Command and the Army Medical Command said they are “taking this issue very seriously.”

The Seattle Times reported last week that the leader of the forensic psychiatric team, Dr. William Keppler, and another Army doctor had been suspended from clinical duties while the Army investigates.

The Army Medical Command’s probe is being monitored by Sen. Patty Murray, who chairs the Senate Committee on Veterans Affairs. She said doctors should not take financial considerations into account as they make a mental-health diagnosis.

“This is the opposite of everything that we are working for,” Murray said of the statements detailed in the memorandum. “It is very disheartening to see this in writing.”

The Army surgeon general’s office also has asked psychiatrists from Walter Reed Army Medical Center to evaluate the mental health of more than a dozen soldiers who complained that the Madigan team had unfairly dropped their PTSD diagnoses as they prepared for medical retirement. Some said the team branded them as malingerers who were lying or exaggerating their symptoms.

PTSD is a condition that results from experiencing or seeing a traumatic event, such as a battlefield casualty. Soldiers are often diagnosed with it as they move through the Army medical system.

At Madigan, the team’s validation of a PTSD diagnosis can help qualify a soldier for a medical retirement with considerable benefits that include lifelong health insurance for a retiree, spouse and dependents, and monthly pay, and also can help qualify a retiree for disability benefits from the U.S. Department of Veterans Affairs.

The September lecture was intended to help social workers, nurse case managers and others understand the role of the forensic team in the Medical Evaluation Board system.

After the comments about the financial cost, the meeting room “was exceptionally quiet,” the ombudsman wrote. “Not sure if it was because people didn’t know how much a diagnosis of PTSD equated to or why we are talking about dollars in relation to our soldiers.”

Under the VA system, a 25-year-old veteran with a 100 percent PTSD disability currently can receive $2,769 per month, and at that rate of compensation would tally more than $1.5 million in payments over 46 years.

In its written statement, the Western Regional Medical Command said that a soldier with a PTSD diagnosis gets at least a 50 percent Army disability rating. However, the statement said that rating might not be permanent and that the diagnosis is periodically reviewed.