Records agency to ignore Madigan Army Medical Center diagnoses

Staff writerNovember 15, 2013 

An Army agency that sets final medical records for disabled soldiers has been ordered to disregard reports from Madigan Army Medical Center doctors under scrutiny last year for their handling of patients with post-traumatic stress disorder.

The new order by an assistant secretary of the Army is meant to clear the way for up to 21 former Madigan patients to receive benefits for mental health conditions. It comes nearly two years after the Army suspended the hospital’s forensic psychiatry team over concerns that its doctors were reversing PTSD diagnoses.

Those former soldiers were among some 400 Madigan patients who were called back to the hospital last year and re-evaluated by Army psychologists. Of that group, 158 left the process with PTSD diagnoses that should have entitled them to better disability benefits.

Some, however, could not persuade the Army to correct their official records.

They were blocked by the Army Board for Correction of Military Records, which in some cases upheld the original diagnoses from Madigan’s forensic psychiatrists denying patients benefits for PTSD.

The new directive signed by Assistant Secretary of the Army Karl Schneider on Nov. 7 says reports by the forensic psychiatrists should be discarded if they conflict with other patient reviews.

It noted that Madigan was the only hospital in the Army with a robust forensic psychiatry program, so its diagnoses should be regarded as outliers in the military system. In the civilian world, forensic psychiatrists often are called to review mental health reports in the criminal justice system.

Former Madigan patients caught in the limbo expressed guarded relief about Schneider’s order.

“I’m hopeful they’ll change my records because I think that’s the right thing to do, but I’m proud I didn’t take being a victim of the system without fighting it,” said Jeanie Chang, 30, of Tenino, who has been working with Washington Democratic Sen. Patty Murray’s office to adjust her medical records.

Madigan’s forensic psychiatry team once represented the “gold standard” for Army behavioral health diagnoses. Its doctors had the final say on diagnoses for patients receiving medical retirements out of Madigan.

They changed up to 40 percent of the diagnoses they reviewed. Sometimes, according to documents obtained by The News Tribune, they adjusted diagnoses to PTSD. In other cases, they “downgraded” PTSD diagnoses to other conditions.

A Madigan ombudsman in late 2011 drew attention to the team after obtaining a PowerPoint presentation that suggested its members were adjusting diagnoses to save the Army money.

A subsequent Army review found the doctors were doing their jobs correctly, but that forensic reviews were not appropriate for widespread use in the Army medical retirement system.

Murray pressed the military to reform practices at Madigan and across the Army. Her office held a meeting with Pentagon officials to raise concerns about Chang’s case and others who were having trouble adjusting their benefits after receiving new diagnoses.

Chang left the Army in 2011 after seven years with a medical separation that included diagnoses of personality disorder and major depressive disorder. Those diagnoses suggested her medical conditions were not related to her service in the Army.

Chang felt offended by her diagnosis from a Madigan forensic psychologist, particularly a report she felt downplayed her rape by another service member in 2008.

Chang returned to Madigan last year and received a PTSD diagnosis from another doctor. She forwarded the report to the medical corrections review board and received a response that heavily favored the original diagnosis.

Chang said she felt mistreated by the medical corrections board. She says she has trouble trusting psychologists and getting care for her mental health conditions because of her experiences at Madigan.

“I’m afraid of what they’re writing on the paper,” she said.

Murray said she was frustrated hearing about service members such as Chang who were entangled in red tape by a process that was created to eliminate it.

“These veterans and their families have been through repeated reviews and deserve better than to be once again faced with bureaucratic hurdles to the care they deserve,” Murray said in a written statement to The News Tribune.

Adam Ashton: 253-597-8646

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