Is the VA Directing Its Medical Staff to Avoid Using PTSD as a Diagnosis?

In its May 16, 2008 edition, the Washington Post reports that a Texas VA psychologist named Norma Perez distributed an email to staff members under her supervision directing them to avoid making PTSD diagnoses:

“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,” Norma Perez wrote in a March 20 e-mail to mental-health specialists and social workers at the Department of Veterans Affairs’ Olin E. Teague Veterans’ Center in Temple, Tex. Instead, she recommended that they “consider a diagnosis of Adjustment Disorder.”  VA staff members “really don’t . . . have time to do the extensive testing that should be done to determine PTSD.”

Why would the VA wish to discourage PTSD diagnoses?  The Post reports that:

Adjustment disorder is a less severe reaction to stress than PTSD and has a shorter duration, usually no longer than six months, said Anthony T. Ng, a psychiatrist and member of Mental Health America, a nonprofit professional association.

Veterans diagnosed with PTSD can be eligible for disability compensation of up to $2,527 a month, depending on the severity of the condition, said Alison Aikele, a VA spokeswoman. Those found to have adjustment disorder generally are not offered such payments, though veterans can receive medical treatment for either condition.

Then presidential candidate Barack Obama wrote a letter to the VA demanding an explanation and a full investigation.  Not surprisingly Veterans Affairs Secretary James Peake responded by stating that Perez’s e-mail was “inappropriate” and does not reflect VA policy. It has been “repudiated at the highest level of our health care organization,” he said.

Peake said Perez has been “counseled” and is “extremely apologetic.” Aikele said Perez remains in her job.

Has anything changed?  The VA recently published proposed rules designed to “streamline” the process for evaluating PTSD before the VA.  According to veterans’ advocate site VeteransToday.com:

The problem with the rule change is that a VA-appointed psychologist or psychiatrist must sign off on the veteran’s claim and the VA is not a trusted authority in such matters as helping veterans obtain disability benefits. In so many words the culture of denial goes on, if the VA so decides.

“Only a VA Doctor can make the diagnosis. Get it. Only a VA Doctor can make the diagnosis. My guys with Silver Star Medals and two Purple Heart Medals that the VA says don’t have PTSD. What do they do if the rules change? Can’t go see a private shrink,” says one veterans’ advocate speaking on background because she often deals with the VA.

Have you had trouble with the VA and PTSD claims?  Please comment and let us know.