Connecting The Dots

It started in December 2004 when the Chicago Sun-Times ran a series of articles highlighting variations among states’ veterans disability compensation payments. The report showed that New Mexico had the highest compensation payments and Illinois the lowest. Rep. Lane Evans (D-Ill.) and other Illinois members of Congress sent a letter to VA Secretary Nicholson calling for a review. Subsequently, the Secretary asked for the Office of the Inspector General (OIG) to report on the differences.

In May 2005 the resultant OIG report noted that a review of 2,100 PTSD compensation cases found that in approximately 600 cases the compensation payment outcomes differed as a result of the stressor verification requirements varying from state to state. Members of Congress used the results of this OIG report as the basis for claiming “fraud” among PTSD claims, especially those involving Vietnam veterans.

Secretary Nicholson then issued notice that there would be a review of 72,000 PTSD claims awarded at 100 percent disability from 1999-2005. But after pressure from veterans’ groups (including VVA) and Sen. Patty Murray’s (D-Wash.) amendment to halt the review passed the Senate 98-0, the VA Secretary announced cancellation of the review last November 10.

However, just six days later, another PTSD review was announced in a press release issued by Sen. Larry Craig (R-Idaho), the chair of the Senate Committee on Veterans’ Affairs. This time neither the Secretary nor the VA announced the review. Sen. Craig’s press release stated that the VHA had contracted with the Institute of Medicine (IOM) to conduct a new review of PTSD diagnosis, treatment, and compensation for approximately $1.4 million. According to a subsequent VA “fact sheet,” the IOM will form two committees to conduct its review. One committee will “review the literature of various treatment modalities (including pharmacotherapy and psychotherapy).” This phase is expected to be completed in 12 months.

The other committee will review “the objective measures used in the diagnosis of PTSD and known risk factors for the development of PTSD,” and “the utility and objectiveness of the criteria in the DSM-IV and will comment on the validity of current screening instruments and their productive capacity for accurate diagnoses.” This phase is expected to be completed within six months.

Perhaps you’re now thinking along the lines of a December article penned by Larry Scott in OpEdNews.com, who wrote that “they are trying to rewrite the book on PTSD.” But there are more pieces to this puzzle.

In a front-page Washington Post article on December 27, reporter Shankar Vedantam noted that “PTSD experts were summoned to Philadelphia” for a secret two-day “expert panel” meeting in which they were asked to discuss “evidence regarding validity, reliability, and feasibility” of the department’s PTSD assessment and treatment practices, according to an e-mail invitation obtained by the Post. The goal, the e-mail said, was “to improve clinical exams used to help determine benefit payments for veterans with Post-traumatic Stress Disorder.”

The so-called experts quoted in this article included Sally Satel, the American Enterprise Institute’s conservative voice on PTSD, along with Chris Frueh from the Charleston, South Carolina, VA Clinic, whose claim to fame includes trying to show fraud among veterans seeking treatment for PTSD, and VA spokesperson Scott Hogenson, the former executive director of the Conservative Communications Center. In this article, Satel makes the outrageous claim that “an underground network advises veterans where to go for the best chance of being declared disabled.” VVA President John Rowan formally responded to the Post article on December 28, asking for the list of participants at the Philadelphia meeting. But as of this writing, VVA has not received a response to the request for the meeting’s participant list.

But here’s more: David Oaks, Director of MindFreedom International, a mental health advocacy organization, wrote in a January 6 editorial that “the U.S. government is helping to fund a series of private conferences throughout the world with the American Psychiatric Association (APA) about the Future of Psychiatric Diagnosis.” According to Oaks, “the Bush administration provided the APA with $1.1 million for the meetings.” One goal of this series of invitation-only conferences is “to promote international collaboration in order to increase the likelihood of developing a future unified DSM/ICD,” Oaks said.

“The DSM is the APA’s psychiatric label book, while ICD is the disease classification system used internationally. In other words, these meetings are about the U.S. and the APA influencing a global system of classifying psychiatric disorders.”

You don’t have to be a rocket scientist to connect the dots on this one.

Wrong Answers

A December 31 Kansas City Star article reports that, according to the VA’s own data, people who call the agency’s regional offices for help and advice are more likely to receive completely wrong answers than completely right ones. During 2004, VA benefits experts called each of its regional offices that process veterans’ disability claims to see how well its employees answer typical questions from the public. The callers, saying they were relatives or friends of veterans inquiring about possible benefits, made 1,089 calls. Amazingly, 81 percent of the time they received answers that the VA said were either completely incorrect or partly incorrect.

According to an internal VA memo on the mystery-caller program, 22 percent of the answers were “completely incorrect,” 23 percent were “minimally correct,” 20 percent were “partially correct,” 16 percent were “mostly correct,” and only 19 percent were “completely correct.”

The program also found that some VA workers were dismissive of some callers and rude to others. For example, one caller said: “My father served in Vietnam in 1961 and 1962. Is there a way he can find out if he was exposed to Agent Orange?” The VA’s response, according to the VA memo: “He should know if they were spreading that chemical out then. He would be the only one to know. Okay (hung up laughing).”