Story here. I cannot fracking believe this. Somebody please tell me it ain’t so.
Wow… I’m pretty jaded, but that looks like one hell of a scandal. People will gripe that it’s in The Nation, but it looks pretty well attested. Fan, meet shit.
The problem with this of course is that PD as a diagnosis that carries some pretty huge baggage. Pretty much noone is keen to be diagnosed with it, so finding someone who agrees that its a legitimate diagnosis is often pretty hard work. Theres also a bit of disagreement in general about when its appropriate to diagnose it or not in any case.
Id want to look at the relative diagnosis rates in general - sure PD diagnosis has gone up by 10% or so in the last few years, but whats the rate of increase for other diagnoses, particularly PTSD? Statistically some misdiagnosis is bound to have occurred, but the case that this is widespread and relatively institutionalised needs some better data than this in my view. The cases should have documents about the stated rationale for the diagnosis, you’d think they could show absence of proper procedure or not properly meeting the criteria for the condition in those pretty easily.
My main concern is that idea that it was ‘latent’, that sure seems like a potential misuse of the diagnosis. If theres a widespread belief thats a legitimate part of the diagnosis, Id be pretty worried.
Otara
Is there any disagreement about its medical definition or symptoms?
Well for a start you dont just have PD, theres various types of PD.
In practise when checks are done, theres pretty low intercorrelation between different professionals diagnosing it or even with test/retest over time. Basically theres a lot of ‘wiggle room’ in the diagnosis, because it relies on clinical judgment for the criteria. So on that basis alone, disagreements about whether someone has the diagnosis arent uncommon and its been pretty heavily criticised for that and other definitional issues.
Basically its one of the more controversial areas of disorder/diagnosis in the mental health area. So this could just be a reflection of the difficulties of the issue in general, rather than anything specific to the military.
Otara
A contrary conclusion is at least suggested by the fact that there is money at stake here.
Well the potential motives like money and/or easily getting rid of ‘problems’ means its definitely worth checking out further and not dismissing it out of hand.
I just think theres various items of evidence Id think they could easily get that dont seem to be in the article, eg changes in diagnosis rates in general. So I dont feel too convinced either way at this stage.
Otara
As an aside, I’m having trouble with some of the math in that article, although I don’t doubt the general conclusions.
My Windows 2000 calculator says 22,500 soldiers times $5,000 is $112.5 million. Is there a missing “per year” on that $5,000?
Sailboat
Shades of Catch-22! I just noticed one of the officials diagnosing this financially convenient disorder is named Colonel A. Parodi.
Sailboat
Sailboat, you’ve managed to whoosh yourself. It’s right there in your quote… the per year, I mean.
:smack:
Color me slightly dubious. The military and VA are separate entities. They have separate funding. Why would the army work so hard to screw over its retirees to save a buck for a completely separate federal agency?
When my husband was in the Army and injured his knee so badly he could not walk and was discharged, the first diagnosis by an Army doctor was bone cancer which the doctor said was pre-existing and so he would not treat it. The doctor was deliberately misdiagnosing those who got injured in boot camp so they were less likely to get service connection. The doctor in my husband’s case was prosecuted and lost his license.
My husband did get service connection, after a long fight, as did several other very confused young men. He also got an honorable discharge. His testimony and persistence were key in ridding the Army of that filth who would rather scare young men and women with the big C so they would sign any document put in front of them than fill out paperwork for service connection and actually treat the injuries as they needed to be treated.
I do not know that the doctor had any reason other than personal to do what he did. It seemed motivated to avoid paperwork and hassle and costs, but at the time there was no indication that this was a systematic effort by the Army to save the government money.
About four years ago he fought the VA to try to get an artificial knee. The games the VA played to deny that were clearly motivated by federal money-saving policies. Eventually we had his knee replaced with our private insurance, which we were lucky enough, and stuck the VA with the bill.
I have no qualms about making the government pay for that knee. It needed to be replaced because the drill sergeant over filled a truck, broke the speed limit, and then tried to deny the severity of the injury delaying treatment and then treatment was further delayed due to the whole cancer scare.
After his initial surgery, it was another three years before he found a surgeon with privileges at a VA hospital who would take a second look to try to find out why he had so much pain. That doctor was temporarily able to fix up the knee well enough that with therapy, my husband could walk. The reason for the pain that had prevented him from even trying to walk was that there were bone fragments left under the patella that were sharp and would have done injury whenever he tried to bear weight on it. Three years my husband could not walk because a surgeon missed those fragments and no other could be arsed to look into the issue. Instead they slapped the label “Conversion disorder” on him. Mind you that terminology was way out of date by that time.
Recently, my husband went on social security disability. His first claim was denied apparently because it is policy to deny the first claim for the hell of it. According to those we talk to familiar with the situation this is a policy tied to the current administration.
So, deliberate mis-diagnosis is nothing new, neither are money saving policies which harm individuals and deny them deserved care. Some of these policies are official and pervasive, but others may be attributed to individuals or small groups who have motivations as simple as not liking to fill out paperwork.
I’ve got some questions about the article, I’ll admit.
I’m not entirely certian that my understanding is correct, but it’s my belief that so long as a veteran’s discharge was considered honorable, the VA will provide services to the veteran. The reason for the discharge doesn’t matter, so long as the service is considered to have been honorable. Whether the VA will charge the veteran, based on a needs test, for services is something else entirely. And not all services that the VA offers are available for persons without a service connected injury - dental is the thing that comes to my mind off the top of my head.
One of the reasons that I believe this is that I recieved an administrative discharge, for reasons relating to a medical condition. That was why I was discharged before I served the full 2,192 days I’d obligated myself to. That doesn’t mean that I didn’t receive an honorable discharge. And I’m getting treatment from the VA, for something that’s not service connected.
I’m not saying that there aren’t problems with what the article is reporting: As I mentioned (and as lee mentions in her post) being discharged with record of a service connected injury does open up a lot more support for veterans. But it’s not quite the all-or-nothing that the article seems to imply it might be. Nor am I trying to deny that this crap is a shame that should be corrected. Just trying to hit some of the mistakes I believe I spotted in the article.
I don’t know that you’re wrong, but I suspect it’s a longer established policy than simply this administration. Certainly when it was first suggested I try to qualify for SSI(Disability) I was warned at the time that most first time claims are rejected automatically. And that was back in 1997.
IMO, if there is this “wiggle room” in the diagnosis, then the military Dr.'s should err on the side of caution on the benefit of the wounded soldier.
On a personal note, one thing I noticed on the few, rare occasions I went on sick call, is that the level of service one received (and the accompanying attitude of the military doctors) was the attitude they picked up from the wounded/injured soldier (I’m not talking combat injuries here, just run-of-the-mill, day-to-day working injuries).
It seemed that if the soldier was motivated to get better, and get back to their unit and to work, then the treatment was, oh, I’d say, more “complete;” the Dr.'s attitudes were more “professional.”
But if they caught even a whiff that the soldier was trying to “sham” out of work or assignments, then their attitude changed quickly to that of callous, and brusque.
Case in point: I have a tendency towards ingrown toenails, and during basic, I had one act up, necessitating a trip to the base Podiatrist. My questions to the Dr. were NOT along the lines of “How long will this keep me out of PT?” They were more along the lines of “How soon can I get back into PT, and doing my training,” like I was eager to get better and get back to work. I maintained that attitude when I got back to my unit, and my DI’s were helpful, supportive, even protective.
And I saw plenty of examples of them mercilessly riding those they perceived as “sick call commandos.” And it’s not that those other soldiers weren’t sick, or injured, but the attitude they typically projected was one of “How long will my injury keep me from doing all this hard, unpleasant shit?”
Just IME, and all that. YMMMV.
Apparently a “personality disorder discharge” is not considered honorable.
Yeah a ‘prior condition’ would generally count as ‘you’re on your own’ I imagine and personality disorders are considered to be well, your personality, ie something you’ve had for a very long time.
“IMO, if there is this “wiggle room” in the diagnosis, then the military Dr.'s should err on the side of caution on the benefit of the wounded soldier.”
Well for all we know they generally do and only the more extreme cases get it as a diagnosis. As I said we still dont even know for sure that the diagnosis has significantly increased compared to other conditions or what level of error rate/misdiagnosis we’re talking about here. But I certainly agree in principle its a diagnosis that should be used cautiously. Heck any diagnosed condition should be really.
Its not a popular diagnosis after all and fairly contestable. You can be fairly sure that many people would fight it tooth and nail, and they’d have to be able to back it up in court. Id be interested to see how often they’ve decided to settle when it got to that point.
Otara
Quite possibly. What I’d meant is that I’m aware of three kinds of discharge*: Honorable, General, and Other than Honorable, with both the Dishonorable and Bad Conduct Discharges being a specific kind of OTH Discharge. The article you linked in the OP seemed to be implying that this “personality disorder discharge” is either a new category, or a kind of Dishonorable Discharge, rather than an administrative reason for separation that is then covered in one of the three discharge categories I’d mentioned here. Based on the other details provided in the article I think that this “personality disorder discharge” seems to be coming under the Other than Honorable category, but if that were the case, it’s never mentioned in the article. And while OTH seems to be the general category that DD and BCD come under, they are by no means the only reasons that an OTH catogorization may be issued.
However, there’s no discussion of what kinds of discharges are available from military service in the article. And, glaring flaw to my mind, I got the impression that the writer had the belief that there’s either an Honorable Discharge, or a Dishonorable Discharge. It really reads to me like someone who has only half the background information they need to make a coherent report to others. So, I find myself having to believe that the writer of the article either doesn’t quite understand the military’s discharge categories, or that the military has in the past ten years come up with a completely new category of discharge.
I’m afraid I shave my data with Occam’s razor, and so lean towards thinking it’s poor reporting. And because of that apparant flaw, I’m skeptical of a lot of the rest of the general information that the article presents as fact.
*The link I’m offering is a bit more detail explaination of what the categories are, and how a service member gets issued one. It jibes well with what I recall from my own separation briefs, but both my memory may be flawed or the linked article. Or we could both be made obsolete - just because I find it more likely to believe that the reporter made an error describing the situation doesn’t mean it’s impossible for me to wrong and that the military (Department of Defense, actually) did make up a new category of discharge.
Brain Glutton, I want to make it clear that whatever the details of the type of discharge that Specialist Town recieved, I agree he, and other veterans in similar situations, are being treated shoddily and the situation needs to be fixed. I’m only trying to fight a little ignorance, and do a little nit-picking at the sides, not trying to defend the specific situation that Specialist Town is facing.