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Health task force to survey soldiers' records

Jun. 4, 2012 - 02:11PM   |   Last Updated: Jun. 4, 2012 - 02:11PM  |  
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Note: A version of this article ran in the June 4, 2012, edition of the newspaper. The article below clarifies that the Army will survey soldiers' records and not the soldiers themselves.

The Army will survey current and former soldiers' records to learn about their treatment as part of its sweeping, multipronged review of behavioral health cases from the last decade of war, according to a top Army official.

The case files of current and former soldiers who were screened for medically separation by a Medical Evaluation Board will be part of the survey. The idea is "to take care of those individuals who weren't treated well," said Army Undersecretary Joseph Westphal, one of the officials leading the review.

The servicewide review of mental health cases dating back to 2001 is meant to ensure that soldiers suffering from a behavioral health illness were not denied appropriate medical retirement benefits.

While the time frame of the study is set, Army officials are working on determining how many soldiers' records will be surveyed and what the selection criteria will be, Westphal said.

"Once the charter for the Behavioral Health Task Force is finalized and approved, we will take a hard look at this and we will clarify both issues," he told Army Times.

Lt. Col. Don Peters, a spokesman for the task force said it will review "every single record of every single [Medical Evaluation Board] done in the Army."

When a service member has a medical or mental health condition which renders them unfit for duty, they may be separated or retired from the military for medical reasons. The process to determine medical fitness for continued duty involves two boards, one of which is the Medical Evaluation Board.

Army Secretary John McHugh and Gen. Ray Odierno, the Army chief of staff, announced the move May 15, following findings this year that several post-traumatic stress disorder diagnoses at Joint Base Lewis-McChord, Wash., may have been reduced based on the expense of providing care and military benefits.

After several soldiers complained to the office of Sen. Patty Murray, D-Wash., head of the Senate Veterans' Affairs Committee, it emerged that the team had been briefed by its chief on the cost of treatment for a PTSD-stricken soldier over his or her lifetime: between $750,000 and $1.5 million.

"We realize — the president understands this, I'm convinced, and the secretary of defense and the secretary of the Army are convinced — we put men and women in harm's way; we asked them to make incredible sacrifices for our country, and when they come back, if they're wounded or ill, or whatever happens to them, we need to take care of them," Westphal said.

Westphal said he and Gen. Lloyd Austin III, the Army vice chief of staff, were tapped to supervise a task force that will conduct the review as a "comprehensive look" at the treatment of soldiers across the Army.

Lt. Gen. David Perkins, the commander of Fort Leavenworth, Kan., is leading the task force.

The Army review will also scrutinize how well soldiers can participate in the system that assesses their ability to receive medical retirements, including whether the appeal process is adequate and whether any nonmedical factors may affect the diagnosis.

The Army inspector general is also conducting a systemwide review to determine whether psychiatrists overturn PTSD diagnoses to save money. The evaluations are the key first step in determining soldiers' disability benefits.

Westphal said the task force will receive input from the inspector general and the ombudsman, ultimately recommending an action plan to "fix anything that might be broken" and "find better and more effective ways to address all these health issues for our soldiers."

The task force is expected to provide recommendations about the Integrated Disability Evaluation System, set up to provide soldiers with official government disability evaluations. The system is facing congressional scrutiny for average backlogs of a year. Murray said that at Lewis-McChord's Madigan Army Medical Center, more than 40 percent of the cases 2007 that involved candidates for retirement had been overturned.

During a recent Senate hearing, she said that of the 1,680 patients screened at Madigan, more than 690 had been diagnosed with PTSD. The psychiatric team there reversed more than 290 of those diagnoses.

Based on a review at Madigan, more than 100 service members have had their PTSD diagnoses restored, she said.

Westphal said that, even if the review uncovers thousands more cases in which soldiers were misdiagnosed, the situation must be rectified. Costs, he said, cannot be placed ahead of proper care for soldiers.

"We owe it to them," he said. "The one thing we don't want to do is put economics ahead of that activity. That's precisely what we want to avoid."

Westphal said there are costs to consider when soldiers' problems can worsen without treatment, beyond the cost of their care.

"These problems accrue," he said. "They accrue not only in their financial cost but in their cost to families, the cost to the Army in terms of readiness and effectiveness. They have an overwhelming impact on our societies as a whole."

Westphal likened the situation to the treatment of veterans with Gulf War syndrome, whose ailments were not recognized by the Department of Veterans Affairs until 2010, long after the 1991 Persian Gulf War.

"I think that's a lesson to be learned, and one that I feel is important," he said.

Army officials say soldiers sent to war may be evaluated up to five times, including before being deployed, during combat, once they return home and six months and a year later. Every soldier returning from deployment completes what the Army calls a post-deployment health assessment and a face-to-face interview with a mental health professional.

The Army screens soldiers for depression and PTSD, asking questions to find out about any social stressors, sleep disruption and other problems. Those who are detected as having problems go on to a second phase of screening.

Officials say, however, that no test is considered diagnostically definitive for mental illness in general, or PTSD in particular.

A Congressional Budget Office report found a "great deal of uncertainty" surrounding the prevalence of PTSD and TBI among recent veterans, and hence, the number of veterans who will need care from the Defense Department and Veterans Health Administration.

More than 134,900 Army personnel were diagnosed with traumatic brain injuries between 2000 and 2011. Of those, 75 percent, or more than 100,000, were diagnosed as having a mild or regular concussion.

Army policy calls for every service member involved in a blast, vehicle crash or a blow to the head to be medically evaluated.

The Associated Press contributed to this report.

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