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Houston Chronicle: VA doctor defends e-mail on diagnosing stress disorders;
Senators told cost-cutting was not her motivation
June 5, 2008
JENNIFER A. DLOUHY, Hearst News Service
WASHINGTON - A Department of Veterans Affairs psychologist told senators Wednesday that cost-cutting was not the reason she urged fellow clinicians at the Temple, Texas, VA hospital to "refrain from" diagnosing veterans with post-traumatic stress disorder.
The doctor, Norma Perez, said her March 20 e-mail was only intended to remind colleagues that they had the option of initially diagnosing patients with a less severe condition known as "adjustment disorder."
Perez said she was concerned that veterans would get "conflicting messages" and varying diagnoses from the VA. Veterans who were told they have PTSD at one appointment - but then later told they didn't meet the clinical guidelines for that diagnosis when VA officials reviewed their eligibility for compensation - have been "frustrated" and confused by the discrepancy, Perez said.
"In retrospect, I realize I did not adequately convey my message appropriately," Perez told skeptical senators at a Senate Veterans' Affairs Committee hearing.
The panel is probing whether her e-mail indicated a cutback in VA treatment of PTSD.
An inspector general at the VA is conducting an independent investigation of the e-mail and the adequacy of care for veterans with PTSD.
Although a veteran diagnosed with PTSD could be eligible for disability payments of up to roughly $2,500 a month, veterans with the less severe condition of adjustment disorder generally are not entitled to disability compensation.
Sen. Patty Murray, D-Wash., said Perez's message seemed to indicate that strained resources at the VA are blocking veterans from getting "both the proper diagnosis and the care they need."
The e-mail, with the subject line "Suggestion," was widely distributed by watchdog groups in May. In it, Perez said: "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."
Perez continued: "Additionally, we really don't ... have time to do the extensive testing that should be done to determine PTSD."
In testimony Wednesday, Perez said that comment was meant to refer to the initial medical appointments done at the Temple walk-in center.
VA Secretary James Peake has repudiated the e-mail.
Sen. Daniel Akaka, D-Hawaii, chairman of the Veterans' Affairs Commmittee, said the e-mail "appears to have linked the increase in veterans seeking compensation for PTSD with a desire to assign a lesser diagnosis of adjustment disorder."
Perez said her VA hospital is not connected to compensation in any way.
Michael Kussman, the VA's undersecretary for health, said there was "no systemic effort to deny a diagnosis" to veterans.
He noted that the VA expects to spend $3.5 billion on mental health care in fiscal 2008 and conducts PTSD screening for all VA applicants, regardless of their stated medical complaints.
Year: [2008] , 2007 , 2006
June 2008
- Honolulu Advertiser: New GI Bill steps up veterans' educational benefits [June 30, 2008]
- Honolulu Star-Bulletin: File now for stimulus payments [June 21, 2008]
- Honolulu Star-Bulletin: Political debate rises along with gas prices [June 13, 2008]
- Honolulu Advertiser: Kamehameha's birth celebrated at Capitol [June 9, 2008]
- Honolulu Advertiser: GOP stalls climate-change bill [June 7, 2008]
- Houston Chronicle: VA doctor defends e-mail on diagnosing stress disorders;
Senators told cost-cutting was not her motivation
[June 5, 2008]
- Honolulu Advertiser: VA e-mail reflects indifference to mentally-ill troops, Akaka says [June 5, 2008]
- CQ: Senators Question Care for Veterans Suffering from PTSD [June 4, 2008]
- CQ: Senate Passes Veterans’ Mental Health Package [June 3, 2008]
- CBS News: VA Staffer To Testify Over PTSD E-Mail [June 3, 2008]
- Maui News: Loss of doctor bemoaned - Maui veterans fighting for health care [June 3, 2008]
- AP: Army Corps of Engineers wants to consult Native Hawaiians [June 3, 2008]
- KGMB9: Emergency Federal Funding for Airlines Workers Who Lost Jobs [June 2, 2008]
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