Tag Archives: Army

Military’s spotty recordkeeping hurts veterans

At the Center for Investigative Reporting, Aaron Glantz dug deep into the widespread recordkeeping errors and lapses that are bedeviling the VA’s disability claims system and making it difficult for veterans of Vietnam, the Gulf wars, and the war in Afghanistan to prove they were in combat, exposed to harmful substances, or even injured. A few days later, ProPublica and The Seattle Times published a similar investigation, which focuses most on more recent conflicts.

According to Glantz, “A Center for Investigative Reporting review of the VA’s performance data reveals chronic errors – committed in up to 1 in 3 cases – and an emphasis on speed over accuracy that clogs the VA system with appeals, increasing delays for all veterans.”

A few more numbers from Glantz’s work:

  • “The VA acknowledges it makes mistakes on 14 percent of disability claims.”
  • “A CIR analysis of 18 audits published this year by the VA’s inspector general shows the problem could be much worse, especially in high-profile cases. The analysis found a 38 percent average error rate for claims involving disabilities like traumatic brain injury and illnesses linked to the Vietnam-era defoliant Agent Orange.”
  • One internal VA document … shows that during the first three months of 2008 … the agency failed to perform its duty to assist in nearly 11,000 cases.

Likewise, the Seattle Times/ProPublica reporters write that military historians found that “at least 15 brigades serving in Iraq at various times from 2003 to 2008 had no records on hand. The same was true for at least five brigades deployed to Afghanistan.”

Records were so scarce for 62 more units that served in Iraq and 10 in Afghanistan that they were written up as “some records, but not enough to write an adequate Army history.” This group included most of the units deployed during the first four years of the Afghanistan war.

DoD spent nearly $363 million on weight-loss surgeries in past decade

Reporting for KIRO-Seattle, Chris Halsne used FOIA requests to find out how much the military’s TriCare plan is paying for weight-loss surgeries for soldiers and their dependents. Including post-surgery tummy tucks, Halsne calculates (PDF) that the government was on the hook for at least $362,971,831 for such procedures over the past decade.

The military defends the expenditures by pointing to the long-term savings of having healthier TriCare enrollees, though Halsne found those savings difficult to prove, as 86 percent of soldiers and their families leave the plan before they qualify for lifetime benefits.

Halsne found that even some active-duty personnel are getting bariatric procedures, which are officially off limits to them as they are required to stay fit through diet and exercise to remain in the military.

While analyzing Defense Department records on health-related costs, KIRO Team 7 Investigators also discovered the military continues to pay for some weight loss surgery for active duty personnel. Records show $2,400,000 worth since 2001. The military banned bariatric procedures for active duty soldiers and sailors in 2007, yet it appears they approved around 57 of them after that.

Tricare, the military’s health insurance program funded by federal taxpayers, declined KIRO’s repeated questions for an interview.

Stories focus on suicides of doctors, soldiers

New York Times columnist Pauline Chen, M.D., serves up a reminder that suicide prevention isn’t just a matter of access to counseling and resources, in the form of a story about high physician suicide rates. If there’s any sector of the population that should be able to recognize that they are suffering from mental illness, and that the condition is treatable, it should be doctors, Chen writes. Yet still they kill themselves at a rate above the American average.

For several decades now, studies have consistently shown that physicians have higher rates of suicide than the general population — 40 percent higher for male doctors and a staggering 130 percent higher for female doctors. While research has traced the beginning of this tragic difference to the years spent in medical school, the contributing factors remain murky. Students enter medical school with mental health profiles similar to those of their peers but end up experiencing depression, burnout and other mental illnesses at higher rates. Despite better access to health care, they are more likely to cope by resorting to dysfunctional behaviors like excessive drinking and are less likely to receive the right care or even recognize that they need some kind of intervention.

Chen mentions two recent studies published in the Journal of the American Medical Association that shed more light on the issue, one showing that in medical school depression and burnout are separate entities, and the other showing that depressed students believe others view them as incompetent. In the end, she calls for further long-term research, but does not take the next logical step and investigate comparative research and statistics. Is it just American medical students who are depressed? Do countries with low-cost, low-pressure med schools produce doctors with better mental health? There’s a lot of room for investigation.

Suicides in another high-access group

Chen’s New York Times colleague, James McKinley, writes that as many as 20 soldiers connected with the Army base at Ft. Hood have killed themselves this year, despite the Army’s suicide prevention efforts.

The spate of suicides in Texas reflects a chilling reality: nearly 20 months after the Army began strengthening its suicide prevention program and working to remove the stigma attached to seeking psychological counseling, the suicide rate among active service members remains high and shows little sign of improvement. Through August, at least 125 active members of the Army had ended their own lives, exceeding the morbid pace of last year, when there were a record 162 suicides.

As of July, the Army requires all returning soldiers to be evaluated by a mental health specialist, though veteran advocates still point to a shortage of psychiatrists and an emphasis on treatment through medication rather than through therapy. The system is taxed by record numbers of soldiers seeking help for psychological problems, and mental health was the leading reason for hospitalization in the Army last year, McKinley writes.

Each suicide is unique, McKinley writes, and it’s hard to find patterns.

PTSD or personality disorder? It matters to soldiers

The AP’s Anne Flaherty has put together a story that illuminates the Army’s refusal to admit that it could have misdiagnosed (and discharged) hundreds of soldiers who may have had PTSD or traumatic brain injury instead of a personality disorder. Keep in mind that a discharge for “personality disorder” means no veterans’ benefits and a lifetime of stigma. A diagnosis of PTSD or injury, on the other hand, means treatment will be covered by the government.

dentistPhoto by isafmedia via Flickr

The Army, for its part, has decided there’s nothing unusual about the following chain of events (taken from Flaherty’s story):

  1. The Army “discharged about a 1,000 soldiers a year between 2005 and 2007 for having a personality disorder.”
  2. In 2007, The Nation‘s Joshua Kors writes a cover story exposing the Army’s apparent habit of diagnosing soldiers with a personality disorder instead of considering the possibility of PTSD or traumatic brain injury.
  3. Soon after, “the Defense Department changed its policy and began requiring a top-level review of each case to ensure post-traumatic stress or a brain injury wasn’t the underlying cause.”
  4. Sure enough, “the annual number of personality disorder cases dropped by 75 percent.”
  5. At the same time, the number of post-traumatic stress disorder cases has soared. By 2008, more than 14,000 soldiers had been diagnosed with PTSD — twice as many as two years before.
  6. Army officials “reviewed the paperwork of all deployed soldiers dismissed with a personality disorder between 2001 and 2006” and said they “did not find evidence that soldiers with PTSD had been inappropriately discharged with personality disorder.”

DoD campaigns against stigma of depression, PTSD

The Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury’s new Real Warriors campaign is designed to aid soldiers with what they seem to see as the three r’s of military mental health: resilience, recovery and re-integration.

The RealWarriors.net site not only directs soldiers to additional resources, but also shares anecdotes from their peers and provides them with guidelines for good mental health, both in combat and out of it.

The effort, launched in May, even has a Twitter account.

(Hat tip to Arline Kaplan of the Psychiatric Times)


Bay Area panel on veterans’ health highlights untold stories