Wednesday, October 13, 2010

Soldiers With Head Injuries, PTSD Discharged For Personality Disorders

Suddenly, their problems stem from psychological disorders existing prior to their military service

Any man who is good enough to shed his blood for his country is good enough to be given a square deal afterwards." - Theodore Roosevelt

When incumbent Representative Chet Edwards mentions keeping the Waco VA Medical Center open as a resource for treating soldiers with traumatic head injuries, this is a big part of what he's talking about.

When he debates Republican challenger Bill Flores on Oct. 24 and 25, be sure and ask both of them about this little problem of the soldiers who can't get medical treatment or benefits because their conditions after being injured in combat were suddenly diagnosed as pre-existing personality disorders.

Their stories are depressingly similar.

Let's try this one for starters.

Sergeant Chuck Luther was a “bullet magnet,” the grunts' slang nomenclature for a combat scout, serving at Camp Taji, 20 miles north of Baghdad.

He was in an observation tower standing guard when a mortar round flattened the structure. His head slammed the concrete. When he was able to make it to his feet, there was a clear fluid leaking from his nose, his right shoulder was hurting, and his right ear was killing him.

He finished his shift and took some Ibuprofen for the pain.

But the pain did not go away.

Neither did the Purple Heart the Army awarded him for valor and for sustaining a combat wound due to hostile enemy fire.

When Sgt. Luther reported to sick bay, he told them his vision was blanking out in one eye and it felt like someone was stabbing him in the other. His shoulder was inoperable for most military tasks and the headaches were getting worse. What's more, there was a constant ringing in his ear.

Quite simply, they said he was faking. A pediatrician said so. Capt. Aaron Dewees gave the professional opinion that the Sergeant was misrepresenting himself for “secondary” gain. He said Sgt. Luther was looking for that fabled million-dollar wound. That's the one Forrest, Forrest Gump was talking about when he said, “The Army must keep that money because I haven't seen any of it.”

Still, the sergeant persisted in trying to get medical treatment for his broken body.

No dice.

Severe nosebleeds, persistent “sharp and burning pain,” and all his other symptoms the doctor chalked up as complaints from “Sergeant Narcissistic;” he noted that Luther was trying to get out of his military duties by faking his injuries.

So, how did the Army respond?

They had him placed in an isolation “cell,” a 6 by 8-foot walk-in closet crammed with cardboard boxes, a cot and a bedpan. They never turned out the lights and there was constant noise.

After a month of sleep deprivation in the hole, Sgt. Luther cracked up. He made a move for the commanding officer's office and they restrained him.

The remedy was simple enough. All he had to do was sign a document stipulating that his problems were pre-existing, a personality disorder, and he would get an honorable discharge immediately.

Discharge under Chapter 5-13 of the regulations precludes any medical treatment or service-connected compensation for wounded veterans.

Here's how the administrative details work out.

According to an Army fact sheet on personality disorder, “We separate soldiers under Chapter 5-13 only if the doctoral-level provider concludes the disorder is so severe that the soldier's ability to function effectively in the military environment is significantly impaired. This condition must be a deeply ingrained maladaptive pattern of behavior of long duration that interferes with the soldier's ability to perform duty (combat exhaustion and other acute situational maladjustments do not meet this criterion). The diagnosis of personality disorder (see DSM-IV) must be established by a psychiatrist or doctoral-level clinical psychologist with necessary and appropriate professional credentials privileged to conduct DoD evaluations.”

Okay. Check the logic.

Luther enlisted right out of his hometown. He withstood a background check by law enforcement types – FBI, the local PD – and went on to be examined by military doctors at the Armed Forces Entrance and Examination Station. From there, he endured basic training, advanced infantry training, further psychological evaluation, indoctrination as an elite scout, seven months of combat duty, and a combat wound sustained in the heat of battle.

Suddenly, he had a pre-existing condition of narcissistic personality disorder. Therefore, he could derive no VA benefits, no medical care, and no compensation for combat-related, service-connected disabilities. On top of that, any enlistment or re-enlistment bonuses previously paid had to be repaid.

Said an Army psychiatrist, “Imagine: You get your leg blown off, you get a Purple Heart, and now they say it's from personality disorder. It's absurd.”

What's more, the diagnostic manual precludes all these diagnoses. It says that a pattern of erratic behavior cannot be labeled a “personality disorder” if it's from a head injury. Most of the soldiers so affected had no such symptoms – hearing loss, headaches and anger – until after the attacks that knocked them silly and left them bleeding from their ears.

How often does it happen?

According to figures released by Army admin types, close to 30,000 soldiers got pink-slipped after sustaining life-threatening head injuries, PTSD and other wounds both psychological and physical that will follow them for the rest of their lives.


It's simple enough to see for yourself. “They're saving a buck. And they're saving the VA money, too. It's all about money,” said an Army officer who processes these discharges.

In the lifetime of a discharged veteran with service-connected injuries, millions of dollars are spent on compensation, medical care and prescriptions.

Discharging 22,500 soldiers for pre-existing personality disorders, according to figures extrapolated by Harvard professor Linda Bilmes, saves an average annual benefit payment of $8,890 per year, $5,000 in medical care and over a life expectancy of 44 years following service, would result in $8 billion in disability pay and $4.5 billion in medical care.

All of this took place during a time when the Bush Administration was spending an estimated $700 billion per month on the two-front war in Iraq and Afghanistan while maintaining a defensive perimeter of ships, air bases, soldiers, sailors and Marines surrounding a huge area of the world stretching from the eastern Mediterranean and Arabian Peninsula to the mountainous hinterlands of the Pakistani border and the Iranian frontier with Iraq.

Is there a remedy?

Yes, but it's very rarely effective. There is a maze of appeals boards, examinations, hearings and federal courts to navigate. Even with the most expert advocacy available, most soldiers never make it.

Is anyone working on the problem?

U.S. Representative Bob Filner (D-CA), chairman of the House Veterans Affairs Committee has held numerous hearings on the subject. He is on record calling for an independent evaluation of the Army's diagnostic methods.

He told an Army officer off in hearings before his committee by saying the allegation that “there's a systematic and policy-driven misdiagnosis of PTSD as personality disorder to get rid of soldiers early, to prevent any expenditures in the future, which were calculated in the billions of's a pretty serious allegation...And if you think that we're going to believe an evaluation of 295 cases, whichever ones you happen to pick – that we're going to believe what yu say – I'll tell you now. I'm not going to believe it. So why bother? Let's have an independent evaluation.”

Mr. Filner represents the San Diego district that stretches from the Navy's bases in town to the Mexican border, including Imperial Beach.

His constituency is by and large made up of Navy and Marine Corps enlisted men, most of whom are lifers.

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