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Thursday, May 17, 2012 - Page updated at 07:30 p.m.

Army opens wide review of PTSD-diagnosis system

By Hal Bernton
Seattle Times staff reporter

Army Secretary John McHugh on Wednesday announced a major review of post-traumatic stress disorder (PTSD) and other behavioral-health diagnoses received by soldiers evaluated for medical retirement.

The review will look at diagnoses made at Army medical facilities as far back as Oct. 7, 2001, as the nation was launched into a period of prolonged warfare in Afghanistan and then Iraq.

The review team will identify problems with the diagnostic program and find ways to fix them, according to an Army statement.

The Army announcement follows an investigation this year at Madigan Army Medical Center, where soldiers under consideration for medical retirement complained that their original PTSD diagnoses were reversed by a screening team, with some of the soldiers labeled as possible malingerers.

The results of that investigation have not been released, but the Army Surgeon General identified more than 300 diagnoses that had been reversed and has offered new evaluations to those soldiers.

U.S. Sen. Patty Murray, D-Wash., who this year pressed the Army to investigate the Madigan screening process, said that re-evaluations at the military hospital near Tacoma have reinstated the PTSD diagnoses to more than 100 service members who had that diagnosis dropped when they were screened for medical retirement.

A PTSD diagnosis can qualify a soldier for a 50 percent disability rating and a medical retirement that includes a pension and other benefits.

In March congressional testimony, McHugh said that the issues at Madigan did not appear to be systemic.

But the scope of the review announced Wednesday indicates broader concerns about how the Army handles the diagnoses of PTSD for patients under consideration for medical retirement.

"We owe it to every soldier to ensure that he or she receives the care they need and deserve," McHugh told Congress in a statement.

The statement added that the evaluations should be "influenced only by the opinion and expertise of our medical professionals."

The review will be led by Undersecretary of the Army Joseph Westphal and Vice Chief of Staff Gen. Lloyd Austin.

The Army Inspector General will also separately examine how soldiers fare in the disability-evaluation system, whether the appeal process is adequate and how commanders might be influencing the diagnostic system.

If the review finds soldiers who have been "adversely impacted," the team is supposed to develop ways they can obtain "appropriate redress."

Murray called the larger review "truly historic."

But she said it will require "continued engagement from Army leadership at the highest levels, prompt attention to the problems of service members identified during the review and quick action to implement and enforce solutions."

PTSD is a condition that results from experiencing a traumatic event, such as battlefield violence. Symptoms can include recurrent nightmares, flashbacks, irritability and feeling distant from other people.

The controversy at Madigan was triggered by the complaints of some soldiers to an Army Medical Command ombudsman that they were unfairly denied medical retirements by a PTSD screening team headed by a forensic psychiatrist.

The team routinely gave the soldiers, who had previously been diagnosed with PTSD, written tests that were offered as an objective way to help determine whether they were exaggerating symptoms.

Madigan is the only Army facility that uses a forensic team for screening patients.

The forensic team no longer is in charge of the Madigan screening.

A document released in April by the Army Surgeon General's Office said that PTSD typically is being underdiagnosed, not overdiagnosed.

Hal Bernton: 206-464-2581 or hbernton@seattletimes.com

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