Army Changes PTSD Evaluations Forensic Methods; Had Led to Loss of Pensions
The Army Surgeon General’s Office has issued new guidelines for diagnosing PTSD that criticize an approach once routinely used at Madigan Army Medical Center.
The policy, obtained by The Seattle Times, specifically discounts tests used to determine whether soldiers are faking symptoms of post-traumatic stress disorder. It says that poor test results do not constitute malingering.
The written tests often were part of the Madigan screening process that overturned the PTSD diagnoses of more than 300 patients during the past five years.
Madigan medical-team members cited studies that said fabricated PTSD symptoms were a significant — and often undetected — phenomenon.
They offered the tests as an objective way to help identity “PTSD simulators” among the patients under consideration for a medical retirement that offers a pension and other benefits.
The team’s approach once was called a “best practice” by Madigan leaders, including Lt. Gen. Patricia Horoho, a former commander who now serves as the Army’s surgeon general.
But earlier this year, amid patient protests about overturned diagnoses, the team was shut down as the Army launched several investigations. Though none of the Army findings have been publicly released, the April 10 “policy guidance” from the surgeon general charts new directions for PTSD screening at Madigan and elsewhere in the Army medical system. PTSD is a condition that results from experiencing a traumatic event, such as a battlefield casualty.
Symptoms can include recurrent nightmares, flashbacks, irritability and feeling distant from other people. Some people recover from PTSD. For others, it may be a lifelong struggle.
The new policy downplays the frequency of soldiers faking symptoms to gain benefits, citing studies indicating it is rare.
It also rejects the view a patient’s response to the hundreds of written test questions can determine if a soldier is faking symptoms for financial gain, and it declares that a poor test result “does not equate to malingering, which requires proof of intent … . “
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