Army Reinstates Medical Center Head in PTSD Probe


WASHINGTON -- The Army has reinstated the head of a West Coast medical center and changed its screening system after an investigation into whether officials reversed soldiers' post-traumatic stress diagnoses to save money, senior leaders announced Tuesday.

The review found that Col. Dallas Homas, commander at Madigan Army Medical Center in Washington state, "did not inappropriately influence PTSD diagnoses" but that the system being used to diagnose soldiers was inappropriate for the military.

Problems with the system at Madigan, which is at Joint Base Lewis-McChord near Tacoma, came to light when officials reversed some of the soldiers' initial diagnoses of PTSD during additional evaluations. The reversals raised questions about whether the changes were being made to save money.

As a result, Army leaders in May launched a sweeping review of how the service evaluates soldiers for mental health problems at all its facilities. Defense Secretary Leon Panetta later ordered a similar review across all branches of the armed services. Those larger reviews continue.

Part of the focus of the investigation at Madigan was a forensic psychiatric team that had the lead role in screening soldiers being considered for medical retirement and benefits due to PTSD, a condition that results from experiencing or seeing a traumatic event, such as a battlefield casualty or the brutal rigors of war.

"My review found that Col. Homas did not exert any undue influence over PTSD diagnosis, and that he acted appropriately enforcing standard medical guidelines," the Army's vice chief of staff, Gen. Lloyd Austin, said in a statement Tuesday. Suspended as a matter of routine during the probe, Homas is getting his job back immediately.

"What we found is that the forensic methods are not the right ones for the United States Army disability evaluation system," Austin said, noting that new policies and procedures are in place to review PTSD cases. He said that while the forensic screening may be fair, it was "simply not optimal for the unique cases that the Army diagnoses and reviews. We've fixed that."

Earlier this year, Sen. Patty Murray, D-Wash., said that more than 40 percent of the PTSD cases since 2007 that involved candidates for retirement had been overturned. She said that of the 1,680 patients screened at Madigan, more than 690 had been diagnosed with post-traumatic stress disorder. The psychiatric team there reversed more than 290 of those diagnoses.

According to an official familiar with the review process, 229 servicemembers have been re-evaluated, and of those, 127 have had their PTSD diagnosis reinstated after a review at the facility at Madigan. The official spoke on condition of anonymity because the totals have not been made public.

On Tuesday, Murray released a statement saying that the changes at Madigan should provide more accurate diagnoses for the soldiers.

Forensic psychiatry evaluations, which were being used only at Madigan, are more rigid and require additional testing and scrutiny. The Army said Madigan used them to "make the most accurate diagnosis possible." But they also apply certain strict criteria, which does not work well in the military PTSD evaluation.

While the forensic method, which is standard practice for civilians, is legal and provides additional information, the Army determined that a different, clinical approach -- which is being used in the other facilities -- is better for the military.

"I also hope that it encourages more servicemembers to come forward and seek help, knowing they won't be treated unfairly or accused of lying about their symptoms," Murray said. She added that it is important for the Army to try to change the attitude about the mental wounds of war and increase the level of transparency around the disability system.

Homas is a West Point graduate whose career has included deployments to Afghanistan and Iraq, where he served as command surgeon. He was appointed in 2011 as commander at Madigan, which serves thousands of soldiers who have been to Iraq and Afghanistan.

Austin on Tuesday said he is confident that Homas "is the leader our medical community needs to implement these new systems and ensure world-class care for our soldiers and their families."

In 2011, an ombudsman investigated complaints from soldiers who said the forensic psychiatric team had reversed earlier diagnoses of PTSD and tagged some of them as possible malingerers.

The ombudsman also wrote a memo about a lecture in which a member of the forensic psychiatric team talked about the need to be good stewards of taxpayer dollars and not rubber stamp PTSD diagnoses that could result in a soldier earning $1.5 million in benefits over a lifetime.

Of the 2.6 million soldiers, sailors, airmen and Marines that have deployed to Iraq and Afghanistan, it's estimated that 13 percent to 20 percent have symptoms of PTSD.

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