Secretive Va Launches New Ptsd Review

[rainvet]

SECRETIVE VA LAUNCHES NEW PTSD REVIEW November 28, 2005

Just six days after canceling one PTSD review, the VA “sneaks in” another – Culture of secrecy makes agency designed to help veterans their biggest foe
by Larry Scott

www.opednews.com

Over the past year, the Department of Veterans’ Affairs (VA), led by Secretary Jim Nicholson, has turned a deaf ear to veterans and quietly made numerous decisions designed to strip veterans of benefits and compensation.

Secretary Nicholson came to the VA with no understanding of veterans’ advocacy and no experience in the healthcare sector. He had been Chairman of the Republican National Committee and Ambassador to the Vatican. As one pundit put it, “Jim Nicholson can write a good political bumper sticker and knows how to kiss the Pope’s ring. That’s about it.”

But, with Secretary Nicholson at the VA helm, veterans have come to feel isolated from the agency’s decision-making processes. And, recent developments have done nothing quell that uneasy feeling.

Earlier this year, veterans were surprised by the VA’s “second signature required” (SSR) policy. SSR applied to approved claims for many “high-dollar” disabilities and stipulated that the claim be re-approved by another VA staffer. However, if the claim was denied by the first staffer, there was no second review.

Veterans’ groups claimed that a SSR policy should apply to all claims for any condition whether they were approved or denied. The fact that the VA chose to apply SSR to disabilities with “high-dollar” compensation was proof to many veterans that the agency was just trying to save money by denying benefits.

The SSR policy was NOT announced by the VA. Only some very good investigative work by Cheryl Reed of the Chicago Sun-Times brought the story to light. This is just one of many instances where the VA has instituted policies detrimental to veterans without making the actions public.

The latest “unannounced” move by the VA is a new review of PTSD diagnosis, treatment and compensation. The VA’s plans came to light on November 16, just six days after they had canceled a review of 72,000 PTSD claims awarded at 100 per cent disability. Pressure from veterans’ groups and Democrat members of Congress forced the cancellation.

The VA’s new PTSD review was not announced by the VA. There was no VA press release. There was no VA press conference. The information was not posted on the VA web site.

Information about the new PTSD review was made public in a press release by Senator Larry Craig (R-ID), Chairman of the Senate Committee on Veterans’ Affairs. The release, in part, said, “The Department of Veterans Affairs announced today that it has contracted with the Institute of Medicine (IOM) on a two-pronged approach to the examination of PTSD.”

Except, the VA hadn’t announced anything. They were using Senator Craig as their conduit to hand out the bad news. Since Craig’s press releases don’t have a high readership, this information has gone virtually unnoticed.

Upon reading Senator Craig’s press release I called the Public Affairs Office at the VA. They had no knowledge of the review. I then called the Institute of Medicine. They had no knowledge of the review.

Senator Craig’s office was more helpful. They forwarded the two documents the VA had sent to them. One document is a Fact Sheet detailing the contract between the VA and the IOM. The other is a Question and Answer sheet. (NOTE: The VA documents are available at the following URL – www.vawatchdog.org/newsfl...2005-3.htm )

I encourage all veterans to read the VA documents. They detail a plan to redefine PTSD by altering diagnostic and treatment techniques that will then lead to a complete restructuring of VA compensation. Following are a few excerpts from the VA Fact Sheet.

The IOM “…will review the utility and objectiveness of the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM- IV), and will comment on the validity of current screening instruments and their predictive capacity for accurate diagnoses.”

This will allow the VA to write an alternate definition of PTSD exclusive of the DSM-IV and institute new methods of treatment outside of normally accepted guidelines. I wonder what the American Psychiatric Association will say about this?

Also, the IOM “…will review the literature on compensation practices for PTSD…and how changes in the frequency and intensity of symptoms affect compensation practices for PTSD; assessing how compensation practices and reevaluation requirements for PTSD compare with other chronic conditions which have periods of remission and return of symptoms; and reviewing strategies used to support recovery and return to function in patients with PTSD.”

And, this will allow the VA to lower PTSD compensation based on “frequency and intensity of symptoms” and “remission and return of symptoms.” The VA will also be looking to deny PTSD benefits based on the concept of “recovery and return to function.” VA Secretary Nicholson has often used the word “recover” (terribly close to the word “cure”) when speaking of veterans with PTSD. The IOM reviews will be completed in a year.

Also, there were two big surprises found in the Question and Answer document. “QUESTION: Why is this study being conducted now? ANSWER: Over the next two years, the [VA] Secretary and the Veterans’ Disability Benefits Commission (VDBC) is (sic) closely examining compensation for all health conditions, including PTSD.”

Surprise number one is that the VA has not announced that Secretary Nicholson is examining compensation “for ALL health conditions.” Veterans can only look forward to fewer benefits and lower compensation with Nicholson directing this endeavor.

The second surprise is Secretary Nicholson’s mention of the VDBC. The VDBC, by law, is “independent of the Department of Veterans’ Affairs.” However, to discover that they are coordinating their efforts should not be a surprise. The VDBC is made up of 13 members who are currently studying all areas of VA compensation. Nine VDBC members were appointed by Republicans. Secretary Nicholson was appointed by President Bush.

Then there is the matter of timing. The VDBC’s charter stipulates that their reports must be done by October of 2006. But, the VDBC has also contracted with the IOM for studies that will not be complete for at least a year. They will be asking for an extension. This means that the VDBC reports from IOM and the VA reports from IOM will be released at the same time, well AFTER the 2006 elections. I don’t believe in coincidence.

Sometime in early 2007, after the elections, VA Secretary Jim Nicholson will be armed with reports from the VDBC and the VA’s IOM studies. Expect a two-fisted attack on veterans’ benefits and compensation from an administration that is the first to shout “Support Our Troops”…until they become veterans.

www.opednews.com/articles...aunche.htm
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DOCUMENTS DETAIL VA'S NEW PTSD REVIEW --
THIS LOOKS LIKE ANOTHER ATTEMPT TO CUT PTSD BENEFITS AND COMPENSATION!

Sorry about sending this your way on the eve of Thanksgiving...but I just got these very interesting documents today.

On the 16th of November, Senator Larry Craig (R-ID), Chairman of the Senate Committee on Veterans' Affairs, issued a press release announcing a new PTSD review by the VA. Press release here... http://www.vawatchdog.org/senatecvan...ws11-16-05.htm

This came as a complete surprise.

What was interesting is that the VA PR people knew nothing about this. Neither did the Institute of Medicine (IOM) who is doing the study. Story here...

http://www.vawatchdog.org/newsflash/...-18-2005-2.htm

Finally, Jeff Schrade, Communications Director for the Senate Committee on Veterans' Affairs, forwarded the documents that the VA had given Senator Craig. Thanks, Jeff! See below to download or view documents...

The VA's fact sheet was prepared by the VA's Office of the Under Secretary for Health and details the study. The Q&A sheet was prepared for members of Congress and the press.

Please read these carefully and I would appreciate your thoughts on where this review is going. Initially, I feel it is just another way to "clamp down" on PTSD compensation. The VA is looking to save money and they can do this by rewriting the PTSD diagnosis, treatment and compensation regulations.

Quotes of note from the Fact Sheet: ...the committee will review and comment on the objective measures used in the diagnosis of PTSD and known risk factors for the development of PTSD. The committee will review the utility and objectiveness of the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), and will comment on the validity of current screening instruments and their predictive capacity for accurate diagnoses.

...the committee will review the literature on best treatment practices, types and timing of specific interventions, and comment on the prognosis of individuals diagnosed with PTSD (and existing comorbidities). The committee will review the literature on compensation practices for PTSD including examining the criteria for establishing severity of PTSD as published in the VA Schedule for Rating Disabilities (VASRD); evaluating the basis for assigning a specific level of compensation to specific severity levels and how changes in the frequency and intensity of symptoms affect compensation practices for PTSD; assessing how compensation practices and reevaluation requirements for PTSD compare with other chronic conditions which have periods of remission and return of symptoms; and reviewing strategies used to support recovery and return to function in patients with PTSD.

This is all very upsetting to me. They truly are trying to rewrite the book on PTSD.

Quote of note from the Q&A sheet: Question: Why is this study being conducted now? Answer: Over the next two years, the Secretary and the Veterans Disability Benefits Commission is closely examining compensation for all health conditions, including PTSD.

What the ____ is this? The Secretary AND the Veterans' Disability Benefits Commission (VDBC)?

First, who knew that the Secretary, Jim Nicholson, was studying "compensation for all health conditions." No one. This is just another way of saying that the VA is looking to cut benefits. The part about "all health conditions" is particularly troublesome.

Second, since when did the VDBC and the VA start working together? The VDBC is, by charter, an INDEPENDENT commission. The documents page of the VDBC's web site states, "...the Commission is independent of the Department of Veterans Affairs and the Department of Defense." (VDBC web site here...

http://www.va.gov/vetscommission/index.htm )

It is now obvious that the VA and the VDBC are working hand-in-hand...and that really spells bad news. More on the VDBC and their political agenda here... http://www.vawatchdog.org/milcom/vdbcstackeddeck.htm

I'm sure that more will shake-out in this in the next few days...so, stay tuned.

And, again, please give me your input on this. Where do YOU think this is leading?

http://www.vawatchdog.org/newsflash/...-23-2005-3.htm
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"PTSD is caused by the lack of release of the high excitement or anxiety biochemical and electrical energy

November 28, 2005

Understanding trauma and its aftermath

Updating what we know about trauma can help speed recovery. A catch word for a wide range of experiences, trauma is defined as any short or long term overwhelming experience that ignites the fight/flight survival response without resolution.

Trauma devastates our health, emotional well-being, careers, relationships and communities. Prenatal and birth experiences, childhood abuse, neglect, sexual violations, surgery, dental work, accidents, natural disasters, violence, war, torture, poverty all come under the category of trauma. Just living under the constant threat of danger can evoke trauma.

Local somatic and trauma therapist Ellen Bynes explains: "Most of us can think of a situation where we reacted to something and realized that our thoughts or feelings had little to do with what was really going on. This is an example where we unconsciously may be reacting to our perception of threat created by an earlier event, with little or no reference to whether we are safe in the present moment"

Our inborn responses to life-threatening experiences can and often do save our lives. But when trauma recovery isn't forthcoming the challenges can become devastating. Reactions are far-reaching and range from hostility to deep-seated fear. The disconnections caused by trauma leads to many types of illnesses including depression.

"When the brain perceives threat, a chain of physical changes occurs in our body almost instantaneously" explains Bynes. "The nervous system and hormones trigger a readiness which may result in an increased heart rate, shallow breathing, tingling and muscular tension. Often this is accompanied by worry and racing thoughts. Unchecked, this arousal may progress to helplessness, immobility and collapse"

The term for unresolved trauma is called Post Traumatic Distress Disorder or PTSD. Commonly regarded as a psychological and medical disorder PTSD is thought to best be helped by talk therapies and drugs. But new research in physiology how the body functions indicates that trauma is a complex response involving parts of our brain, the autonomic nervous system and our biochemical responses. In other words trauma is a biological response to a lack of safety.

"PTSD is caused by the lack of release of the high excitement or anxiety biochemical and electrical energy that was generated at the time of the traumatic event clarifies trauma recovery expert David Berceli. "Since the body continues to seek a discharge of this over stimulation, the brain unconsciously reproduces situations similar to the original trauma called repetitive compulsive behavior in an attempt to replay the scenario so that the energy can be discharged but now the victim can become the survivor. The most common example of this is when abused children enter into abusive relationships as adults."

www.santacruzsentinel.com...1style.htm
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Mother Nature Leaves a Storm of Mental Health Concerns

Hurricanes this season have left more than physical damage. Mother Nature has also given rise to mental health concerns. Experts in this field at Mount Sinai Medical Center in New York are available for interviews.

Newswise — Hurricane season may be almost over at the end of November but the mental health storm of repercussions is not. The United States has been bombarded with hurricanes this year including the latest-Hurricane Katrina. It’s been twelve long weeks for the people affected by this last mighty hurricane.

Besides destruction, hurricanes have brought a lot of fear to the people that live in storm prone areas. The shock of a powerful storm targeting and rampaging through your once safe home and neighborhood is unimaginable to most. And when it does hit, it can wipe away everything a family has built over a lifetime, leaving them homeless and sometimes emotionally unstable.

Disasters like Hurricane Katrina can be traumatic. Many people suffer significantly from these events and are left feeling helpless. Traumatic events not only affect survivors and rescue workers but also their friends and relatives. According to the Center for Disease Control fear, grief, anxiety and depression may set in. Physical and behavioral responses can include nausea, dizziness, changes in appetite, disturbed sleep patterns and social withdrawal. Responses to trauma can last for weeks to months before victims start to feel normal again. Most people report feeling better within twelve weeks after a traumatic event. But sometimes the problem can become worse or last longer than one month. If this occurs then the person may be suffering from post-traumatic stress disorder (PTSD).

Mount Sinai Medical Center has a team of experts that can talk in depth about the mental health challenges that natural disasters like Hurricane Katrina and other traumatic events are causing victims and their families. Dr. Rachel Yehuda, Ph.D. is a professor of psychiatry and the Director of the Traumatic Stress Studies Division at the Mount Sinai School of Medicine and Bronx Veterans Affairs Medical Center. She is also an active researcher in the field of post-traumatic stress just like Dr. Claude Chemtob, Ph.D. He specializes in trauma in adults and children. Dr. Chemtob is a clinical professor of psychiatry and pediatrics at the Mount Sinai School of Medicine. He is also involved in the Children After Trauma Care and Health Program (CATCH) at Mount Sinai.

www.newswise.com/articles/view/516355/