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Advice to Stop PTSD Diagnoses Triggers Probe

More and more military veterans returning from Iraq and Afghanistan are seeking help and compensation for post-traumatic stress disorder. That has created concern by veterans and others that the government could try to minimize the problem of PTSD to save money. An incident at a veterans' hospital near Fort Hood, the Army post in Texas that is one of the nation's largest military bases, has stoked that concern.

In an e-mail, a psychologist at the Olin E. Teague Veterans' Center in Temple, Texas, advised her staff to stop diagnosing veterans with PTSD to save money. The e-mail became public last week.

The head of the Department of Veterans Affairs insists that's not VA policy.

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Psychologist Norma Perez was hired last summer to help coordinate a PTSD program at the center, which draws a lot of veterans. Not long afterward, Perez announced she would disband a dozen or so PTSD therapy groups, in which about 140 veterans met monthly with a clinical counselor. Perez wanted to replace the long-term groups with short-term plans — lasting no longer than three months — that focus on coping skills and cognitive processing therapy. The VA uses a broad range of therapies for PTSD, including group therapy.

Some veterans in the program said Perez told them that long-term group therapy doesn't work. Some vets accused Perez of personally trying to destroy their groups.

But Kim Larsen, a former Army medic and Vietnam vet with PTSD, who attended two VA forums about the plan to disband the groups, had a different impression. He thought Perez was simply the messenger. Then he saw an e-mail from Perez to her staff, advising them to "refrain from giving a diagnosis of PTSD straight out...." It was dated March 20.

Incensed, Larsen shared the e-mail and it wound up with Citizens for Responsibility and Ethics, a watchdog group, and VoteVets.org, a veterans advocacy group. Last week, the groups posted the e-mail on the Internet, setting off a tempest.

Congressional leaders and Democratic presidential candidate Sen. Barack Obama called for an investigation, and the inspector general of the VA has begun one.

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Rep. Bob Filner, a California Democrat who heads the House Veterans Affairs Committee, said of Perez: "I can't believe that someone at that level position is doing this on her own. Somewhere in the hierarchy people are saying, 'It's costing us too much with these PTSD diagnoses. Cool it.'"

The VA has refused interview requests about the incident. In a statement, Secretary James Peake characterized the e-mail as an isolated example: "A single staff member, out of VA's 230,000 employees, in a single medical facility, sent a single e-mail with suggestions that are inappropriate and have been repudiated at the highest level of our health care organization."

The VA's inspector general's office is headed to Temple to find out if anyone higher up is telling the VA to "cool it."

Meanwhile, the VA has reassigned Perez from the PTSD clinic, but it won't say where.

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