My friend's dad, who served in Vietnam,and was a POW and gets sick due to Agent Orange exposure, had SURGERY this week - Monday, June 16, 2008. They had to CUT HIM OPEN quite a bit to work on him.

On Wednesday they didn't give him ANY PAIN MEDICATION - ALL DAY!!! He was in dire pain all day and night. AND the REASON he didn't receive any pain medication...... pause....... get ready... it is because THEY RAN OUT at the VA hospital where he had the SCHEDULED surgery and was recovering in!!!!!!! HELLO!! What the h*ll is going on. Haven't these war veterans been through enough?? I mean there are three other hospitals within 15 miles and one is maybe 2 miles away. And if they couldn't have helped... we have a ton of pharmacies. And even if these places would need a day or two go get the pain meds - they SHOULDN"T have RUN OUT. WHY was it a problem to prepare for a low supply of urgently needed medication, with all these resources available"? Who the heck was keeping track of the medication suppies anyway?

We need responsible, intelligent,farsighted men and women in Congress and the White House who can see further than the noses on their faces. People who will NOT make such undermining cuts to both physical and mental health care facilites, and other social programs that help the people who need them stay ahead of their pain be it physcial, mental or both.

"Government", when expanded is "go over earnings of men before T{they cross-die"! "Politics" is Poli{synonym for many and bond}. Put together is a "bond of many" and Tic{tick is a blood sucking parasite to irritate it's host}. "Leader" when rightly divided "le" is french for "the" and an "adder" is a serpent! When put together, THEY are "a bond of many blood-sucking snakes! How do you KNOW when a politician is speaking lies? When their mouths move! "Politics", is "the art of deception"!!!

I could say that you should consider yourself lucky that you have not had to deal with the likes of a Norma Perez above you but better than that would be to prepare yourself along with your fellow department professionals for when that day comes.

I caught some of the webcast of her appearence before the Senate panel and related stories and am still muttering to myself over her excuse that she "is not a good communicator". This from an individual that apparently has a Phd, calls herself a psychologist and is a department supervisor of other psychologists (some of which are propely licensed and have hands on working experience in that field and with veterans - attributes that career bureaucrat Norma seems to lack) where being "a good communicator" is probably the most important attribute one could have for that postion.

As a licensed engineer and a veteran I've had to deal with my share of Norma Perez's. Self centered ego driven status seekers that will manage the b'jesus out of anything despite having little or no knowledge of what it is that they're managing, only a mad desire to make a bigger name for themselves. It's a big reason as to why bridges, tunnels, and cranes collapse. It's a tired act coming from these people like her.

Although there is not much chance of it happening there's still the hope that the next President and Congress will do their jobs of managing the federal government and start firing all the Norma's (and those that hire them) they can find instead of focusing on how much more they can loot it.

Who ever this person is should be married to someone who suffers from PTSD. Your life with them is a very hard and stressful one on a daily basis , 24 hours a day. As a wife, I must endure sparatic outburst of anger, hellish nightmares with screaming out in the middle of the night,and frequent moments of depression. I'm speaking of a vietnam vet who still suffers from this trauma, so I'm going to pray for this person that they never ever have to experience such trauma in their life, as a vet or a vets spouse, brother, sister, mother or child.

I would like to invite that person to spend a year or more in the worst parts of Iraq, and then see what his/her suggestion would be like when coming back. Reading that really made my blood boil!!!

I'm glad they black out his/her name on the email for safety reasons. Unbelievable!

I am a civilian who has suffered from a form of PTSD. May God help the person or persons who deliberately mis-disgnoses a soldier returning from this terrible war in order to save our government some money!

WHo is she to tell the doctors how they should be treating and diagnosing?? I didn't see any initials behind her name. All I seem to see is money signs, isn't it sad that a veteran who would give his life for his country, can't even get his country to give him a means to a life when he returns from service... sad sad sad day for our country

The comments made by this woman are unjust! But, she is not the only one. A woman psychologist from the Pittsburgh VA area made the same comments and implemented them. I feel this way. If you haven't heard the song of the bullet and haven't been in the arena of COMBAT and war the same time as I then keep your opinions to yourself. Everyone knows that opinions are like assholes and everyone has one including specialist trained to deal with situations like PTSD but all of the crap ALWAYS comes out the wrong hole yet still rolls down hill to the vet. I love gravity...don't you? If there's a problem....fix it! VA is rampant with problems and it is not the past or present veterans who are causing it. I am a Viet-Nam veteran who battled with VA from 1979 to 2004 for treatment and disability. Not only from PTSD but pain from war wounds, Type II diabetes, anger management, etc. Twenty-five years later, one divorce, two stays in jail, job after job, arguments and violent physical contact with other people, and it was the Military Order of the Purple Heart who did more to get me disability and treatment than any other. People who go to war, especially combat personnel, who see things happen of unimaginable horror, do things out of the norm to keep themselves and their buddies alive, manage to survive whole, disabled in body and/or mind, do not return to this country normal or "fit" right in to this sorry ass society. We're labeled from the start. One person on this site already labeled people like us as "trained killers". God! Some Americans haven't changed in 40+ years. Try living with hyper-vigilance, pain, things that NONE who did them can forget, the nightmares,the memories of a certain day and place that no one heard about or really cares about but you and the others who were there, the deep anger and hatred for everyone and no one, the volatile temper (John McCain), the isolation, survivors guilt, and so many other things that "normal" people never experience and then have your government put you through hell to "prove" you have become what you are due to war. To the veterans of today who are experiencing this my heart and prayers go out to you and DON'T GIVE UP. I won't blame the VA entirely for these comments for our government continues to slash funding for VA so new roads can be built, bridges repaired, and more items that are "more important" than the "PROPER" treatment and care for the veterans who did what this country and it's government asked them to do. Trained psychologist, like most people are filled with opinions. We all know that opinions are like ass-holes and everyone has them to include trained personnel like psychologists. Unfortunately, all the crap comes out of the wrong hole and decision makers listen to them and yet all of the crap continues to roll downhill to the veteran.(You have to love that gravity!) One divorce, 2 jail terms, job after job, isolating yourself from others to include your family, maximum depression, the volatile anger, the taking of pill after pill, sessions in therapy, anger management and trying your utmost to change does not always meet with success. The system needs fixed...for sure! Who is going to do it? Who will stop those taking funding away from VA to support a corrupt government that's for big business and special interest groups and not "FOR THE PEOPLE"? Elections? I doubt it. Especially after how this last sitting president got into the White House. No, the veterans will continue to fight for what is rightfully theirs to survive or it's back to the gun like the Medal of Honor recipient who was shot to death while robbing a store. Maybe, just maybe, if a little more money at that time would have been available to properly diagnose and treat him, and others like him, they might still be with us today. Am I angry? You can bet your sweet-ass I am and will continue to be until this country's veterans get the treatment, the disability, the respect, and have to quit trying to adjust to a society that can't even adjust to itself. Thank you, ALL VETERANS, for what you did, are doing, and going through yourselves. Thank you all.

I asked for an increase in my disability based on my doctors advice. When I went to the C&P exam my doctor told me my injuries were from old age and not having been blown up by a bomb. He then documented that I was a 76 y/o patient, I was 35 y/o. He refused to change my record and no one in the hospital would. I went as far as Sen. Lindsey Graham, before I realized that it would remain in my record that I suffer from old age. The terrorists I fought didn't do me as much psychological harm as the VA has.

JG

As a vietnam, desert storm veteran, I had to go to my own doctor and use my own insurance to get my diagonis of PTSD. The VA would not even evaluate me, for the condition, I have appealed their denial of my claim, and have been waiting over a year for the denial to be heard.

I'm not very suprised by the actions of Norma Perez. I aggree with the writer who stated that she is just part of a corrupt system that has allowed her to be a scapegoat and a distraction from the systematic abuse perpetrated upon veterans who are not fortunate enough to personally have someone of influence to support them.

I am an Iraq war vet that didn't get a diagnosis of PTSD, but of depression with a rating of 10% disability. If it weren't for other disability ratings I wouldn't end up with enough money to buy a daily cup of coffee at one of the corporate coffee chains. By the way, we drank coffee in the army that was made by adding hot water to a concentrated liquid coffee syrup - disgusting taste but with the same amount of caffeine I assume.

I have to deal with lack of energy and the conflicting actions of the different medications my VA doctor has perscribed for me. I can't get chiropractic treatment for my back problem - only medications that don't work or put me to sleep. I'm told that these alternative treatments are only recommended/approved/authorized in a very few cases. Maybe one has to be a commissioned officer? I don't know because they won't tell me.

Also, I can relate to the woman whose father is a WWII veteran because my girlfriend's dad is too. He doesn't talk about the war much, but about his time as a NYC police officer. I suspect that this, as today, is one of the few jobs available (along with security gauard) that vets are qualified to do coming out of an army that trains soldiers primarily for combat and security missions and little else.

-bw

As I myself am a physician (not a mental health specialist) at a large west coast VA medical center I would like to make a few comments.
1. All physicians I work with are dedicated and feel great empathy for OIF/OEF veterans who have put themselves in harms way based on their sense of duty.
2. When many combat veterans return to the U.S. they experience symtoms of sleeplessness, disturbed dreams, hyperalertness and other symtoms. Transitioning from a so called "battlemind" situation to civilian life can be difficult. Some will make the transition fairly quickly (perhaps with the help of counseling or particpating in group sessions) and others will have more difficulty and require ongoing care. The former have adjustment disorder and the latter have PTSD. Unfortunately we do see many cases of full blown PTSD and we have highly trained PTSD experts who provide ongoing care for them.
3. All returning OIF/OEF veterans complete a set of screening questions related to PTSD symptoms and those who have such symptoms are referred to our PTSD clinic for definitive diagnosis and treatment by experts.
4. Contrary to what some may think, not all returning combat veterans want to be labeled with PTSD the first time they seek medical care and mention they are having trouble sleeping and getting combat out of their mind. Many plan on applying for law enforcement jobs and are concerned the label will harm their future careers.
5. Physicians in the medical branch of the VA have nothing to do with the benefits branch. As a physician in the medical branch personally I don't care how much the VA has to pay for claims. That is the cost of war and veterans with PTSD or any other physical or mental condition have the right to proper medical care and compensation. NO one has EVER told me to do anything to reduce costs of benefits and no one has ever asked me to change a diagnosis I have made to save money. Furthermore, since compensation decisions are made by the benefits branch it would make no sense for anyone to try.
6. The comments to this story indicate that many have problems with the VA. I am sure this is true but most returning combat veterans I know value the help the VA offers them. All our OIF/OEF veterans are seen by a case manager who goes over all benefits and services they are entitled to and are seen by a physician for a thorough exam designed to pick up post-deployment issues.
7. Finally, I have no defense for Dr Perez memo as it implied that her advice was based on compensation issues. But frankly I do think that there are times when the INITIAL diagnosis of adjusment disorder is justified until the scope and duration of the patients condition is clear. Certainly there are clear cut cases where PTSD can be diagnosed at the first visit but for those with mild symptoms of short duration one has to see how the returning veteran does. Such patients should be offered help and it will soon be apparent what the diagnosis is.

Taken out of context, by itself, this email is not unreasonable. It is standard with mental health diagnoses to consider the possibility of malingering. In some dx's that are more commonly faked than real, that concern is directly stated in DSM guidelines. (eg. Multiple Personality Disorder)

In the context of the general treatment that the VA gives to veterans at their hospitals, it is yet another outrageous money saving tactic.

I am the former caregiver of a veteran with a disputed diagnosis of PTSD, and have heard the stories at the VA hospital of a large minority of other patients who had trouble getting treatment.

This is an issue of great concern, and I abhor the tactics that the VA sometimes uses, but I understand the need to keep an eye on the bottom line, as well. The more difficult it is for profiteers to cheat the system, the less they will do so. The more difficult it is for the legitimately sick to get help, the less they will do so, too.

To make matters worse, the legitimately ill, especially the mentally ill, are less able to advocate for them selves.

I see no easy solutions here. I am not so much upset at the email originator as I am with the failures of the system as a whole. More money would help, but would also provide a stronger enticement to fraud. Smarter money would be better, but I have little to suggest here. Fraud tailors itself to work the system, and the systems only effective resistance is skepticism. We accept in the court room that it is better to let 100 criminals go free than to lock up one innocent. (But that actually saves us money superficially, in reduced prison costs.) It would be nice to also say that it is better to let 100 people get away with fraud than to deny one injured person needed care. But that costs money right out of the gate, and principals are harder to maintain when you have to find the money to pay for them.

C. Caerbhallain

This internal VA e-mail absolutely turns my stomach. To think that this may be going on is beyond belief. Haven't we suffered enough?

i should get money,,,i suffered plenlty long

That James Peake's response to this deeply thought out act of intentional misconduct by a VA manager is to do nothing more than "reassign" Norma Perez (and probably have a good laugh about it) stands as nothing but a testament as to his own lack of character and unfitness to be VA Secretary or to attach MD to his name.

As a VETERAN I see both side. To many want to claim to have PTSD to collect monies. It only takes a few to bog down the profesionals to the point they become cynical.The number given is by a partisan person who is against the war. So how bias do you think is there. Yes there are real cases as there was in WW1, WW2, Korea, Vietnam. The numbers being thrown out there serve ONLY the anti-war munions. So they are VERY self serving.

Bureaucrat Norma Perez's (who does not appear to be a properly licensed psychologist in any state)email encouraging intentional misdiagnosis of a medical condition will now ultimately force the VA to have to reopen and re-evaluate every case done at that facility/department while she has been a manager there.

That's going to cost a lot of money. Who should pay? Let's start by garnishing Norma's generous salary and those of other VA employee in her chain of command up to and including political appaointee VA Secretary James Peake who himself tries to blow this atrocity off by trying to pass off Norma Perez as just another faceless worker and not the irresponsible significant department manager that she was acting as.

This entire incident is typical of an administration loves having a great gluttonous feast for itself and then refuses to pay the tab.

This is so unbelievably shameful and yet it really isn't new. I am the daughter of a WWII vet. I want you to know that my father was severly wounded PHYSICALLY...lost an arm, all of his hearing, and a deep wound in his side. For these he was treated...they were "respectable wounds". He was able to deal even with the loss of the arm BUT for the mental wounds he never received an ounce of treatment. Mental wounds were NOT respectable, you see.
Therefore they affected to such a great degree, not only his own life but the lives of his wife and children. Today at 85 years old, he STILL suffers the effects. His children continue to deal with what his illness did to them.
Now we have identified the illness PTSD, but we don't want to pay the price. So we deny it's existance. Still isn't respectable is it? We will hurt these soldiers and their families until the day they die....WHAT A DISGRACE!
I tell my 3 sons, ages 16, 19 and 21..I NEVER want them to even consider a military career. "Serve Your Country'???
No Please.....Our country doesn't care enough to treat our vets right.
sign me......
A Vet's daughter not wishing to be a vet's mother.

I think it is horrible. I mean we send these people to these hellish conditions and expose them to extreme horrors. And they expect them when they come back to be normal within a couple of months? It is an unjust war. It is a little different if you are fighting for a just cause but there was no valid sane reason to invade that country. Now we have lost over 4000 young men and women and countless innocent Iraqis and for what?? And then we don’t even have the decency to provide adequate medical treatment upon their return home? Is the war costing us this much money that we have to cut back on the medical care that our soldiers need? Remind me please, we are spending billions on this war for what? Hmmm, it doesn’t seem the planners of this great liberation campaign actually did any planning whatsoever except how they are going to line their own pockets! I won’t even begin on the Vietnam vets, they got screwed all the way around then and it continues today. How many of the Vietnam vets are homeless? Hasn’t statistics proven that these vets need the most help? The horrors they experienced, the chemical warfare, then they mistreatment here by the people and the government…. My uncle, who is Vietnam vet will not even utter one word about that war. I wonder what all he was exposed to. That is my 2 cents for the day. J

The article states that Norma Perez is a Psychologist. That means that she is Not a Medical Doctor / M.D.

She is not (legally) allowed to 'Diagnose' and she cannot Prescribe Medication.

She is SCUM and should be prosecuted- and have her credentials taken away.

She is certainly no 'doctor'.

I'm glad someone else noticed that she spelled incidents incorrectly- thought I was the only one.

We need to support our Veterans.
Vote for Obama- He called for an investigation.

As a Vietnam veteran I am not at all surprized by this development.
Billions for those who supply and profit from the war.
Pennies for those who fight and suffer from it.
James Carpenter. USMC 68 - 71.

I understand that this news is outrageous. I am outraged. On the other hand, veterans have been subjected to this for many, many years--probably since Reagan came into office. I was never able to trust the VA, which I began dealing with in 1989. My experience with them, up until the moment they finally gave me a diagnosis and disability compensation, was a nightmare. They, and all other federal agencies, will fight tooth and nail to keep employees (soldiers or public servants) from getting any benefits at all. Misdiagnoses to make the soldier go away, prolonged legal battles that only the smartest, best educated, and most alert soldier can win--the VA has never been the soldier's friend. This is why so many vets with PTSD end up homeless. They can't win, and once they're homeless, they don't have a prayer.

The VA has not tried to hurt me for many years, now, but I still don't trust them. I still cringe whenever I get VA mail. For many, many years it has been the same: Republican power-brokers--and the Administration--lean heavily on the VA, and the pressure is felt all the way down through the ranks. The exact same process is used in ALL federal agencies. None of them are actually there to do the job they were meant to do: they're there to save money and dish up misleading statistics and opinions for the Republicans to use.

John McCain, ironically enough, is an active player in this game. If he is elected, you can count on these travesties to continue--and on veterans' benefits to continue to erode.

This should not shock anyone, (which is shocking in and of it's self), after all this adminastration led us into this war with an intentional mis-diagnosis. Where are the WMD's????
Nothing this clan of self-rightous, self-serving, war profitears does shocks me, I feel the only thing that will supprise me, is if they recieve justice that they have earned.

First of all, any mental diagnosis, PTSD, Anxiety disorder, Major Depressive disorder, to name a few, are all rated under the same criteria. Read CFR 38

What this means is that there isn't a increase or reduction in a veterans compensation.

Service connected compensation is based on the severity of the disability.

The ratings exam process is a joke ... but it' the only joke we have.

I challenge you to help me improve and rememdy the existing system.

Lets start by ridding the system of aspiring actors.

There needs to be a full investigation of the Temple VA hospital and the Waco Regional Office to locate the veterans who have sought treatment for PTSD and/or filed claims for same. It must be assumed that there are veterans who have already been misdiagnosed due to this doctor, or the colleagues thereof, and that there have been claims denied based on such misdiagnosis. These claims need to be reopened, dating back to the time that this particular doctor began work at the VA. These veterans need to be reexamined, by doctors in no way connected with this particular doctor or the Temple VA hospital, and if diagnosed with PTSD their claims should be granted and made retroactive back to the date of original filing. This is the only way to see that these veterans receive justice.

They should, also, be allowed to sue the doctor making this statement personally.

This doctor should be fired immediately and if found to have been intentionally misdiagnosing patients charged federally with falsifying medical and federal documents.

Rocky, VA Rep.
Chapter XVII, 173rd Airborne Brigade (Sep)
Charlie Company 75th Inf. Airborne Rangers
100% SC Vietnam Veteran

I work for the VA and am also a Gulf War veteran. What this woman did infuriates and offends me.

Someone in an earlier post mentioned trying to find the e-mail address for this woman: For the most part, it is very easy to figure out an employee's e-mail address. Generally it is the person's first name, then a "dot," followed by their last name, then the @ sign, and then "va.gov" (i.e. Johnboy.Doe@va.gov) Only if there are two or more people in the VA system with the same name does it become less straightforward.

Most of the employees in the VA system are actually very dedicated and hard working. Please don't presume the actions of one person are characteristic of us all. We are trying to do the best with what we have available. Yes, the VA budget has increased, but because of the rules Congress has put in place, the individual facilities are often not able to use the increased budget where they need it the most. For example, there may be two million dollars available for building a new building--but what the facility really needs are more orthopedic surgeons. What happens is that the facility is not able to hire the needed staff and the two million dollars isn't enough to build a new building--and even if they DID build a new building, they don't have the money to staff it. If Congress was smart, they would allow the individual VA's to transfer money between accounts and thus use it where it is needed the most.

Congress and Central Office VA have also imposed rules that "tie our hands." A facility needs more parking? If you make a gravel lot, it doesn't "count" as a parking lot. If you pave the lot, that throws the project into a ridiculous category involving many layers of bureaucracy going all the way to Washington, DC. The gravel lot can be done at the local level.

I could go on forever with examples. Please just recognize that the majority of VA employees are veterans themselves and that we are doing our best to help the veterans we serve.

I went to the VA because I was having problems thinking, reading, driving... My house was a mess; I have no idea how long I was wearing the same clothes. A lady told me I was talking like a 5 year old and to go the hospital. They sent me to counseling. That counselor thought I had depression. Which, I did. I went to the VA because it was supposed to be free. They wanted to put me on anti-depressants and tried to diagnose me as having PTSD. I ended up going to a civilian doctor, a neuropsychiatrist. Turns out I had post concussion syndrome and got help. As you can see I can write and think. I've completed a BA degree and know how to care for myself. No thanks to the VA. Thank God for the civilian neuropsychiatrist or I'd been in a long term nursing facility.

These people at the VA need to stop playing amateur hour and guess work. Too many soldiers are coming back with Traumatic Brain Injury, Post Concussion Syndrome along with Depression and/or PTSD and not being properly diagnosed or treated.

If treated, these honorable veterans can keep their pride and dignity while going on to be successful, contributing citizens.

If not treated, these honorable veterans might become drug/alcohol abusers, family abusers, even criminals in jail without ever knowing what life could have been like.

May God help us all.

From Rusty Rustan, founder of www.vfvs.com The cancer of the VA and their power is having the FERES Doctrine of 1950 wiping out combat veterans the right to sue for compensation caused by combat. Mandatory full funding of the VA does not exzist due to the fact that our government has full control over our health care by taking away our native born rights to sue for grevances caused by the abuses of goverment employees in military hospitals and the VA hospitals.The FERES Doctrine wipes us out. PTSD if ignored will create mass suicides especally the first 10 years after combat we lost over 150,000 veterans after Vietnam WAR to mass suicides and still counting becasue of lack of care only because our government cannot be sued for injures caused by combat. Abolish the FERES Doctrine and see how fast our government adopts full funding of the VA healthcare system. Go to www.offe2008.org for full funding support of the VA.

I have a heart condition called Sick Sinus Syndrome, a result of years of PTSD. Even now, no doctor will confirm a diagnosis of PTSD. There are the actuarial costs. I would have recieved larger disability payments, and they would have went back much farther.
There are a great many people who are effectively disabled after a serious injury or terrible incident.
I've spent years selling everything I own to survive. My heart beats at 60 fired by electrical impulses from my pacemaker. I am pretty much unable to do much except sit in the house. I get cold easy, have COPD and have asthma attacks when I try exertion. I can accomplish some things, but I cant seem to compete with anyone anymore. I am not a soldier.
I was a crime victim, but it doesn't matter.
These guys coming home need a stress free atmosphere while they get on their feet. After the danger they have faced doing this country's dirty work, these guys should all recieve disability pay as long as they dont have a job. These guys are young. They have to be set on a good road.
Why is it we can bail out banks and give a million dollar tax break to millionaires but we cant take proper care of these guys?

I have a heart condition called Sick Sinus Syndrome, a result of years of PTSD. Even now, no doctor will confirm a diagnosis of PTSD. There are the actuarial costs. I would have recieved larger disability payments, and they would have went back much farther.
There are a great many people who are effectively disabled after a serious injury or terrible incident.
I've spent years selling everything I own to survive. My heart beats at 60 fired by electrical impulses from my pacemaker. I am pretty much unable to do much except sit in the house. I get cold easy, have COPD and have asthma attacks when I try exertion. I can accomplish some things, but I cant seem to compete with anyone anymore. I am not a soldier.
I was a crime victim, but it doesn't matter.
These guys coming home need a stress free atmosphere while they get on their feet. After the danger they have faced doing this country's dirty work, these guys should all recieve disability pay as long as they dont have a job. These guys are young. They have to be set on a good road.
Why is it we can bail out banks and give a million dollar tax break to millionaires but we cant take proper care of these guys?

While this email provides more proof that the VA is doing this it is not new. The VA has been doing the same thing for decades. The VA makes an extraordinary effort to use "adjustment disorder" diagnoses instead of PTSD for the exact reason stated in the email. The VA thinks that Veterans who seek to get disability benefits that the law allows are "compensation seeking". When are we going to start seeing VA employees arrested and prosecuted for these kinds of criminal behaviors?