"Casualties of War,"
"Walking Wounded,"
"Victims of a government
that would back stab them
in a minute."

 

Army "suggests" discontinuing counseling [on disability issues.]

    The above memo from the Department of Veterans Affairs contradicts an assertion made by the Army surgeon general that his office did not tell VA officials to stop helping injured soldiers with their military disability paperwork at a New York Army post.

    The paperwork can help determine health care and disability benefits for wounded soldiers.

    Last week, NPR first described a meeting last March between an Army team from Washington and VA officials at Fort Drum Army base in upstate New York. NPR reported that Army representatives told the VA not to review the narrative summaries of soldiers' injuries, and that the VA complied with the Army's request.

    The day the NPR story aired, Army Surgeon General Eric B. Schoomaker denied parts of the report. Rep. John McHugh (R-NY), who represents the Fort Drum area, told North Country Public Radio, that "The Surgeon General of the Army told me very flatly that it was not the Army that told the VA to stop this help."

    Now, NPR has obtained a four-page VA memo that contradicts the surgeon general's statement to McHugh. It was written by one of the VA officials at Fort Drum on March 31, the day after the meeting. The memo says Col. Becky Baker of the Army Surgeon General's office told the VA to discontinue counseling soldiers on the appropriateness of Defense Department ratings because "there exists a conflict of interest."

    When contacted by NPR, Baker referred an interview request to the Army Surgeon General's spokeswoman. The spokeswoman rejected requests for interviews with Baker and Schoomaker.

    The memo says that before the Army team's visit, people from the Army Inspector General's office came to Fort Drum and told the VA it was providing a useful service to soldiers by reviewing their disability paperwork.

    According to the memo, joining Baker on the Army team at the Fort Drum meeting was Dr. Alan Janusziewicz. He retired as deputy assistant surgeon general for the Army in October.

    "I was part of the team, and I was probably instrumental in the surgeon general denying that the Army had instructed the VA" to stop reviewing soldiers' Army medical memos, Janusziewicz told NPR in a phone interview.

    Janusziewicz says he has no memory of Baker telling the VA to stop helping soldiers with their military paperwork. In fact, he says, he thought the VA at Fort Drum was doing the best job of any base he visited. But he also says his recollection of the meeting is spotty, since it took place almost a year ago.

    "I believe that memo is more likely to represent a miscommunication of intent between what Col. Baker was trying to get across and what folks on the receiving end of that communication likely heard," Janusziewicz said.

    The memo describing the meeting at Fort Drum says the primary purpose for the visit was to "ensure that there are no other 'Walter Reed' situations at other Army installations." That's a reference to the scandal at Walter Reed Army hospital in Washington, which detailed reports of neglect of soldiers recovering from injuries sustained in Iraq and Afghanistan.

    According to the memo, Rosie Taylor, who recently retired as Fort Drum's Disability Program manager, described soldiers at the base in conditions of squalor and neglect. In an interview on Wednesday, Taylor described "soldiers crawling on their bellies to go to the bathroom, or soldiers who'd had surgery who couldn't go to chow because they had no way to get there."

    The memo says one soldier was bedridden for three days without a change of clothes or meal. Taylor says nobody listened to her complaints until the Walter Reed scandal.

    "Every time I walked into a meeting before, it was like 'Oh my God, there goes $70,000.' And after Walter Reed hit the fan, it was like I was getting phone calls, 'Rosie we're doing over a building and we need your advice on access,'" Taylor says.

    Taylor says the accessibility problems have generally been solved.

    She doesn't remember whether the Army told the VA to stop helping soldiers with their disability paperwork. But she will say this about Fort Drum's VA workers: "They stand on their heads for soldiers. They put their jobs on the line for soldiers. They don't care if they're not supposed to do something; if a soldier needs something done, they do it anyway."

    Sen. Hillary Clinton (D-NY) has already asked the Army to investigate the situation at Fort Drum. She called the allegations in last week's report "deeply disturbing."

    Whether the situation at the Army base is a result of poor communication, poor memory or something else altogether, the result is the same: For the last year, hundreds of disabled soldiers at Fort Drum have received less help with their disability paperwork than the soldiers who came before them.

Source:   NPR


    Army officials in upstate New York instructed representatives from the Department of Veterans Affairs not to help disabled soldiers at Fort Drum Army base with their military disability paperwork last year. That paperwork can be crucial because it helps determine whether soldiers will get annual disability payments and health care after they're discharged.

    Now soldiers at Fort Drum say they feel betrayed by the institutions that are supposed to support them. The soldiers want to know why the Army would want to stop them from getting help with their disability paperwork and why the VA

'A Worn Pair of Boots'

    One disabled soldier, who spoke on the condition of anonymity because he fears retaliation from the military, says it feels like a slap in the face.

    "To be tossed aside like a worn-out pair of boots is pretty disheartening," the soldier says. "I always believed the Army would take care of me if I did the best I could, and I've done that."

    At a restaurant near Fort Drum, the soldier described his first briefing with the VA office on base. According to the soldier, the VA official told a classroom full of injured troops, "We cannot help you review the narrative summaries of your medical problems." The official said the VA used to help soldiers with the paperwork, but Army officials saw soldiers from Fort Drum getting higher disability ratings with the VA's help than soldiers from other bases. The Army told the VA to stop helping Fort Drum soldiers describe their army injuries, and the VA did as it was told.

    It's unclear why the Army wanted to stop the soldiers from getting help with the disability paperwork. Cynthia Vaughan, spokeswoman for the Army surgeon general, says the VA was not doing anything wrong by helping soldiers at Fort Drum.

    "There is no Army policy on outside help in reviewing and/or assisting soldiers in rewriting their narratives during the 10-day period which they have to review them," Vaughan says.

    She says the officers who asked the VA to stop helping Fort Drum's soldiers were part of what the Army calls a "Tiger Team"— an ad-hoc group assigned to investigate, in this case, medical disability benefits.

    According to Army spokesman George Wright, the Tiger Team thought the VA should not be helping soldiers with their medical documents. The Army delivered that message to VA officials in Buffalo, N.Y., who went along with the request, even though the VA's assistance complied with Army policy.

    The Army declined to provide any information about the Tiger Team members' identities or their motivations in asking the VA to stop reviewing the soldiers' paperwork. However, private attorney Mara Hurwitt points out that the Army has a financial incentive to keep soldiers' disability ratings low.

    "The more soldiers you have who get disability retirements, the more retirement pay is coming out of your budget," Hurwitt says.

Qualified to Help?

    Another question is why the VA would go along with the Army's request.

    Tom Pamperin, deputy director of the VA's compensation and pension service, believes VA officers are not qualified to help with soldiers' disability paperwork.

    "We do not train our employees in the intricacies of the Defense Department's disability evaluation system, so we would feel that it would be inappropriate for our employees to apply VA standards to a Defense Department process," Pamperin says.

    But Hurwitt argues the VA is more equipped than anyone to help soldiers with their paperwork.

    "VA counselors understand the disabilities, what the different kinds of conditions are, how they should be properly described in the paperwork," Hurwitt says.

    She points out that VA officials have to look at a soldier's medical history anyway to counsel him or her on VA benefits, which are separate from Army benefits.

    "Really what it comes down to is you're just helping the soldier get what he's entitled to under law," Hurwitt says.

System 'Unfair'

    This is just the latest in a string of controversies about disability payments for injured veterans.

    Former Health and Human Services Secretary Donna Shalala, who co-chaired President Bush's recent commission on veterans' care, says stories like this one show how the whole disability rating system is broken and needs to change.

    The system is "fundamentally unfair," according to Shalala, "and that's the point about the need for reform in the system. It has to be reformed for everyone."

Source:   NPR

Army Blames 'Miscommunication' in Fort Drum Flap

    According to the memo, one member of the Tiger Team told the VA not to counsel soldiers on their disability benefits because "there exists a conflict of interest." Schoomaker told reporters Thursday that he apologized for his earlier, incorrect assertion that the Army surgeon general's office had not counseled VA officials on the matter.

    "We have always encouraged competent counseling for our soldiers. We have no policy that denies them access to any counselor. So it just didn't make sense to me. And then when I spoke to members of the team that went up there, they had no recollection of that having been a part of their exchanges. In fact, their recollection and their re-creation of that visit up to Fort Drum was very, very positive."

-Army Surgeon General

You do not need permission for: Individual Use:   NPR content may be printed for your own personal, non-commercial use.     In the event of such use, all copyright and other notices and clear attribution to NPR must be maintained.     The content may not be modified, distributed, retransmitted, or used, in whole or in part, in derivative works.

How Specialist Town Lost His Benefits
Joshua Kors     March 29, 2007 (April 9, 2007 issue of Nation)

    Jon Town has spent the last few years fighting two battles, one against his body, the other against the US Army. Both began in October 2004 in Ramadi, Iraq. He was standing in the doorway of his battalion's headquarters when a 107-millimeter rocket struck two feet above his head. The impact punched a piano-sized hole in the concrete facade, sparked a huge fireball and tossed the 25-year-old Army specialist to the floor, where he lay blacked out among the rubble.

    "The next thing I remember is waking up on the ground." Men from his unit had gathered around his body and were screaming his name. "They started shaking me. But I was numb all over," he says. "And it's weird because... because for a few minutes you feel like you're not really there. I could see them, but I couldn't hear them. I couldn't hear anything. I started shaking because I thought I was dead."

    Eventually the rocket shrapnel was removed from Town's neck and his ears stopped leaking blood. But his hearing never really recovered, and in many ways, neither has his life. A soldier honored twelve times during his seven years in uniform, Town has spent the last three struggling with deafness, memory failure and depression. By September 2006 he and the Army agreed he was no longer combat-ready.

    But instead of sending Town to a medical board and discharging him because of his injuries, doctors at Fort Carson, Colorado, did something strange: They claimed Town's wounds were actually caused by a "personality disorder." Town was then booted from the Army and told that under a personality disorder discharge, he would never receive disability or medical benefits.

    Town is not alone. A six-month investigation has uncovered multiple cases in which soldiers wounded in Iraq are suspiciously diagnosed as having a personality disorder, then prevented from collecting benefits. The conditions of their discharge have infuriated many in the military community, including the injured soldiers and their families, veterans' rights groups, even military officials required to process these dismissals.

    They say the military is purposely misdiagnosing soldiers like Town and that it's doing so for one reason: to cheat them out of a lifetime of disability and medical benefits, thereby saving billions in expenses.

The Fine Print

    In the Army's separations manual it's called Regulation 635-200, Chapter 5-13: "Separation Because of Personality Disorder." It's an alluring choice for a cash-strapped military because enacting it is quick and cheap. The Department of Veterans Affairs doesn't have to provide medical care to soldiers dismissed with personality disorder. That's because under Chapter 5-13, personality disorder is a pre-existing condition. The VA is only required to treat wounds sustained during service.

    Soldiers discharged under 5-13 can't collect disability pay either. To receive those benefits, a soldier must be evaluated by a medical board, which must confirm that he is wounded and that his wounds stem from combat. The process takes several months, in contrast with a 5-13 discharge, which can be wrapped up in a few days.

    If a soldier dismissed under 5-13 hasn't served out his contract, he has to give back a slice of his re-enlistment bonus as well. That amount is often larger than the soldier's final paycheck. As a result, on the day of their discharge, many injured vets learn that they owe the Army several thousand dollars.

    One military official says doctors at his base are doing more than withholding this information from wounded soldiers; they're actually telling them the opposite: that if they go along with a 5-13, they'll get to keep their bonus and receive disability and medical benefits. The official, who demanded anonymity, handles discharge papers at a prominent Army facility. He says the soldiers he works with know they don't have a personality disorder. "But the doctors are telling them, this will get you out quicker, and the VA will take care of you. To stay out of Iraq, a soldier will take that in a heartbeat. What they don't realize is, those things are lies. The soldiers, they don't read the fine print," he says. "They don't know to ask for a med board. They're taking the word of the doctors. Then they sit down with me and find out what a 5-13 really means--they're shocked."

    Russell Terry, founder of the Iraq War Veterans Organization (IWVO), says he's watched this scenario play itself out many times. For more than a year, his veterans' rights group has been receiving calls from distraught soldiers discharged under Chapter 5-13. Most, he says, say their military doctors pushed the personality disorder diagnosis, strained to prove that their problems existed before their service in Iraq and refused to acknowledge evidence of posttraumatic stress disorder (PTSD), traumatic brain injury and physical traumas, which would allow them to collect disability and medical benefits.

    "These soldiers are coming home from Iraq with all kinds of problems," Terry says. "They go to the VA for treatment, and they're turned away. They're told, 'No, you have a pre-existing condition, something from childhood.'" That leap in logic boils Terry's blood. "Everybody receives a psychological screening when they join the military. What I want to know is, if all these soldiers really did have a severe pre-existing condition, how did they get into the military in the first place?"

    Terry says that trying to reverse a 5-13 discharge is a frustrating process. A soldier has to claw through a thicket of paperwork, appeals panels and backstage political dealing, and even with the guidance of an experienced advocate, few are successful. "The 5-13," he says, "it's like a scarlet letter you can't get taken off."

    In the last six years the Army has diagnosed and discharged more than 5,600 soldiers because of personality disorder, according to the Defense Department. And the numbers keep rising: 805 cases in 2001, 980 cases in 2003, 1,086 from January to November 2006. "It's getting worse and worse every day," says the official who handles discharge papers. "At my office the numbers started out normal. Now it's up to three or four soldiers each day. It's like, suddenly everybody has a personality disorder."

    The reason is simple, he says. "They're saving a buck. And they're saving the VA money too. It's all about money."

    Exactly how much money is difficult to calculate. Defense Department records show that across the entire armed forces, more than 22,500 soldiers have been dismissed due to personality disorder in the last six years. How much those soldiers would have collected in disability pay would have been determined by a medical board, which evaluates just how disabled a veteran is. A completely disabled soldier receives about $44,000 a year. In a recent study on the cost of veterans' benefits for the Iraq and Afghanistan wars, Harvard professor Linda Bilmes estimates an average disability payout of $8,890 per year and a future life expectancy of forty years for soldiers returning from service.

    Using those figures, by discharging soldiers under Chapter 5-13, the military could be saving upwards of $8 billion in disability pay. Add to that savings the cost of medical care over the soldiers' lifetimes. Bilmes estimates that each year the VA spends an average of $5,000 in medical care per veteran. Applying those numbers, by discharging 22,500 soldiers because of personality disorder, the military saves $4.5 billion in medical care over their lifetimes.

    Town says Fort Carson psychologist Mark Wexler assured him that he would receive disability benefits, VA medical care and that he'd get to keep his bonus--good news he discussed with Christian Fields and Brandon Murray, two soldiers in his unit at Fort Carson. "We talked about it many times," Murray says. "Jon said the doctor there promised him benefits, and he was happy about it. Who wouldn't be?" Town shared that excitement with his wife, Kristy, shortly after his appointment with Wexler. "He said that Wexler had explained to him that he'd get to keep his benefits," Kristy says, "that the doctor had looked into it, and it was all coming with the chapter he was getting."

    In fact, Town would not get disability pay or receive long-term VA medical care. And he would have to give back the bulk of his $15,000 bonus. Returning that money meant Town would leave Fort Carson less than empty-handed: He now owed the Army more than $3,000. "We had this on our heads the whole way, driving home to Ohio," says Town. Wexler made him promises, he says, about what would happen if he went along with the diagnosis. "The final day, we find out, none of it was true. It was a total shock. I felt like I'd been betrayed by the Army."

    Wexler denies discussing benefits with Town. In a statement, the psychologist writes, "I have never discussed benefits with my patients as that is not my area of expertise. The only thing I said to Spc. Town was that the Chapter 5-13 is an honorable discharge.... I assure you, after over 15 years in my position, both as active duty and now civilian, I don't presume to know all the details about benefits and therefore do not discuss them with my patients."

    Wexler's boss, Col. Steven Knorr, chief of the Department of Behavioral Health at Evans Army Hospital, declined to speak about Town's case. When asked if doctors at Fort Carson were assuring patients set for a 5-13 discharge that they'll receive disability benefits and keep their bonuses, Knorr said, "I don't believe they're doing that."

Not the Man He Used to Be

    Interviews with soldiers diagnosed with personality disorder suggest that the military is using the psychological condition as a catch-all diagnosis, encompassing symptoms as diverse as deafness, headaches and schizophrenic delusions. That flies in the face of the Army's own regulations.

    According to those regulations, to be classified a personality disorder, a soldier's symptoms had to exist before he joined the military. And they have to match the "personality disorder" described in the Diagnostic and Statistical Manual of Mental Disorders, the national standard for psychiatric diagnosis. Town's case provides a clear window into how these personality disorder diagnoses are being used because even a cursory examination of his case casts grave doubt as to whether he fits either criterion.

    Town's wife, for one, laughs in disbelief at the idea that her husband was suffering from hearing loss before he headed to Iraq. But since returning, she says, he can't watch TV unless the volume is full-blast, can't use the phone unless its volume is set to high. Medical papers from Fort Carson list Town as having no health problems before serving in Iraq; after, a Fort Carson audiologist documents "functional (non-organic) hearing loss." Town says his right ear, his "good" ear, has lost 50 percent of its hearing; his left is still essentially useless.

    He is more disturbed by how his memory has eroded. Since the rocket blast, he has struggled to retain new information. "Like, I'll be driving places, and then I totally forget where I'm going," he says. "Numbers, names, dates--unless I knew them before, I pretty much don't remember." When Town returned to his desk job at Fort Carson, he found himself straining to recall the Army's regulations. "People were like, 'What are you, dumb?' And I'm like, 'No, I'm probably smarter than you. I just can't remember stuff,'" he says, his melancholy suddenly replaced by anger. "They don't understand--I got hit by a rocket."

    Those bursts of rage mark the biggest change, says Kristy Town. She says the man she married four years ago was "a real goofball. He'd do funny voices and faces--a great Jim Carrey imitation. When the kids would get a boo-boo, he'd fall on the ground and pretend he got a boo-boo too." Now, she says, "his emotions are all over the place. He'll get so angry at things, and it's not toward anybody. It's toward himself. He blames himself for everything." He has a hard time sleeping and doesn't spend as much time as he used to with the kids. "They get rowdy when they play, and he just has to be alone. It's almost like his nerves can't handle it."

    Kristy begins to cry, pauses, before forcing herself to continue. She's been watching him when he's alone, she says. "He kind of... zones out, almost like he's in a daze."

    In May 2006 Town tried to electrocute himself, dropping his wife's hair dryer into the bathtub. The dryer short-circuited before it could electrify the water. Fort Carson officials put Town in an off-post hospital that specializes in suicidal depression. Town had been promoted to corporal after returning from Iraq; he was stripped of that rank and reduced back to specialist. "When he came back, I tried to be the same," Kristy says. "He just can't. He's definitely not the man he used to be."

    Town says his dreams have changed too. They keep taking him back to Ramadi, to the death of a good friend who'd been too near an explosion, taken too much shrapnel to the face. In his dreams Town returns there night after night to soak up the blood.

    He stops his description for a rare moment of levity. "Sleep didn't use to be like that," he says. "I used to sleep just fine."

    How the Army determined then that Town's behavioral problems existed before his military service is unclear. Wexler, the Fort Carson psychologist who made the diagnosis, didn't interview any of Town's family or friends. It's unclear whether he even questioned Town's fellow soldiers in 2-17 Field Artillery, men like Fields, Murray and Michael Forbus, who could have testified to his stability and award-winning performance before the October 2004 rocket attack. As Forbus puts it, before the attack Town was "one of the best in our unit"; after, "the son of a gun was deaf in one ear. He seemed lost and disoriented. It just took the life out of him."

    Town finds his diagnosis especially strange because the Diagnostic Manual appears to preclude cases like his. It says that a pattern of erratic behavior cannot be labeled a "personality disorder" if it's from a head injury. The specialist asserts that his hearing loss, headaches and anger all began with the rocket attack that knocked him unconscious.

    Wexler did not reply to repeated requests seeking comment on Town's diagnosis. But Col. Knorr of Fort Carson's Evans hospital says he's confident his doctors are properly diagnosing personality disorder. The colonel says there is a simple explanation as to why in so many cases the lifelong condition of personality disorder isn't apparent until after serving in Iraq. Traumatic experiences, Knorr says, can trigger a condition that has lain dormant for years. "They may have done fine in high school and before, but it comes out during the stress of service."

    "I've never heard of that occurring," says Keith Armstrong, a clinical professor with the Department of Psychiatry at the University of California, San Francisco. Armstrong has been counseling traumatized veterans for more than twenty years at the San Francisco VA; most recently he is the co-author of Courage After Fire: Coping Strategies for Troops Returning From Iraq and Afghanistan and Their Families. "Personality disorder is a diagnosis I'm very cautious about," he says. "My question would be, has PTSD been ruled out? It seems to me that if it walks like a duck, looks like a duck, let's see if it's a duck before other factors are implicated."

    Knorr admits that in most cases, before making a diagnosis, his doctors only interview the soldier. But he adds that interviewing family members, untrained to recognize signs of personality disorder, would be of limited value. "The soldier's perception and their parents' perception is that they were fine. But maybe they didn't or weren't able to see that wasn't the case."

    Armstrong takes a very different approach. He says family is a "crucial part" of the diagnosis and treatment of soldiers returning from war. The professor sees parents and wives as so important, he encourages his soldiers to invite their families into the counseling sessions. "They bring in particular information that can be helpful," he says. "By not taking advantage of their knowledge and support, I think we're doing soldiers a disservice."

    Knorr would not discuss the specifics of Town's case. He did note, however, that his department treats thousands of soldiers each year and says within that population, there are bound to be a small fraction of misdiagnosed cases and dissatisfied soldiers. He adds that the soldiers he's seen diagnosed and discharged with personality disorder are "usually quite pleased."

    The Army holds soldiers' medical records and contact information strictly confidential. But The Nation was able to locate a half-dozen soldiers from bases across the country who were diagnosed with personality disorder. All of them rejected that diagnosis. Most said military doctors tried to force the diagnosis upon them and turned a blind eye to symptoms of PTSD and physical injury.

    One such veteran, Richard Dykstra, went to the hospital at Fort Stewart, Georgia, complaining of flashbacks, anger and stomach pains. The doctor there diagnosed personality disorder. Dykstra thinks the symptoms actually stem from PTSD and a bilateral hernia he suffered in Iraq. "When I told her my symptoms, she said, 'Oh, it looks like you've been reading up on PTSD.' Then she basically said I was making it all up," he says.

    In her report on Dykstra, Col. Ana Parodi, head of Behavioral Health at Fort Stewart's Winn Army Hospital, writes that the soldier gives a clear description of PTSD symptoms but lays them out with such detail, it's "as if he had memorized the criteria." She concludes that Dykstra has personality disorder, not PTSD, though her report also notes that Dykstra has had "no previous psychiatric history" and that she confirmed the validity of his symptoms with the soldier's wife.

    Parodi is currently on leave and could not be reached for comment. Speaking for Fort Stewart, Public Affairs Officer Lieut. Col. Randy Martin says that the Army's diagnosis procedures "have been developed over time, and they are accepted as being fair." Martin said he could not address Dykstra's case specifically because his files have been moved to a storage facility in St. Louis.

    William Wooldridge had a similar fight with the Army. The specialist was hauling missiles and tank ammunition outside Baghdad when, he says, a man standing at the side of the road grabbed hold of a young girl and pushed her in front of his truck. "The little girl," Wooldridge says, his voice suddenly quiet, "she looked like one of my daughters."

    When he returned to Fort Polk, Louisiana, Wooldridge told his doctor that he was now hearing voices and seeing visions, hallucinations of a mangled girl who would ask him why he had killed her. His doctor told him he had personality disorder. "When I heard that, I flew off the handle because I said, 'Hey, that ain't me. Before I went over there, I was a happy-go-lucky kind of guy.'" Wooldridge says his psychologist, Capt. Patrick Brady of Baynes-Jones Army Community Hospital, saw him for thirty minutes before making his diagnosis. Soon after, Wooldridge was discharged from Fort Polk under Chapter 5-13.

    He began to fight that discharge immediately, without success. Then in March 2005, eighteen months after Wooldridge's dismissal, his psychiatrist at the Memphis VA filed papers rejecting Brady's diagnosis and asserting that Wooldridge suffered from PTSD so severe, it made him "totally disabled." Weeks later the Army Discharge Review Board voided Wooldridge's 5-13 dismissal, but the eighteen months he'd spent lingering without benefits had already taken its toll.

    "They put me out on the street to rot, and if I had left things like they were, there would have been no way I could have survived. I would have had to take myself out or had someone do it for me," he says. The way they use personality disorder to diagnose and discharge, he says, "it's like a mental rape. That's the only way I can describe it."

    Captain Brady has since left Fort Polk and is now on staff at Fort Wainwright, Alaska; recently he deployed to Iraq and was unavailable for comment. In a statement, Maj. Byron Strother, chief of the Department of Behavioral Health at Baynes-Jones hospital, writes that allegations that soldiers at Fort Polk are being misdiagnosed "are not true." Strother says diagnoses at his hospital are made "only after careful consideration of all relevant clinical observation, direct examination [and] appropriate testing."

    If there are dissatisfied soldiers, says Knorr, the Fort Carson official, "I'll bet not a single one of them has been diagnosed with conditions that are clear-cut and makes them medically unfit, like schizophrenia."

    Linda Mosier disputes that. When her son Chris left for Iraq in 2004, he was a "normal kid," she says, who'd call her long-­distance and joke about the strange food and expensive taxis overseas. When he returned home for Christmas 2005, "he wouldn't sit down for a meal with us. He just kept walking around. I took him to the department store for slacks, and he was inside rushing around saying, 'Let's go, let's go, let's go.' He wouldn't sleep, and the one time he did, he woke up screaming."

    Mosier told his mother of a breaking point in Iraq: a roadside bomb that blew up the truck in front of his. "He said his buddies were screaming. They were on fire," she says, her voice trailing off. "He was there at the end to pick up the hands and arms." After that Mosier started having delusions. Dr. Wexler of Fort Carson diagnosed personality disorder. Soon after, Mosier was discharged under Chapter 5-13.

    Mosier returned home, still plagued by visions. In October he put a note on the front door of their Des Moines, Iowa, home saying the Iraqis were after him and he had to protect the family, then shot himself.

    Mosier's mother is furious that doctors at Fort Carson treated her son for such a brief period of time and that Wexler, citing confidentiality, refused to tell her anything about that treatment or give her family any direction on how to help Chris upon his return home. She does not believe her son had a personality disorder. "They take a normal kid, he comes back messed up, then nobody was there for him when he came back," Linda says. "They discharged him so they didn't have to treat him."

    Wexler did not reply to a written request seeking comment on Mosier's case.

Thrown to the Wolves

    Today Jon Town is home, in small-town Findlay, Ohio, with no job, no prospects and plenty of time to reflect on how he got there. Diagnosing him with personality disorder may have saved the Army thousands of dollars, he says, but what did Wexler have to gain?

    Quite a lot, says Steve Robinson, director of veterans affairs at Veterans for America, a Washington, DC-based soldiers' rights group. Since the Iraq War began, he says, doctors have been facing an overflow of wounded soldiers and a shortage of rooms, supplies and time to treat them. By calling PTSD a personality disorder, they usher one soldier out quickly, freeing up space for the three or four who are waiting.

    Terry, the veterans' advocate from IWVO, notes that unlike doctors in the private sector, Army doctors who give questionable diagnoses face no danger of malpractice suits due to Feres v. U.S., a 1950 Supreme Court ruling that bars soldiers from suing for negligence. To maintain that protection, Terry says, most doctors will diagnose personality disorder when prodded to do so by military officials.

    That's precisely how the system works, says one military official familiar with the discharge process. The official, who requested anonymity, is a lawyer with Trial Defense Services (TDS), a unit of the Army that guides soldiers through their 5-13 discharge. "Commanders want to get these guys out the door and get it done fast. Even if the next soldier isn't as good, at least he's good to go. He's deployable. So they're telling the docs what diagnosis to give to get what discharge."

    The lawyer says he knows this is happening because commanders have told him that they're doing it. "Some have come to me and talked about doing this. They're saying, 'Give me a specific diagnosis. It'll support a certain chapter.'"

    Colonel Martin of Fort Stewart said the prospect of commanders pressuring doctors to diagnose personality disorder is "highly unlikely." "Doctors are making these determinations themselves," Martin says. In a statement, Col. William Statz, commander at Fort Polk's Baynes-Jones hospital, says, "Any allegations that clinical decisions are influenced by either political considerations or command pressures, at any level, are untrue."

    But a second TDS lawyer, who also demanded anonymity, says he's watched the same process play out at his base. "What I've noticed is right before a unit deploys, we see a spike in 5-13s, as if the commanders are trying to clean house, get rid of the soldiers they don't really need," he says. "The chain of command just wants to eliminate them and get a new body in there fast to plug up the holes." If anyone shows even moderate signs of psychological distress, he says, "they're kicking them to the curb instead of treating them."

    Both lawyers say that once a commander steps in and pushes for a 5-13, the diagnosis and discharge are carved in stone fairly fast. After that happens, one lawyer says he points soldiers toward the Army Board for Correction of Military Records, where a 5-13 label could be overturned, and failing that, advises them to seek redress from their representative in Congress. Town did that, contacting Republican Representative Michael Oxley of Ohio, with little success. Oxley, who has since retired, did not return calls seeking comment.

    Few cases are challenged successfully or overturned later, say the TDS lawyers. The system, says one, is essentially broken. "Right now, the Army is eating its own. What I want to see is these soldiers getting the right diagnosis, so they can get the right help, not be thrown to the wolves right away. That is what they're doing."

    Still, Town tries to remain undaunted. He got his story to Robinson of Veterans for America, who brought papers on his case to an October meeting with several top Washington officials, including Deputy Surgeon General Gale Pollock, Assistant Surgeon General Bernard DeKoning and Republican Senator Kit Bond of Missouri. There Robinson laid out the larger 5-13 problem and submitted a briefing specifically on Town.

    "We got a very positive response," Robinson says. "After we presented, they were almost appalled, like we are every day. They said, 'We didn't know this was happening.'" Robinson says the deputy surgeon general promised to look into Town's case and the others presented to her. Senator Bond, whose son has served in Iraq, floated the idea of a Congressional hearing if the 5-13 issue isn't resolved. The senator did not return calls seeking comment.

    In the meantime, Town is doing his best to keep his head in check. He says his nightmares have been waning in recent weeks, but most of his problems persist. He's thinking of going to a veterans support group in Toledo, forty-five miles north of Findlay. There will be guys there who have been through this, he says, vets who understand.

    Town hesitates, his voice suddenly much softer. "I have my good days and my bad days," he says. "It all depends on whether I wake up in Findlay or Iraq."


Specialist Town Takes His Case to Washington
Joshua Kors     September 27, 2007 (October 15, 2007 of Nation)

    On April 9, Spc. Jon Town was featured on the cover of The Nation, in an article that told how he was wounded in Iraq, won a Purple Heart and was then denied all disability and medical benefits. Town's doctor had concluded that his headaches and hearing loss were not caused by the 107-millimeter rocket that knocked him unconscious but by a psychological condition, "personality disorder," a pre-existing illness for which one cannot collect disability pay or receive medical care.

    Soon Town became a national figure, the human face of the 22,500 soldiers discharged with personality disorder in the past six years. His story was picked up by the Army Times, Washington Post Radio and ABC News's Bob Woodruff. It was dramatized in a May episode of NBC's Law & Order. And rock star Dave Matthews began discussing Town's plight at every stop in his spring concert series.

    Further investigation by The Nation has uncovered more than a dozen cases like Town's from bases across the country. All of the soldiers interviewed passed the rigorous health screening given recruits before being accepted into the Army. All were deemed physically and psychologically fit in a second screening as well, before being deployed to Iraq, and served honorably there in combat. None of the soldiers interviewed during this eleven-month investigation had a documented history of psychological problems.

    Yet after they returned from Iraq wounded and sought treatment, each was diagnosed with a pre-existing personality disorder, then denied benefits. As in Town's case, Army doctors determined that the soldiers' ailments were pre-existing without interviewing friends, family or fellow soldiers who knew them before they were wounded in combat.

    In this article you will hear from Army doctors who say wounded soldiers are routinely misdiagnosed. One says he was pressured by superiors to diagnose personality disorder in cases where soldiers were physically wounded or suffering from posttraumatic stress disorder (PTSD).

    Maj. Gen. Gale Pollock, acting surgeon general of the Army, was briefed on the problems with the Army's personality disorder discharges. Instead of correcting cases like Town's, she buried them. The surgeon general released a series of memos filled with fabrications. Pollock then informed wounded soldiers that their cases had been thoroughly reviewed by an independent panel of health experts when in fact no such review was conducted.

    "This is not the way the government ought to work. It's not the way they should be responding to veterans," says Representative Bob Filner, chair of the House Committee on Veterans' Affairs. He first heard Town's story in April and began working soon afterward to bring the soldier to Washington. There Town would get his chance to tell Congress everything: about his diagnosis, his discharge and the work of Surgeon General Pollock.

'Thoroughly Evaluated and Reviewed'

    Andrew Pogany, an investigator for the soldiers' rights group Veterans for America, has been looking into personality disorder discharges for two years. The discharge, officially known as Regulation 635-200, Chapter 5-13, is simply a loophole, he says, to dismiss wounded soldiers without providing them benefits. Pogany says Town's case is a textbook example of how Chapter 5-13 is being applied. Town had no history of psychological problems and had served seven years, winning a dozen medals, before being discharged with a personality disorder.

    The investigator was so disturbed by the Army's use of 5-13 discharges that he brought his research to Pollock. In late October 2006, he and Steve Robinson, Veterans for America's director of veterans affairs, met with Pollock and presented her with a stack of personality disorder cases, including Town's. The surgeon general promised a thorough review.

    On March 23, five months after her meeting with Pogany, Pollock released her findings. Her office had "thoughtfully and thoroughly" reviewed the personality disorder cases and determined that all of the soldiers, including Town, had been properly diagnosed. Pollock commended the doctors who diagnosed personality disorder for their excellent work.

    Four days later the military followed up with a press release, this one signed by Lieut. Col. Bob Tallman, the Army's chief of public affairs. Tallman's memo provided further detail on Pollock's review. A panel of behavioral health experts had reviewed the personality disorder cases, Tallman wrote, and they didn't stop at the stack of cases presented to the surgeon general. They "thoroughly evaluated and reviewed" all the Chapter 5-13s from the past four years at Fort Carson, where Specialist Town had been based, and determined that all of those cases had been properly diagnosed as well.

    There was a glaring problem with Pollock's review. In the five months she spent "thoughtfully and thoroughly" reviewing the cases, her office did not interview anyone, not even the soldiers whose cases they were reviewing.

    Asked how he could call the surgeon general's review "thorough" when no soldiers were interviewed, Tallman said he could not. "Let me be honest with you," he said. "I know nothing about this memo and little to nothing about the review." Tallman said the memo bearing his name was actually ghostwritten by Pollock's office. The lieutenant colonel added that as far as he knew, Pollock conducted no review at all.

    Pollock's office quickly admitted that it had ghostwritten the Tallman memo but assured veterans' groups that the surgeon general had indeed conducted a review. In an e-mail Pollock's chief spokeswoman, Cynthia Vaughan, explained that the surgeon general did not want to interview soldiers because she felt they had no medically valid information to share. "Calling a soldier who underwent a 5-13 Chapter in 2003 and asking him (in 2007) to recall his mental condition in 2003 does not hold medical validity," Vaughan wrote.

    Research support was provided by the Investigative Fund of The Nation Institute. More information on personality disorder is available at http://JoshuaKors.com.

    That statement angered many soldiers, including Jon Town. "You'd think I'd remember, even today, if I had headaches and hearing loss before the rocket attack," he says. The surgeon general tried to quell veterans' groups by emphasizing that, as stated in the March memos, the comprehensive review was conducted by a panel of health experts and that those experts "did not provide the initial evaluations." This wasn't a case of one doctor reviewing his own work, the surgeon general said.

    Both of those assurances crumbled on May 4, when Army Times reporter Kelly Kennedy revealed that in fact there was only one reviewer: Col. Steven Knorr. Knorr was a strange choice to be the sole reviewer. He was far from an objective observer. As chief of Fort Carson's Behavioral Health unit, Knorr had overseen all the original diagnoses and, in his capacity as a psychiatrist, also diagnosed several soldiers with personality disorder.

    Months earlier Knorr had spoken out in defense of the Army's practice of not interviewing soldiers' family or friends before labeling their condition "pre-existing." Unlike his staff, he said, family members are not trained to recognize signs of personality disorder, so speaking to them would be of limited value. "The soldier's perception and their parents' perception is that they were fine. But maybe they didn't or weren't able to see that wasn't the case."

    In the same interview, published in The Nation, Knorr said there was a simple reason why in so many cases the lifelong condition of personality disorder isn't apparent until after troops serve in Iraq. Traumatic experiences, he said, can trigger a condition that has lain dormant for years. "[Troops] may have done fine in high school and before, but it comes out during the stress of service," he said. Knorr's assertion was a sharp break from the accepted medical understanding of personality disorder and provoked a flood of angry letters from psychiatrists and veterans' leaders.

    Veterans were further agitated by a vivid profile of Knorr, by NPR's Daniel Zwerdling broadcast in late May. Zwerdling details a memo written by Knorr in which he advises his doctors that trying to save every soldier is a "mistake." "We can't fix every Soldier," the memo states. "We have to hold Soldiers accountable for their behavior. Everyone in life beyond babies, the insane, and the demented and mentally retarded have to be held accountable for what they do in life."

    Knorr's memo, which he posted on his office's bulletin board, warns his doctors not to take soldiers' descriptions of their ailments at face value. "We're not naïve, and shouldn't automatically believe everything Soldiers tell us," the colonel writes. Knorr also urges his doctors to discharge troubled soldiers quickly--as he puts it, "Get rid of dead wood."

    That memo made me sick," says Russell Terry, founder of the Iraq War Veterans Organization. "It's incomprehensible that [Pollock] would choose him to lead the review." Terry says that if she had wanted to do a real review, the surgeon general could have organized a panel of impartial medical experts. "By having Knorr review his own stuff, there's no outside opinion, no one to uncover the misdiagnoses--no one to object."

    The surgeon general declined to be interviewed. But in a recent statement, Pollock defended her office's review and showed continued support for Knorr, calling him an "appropriate" choice to spearhead the review.

    By May the Army had a nascent PR nightmare on its hands. The story of Pollock, Knorr and the "thoughtful and thorough" five-month review had been picked up by news talk programs on NPR, Washington Post Radio and ABC News. To stem the tide, officials at Fort Carson did something odd: They released a new memo stating that fifty-six soldiers discharged from Fort Carson with personality disorder actually had PTSD.

    It was a stunning admission. As soon as they released it, officials tried to downplay it. Col. John Cho, former commander of Fort Carson's hospital, quickly submitted a second statement, saying that the first memo was not an admission of guilt. Soldiers suffering from PTSD could be rightfully discharged with personality disorder if they had that condition too and their PTSD was not "severe," he said. But Army Regulation 40-501, Chapter 3-33, is clear. It states that if a soldier is suffering from PTSD, he must be discharged by a medical board, which can provide him the lifetime of disability and medical benefits denied soldiers discharged with personality disorder.

    Fort Carson officials provided an unintentionally comic coda to their admission when they insisted that all fifty-six cases were properly diagnosed, shortly after Cho admitted in writing that his office could find only fifty-two of them. Base officials said the remaining four cases had been lost or misplaced. They could not explain how they knew those cases were properly diagnosed when they couldn't be found. "It's incredible when you think about it," says Pogany. "They're doing everything they can to cover this up--and doing a lousy job of it."

    On May 16, Army officials clarified: The four-year review of personality disorder cases trumpeted in the Tallman memo never occurred.

'I Refused to Diagnose as They Wanted'

    By the time Dr. Michael Chen stepped down, he had been serving the Army for more than thirty years. The psychiatrist had treated soldiers at several bases and looked forward to continuing his work at a new installation after being transferred.

    Chen's enthusiasm was short-lived. Soon he began clashing with his superiors. "I refused to diagnose as they wanted," he says. "They wanted the diagnoses to be personality disorder, instead of PTSD." The psychiatrist says the soldiers he saw weren't suffering from pre-existing conditions; they had PTSD and traumatic brain injury (TBI). Chen says he relayed this information to his colonel, to no avail. "The establishment wants to hear what the establishment wants to hear."

    Chen is not the doctor's real name. Because he fears retribution from the Army, the psychiatrist agreed to speak only if his name and base were not revealed. He says he wasn't the only doctor pressured to misdiagnose: Other psychiatrists were pressed as well, resulting in numerous fraudulent diagnoses of personality disorder. "I've seen that story happen hundreds of times," he says.

    While serving at the Army hospital, Chen did diagnose personality disorder. But eventually the absurdity of the recommended diagnoses proved too much. The psychiatrist recalls one soldier who returned from Iraq with a massive hunk of his right calf missing. "They thought he had personality disorder," Chen says, the anger in his voice suddenly palpable. "Imagine: You get your leg blown off, you get a Purple Heart and now they say it's from personality disorder. It's absurd." Frustrated, the psychiatrist approached the commanding general of the hospital. Chen says he met with the official numerous times. But the pressure to misdiagnose continued.

    "It's just criminal," he says. The doctor says that at his base wounded soldiers were treated like broken appliances: When they no longer functioned, the command simply wanted to "throw them out" with a pre-existing condition. "And it's appalling to me that my colleagues would go along with it."

    The psychiatrist says he doesn't blame the commanding general for the pressure on him and other doctors to misdiagnose soldiers. Their meetings made it clear that the general was simply taking orders from "high up on the food chain." In some sense, says the doctor, that was to be expected, because with personality disorder, there's so much money at stake. The Nation reported in April that the military is saving $12.5 billion in disability and medical care by discharging soldiers under Chapter 5-13, a figure drawn from a recent Harvard study by Professor Linda Bilmes. Chen believes $12.5 billion is a gross underestimate--that from what he's seen at his medical center, if all the wounded soldiers returning from Iraq were properly diagnosed, the long-term cost of benefits would be exponentially larger.

    As it was, says Chen, the medical ethic at the Army hospital followed the guidelines of the Knorr memo, which urged doctors not to take soldiers' descriptions of their ailments at face value. The psychiatrist's own approach was radically different. "If a soldier said he had PTSD, I wrote up 'PTSD.' Finally I was told I couldn't see any more soldiers because I diagnosed PTSD too much." Chen left the hospital soon after. Today he treats patients at a nonmilitary facility.

    Dr. Brian Harrison still works for the military. Like Dr. Chen, his years as an Army psychiatrist have been contentious. Harrison says that at his medical center, "there has been a tradition of 'underdiagnosing.'" That means soldiers with PTSD don't always receive that diagnosis. And their health isn't always the top concern. Foremost on the command's mind, says Harrison, is getting soldiers back to Iraq. He says doctors at his base understand that when wounded soldiers seek treatment from them, their job is to get the soldiers back to the battlefield, even if they are traumatized. The psychiatrist quotes his hospital's chief of Behavioral Health as saying, "If they're not suicidal or homicidal, they're fit to go back." If they don't meet that standard, the doctors are to get rid of them fast. Wounded soldiers are "seen as damaged merchandise," Harrison says. "The command wants people like that out of their hair, out of their way."

    Harrison is also a pseudonym. The doctor says he is speaking out in violation of an e-mail from his superiors ordering psychiatrists at his facility not to talk to the media. If he gives his name, he says, he could be fired.

    The doctor says he has never been pressured to misdiagnose. The biggest challenge he has faced is making a correct diagnosis, given the brevity of his appointments. Until recently, he was allowed to meet with soldiers for an hour. But now, he says, the chief of his department has pressed him to cut his evaluation time to half an hour and make future appointments between fifteen and thirty minutes. "I can't do an evaluation in half an hour," says the psychiatrist. "To properly diagnose a soldier, you need at least an hour." Like Chen, Harrison doesn't blame his department's chief, noting that there's pressure on him from his superiors--"the money managers," Harrison calls them. "Those jackasses--they don't have any clinical experience, they've never worked with soldiers, and they don't care."

    The bitterness in his voice is broken suddenly with a warm laugh. "Maybe I'm just old-fashioned," says the elderly doctor. Harrison has been practicing psychiatry for almost forty years and still insists on some decidedly "old-fashioned" techniques, like interviewing soldiers' families when diagnosing a pre-existing condition to see whether the soldiers' troubles existed before joining the service. Other doctors at the Army hospital "don't make any effort to do that," he says. "And they don't have time to. They're busy herding people through."

    Surgeon General Pollock declined to comment on Chen's and Harrison's allegations. In a statement, she says she is disturbed by the idea that "individuals [are] pressuring providers to falsify diagnoses.... Such conduct, of course, would be totally unacceptable." Pollock advises doctors who feel under pressure to diagnose personality disorder to contact the Inspector General. She asks soldiers who feel they have been misdiagnosed to approach her directly. Due to "my concern over these issues, they may provide their information to me and I will have the staff review their records."

Flying Blind

    In May, before most in Washington had even heard of Chapter 5-13, Senator Kit Bond was studying the discharge--and calling for its abolition. "You have 22,000 soldiers who passed through all the tests required to send them to Iraq, and they came back and were diagnosed with a pre-existing condition? It just doesn't compute. We need to fix the system," he says. "They ought not have the 5-13 as an easy way to put these soldiers out." As the system is now, the Senator says, some of the cases he's seen "just scream out to me: 'This person was railroaded.'" The Republican from Mi

    ssouri helped put together a coalition of thirty-one senators spanning the political spectrum, from Hillary Clinton to Joseph Lieberman to fellow conservative Elizabeth Dole. In June they wrote a letter to Defense Secretary Robert Gates requesting that he investigate the 5-13 discharge process. Bond also co-wrote a defense authorization amendment with Senator Barack Obama and others that would put a temporary freeze on all personality disorder discharges. The amendment has been referred to the Armed Services Committee.

    The past year has exposed several problems in the way we're treating veterans, says Bond. "And this 5-13 seems to be a major part of the problem."

    By July the Senate wasn't the only organization in Washington concerned about personality disorder. The Department of Veterans Affairs was worried too. "We wanted to prioritize injured [Iraq War] veterans. We want to provide a seamless transition" from the Army, says a top VA official. But with these personality disorder discharges, "you have people now falling through the cracks." The official, who demanded anonymity because he had not received clearance to speak, says the problem with phony discharges like personality disorder is that they short-circuit the VA's Red Flag system.

    The Red Flag system is an informal name for the VA's method of identifying the most wounded soldiers. The agency does this, explains the official, by keeping its eye on the Army's medical board hearings, where wounded soldiers are supposed to go before their discharge. The board evaluates injured soldiers and gives them a disability rating. Under the Red Flag system, those who leave the Army's medical board hearings with a high disability rating are flagged and targeted for immediate medical care.

    But soldiers discharged with personality disorder are denied the opportunity to see a medical board and thus don't get a disability rating. As a result, they fly under the VA's radar. Those who need immediate medical care get dumped into the stack of 800,000 cases currently waiting to be processed by the VA. For the VA to function, says the official, the Army has to pass wounded soldiers through its medical boards. Otherwise, the agency is flying blind.

    Jon Town knows firsthand the price of that blindness. He submitted an application for VA medical care shortly before leaving the Army. Seven months later he was still waiting for his first doctor's appointment.

    Without medical treatment, Town struggled alone with deafness, memory loss, insomnia and a headache that was still raging three years after the rocket attack. The specialist tried to take a few jobs, but each time he was fired after his health proved too much of an issue. His wife, Kristy, had to keep the family of four afloat with her minimum-wage job on the assembly line at Filtech, an oil-filter manufacturer in their hometown of Findlay, Ohio. Soon the family was teetering on the verge of bankruptcy. In May, the phone company shut off their service because the Towns couldn't pay their bill.

    The media took note. In April came the Nation article, followed by the Law & Order episode, which introduced Town's story to 9 million viewers. When musician Dave Matthews saw the article and began discussing it in concerts, his enraged fans took up a collection for Town, which raised $3,000. The guitarist followed up by posting a petition on his website, urging Congress to hold hearings on personality disorder. Within weeks the petition was signed by 23,000 people.

    "There are times when an injustice is so clear, it's not a matter of opinion," says Matthews. "Nobody would argue that what's happening to Jon Town is right. And to think that it's happening over and over again...it's just astounding. It's a crime against these young people that's so profound--and it's happening right now. I had to ask myself, 'Does America think this is OK?'" People won't think it's OK once they learn what's going on, says Matthews. "We can fix this catastrophe. It's just a matter of getting people to know about it."

    Soon Nation readers, NBC viewers and Matthews fans were reaching out to Town en masse: e-mails, phone calls, small personal checks. The local chapter of Veterans of Foreign Wars organized a motorcycle ride to honor his service. A veteran from Boston offered Town his disability pay until the specialist could secure his own.

    Strangely enough, Town's big break came not from Matthews, NBC or even Senator Bond but from Lou Wilin, a reporter at the Findlay Courier, Town's hometown paper (circulation 23,000). After reading Town's story in The Nation, Wilin wrote a profile of the soldier, which ran in the newspaper's April 16 edition. The article caught the eye of an admiral in the VA who happens to live a few miles east of Findlay. The admiral flagged Town's case, kicked it to the Cleveland VA, which passed it to the Dayton VA, where case manager Janine Wert was ready to take action. Wert received Town's case the morning of April 19 and had the soldier in her office before the end of lunch. She listened to his story and cried.

    "His childhood, high school and military history--none of it supports a personality disorder. When you're a teenager, there are certain things that pop up that are vividly obvious, red flags for personality disorder. Those aren't present in Jon's history," says Wert, a social worker with a master's degree in mental health. Wert says Town's PTSD and TBI symptoms were obvious from their first meeting. She was struck by the absurdity of the Army's diagnosis. "I have never in my life heard of personality disorder causing deafness," says the counselor.

    Wert arranged an immediate doctor's appointment for Town and scheduled an evaluation by a VA medical board. On June 11 the VA ruled that Town was in fact wounded in combat. The agency declared him 100 percent disabled.

    Town's VA rating guaranteed him disability and medical benefits for the rest of his life. The VA also provided the disability pay that Town should have received in the months following his discharge. On June 25, just weeks after his family's phone had been shut off, the specialist received a check for $20,000.

    "I almost started to cry," says Town. "They were ready to repossess everything. And now I knew we weren't going to lose our cars to bankruptcy, that we'd have food on the table for years to come.... There isn't a word for what I was feeling."

    The diagnosis was a remarkable victory for the Town family--and a pointed defeat for the Army, which to this day insists that Town was not wounded in combat and that his health problems stem from a personality disorder. He still has not received any of the benefits owed him by the Army.

    "This is a scandal," Representative Filner said in May. And members of his VA Committee would be interested in pursuing it, "but right now, they just don't know anything about it." With the uproar about Town, Filner saw an opportunity to change that. On July 12 he announced that his committee would hold a hearing on personality disorder. To do it right, he said, "we definitely want to hear from soldiers."

    Filner had a particular soldier in mind.

'This Would Be Wrong'

    July 25. By 10 am, it's standing room only at the Cannon House Office Building, the hearing room swimming with men in uniform, veterans with camouflage accessories, protesters in bright pink sporting handwritten placards demanding justice for soldiers. A row of photographers crouch beside the CBS News camera; reporters for ABC News, NPR and the New York Times have set up shop behind the soldier at the witness desk.

    Not surprisingly, Town didn't sleep the night before. His headache is still raging; his eyes look a bit bloodshot. But his blond bangs are combed, and his favorite red-striped Old Navy shirt is gone, as is the brown ball cap and reflective sunglasses, replaced with a well-pressed navy suit and crimson tie. Town holds his dog tags in his hand and rubs them nervously between his thumb and forefinger as he looks up at the committee, his voice defiant and jittery.

    "I want to state that I did not have a personality disorder before I went into the Army, as they have stated in my paperwork. I did not suffer severe nonstop headaches. I did not have memory loss. I did not have endless, sleepless nights. I have posttraumatic stress disorder and traumatic brain injury now due to the injuries I received in the war, for which I received a Purple Heart," he says. "I shouldn't be labeled for the rest of my life with a personality disorder, and neither should my fellow soldiers who also incorrectly received this stigma."

    Filner looks down at the specialist with paternal eyes. When the applause dies down he says, "Thank you, Mr. Town. You did not sign up to have to do this. But you are helping a lot of people, and we thank you for your courage."

    Two hours later Surgeon General Pollock's psychological consultant, Col. Bruce Crow, sits at the witness desk. Pollock herself was called to testify; her name appeared on the original witness list. But today she's nowhere to be found, a fact that angers several of the Congressmen. Speaking in her stead, Crow says, "Questions have been raised about whether Army psychiatrists and psychologists are misdiagnosing soldiers with personality disorder instead of correctly diagnosing PTSD or traumatic brain injury." If they are misdiagnosing soldiers, says Crow, "this would be wrong."

    Pollock's consultant says that the surgeon general is reviewing the cases of 295 soldiers discharged with personality disorder. Pollock will conduct the review, says Crow, by having "a team of senior mental health providers" look over the soldiers' paperwork.

    Filner shakes his head, baffled. "The first panel shocked me," says Filner, referring to Town's testimony. "You guys shocked me even more." The allegation "that there's a systematic and policy-driven misdiagnosis of PTSD as personality disorder to get rid of soldiers early, to prevent any expenditures in the future, which were calculated in the billions of dollars...it's a pretty serious allegation." Crow looks back at Filner. He says nothing. "And if you think that we're going to believe an evaluation of 295 cases, whichever ones you happen to pick--that we're going to believe what you say--I'll tell you now, I'm not going to believe it. So why bother?" says the chairman. "Let's have an independent evaluation."

    When the hearing ends, Crow exits. Several Congressmen walk toward the gallery to shake Town's hand. The hearing went well, says the soldier. He was glad to hear support on both sides of the aisle for the Bond/Obama amendment to freeze 5-13 discharges and its companion legislation in the House, HR 3167, put forward by Congressman Phil Hare and others.

    Now that Town has gotten his VA benefits, his eye has turned toward the national issue of 5-13 discharges. That is where there's a lot of work left to be done, he says. Town points out that still today, not a single person has been held responsible for the 5-13 discharges--not Surgeon General Pollock, not Colonel Knorr, not even the Army psychologist who diagnosed his personality disorder, Dr. Mark Wexler.

    And there hasn't been any effort to go back through the files and find the thousands of Jon Towns who are struggling right now without benefits or the media spotlight. "The Army needs to go back and find these guys," says the specialist. "They need to show up and say, 'We apologize--and we're here to rectify the situation.'"

    Until that happens, he says, his work is not done.

Uncle Sam Adds Insult to Injury

Nation Readers & Joshua Kors
Needham, Mass.

    Thank God someone has finally lifted the curtain on the appalling practice of tagging injured veterans with "personality disorder" to avoid giving them VA care. The unconscionable, revolting, self-serving weasel words from the military bureaucrats make one's blood boil [Joshua Kors, "How Specialist Town Lost His Benefits," April 9]. How do we get this to the larger stage? It needs to be exposed as a massive scandal. Any decent person would share my reaction: white-hot rage.
 
SECRECY:   Army Blocks Public's Access to Documents
    in Web-Based Library
By Christopher Lee
Washington Post Staff Writer
Thursday, February 21, 2008; Page A13

    The Army has shut down public access to the largest online collection of its doctrinal publications, a move criticized by open-government advocates as unnecessary secrecy by a runaway bureaucracy.

    Army officials moved the Reimer Digital Library ( http://atiam.train.army.mil) behind a password-protected firewall on Feb. 6, restricting access to an electronic trove that is popular with researchers for its wealth of field and technical manuals and documents on military operations, education, training and technology. All are unclassified, and most already are approved for public release.

    "Almost everything connected to the Army is reflected in some way in the Reimer collection," said Steven Aftergood, director of the Project on Government Secrecy at the nonprofit Federation of American Scientists. "It provides the public with an unparalleled window into Army policy. It provides unclassified resources on military planning and doctrine."

    Aftergood, a daily user of the library until he was shut out by the new firewall two weeks ago, said the collection offers specialized military manuscripts that do not appear on the shelves of local libraries. These include documents on the Army's use of unmanned aircraft; tactics and techniques for the use of nonlethal weapons; a field manual for non-engineers on the fundamentals of flight; and a manual on working dogs in the military.

    "All of this stuff had been specifically approved for public release," Aftergood said. "I think it's a case of bureaucracy run amok. And it's a familiar impulse to secrecy that needs to be challenged at every turn."

    For years, open-government advocates have complained about the Bush administration's penchant for confidentiality, from the White House's long-standing refusal to release lists of presidential visitors to the secrecy surrounding the administration's warrantless wiretapping program and Vice President Cheney's energy policy task force.

    In 2006, the National Archives acknowledged that the CIA and other agencies had withdrawn thousands of records from the public shelves over several years and inappropriately reclassified many of them. Early in 2002, then-Attorney General John D. Ashcroft issued a memo urging federal agencies to use whatever legal means necessary to reject Freedom of Information Act requests for public documents.

    Army officials said yesterday that they were compelled to limit access to the Reimer library site to comply with Department of Defense policies that call for tightening the security of military Web sites and to keep better track internally of who is accessing them and why.

    "You've got to be a member of the military or a Department of Defense worker to have access to it," and not all of them can get in, said Ray Harp, a spokesman for the Army Training and Doctrine Command, which oversees and maintains the Reimer collection. "They did this to make sure they are in line with the current DOD and DA [Department of the Army] information assurance policies."

    Harp said some of the documents in the collection still are available to the public through the Army Publishing Directorate ( http://www.usapa.army.mil). That is not good enough, according to Aftergood, who said many of the most important documents on that site are password-protected, as well, despite having been cleared for public release. His group recently filed a FOIA request for all of the unclassified documents in the Reimer collection in order to replicate the archive on its own publicly accessible Web site.

    "They can configure Army Web sites however they like," Aftergood said. "What they cannot do is to withhold information from the public that is subject to release under the FOIA. . . . What we really want to do is to persuade them to adopt a reasonable policy of openness, not to provide an alternative -- unless we have to."
 
When he called the security meeting at his Western White House in California on 31 May, it was to tell his aides to carry on without regard to public opinion at home.

"I want you to put the air in there and not spare the horses - do not withdraw for domestic reasons but only for military reasons," the files released by the US National Archives show him as saying.

"Just do it. Don't come back and ask permission each time."

"We cannot sit here and let the enemy believe that Cambodia is our last gasp," he argued in the memo, marked as