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Soldiers discharged, not given treatment

WASHINGTON — The U.S. military has been discharging troops suffering from combat stress instead of providing treatment, according to U.S. Sen. Kit Bond, R-Mo., and several veterans' advocates.

That means many soldiers who could be afflicted with mental health conditions — including post-traumatic stress disorder and traumatic brain injury — have left the service without official medical diagnoses and no chance for medical benefits.

"If somebody comes back with battle-related stress and invisible injuries, we owe them a tremendous amount," said Bond. "We need to determine what their problem is, not kick them out and let them fend for themselves."

The concern over questionable discharges comes against a backdrop of multiple deployments that send some troops back to war zones more than once, a shortage of military doctors, a record number of suicides among National Guard and Reserve troops, and high instances of PTSD and combat-related brain injuries.

The discharges in question are for "adjustment disorders," a temporary condition that can occur when a person has trouble handling a stressful event. Troops who have experienced combat or undergone other types of stress might be discharged as a result of actions such as sleepwalking or severe nightmares.

The procedure bypasses the lengthier medical discharge process. But critics contend that many troops are discharged erroneously and lose out on medical benefits.

"A service member who has a mental health condition is tempted with the carrot of going home to see family, and most service members will leap at the chance," said Paul Sullivan, executive director of Veterans for Common Sense, an advocacy group. "Without a medical exam and legal advice, they quickly sign the discharge papers so they can go home. Most often they are not told they are sacrificing benefits."

Veterans' advocates who have worked with discharged service members said adjustment disorders were often a "catch-all" for a misdiagnosis of something more serious.

An Army report this year on suicide prevention said that more than one-quarter of all active-duty troops whose suicides involved mental health issues had been diagnosed with adjustment disorder.

Seeking information

After several attempts to obtain data on discharges from the Pentagon, Bond and three Senate colleagues last week called on Defense Secretary Robert Gates in a letter to pry that information loose.

"We are particularly concerned that troops who display symptoms of combat stress are expeditiously chaptered out of the military by the medical bureaucracy prior to their condition meeting formal diagnostic criteria for PTSD or other conditions that would constitute disability," their letter said.

Sens. Patrick Leahy, D-Vermont; Sam Brownback, R-Kansas; and Charles Grassley, R-Iowa, also signed the letter.

"Combat troops suffering from PTSD and TBI (traumatic brain injury) who go untreated can face broken marriages, addiction problems, lost jobs, and even suicide," Bond said. "The science to treat these invisible injuries and prevent this tragic legacy is there, but we must have the political will to ensure that our troops receive the care and benefits they earned on the battlefield."

Pentagon spokeswoman Eileen Lainez said the department would respond to the senators' letter "as appropriate."

Faulty discharges?

Bond and veterans' advocates are particularly angry because Congress has already cautioned the military about quickly discharging troops who might need mental health treatment.

In 2007, Congress stopped the military from using pre-existing personality disorders as a discharge trigger for combat-stressed troops. Pre-existing medical conditions disqualify service members from receiving benefits.

Critics said they often were sham discharges because many troops had originally been found fit by the military to deploy to Iraq or Afghanistan. They said the pressure to remove troops quickly, instead of going through the lengthy medical discharge process, was high because it saved money.

Since then, personality disorder discharges have plummeted, according to the Pentagon. They have dropped from 1,072 in 2006 to just 64 through last March.

But adjustment disorders during almost the same period have jumped from more than 1,400 in 2006 to more than 3,800 last year.

"The military is trying to kick soldiers out as fast as possible," Sullivan charged. "When it was caught red-handed improperly using personality disorder discharges, it simply shifted gears and now uses adjustment disorder."

A recent study found that nearly a third of returning male Iraq and Afghanistan war veterans and nearly a quarter of females who sought help at the Veterans Health Administration had PTSD.

A diagnosis of PTSD in the military qualifies active-duty service members for medical retirement and lifelong compensation, as well as medical care for them and their families.

A PTSD diagnosis by the Department of Veterans Affairs would qualify the veteran for benefits, though not as extensive.

"That means if they were on active duty and received the wrong diagnosis, they were cheated out of health care and compensation that would have come out of (the Department of Defense ) budget," said Steve Robinson, a veterans' advocate and former Army Ranger.

"For every person who gets kicked out by adjustment disorder who later finds out it was wrong, there is no recourse."

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