Secretary Nicholson came to the VA with no understanding of veterans ' advocacy and no experience in the healthcare sector. He had been Chairman of the Republican National Committee and Ambassador to the Vatican. As one pundit put it, "Jim Nicholson can write a good political bumper sticker and knows how to kiss the Pope 's ring. That 's about it. "
But, with Secretary Nicholson at the VA helm, veterans have come to feel isolated from the agency 's decision-making processes. And, recent developments have done nothing quell that uneasy feeling.
Earlier this year, veterans were surprised by the VA 's "second signature required " (SSR) policy. SSR applied to approved claims for many "high-dollar " disabilities and stipulated that the claim be re-approved by another VA staffer. However, if the claim was denied by the first staffer, there was no second review.
Veterans ' groups claimed that a SSR policy should apply to all claims for any condition whether they were approved or denied. The fact that the VA chose to apply SSR to disabilities with "high-dollar " compensation was proof to many veterans that the agency was just trying to save money by denying benefits.
The SSR policy was NOT announced by the VA. Only some very good investigative work by Cheryl Reed of the Chicago Sun-Times brought the story to light. This is just one of many instances where the VA has instituted policies detrimental to veterans without making the actions public.
The latest "unannounced " move by the VA is a new review of PTSD diagnosis, treatment and compensation. The VA 's plans came to light on November 16, just six days after they had canceled a review of 72,000 PTSD claims awarded at 100 per cent disability. Pressure from veterans ' groups and Democrat members of Congress forced the cancellation.
The VA 's new PTSD review was not announced by the VA. There was no VA press release. There was no VA press conference. The information was not posted on the VA web site.
Information about the new PTSD review was made public in a press release by Senator Larry Craig (R-ID), Chairman of the Senate Committee on Veterans ' Affairs. The release, in part, said, "The Department of Veterans Affairs announced today that it has contracted with the Institute of Medicine (IOM) on a two-pronged approach to the examination of PTSD. "
Except, the VA hadn 't announced anything. They were using Senator Craig as their conduit to hand out the bad news. Since Craig 's press releases don 't have a high readership, this information has gone virtually unnoticed.
Upon reading Senator Craig 's press release I called the Public Affairs Office at the VA. They had no knowledge of the review. I then called the Institute of Medicine. They had no knowledge of the review.
Senator Craig 's office was more helpful. They forwarded the two documents the VA had sent to them. One document is a Fact Sheet detailing the contract between the VA and the IOM. The other is a Question and Answer sheet. (NOTE: The VA documents are available at the following URL http://www.vawatchdog.org/newsflash/newsflash11-23-2005-3.htm )
I encourage all veterans to read the VA documents. They detail a plan to redefine PTSD by altering diagnostic and treatment techniques that will then lead to a complete restructuring of VA compensation. Following are a few excerpts from the VA Fact Sheet.
The IOM " ...will review the utility and objectiveness of the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM- IV), and will comment on the validity of current screening instruments and their predictive capacity for accurate diagnoses. "
This will allow the VA to write an alternate definition of PTSD exclusive of the DSM-IV and institute new methods of treatment outside of normally accepted guidelines. I wonder what the American Psychiatric Association will say about this?
Also, the IOM " ...will review the literature on compensation practices for PTSD ...and how changes in the frequency and intensity of symptoms affect compensation practices for PTSD; assessing how compensation practices and reevaluation requirements for PTSD compare with other chronic conditions which have periods of remission and return of symptoms; and reviewing strategies used to support recovery and return to function in patients with PTSD. "