Army sergeant was accused of 'exaggerating' the stress of war

Stephen Davis spent months after returning from Iraq trying to explain to U.S. Army therapists what was wrong.  The nightmares. The anxiety when there was nothing to be anxious about. The bouts of confusion that drove his wife, Kimberly, crazy — until she remembered he wasn’t the same man who’d left for war.

“I’ve been married to my husband almost 19 years. I have not seen the husband I know back yet," she said. "I’ve been waiting two years for him to come back, and he’s still not back.” 

On Wednesday, though, the couple announced that their most perplexing battle — trying to convince the Army that something was seriously wrong — was over.  Amid an investigation into charges that the Army’s Madigan Healthcare System hospital in Washington state has been reversing legitimate diagnoses of  post-traumatic stress disorder to save money, U.S. Sen. Patty Murray (D-Wash.) announced that Davis was one of 14 service members at Joint Base Lewis-McChord whose cases had received new independent reviews.

“I think it is deeply disconcerting and should be to everyone in this country that it seems clear that the diagnoses that these soldiers were given [were] based on how much money it might cost this country if they were given a diagnosis of PTSD, rather than doing what needed to be done to make sure they got the correct care,” Murray said at a Seattle news conference.

Davis was among six soldiers notified Tuesday and Wednesday that an independent review by mental health officials at the Walter Reed Army Medical Center had confirmed they suffer from PTSD.  Walter Reed physicians found that eight others have behavioral conditions other than PTSD, the Army’s Western Region Medical Command said in a statement.

“Our goal is to first provide an accurate medical diagnosis,” said Col. Rebecca Porter, head of behavioral health for the office of the Army Surgeon General, who conducted the meetings with service members. “When any of our providers are assessing the health of our soldiers, their practice is guided by evidence-based interventions that are widely used by medical providers throughout the United States, and that are individualized to the patient’s specific condition." 

The notification meetings represented a significant change in tone for soldiers like Davis, who had been told he was “over-reporting” and “exaggerating” his symptoms in a way that made it seem unlikely he truly suffered from PTSD.

That was a bitter blow for the 45-year-old 1st sergeant, a veteran of two tours in Iraq and Afghanistan, whose therapists had all insisted he had a clear case of PTSD and ought to be eligible for the full range of benefits available to soldiers diagnosed with the condition.

Davis, a father of three from Tacoma, Wash., said at Murray's news conference that he initially received a PTSD diagnosis, but it was reversed after a 10-minute meeting with a forensic psychiatrist at Madigan who had never seen him before, but who quickly reviewed the results of a written test Davis had taken.

“It was about 100 questions, it took about an hour. It just asked you questions as far as your anxiety levels, confusion, your ability to sleep, and things like that,” Davis said.  “I answered them to the best of my ability, that I do have anxiety, I do have confusion … and I have difficulty sometimes expressing what I want to say… And then when it came back, it was that you over-reported your symptoms.”

Instead of PTSD, Davis was diagnosed with anxiety disorder. That meant he was no longer entitled to the automatic 50% disability rating granted soldiers with PTSD, a rating that provides some continuing disability pay after service members leave the Army as well as some continued healthcare benefits for themselves and their families.

Army officials said Madigan, one of the largest Army hospitals on the West Coast, has operated a unique system under which PTSD cases diagnosed by therapists were reviewed by a team of forensic psychiatrists who sometimes reversed them without conducting thorough one-on-one evaluations.

An Army ombudsman reported that Madigan’s forensic psychiatry team appeared to be taking into consideration the high cost of benefits to those diagnosed with PTSD — perhaps up to $1.5 million over a lifetime — and the need to be “good stewards” of taxpayer money. The head of the psychiatrist team, along with the chief of Madigan Healthcare System, have been suspended pending two investigations.

“This is an injury. It’s an injury, and we have to treat it as an injury,” Murray said.  “No doctor should be making a decision based on whether it’s going to cost taxpayer money.”

Porter said Walter Reed physicians conducting the evaluation had no contact with those who decide on disability benefits. "The diagnostic process is intentionally separate from the compensation determination process, because our role is to provide an accurate and complete diagnosis based on the needs of each patient,” she said in a statement.

More important than the benefits, Davis said, was that finally the military believed him about the crippling disability he brought home from the wars.

“This isn’t just about money or benefits to myself and my wife or the other soldiers and their wives that continue to fight this process,” he said. “It’s doing what’s right -- taking care of the soldiers that are coming home.”

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