ptsd Copy Of E Mail On Iom Ptsd

[Testvet]

Attached is a fact sheet that describes the studies being conducted on posttraumatic stress disorder (PTSD) by the Institute of Medicine. The Department of Veterans Affairs has requested the studies. If you require additional information, please email: gulfwarandhealth@nas.edu or visit: www.iom.edu

Additionally, there will be an open meeting on PTSD on February 13 from mid-morning until the end of the day. The open agenda will be posted on our website noted above as soon as we finalize the agenda.

Here is a copy of the PDF File

The National Academies

Institute of Medicine

Board on Population Health and PuBlic Health Practice

Board on Military and Veterans Health

POST-TRAUMATIC STRESS DISORDER (PTSD): A REVIEW

At the request of the Department of Veterans Affairs, the IOM will conduct a study on Post-Traumatic Stress Disorder (PTSD). In December, the VA signed a contract with the IOM to convene two separate committees to examine the peer-reviewed literature on PTSD. One committee will review the current scientific and medical literature related to the assessment of PTSD and the validity of screening instruments used to diagnosis PTSD. It will also assess the different treatment approaches and comment on the prognosis of individuals with PTSD. A second committee will provide technical assistance on issues related to compensation of PTSD. Where relevant, recommendations will be made that provide the scientific basis for future policy decisions.

The competence and impartiality of IOM committees determine the quality of the IOM work. Selecting the right committee--one that encompasses the range and depth of expertise needed and one that is balanced so that it can approach its task objectively--is one of the most critical factors in the success of an IOM project. IOM committees are composed of scientists and experts who serve without compensation. Committees are composed to be balanced with regard to expertise and experience, and to assure impartiality and diversity of views. Committee members are carefully screened to avoid bias and conflict of interest. Any unavoidable conflicts are formally determined, and publicly disclosed.

DESCRIPTION OF THE STUDY AND WORKPLAN

Committee 1: PTSD Diagnosis and Treatment

Specifically related to the assessment and diagnosis of PTSD, the committee will review and comment on the objective measures used in the diagnosis of PTSD and known risk factors for the development of PTSD. The committee 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. The committee will also review the literature on various treatment modalities (including pharmacotherapy and psychotherapy) and treatment goals for individuals with PTSD. The committee will also comment on the prognosis of individuals diagnosed with PTSD and existing comorbidities.

Work Plan: IOM will use the existing committee on Gulf War and Health: Physiologic, Psychologic, and Psychosocial Effects of Deployment Related Stress to complete the task related to diagnosis and validity of diagnostic instruments and treatment issues. The existing committee will form a subcommittee of members with the expertise to respond to the new statement of task. The subcommittee will meet separately from the main committee and deliberate; they will work with consultants, and following their deliberations write two short reports which will be presented to the main committee for consideration and sign off. The first report on diagnosis will be completed in 6 months; the second report on treatment will be completed in 12 months. The reports will undergo external review and following review, will be released to the public.

Committee 2: Compensation Practices for PTSD

The second committee will review the literature on compensation practices for PTSD including examining the criteria for establishing severity of PTSD as published in the VA Schedule for Rating Disabilities (VASRD); evaluating the basis for assigning a specific level of compensation to specific severity levels 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.

Work Plan: An IOM committee of approximately 12 experts will be convened to meet four times during the period of the 12 month study. At the first data gathering meeting which will be open to the public, the sponsor will review the study tasks for the committee and allow discussion to clarify aspects of the implied tasks not explicitly stated in the written study tasks, veteran service organizations will also be invited to attend this open meeting. During subsequent data gathering meetings, the committee will hear from experts both in the Veterans Health Administration (VHA) and the Veterans Benefit Administration (VBA) about how PTSD cases are adjudicated and learn about VA compensation policies and practices. The committee will hold at least one meeting where veterans and veteran service organizations/associations can make presentations about how their PTSD has been managed by the VA. The emphasis of this meeting will be on understanding attitudes about care and compensation. The committee will review the literature, conduct data gathering meetings, and deliberate; following their deliberations they will write a report that will undergo external review and following review, the report will be released to the public.

For further information email: gulfwarandhealth@nas.edu

Or visit: www.iom.edu

Edited January 7, 2006 by Testvet

[Pete53]

I was called in yesterday by the Copper Clinic my VA Mental Healh Clinic for an interview. I arrived 20 minutes early and asked why I had the appointment.The receptionist looked at computer for a long time and with a blank look on her face said she did not know other than Susan might have scheduled it cause I had not been there in 3 years.

Anyway, I met Susan and she asked a boatload of questions and than said that she would make a recommendation that my primary doc prescribe my xanax and that I would only go in to Mental Hygine if I felt that I needed too. I asked if that would trigger some action from the VARO and she said no.

The last I went to Menatl Health Clinic was 3 years ago.

[Testvet]

I just posted the letter as soon as I received it, I personally do not understand why the VA insists on paying for this IOM study when they already have the DSM-IV that is accepted nationwide as the bible for mental health, they have the National Center on PTSD who employs many VA doctors, the VDBC is also reviewing compensation etc these comments on PTSD now being "curable" a "phenomenom" etc by the VA secretary are all giving the impression that PTSD is under attack, as it is the most expensive disease the VA is treating and compensating. Myself I have not missed a mental health appt in 3 years, I refill all my scripts, I am glad my appts have gone from monthly to every 3 months, my gaf stays at 35 or 30 and the VARO insists I am only 50% I have it on appeal. I have not worked since June 2002.

[john999]

TestVet

You know it is the VA just trying to get out of paying compensation for PTSD and has nothing to do with helping vets. All this group in there now is concerned with is cutting costs.

[WeAre#1]

I just posted the letter as soon as I received it, I personally do not understand why the VA insists on paying for this IOM study when they already have the DSM-IV that is accepted nationwide as the bible for mental health, they have the National Center on PTSD who employs many VA doctors, the VDBC is also reviewing compensation etc these comments on PTSD now being "curable" a "phenomenom" etc by the VA secretary are all giving the impression that PTSD is under attack, as it is the most expensive disease the VA is treating and compensating. Myself I have not missed a mental health appt in 3 years, I refill all my scripts, I am glad my appts have gone from monthly to every 3 months, my gaf stays at 35 or 30 and the VARO insists I am only 50% I have it on appeal. I have not worked since June 2002.

I think this will help

REASONS OR BASES INADEQUATE

§

In view of the mandate of [38 U.S.C.] § 4004(d)(1) that the BVA articulate with reasonable clarity its ‘reasons or bases’ for decisions, and in order to facilitate effective judicial review . . . . These decisions must contain clear analysis and succinct but complete explanations. A bare conclusory statement, without both supporting analysis and explanation, is neither helpful to the veteran, nor ‘clear enough to permit effective judicial review’, nor in compliance with the statutory requirements.

Gilbert v. Derwinski, 1 Vet.App. 49, 57 (1990); see also Browder v. Derwinski, 1 Vet.App. 204, 208 (1991) (“Integrated with the ‘reasons or bases’ requirements of [38 C.F.R.] § 4004(d)(1) is the requirement that the BVA decision include a ‘written statement of the Board’s findings and conclusions . . . on all material issues of fact and law presented on the record. . . .’” citing Sammarco v. Derwinski, 1 Vet.App. 111, 112 (1991)); Cf. Bone v. Brown, 9 Vet.App. 446, 450 (1996).

[SLEDGE]

HUH?

"In view of the mandate of [38 U.S.C.] § 4004(d)(1) that the BVA articulate with reasonable clarity"

is a joke.

When they start following the law I'll let ya know.

sledge

[Guest Jim S.]

"In view of the mandate of [38 U.S.C.] § 4004(d)(1) that the BVA articulate with reasonable clarity its ‘reasons or bases’ for decisions, and in order to facilitate effective judicial review . . . . These decisions must contain clear analysis and succinct but complete explanations. A bare conclusory statement, without both supporting analysis and explanation, is neither helpful to the veteran, nor ‘clear enough to permit effective judicial review’, nor in compliance with the statutory requirements."

Is it to late to add this as supporting law, that the VARO failed to give reason and basis supporting their findings that an alternative diagnosis had been offered to refute the original diagnosis for which disability was proposed upon?

Does (38 U.S.C.) 4004 (d)(1) apply to claims at the VARO also?

Is this mandate subject to CUE claims where the VARO or BVA failed to show reason and basis for their decision?

Jim S. :D