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By Investigative Journalist, Barry R. Clausen
June 17, 2013
NewsWithViews.com

Establishing Pre-existing Conditions

According to a FOX News report aired on May 20, 2013 the U.S. military is discharging members of the military with less that honorable discharges. This is apparently a direct result of Veterans actions who have Post Traumatic Stress Disorders (PTSD). With these discharges, the action results in Veterans being denied much needed treatment for not only PTSD but it also denies combat wounded Veterans the medical and/or mental health services.

Then on May 26, 2013 the weekly television show “Huckabee” aired on the Fox Channel detailing the negative ramifications of PTSD on returning military personnel. His show also highlighted the inexcusable actions of the VA to these warriors.

Currently, there is a new “Mental Health Admission Package” Veterans are told they must fill out in order to receive services at the Northern California VA health systems facilitated at Mather California. The package contains a twelve page questionnaire which requests information and disclosures many Veterans find as rude intrusion into their personal lives.

Within the admission package, just prior to the questionnaire is the statement that the form must be completed by: “All established patients every six months, all patients new to some VA Mental Health Clinics and any established patient whose information has changed” This statement is misleading and deceptive as some VA staff claim that it is not mandatory to fill out the requested information.

It is important to consider that upon arrival at VA mental health facilities, some new patients are verbally told that the twelve page form must be filled out in its entirety prior to receiving care. While researching this story, it was found that some VA staff admitted that the form is not mandatory, yet at the same time many staff are informing Veterans that the form is mandatory.

On February 28, 2013, Dr. Addagatla, Clinic Director at the McClellan VA Clinic, stated during a “Voice of the Veteran” meeting that the form did not need to be filled out. She revealed at that time that it was a decision for the Veteran to make for him/herself. Her words were echoed by Robin Jackson, Chief Public Affairs officer at the Northern California Health Care System located at Mather California.

A few of the invasive questions include requests for information regarding the Veteran’s childhood such as history of child sexual abuse, educational history, employment history, military history and military related trauma, questions targeting the Veteran’s memory functioning, personal legal history, alcohol and substance use history, and religious type questions such as what church the Veteran attends. Some of the questions related to alcohol usage include explaining how many drinks containing alcohol that the Veteran had consumed during the past year. The form further requests information about the Veteran’s children and the developmental history of the children, and requests personal financial information such as the source of the Veteran’s income and the amount that the Veteran receives from any income sources per month.

In at least one current documented case, the questions directed toward a post-traumatic stress disorder (PTSD) patient by one of the VA’s psychiatric nurse practitioners were: “Do you own any guns?,” and “Have you ever killed anyone?” To date, all Veterans who have been interviewed concerning this new form and verbal questions as part of the intake practice and continued care practice, have expressed negative angry responses indicating that, “It is none of their f****** business.”

Admittedly, some of these questions in the form may be useful to a patient’s mental health professional “if” the Veteran feels emotionally comfortable enough to share the information with his or her physician or mental health therapist. However, because this lengthy questionnaire is openly available to all VA staff, this results in what many Veteran’s believe to be an unethical distribution of private and confidential information typically shared within the boundaries and confines of patient/doctor confidentiality protection.

Nearly all mental health clinicians agree that providing psychotherapeutic services is unique, in that, a therapeutic alliance is established between the patient and their therapist. In most cases the Veteran will make disclosures during a therapy session that he or she has not shared with another person, and these same Veterans frequently do not want his or her information shared with any other person as a result of an intrusive questionnaire or under any other circumstances. This issue becomes significantly relevant with Veterans suffering with posttraumatic stress disorder (PTSD) and military sexual trauma (MST), which as we know afflicts many military Veterans.

There are wider potential implications associated with the practice of the VA system implementing these practices with the Veteran population. When considering the purpose and potential implications of the VA questionnaire currently being used by some VA mental health clinics, it is likely that this type of practice may be utilized as a new and creative way of continuing the insurance industry practice of determining a “pre-existing condition” which would therefore deny an individual current and or future claims submitted by disabled Veterans.

The pre-existing condition rule and practice that has been used for decades by insurance companies has been a tool or loop hole used by the insurance industry to deny people coverage at the time of application for insurance because of an alleged previously diagnosed medical or mental health condition. Additionally, if an insurance company chose to provide coverage the categorized “pre-existing condition” would view the so-called pre-existing condition as a “risk.” In other words, the pre-existing condition practices used by insurance companies has historically allowed these companies to use any past medical and mental health history, and prescription history to measure whether or not to provide coverage, determine what type of coverage the individual would be allowed to have including denied and limited coverage, and determine the length of time typically 5 years that an individual is considered “at risk” and supposedly after this 5 year waiting period the individual would then be re-evaluated for improved health coverage.

These practices are congruent with what automobile insurance companies do when a person has too many tickets, accidents, and so forth, whereby during that “waiting at risk period” if the person has a problem that is connected the so called “pre-existing condition” then the insurance company does not pay for or provide coverage for it. In other words, the medical or mental health problem deemed by the insurance company as “pre-existing condition” is excluded from the insurance coverage of the policy altogether, leaving the individual without suitable and appropriate health care. This appears to be the objective of the VA and it is directed towards our Nations Veterans.

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To find the truth in this story we were led to VA facilities in parts of California as there are no identifiers on the paperwork. From California we were sent to the office of Lynda Duncan, VA Health Administration Affairs Office in Washington D.C. who did not return calls. We later discovered it was written by unnamed VA staff in Northern California. A last minute call from VA officials stated that the questionnaire is being reviewed.

The names of those Veterans interviewed have been left out of this story as many are concerned that their benefits would be impacted if the VA discovered their names.

� 2012 Barry R. Clausen - All Rights Reserved