May 7, 2012 (Fayetteville Observer) – Two years ago, Fort Bragg Sgt. Jody Lee Piercy was ordered to take a battery of psychological tests to determine whether he was faking his service-related ailments.
After the testing, medical records show, a doctor at Womack Army Medical Center concluded that Piercy was exaggerating symptoms of post-traumatic stress disorder and wrote that a diagnosis of malingering “should be strongly considered.”
Six months later, the records show, Piercy underwent another battery of psychological tests for issues related to traumatic brain injury. This time, a different Womack doctor did not waffle. Piercy, he said, was faking.
The Army’s testing seemed to demonstrate that Piercy was fabricating his problems to get increased benefits once he left the service.
Piercy, a member of Fort Bragg’s Warrior Transition Battalion for wounded soldiers, says nothing could be further from the truth. He’s been trying to fight back against the malingering accusation. And now the Army itself may have given him some ammunition.
This month, the Army’s Office of the Surgeon General issued a new policy on the assessment and treatment of PTSD that discounts the use of psychological tests to determine whether soldiers are malingering.
The policy says incidents of soldiers faking or exaggerating their symptoms are rare – less than 1 percent of the cases, according to one study. It also says that a poor result on a psychological test “does not equate to malingering, which requires proof of intent.”
Piercy said he knows of about 25 other soldiers in Fort Bragg’s battalion who have been accused of malingering, including nine who appeared at a meeting for disgruntled battalion soldiers last month.
For a soldier who was injured while serving his country, Piercy said, the Army could not have come up with a worse label.
“You could have done anything other than call me a malingerer,” he said. “You might as well put a gun to my head.”
PTSD is a mental health condition triggered by a terrifying event. Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event. While most people get better over time, symptoms can get worse and last for years.
According to the new PTSD policy, between 5 percent and 25 percent of soldiers who have deployed suffer from PTSD.
The surgeon general’s new policy also addresses one of the other major complaints voiced by soldiers in Fort Bragg’s Warrior Transition Battalion: They say they are being overmedicated for their PTSD symptoms.
According to the policy, which has been distributed to Army medical commanders, the routine treatment of PTSD with Valium, Xanax and other anti-anxiety drugs – collectively known as benzodiazapines – may do more harm than good.
“Once initiated in combat veterans, benzodiazapines can be very difficult, if not impossible, to discontinue due to significant withdrawal symptoms, compounded by the underlying PTSD symptoms,” the policy says.
The number of prescriptions for anti-anxiety drugs issued to Fort Bragg soldiers nearly doubled between 2004 and 2010 – from 3,100 to 5,892, according to figures provided by Fort Bragg last year.
The policy also says the use of Risperidone and other so-called “second-generation antipsychotics” to treat PTSD have “shown disappointing results” and have “potential long-term adverse health effects.”
Instead of using potentially harmful drugs, the policy encourages the use of intensive counseling and other alternatives, including yoga, acupuncture and massage therapies.
On Tuesday, Fort Bragg officials were asked to respond to the new PTSD policy guidelines. Among the questions was whether the policy would result in the re-evaluation of soldiers who have been accused of malingering.
A spokesman for Womack said the questions were sent to the Army’s medical command, which had not responded.
The Army’s Office of the Surgeon General spelled out its new PTSD assessment and treatment policy in a memo dated April 10 to regional medical commanders.
A week later, Fort Bragg commanders announced that an inspection of the post’s Warrior Transition Battalion found areas that need improvement, but they made little mention of the battalion soldiers who were complaining about being overmedicated or being accused of malingering.
Instead, the soldiers were told to take those complaints to their chain of command.
Some of the soldiers had been complaining publicly since Feb. 14, the day Lt. Gen. Frank Helmick, commander of Fort Bragg and the 18th Airborne Corps, ordered the inspection.
The next night, about a dozen of the battalion’s soldiers and their spouses or family members met to air their complaints. Col. Maggie Dunn, Fort Bragg’s inspector general who conducted the inspection, also attended.
At that meeting, Marlena Pennington spoke about her late husband, Army veteran Dale Pennington.
Marlena Pennington said her husband was separated from the Army with a less-than-honorable discharge after testing positive for marijuana and being accused of faking seizures.
She said her husband had been taking several medications, including the second-generation antipsychotic Seroquel, to treat PTSD, high blood pressure, seizures and other ailments.
Shortly after his release from the Army, he collapsed in his home and died of what Marlena Pennington described as an enlarged heart.
For years, Dr. Fred Baughman, a neurologist living in California, has criticized the Army’s practice of prescribing soldiers suffering from PTSD a combination of antidepressants and second-generation anti-psychotics. Baughman said the cocktail of medications can cause sudden cardiac death.
Using the Internet, Baughman and other advocates for wounded troops have compiled a list of more than 300 soldiers who have died suddenly. Baughman believes many of the deaths were caused by the medications the soldiers had been taking.
Baughman said the new policy acknowledges that Risperidone and other anti-psychotics have “never proved of any value, and yet the military has spent $1.5 billion on them over the last decade.”
The inspection of Fort Bragg’s Warrior Transition Battalion included a review of medication and management practices used by Womack Army Medical Center in its treatment of battalion soldiers.
“There is no indication of any problem with misprescribing of medicines by our staff,” Brig. Gen. Michael X. Garrett said when announcing the findings in April.
During a deployment to Afghanistan in 2009, Sgt. Piercy said he ran from an incoming mortar and tripped over a cement culvert. He said he hit his head hard enough to black out for a short time and also hurt his knee and hand.
Initially, Piercy said, he didn’t think his injuries were serious enough to report them, so he soldiered on. But soon, he said, his knee swelled, his memory deteriorated and he became irritable. A doctor told him he needed surgery to repair his knee.
Piercy, who is 43, was flown home and eventually wound up in the Warrior Transition Battalion, where he was diagnosed as having PTSD, a traumatic brain injury and physical ailments, including back, knee and foot problems. He has spent two years in the battalion.
Not long after arriving in the battalion, Piercy was ordered to take the psychological tests to determine whether his PTSD, and, later, his TBI, were real or fabricated. Both tests included the Minnesota Multiphasic Personality Inventory-2, the most widely used test to assess mental health problems in the country.
The surgeon general’s new policy singles out the Minnesota test, saying it and similar ones “may be helpful in diagnostic clarification in some patients, but are also not themselves sufficient to make a diagnosis of PTSD.”
Piercy said many of the soldiers who have been accused of malingering suffer from traumatic brain injury and are being ordered to take the psychological tests by doctors in the post’s TBI clinic.
Last month, David Weitzman, a former Womack doctor for the Warrior Transition Battalion, said he had routinely ordered soldiers who he thought were faking injury or illness to take the tests. Weitzman called the tests infallible but said political pressure caused him to stop ordering them after diagnosing five or six soldiers as malingerers. Weitzman could not be reached for comment on the surgeon general’s new policy.
Dr. Ralph Kiernan, a California neuropsychologist for 40 years, said it’s about time the Army acknowledged the tests for what they are.
“The tests don’t work,” Kiernan said. “They just simply don’t work.
“It’s probably the worst of all the things that have been used to detect the so-called malingering.”
Piercy believes the use of the term malingering in his medical records will limit his military benefits once he leaves the Army.
Piercy is in the long process of being separated from the Army on a medical discharge. His case will soon come up for review by the Army’s Medical Evaluation Board, the next step in determining a rating for benefits.
Piercy said he has tested Helmick’s open-door policy. He said he recently met with Helmick, then Col. Brian Canfield, commander of Womack, and, finally, Frank L. Christopher, deputy commander for clinical services at Womack.
Piercy said Christopher told him that he cannot make a doctor change the malingering references in his medical records, which will be used by the Medical Evaluation Board in determining benefits. He said Christopher told him he has the right to add a letter of disagreement.
Piercy said it doesn’t seem to matter that two later psychological evaluations – one by Womack and the other by a private provider – make no mention of malingering.
He said he hopes the surgeon general’s new PTSD policy will help him and other soldiers plead their cases.
In the meantime, he said, he knows of another soldier who was ordered to take the psychological tests within the last week or so.
