Sally Satel is back

THINK-TANKER SATEL PUSHES "TREATMENT FIRST"

LEGISLATION FOR PTSD VETS -- "Treatment First Act"

would urge vets with mental health issues not to file

for VA disability but seek treatment instead.




Dr. Sally Satel of the
American Enterprise Institute



by Larry Scott



Dr. Sally Satel is a psychiatrist, paid mouthpiece and think-tanker for the American Enterprise Institute. And, she's back in the news pushing her agenda to marginalize PTSD veterans.

This time she's joined by two old friends, Sen. Richard Burr (R-NC) and Sen. Larry Craig (R-ID). Burr is the Ranking Member of the Senate Committee on Veterans' Affairs. Craig was the Ranking Member until the Republican party removed him after he got caught playing tappy-toes with an undercover cop in an airport men's room.

Burr has introduced a bill (S. 2573) titled Veterans Mental Health Treatment First Act. Craig is the only cosponsor of the bill.

Now, Satel, who is not known for her love of veterans or her ability for rational thought, has decided that "Treatment First" is a must for veterans with mental health issues. (For background on Sally Satel, use the VA Watchdog search engine...click here...
http://www.yourvabenefits.org/sessearch.php?q=satel&op=and )

Satel's basic premise is: Work will set you free. Seems to me I've heard that someplace. Satel says, "By abandoning work, the veteran deprives himself of its therapeutic value: a sense of purpose..."

Satel's web site is here... http://www.sallysatelmd.com/
Satel's email is... satel@sallysatelmd.com

The "Treatment First Act" will give a small allowance to vets with mental health problems who forego filing a VA disability compensation claim and enter treatment.

The "Treatment First Act" is just a way for the VA to save money by conning veterans into delaying filing a claim. Even if the veteran goes into treatment, and then a year later files a claim, a lot of money has been saved.

Also, this program would cause a shift in attitude at the Veterans' Benefits Administration (VBA) that handles claims. If a vet does not go into the program and just files a claim, it would be easy for a claims person at VBA to feel that the vet doesn't want to "get better" and then deliberately mishandle the claim, causing delays in compensation.

Below you will find two pieces of information. First is the Sally Satel opinion piece from The Wall Street Journal. Second is the Veterans Mental Health Treatment First Act as posted on Thomas.

Satel opinion here... http://online.wsj.com/articl
e/SB120399050749092455.html?mod=googlenews_wsj

Opinion below:

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OPINION

A Helping Hand for Vets

By SALLY SATEL



Imagine you are a young soldier wounded in Iraq. Your physical injuries heal, but your mind remains tormented. You are flooded with memories of the bloody firefight you survived, you can't concentrate, and sudden noise makes you jump out of your skin. At 23 years old, you are about to be discharged from the military, afraid you'll never again be able to hold a job or fully function in society.

For the thousands of young men and women who apply for disability benefits upon return from Iraq and Afghanistan, these fears are becoming a reality.

When a veteran files a psychiatric disability claim with the Department of Veterans Affairs (VA), an examiner is assigned to determine the extent of incapacitation. As part of the assessment, the examiner requests a psychiatric evaluation to obtain the veteran's diagnosis. Once the veteran is diagnosed with a service-related mental condition (typically depression, post-traumatic stress disorder or another anxiety disorder) the claims examiner assigns a disability rating.

The most severe level for a veteran leaving service is 100%. But even a 50% rating denotes significant impairment (e.g., "difficulty in understanding complex commands"), according to the Veterans Benefits Administration.

Remarkably, something essential is missing from the claims process: treatment. Veterans can go straight to a claims examiner and be granted psychiatric benefits without ever being treated for their mental illness. Some even do so as soldiers, just prior to discharge from the service. Judging an individual to be doomed to a life of invalidism before he has even had a course of therapy and rehabilitation is drastically premature, even reckless.

In the short term, yes, a monthly check of about $2,500 for full disability, tax-free, is a great relief to the struggling veteran and his family. But serious consequences can accompany a rush to judgment about a veteran's rehabilitative potential.

First, a veteran told he is disabled may think: Why bother with treatment? But this would be a terrible mistake. The postdischarge period is when symptoms are most responsive to interventions such as behavioral techniques, medication, psychotherapy, family counseling or a combination. And full disability status may actually undermine the possibility of recovery. A veteran who thinks of himself as beyond recovery -- the message carried by a high disability rating -- risks fulfilling that prophecy.

By abandoning work, the veteran deprives himself of its therapeutic value: a sense of purpose, distraction from depressive rumination, a structure to each day, and the opportunity for friendships. The longer he sits at home, the more his confidence in his abilities erodes and his skills atrophy.

Last year the Government Accountability Office, the President's Commission on Care for America's Returning Wounded Warriors, and the Veterans' Disability Benefits Commission all urged that the disability, compensation and rehabilitation benefits systems be reformed and updated. And last month, Sen. Richard Burr (R., N.C.), ranking member of the Senate Veterans' Affairs Committee, introduced the Veterans' Mental Health Treatment First Act.

The purpose of this bill is to induce new veterans to embark upon a path to recovery. Any veteran diagnosed with major depression, post-traumatic stress disorder or other anxiety disorder stemming from military activity would be eligible for a new program that provides a financial incentive of $11,000 distributed over the course of a year (or completion of recommended treatment, whichever comes first).

The compensation is offered in exchange for two commitments. First, the veteran must adhere to an individualized course of treatment. Second, he must agree to a pause in claims action for at least a year or until completion of treatment, whichever comes first. Should he fail to improve -- and, sadly, this will happen to some -- the veteran remains eligible for 100% long-term disability.

The great virtue of the Treatment First Bill is that it offers an opportunity to receive payment as a condition of trying to get better. Mr. Burr calls it a "wellness stipend" to distinguish it from a "disability benefit." As it stands now, the only way a veteran can receive payment is to be disabled.

There are practical considerations, of course. For example, is $11,000 enough? For patients needing intensive treatment and still too fragile to work, the stipend falls short as income replacement. The constant stress of financial insecurity will not only impede the veteran's clinical progress, it makes the formal disability option -- the very alternative that Treatment First seeks to avert -- look very attractive.

Nonetheless, the proposal delivers a bracing dose of clinical wisdom. Imagine giving young men and women permission to surrender to their psychological wounds without first urging them to pursue recovery. For many young veterans, a "treatment first" approach could be their road to recovery and a rich civilian life.



Dr. Satel is a resident scholar at the American Enterprise Institute and co-author of "One Nation Under Therapy" (St. Martin's Press, 2005).

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S. 2573 can be found on Thomas... http://thomas.loc.gov/

S. 2573 printed below:

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Veterans Mental Health Treatment First Act (Introduced in Senate)

S 2573 IS

110th CONGRESS

2d Session

S. 2573

To amend title 38, United States Code, to require a program of mental health care and rehabilitation for veterans for service-related post-traumatic stress disorder, depression, anxiety disorder, or a related substance use disorder, and for other purposes.

IN THE SENATE OF THE UNITED STATES

January 30, 2008

Mr. BURR (for himself and Mr. CRAIG) introduced the following bill; which was read twice and referred to the Committee on Veterans' Affairs

A BILL

To amend title 38, United States Code, to require a program of mental health care and rehabilitation for veterans for service-related post-traumatic stress disorder, depression, anxiety disorder, or a related substance use disorder, and for other purposes.

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the `Veterans Mental Health Treatment First Act'.

SEC. 2. MENTAL HEATH CARE AND REHABILITATION FOR VETERANS FOR SERVICE-RELATED POST-TRAUMATIC STRESS DISORDER, DEPRESSION, ANXIETY DISORDER, OR RELATED SUBSTANCE USE DISORDER.

(a) In General- Subchapter II of chapter 17 of title 38, United States Code, is amended by inserting after section 1712B the following new section:

`Sec. 1712C. Mental health care and rehabilitation for service-related post-traumatic stress disorder, depression, anxiety disorder, or related substance use disorder

`(a) In General- The Secretary shall carry out a program of mental health care and rehabilitation for veterans who--

`(1) are diagnosed by a physician of the Department with post-traumatic stress disorder, depression, anxiety disorder, or substance use disorder related to post-traumatic stress disorder, depression, or anxiety disorder that is service-related (as determined in accordance with subsection (b)); and

`(2) agree to the conditions of participation applicable to such veterans set forth in subsection (c).

`(b) Treatment of Conditions as Service-Related- (1) A condition of a veteran described in subsection (a)(1) shall be treated as service-related for purposes of this section if--

`(A) the condition has previously been adjudicated by the Secretary to be service-connected; or

`(B) the condition is judged by the physician of the Department making the diagnosis for the veteran as described in subsection (a)(1) to be plausibly related to the service of the veteran in the active military, naval, or air service.

`(2) The Secretary shall prescribe in regulations the standards to be utilized by physicians of the Department in judging under paragraph (1)(B) whether or not a condition of a veteran described in subsection (a)(1) is plausibly related to the service of the veteran in the active military, naval, or air service.

`(c) Conditions of Participation- (1) As conditions for participation in the program under this section, a veteran seeking mental health care and rehabilitation under the program for a condition described in subsection (a)(1) who has not yet filed a claim for disability under this title for such condition shall agree as follows:

`(A) To comply substantially with the treatment regimen and rehabilitation plan prescribed under subsection (d) for the veteran.

`(B) Not to submit a claim for disability compensation under chapter 11 of this title for post-traumatic stress disorder, depression, anxiety disorder, or a related substance use disorder until the earlier of--

`(i) the end of the one-year period beginning on the date of the commencement of the program by the veteran; or

`(ii) the conclusion of the treatment regimen and rehabilitation plan prescribed under subsection (d) for the veteran.

`(2) As conditions for participation in the program under this section, a veteran seeking mental health care and rehabilitation under the program for a condition described in subsection (a)(1) who has filed a claim for disability under this title for such condition that has not been adjudicated by the Secretary at the time of the diagnosis of the veteran described in subsection (a)(1)--

`(A) shall agree to comply substantially with the treatment regimen and rehabilitation plan prescribed under subsection (d) for the veteran; and

`(B) may agree, at the election of the veteran, to the suspension by the Secretary of adjudication of such claim until completion by the veteran of the treatment regimen and rehabilitation plan.

`(3) As conditions for participation in the program under this section, a veteran seeking mental health care and rehabilitation under the program for one or more conditions described in subsection (a)(1) that have been determined by the Secretary to be service-connected shall agree as follows:

`(A) To comply substantially with the treatment regimen and rehabilitation plan prescribed under subsection (d) for the veteran.

`(B) Not to submit a claim for an increase in disability compensation under chapter 11 of this title for or based on such condition or conditions until the earlier of--

`(i) the end of the one-year period beginning on the date of the commencement of the program by the veteran; or

`(ii) the completion of the treatment regimen and rehabilitation plan prescribed under subsection (d) for the veteran.

`(d) Treatment Regimen and Rehabilitation Plan- (1) The Secretary shall provide for each veteran who participates in the program under this section a treatment regimen and rehabilitation plan for the post-traumatic stress disorder, depression, anxiety disorder, or related substance use disorder of such veteran as described in subsection (a)(1). The treatment regimen and rehabilitation plan shall be devised by appropriate clinicians and other appropriate personnel of the Department assigned for that purpose.

`(2) The treatment regimen and rehabilitation plan for a veteran under this subsection shall include such mental health care and rehabilitation as the clinicians and other personnel concerned consider appropriate for the remediation of the condition or conditions of the veteran covered by the plan.

`(3) The duration of each treatment regimen and rehabilitation plan under this subsection shall be such period as the clinician concerned considers appropriate.

`(e) Wellness Stipends- (1) Subject to paragraph (4), each veteran covered by subsection (c)(1) who participates in the program under this section shall be paid a stipend as follows:

`(A) $2,000 payable upon commencement of the treatment regimen and rehabilitation plan provided under subsection (d) for such veteran.

`(B) $1,500 payable every 90 days thereafter upon certification by the clinician treating such veteran under the program that such veteran is in substantial compliance with such treatment regimen and rehabilitation plan, except that the total amount payable to such veteran under this subparagraph may not exceed $6,000.

`(C) $3,000 payable at the earlier of--

`(i) the date of the conclusion of such treatment regimen and rehabilitation plan; or

`(ii) one year after the date of the commencement of such treatment regimen and rehabilitation plan by the veteran.

`(2) Subject to paragraph (4), each veteran covered by subsection (c)(2) who participates in the program under this section shall be paid a stipend as follows:

`(A) If such veteran agrees as provided in subparagraph (B) of subsection (c)(2), the stipend payable under paragraph (1).

`(B) If such veteran does not agree as provided in subparagraph (B) of subsection (c)(2), the stipend payable under paragraph (3).

`(3) Subject to paragraph (4), each veteran covered by subsection (c)(3) who participates in the program under this section shall be paid a stipend as follows:

`(A) $667 payable upon commencement of the treatment regimen and rehabilitation plan provided under subsection (d) for such veteran.

`(B) $500 payable every 90 days thereafter upon certification by the clinician treating such veteran under the program that such veteran is in substantial compliance with such treatment regimen and rehabilitation plan, except that the total amount payable to such veteran under this subparagraph may not exceed $2,000.

`(C) $1,000 payable at the earlier of--

`(i) the date of the conclusion of such treatment regimen and rehabilitation plan; or

`(ii) one year after the date of the commencement of such treatment regimen and rehabilitation plan by the veteran.

`(4) In the event a veteran is determined by the Secretary to have failed to comply with any condition agreed to by the veteran under subsection (c), payment to the veteran of any stipend otherwise authorized to be payable under this subsection shall cease.

`(f) Limitation on Participation- (1) Except as provided in paragraph (2), a veteran may participate only once in the program under this section.

`(2)(A) A veteran may participate more than once in the program under this section if the Secretary determines that such additional participation in the program will assist the veteran in achieving the remediation of the condition or conditions addressed by participation in the program.

`(B) The total amount of stipend payable under subsection (e) to a veteran covered by subparagraph (A) may not exceed $11,000.'.

(b) Clerical Amendment- The table of sections at the beginning of chapter 17 of such title is amended by inserting after the item relating to section 1712B the following new item:

`1712C. Mental health care and rehabilitation for service-related post-traumatic stress disorder, depression, anxiety disorder, or related substance use disorder.'.

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posted by Larry Scott
Founder and Editor
VA Watchdog dot Org

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The damage that this woman has created to the nations disabled veterans in the past decade should have earned her the scorn of every veteran in this nation. A few years ago she was the one who led then Chairman Larry Craig to propose the review of 72,000PTSD claims files, the review never happened because on the way, they started with 2100 files, which led to a few suicides by veterans who feared having their benefits revoked or reduced in the ensuing witch hunt. The reviews were stopped after Congressmen across the nation reacted with rage after hearing from Veterans Organizations, widows of veterans who did committ suicide in direct relation to the reviews, etc. What the 2100 files reviewed did show was that any errors in the claims were not fraud on the veterans part, but rather sloppy record keeping by the Regional Offices, incomplete paperwork, lazy office workers who did not do the proper verifcations of "stressor incidents" etc, but the fraud that DR Satel and others have complained about just wasn't there.

I don't care what the VA or the Congress proposes but if DR Satel's name is attached to it, it scares the hell our of veterans.

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