Army report suggests military over-diagnoses TBI

Yesterday, the Associated Press highlighted a new report published in this week's New England Journal of Medicine, claiming that the military has over-diagnosed Traumatic Brain Injuries.

The report was compiled by Charles Hoge, director of psychiatry and neuroscience at Walter Reed Army Institute of Research, Carl Castro, a psychologist with U.S. Army Medical Research and Material Command, and Herb Goldberg, an Army communications specialist from Walter Reed.

Both Hoge and Castro believe that the VA should characterize many mild head injuries simply as concussions, rather than brain injuries. Hoge contests that the latter diagnosis implies that the condition is permanent, forcing the military and VA to provide additional benefits and care for those who are diagnosed.

According to a recent RAND Corporation study, nearly 300,000 veterans of Iraq and Afghanistan have suffered some kind of brain injury, whether mild or severe, and relatively few receive adequate treatment. Though this report points out that many of these injuries may not have permanent consequences, it is dangerous to suggest that the Army and VA should not diagnose brain injuries.

We've seen in recent months that even head injuries initially labelled as "mild" can have serious, long-lasting, and potentially life thretening effects. It would be a disservice to our veterans to "low ball" their diagnoses in the interests of saving money, as the report suggests.

We applaud the VA for pointing out that they continue to work with veterans to properly identify and diagnose brain injuries, and we hope that this trend continues, in light of the new Army report.

Over the years, veterans have sought the council of AMVETS service officers, hoping to receive the benefits and care for their war-time injuries. Enought hurdles already exist for our veterans, we don't need physicians second guessing diagnoses and downplaying the severity of head injuries.

Sadly, this new report seems to echo grumblings from the traditionally liberal news sources such as Salon, purporting that the military is encouraging doctors to underdiagnose PTSD as lesser maladies such as anxiety or personality disorders. The invisible wounds of war can often be the most serious, and it is the duty of our military medical system to ensure that troops are properly cared for once they return home.